You are here

Picking kids up from school sick – and what counts as sick?

completely overwhelmed's picture

Every day this week SD’s school has called DH and told him SD (16) is sick and he needs to pick her up – which is impossible for him since his current jobsite is 1.5 hours away and there’s no way his boss will allow him to leave.

SD isn’t actually sick. She complains all the time that she’s dizzy, lightheaded and tired. It’s the side effects from all the medications she takes. Her doctors have adjusted the meds as much as they can and its at the point where she needs to learn to live with the side effects. Her primary psychiatrist doesn’t think the side effects are so severe that she can’t cope with them (and significant effort has been spent building a plan of action to cope with the side effects). But she doesn't want to cope with them. She wants to use them an excuse to do nothing.

SD is in a Special Ed program and they have an area where students can go if they are feeling overwhelmed and lie down. SD has learned that she can tell her teacher or aide she’s too dizzy to sit up or too tired or not feeling well and she gets to lie down in the quiet area and doesn’t have to do anything. Every day for the past month she has done that and her teachers are fed up and want her to go home if she can’t sit at a desk the whole day.

My mom has gone and picked her up a few times, but DH has told them he isn’t going to come get her if she’s just dizzy because she’s always dizzy. The threat is that if someone doesn’t pick her up, the vice principal said they will call an ambulance. I’m not even sure an ambulance is going to take her to the hospital if she’s only vaguely dizzy and drowsy due to psychiatric medications.

The main problem is SD doesn’t bother trying at all. She has an excuse – I’m dizzy, I’m tried, my mouth is dry, my stomach hurts – and she uses that as an excuse for why she doesn’t have to do anything. And she isn’t doing anything to cope with the side effects. It’s all an excuse to do nothing.

The whole partial hospitalization last summer was wasted because she slept though most of it since the meds completely knocked her out and the only thing they really dealt with was trying to adjust meds and find ways to counter the side effects (like when she takes the meds, taking the meds with food) but a lot of coping methods was how she can respond to feeling that way – take a walk and get fresh air at lunch time, trying to not think about it, writing in her journal how she feels so the doctors have more information, etc. She is allowed to have a water bottle at her desk to deal with the extreme dry mouth, but she never does and she complains about drinking water.

I hate that my mom is the one who we’re going to have to dump this on because I can’t leave work to deal with SD and neither can DH.

DH is essentially a single parent and I know there are a lot of single moms that struggle with sick kids in elementary school or day care, but these seems overboard to send SD home when she’s dealing with a chronic condition that there’s nothing we can really do anything about.

Comments

ntm's picture

In our district, they can stay in the nurse's office as long as there's no fever or vomiting. Not sure why they're insisting she go home.

completely overwhelmed's picture

I don't think there's a full time nurse on staff. She has an aide who can watch her, but I think the issue is she can't actually be in class. She's sleeping at school all day.

SonOfABrisketMaker's picture

Just because the doctor says the side effects are manageable doesn't mean they are for your SD. No one but her knows how she really feels.

I am honestly in awe of people who can admit when they are feeling bad and ask for a break.

mtnwife530's picture

As for them calling an ambulance, they would take her to the hospital because the school requested it ( by just calling them) the child can't legally refuse, and no parent is on site to sign the sign the papers (AMA) to refuse.

DaniellaR's picture

I would talk to her psychiatrist and see if they could back off on meds. Explain what is going on and have him write a letter to the school explaining it is a side effect of medication and she is ok to stay at school. I would also get the illness policy of the school, highlight it and then have a meeting with the principal. There has to be something in there about the ambulance policy and I know they have an illness policy, every district does. I would make it clear to the principal that calling an ambulance for a non emergency and making threats will result in a lawsuit against him and you will pursue if he keeps singling your family out for harassment. Make sure their district policies back you first. This child should already have an IEP or 504 plan and the dizziness should be addressed there. Time outs to deal with it, water etc.

Schools here annoy me with that crap, they call for parents to pick up kids over every little thing. They use to do it with my son, he would tell them he vomited. When they would call I would ask, did anyone see it? Ummm, no. Is he vomiting now? Ummm, no. This happened after lunch? Yes. You realize he eats too much and when he gets indigestion he likes to call that vomit. Ummm uh, you need to pick him up. So I went once, brought my prescription pad, did a quick assessment on him and made sure the secretary that called me was there while I wrote him an ok to return to school and chewed her ass out. They all call me and ask me if I think I need to pick up my kids now.

Tomatoe's picture

This isn't working for her. It isn't laziness. To me being dizzy is the worst thing to happen to me. I go from full boar to full stop and am helpless. She may react the sane way and since this is psych meds she won't continue them as soon as she is able. Talk to her dr and get her help another way that will help long term.

z3girl's picture

I agree with the others. There is an issue with the medication. I was on psychiatric meds in my early 20's, and I was a zombie for 2 weeks everytime my meds were adjusted, and then I'd feel ok. I would think if after 2 weeks she is this tired, then there's a real issue. JMO, but what are your options? Current situation isn't sustainable, so the only option is to reduce/change/take off the meds to get her to function in school.

lieutenant_dad's picture

If I remember correctly, without psych meds, your SD is a danger to herself and others. On meds, she's stable, albeit difficult given all the side effects.

Given the options of "dangerous" or "dizzy", I can see why you would pick dizzy. This isn't something that is going to go away; this is something SD is going to have to learn to live with if she wants any kind of life outside institutional care.

Is there an option for her to do part-time at school and part-time online? Or that her class work could be done on a tablet or laptop by laying down? If she is dizzy, then sitting at a desk may really not be an option. However, that doesn't mean she is incapable of doing school work with some adjustment. If you all and the school can find a workaround where SD can lay down but still has to do school work, then maybe SD will start only complaining about it when she actually feels like crud versus when she wants to be lazy.

completely overwhelmed's picture

She's talked about and tried to harm herself but she isn't a threat to others. The meds increase the risk she will harm herself but there isn't anything else we can do. She doesn't participate in therapy and she can't do electroshock therapy due to her heart condition.

The issue with online school is that it's essentially home schooling and she can't be home alone. If DH quits his job and stays home with her, it will be one big fight to get her to do her schoolwork. It will add to the stress.

Pharlap's picture

The school can't keep devoting the resources everyday to deal with this nor take the liability risk if she really is getting sick like 'this everyday. A private tutor at home would probably be the best course of action if you can't get the side effects or faking under control.

Dontfeedthetrolls's picture

Work with the school on updating her IEP. Threatening to call the ambulance if she's not picked up is absurd. The child isn't ill. Make sure to have all the documentation from the doctors to help prove this even though they should know this.

The school is failing her. I'm not one for blaming the school but in this case they should have the ability to deal with her. If she is in a special program then she already has an IEP. School must provide adequate adjustments. In extreme cases this means one on one staffing for certain students sometimes even more. We had a "kid" in our school who had two teachers just for them. She had a room completely to herself also. She also had down syndrome but you get my point. I'm not saying she needs that but the idea that sending her home instead of letting her put her head on the desk isn't meeting her needs. She has behavioral issues going on. If they can't help then the maybe school district has a "therapeutic schooling option." This is in larger areas.

Around here there are at least 3 programs that are part of the public school. The have ongoing counseling and plenty of staff to deal with behavior issues. They have people who are solely there to handle aggressive behavior because that's what it takes. Children are in classroom settings with teachers and therapist on staff. The program is set up to handle kids who don't behave.

Honestly though work with the school. This is all behavior and yeah they are tired of dealing with it but unless they have reason to expel her which they don't then they could face lawsuit for basically denying your child the right to learn. I know it's the kids fault BUT they have to work with you and her. Sending her home is NOT the answer and they can't show how her putting her head down in class is causing harm to anyone. Yeah she's not learning but that's their job to work with her on motivating / finding consequences that work. Doesn't mean it's all off you guys but she needs to stay in the classroom to start.

completely overwhelmed's picture

Her teachers and aide are beyond frustrated because she uses not feeling well as an excuse and after that they can't do anything. It's not a few minutes or hours but the whole day. I can understand where they are coming from since SD drives me crazy too and I feel sorry for them having to deal with her.

The issue is that she's being dropped off at school drizzy, drowsy and lightheated and not feeling well enough to be able to sit up and learn but is being dropped off at school. The argument is if before the bell even rings she tells her teacher she can't sit at her desk and can't do any schoolwork, why did her father let her go to school. But she would miss every day of she stayed home for the side effects and no one can babysit her all day. We are essentially using school as a babysitter but that's the only option.

There's a meeting scheduled next week with school staff and they do want to be accommodating but there's one teacher in particular who wants DH to stop sending her school "sick".

Dontfeedthetrolls's picture

But she's not sick. You have a doctor who can back this. Like you said she's using it as an excuse. She's getting away with crying wolf because she's learned whine a little bit and she'll be sent home no matter what.

The school's tired of her taking space. Too bad. She's not harming anyone or even really impacting anyone else's ability to learn so they can't use that excuse. They have to deal with her or provide another possible option such as alternative school programs. That's what the ADA says for any school that is give government funding also known as public schools. Some schools have even had to send a privet tutor to a home free of charge for the parents because of those requirements.

The teacher is going to have to get over themselves and learn how to accommodate this student. Again that doesn't put you guys off the hook but as you said homeschooling wont work. You're not treating them like a babysitter your treating them like a school but they are looking for the short cut. Don't let them. They created this monster and if they keep pushing her out you can sue.

IT'S THEIR JOB. THEY GET FUNDING. They are neglecting their responsibility for this student. "She's difficult to work with" isn't enough. I've known students in schools who repeatedly attacked their teacher and peers and guess what. They stayed in school because their IEP was in place and provided different ways to handle it. The school was unable to expel these students because they had a disability.

I've worked in mental health for a good little while now. I know about the ADA. I know what schools are REQUIRED to provide. I've been apart of changing wording of laws in my state so that my profession get's the funding it's suppose to in schools. I've seen the first of my peers enter into school districts to provide services. I've talked with special education teachers. I've worked inpatient with sub-acute teenage patients who had to attend schooling while getting therapeutic treatment. Maybe your child needs long term care at a residential program? That seems to be your other option. Either make the school step up or look at that.

completely overwhelmed's picture

What I'm not sure is what her psychiatrist will say about whether she is sick. He admits there are side effects but she has to learn to live with them. I can't say she's completely faking how she feels, but she isn't sucking it up and plugging along at life.

Last year she was expelled essentially from the alternative school (which was a very bad fit for her) and the school district figured a place they could put her because they have to provide her an education and couldn't expel her for behavior caused by her disability. Whether they will provide an in-home tutor is something I'll have to look into. Everyone at her school would rather she be home schooled than have to deal with her every day, but it's not practical for us.

I wish she could go to a residential program. I'm not sure I can keep dealing with her every day but she did so poorly at the RTC/therapeutic boarding school and the meds situation is such a mess due how she responds to side effects and her heart condition. Every time she's hospitalized, she is "stabilized" and then doesn't really get any better but they send her home with the hope that she'll do better at home. The partial hospitalization seemed like a better solution, but she slept through all of it and they couldn't do anything to make her participate and actually try to take an active role in her recovery. She just sleeps all the time. I can see if we send her to a residential program we waste more money on her spending all day sleeping.

Dontfeedthetrolls's picture

It depends on the program.

I changed jobs because where I worked had just gone too far in a direction I couldn't go BUT there were things I did agree with.

Once up doors would be locked so kids couldn't get back in. If we had a kid who refused to get up there were a few things we could do.... 1 was to lock the bedroom bathroom so they had to come sooner or later then we'd go lock the door. I've help pull blankets off a kid. Taken pillows and all general comforts. Don't want to listen you can stay in scrubs on the unit. No meals on the cafe which means no soda. No outside time no privileges. Now when I say kids I do mean teens.

Sure a kid could go lie down on the floor but that things hard and cold and sooner or later cold cut sandwhichs suck. I know it sounds almost like prison but this was extreme cases. Most kids got with the program after a few days. We could handle setbacks. The blankets were taken from a kid been in and out of the program multiple times and it was his second day of not leaving his room. Doors being locked was normally enough.

It's about finding the right carrot with her and you need to do it sooner then later. What's the plan for when she's an adult?

completely overwhelmed's picture

There really isn't a plan until at least her behavior starts to improve or at least we hit rock bottom. She wants to go live with her mom. There's no way DH will let that happen. Last year DH was tried to impress on her how she needed to graduate from high school and pointed out to her a young man with Down Syndrome who bags groceries and said that was the only type of job she'll be able to get if she doesn't try harder in school. She told her therapist later that week she had no future. She isn't willing to try or to do any low level job like that.

The RTC/boarding school was a last resort and she went went downhill so badly there. If we could find someplace more suited for her but she's not exactly typical. That place usually deals with teens with minor mental illness and drug or alcohol problems who are highly social. SD is fine never speaking to a single person all day. She constantly wet her pants there and hid under furniture. They had no ability to cope with her then when she went to the psychiatric hospital she was treated like an uncooperative adult patient and they didn't put up with her nonsense but that made her behavior even worse. None of these facilities have made any difference.

Dontfeedthetrolls's picture

Seriously you guys do need to be looking ahead at what the plan is for her as an adult.

She seems like she's going to be "disabled". The only reason I quote it is because you seem to express that she could do more but doesn't want to. Sadly I know many young adults who get away with minimal effort.

Look into long term care in advance as it might at least keep you sane at home.

completely overwhelmed's picture

DH has looked into (well, googled) conservatorships or how to prevent SD from leaving and living with her mom when she turns 18. SD has been telling everyone she's going to live with her mom - enough that one of her teachers thought this was something that would be happening soon. The teacher thought that the problem of SD's behavior was solved - she was leaving - and when DH corrected her and said there is no way in hell SD is ever living with her mom. That's when the teacher started pushing for SD to go home rather than staying all day in the quiet area.

Livingoutloud's picture

It’s very dangerous to just let a child sleep all day at school because at any given point no one can guarantee that a child is not passed out unconscious rather than simply asleep. There is a big difference between giving child supervised breaks and let her rest and letting her sleep all day. It’s not ok. Talk to her special ed case manager or districts special ed director if there are some type of center programs in
the area or residential settings.

Also I am aware of serious side effects, but it seems that these side effects are exessive. There need to be some adjustments to these meds.

And it’s easy to blame school but how could they work with her and provide her with special ed services if she is sound asleep all day? It’s not beneficial to a child to be asleep all day at school and it’s quite dangerous as I mentioned above. No IEP on this planet could outline services and accommodations offered to a child who isn’t awake all day. Something needs to happen to stabilize a child first, starting with medication adjustment.

Dontfeedthetrolls's picture

It doesn't feel like from what OP explained that the child's medication is causing her to sleep and from my experience most that do have a sedative affect are given either at night or PRN (as needed). If its a long term sedative for the day the dose is low enough that you can adjust to the effect.

This is what I've observed in my patients and myself. I work in mental health. I do not prescribe medication but I'm aware of what they are on and do report issues back to the doctor such as being to sedated to engage in groups. I myself also am diagnosed and medicated, my medication MUST be taken at night. I am able to 'fight' the drowsiness if I try but I wouldn't feel safe driving.

It feels like the child isn't putting in the effort. She's not knocked out, she's refusing to try and be awake. Even a child without medication could act this way and a teacher would struggle to make them stay awake.

I agree that the child may need to be moved out of the "normal" school if the district has any other offers such as TDT. It feels like she's just in a segregated classroom. From personal experience these settings simply push children through. Teachers get burned out quickly because they are taking care of the 'worst' students. Many of these kids are capable of better but don't put in the effort behaviorally. They basically do whatever they have to to get through. It's easier to just let her sleep in the first place. Then down the road they start getting dinged by oversight so they start putting more of the blame elsewhere and sticking with the easiest 'solution' which is to claim the girl is physically ill and kick her out.

completely overwhelmed's picture

She takes most of her meds before she goes to bed. One was moved to before dinner to make sure it didn’t interact with another med and so it’s taken with food.

From what I know, the doses aren’t unusually high and can’t be reduced any further. She is tiny and medication does have far more of an impact on her than other people. Her primary psychiatrist admits the meds may make her tired but she just needs to get used to it and do what she can to cope with the side effects.

She has zero tolerance for any discomfort combined with having no problem being bored and sleeping all day. What she wants is to stay in the quiet area of the main Special Ed classroom. She doesn’t want to go home, so her teachers threatening that she has to go home might seem like something that would motivate her, but she doesn’t cooperate. If she’s not allowed to go to the quiet area, she will get out of her chair and lie on the floor.

What has been completely unsuccessful is doing anything to alter the way she thinks or getting her to actually do any of the coping methods or skills that so many people have tried to get her to learn. You can ask her a dozen times what she’s been taught to do when she feels dizzy or lightheaded and then at school, she doesn’t do any of those things, demands to go to the quiet area and then behaves like a toddler having a tantrum when her teacher says she can’t go to the quiet area.

IMO "I don't feel good" followed by an excuse that she's tired/dizzy/lightheaded is her way of getting out of anything. She'd rather be lying down in the quiet area than anything else. If she could spend the weekend in the quiet area and never come home she would. If she wasn't tired or dizzy, she would complain about being itchy (the hives are still an issue) or having a headache or stomach ache or whatever else. Something is always wrong.

It's not just at school that she does this. She's barely been out of bed this weekend. It's a relief to not have to deal with her but a pain to drag her out of bed so she will eat and take meds.

Dontfeedthetrolls's picture

Has any psychiatrist said about an axis 2 diagnose. With her being so young they may be avoiding labeling her with any sort of personality disorders BUT from what you explain she's learned how to cope. It's just her methods are maladaptive and not a long term solution.

People learn how to cope with situations and once they learn coping mechanisms it's hard to change. Some people become really stubborn and stuck in their ways. The idea is that it worked in the past so it will work again. She's learned she can get away with these fits and poor behavior. Going home really isn't that negative because it removes her from the unwanted environment. If it doesn't work at first she just has to wait.

I've worked with patients who have taken this to an exterem. One girl was in a wheelchair with a feeding tube when I met her. At 18 she remained in this situation because it prevented her from having to be an adult. I've sat with a woman who was given massive amounts of IV fluids because she refused to leave her bed on the BHU. We had to Cath her to get a urine sample to make sure there weren't any serious medical ossues.

I share these as an example of how far people can go and just how long these issues can remain. People can get better but if she is set so far in her ways it would take extensive long term therapy. Individuals diagnosed with borderline personality disorder may easily require 2+ years of ongoing possibly weekly therapy sessions.

Also you say meds? I'm assuming some are for her phsycial medical condition, heart, and others for psychiatric. I know you've most likely been on this path for a LONG time but multiple medications can really cause issues because as you said they can interact. Now illnesses like bipolar with psychotic features would require two meds, one to stabilize mood and one to handle the delusions / hallucinations. However if the doctor is piling on multiple meds of the same kind I'd be really questioning. Sometimes taking a whole new approach is the right way. Of course I don't know your child personally so please take all this however you will.

Good luck. Make sure you also take care of yourself and your husband. The strain of caring for someone with mental illness can be extremely draining. Make sure you have your own time and outlet. It's ok to be frustrated and upset.

completely overwhelmed's picture

The plan is to stabilize before she gets labeled with anything beyond anxiety and depression. DH wants a definitive diagnosis like this is a normal disease - she has x and you do y and z and she gets better. There are so many other things going on from development delays to possible fetal alcohol syndrome to all the weird issues she has with sensory processing and hives. It doesn't seem like there's a huge difference in the treatment if she does have a personality disorder and CBT just doesn't work for her.

They've tried a number of add-ons to see if a combination of meds will work better than just one. They added a mood stabilizer to see if it would help earlier this year and there wasn't any impact. I don't follow all of it that much. I don't follow what's going on that much and DH doesn't have time - which I know isn't ideal. We just let the doctors do their thing and I drive her to appointments.

The two big turning points was when she told her therapist she figured out it didn't really matter if she got in trouble at school or home and that it wasn't worth trying anymore since she always fails. That was about two years ago and those attitudes haven't changed at all. It's not easy because at school, she did ok in elementary school but is never going to be able to pass geometry or chemistry. She has so many problems with fine movements with her hands art class is difficult. Even computer classes are difficult. But she's not disabled enough that you can praise her for just trying. Her paternal grandparents are immigrants from SE Asia so there are expectations to be smart and she's never going to be. She has cousins applying to Stanford and Yale and that won't ever be her.

So it's possible this is all due to how she's avoiding dealing with those problems. Or there is some more serious mental health issue going on that she isn't willing to talk about.

Acratopotes's picture

what about changing her meds again and then tell her the side effects is people start concentrating well and do funny things like reading biographies and they develop photogenic visions

another side effect is washing daily and a sterile clean room and house... hey maybe just maybe she will get side effects