Double Edged Pill

Yesterday morning, Husband handed Diminutive One a small white pill. A perfectly harmless looking thing, really.

Diminutive One did not want to swallow it.

His reluctance had nothing to do with philosophical concerns or apprehension over side effects. He has a sensitive gag reflex and simply didn't relish the thought of throwing up, which is his usual reaction when made to swallow anything unpalatable. At nine he still requires chewable or softmelt medication.

My objections were not so simple.

The decision to medicate him was actually made some weeks ago, when it became clear that he simply cannot function in the fourth grade, despite his intelligence. There is a greatly increased workload, much of which is self-directed. He lacks the ability to keep himself on task. And, he is a disruption to the entire class. Other children are suffering because of his issues.

But I've been dragging my feet. The medication recommended for him is a powerful stimulant that carries the potential for a multitude of side effects. Some are mild, some are very frightening. It has street value.

I find myself in the position of having to decide between the lesser of two evils for my child. That's a not a good feeling. It's a very helpless and hopeless feeling.

As mothers we are indoctrinated into the belief that we must do the best for our children. But in Diminutive One's case, there is no best. There is only less bad. And that just doesn't seem good enough.

But this week was a particularly difficult week. Things came to a head and demonstrated quite clearly that Diminutive One cannot continue the way things are going.

I was in the bathroom directly above the kitchen as Husband gently, but firmly made Diminutive One practice swallowing until the little pill finally slid down. I listened, and my stomach cramped in sympathy. I felt breathless with anxiety.

What have I done to my child???

It wouldn't go away, that question.

I watched him closely all day. I felt the need to touch him often. Several times I caught him looking at me quizzically. My over attentiveness was puzzling him, but he wasn't particularly worried, I don't think.

He didn't freak out. He didn't threaten to kill himself. He didn't threaten to kill anybody else. He didn't get nauseaous or dizzy or anxious. He did get a headache, but...so did I.

He seemed calmer, but I wondered if it was wishful thinking. I asked Husband, who tentatively admitted that he thought so too. But we both realize that one day is no indiction of how the medicine will ultimately affect him. And because he started at a relatively low dose, we kniw it's possible that we might not see any improvement at all.

We got something of an answer at 5:30, when the medication promptly and spectacularly wore off in the middle of a baseball game. He became a whirling dervish of activity. In the dugout, he was nearly manic with energy. On the field, he couldn't stay in one place and gesticulated wildly. The poor dugout Dad was at a loss for how to deal with him.

Husband and I looked at one another with understanding. So it had been working! This was good. But the fact that it wore off at 5:30 was bad. He had taken it later than he would need to take it during the week, (he gets on the bus at 7:00 am) so theoretically, it would be wearing off just about the time school let out. He would need it to last a little bit longer in order to get through homework and function during extracurriculars.

The trick is accomplishing that, without having him high as a kite at bedtime, which is a crap shoot under the best of circumstances.

So there's still work to be done. There still might be side effects. It still might be that we can't find the right balance with this medication.

And I'm still worried.

Looking back, I feel like I should have known what was wrong. He has never slept well. The first month of his life I was nearly delirous from sleep deprivation. But then we found he had severe silent reflux. He was prescribed medication and seemed better.

But he gave up napping at 18 months. No more naps, ever. It was a sad and disspiriting day. I was already bone weary.

We discovered a couple years ago that he had obstructive sleep apnea due to drastically enlarged tonsils. We blamed the sleep problems on that, but strangely it didn't improve much with their removal, though his supposed "asthmatic" episodes disappeared.

He crawled at seven months and walked at nine. He had places to go, people to see, things to do. No sitting on his laurels...no sitting at all, really. As a toddler he was in constant motion. He climbed everything. I couldn't take my eyes off of him for one second. Ever.

Due to the reflux, he has some scarring in his lungs from aspirating stomach acid. This makes him very prone to pneumonia. The first time he was given Albuterol both of us nearly lost our minds. Normal kids get a little wired from inhaled steriods, Diminutive One went completely insane. Certain brands of cough syrup do that to him as well, and certain food dyes and sugar. Corn Syrup is like crack to him.

Everybody said he was just "energetic" and "all boy". But I knew. I knew there was something WRONG. But I let them persuade me, because nobody wants to admit that their child has a serious, debilitating condition. I let them persuade me until I couldn't be persuaded any more. Everybody was wrong.

And now here I am...giving my child powerful mood altering drugs, hoping it's the right thing to do.

Shit.

This a whole lot harder than deciding what brand of diapers to use. It makes issues like breastfeeding and crying it out seem petty and inconsequential by comparison.

He asked me, yesterday, if this medicine would make him smart. And oh how I wanted to say yes.

I told him he was already smart, but the medicine would help him use his smart better.

I hope to God I was right.

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On a more gratifying note:

I'd like to thank Sandy G, Momish and Slackermommy for graciously bestowing me with awards this week. I am late acknowledging their kindness, and I apologize!!













I promise to spread the love when I have an opportunity to properly reflect upon it.