Thursday, January 14, 2010

How we got here

Many of you have asked how little man was diagnosed. This was the diagnostic criterion used by his pediatrician in aiding in the diagnosis. We (the Dr, my husband, my parents, my husband’s parents, teachers, aunts, and uncles) had all seen these symptoms manifesting in my man since an early age. Approximately 3 years ago, his doctor started paying attention and commenting on his behavior. I have to say that we are blessed, we have a pediatrician that we know, love, and trust. Not only is he a family friend, he was our doctor (my brother, sister, and I) when we were little.
Little man’s teacher mentioned something when we had our first conference (of many) in regards to little man’s lack of attention and focus in the classroom. She said it was something to keep in the back of our minds.
The school counselor had gone into the classroom as asked by our pediatrician to monitor his behavior in the classroom for one day to see what she saw.
So little man’s teachers, school counselor, hubbie, his doctor and myself all completed evaluation forms. The questionnaire had questions about home, school, and social interactions in addition to interactions with his siblings.
And without further ado the diagnostic tool (I was actually familiar with the DSM from my rotation in psych nursing during nursing school):

Symptoms and Diagnostic Criteria from Diagnostic and Statistical Manual of Mental Disorders (DSM) – information from ADHD Help.org
AD/HD - Predominantly Inattentive Type

Fails to give close attention to details or makes careless mistakes.
Has difficulty sustaining attention.
Does not appear to listen.
Struggles to follow through on instructions.
Has difficulty with organization.
Avoids or dislikes tasks requiring sustained mental effort.
Loses things.
Is easily distracted.
Is forgetful in daily activities.

AD/HD - Predominantly Hyperactive/Impulsive Type

Fidgets with hands or feet or squirms in chair.
Has difficulty remaining seated.
Runs about or climbs excessively.
Difficulty engaging in activities quietly.
Acts as if driven by a motor.
Talks excessively.
Blurts out answers before questions have been completed.
Difficulty waiting or taking turns.
Interrupts or intrudes upon others.

AD/HD - Combined Type

Individual meets both sets of inattention and hyperactive/impulsive criteria.


In order to meet the criteria – individuals must meet these symptoms for greater than 6 months and display at minimum 6 of these characteristics. The symptoms must also be present in at least 2 areas of the child’s life at home, school, or social settings.


AD/HD medication is supposed to be used in conjunction with behavior modification and diet control (reducing refined sugars is a major component). When little man’s teacher had first mentioned we might have issue, I read the research and reduced what little refined sugar we (I mean the kids) were eating. Little man never (okay never might be a little strong rarely might be more appropriate) got a pop tart for breakfast. Typically breakfast is oatmeal or toast and egg, perhaps a banana and yogurt. He never eats sugary cereal. I actually didn’t have to do much to change diet. Thank goodness I love to cook!

Behavior modifications. We had read several books in the last few months about managing stubborn children, raising difficult children. We had changed several things around the house to assist us in dealing with little man’s “stubborn” behavior. We also have met with his teacher, the school counselor, and his assistant teacher in working on various different approaches to him in the classroom. I also volunteered as often as I could in the classroom on my days off, so I could spend more time with him trying to catch him up on the class work. So many of AD/HD behavior modifications, we were already trying. So we weren’t going to be able to do much there either.

So, I just called the doctor’s office….against what hubbie and I had initially felt, we feel that we must put our prejudices aside and for our little man’s success in school – we have to put him on some type of medication.

Our Concerns:

1. AD/HD medications can cause drug use later in life. Thankfully the above referenced website contained many studies which indicate that AD/HD medications are not necessarily gateway drugs. Thank goodness. These studies also state that children who are not treated for AD/HD and suffer from lack of success in school and low self-esteem are more likely to use drugs than their peers.
2. Little man would become a zombie and lose his awesome personality. Never fear, the dr understood our concern on this front. He initially doses the boy at half-strength to see how his behavior reacts. He will be seeing us every 3 months to determine whether or not the medication is effective and if so adjusts will be made. He will also be monitoring his overall health: blood pressure, weight gain, sleeping habits, etc.
3. This would stifle the person that he is meant to become. Would Picasso have been the painter that he was if his ADD had been treated? Our ped seems to think so, he didn’t create his wonderful works until adulthood. Our ped kept referring to the medicine as a crutch that our boy needs to get thru school successfully.


Our hearts were so torn…but we remembered a promise. We made his biological mother a promise. We would help little man to become the best man that he could be. Part of that is recognizing that he may help getting through school. We have to keep in mind his genetics. We don’t know all of his biological makeup. We always hoped that we could nurture past any nature things. But, nope we can’t make neuro receptors respond to dopamine or norepinephrine. Sad but true.

We (husband and I) have to recognize that like depression or any other mental illness that there is a chemical imbalance in our little man’s brain. I wouldn’t ask someone who maintained a healthy lifestyle but continued to struggle with high blood pressure or diabetes not to treat their illness with medication.

More on this to come – baby duty and housecleaning calls….

5 comments:

Anonymous said...

very informative, you have definately done your research. Hope all goes well for your family!

Christina

Krissy said...

It's hard to know what is the right choice. Good for you for doing your research and making sure your concerns were addressed. Good luck! I'm sure you will make the right decision for your little man!

Wendy said...

Having an adhd diagnosis is the first step in helping them. If you have any questions (since I have been dealing with this for almost 8 yrs) feel free to ask me. It will get better just have patience with him, the meds and yourself!

MisAdventuresofMomof3 said...

Thanks everyone! We need ALL the support we can get. I can tell this is going to be a very bumpy road.

Wendy - so we started Adderall 5mg (generic) yesterday. He was fine all day until around 5:30 and then he cried uncontrollably for 3 hours. It was awful and so sad. Is that normal? This coming down behavior? What was your experience with Adderall? We are just nervous as we are supposed to increase his dose to eventually 15 mg....

Diane Schmidt said...

I'm following from #FF.
(Thanks for visiting my blog and following) I scrolled down and read this post and I'm feel like I wrote it a few years ago. If your interested we can exchange emails. Since It's my first visit to you blog I haven't figured out your sons age exactly 6-7ish?