We don't need no stinkin' blood draw to know that Annika's ammonia levels are on the rise.
We've got 1 ripped window screen fluttering in the central Illinois breeze, 15 pairs of socks deemed unbearably itchy and generally unwearable, 54 breakdowns into raging tears (not always hers, I confess), and a suddenly nocturnal 6-year-old with the type of insomnia that Robin Williams would find fascinating, all working together to let me know that Annika's meds may no longer be successfully controlling her hepatic encephalopathy.
Or she may just be a scared kid, tired of all the tests and blood draws, and letting us know by acting like an alien bent on destroying our house while cheerfully humming hits from the 80s, and then twirling around to huff "No! You're fired!" at me when I protest. I'm not sure where she's picked up the wacky Donald Trump approach to child-parent relationships, but I figure that at least she recognizes that parenting an out-of-her-mind kid is work.
So, yes, our house has become time-out central, although I'm having to babyproof Anni's room again, slowly but surely, to make sure she's safe if she's left alone in there. The frustrating thing is not knowing if time-outs are even effective when your brain's all jacked up on unfiltered toxins.
The good news is that, given Annika's lung issues, no matter how crazy and confused she gets, I know I don't have to worry about her running away from home. She'd never even make it too far past our dandelion-filled yard before she needed to take a rest break.
Of course, we've also considered the fact that Annika's increasingly erratic behavior and worsening insomnia over the past couple of weeks is just the result of being 6, and not understanding everything that is happening to her. I know that, no matter how hard I try to hide it, Annika must be picking up on the fact that I am stressed out and worried. It's hard to know how to talk to her about what is going on, but I feel like I need to say something, since she already knows something has changed around here.
Not that figuring out the cause for her behavior would actually change anything. She's already on the maximum dose of ammonia-reducing meds she can be for her encephalopathy. On the other hand, if the sleeplessness and confusion is just the result of 6-year-old nervousness before the unknown, then I really can't fault her for having the exact same reaction I'm having right now.
In other words, I'm on no sleep, too. And I don't know if you'd call it "erratic behavior," but I currently have a nearly uncontrollable urge to buy every rocking chair I see at the garage sales popping up around town. Plus, I can barely string my thoughts together into anything resembling, well, a string of thoughts, much less anything like commentary or reflection worthy of even the admittedly low standard of hitting the "publish now" button.
Annika and I are off to Chicago again today. Her test isn't until Tuesday, but I'm tired of making the long round trip in one day. I hope this next one will be the last for Annika for at least a month.
Meanwhile, I'm spending my not-sleeping time trying to make sure Annika doesn't shred any more of our window screens or recreate the Great Wall of China using every single one of my books or empty all my photo albums and then arrange the liberated photos along the floor like a new textile of irreplaceable memories.
Also, I'm reading Ahab's Wife, which is perfect for my hazy, battered state of mind right now. Naslund writes her novel in the wandering literary style that allows characters to meander for several long sentences, trying to capture just the right metaphor for the experience of, for example, being temporarily blinded by lightning. Frequently I find myself drifting away while reading, then catch myself, and worry that I've missed some plot point, only to realize that I've just been lulled by another of her circling descriptions into a lovely state of waking dreaminess. I'm loving it, in other words. It's like doing drugs, but without any of the nasty side effects. Except for, perhaps, the tendency to repeat the phrase "reverence for experiencing!" over and over to yourself.
I even have my next read all lined up, since I got an email pointing me to this book, although I'm not sure any writer would want to imagine her book being subjected to my worry-addled, sleep-deprived, rocking-chair-craving brain right now.
I forgot last week to point out that Clark Bartram at Unintelligent Design worked overtime to produce a year-in-review celebration of Pediatric Grand Round's first anniversary. It's a great collection from numerous points of view, and well worth your coffee break time.
I'll be hosting Pediatric Grand Rounds here on May 6, so be sure to send me any of your own posts, or suggestions of any outstanding posts you've run across on the topic of kids' health issues. I'll accept submissions until Saturday, May 5, noonish, at moreenaATgmailDOTcom.
At this point I feel the need to offer a disclaimer about Clark and other med bloggers quaking in their scrubs when they hear I'll be hosting, click-and-clack-style, but I promise I won't push for a garage-sale-rocking-chair theme.