Blogs Are Stupid

Doesn't anyone believe in Dear Diary anymore? What happened to the joy of putting actual pen to paper? And why does every ordinary Jane and John think they can write well enough to burden the world with their scribblings? It’s a mystery that badly needs solving. My first entry contains my thoughts about blogging and will set your expectations. The rest will probably be stream of consciousness garbage, much like you’ll find on any other blog. Perhaps we will both come away enlightened.

Monday, February 11, 2008

The Medicated Child; Part II

In 2nd grade, my oldest child began having problems in school, I first thought it was due to having recently relocated from private school to public.

He read at 4, was doing simple algebraic equations by first grade and had the critical thinking skills of a much older child.

How could he possibly be struggling?

I blamed the teacher, the lack of one on one interaction, and the failings of the public school system to treat children as individuals. I told myself he was bored because he was so advanced. I told everybody else too.

But despite my efforts to assure myself, I began to feel some niggling doubt. And, some fear. Things had begun happening at home too. Little things, things that caused most friends and relatives to assert that "He's just being a typical boy."

But I knew better. His academic edge was disappearing as he struggled with routine tasks. His intelligence hadn't evaporated, that I knew. So very slowly, I allowed myself to admit that there was something wrong.

The following year, his teacher, who was Teacher of the Year in our district and for whom I had an enormous amount of respect, requested a conference shortly after school started. She gently suggested to me that he might benefit from an evaluation by the school psychologist.

I asked her if she thought his problem went beyond what was typical distractability for a boy his age. Her reply was simple, but emphatic. Yes.

It was both a shock and a relief. But at least I had somewhere to start. And so, we did it. And then I took the little piece of paper they gave me, which suggested that maybe my son had a tendency towards innattentiveness and anxiety, to a pyschiatrist, unsure of what was going to happen.

I chose his therapist from our preferred provider list.

On our first visit, she took the paper I presented to her, skimmed it briefly, and then said,

"It looks like ADHD. Let's put him on Concerta and Strattera for that, and Paxil for his anxiety."

I looked at her, stunned. She hadn't even spoken to him. She had no idea what was going on with my child, apart from the very vague information on that paper. And yet, she felt comfortable prescribing a powerful chemical cocktail for him.

"Uh. Is there anything aside from medication that we could try first?"

Now she looked stunned. I really didn't think my questions was that unusual, but apparently it was.

"Well, what are his symptoms?"

Perhaps it would have been prudent to ask that question before prescribing three types of medication for an 8 year old child....hmmmmm?

We talked for about 30 minutes, but she barely spoke to Pre-Pubescent One. She really did not know him as a person or a patient, nor, I suspected, did she care to. To her, he was a chart, a case...30 minutes out of her busy day.

Luckily, I had already done a lot of research on meds as well as behavior modification techniques, many of which we were already implementing. I had also spoken with several women whose children had a multitude of issues and who had a wealth of experience between them when it came to dealing with doctors and navigating the system.

I knew that the best approach to these disorders was a combination of therapy, behavior modification and medication. I had already accepted that he would most likely need some medication, but I'd be damnded if I was going to start pumping him full of drugs willy nilly.

I took a deep breathe and said to the doctor,

"We would like to start with a small dose of Strattera and see how that meets his needs. We can increase if necessary. I do not believe he has hyperactivity, so I don't want to consider stimulants yet. And I believe that much of his anxiety is directly related to his problems at school, so I would like to wait and see if that improves on it's own once his other symptoms are addressed."

Again, she looked stunned.

"Well...we could try that approach, yes."

"Good, then we're agreed."

"But in my experience as a licensed mental health practitioner, the combination I suggested would be the most effective."

"Upon what criteria is that opinion based?"

She had no answer for me. She had not conducted a thorough clinical evaluation. She hadn't even spoken to my son. She hadn't consulted his teacher, or even asked ME very many questions.

Finally, she said, "It's based upon historical data, education and experience."

I wanted to tell her that my child was more than historical data. He was a person, a child, with hopes and dreams and tons of unrealized potential. He wasn't a lab rat or a control group. And her experience meant nothing to me, since she had none with my son.

But I held my tongue and took the prescription for Strattera.

And that was that. We did not go back.

I asked our family practitioner if she would be willing to monitor his liver function, blood pressure and growth and prescribe as necessary, which she agreed to do, provded we find another mental health professional to see several times a year.

The Strattera helped him enormously, his side effects were few, and his anxiety lessened noticeably once he began doing better in school. He tested into the gifted and talented program, and began taking accelerated math classes. For the first time in several years, I felt his performance reflected his true capability.

Needless to say, I was relieved.

We had an entirely different experience with Diminutive One, thankfully. I originally took him to see the child psychologist for reasons unrelated to a learning disorder. She was a god send for us both. She did a very thorough evaluation. She interviewed both Husband and me, as well as several of his teachers. She observed him for nearly six months before offering a diagnosis and suggesting a very conservative dose of Concerta.

But aside from just writing a prescription, she offered me a lot of constructive and creative solutions for dealing with his behavior. She listened to me when I was frustrated. And she was a calming influence when I couldn't cope.

She helped him take responsibility for his actions and to recognize when he was getting out of control. She gave him a lot of tools for dealing with the stress of being "different" and helped him to realize that he had great potential. She helped him to believe in himself.

She was everything I had hoped to find for Pre-Pubescent One.

Now both my boys take medication. They are doing well. They may outgrow their respective conditions, they may not. But I have come to terms with being the parent of medicated children.

It is not something I have accepted lightly, however.

I really dragged my feet with Diminutive One's diagnosis. I was reluctant to give him stimulants. Their side effects are much more profound, and it can lead to a cascade effect in terms of medications. I was extremely nervous about going down that road.

But it has turned out to be the right decision to make. It has helped him so enormously, that I initially suffered a lot of guilt over not giving them to him sooner.

What we have to understand as parents, is that medication is a tool. Not a quick fix. Not a solution. A tool.

Diminutive One is a stubborn, defiant, persistent, strong willed, and sometimes, profoundly irksome child. That cannot be medicated away. Because if we medicate that away, we also medicate away the creative, perceptive, intuitive, inquisitive child. And that would be a terrible tragedy. I don't want to change who he is. I just want him to be able to lead the best life possible.

It's true that most of us do not posses a medical degree. But most of us do possess a modicum of common sense, as well as a pretty strong maternal instinct. We know when a clinician has not taken the time to evaluate our children thoroughly. We know when they are prescribing medications for our children injudiciously. And we know when the essence of our child has disappeared in a miasma of pharmaceutical side effects.

My advice to parents facing the decision of whether or not to medicate their children is this:

1. Question everything.

2. Do your homework.

3. Know your child, listen to your child.

4. Trust your instincts.

5. Don't be intimidated by clinicians who presume to know better than you do, how to treat your child. A medical degree is not a guarantee of infallibility.

6. If it feels wrong, it probably is.

7. It's okay not to follow the advice of a clinician.

8. It's okay to seek a second opinion.

9. It's okay to change doctors.

10. It's okay to change your mind.

11. YOU make the decisions. NOT the doctor.

It's truly frightening to contemplate medicating your child, especially when it's quite clear that children are being routinely misdiagnosed and drugs are being overprescribed to an alarming degree.

A defining moment for me with both of my boys, was witnessing the devastating effects these disorders were having on their self-esteem.

Ask any parent who has heard thier child say, "Mom, I'm just too stupid." Ask any parent who has heard anguish and defeat and worthlessness in their child's voice. Ask any parent who has watched a brilliant child fail time and time and time again. It will do a lot to motivate a parent to find what is wrong and how to fix it.

Prescribed and used properly, these drugs can really help a child that is struggling. They can help otherwise deeply disturbed children lead normal lives. They can help intelligent children realize their potential. They can help painfully withdrawn and isolated children step out into the world.

We have more tools at our disposal these days than our parents ever did. More resources. More options. More power to change the world for our children.

And I think we can.

We just have to be smart about it.

21 Comments:

  • At 11:29 AM, Blogger WrapAroundSam said…

    An absolute diamond of a post. Very, very well written and extremely persuasive. Great job...

     
  • At 11:59 AM, Anonymous Doug said…

    Great post!

    We struggled long and hard with the decision about Stratera for my daughter. In the long run it didn't work very well for her (the side effects).

    Interestingly enough, some medical choices have been easy. Anxiety and panic attacks run in my wife's family. So the choice to medicate for that one was a no-brainer. We were even able to tell her pediatrician the drug that would probably help the most.

     
  • At 12:24 PM, Anonymous Anonymous said…

    I had a very similar experience with our older son - he was written an ADHD prescription within 15 minutes of a phychologist in a well-respected facility trying to talk with him. At the time, he was VERY shy around strangers - so he barely looked or talked with her. After asking him to leave the room, she had the nerve to tell me my child was 'unhappy', non-social, etc and prescribed something that we never bothered filling. After talking with a Special Ed Teacher Friend that knew our son well, we used behavior mod's that she suggested - and they did the trick. Thankfully. It would've tortured me to put a drug into my child's system.
    Fast-Forward 10 years - our son is in Gifted classes in High School and is a social butterfly.
    Thank goodness we listened to our guts and not some 'professional'.

     
  • At 2:22 PM, OpenID wheelsonthebus said…

    Fantastic post. The biggest disservice we can do our children is ignoring our instincts.

     
  • At 2:24 PM, Blogger Hairline Fracture said…

    Excellent post! And so helpful for those of us who have children who are not school-age, so we know what to look for and what to do should it be necessary.

    BTW, as a former teacher, I can wholeheartedly endorse the notion that many kids really NEED medication to succeed in school. While there may be lots of kids on meds that don't need them (or that are on too high a dose), that doesn't negate the fact that they have helped a lot of children. And behavioral modification should be a more accessible option, too.

     
  • At 2:46 PM, Blogger Chicky Chicky Baby said…

    I don't even medicate my DOGS without getting all the facts, and even then it's with trepidation and I usually try to go homeopathic first. The story of that first doctor had steam coming out of my ears.

    Medication is needed for some children, probably a lot of children, but I believe that a lot of kids are needlessly medicated because their parents don't know enough or are afraid to speak up. Good for you!

     
  • At 3:18 PM, Blogger All Things BD said…

    Excellent, excellent post. Thank you so much for sharing your experience.

     
  • At 4:03 PM, Blogger Life As I Know It said…

    Wow! I can't believe that first doctor would medicate before even talking to you or your son. Good for you for doing your homework and being the best advocate for your kids.
    Great post.

     
  • At 5:35 PM, Blogger Kady said…

    What a great post. My babies are only 3 and 1 and already I fear what will happen when they enter the school systems. (They are both very willful, tend to be disruptive and have a hard time focusing). I wish I had your fortitude in facing down authority, though my traditional modus operandi has been to avoid diagnosis by avoiding authority figures.

     
  • At 6:10 PM, Blogger Ruth Dynamite said…

    Every parent - heck, every person - should read this post and be inspired by your resolve to question everything.

    An MD's recommendation is not gospel, and it's up to parents - and people - to do the homework and understand the long and short term effects of medications as well as the available alternatives.

     
  • At 6:52 PM, OpenID realitytesting said…

    And this advice works equally well for adults who are facing similar diagnoses. Great piece.

     
  • At 7:24 PM, Blogger jen said…

    you are SUCH a good mama. a tigress.

    and i can't believe that first MD wanted to prescribe drugs sight unseen. i really can't believe that.

     
  • At 10:39 PM, Blogger slouching mom said…

    what a service you've done by publishing these two posts.

    brava, BA!

     
  • At 11:07 PM, Anonymous Chelle said…

    It's a hard decision for a parent to make when it comes to medicating their child. You were smart enough to do the research and to question the therapist, most parents won't do that. They can't handle it and tell the dr and the dr prescribes without seeing the child.

    I am proud of you for questioning the first therapist, it was the right thing to do.

     
  • At 1:41 AM, Blogger Jozet at Halushki said…

    I think that your list of "to dos" is perfect, and can and should be applied even for our own office visits for ourselves.

    My favorite doctor is the one who said to me "You are going to be the expert on your child in regard to his condition; I'm just the expert on the condition."

     
  • At 1:09 PM, Anonymous flybunny said…

    This is fantastic. Thank you so much for writing both of these posts.

    Honestly, I had avoided watching the show because I was afraid I would feel judged as I so often do even though I KNOW medicating my child is the right decision.

    I recently posted on a local Mothers board looking for someone who was going through the same thing, primarily on the anxiety/depression angles. My initial post was rather vague but I was taken aback by the sheer number of people who told me to not let any dr's diagnos my daughter with adhd because it is so overdiagnosed (it is, I agree) and so on and so forth so immediately I was defensive and I really had no reason to be.

    Like you, I know what is right for my child. We are on our 3rd stimulant because I knew instinctively that the side effects of the others were not something we could live with (primarily anger)but we are happy with what she is on now. We not only see a psychologist but also a psychiatrist and our pediatrician has requested all transcripts so she can keep up with what is going on and she really serves as our independent third party observer and she gives me her honest opinion on her observations - I know I am lucky to have these Dr's in our life because I fear for what it would be if we didn't.

    Thank you again for such well written reminders!

     
  • At 1:42 PM, Blogger Amy Y said…

    Very well said, Mama.
    We haven't had to go down this road, and hopefully we won't have to. But it's early ~ my boys are still young ~ and it's nice to know that there are brilliant mama's out there like you who have been through this and have excellent advice to give as a result of their experiences to turn to, should we cross this bridge.

     
  • At 3:03 PM, Blogger Mitzi Green said…

    i'd like to add a #12, if i may:

    12. regardless of how they perceive you as a parent, at the end of the day (and the trial), the judge and guardian ad litem and whoever else is involved will not be there to advocate for your child--only you. to hell with what they may or may not think.

     
  • At 8:07 PM, Blogger mamatulip said…

    Excellent, excellent post, BA.

    Bravo to you and your husband. You are both exceptional parents.

     
  • At 8:43 PM, Blogger Fairly Odd Mother said…

    Absolutely agree with you! You have really thought this through and have done good things for your boys.

     
  • At 4:48 PM, Anonymous Anonymous said…

    Nice post.

    We recently had a similar experience with our son, who is 14. We found black mold in his bedroom and, based on a mold specialist's recommendation, took him to an allergist to find out if his tiredness and headaches could be related to the mold exposure. The allergist (barely) listened to his lungs, said he had asthma, and prescribed Singulair. My antennae went way up, as this child doesn't cough or wheeze, doesn't routinely get colds or upper respiratory infections, etc. I took him to a pulmonologist who took a good history, spoke in a kid-savvy way with DS, and determined there's not a thing wrong with him.

    Singulair is a benign medication, from what I'm told, but as the pulmonologist said, "Why would you medicate a problem that isn't there?"

    Also, I'm a school psych and I can't tell you the number of children I see who have gotten heavy diagnoses and meds or treatments based on very brief, superficial "exams" from all kinds of doctors. I spend a lot of time un-diagnosing and re-framing kids' behavior with parents who either wanted their kids labeled and medicated (awful but true), or who didn't believe that they just might be the experts on their own kids.

    -- mamacita

     

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