Is it okay to just ask for some hugs?

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Registered: 03-26-2003
Is it okay to just ask for some hugs?
7
Sat, 04-05-2003 - 7:35pm
Hi all. I posted last week about my 6.5 YO son starting on Strattera. He had been on Ritalin, but had developed a facial tic that alarmed our PED, and had some issues with appetite suppression (something my already-peanut kid does NOT need!) so we are going the Strattera route for now.

DS had NEVER, ever had any problems in school WRT to ADD - he is in the gifted program, and by all accounts he is a nice, polite, funny, enthusistic kid who participates in class, does great work, and gets along with his teachers and peers. (Sometimes I almost wish he *lived* at school if you know what I mean!) He was totally off of the Ritalin as of last Friday, started an 18 mg dose of Strattera on Thursday, and started the full 25 mg dose of the Strattera on Monday, so at this point he has been on Strattera for about a week. I sent a note into his regular teacher, his gifted pull-out teacher, and the school nurse when he started on the Strattera, just to give them a "heads up" and ask them to keep me posted if anything just didn't feel "right". On Friday (yesterday), I sent a note in for his regular teacher, asking her for feedback on how ds had fared last week. (Now, remember, the one thing I could ALWAYS count on with ds was really great behavior and "performance" at school) ...

He has been calling out consistently all week, 3 or 4 times a day (never before an issue). His concentration/focus in the afternoons is still not great (this was an issue on the Ritalin, too). He pulled the hair of one of his classmates -- hard, apparently, since he actually pulled a strand out -- and when the teacher asked him why, he said "I don't know" (he has NEVER been physical with anyone but dh and me). (He later told me that she had plopped in front of him on the floor when the teacher was going over something and he couldn't see. Ohhhh-kay. Myself, I would have gone for a simple "excuse me", but whatever ...)

Our weekend so far has been hellacious. I have had sneakers thrown at me. My hand pinched. My arm kicked. My hair pulled. DS has been fresh, rude, and belligerent. He has spent more time in his room than out. Trying to get him to straighten up his bedroom, and to write notes of apology to his teacher and the girl whose hair he pulled, was like banging our heads against a brick wall. But, he also had a great tennis class this morning, and we had a nice trip to Barnes and Noble in the afternoon. So, I see, heartbreakingly, glimmers of some *really* good stuff in-between, but the cr*p is just getting tough to take. Especially since most of these issues had been either non-issues or pretty minimal with the Ritalin. I know that, compared to what some people put up with, this is *nothing*, and I am so sorry to be such a whiner.

My other fear is that this (hopefully temporarily) aberrant behavior will be reflected on ds' report card. His teacher this year has been *great* in terms of challenging him where he needs it cognitively while recognizing *and* dealing with his "focus" issues when they arise. But, she knows ds and what an awesome kid he is. She also knows that he *has* been really well-behaved all year til now. I am just afraid that if he gets marked down in behavior, his teacher for next year who *doesn't* know anything else about him other than his name will see that and -- along with knowing that he is being treated for ADD/ADHD -- she will prejudge him and he will come into the class already at a disadvantage. Unfortunately, report cards come out in a couple of weeks and one of those weeks is Spring break.

I spoke with our PED yesterday (who is typically a WONDERFUL doctor and who we trust and respect), and he would like to keep ds on the Strattera for at least another week, since there is that whole "4 - 6 week" issue. I need to call him (the PED) with an update toward the end of next week. So, not a lot of time to "rebound" in the good sense of the word. My stomach is in knots here.

I will reply to his teacher's note on Monday just to let her know what is going on. I am also going to e-mail his pull-out teacher and see how he's been doing in there. That class requires a lot of critical thinking "outside the box" and deductive reasoning ... and that stuff is not exactly ds' forte when his ADD/HD is "in the house".

Oh, and I asked the PED about possibly mixing in another med *with* the Strattera, at least until it is completely in ds' system. He is not comfortable with doing that, and said that if we wind up having to go that route we will need to start in with a psych. The thought of starting "over" is rather intimidating right now.

I'm tired, you guys. Does this ever get better? Or am I gonna have to learn to suck it up and DEAL a heck of a lot better than I am? Right now, ds is reading in his bed, kind of winding down for a bit before he goes to sleep (he LOVES to read). Aside from yet another time-out about an hour ago, he actually had a good bedtime - pajamas on, teeth brushed without a major (or even minor!) blow-up. He is being sweet as can be. My sweet, funny, bright, awesome kiddo. This is just so frustrating, and heartbreaking.

I am sorry that this is running on so long. I just needed to talk to someone, anyone, who "gets it". Any words of wisdom, kicks in the pants, or just plain old shoulders to lean on will be GREATLY appreciated!! Thanks! ~ ruth

Avatar for keke0116
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Registered: 03-26-2003
Sun, 04-06-2003 - 7:43am
Big (((HUGS))) to you, Ruth! I do know how you feel. My DS, Kevin (now 11) has both ADHD and ODD, and we dealt with the ODD for years before learning of the ADHD diagnosis, and he's also in a pull out gifted program, and generally does very well in school. I think the fact that the teachers already KNOW your son and what a great kid he is, and they know he is in the midst of a med-change, will allow them to be more lenient in their assessment of his behavior when it comes to report cards. AND, if not, then you need to explain next year to the teacher why there was a problem. They will see all 4 semesters and not just one, and they will be able to recognize that there were probably extenuating circumstances.

Kevin, too, recently switched over to Strattera (from Concerta.) The Concerta really was a wonder-drug for him, helping with the ODD behaviors (miraculously!) as well as the ADHD issues. About 2-3 months ago, however, after 15-16 months on it, we felt the Concerta was losing it's effectiveness. Rather than increasing the dose, the doc tried Strattera ... and we've increased this up to 60 mg, without seeing the same (good) results we did on the Concerta. Kevin was getting giddy and goofy (almost 'hyper') in the afternoons ... which, for us, was bizarre because despite the ADHD diagnosis, he is NOT hyper! I called the doc and suggested we either split the dose of Strattera (like 40 mg in the a.m. and another 18 or 24 after school) ~OR~ go back on Concerta. What our doc did is add 18 mg of Concerta (he had been on 36) to the Strattera and so far (knock wood) this seems to help. The added boost of the stimulant seems to be making/helping the Strattera do what it's supposed to. No problems with appetite or anything either.

Sometimes the Strattera needs a little help to get the full effect. Also, remember that the Strattera is advertised as having '24 hour effect' but that's more of a marketing ploy. What the doc said to us is that it really just has a 'longer effect' than some of the others ... and is NOT truly 24-hours. Kevin has been on Strattera for about 8 weeks, during that time we were increasing, so it's probably been about 4 weeks on the 60 mg dose, and another 2 with the Concerta boost ... and we are (finally!) seeing the results we'd hoped for. If the doc doesn't want to add a 2nd med to help the Strattera, then perhaps an increase in the total daily dose, but splitting the timing, might be an option. It comes in 18 mg, 24 mg, 40 mg, and 60 mg ... I think ... so perhaps 18 each in the a.m. and after school might be an option ... ?

Also, ask the doc what effect caffeine might have on this. I've been told in the past that often caffeine helps calm down these kids. Think about it ... most kids get a little hyper when given caffeine. Our kids calm down when are given a stimulant. SO, if they have a boost of caffeine, it may have the opposite effect on them. If he has some coke or chocolate, might that be enough of a 'stimulant' to help calm him a bit? (Possibly worth trying on the weekend when he's home with you to see if there's any effect at all ... ?)

As far as consequencing, I'm not big on punishing a kid for behaviors he can't control ... this comes from my years of dealing with "ODD issues" ... and find that it only increases their frustration level. Focusing on the positive and ignoring (as much as possible) some of the negatives tends to generate more positive behaviors. Especially during a med change. It's so hard because it's so frustrating ... but as much turmoil as they cause, their 24/7 inner turmoil is so much harder. So, on that count, I'd say you need to try to overlook as much of the difficult behaviors right now as you can while the med is taking effect or you'll both just end up more frustrated.

(((HUGS))) and Good Luck! You will get through this.

Nancy

Nancy 

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Registered: 04-08-2003
Tue, 04-08-2003 - 4:46pm
Oh This is so familiar. Todd is 8 and was on Concerta for two years and it worked great except in the end he developed an AWFUL facial tic and vocal tic. His behaviour was not what it used to be either. So, we tried Adderall. Nightmare. Then Foclin, which is Ritalin but configured different and that was great, although it only lasted 4 hours. But the tic came back. Next we tried the Stratera and that just didnt' seem to be enough. He still had the tic, so back to the Focalin. I am thinking if the tic won't go away, I may lose my nerves. He CAN'T go without meds, as much as I would like that- it isn't fair for him.

When I switch meds, I was advised NOT to tell the teachers so we could get some unbiased feedback.

Good luck, I am still searching.
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Registered: 04-08-2003
Wed, 04-09-2003 - 8:10am
Many, many, many hugs to you Ruth! We are here for you - don't forget that. I am sorry that you have been having such a rough time of it lately. Take some time for you and go take a walk, a long hot bath, or go to a movie. We need to take good care of ourselves so we can take care of our great kids.

I am hear to listen whenever you need to "vent" or boast!!

Nancy

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Registered: 03-26-2003
Wed, 04-09-2003 - 9:20am
Thanks so much, Nancy! It helps to know that I am not the only one in this big ol' lonely boat!! Thanks, too, for some great ideas to think about. I will keep you guys posted if that's okay. I'm so glad I found your board!! ~ ruth

iVillage Member
Registered: 03-26-2003
Wed, 04-09-2003 - 9:25am
Thanks so much for the feedback, and for your kind words. Knowing that I am not alone in this means more to me than you can imagine (well, perhaps you can!)

You've offered an interesting perspective on telling/not telling TPTB at school about med switches. I have told the teachers/nurse when we have switched meds because 1) ds was taking a mid-day dose of Ritalin which he no longer goes to the nurse's office to take (concerta didn't work well for him, he needed the "boost" of the stimulant med after lunch) and 2) I am neurotic! I am always a little worried about some unforeseen side effect with a new med (for anyone!) and I feel better if the nurse and the teacher know exactly what he is taking, so that if he does seem "off" they may react more quickly. Like I said, neurotic ! But, your "take" makes a lot of sense, too.

Thanks again! I really appreciate your thoughts! ~ ruth

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Registered: 03-26-2003
Wed, 04-09-2003 - 9:33am
{{{Nancy}}} I am actually teary-eyed over all of the support and insight I have received in response to my whiny post!!! I know (rationally) that I have so little to stress about with regard to ds as compared with other parents; I try to keep that in mind "in the heat of the moment", but sometimes I am more successful than others, ya know? I guess that even though some people have paper cuts and some have broken legs, that doesn't make the paper cuts any less "ouchy" (okay, bad analogy, but you get my point I hope!)

It means so much to know that I am not alone out here with all of this. I suspect that I am at the beginning of a looooooong and sometimes-arduous journey. I love my ds to pieces and wouldn't trade him for the world, but sometimes I just get ... tired. I look at so many other parents who seem to have it so "easy" (though, of course one never knows the WHOLE picture) and think, "why can't *my* life be like that, rather than this roller coaster ride?" But, it can't. So, I am trying my darnedest to make the most of it, and even enjoy the ride along the way!

Sorry to ramble! I am really glad that I found this board and all of you amazing people. I hope you don't mind if I join in from time to time. Thanks again! ~ ruth

iVillage Member
Registered: 04-08-2003
Wed, 04-09-2003 - 1:23pm
You join in anytime and your post was far from whiny, my friend. It is very tough some days isn't it? Please remember that's what we are here for. Vent anytime and always remember you are not alone.

Nancy