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Tuesday, February 22, 2011

Our Family's ADHD Journey - Part Two

(If you missed Part One, you can find it HERE.)

Last April, when I took The Archangel for his annual well child check-up, I talked to our doctor about his (The Archangel, not our doctor's...LOL!) behaviors & hyperactivity. Based on my descriptions & The Archangel's constant movement & interruptions in the office that day, he said that it definitely was ADHD. We decided to try medicine.

I've learned over the past year that there are MANY medicines used to treat ADHD & they fall into four main categories: stimulants, non-stimulants, anti-depressants, & anti-hypertensives (originally for blood pressure). Doctors always start w/ the lowest dose & go from there. As you can probably guess, there is no quick fix, toss back a Ritalin, & be good to go! EVERY child w/ ADHD is different & many have other disorders, too (depression, ODD, OCD, Tourette Syndrome, etc.) Therefore, treatment is through a process of trial & error, lasting many months in most cases.

Whatever meds we would go with, we had to watch side effects. The most common w/ many of the meds is a loss of appetite. The Archangel has always been a little guy, barely on the weight growth chart at times. He's grown steadily, just not a lot & he's also been a VERY picky eater. Add that to the fact that he's always on the go, burning off those few consumed calories, you can see our concerns.

The first med we tried was Concerta, a stimulant. For one month there was no change in the hyperactivity, but the anger/aggressiveness increased drastically. We returned to the doctor & this time tried a non-stimulant (Strattera). While the anger/aggression went back to how it was previously, three different doses had absolutely no effect on him. Four months down...how many to go?

At this point, our doctor felt it was time for some psychological intervention & referred us to the behavioral department of one of the smaller branches of our local children's hospital. For the first month or so, The Archangel met w/ a psychologist every other week to talk about his feelings & discuss ways to help calm himself. After a couple of months & her assessment, we decided to try another med. This required yet another doctor...a psychiatrist.

After speaking to the psychiatrist, he suggested a fairly newer med, a non-stimulant called Intuniv that is supposed to be good for hyperactivity & aggression. The lowest dose is 1 mg & it usually takes about a week before you see any changes. The biggest side effect is drowsiness, which I figured would be manageable. Being homeschooled, he could take a nap if he needed to in the afternoon.

Let me say that the first week on Intuniv was Hell! Days one & two weren't bad, but by day three he was on the biggest emotional roller...EVER! The tiniest thing would set him off, sobbing uncontrollably for at least 20 minutes at a time. One instance in particular stands out.

He was in the basement playing w/ his siblings & The Saint took his bag of Lego mini-figures & dumped them in w/ the rest of his Legos. The Archangel came stomping up the stairs in tears, even though The Prophet offered to help him sort the Legos back out. He curled up on the couch, sobbing. After about 20 minutes of this, he finally cried himself to sleep. Many people get grumpy or emotional when they are tired. I think, in his case, the drowsiness hit him like a ton of bricks & he didn't know how to handle it. He did not want to be touched or consoled. No one could talk to him or even go near him. When he woke up about a hour later, he was still upset, but would at least let me hold him some.

After a couple more days of emotions (& they usually occurred around 3pm), his system started to get used to the medicine. We had a few outbursts here & there, but the hyperactivity didn't change one bit! The psychiatrist said that we could raise the dose to 2mg if we felt the need, but I hesitated. It was the beginning of December...Advent & Christmas preparations were in full swing, & all of the munchkins were excited & hyper. We decided to continue w/ the current dose until January when we returned to our school schedule.

(To Be Continued)

1 comments:

Angela said...

Love the new look, btw.

I wish that I had the ability to burn calories like that.

But I also wish that there were easy answers for you. e