Thursday, May 23, 2013

Is this something more?

B—'s tics are getting worse: vocal and motor. He blinks rapidly, often in groups of 3; clears his throat compulsively; emits "mhm-mhm-mhm" frequently; he is shrugging his shoulders in 3s and rubbing his head against the back of his neck. I'm trying to stay calm about the growing severity. B— says he can't help them, and I believe him.

I'm wondering if there is a co-morbidity going on with his PDD-NOS. Autism sometimes features tics, but with the number of tics and the severity I'm seeing now I'm concerned this may be a manifestation of Tourette's Syndrome. Everything I've read says medication is largely not needed, that behavioral therapy may be helpful, and that maintaining a low-stress environment and educating people around B— so that they understand what is happening to him is the best form of intervention. Diagnosis is of course preferred, but B— isn't insured and getting insurance is complicated.

Previous to my marriage B— was covered by Medicaid. His father was being tapped for insurance backup through his work, even though he was eluding child support payments. When B—'s father relinquished parental rights, believing as I did that my husband was planning to adopt B—, his responsibility for any financial support ceased. The fact that my husband immediately turned a 180 claiming he no longer had interest in adopting B— once parental rights were terminated is a double-edged sword. While I do not have to submit B— to continued exposure with his step-father, I have no way of providing coverage for B—'s medical needs without going back to the State. I'm guessing that such a move will prompt the forfeiture of parental rights to be expunged, and bring B—'s birth father back into the picture, further complicating the emotional trauma this little boy has already undergone. 

So I look at the situation. My son has tics, a little worse than moderate. Whether we have a diagnosis or not, they are what they are and they may or may not improve over time.

Otherwise, he is happy and sweet and loves people. I'm not certain that pulling strings to see a medical professional, or stirring whatever pot needs stirring to get medical coverage is worth the grief.

There are needs. There are wants. Poor little B— is plagued by so much extra. For him it seems there is always something more.

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