Monthly Archives: January 2014

Medication Observations One Week In

Mikey is a full week now into taking his “good choices medicine,” as he calls it. In short, we’ve noticed remarkable, astounding results. The first day he took it, he really didn’t swallow too much of the pill–chewed it up despite our protests and nullified the extended release features–and he still had the best day he’s had in months.

If I recall, I took the kids to the museum solo that day, and he was utterly peaceful and agreeable. Very cooperative. This was the very museum I once vowed I’d never revisit after he escaped from me many times, climbed some of the dinosaur skeletons, and was so generally unmanageable that I locked us in one of the bathrooms so I could cry for a long time.

The whole weekend, we were pretty much trapped indoors at our house because we got a whole bunch of snow, and thanks to the good-choices-medicine, Mikey was able to be peaceful with our family, and even enjoy a nice play date with some neighbors.

Sure, he was his usual self. He has been spirited and quirky and very protective over specific cars and toys. He’s had a lot of interesting things to say about potential scenarios that could shake out with the family of foxes living in the woods behind our house. But he hasn’t felt like a lightning bolt about to strike.

We haven’t felt his energy simmering, about to explode. He’s been level.

At school Monday, I got a great report from his teacher and I broke down crying. She hadn’t realized how immediately the medication would begin to affect him. This specific medication doesn’t need to “build up” in his system and wears off after 6-8 hours.

In fact, we can watch and observe the moment it wears off. Today, for instance, when I picked Mikey up at school, I was watching from afar while helping the carpool kiddo get his things. Mikey was sitting on the rug with his classmates, eating snack. Then, out of nowhere, he sprang up and began running circles around the room. It’s just that fast, that dramatic a difference.

Mikey has been complaining of some stomach pain this week, which is a side effect. He and Cody had a nice little moment discussing this stomach pain, since Cody experienced it when he began taking ADHD medication. “That goes away so soon, Mikey,” he assured him. “Your body just has to get used to it.”

And getting him to take the pill each morning has been, well it’s been really fucking terrible. We’ve tried a very long list of suggestions from other parents whose young kids have had to take medication. Usually, we’ll try for about a half hour and then either Mikey will get frustrated and chew the darn pill or else Cody will ram a popsicle stick from the craft bin down Mikey’s gullet and drop in the pill.

Today, the whole pill-taking process only took 18 minutes!

While our pediatrician says we can choose to take medication vacations on weekends, we’re not going to do this until Mikey is more used to taking his pills. We want him to practice swallowing it and we want him to see and feel what it’s like to be able to concentrate and actively CHOOSE his behaviors.

In sum, we’re beyond thrilled with the results and it would appear (so far) that reality is meeting my expectations for this intervention.

Will They Stop Calling Me “Bad Boy”?

I met with Mikey’s pediatrician yesterday. It was a very productive conversation. Unlike past visits with him, where I’ve felt geared up for a fight to “prove” I wasn’t insane, that something was going on with Mikey, yesterday’s visit was definitely two people on the same page from the start. I suppose it helps that he is the one who suggested the meeting.

Just in case, I came in to the meeting with a note from Mikey’s teacher, listing all the particularly concerning behaviors, but I didn’t need it. Once I talked about the bolting from school, Dr. H leaned back and said, “Yes. I think medication will be an emergency intervention for Mikey.”

We talked about the categories for which it gets prescribed: hyperactivity, impulsivity, distractibility. We talked about the long list of ways Mikey meets all those categories. We talked about how I take Alex with me to the bathroom because I can’t be sure Mikey won’t decide to smother him with a blanket or pour water on his head or flick him in the eye.

And then we got down to brass tacks and talked about which medication would be appropriate, which dose, what to watch out for, etc.

I learned our pediatrician has a pediatric narcotics license, and that he can prescribe these sorts of medications without additional support from a psychiatrist. Mikey will go in to the office every month for weight checks and follow-up, at least for awhile, and I don’t have to add an additional doctor and clinic visits to my full schedule of managing his care.

Last night, Cody and I told Mikey we’d be giving him some medicine to help him make good choices. We talked about how the medicine should help him to pay more attention, even when his behavior team is talking to him about how to make better choices, so he’ll be able to remember more of what they say.

He nodded and then asked us if the other children would know he takes this medicine. We said that was up to him if he decided to tell them. He said, “Will they stop calling me ‘bad boy’ if they know I’m taking the medicine?”

Oh! My heart breaks. He told us the other children all call him “Bad Boy” at school, all except one girl who is soft spoken and, in Mikey’s words, “A kind girl.”

I was reading about how children with ADHD tend to have a low sense of self-worth, probably because their behaviors cause others to think of them…well, as bad boys. As rough kids. I’m so sad that the kids at school don’t see Mikey as a funny guy, as a boy who can tell you about vervet monkeys or find all the scrolls in the Waldo book.

They just see his symptoms. They see a rough boy who screams in the classroom and runs and eats the art supplies. Already at four, they see him this way.

Cody and I feel very positive about our choice to begin this medication. We just gave him the first pill. I’m trying not to get my hopes up too high, but our pediatrician thinks the results will be instant and dramatic.

I’ll keep you posted.

Bolting Again

Mikey’s TSS started joining him at school this week. Our BSC prepared us that it would be a rough transition and that things would get bad before they get better. I guess I just didn’t think they would get THIS bad as he started testing his limits?

He bolted from school twice this week and I only heard about it today, the second time, because he made it off the school grounds and on to the sidewalk on a busy-ish side street.

It’s hard for me to tell whether I’m over-reacting or the teacher is under-reacting. Like, I don’t know if it’s a Montessori thing or if I’m a tightly wound nut job, but Mikey’s teacher told me she told him if it happens again, then he has to start holding an older kid’s hand on the walk to and from lunch.

I’d like for it to not happen again. Ever.

I know my kid is fast and determined, but I was surprised that he could evade the grasp of not only his TSS, but his BSC, teacher, and teacher’s aide all in his impulsive urges to…just run.

Tuesday, I guess he ran out the door of the building outside the cafeteria and only made it a few feet out the door. They didn’t tell me about it that day. Wednesday, he kept on going. I’m pretty shaken up.

All of this comes on top of some pretty aggressive behaviors on Monday and Tuesday, again with Mikey sort of testing the limits of what it means to have a TSS with him in school. Needless to say, I’ve eaten a lot of chocolate today.

Our action steps have been to email the entire team of people who were at our IEP meeting (principal, Early Intervention folks, medical coordinator, family advocate) to request a meeting to discuss some prevention strategies.

Then, we finally made the appointment with our pediatrician to discuss ADHD medication, especially after reading further about some of the medications and reading the discussions of their effect on impulsive behaviors.

It’s going to be another rough year. I’m just sad that I let a good week lull me into the false hope that things would just be sort of normal. I really thought we’d be able to stop crisis management and focus on social behaviors. Maybe next month…

No Crying!

I’ve been hesitating to even write about this, because I don’t want to jinx anything, but Mikey hasn’t wept in a week. You read that correctly. No crying!

During the past week, he has also begun sleeping past 7 in the morning. The sudden transition from only 10 hours’ sleep per day (despite ALL EFFORTS from Cody and me) to 12+ hours’ sleep per day has resulted in a child who does not cry!

Sure, he gets frustrated and hits his brother and snatches and pinches other kids’ cheeks at school. But he doesn’t lie on the ground and weep, stiff-bodied, over a pair of pants. Or even if we run out of gum! OR! Even if his boogers are brown instead of green.

It’s like he is all of a sudden much more rational, much more capable of handling the world. Almost all of his behavior issues that have been plaguing us have vanished.

I’ve long felt in my bones that the majority of my parenting struggles with Mikey have been related to his lack of sleep. It’s nice to see this theory coming to fruition.

Even with Alex standing in his face screaming, Mikey has been able to sleep right on through. We’re just not sure what happened.

We do know Mikey had been having nighttime accidents again, and I got sick of washing the sheets every morning, so we stuck him back in Pull-ups at night. This was a big deal, I assure you, because he asserts Pull-ups are for babies. I can see where he’s coming from. He’s been out of Pull-ups for just about a year.

But the change seems to have enabled him to push past that 5am light sleep period. I’ll gladly pay about $.50 per disposable pee-catcher for a kid who doesn’t begin his day with 90+ minutes of sobbing!

We’re also able to see some other challenges that I think will make it into our next treatment plan in terms of goals. Mikey really has some issues with social norms. Not sure if it’s manners or something going on with the way his brain works, or what, but there’s a definite lack of awareness of others and their feelings. Just a real absence of considering other people as…important, especially if they are “in the way” of one of his goals, like watching a program or drinking a glass of chocolate milk.

It’s hard to explain really what we’re seeing happening, and I’m excited that we’re seeming to move past the phase of emergent crisis management to be able to focus on new things like social skills.

What a relief that we haven’t been on red alert! Our house has been so much calmer.

If we could only get Alex to sleep a little bit better, we’d be utterly transformed as a family.

EDITED TO ADD: Totally jinxed myself. Today they were both up before 6 and have spent the whole morning weeping.