We are still having issues with Emery. The increase in fluoxetine had zero effect. We ended up bringing her back down to her normal dose. We then began reducing her clonodine and slowly adding guanfacine. After many ups and downs and an appointment with the neurologist, we now have her on the maximum dose of guanfacine and completely off clonodine. I am still playing with the timing of the doses. She gets 4 pills per day and they can be taken all in the morning or some in the morning and the balance at lunch time. Splitting them two and two did not work. The two in the morning did not calm her down enough. Four in the morning knocked her out for two hours. We just tried a three and one split. She was more balanced today. Will try it again tomorrow. We still have not completely got rid of the throwing, hitting, poking and pushing. Although there has been a significant reduction. Her face pressing seems to have increased a bit, but her focus has improved. She has been able to focus on her iPad apps more often and for longer periods. Her spontaneous talking has also increased. Not sure why that is, but we all enjoy hearing her voice more frequently. The neurologist believes she has impulse control issues as opposed to aggression issues. With aggression issues, the harm to others is usually accompanied by anger. This is not the case with Emery. She is almost giddy when she hits, pushes, pokes, throws. This doesn't not help the recipients of this behavior at all. It does help the doctor determine what type of medication to try. Her behaviors became so bad the last week of school before break, I had to keep her home from school 2 and 1/2 days. She is still pulling out her hair. She basically has about a 2 inch strip of baldness in the back of her head that runs from the top to the bottom. This is the third fall/winter that Emery has had some sort of hair loss issue. So many unknowns with this kid. She did well through the holidays and really enjoyed unwrapping gifts, visiting Santa, making cookies and celebrating New Year's Eve. She also has been more interested in doing things for herself. She has dressed herself most days over the break and even has brushed her own hair and cleaned her own eye glasses. She still occasionally gets her shirt on backwards, but other than that, does a good job. I also have her doing her own showering. She still needs several prompts and help with rinsing her hair, but she does fairly good with everything else. My next step is to divide the entire showering process into sections, print picture cards for the 4 or 5 steps per section, and start one section at a time having her complete the steps with no prompts. It is a slow process, but she will get there. Despite all of her issues, Emery is a happy and loving kid. She wants to sit on my lap several times a day just to be held and cuddled. She is not happy when I leave the house without her. When I return, I get kind of a look of disgust from her. But, within a few minutes, she puts her arms out to be picked up and I get a very long big hug. Yes, I can still pick her up at 60 pounds, but I know that time will be over soon. So I hold her any time she wants. It's amazing how much you can love such a high maintenance little being :).
Hope everyone enjoyed the holidays. I can't believe we have to get back to normal in just two days. It goes by so fast, but is always a lot of fun. We took the Christmas tree down today and undecorated the house. Big project! Still have to put away all the Christmas dishes. On my list for tomorrow. I am officially rejoining the workforce on Monday, after 12.5 years of being a stay at home mom. Only part-time, but I really need to get organized on Sunday so I can still feed everyone next week, send them to school in clean clothes, and hopefully not forget to pick up anybody from anywhere! Should be an interesting change to our household. Probably will need a few prayers!