Obstacles with Popsicles
I won't lie to you. It's an arduous journey. Well, not for everyone, I've heard a ton of stories about children having a complete transformation over night after adding stimulant medications. There is great hope for many of you that are just dipping your toe in the medication pool. It wasn't really any surprise that our pool would just happen to be on fire. Lucky for you, you get a rare peek at the answer to, “what are some examples of bad things that could happen?” Rest assured, everyone I’ve known personally has the above mentioned ‘complete transformation’ story, but I can't help but feel that sometimes parents need to hear the bare naked truth about one's hard experiences, the stories nobody wants to talk about. We otherwise wonder if our own stories are on the wrong side of normal. I could have used this blog all along the way.
First stop: Ritalin (methylphenidate)
I stared at the hideous yarn-stitched clown, donning a frown face, fixed in a picture frame on the doctor's office wall. What an awful choice of wall hanging for a pediatrician. Come in children! Even something as scary as clowns are sad here! Come let me poke you with needles! I waited for the doctor to enter the room. - This doctor, by the way, is the one who knew by the age of two that Abby would, one day, be diagnosed with ADHD. The same doctor I had previously, on more than one occasion, reached out to for support. At a particularly desperate moment, I had once pleaded, "I JUST NEED TO HEAR IT’S GOING TO BE OK." I will never forget her unbearable mixed expression that looked a lot like, "I'm not willing to say that", and "I doubt it". - So, it being THAT doctor, at least I didn't have to justify to a stranger why I was medicating my child. Which, after all we had been through, would have been intolerable.
After enduring an eternity of trying to keep Abby out of the tongue depressors and cotton balls and destroying the paper on the exam table, the doctor finally entered. There were no questions asked, I had a prescription in my hand before Abby had time to beg for her stethoscope, to which the answer was always no.
That was a Wednesday. We decided to just go for it and start her the next day. We needed a change now and we had such high hopes. I could already picture myself telling our transformation story. I was also extremely uneasy. It's really scary to give your child something you've never personally taken and then leave them with someone else to monitor. The balloon of anxiety was back in my chest and I literally could not wait to hear how it was going.
Around lunchtime I received a phone call - heart slamming - I answered. The teacher walked me through her behavior that morning. Abby wasn't able to participate in class at all, she refused to stop organizing all the markers, books and folders by color. The teacher explained it as, "really strange behavior", and that her mind was clearly unable to adhere to any topics, she was all of over the place, talking nonsense. My daughter was essentially tweaking out. I couldn't handle the thought of my little girl going through this. When the medication wore off, she got extremely agitated; you could visibly see her skin crawling.
We otherwise wonder if our own stories are on the wrong side of normal.
Here is where it starts getting hard. It's one thing to try a medication, throw it out and start a new one. While not without some hard days, you could get through the plethora of options fairly quickly. But it doesn't work that way. The doctor insists you give it two weeks. The body can't adapt and respond to it's potential with a medication without an ample sample. You claw your way through the two weeks and then they want to UP the dosage. So that's the process, give it two weeks, up the dose, give it 8 more days and then we try something else. With most medications you would then have to wean them off slowly while slowly introducing the new medication - they call it cross-tapering. Stimulants, however, leave your system fairly quickly so we could move on. I called the doctor and scheduled an appointment to reach our next stop in the journey.
Second stop: Adderall (dextroamphetamine and amphetamine)
We won't spend a long time at this stop; there was nothing there for us. We gave Abby a few days before introducing a new med but again, I shipped her off to school on trial day number one. The Vice Principal called me an hour after school started. Abby was in a complete rage, she was violent and growling and unapproachable by even her favorite supporters. I was told it wasn't safe for her to be there as she was a risk to herself and to others.
I raced as fast as I could to get there. I was crying and felt so guilty for subjecting her to something that made her feel so terrible. By the time I got there the [wonderful] Vice Principal was sitting on the ground with her in her lap, rocking her back and forth. Abby had exhausted herself and now only love and comfort could calm her. I scooped her up and held her so tight and told her how sorry I was over and over. I gave her 5 mg of melatonin… and a popsicle :).
In retrospect, and a word of advise, I would have waited for the weekend to try these meds, where I could see firsthand how it would affect her. I still wrestle with that guilt.
Please note, how one person responds to a medication is no indication how someone else may respond. Both of the above mentioned medications work beautifully for a lot of people. Individual chemical makeup, genetics and functionality of our neurotransmitters cause us to respond differently from one person to another. If you're going to start the path, stimulants are usually the starting place for doctors and psychiatrists because of their success and effectiveness. Again, our journey was just more an obstacle course.
Some posts are harder to write than others. It’s particularly difficult to resurface these sunken memories. Hence why I break up the black and white reel with Abby’s ever-so-colorful and famously (sometimes infamously) funny moments, posted as Flashback Fridays! We've had wonderful days and a lot of laughter. Kids with ADHD and behavior disorders have obstacles, you just pick them, dust them off and stop at nothing... and give them popsicles.
At this point we were beyond the scope of expertise of a general pediatrician. We needed to find a specialist to study our options beyond stimulants. It was time to pound the pavement in a search for a pediatric psychiatrist. Join me next time for a detailed walk-you-through-it guide to finding one... that is accepting new patients, has an M.D., specializes in children, takes your insurance....