Matthew is back at 4 winds

If you have been following along recently, it should come as no surprise that Matthew is back in the hospital.  I am not at the point where I can write a lot, too much is in my head right now, but there are a few things I have to share.

1.  I got a call saying 4 winds had a bed for him at 9 and at 11:30 I got a call saying he was struggling at school.  They were "surpised to see him so upset".  Are they not seeing the same child I am seeing? Are they not reading the emails I am sending....Is it too much to ask for a consistency of care between home and school.

2.  Upon arriving at 4 Winds I met with a nurse practitioner to discuss medications because the psychiatrist had gone home sick.  Now I am not, nor do I profess to be a psychiatrist, however, as Matthew's mom, I do believe I know him best.
 His outpatient doctor increased his prozac in October because he was seeming to be very anxious and starting to show an increase in behavior.  The nurse practitioner today said the dose is too high.  The outpatient doctor who I spoke to over the past week had no concerns about the dose.......who is right?  Who is wrong?  how will we know?

The hospital last time played with a variety of doses of seraquel for Matthew settling on an extended release dose at night.  He had been on a higher dose, no effect, he had been on a lower dose, no improvement.  This was the target and appropriate dose less than a year ago.    The outpatient doctor has not touched this dosage and sees no reason to.  The nurse practitioner today wants to increase that dose.  I begged her to please read through his chart. 
I truly believe we can't just add meds. We can't just increase dosages.  We hvae to get him off some medications, then evaluate and then try new medications.  However, this is where the insurance company comes into play......he can only be in the hospital while it is seen as "necessary".  "nescessary" is defined as them changing medications.  If they are not making daily changes or changes every other day, the insurance company questions whether he needs to be in the hospital, but if you change psych meds this often you are not giving them a chance to work. 

Tomorrow I will talk to the doctor and hopefully the social worker and a plan will be made.  For today, he is ok.  The little boys both acknowledged that they needed this break, and I am at peace with my decision.  I need a healthy boy back, and this is hopefully the road to healthy.