Back to school and back to the weekly grind.  Monday morning we were all up bright and early and I was excited to see my school friends.  Nixi was a little confused and anxious about not having school on Monday, though she never does, but she worked through it.  I had a pretty good week, but its hard to go back after a long break.  I had to get readjusted to the noise of the classroom.  By mid day, even two kids whispering was driving me nuts.  No major meltdowns, but it was obvious to my teacher that I was struggling.  It was obvious back home, too.  I cried on a few days saying I didn't want to go to school until mom said "ok", then I begged to go.  Mid week mom told me that I was going to have a play date over the weekend with one of my classmates, Sophia, and took the sting out of the rest of the week!

Nixi had a rough go of the transition back.  Tuesday was ok but Thursday morning she was crying and saying that she didn't want to go to school because it would make her "tired."  (*Side note from mom: psychotic disorders have two categories of symptoms, positive and negative.  Positive symptoms are the psychotic symptoms that are added to a person's life like hallucinations, delusions, disorganized thinking, etc. Negative symptoms are the things that are taken away from someone's life like motivation, concentration, energy, social motivation, etc.)  Lately, everything makes Nixi "tired", coloring, moving a wii controller up and down, going to a grocery store, etc.  Its more mental fatigue than physical.  She is doing a great job of realizing when things are too much for her and telling mom and dad.  Mom told her she didn't have to go, which then set her off on a crying jag about not going.  She pulled it together and went to school but the teacher reported that it was her worst day since she's been there (remember, this teacher just came back from maternity leave in November).  Nixi was angry often, emotional, contradictory, and sad.  The teacher got a little taste of what its like at home for all of us, where Nixi wants one thing and within seconds flip flops to not wanting it, wanting it again, total confusion.  Mom will request and IEP (Individualized Education Plan) with Nixi's teachers and stand in Speech and Occupational Therapy folks (both regular ones are going out on maternity) to talk about how we can best help Nixi given her new primary diagnosis of Psychosis NOS.

The report from UC Davis finally came in.  It was everything the psychiatrist had already talked about with mom when they were up there.  He wrote that "Symptoms are consistent with early onset schizophrenia but must also consider the impact of mood dyscontrol, including bipolar disorder.  However, psychotic symptoms are profound and separate from mood episodes.  In this brief clinical snapshot, her eye contact, social reciprocity, and playful fantasy was not consistent with spectrum disorders, but there may be some overlaps."  So, still looking at course of symptoms to decide between schizophrenia and bipolar, though he seems to lean toward schizophrenia and rule out autism.  In his treatment plan he discussed medication when it becomes absolutely necessary, enrollment in the National Institute of Mental Health (NIMH) study for early onset schizophrenia at age 5-6, and to consider labs for early psychosis work up.  Mom met with our pediatrician on Friday to discuss the report and any possible medical issues that we could look in to.  He was kind and empathic, and honest.  He said that there were no labs to run as he went down the list of rare disorders that mom brought, checking each off as he went.  To make mom feel better and to say we looked at everything he said he would order a metabolic screen, check ammonia levels, and re check thyroid functioning.  Mom will take Nix in this week for a blood draw.  That should be interesting.

I had a play date on Saturday with my friend Sophia from school.  We met at ImagineU and it was super fun. Nixi went too, even though she was a bit of a wild card that day.  We got to make fossil imprints to take home, we had a blast pretending to be sirens on the fire truck, and we put on a show on the stage...and then it happened.  Nixi grabbed a dress that I was going to put on.  I told her I wanted and she screamed at the top of her lungs.  I hate when she screams, and I really wanted the green dress, so I screamed at the top of my lungs and cried.  We were locked in a dueling banjos style scream fest in the dressing room...right in front of Sophia.  Mom came in and tried to broker a deal to no avail so she quickly got Sophia out of the dressing area and was able to calm us down.  It was awful.  I was so embarrassed and mad at Nixi.  Nixi was barely able to get it together to leave but I was able to pull it together and go give Sophia a hug.  Mom says the only good thing about it is that Sophia's step mom is a mental health worker and her dad is a psychiatric technician so at least she didn't have to explain anything.  Later that night Sophia's step mom posted on Facebook that they had a great time and hoped that it was the first of many play dates.  Phew!  What a relief!

So, that was our week.  We finally got all of the Christmas lights down and dad got a really cool new bike (Thanx Nana!), and we're ready for the new week ahead.  On Monday we get to go to the Shook's house and we're very excited to wish Penelope a happy belated birthday and to have a blast.  Check back in next week to see how Nixi's blood draw went........

xoxo

Safi