Caged (part 3 of 3)

“Running from my feelings kills me, but feeling them never does.”

Bonnie

After I had settled down a bit in our room in the Children’s Unit, and had had a little breakfast and some coffee (I had Starbucks Vias in my purse, thank God, to add to the brown water that they call coffee), I finally looked at the CNA.  She was sitting in a chair across the room from me, and was watching Cale sleep.  She had long red hair, light freckles, and very white skin, the exact combination that I would’ve chosen for myself had I ever been given the choice.  “Do you have any kids?” I asked her.

“Three,” she answered, not taking her eyes off of Cale.

“Me too,” I said.

“In fact,” she continued, cocking her head slightly to the side as Cale began to snore softly, “I have one like him.  She’s five years old too.”

You never meet anyone by accident.  Ever.  I really do believe that.  I could actually see the anger that is so familiar to me, swelling up underneath her skin as she decided whether or not to continue telling me about her daughter.

“And she’s been so wild lately,” she decided to continue, “I’ve gotten so damn sick of her that I’ve been seriously contemplating dropping her off on the doorstep of the mental health center and leaving her there permanently.”

The mental health center, now I had never thought of that one.  I had thought of CPS, certain doctors’ offices, and even the police department.  But the mental health center would be a kinder option for sure.  I quickly filed that one away in my mind for possible future reference, and couldn’t help but let out a quiet chuckle while I was doing so because I could relate with this woman so intensely.  That’s when she finally managed to rip her eyes off my son and flash a look at me.  “I’m not kidding,” she said.

“I know you’re not,” I said.

She had heard me talking to my mother on the phone a bit earlier, and she said, “You know, my daughter’s on an anti-depressant and an ADHD medication too.  Maybe I should have her medications re-evaluated.”

We talked about psych. medications for a little while longer - Risperdal, in particular, because it’s a pure, unadulterated anti-psychotic with no selective serotonin re-uptake inhibitor (anti-depressant) in it.  “Oh, how I miss the days when Cale was on Risperdal,” I told her.

I didn’t make it very far into our conversation though, before I collapsed onto the bed next to Cale’s bed (I didn’t dare chance waking him by trying to snuggle up in his bed) and fell fast asleep.  Cale slept until 10am.  Five hours.  “That’s hardly all day,” I complained (I was a bit crabby, as I had only slept for about an hour by the time Cale woke up).

He started wrestling again, this time requiring four of us (including Shane, who had gotten Alden and Isabel into the care of his mom by that point, and had come to the hospital), to keep him from pulling his I.V. out, and to keep him in the bed.  From 10am until just past 11am, there were six of us on Cale, four holding him down, and two re-doing the I.V. again and trying to figure out the best way to secure it into him.  I cried the whole time, probably because I was so tired, and I tried really hard to send a little telepathic message to Cale, “Son.  Son.  Quit fighting it son.  Please.  It would hurt so much less if you would just stop fighting it.”

The message apparently didn’t get through though, because he didn’t stop fighting.  They gave him an adult sized (2 milligrams) dose of Verset (you know the stuff that they give you and then ask you to count backwards from 100, after which you barely get to 97 before you’re out cold), which, shockingly, didn’t make him sleepy at all, but at least it only took two of us to wrestle with him after that.  He didn’t actually go sleep again until a few minutes later, after they’d given him another 2 milligrams (another adult sized dose) of Atavan in addition to the Verset.  

I had some idea about what was going on with Cale by the time the pediatrician came to talk with us, because I had spoken with my mom (who’s a psychologist with a lot of clients who take various psychiatric medications), and because I had discussed her little theory in a fair amount of detail with our CNA.  But, to be perfectly honest with you, I was still just a tad surprised that my mom had hit the nail so accurately on the head.  The pediatrician explained to me that Cale was suffering from a condition called Serotonin Syndrome.

“What happens,” the pediatrician explained, “when you take a selective serotonin re-uptake inhibitor (an anti-depressant, the Prozac in Cale’s case) when you don’t actually have a deficiency in serotonin (when you’re not actually depressed), is that there can be a gradual build-up of serotonin.  The symptoms of this include agitation (and this is an understatement), hyperactivity, high heart rate, fever, sweating, and muscle spasms in the feet.  See his feet?”

They were, in fact, twitching.

“So this is probably what had been going on with this little guy in the first place," he explained, "Then you guys added a stimulant (the Vyvanse) to the top of it.”

I almost vomited. 

“I would think that this was simply a Vyvanse overdose (a psychiatrist prescribed Vyvanse over dose, just to be perfectly clear here),” he continued, “if his feet weren’t twitching like that.  But this particular type of spasm in the foot is specific to having too much serotonin in the system.  And, seeing as how his feet are twitching like that, not to mention the fact that we’re having such a hard time keeping him sedated this long after his one and only, tiny dose of the Vyvanse, I’m diagnosing him with Serotonin Syndrome.  But the treatment is the same either way.” 

“I want to keep him asleep for the rest of the day and all night tonight, because the Vyvanse actually takes about sixty hours to completely clear the system, and because we need to monitor his vital signs while he’s on all of these sedatives.  Then we’ll just have to see if he acts calmer tomorrow, because I’m afraid that the Prozac could actually take two to four weeks to clear his system.”

The doctor set up a schedule of sedatives.  Cale had another dose at noon, which they administered while he was still asleep.  And he was scheduled to have another dose at 3pm, but didn’t actually get it until 4pm (after Shane had played the part of Shirley McClain in Terms of Endearment), so he woke up of course. 

We wrestled with him for the next four hours, during which they gave him every dose of every kind of sedative that they could safely give to him.  And, by 8pm, they had completely given up on him going back to sleep.  That’s when they pulled out the cage.

I had threatened Cale, periodically, throughout the day, that if he didn’t chill out then we were probably going to put him in the pink cage behind the curtain in the corner of the room.  They called it a crib.  They had put a mattress in it, had filled it with soft, cotton baby blankets with tiny yellow ducks on them, and had spray painted it pink.  But it was metal, had a barred top on it, and stood high on top of four metal legs.  It was really a well decorated cage.

They didn’t use the pink one though, I’m guessing because Cale is a boy.  Instead, they managed to produce a gray one.  And it was kind of amazing to me just how much the pink helped the other one, because this gray one literally looked like something a circus animal would be kept in. 

We put an industrial sized crib bumper around on the inside of it, so that he wouldn’t get hurt when he tried to slam himself into the bars.  We succumbed to the idea that he probably would pull his I.V. out, but took comfort in the fact that we didn’t have to wrestle with him anymore.  And we played Bob the Builder on the T.V. set, because it somehow made us feel more humane.  Then we rested.

Cale screamed and flailed around in the cage until around 10pm (about two hours), after which he had the next dose of sedative that he could safely tolerate.  He eventually settled down, watched Bob the Builder for a little while, and then finally fell asleep around 11pm.

Shane told me to go home and get some sleep, as I had been up all night the night before, and had been up all day as well.  But I wanted to stay.  I wanted, if Cale woke up, for him to be able to see that both of his parents were there. 

Shane was exhausted too, from everything that had happened all day.  So I lied and told him that I’d go home and go to bed in a little while if I felt sleepy, and that he should lie down on the bed next to Cale’s cage and get some sleep.  So he did.

I sat up and read my book, The Girl Who Played with Fire, until the words literally blended together from barely being able to keep my eyes open.  Then I tried to go to sleep in the chair, but just couldn’t get comfortable enough.  So I went behind the curtain in the corner of the room, where they kept the other cages.  And I crawled into one of them, a friendly looking red one, and lay down.   

It still took me a long time to doze off, because I felt so angry about everything in the whole wide world.  I felt angry about the kinds of things that kids have to go through.  I felt angry about the kinds of things that parents have to go through with their kids.  I felt angry about the powerlessness.  And I felt angry that the ones with the power (the doctors) don’t always know what they’re doing.  I thought about the CNA and her poor daughter.  And I thought about the children of some other people that I know and love.  I thought about Alden and Isabel.  And I thought about Cale.

For a little while, I thought that I might actually drown in my anger.  My son, right then, was inside of a well decorated cage.  I was inside of a well decorated cage.  Hell, even my boobs were inside of a well decorated cage.

I had been wearing my not so fantastic, A cup sized bra, all night and all day.  It was so pretty, but it was like the thing had a malevolent little mind of its own.  During all those hours of wrestling with my son, and all the sedatives, and all the crying, etc., that stupid little bra crushed and poked and squished and jabbed.  Even right then, the nasty thing was busily chewing on my right boob while I lay there.  I thought hard about taking it off as I drifted in and out of sleep, and I began to dream about getting up to go to the bathroom in the middle of the night, bra-less, in front of the CNA.

I suddenly had national geographic boobs, hanging out the bottom of my t shirt.  They hit the ground as I stood up, and I had to be careful not to step on them as they dragged across the floor in between my feet while I walked to the bathroom.  As I entered, I had to turn around and kick one of them the rest of the way in so that I wouldn’t shut the door on it.  Then I caught a glimpse of the horrified look on the CNA’s face as she stared at me, just before I closed the bathroom door.

I startled awake.   

“Nope, it’s staying on,” I thought to myself (Heaven forbid a certified nurse’s aide, working in a hospital, see something undignified).

I thought about the CNA.  She had been there all day long, helping me wrestle with Cale.  And she was still there, watching over him so that Shane and I could get some sleep.  I thought about all of the people who had been with us throughout this whole thing – the reception who’d helped me in the E.R., the nurses and all of the extra love that they’d shown to Cale in spite of the way that he’d been behaving, the doctors and all of their extra concern, the extra medical staff that we were provided with, the visits from friends and family, all of the texts and phone calls, etc.  And I realized that even though we have to go through really shitty things sometimes, we never have to go through any of them alone.

I knew this already, of course, as this is something that one would hear at church on Sunday mornings.  But somehow, this was a new realization of it.  And thinking about it seemed to poke a little hole in mind, allowing my anger to drain away so that I could go to sleep. 

I woke up around 8am the following morning, crawled out of the red cage, and stretched out all of my limbs.  Everything looked better in the daylight.  The room was bright.  People were smiling.  Cale’s cage had even turned into a crib.  Shane and I went down to the cafeteria and had a long, leisurely breakfast.  And Cale was still asleep when we got back up to the room.  They had given him another dose of Atavan at midnight, and had given him his last dose at 4am.

Cale finally woke up around 11am.  We got him out of the crib and, thankfully, he was much calmer.  He didn’t try to wrestle at all, so Shane and I took turns rocking him in the rocking chair.

Cale did try to stand up on his own a couple of times, but, realizing that he couldn’t yet, he stopped trying to.  He just sat in one of our laps, or rocked in the rocking chair, or sat in the bed, for the whole rest of the time that we were at the hospital.  We fed him a big breakfast of bacon and cereal and apple juice, and they let us leave for home around 2:30pm.  It was only Monday, but Saturday night in the E.R. felt like it had happened a month ago.

As we were getting into the car in the parking lot, I put Cale’s seat belt on him.  He immediately unhooked it and began to cry when he couldn’t get it hooked again.  So I hooked it again and said, “Leave it alone now Cale.”

And he did.

He couldn’t walk for the rest of the day, so we put the baby gate up on the stairs, and stayed with him in the family room in the basement where it’s carpeted, clear until bedtime.  He quickly grew used to having to roll everywhere that he wanted to go.  The sedatives didn’t wear off entirely for the next couple of days.

You can still see the damage on Cale’s poor little body.  He’s got bruises all over his arms, legs, back, chest, and tummy.  He’s got one black eye, two I.V. holes, and one small clamp wound (they used a clamp to hold his I.V. in place, but accidentally clamped it directly into his skin during all of the wrestling in the E.R. – they noticed this later and fixed it once we got up to the Children’s Unit). 

He’s back to all of his usual behaviors now – my bathroom floor is flooding as I’m writing this.  But I must confess that I have a whole new appreciation for this, because the behaviors that seemed like such a big deal when I went underwear shopping last Thursday are nothing compared to what I saw at the hospital over the weekend.  The house is just a house, after all.  It’s nothing at all compared to my sweet, wild little boy, who is thankfully smiling and laughing again.

I wish I could tell you that Cale’s psychiatrist has called to see if Cale is okay, and has offered consult on how to proceed from here regarding the psychiatric medication.  But she hasn’t.  The pediatrician from the hospital called her first thing Monday morning and let her know what was going on.  And he recommended that we follow up with her as soon as is practically possible.  So we’ve called her and left messages every day this week, asking for consult on how to proceed from here.  Neither she, nor her office, has returned our calls.  But there is one good thing that has come out of this whole ordeal.  At least I now know, beyond a shadow of a doubt, that I still need a B cup sized bra.