Saturday, January 5, 2008

Tough Decisions

Back in the fall Ten was diagnosed with ADHD. We've been several years in coming to this, but we had him tested because, quite frankly, I was at my breaking point. His teachers' opinions over the years have ranged from "You need to have him tested for ADHD immediately," to "No way, he's just super smart and as long as I keep him challenged he does fine." His mom's opinion fell somewhere between "Holy crap this kid is smarter than I am," and "Oh my God if this child doesn't stop talking and stop wiggling and stop squirming I'm going to lose my frickin' mind!"

We had him tested for Celiac disease (gluten intolerance) a couple of years ago because there's a family history. It often goes undiagnosed and can cause hyperactivity in children. The blood test came back negative. We moved on with our lives.

He managed to skate along
at a magnet school, making almost all As with the occasional B with very little effort until last year. In third grade came the homework. Hours and hours of it. Every single blessed night. With arguing. And weeping. And gnashing of teeth. It was Mommy Hell. I started to wonder if the magnet school's accelerated curriculum was too much for him. That worry was shot out of the water by his standardized testing scores: advanced in every single category, scores in the 99th percentile in nearly everything. He continued to struggle with homework, but he got by, made either Principal's List or Honor Roll, and still liked school. Most of the time.

Then came fourth grade. All summer leading up to the start of school I dreaded it. I used to teach fourth grade, so I am very familiar with the beast that is a fourth grade boy. Ten (still Nine then) was not. that. beast. I also have a lot of experience with ADHD kids and I knew that he was exhibiting many of the behaviors that those kids did.

He acted like a much younger child. In fact, his younger brother had to remind him to do things constantly, things other kids his age don't need to be reminded about: brush your teeth, clear the table, put away your shoes, coat, backpack, lunchbox, etc. He had trouble with peer relations because he acted goofy, was quick to anger, argued about every little thing. I was not looking forward to the start of school because I knew this would be the year I'd finally have to do something about my child.

This is a kid who, within the first six weeks of fourth grade, went from liking school (not loving it, but liking it) to a child who hates school. Not dislikes it, hates it. Intensely. Crying before school many mornings, crying during homework, calling himself stupid. Saying he hates himself. His self esteem is in the toilet. I have a dry erase board in the kitchen, where I write the date and what's going on that day. Look what he wrote there this week :

This just breaks my heart.

So back in September we had him tested and the psychologist says Ten has ADHD. There are subsets to ADHD. The first is the inattentive child--the daydreamer. The second is the hyperactive, can NOT be still, child. A child in the third subset has both issues. Ten falls into the second group. The psychologist says that he's not inattentive, but he's extra-attentive. He lacks an incoming information filter in his brain that tells him WHAT to pay attention to and what to tune out as unimportant. He's focused on all of it: the hum of the fluorescent lights, the custodian sweeping the hall, the kid sitting next to him whose foot is tapping, the kindergarteners down the hall, everything. He also lacks an outgoing filter that serves to self-censor, so every single one of his thoughts is expressed verbally. Think it, say it. He's also hyperactive so he truly cannot control the constant motion, talking, busy-ness that drive the people around him insane.

After a whole lot of arguments, tears, prayers,
yelling matches, name-calling, research, multiple doctor visits, and more shouting, Dan and I decided to give medicine a try. Well, I decided and dragged Dan along with me, kicking and screaming the whole way. He's such a good dad. We started out with Strattera because it's non-stimulant, non-habit-forming, and both docs recommended it as a good starting point. The psychologist warned us, however, that this particular drug seemed to be more successful at treating the inattentive kid than the hyperactive, impulsive kid. He was right. After two months we saw no change in Ten whatsoever so we stopped giving it to him.

Now we've come to a place where we never wanted to be--giving our kid a controlled substance.

After we told our family doctor that Strattera wasn't working, he advised us to try Daytrana. It's a patch that has the same basic medicine that's found in Ritalin. I'm so divided on this. On the one hand, I hope it works right away and we see a huge, dramatic change in Ten's study habits. On the other hand, I absolutely loathe the very idea of putting a drug into my kid's system unless it's for some life-threatening reason. Although, sometimes I feel I might just threaten his life if I can't get him to calm down. That was a joke. Mostly.

What if the drug works and he has to be on it for years and years? When will he be able to stop taking it? Will he outgrow the hyperactivity when he hits puberty like a lot of kids do? Will he have side effects like insomnia? Or tics? Will it make him lose weight? This kid is so skinny--he doesn't have any to lose. He's already a picky eater--will this suppress his appetite to the point where he won't eat anything? He has sensitive skin and eczema--will this patch hurt his poor little skin?

How am I going to manage a doctor's appointment every single month (because there are no refills on controlled substances)? It's going to cost an extra $65 per month--$45 meds and $20 copay for the office visit. How can I afford to pay for this every month? How can I afford not to if it actually helps him?

We started the medicine today so Dan could be here with me to observe any side effects.
I'm just a nervous wreck about the whole thing. So far we haven't seen any changes, but it did leave a little red square on Ten's skin.

Pray for him and for us to make the right decisions. This parenting thing isn't for wimps.


Three Fold Cord said...

I am so heart broken for you and dan and TEn about the whole thing. I will pray that you are led by Him the one who knows Ten better then you do. I can't imagine being in your shoes except for the threatening his life- I have threatened my 3 1/2 year old daughters in the last week or two. Christmas seems to bring out a terrible side of energy in her and I am DONE!! But then again she comes and tells me good night and thanks me for her dinner and I melt and am back to loving her to pieces.
My thoughts are with you this night and whenever you come across my mind in the next few days!!

MisbehavinAngel said...

Teble, my SIL works in a kindergarten with disable children and she has a lot of experiences with Ritalin.
For the children she works with, it's somewhat special as these are not 'normal' children, but whenever we talk about this, she really is positive about Ritalin.
I really hope this worls for you and Ten. You are in my thoughts and please let us know what's going on.

Love and hugs, Sanna

Anonymous said...

I had to comment on this blog, because so much of what you wrote is agonizingly familiar.

I was seven when I was diagnosed with ADD (the doc said I was borderline hyperactive). What you wrote about the screaming and crying while doing homework brings back memories that make me want to cry. I can't even put into words what that feeling is like other than to say that it is horrible. Those are some of the worst memories of my life. Reading about all of the things that your son is experiencing brings those memories back full blast, and it is NOT fun reliving those.

I was initially put on Ritalin, but developed a facial tic, so I was switched to another drug (whose name I can't remember) and I was on that for several years. When I started middle school, my parents decided to take me off of the drugs. I still haven't entirely forgiven them for that decision. My grades slipped so far that I almost didn't pass several classes, and without the drug to regulate my behavior, I came to seen by my classmates as something of a freak. When I started high school, I demanded to go back on the drugs, and my life improved dramatically. I started taking Adderall, and while I did did lose weight, I was about 50 pounds overweight anyway, so that was actually a good thing. Once I got to my ideal weight, however, I stayed there until I went off of the meds again when I was 21, when I couldn't afford it (I'm back on it now). During the time when I was off of the Adderall, by the way, I was actually dangerous to myself and others while driving, because I couldn't concentrate. I got into so many accidents, including a rollover accident, that my insurance is sky high now.

Anyway, as a kid with ADD, who fully understands what your son is going through, I have some advice for you.

1)As hard as it is, try your hardest to be as patient with him as you possibly can. You haven't said anything about yourself having ADD, and unfortunately, having experience with other kids who have ADD may not be a big help to you. Unless you yourself have experienced what it is like to go thru what your son is going thru, you can't really understand it, and what a torment it can be. My parents weren't patient or understanding. They simply couldn't understand what I was going through, and so their general attitude was, "Well, just suck it up." I sometimes wonder if perhaps my parents thought that "tough love" would make the problem just go away.

2)Make sure that your son knows that he is normal. Unfortunately, ADD and ADHD have become something of a joke to many adults, and they pass that on to their children. I can't count how many times over the years I had to put up with other kids banging their hands against their chests in that "retard" way, crossing their eyes, tongue hanging out of their mouths and saying, "Heh heh, I have ADD, heh heh." I grew up thinking that there really was something horribly wrong with me, and that can really damage your self-esteem. Of course, as I got older, I would make people stop by pointing out to the person that I have ADD, and they would immediately stop and look ashamed (but I never, ever got an apology). There are ADD/ADHD support groups for both kids and their parents that you can go to. I think that that would be really beneficial to both your son (so that he knows that he isn't alone in what he is going through) and you and your husband (so that you know that you aren't alone in your frustrations).

3)While I understand that you have another child, and he needs your attention just as much as your older son does, make sure that you spend as much time as possible with your son so that he knows that you love him. I know that that sounds really obvious, but I have often wondered if perhaps my parents weren't so frustrated with my behavior and their inability to understand that they simply stopped spending time with me, and spending more time with my younger siblings, because I was difficult to be around. In other words, in addition to feeling isolated from my friends and classmates, I was also isolated from my family. This is NOT a good thing. So spend as much time as you can with him, both just the two of you, and with his brother. Always try to treat the two of them the same.

I am now a fully functioning, responsible (mostly ;)), fairly normal (whatever that is) 25 year old. You and your husband can get through this. Your son, with your love, help, support, guidance, and understanding, will get through this. It is frustrating (for both of you), but you can get through this with your sanity intact.


Teble said...

Alison, Thanks SO MUCH for your comments. It's truly a comfort to hear from someone who knows what Ten is going through. He tries so very hard to do his best that it just breaks my heart when his teacher and his friends are unkind to him. I'm going to reread your comments over and over again to keep me focused on doing what's best for my kid. Thanks for the advice!