Thursday, May 5, 2016

Tough Decisions

Those who know me well know that I spent some time working in an outpatient mental health clinic. Now I'm not a therapist, and I'm most certainly not a doctor or NP, but I did work front office and intake, and on more than one occasion was asked to phone in a prescription. I was familiar with many of the medications and their various side effects. I saw people benefit from these medications, and I also saw some go through rigorous trial and error where nothing worked. Some got better. Some didn't. I couldn't imagine what the parents of the children on meds were going through when they made the decision to go that route. I was naive back then. I had no idea what it was like to even have a child, let alone a child with any kind of condition that would require medical treatment.  I remember when I got pregnant with Sweet Pea, I thought to myself: "I don't ever want to put my child on medication. If it comes to that, we will find another way." I knew the stigma that came along with the decision to medicate. I knew how society looked down on parents who decided that this method was the best way to treat their child. My husband and I talked it over and he agreed with me. No matter what, we would find another way.

Never had we thought we'd be faced with this decision.

Getting Monkey's diagnosis was a blow. It was hard enough raising one child with autism, and now we had two. But we put on our big kid pants, strapped on our boots and dove in head first. No choice now. This was the hand that life had dealt us and we were going to play it. Of course, we automatically assumed that everything would go the same as it had with Sweet Pea. We figured he would make the same progress and hit the same milestones in the same way that she did. But of course...

The first time we noticed something different about him was toward the end of his last year at preschool. He couldn't seem to sit still and had trouble staying on task. His behaviors, seemingly gone through the first half of the year, had started to resurface. I spoke with his pediatrician, and he had both myself and Monkey's teacher fill out Vanderbilt Scales. After reviewing the results, the doctor decided that we should revisit the assessment when Monkey started kindergarten. I was hesitant, but agreed with him and decided to wait. Summer came and went, and Monkey made little progress in the summer program. He was acting out more, not listening and was continually unable to focus.  Kindergarten started last fall, and he went through the typical adjustment period with the meltdowns and the lost sleep. Then he leveled out and seemed to be doing okay. He was making pretty good progress and there was talk of moving him into the integrated class for longer than 20 minutes a day. His behaviors decreased again and although he was still fidgety, he seemed to be doing okay.

And then Christmas break came along. Upon returning to school, the behaviors became more prominent. He became increasingly unable to focus or sit still. The rough weeks seemed to outnumber the easy weeks. February rolled around and when we went through the IEP, each and every assessment stated that though he was still making progress, he was being inhibited by his high activity level and his inability to stay on task without constant redirection. Lately he has been having trouble with impulse control and has been hitting teachers. Not maliciously, he just doesn't understand how to control his emotions. He'd also been flopping, screaming, and being unsafe on the playground and in the hallway.  So once again, I put in a call to the pediatrician and we redid the Vanderbilt Scales.Upon reviewing  those and reviewing Monkey's IEP assessments, the doctor concluded that we were indeed dealing with ADHD and that the appropriate route to take would be to put Monkey on a stimulant. He starts them tomorrow.

It was at Christmastime that Daddy Ceda and I began discussing the possibility of our son needing medication to help him be in better control of himself. We were both still very wary. Neither one of us wanted to accept that maybe this was what he needed. We didn't want to do it. We wanted to exhaust every other method first. We were set firm in our decision at that point, the same one we had made when we were expecting Sweet Pea. No meds. So we tried everything. We tried weighted blankets and back packs. No help. We tried deep pressure. Temporary relief, but in the long term not a viable solution. We tried reward charts for good behavior. Worked briefly, but ended up failing. We tried just about everything until there was nothing left to try. We'd reached the end. As reluctant as we were, we both decided that this would be the best route. That medication would be what would help him the most, stigma be damned. Our son's ability to focus in school and function in society was far more important than what the world might think of us.

It was a hard, drawn out decision for us, but the bottom line is this. We are the experts on our child. We know what works and what doesn't, and we have faith that our decision is in his best interest. It doesn't matter what anyone else thinks.

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