To Be or Not to Be…Medicated Part 1

To medicate or not…that is the question.

Hamlet’s angst is nothing compared with the stress parents face in the decision of whether to alleviate ADHD symptoms with medication.

Everyone has an opinion to voice, including 95-year-young great-aunt Judith.

In myyyyy day, we just sent the kids outside to run around until they fell over. Worked like a charm.

Right. That’s helpful. The kid is in school all day, expected to be motionless and butt-in-seat for almost seven hours. A colossal task for a child whose small body vibrates with energy. There’s little time built into the school schedule for “running around.”

I agree that the issue of exercise must be addressed (another post) but changes in a public school drag out as only bureaucracy can.

While school officials and teachers are not allowed to recommend medication, parents of kids who fall under the “ADHD” banner can read between the wide-rule notebook paper lines.

We have tried all the strategies available to us but she’s still having significant trouble keeping up with the class. Have you talked with your pediatrician about sleep, diet changes…other…possible solutions?

And then there are the meddlesome individuals concerned friends with opinions. 

Have you read about the side effects? My friend’s brother’s girlfriend has a facial tic and hallucinates. She was on that Concertadderalin drug for fifteen years. I bet that caused it.

What is a parent to do?

When the kids first came to live with us, our girl was the picture of perfection in public. This byproduct of Reactive Attachment Disorder was a boon, because…the same could not be said for our little guy.

At age five, he unleashed mayhem and havoc with a talent Spiderman’s supervillain Electro would envy. Especially at school.

3893839842_2547318233_zElectro, as photographed by Compulsive Collector

Finding the social worker to be less than helpful, I appealed to a local government agency and procured a behavioral mentor. Three quit, without ceremony, in quick succession.

The last one, a no-nonsense black Mary Poppins, worked magic. As they say in the South, she yanked a knot in his tail. While she was present, he managed to keep his behavior to a notch below “expel that kid.”

The bus ride home…that was a different story. I found myself in the principal’s office, “volunteering” to drive the kids to and from school (because bus behavior was a notch above “expel that kid”). The chaos on the bus was just too stimulating for his hyper little brain.

His behavior was not unlike a puppy with separation anxiety (freaking out, destruction, snapping and biting). And like said pup, once he could see us, he calmed.

By the end of Kindergarten, we thought we’d turned a corner. Maybe the pup was maturing. The behavioral aide told us she didn’t feel he needed her any longer.

What we didn’t realize at the time: he transferred his need for a parental figure temporarily to her during school hours. His ability to self-manage appeared to grow, but in reality, he simply allowed himself to relax when she was present.

Because he seemed to have made such progress, the agency deemed a behavioral aide unnecessary for first grade. Then he escaped school. And then the Assistant Principal tackled him to prevent a second escape. The behavioral aide was reinstated, but Mary Poppins was no longer available.

By this time, we had him in occupational therapy, were using ABA techniques at home and had an in-home counselor visiting several times a week in addition to the”office” counselor. I averaged three hours of sleep, because he woke up between 3 and 4 each morning, screaming. (The girl didn’t fall asleep until after midnight most of the time.) We tried natural remedies like melatonin and installed blackout curtains. I read every book and article available. Tried every behavioral modification. Rewards. Negative consequences. Bribes. Nothing worked.

While cycling through a parade of aides, I began discussing medication with his counselor, who referred me to a psychiatrist. Because the children were still in legal custody of social services, I had to fight with the Bat from Hell to get approval to try meds. Her level of hostile resistance reminded me yet again that she must have spent almost no time learning about these children. Even the school was (unofficially) on my side by this time.

We received grudging approval for a low dose of Concerta. His improvement was almost immediate but the effect was brief; the pill was too small to last through the day. Applying for permission to increase the dose margin, I could almost hear the social worker’s clogs dragging. She ignored most of my requests, but by the middle of second semester, we’d tweaked the prescription to a still low but more effective level.

In late Spring, for reasons unknown, he relapsed into mania. Glue poured over his desk. Crayons broken and thrown. Another child’s head slammed into the wall. Attempts to escape. The social worker suggested an increase in meds; we agreed while graciously gritting our teeth in a slightly we-told-you-so manner.

The higher medicine adjustment allowed him to stay in school, but he stopped eating and began a yawning tic. Dark circles appeared under his eyes. He looked like a patient of chronic illness. The school year ended and I worked with the doctor to remove medication for the summer. The side effects concerned us more than his erratic behavior.

At this point, we discussed home schooling. After that first touch-me-not year, he has always been most settled at my side. I understood the commitment, having home-schooled ten of my own school years. If we homeschooled, he’d have one-on-one attention and infinitely fewer distractions.

Hubby and the counselors and doctors all agreed—against me. He needed the social interaction; many of his issues began (and sometimes still stem) from his inability to handle interaction with others. Keeping him in constant contact with others is key.

When the school year started again, his psychiatrist suggested guanfacine. As I understand it, the drug was initially meant for blood pressure. Soldiers in a military hospital took it for heart health, but their PTSD symptoms were suddenly ameliorated. ADHD and PTSD can be related (and our son does, in fact, have a PTSD diagnosis). We’ve experienced a shift from insanity to relative composure, with no side effects.

The medication also helps him stay asleep. Lack of sleep exacerbates ADHD symptoms (in EVERYONE, right?) so the sleep aid is very beneficial.

For a short time she also prescribed Strattera, but I saw no improvement and didn’t like the possible side effects, so we discontinued the prescription.

Now in fourth grade, he communicates frustration brought on by his impulsivity.

I want to be good. But I do the wrong thing! It’s like I just can’t help it!

The psychiatrist asked our guy if he’d like some help being focused. With a pleading look on his face, he nodded. She described a dose of Vyvanse, so low that our pharmacist had to order it. He’s taken it for two days. Because it wears off throughout the day, I see very little change by the time he’s home. However, his teacher is enthusiastic in her praise for his new attitude. (She’s worked incredibly hard with us to help him self-regulate; we text throughout the day. I am so thankful for her.)

I tell you our story, not to support medication, but to give you my perspective. I am overjoyed that we may have found his perfect match. I am thrilled to see him so happy; it’s evident in both what he says and how he carries himself (he has had two days with no “bad marks” since starting the med, and he’s proud of himself).

I am weighed down by unbelievable, maybe-irrational, massive amounts of guilt for “giving in” and medicating. I am terrified that long term side effects, yet unknown, may plague him in his teen or adult years. I pray the list of already recognized side effects will not visit him. I feel like a failure. Maybe if I’d changed our diet, gotten up an hour early to take him for a run each morning, found an alternative, we could skip the meds altogether.

But at the end of the day, it’s about my boy. And at the moment, he’s moved from feeling that he’s the “bad” kid in class to knowing that he CAN succeed. He has a taste of what it is to enjoy school. To ignore the barbed words from his arch-nemesis. To refrain from throwing the lunchtime green bean back at its sender. To have control. To focus. 

He no longer drags himself to the pickup line, weighed by the knowledge that we need to have yet another discussion about his behavior. He actually trotted to meet me today, a grin on his face.

I got EIGHT green marks today. Eight. And no red ones. Pretty great, huh?

Pretty great, indeed.

 

 

 

 

 

About Casey

Adoption = my life. I'll give it to you straight. Success, failure, truth.

Posted on January 28, 2016, in Adoption, mental health, Parent, parenting, Resources and tagged , , , , , , , , , . Bookmark the permalink. 12 Comments.

  1. Hugs to you and your precious boy! As a Mom of a ADD child who is given to impulsive behaviour,etc. we have tried the medication route and trust me if they would have worked I would have kept her on them! I know how torn a parent can feel about it! It boils down to what works best for the child and in my opinion a HAPPY Child about his 8 green marks is a big green light to continuing with the medication and trusting God with possible long term effects. ❤

    Liked by 1 person

  2. Awesome and thank you for sharing Casey. I want to hug you for the care and love you give this little boy.

    Liked by 1 person

  3. Josette Inspires

    8 green marks!!! Awesome.

    Liked by 1 person

  1. Pingback: Well That’s FantIstic | Hypervigilant.org

  2. Pingback: To Be or Not to Be…Medicated Part 2 | Hypervigilant.org

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