And Now On To The Next Phase

We had another doctor's appointment this afternoon.  Since increasing Brandon's medication two weeks ago, he has improved significantly in the main behavior areas of ADHD.  Where he continues to struggle is with his social cues and lack of a filter.  When Brandon gets an answer wrong in class, he will often yell back at the teacher, or start to cry.  He often tries to be the teacher and tell everyone what to do.  These are symptoms of the impulsivity side of ADHD.

Now that Brandon has improved quite a bit, the doctor has told me it's time to move on to the counseling side of his treatment.  I was hoping that this was the next step.  Counseling is where Brandon will be taught how to handle the "real world" situations that he currently struggles with.  I work with him everyday to remember to only worry about himself, to not act like he's the teacher.  I tell him every night that it's okay to get questions wrong at school.  I'm excited that Brandon will have the chance to work with someone who does this for a living.  And I'm excited to see the new, positive changes that this phase will bring.  Counseling will start 2 or 3 times a week, and then taper off from there.

I do have a few reservations.  I'm hoping that the counseling is more like this:

and not like this:

Counseling, yes:  psychiatry, no.

As we come to the end of this school year, I want everyone to know just how grateful I am to all of Brandon's wonderful teachers.  They have been so patient, kind, understanding, and loving.  They have worked with me, listened to me, updated me.  This process has been made easier because of their involvement.

Could It Already Be Working?

We are just over a week into the increased medication dose with Brandon and it looks like things might be turning around a little for Brandon.  His teachers are reporting that he is doing better at focusing in class, and sitting in his chair; he's also not walking around the room at inappropriate times.  He is much more in control of his emotions, and can handle himself better throughout the entire school day.

It hasn't been all smooth sailing though.  Today, Brandon had a pretty big meltdown.  Some of his classwork was misplaced, and even though Brandon knew that he had turned it in he had to move a card for not having it done.  Brandon has been working very hard the past 4 weeks to always have his card stay on green, so moving to yellow was upsetting for him.  (For those of you who are unfamiliar with what card moves are, it's the behavior system for Excelsior Academy. When a scholar in unprepared, or is disrespectful, etc., they move a colored card to help remind them to work harder)

Anyway, once Brandon was back in control of his emotions, and no longer screaming in the hallway (yikes!), he and his teacher talked about how sometimes mistakes will happen and when they do, we might have to do work over again.  His teacher also told me Brandon hadn't moved his card yet prior to their conversation.  He suddenly says to her, "Oh, I forgot to move my card.  Let me fix that."  Then he moved his card and was proud of himself for doing it.  The best part about this is that before he began medication, a meltdown like this would've tanked the rest of his day.  Today, he was able to completely turn his behavior and attitude around.

I originally heard about his meltdown during my lunch break.  Other teacher's had seen what was happening and let me know.  Brandon is in his math class while I'm at lunch.  Each day, I wait for Brandon after math and walk with him back to his homeroom class.  He lets me know how his day has been going.  After hearing about his meltdown, I was sure that he would break into tears when he saw me, like he has done so many times in the past.  Instead of looking defeated and crying, he had a slight smile on his face while he told me about what happened.  I was very proud of him.

After school he came running upstairs to my room and yelled with joy, "Mommy, I stayed on yellow...I did it!"

We're only a month into this process with Brandon.  I went back and forth about this decision for a while before finally taking him to the doctor.  For Brandon, treating him has made all the difference. There's not a doubt in my mind that I made the right decision.

Let The Games Begin

Thursday Brandon had his first check up since beginning his ADHD medication.  Thankfully he hasn't suffered any of the side effects like nausea, or appetite suppression.  When I emailed his teacher's and asked them how they thought he has been doing the past 10 days, I was really surprised.  His reading teacher (beginning of the day) told me that he's been a rock star; showing a complete turn around; talking out so much less, and able to focus so much more.  I was thrilled to hear that.

When we turn to math and spelling however, things look very different.  This teacher told me that Brandon is almost worse.  He's talking out even more, especially during spelling, which didn't happen very often in the past.  Brandon has begun shouting across the room, and getting very upset if he has the wrong answer to a problem.

His homeroom teacher also reported that Brandon is more emotional, especially if he's asked to move a card for displaying inappropriate behavior in class.  It's this emotional turn that has me the most concerned, and was the highlight of my discussion with the doctor.

Apparently this surge in emotions is normal as Brandon's body adjusts to the medication.  These next 2 weeks will tell us which direction to go next.  If his emotions get worse since we increased the dose just a bit, we'll know it's the medication that is the problem and we will change that.  If his emotions level off, or remain the same, we'll know to increase the dose he's taking.

I also found out that the higher the level of medication, the longer it will stay in his system.  I was happy to hear this because I'd already pushed back the time I give him the medication once.  Any later and it wouldn't work during the beginning of the day.  Even with taking it later, the medication has been running out before school is over.  So having it last longer will be a great advantage for everyone.

Now the medication games begin.  Which one will work, which dose is the most effective....all the games I've been playing with my own medication for the past 16 years.

The Pharmacy Trip From Hell

Yesterday morning I called Brandon's pediatrician to find out if they had heard back from the insurance company regarding his medication.  I come to find out that there was no authorization needed for his medication, so I've waited almost 7 days for nothing.  Fun.  His medication can't be faxed to a pharmacy, so I needed to get the doctor's signature on an actual script.  Of course, the doctor wasn't in his office yesterday, so I was stuck.

I called them this morning to remind them.  I finally received a call at 3pm telling me that Brandon's script was ready.  We stopped by on the way home from school.  Luckily I called the Macey's pharmacy to see if they had the medication in their pharmacy BEFORE I went there.  I WANT TO GET THIS STARTED! Turns out, Macey's doesn't even offer the medication that Brandon needs!  So, it was off to the pharmacy from hell:  Walmart.  (Dun, dun, dun!!!)  I already hate Walmart as it is...don't EVEN get me started on their pharmacy.  Long lines, ridiculously long waits, that's why I prefer Macey's!

The script is for only 14 days, and then we'll evaluate if the medication is working, and decide what to do next.  I've already spoken to my insurance company, so I know that all ADHD medications are in the 3rd tier, which means this medicine will cost $60...FABULOUS, because I'm made of money.

I turned the script in, and was told that they only had 10 of the 14 pills I need.  Wonderful. Walmart only orders medication once a week, (unlike most pharmacy's that will order the medication the next day if a customer needs it!) so if I wanted the entire script, I would have to wait until next Thursday to get it.  I could choose to get the 10 pills, but then I would have to go and get another script from the doctor.  Macey's would've filled the script and then ordered the 4 remaining pills, saving me another phone call and trip to the doctor.  Stupid Walmart.

Again, I WANT TO GET THIS STARTED, so I decided to take the 10 pills and go back to the doctor tomorrow for the new script for the remaining 4.  I was hoping that since I was only getting 10 pills that it wouldn't cost $60.  I was told it would take about 30 minutes, so Brandon and I went walking around Walmart...just how I want to spend my afternoon!

About 20 minutes into the wait, I hear my name over the PA system calling me back to the pharmacy...that can't be a good sign.  We head back and they made a mistake with the insurance.  I also discovered that 10 pills were going to cost me $60!  Whether it's a 30 day supply or 10 pills, it's the same copay.  Stupid insurance.  The nice lady put my script on "critical", which means GET MOVING ON IT, since she made a mistake.  I appreciated that.  We FINALLY got out of there 60 minutes later!

Brandon is oddly excited about starting the medication that is going to help him "sit quietly in his chair, and not shout out".  What bothers me now is that in 10 days we'll have to pay ANOTHER $60 for medication.  Eventually we'll be on a regular schedule with Brandon's medicine, and won't have to pay so much, so often.  And the bottom line is that as long as it works, it will be worth it.

So tomorrow we begin.  Hopefully Brandon won't suffer from any side effects.  And now that the script has been filled at Walmart once, they now have it on file and will be ordering it so that it will be in the pharmacy from now on.  A light at the end of the tunnel....yippie!

ADHD: Facts and Myths

As we await the phone call from Brandon's doctor saying the insurance company has given the "ok" for the medication that has been recommended for Brandon, I have continued to do research on ADHD.  There seem to be two VERY distinct takes on ADHD:

I decided to find a list of myths and facts about ADHD.  The first list is from the website helpguide.org.

Myth #1:  All kids with ADD/ADHD are hyperactive.

Fact:  Some children with ADD/ADHD are hyperactive, but many others with attention problems are not.  Children with ADD/ADHD who are inattentive, but not overly active, may appear to be spacey and unmotivated.

Myth #2:  Kids with ADD/ADHD can never pay attention.

Fact:  Children with ADD/ADHD are often able to concentrate on activities they enjoy.  But no matter how hard they try, they have trouble maintaining focus when the task at hand is boring or repetitive.

Myth #3:  Kids with ADD/ADHD could behave better if they wanted to.

Fact:  Children with ADD/ADHD may do their best to be good, but are still unable to sit still, stay quiet, or pay attention.  They may appear disobedient, but that doesn't mean they're acting out on purpose.

Myth #4:  Kids will eventually grow out of ADD/ADHD.

Fact:  ADD/ADHD often continues into adulthood, so don't wait for your child to outgrow the problem.  Treatment can help your child learn to manage and minimize the symptoms.

Myth #5:  Medication is the best treatment option for ADD/ADHD.

Fact:  Medication is often prescribed for ADD, but it might not be the best option for your child. Effective treatment for ADD/ADHD also includes education, behavior therapy, support at home and school, exercise, and proper nutrition.

This list is from the WebMD website.

Myth	Fact
There is no such medical condition as ADHD.	ADHD is a medical disorder, not a condition of the child's will. A child with ADHD does not choose to misbehave.
ADHD is caused by bad parenting. All the child needs is good discipline.	ADHD is not caused by bad parenting. But parenting techniques can often improve some symptoms and make others worse.
ADHD is a life sentence.	Although ADHD symptoms usually continue into adulthood, the person learns ways to cope with the symptoms. People with ADHD have plenty of energy, are creative, and can often accomplish more than people who do not have the condition.
Having ADHD means the person is lazy or dumb.	ADHD has nothing to do with a person's intellectual ability. Some highly intelligent people have ADHD.
The diagnosis of ADHD is confirmed if certain medicines (psychostimulants) have a positive effect on what seem to be symptoms of ADHD.	Children without ADHD respond to psychostimulants similarly to children with ADHD. A trial of medicine is not used to diagnose the condition.
Medicine for ADHD will make a person seem drugged.	Properly adjusted medicine for ADHD sharpens a person's focus and increases his or her ability to control behavior.
Medicine prescriptions for ADHD have greatly increased in the past few years, because the condition is being overdiagnosed.	ADHD is estimated to affect about 3 to 7 out of 100 school-age children in the United States.1There is little evidence to support claims that ADHD is overdiagnosed and that ADHD medicines are overprescribed.
Psychostimulants are no longer useful after puberty.	Teens and adults with ADHD continue to benefit from medicine treatment.
Children with ADHD are learning to use the condition as an excuse for their behavior.	ADHD is a disability. Children with ADHD have to learn ways to deal with their symptoms (inattention, impulsivity, and hyperactivity) that cause them to have difficulties in life.
Children outgrow ADHD.	About 70 out of 100 children with ADHD continue to have symptoms during their teen years and about 50 out of 100 have symptoms into adulthood.2
If a child has ADHD, he or she can always be diagnosed in the doctor's office.	A child may not always show symptoms of ADHD, especially in an unfamiliar setting. Evaluating a child from one office observation may result in failure to recognize or diagnose symptoms.

A lot of these facts line up exactly with what I believe about ADHD.  I do believe that ADHD has been over diagnosed through out the years.  However, I know that something just isn't right with Brandon. After spending the past year and a half wondering what has been going on, I believe that Brandon struggles with many things on these two lists.  I also feel very strongly that medication alone is not the answer. I'm not trying to just medicate my child to make it all go away.

I look forward to hearing back from the doctor so that we can begin this process while Brandon is still in school.  He struggles with this the most there, and they're only about 30 days left until summer break. I'm also grateful for all my supportive friends and family; you guys are fabulous!

Something Just Isn't Right

Brandon has always been full of energy.  He loves to dance, sing, run, you name it.  He's always been a normal, regular boy.  When we moved to Utah and Brandon began attending his last year of preschool, something began to change.  I would hear more and more about how he had trouble keeping quiet, listening to teachers, etc.  As a teacher, and someone who prides myself on my child behaving, this news was very upsetting.  It continued through the first half of his Kindergarten year, getting worse and worse.

We moved to Tooele, Utah in February of 2013 because I obtained a teaching job at a wonderful charter school; half-way through the school year.  Even in this new, far more structured setting, Brandon was still having trouble talking out all the time, keeping his hands to himself, and was an overall disruption.  I was devestated.

At one point, his teacher brought up the possibility of ADHD.  I hadn't thought about it because Brandon was only 6, and he had just moved to a new, VERY different school.  I was also MORTIFIED by the thought of ADHD.  "Isn't that the "disorder" that doctor's diagnose every child with who can't sit still?"  This was my first reaction.  I let the thought go, and where Brandon was far from perfect, he made it through Kindergarten.

1st grade is when everything changed again.  Brandon became THAT student in class.  The student with the constant behavior problems.  The student who had to sit by himself because he wouldn't leave those around him alone.  The student who didn't realize that his actions have consequences.  The student who had INCREDIBLE, PATIENT teachers, who came up with different ways each week to help him succeed in school.  As a teacher, I knew exactly what this looked like because I know those students; I teach some of them every day.  I had MANY conversations with his teacher, wondering about whether or not Brandon just didn't have a filter yet...or if there was more to it.  Brandon is one of the smartest kids around.  He reads at a 3rd grade level, he's in a 2nd grade math and spelling class....but the behavior thing just wasn't turning around.  We have routines, rewards, consequences, nothing was working.

One day there was a student who I noticed was acting VERY differently than normal.  This student is usually in control, quiet, but full of personality.  This day the student was practically jumping off the walls.  Later the student came up to me and let me know that they forgot to take their medication.  I find out from the student's mom that this student has ADHD.  Oh...it made total sense.  I NEVER in a million years would've thought this student had ADHD, until they came to school without taking their medication.  I continued to think about the possibilities of this regarding Brandon, but it was again pushed to the back of my mind.

The real "come to Jesus" moment came a few weeks later when one day after school, Brandon began telling me that he felt stupid.  When I asked him why he felt that way, he said, "Because I can't sit still and everyone else can".  He also continued to tell me that he didn't know WHY he can't sit still, or WHY he talks out...he just does.

I decided it was time to put my fears aside and begin researching what might by going on with Brandon.  I needed to forget my worries and put Brandon first.  SOMETHING JUST ISN'T RIGHT.  Almost every other student in Brandon's class can control themselves enough to know when they should and shouldn't be talking; they can stop themselves from running in the hallway when a teacher reminds them not to; they can sit in their chair during class and not get up and begin wandering around...Brandon can't.  I went online that night and began looking at the symptoms of ADHD.  As I looked at sites that offered "check lists", the realization that this could be what's wrong became a reality to me.  My answer was yes to every question.  It was a more involved list than the one below, but these were the direction of many of the questions.

I sent the check list to Brandon's 3 main teachers at school and had them fill it out.  They answered the questions more in depth, and then I decided it was time to find a doctor.  A doctor?  How do I find a doctor?!?  Do I go local, in to Salt Lake?  This idea stressed me out.  And then I remembered the student from earlier.  I spoke with this parent and she recommended her child's doctor, who has a lot of experience with this.  And luckily, he's right here in Tooele.  After meeting with a doctor, and spending quite a long time in his office talking all about how this is diagnosed, and what direction we would go if Brandon does have ADHD, he handed me a much more specific paper for each teacher, and Nick and I to fill out.

The doctor called back yesterday.  Brandon does have Attention Deficit/Hyperactivity Disorder and falls into the category of hyperactivity, with a few impulsivity problems thrown in.  Brandon doesn't struggle with inattentiveness, luckily.  He's always been very organized, doesn't make careless mistakes, and is able to pay attention to details very easily.  Where he fails is in acting without thinking, blurting out answers, unable to wait for his turn, often interrupts others or intrudes on their conversations, moves around constantly, and often leaves his seat where sitting quietly is expected. There were many others on the list, but these are the main symptoms.

The doctor that I'm working with is someone I can really stand behind.  He told me that the most effective way to treat those with ADHD is a combination of medication; at the lowest effective dose, that provides more benefits than side effects, along with counseling.  Not "sit on a couch and tell me your problems" counseling, but the type where he's put into real world situations and they talk with Brandon about what would be a better way to handle how he behaves.  This would come after he's stable on a medication.

I have always been a big supporter of doctors and modern day medicine.  I believe that God put these people on the Earth to help us.  If not for the medications that I'm on today, I would be a zombie, sitting on my couch eating bon-bons all day long.  I thank God every day for modern day medicine.  Many people fear ADHD medication and wonder if it will change the personality of the child.  I trust my God-given instincts as a mother, and I know that this is the right thing to do.  Every child is different, so it may take a while to find the right medication, and the right dose.  I understand that COMPLETELY.  I've been riding the medication roller coaster for the past 15 years since I began having seizures.

I don't know what the future holds here.  I'm hoping that Brandon won't be put on the same medication roller coaster that I've been on...but I doubt it.  Luckily I have friends and family who support this decision.