Meltdowns and obsessions — (Circle of Moms)

My seven year old son has a variety of issues. Early on we thought he had PANDAS because of his strange reactions to strep throat and fevers. He would get this waxing of symptoms that were obsessive, anxious, tics, adhd, and poor handwriting. It seemed to follow a pattern until he was four and had shots and things went threw the roof. After that he was never the same boy.

Now at seven and many Dr’s later they are saying he has tourettes, ADHD and aspergers.  Finding a Dr. has been a nightmare for the PANDAS.  The psych has put him on several new meds and most meds he couldn’t tolerate for the ADHD and behaviors went off the charts. The neuro started him on Abilify for the tics and behaviors. He is up to 15 mg AM and then 3.5 in the PM. Maybe it has run its course because we are still seeing horrible behaviors where he can’t be reasoned with. Ususally the meltdowns involve obsessions over things he wants to get and meltdowns follow when he is told to wait. The psch put him on Celexa 15 mg because of the obsessions and anxiety but it doesn’t seem to be doing the trick either. She said we can up it to 20 mg. As a side issue he is having encopresis where he soils his underwear everyday. I am at a loss for what is going on here.

He gets so mad when I try to put him on timeout and is just defiant. Last night he ran away from me at the store and acrossed the parking lot because he couldn’t get a toy. He refused to get into the car. It was really awful. He ran down to the store. Finally he got in the car when the store was closed and ripped up his $20. Then he always blames me. He threw an animal and broke my daughters collection dolls last night because he was mad at her. I don’t know how to handle his anger. Is it the meds, the aspergers, the PANDAS, the tourettes, summer transition, and how do I punish him? He just gets more angered and mouthy when I try to punsh him with time out. Then he destroys something. I use reward charts and 123 magic as suggested by our psych but none of it seems to help. The chart just adds to his obsessions over getting things. I am trying to find a different therapist who specializes in aspergers. Any suggestions? I am considering IVIG next month for the PANDAS. If his brain is swelled maybe that is what is causing his irrational behaviors. I suppose a steroid burst may be appropriate now also. Finding a PANDAS Dr. in OH is impossible. We are planning to go from OH to Maryland in July for the PANDAS specialist. Help!