Friday, May 10, 2013

Taking the Plunge

Yesterday I got a Ritalin-type prescription for Jesse for ADHD. I had reached the conclusion a while ago that this was the right course, but I was surprised as I walked out of the doctor's office by the wave of sadness I felt.  I guess I have always felt that one of my strengths as a mother is to understand and champion my children for who they are. And most of them are quirky and strong-willed. For Jesse especially, I have worked hard over the years to reach him on his level, to love everything that is good and wonderful about his manic little self, and to guide and teach him at his own pace. So I guess taking that prescription felt a little like a betrayal, like pathologizing him instead of embracing him.

On the other hand, this is so, so the right choice. The boy is seven years old and still operates on many levels like a four-year-old. He is finishing his second year of kindergarten and the prospect of a full-day of first grade next year is just a no-go. And I'm so, so tired of managing his behavior on a minute-by-minute level. It's time for him to learn a bit of self-control.

And--this is the most compelling part--he wants to learn those things. He has reached the point where he can see what he should be able to do--focus enough to finish a task, manage his emotions, control his impulses--and he wants to do those things, but he can't. You can see him struggle, try, fail, and feel disappointed.

Case in point: I hadn't said anything to Jesse about medication or ADHD or the purpose of our doctor's visit, but at one point when the doctor was out of the room, Jesse told me that he had had to stay in from recess today because he hadn't finished his math work, and that in fact he missed one of the stories too.  (Don't get me started on staying in from recess as a consequence for a boy who has excess energy.) His tone was sad but resigned. I said, "You know, the doctor wants to give you a medicine that will help you stay on task." His face lit up, "Really??" When we got home, he told Haley, "I'm getting a new medicine to help me stay on task!"

I feel like if the boy is that ebullient about the prospect of help, then it must be right.

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More deets for those of you curious or who may be struggling with a similar decision:

~ The way it worked was I got an official bubble questionnaire from the doctor. I filled out one and so did Jesse's teachers. We scored his focus, attitude, etc. The doctor reviewed those questionnaires and said, "Looks like he's definitely in the range for the hyperactivity-type ADHD."

~ She gave me a low-dose prescription, but I guess it's all very trial-and-error. We go back every month to assess until we feel like we've hit the magic combination of medicine and dosage.

~ The medication is a "controlled substance" so filling the prescription is going to be a logistical hassle. Doctor can't call it in, can only give one month at a time, can't re-write if I lose the prescription, etc.

~ You administer the medicine in the morning and it lasts about 10 hours. Enough to get through the day but leave him unmedicated enough to eat a good dinner and be able to get to sleep at night. Apparently it'll totally kill his appetite, so the idea is to make sure he gets a good breakfast before it kicks in and dinner as it wanes and not worry too much about lunch.

~ The doctor said her view is to use the medication as a temporary crutch until the child can mature and learn their own coping skills and work-arounds. Which I love. That's totally my view. Jess just needs a leg-up to make the transition  into first grade. Eight-year-olds suddenly develop such a greater degree of maturity, problem-solving skills, executive functioning, etc. I said, "It seems like once he has experienced being on task and in control, then he'll be able to figure out how to maintain it better on his own." The doctor said that's exactly what  happens. So yay for a doctor who's not advocating for a lifetime of medication. She kept saying, "Let's just keep him on it all the way through first grade."

~ We're starting the medicine now and will continue it over the summer even though many people leave their kids unmedicated when school is out. My thinking is let's get everything totally figured out and running smoothly so he's ready to rock on the first day of first grade.

4 comments:

  1. This is how I felt when I finally decided to take a medication for something and realized that my entire life I suffered something completely needlessly because there was a cure that came as a result of the miracle of chemistry. Sometimes it takes more courage to take advantage of modern medicine than to ignore it! I think this makes complete sense and you did the right thing, as usual.

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  2. I was on ADD medication from 5th to 7th grade. I had a hard time concentrating particularly on reading and had a hard time getting things turned in on time. After I got on the medication, I went from being the class clown to the class nerd: total, insufferable know-it-all. Mom took me off in 7th grade because the medication I was on was also an appetite suppressant and that worried her. I continued to be a slow and distracted reader, that hasn't really changed, but one learns to manage.

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  3. I think you have the ideal attitude about this whole thing. I have seen ADHD medicine take all the "spunkiness" out of a child I know, and her mom thinks it's just wonderful, but it worries me. I'm sure you will find a great balance for Jesse.

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  4. I have an 11-yr-old with ADHD. I feel guilty about the side effects when we medicate and guilty about his difficulty in school when we don't. It has been off and on for close to 3 years. I think your views about the meds are refreshing and helpful to the opinion I am *trying* to have now, without the worries and guilt.

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