Thursday, September 15, 2011

ADHD.... the continuing saga....

It's been a while since I posted about the house where ADHD lives and I thought I'd share some of the current struggles (and successes?)


Eli is off his meds. We had really good success with medication early on. If you've been reading this blog since the beginning, you'll recall that he was diagnosed with ADHD and giftedness (ask me which one causes more trouble... you'd be surprised what the answer is.... hint... it does not start with "A") in Grade One and after much research and stress, we opted to include medication as part of his treatment (I hate that word.... it shouldn't be 'treatment'... it should be something like 'life skills tool kit'). We started with 18mg of Concerta (a long-acting form of Ritalin... sort of) and it was amazing how much it helped Eli maintain his focus. All of my worries and stresses about his diagnosis and the medication were gone.... As time marched on and Eli grew, we had to increase his dose, first to 36mg and then to 54mg. Once Eli was at 54mg we started to notice that the side-effects were outweighing the benefits (lack of appetite, inability to fall asleep and evening re-bound were the main ones) and reduced his dosage back to 36mg, but it just didn't seem to work that well any more. Concerta is supposed to be a 10-12 hr medication, but we noticed that it would only really last for 5-6 hrs and when it wore off, he would re-bound dramatically (think ADHD on steroids). We began discussing alternatives with his doctor and in the end, decided to try a new medication that has only recently been approved for use in Canada called Vyvanse. Vyvanse is a difference class of medication from Ritalin and is closely related to Aderall. Vyvanse is a 24hr medication and is a prodrug, which means that it won't work unless ingested, which is supposed to help discourage addicts from mixing it in with other drugs and injecting it, but I digress. It seemed to work really well for about 4 months and then we started to notice a few weird little..... things..... He started to pick his face to the point where he would have big cold-sore looking holes all around his mouth, for one,  and he wouldn't leave them alone, so they wouldn't heal. My first thought was to increase the dose to decrease the fidgeting that was causing the picking and to that end we did...... and it worked (although the doctor did say that the picking could be caused by the drugs and to watch him closely)... for a few weeks..... but all of the behaviours returned and he added a couple of new ones for good measure. He escalated his penchant for verbal disagreements (that's my fancy way of saying that he was a MOUTHY little..... uhhhhhh... you fill in the last part.... ) and began exhibiting almost manic hyperactiveness in the evenings which made his old re-bounding seem like a quiet day at the beach. Then one day, he was quiet (relatively speaking... even quiet, both my kids are about 1,000 times louder than any other kids I know).... kind, helpful and sweet, with only the normal amount of disagreeable backtalk that I was used to (and expected from a 10 year old boy who is probably smarter than I am).....  and I thought to myself... if only he could be like this EVERY day, challenging, but not strait-jacket inducing.....  When I tucked him into bed that night he looked at me sheepishly and told me he had forgotten his meds that day (I gave him responsibility for his meds last spring and he has only forgotten to take them 3 or 4 times since then, that's a 98% success rate... pretty good, I'd say)...... the little lightbulb in my brain went on and I spent some time reading about the rarer side effects of the drug. At that point,  I decided to take him off his meds until I could speak to the doctor.

Honestly, I haven't noticed much difference between off and on (once we were over the rebound days.... I don't like saying withdrawl)....and the things I have noticed have been mostly positive. He's stopped picking his face and he's more consistent in his energy levels (which are higher, I'll admit... but not manic). His teacher says that he's mostly paying attention at school, with occasional parts of the day where he can't seem to focus. He does fidget a LOT more and is back to making his weird noises, but we're going to try some focusing exercises at home to see if we can't do some mental retraining and help him to learn how to manage his ADHD.....

One of the things we're going to try is an exercise where he will throw a ball into the air and catch it (small, controlled throws) while he focuses on what it feels like to pay attention. I will talk to him about how he feels during the exercise and we will begin with the word "focus" which I'm hoping will eventually snap him out of his distraction and get his brain focused on his tasks again. We will only do this for one minute to start and work our way up to (I'm hoping) 10 minutes or more.

Another thing we'll try are games where paying attention is crucial: "Simon Says," "What's in the picture (show a picture for a few seconds have have them name 10 things they saw in the picture)," "How long can you sit still and quiet" and working up to "Super Distractor (a game where you assign the child a task and time how long it takes to finish, while you do EVERYTHING in your power to distract him/her from their task)." I'm hoping that by spending 15-30 minutes after school with these exercises, we can start to give BOTH kids more tools to focus and concentrate at school..... because Chey has picked up quite a few of her brother's..... hmmmm... shall I say........ less appealing, attributes......

I also found a website that we might try, once I've done more research on it....

I've got my fingers crossed that these methods will work, but if not..... medication is not a bad thing and we all need to remember that... Even though I've read a million books, articles, forums and websites about ADHD and I am surrounded by it at home... I STILL carry some of the prejudices regarding ADHD and the treatments for it... And every once in a while, I'm surprised at how deep those prejudices are......

We will find the right combination for Eli..... someday......

1 comment:

  1. All I can say is...Eli is lucky to have you on his side. You are doing an amazing job at helping your boy and he'll always have his family to thank for sticking with him through all of this.

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