Monday, November 28, 2011

A Short Update on Meds

The day after my last post, I read that Adderrall can cause irritability. We took him off of it (and the Risperdal) immediately and the violent tantrums all but vanished. After a week, we went back to his pediatrician and told them we wanted to try a nonstimulant ADHD med. they gave us a starter pack of Intuniv.

He's been taking it for two weeks now, and the violent behavior has not returned. Unlike the stimulant meds, Intuniv takes a while to start working, but I think it's helping. We need to talk with his teacher and see if she thinks this dose is helping enough.

Thursday, November 10, 2011

Escalating Violence

Joseph's tantrums at school are still getting worse. He's begun throwing things at the other students. The kids pediatrician gave Kristy a prescription of Risperdal for him. We had it filled but didn't start giving it to him until last night. This isn't like Adderall or Focalin, where we will know if it works or not immediately, and the possible side effects are much more serious.

It's devastating to get an envelope full of "Critical Incident Reports" from the school, or to hear when I pick him up from his 2 hour school day that he spent half of it throwing things, screaming and crying because he wanted to play with cars instead of washing his hands and it took 5 staff members to keep him from hurting himself or someone else. Or that he broke the skin when he bit his teacher, and now she has a staph infection because maybe that impetigo wasn't really gone. I heard somewhere that you're never supposed to apologize for your parents or your children, but I feel like I should. His teacher tells me that they know that this behavior is not him, and he's the sweet little boy when he's not hulking out, and we're doing a great job considering the situation. Anyway, we're lucky to have one day a week that passes without an incident at school (well, we would be if it happened).

I used to think that ADHD was over-diagnosed. That people just didn't know how to discipline their kids, so they went and asked their doctor for pills to solve the problem for them. I used to think that it was outrageous that someone would diagnose a child with bi-polar disorder and treat them with serious drugs like lithium. When we started the kids on Adderall, I justified it by thinking that it wasn't too different from giving them caffeine. The Risperdal is not so easy though.

It's so discouraging. He has been making so much progress over the last 12 months. He used to throw tantrums, but they were the short kind where he would throw himself to the floor and scream a little. I could scoop him up, get in in his car seat, and once we were on the road he would be fine. Now, when he wants to go outside at grandma and grandpa's and he's not allowed, he starts throwing things and knocking things over. I had to physically lay on top of him on a couch for an hour while he screamed at the top of his lungs and tried to bite me (the bruises from the bites lasted for about a week).

I'm doing the best I can. We'll get through this. Everything will be fine.

I'm emotionally exhausted.

Saturday, November 5, 2011

It's been three months since my last confession

Wow, I can't believe it's been three months since I've posted about Joseph.

The new school year got off to a rocky start. After about the first month, Joseph started refusing to get on the bus about have the time. Eventually, we started driving him, but he would refuse to get out of the van. Then I'd go to pick him up and he would refuse to leave the classroom and fight me when I tried to strap him into the van harness.

Tantrums got worse too. One day, at my parents house, we told him he couldn't go back outside to the backyard. First he started knocking things over, I tried to restrain him, but he struggled harder. I ended up having to lay on him for at least an hour while he screamed and thrashes. He bit my arm twice, so hard that it was bruised for a week.

I think it was the day after this incident, he had a particularly bad tantrum about having to get in the car to go home from school, his teacher asked me if anything had changed, if Kristy had gone back to work, or there were any changes to his meds. I told her no, but when I got home and I mentioned it to Kristy, she said they had reduced his Adderrall from 15 to 10mg because he had been falling asleep at school and sleeping through his whole school day. I told her to start giving him 15mg again and he showed an immediate improvement. Not perfect, but he had ONE perfect day last week without any meltdowns.

Since the beginning of the year, he's continued to make progress. In fact, one Friday he came home and just wouldn't shut up! And he wasn't just scripting or talking to himself, he was walking up to adults and saying, "Excuse me! Excuse me!" and then asking us things or telling us things. I emailed his teacher and she said she was going to ask us about it as they'd noticed that afternoon as well and they had no idea what triggered it. He's not talking quite that much now, but still much more than he had been.

Speech therapy in the morning has been, on average, a success. He still has trouble some days, but he's had a lot of great mornings when he cooperates for the entire 45 minute session. His SLP from Children's re-evaluated him and said he's made so much progress (since he was 99% non-verbal) that we need to set new speech goals for him.

He's got a new favorite activity. He draws with crayons in comp books. He carries 3 to 5 of them around in his bookbag and will draw a little in one, then switch. It's very cute and some of his drawings are better than mine. :) I'll scan some and post them later.

Joseph now has disability Medicaid. The kind that, for now at least (thanks Kasich) is unmanaged so we can use it to pay for a home health aide to come and help him with daily living stuff and play with him in the mornings before school so that we can get something done without having to turn the TV on to babysit him. Eventually, this will also pay for ABA aides. We're still looking for an aide at this point.

I think that's everything of note about Joseph. I started a new post back at the end of August about the experience of having a baby after getting an ADHD dx for one kid and an autism dx for the the other. But it sort of went off the rails. I think I need to delete the draft and start it over from the beginning. There's still something there that I need to say.