Wednesday, January 25, 2006

We Have a Few Answers to Billy Ray's Communication by Behavior

Searching for answers to Billy Ray’s communication by behavior is a challenge to say the least but it feels good when we find some answers. We thought there were three potential causes of his behavior on the weekend: 1) acid from too much orange juice, 2) dental pain or 3) his hesitancy to give him clothes that are too tight now that he has gained weight. We have ruled out at least one of those now.

Yesterday we went to see Dr. Hester for an emergency dental appointment. Billy Ray was to have some work done this summer just before his emergency surgeries (appendice and internal bleeding). That had been delayed until he had stabilized. It seemed possible it was now causing his pain. Dr. Hester is so good with Billy Ray and very thorough. He tested each spot to see if it could be causing the pain. He said there is one capped baby tooth (done years ago to keep some of his baby teeth because Billy Ray didn’t get all his adult teeth) that could be causing him pain only if he bit down on it wrong but probably not the source of much pain. We will go back for a long appointment to take care of all the problems at once but Dr. Hester didn’t believe Billy Ray would have tooth aches in the meantime.

When we got home I had an email from Brice Stanley, Billy Ray’s PA, that the lab results show Billy Ray has hypothyroid. Brice said that it could be causing the constipation, his aches, fatigue and “almost assuredly his weight gain”. That may be a big part of his communication by behavior.

Additionally getting Billy Ray’s Depakote level (medication used as a mood stabilizer for Bipolar) stable has been a major difficulty lately. Billy Ray’s chemistry is definitely unique. We know from observing him at various blood levels that he does best when the Depakote level is 105-106 and when it goes over 110 he is more manic, agitated and less focused. We tested it two weeks ago and it was above the desired level even though we had decreased the medication. We decreased it and tested again on Monday. According to Brice’s email it is up 11 points more. Clearly that level is having an impact on his behavior. Brice suggests the hypothyroid might be affecting this problem. Hopefully as we address the thyroid issue we will be able to stabilize the Depakote level.

As we have talked with Billy Ray about the need to get rid of clothes that are too tight and planned a “date” with Mom and our consultant friend, Keddie to go shopping Saturday, Billy Ray seems to be accepting that. Yesterday he willingly wore some bigger things we got out of storage from when he had gained weight on a former medication. The excitement of planning for a few new things has changed his attitude about the outgrown clothes.

Before I close I wanted to share our evening with you. After my husband and I took Billy Ray to the dentist we went out for dinner just the three of us. We hadn’t done much of that lately because of his diabetes. However, his blood sugars have been good and Brice told me it was okay for Billy Ray to have a treat once in a while now that we have his diabetes pretty stable. Billy Ray was so good and it was a delight to watch him enjoy it so much. His stepfather said that on the way out of the restaurant the guy at the door said goodnight and Billy Ray turned around and gave him high five. What an improvement.

Until tomorrow,
Peggy Lou Morgan

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