Double Edged Pill
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.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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!!
![](http://1.bp.blogspot.com/_8qwDACpemvs/RvaMBDPc--I/AAAAAAAAAFo/hzzkfxG46dc/s320/nicematters.jpg)
![](http://3.bp.blogspot.com/_8qwDACpemvs/RvaNTjPc_BI/AAAAAAAAAGA/uVsv3mBzX_w/s320/Donkey+butt.gif)
![](http://3.bp.blogspot.com/_8qwDACpemvs/RvaNcjPc_CI/AAAAAAAAAGI/EPnWJPJFsQM/s320/thinkingblogger.jpg)
I promise to spread the love when I have an opportunity to properly reflect upon it.
22 Comments:
At 1:26 PM,
flutter said…
I wish I knew what to say, other than I know you are doing what you think is best for him and I support your decision.
At 1:32 PM,
Liv said…
I just want to wrap you up in a big hug. I went through this with D, and ended up taking him off the meds. He has such severe oral defensiveness and SID related problems that I was actually crushing the pill and floating it in juice in a syringe to get it down. It was awful.
xoxo things will get better.
At 2:51 PM,
thailandchani said…
I'm with Flutter on this one.
Peace,
~Chani
http://thailandgal.blogspot.com
At 2:57 PM,
S said…
This:
I told him he was already smart, but the medicine would help him use his smart better.
What a beautiful, perfect answer. He's lucky to have you. And it would be strange if you didn't have concerns and doubts, no?
Time will tell, I think.
All we can do is muddle through the best we can. As our kids get older, the solutions to problems are no longer easy or clear.
But so far I think you're doing things just right, FWIW.
At 3:05 PM,
Bea said…
My sister was on a similar medication when she was school-age - I vividly remember the spectacular wearing-off effects, just before supper-time.
You have to try it. You'll know if it feels like the wrong thing.
At 3:26 PM,
merinz said…
What a huge decision to have to make. And like all decisions there are positive and negative aspects.
One advantage of being on the medication is that, sometimes for the first time in their lives, the child starts getting positive feedback at school from teachers and also other students.
And they can now really get about the business of learning.
I hope all goes well with you all.
At 3:46 PM,
Girlplustwo said…
oh honey. they don't tell us all the things we'll need to decide when we decide to become moms, do they? it's so hard sometimes. but you handled this so gracefully, with so much love.
At 3:59 PM,
Anonymous said…
I think you should save these blog posts so that when he is older and wants to understand about himself as a child, you can share them.
You are parenting him so well.
I don't promise many people many things, but I promise that he will always know how much you love him and how you always want to do right by him. Even through bad and hard times.
HUGS
At 3:59 PM,
PunditMom said…
An amazingly difficult decision. When someone even tentatively raised the possibility of medication (not for this but something else) for an issue, at least for the moment, we said a firm no. We'll see how it goes.
Keeping my fingers crossed for all of you.
At 5:23 PM,
painted maypole said…
hard, hard, hard. I hope that you find something that not only works, but that you can feel a peace about doing.
At 5:44 PM,
dawn224 said…
One of the most compelling things I've ever heard as a reason to take the little white pill is: 'it puts him in a state of mind to be ready to learn'.
I heard this from a Ph.D. professor with 20 years in the biz.
I think your answer (I told him he was already smart, but the medicine would help him use his smart better.) is even better.
At 7:08 PM,
Amie Adams said…
This is how I thought about it when I took anti-depressants.
There is something in my body (with the chemicals in my brain) that aren't allowing me to be the person I know I can be. The medication was just evening all the levels out to where they should be.
He can't be comfortable when he's bouncing off the walls. I bet he begins to like being able to concentrate. Who knows what fabulousness he'll be capable of when he can concentrate on it.
I know it's hard. You wouldn't be a good mom if you weren't worried.
At 7:19 PM,
Chicky Chicky Baby said…
Oh man, this is all so much to think about for you and your husband. And of course, for your son too. I wish this was something you all didn't have to go through with but I hope it's some small consolation that I think that few people would handle it better than you will.
At 7:43 PM,
Fairly Odd Mother said…
I know this couldn't have been an easy decision for you. I hope things get better for you all.
At 9:42 PM,
Wife Soup said…
Thank you for sharing your experience. I just came across your blog (cannot recall how I got here). I can really relate to what you are saying and posted about it myself here: http://wifesoup.typepad.com/wife_soup/2007/09/i-came-out-to-m.html We found the rebound to be quite unbearable, also. We have found something that gives us a little more control over the timing of the wear off. I will not post here about it, but if you are interested would be happy to talk via email. Anyway, my thoughts are with you.....
At 9:54 PM,
urban-urchin said…
We just went through this with our daughter- I know EXACTLY how you feel.
At 3:00 AM,
Unknown said…
I'm certain you're doing the right thing. I take that same drug, or maybe I take the other one, both work for me. The difference they have made to my life is VAST!
I don't know which drug Diminutive One is on but if it's R, do you have the slow release version and have you tried splitting the dose? Lots of parents do that with great results. And in the evening, Clonidine is excellent for just slowing the pace down a bit.
He is a lucky lad though, you are there to help him - many parents aren't.
Good on you all!
At 9:14 AM,
Mad said…
What a tough position to be in. I ached when I read that you touched him more frequently all day. I could feel my own arm extending as I read that. I hope the meds do help.
At 10:09 AM,
Anonymous said…
I love this line: I told him he was already smart, but the medicine would help him use his smart better.
I know doing what you think is best in this situation is tying you in knots, but really, you ARE doing the best you can for him, by him, and with him. Hopefully, with a little tweaking, this medicine will help him focus and you can say in a few months that the improvement is worth the medicine. No doubt, your close monitoring of him will give you indication if the side effects are happening with him and you'll take action promptly should you need to. I have no doubt.
You're a good mom, and you're doing the best you can.
P.S. I'll be emailing you about the med-free birth thing you commented on at my site.
At 11:38 AM,
Anonymous said…
Your post pulled at my heart strings. You stated people convinced you he was just "All Boy" and you described him as a busy baby, toddler & child. I see this ALL in my now 2 year old who deprived me of sleep the first year of his life, the second hasn't gotten a good start. He too would walk on the ceiling if he only could. He's presently undergoing tests by his PED, she suggests a chemical problem.. is that possiable? Medication wont be discussed until he's school age.. however I find myself most of the time on pins N needs jsut waiting for his next fearless moment. Love your blog!
At 11:46 AM,
Avalon said…
Give it time. I know that is so simple for me to say as you and your family struggle with doing what is best for DO, but as his body adjusts to the meds, the highs and lows will likely smooth out a bit and there will be less and less of those dramatic differences.
How I wish I had had you as a Mom when I was a kid. Even though my Mom was wonderful, she was overwhelmed and misinformed. It was a different age and time, and I was considered to be oppositionally defiant, instead of an unwilling victim of ADD.
At 9:02 AM,
Anonymous said…
I'm so there with you. I recently too my 4th grader off her meds although I did not want to. They were giving her stomachaches. So now we are trying behavior modification. She has an amazing teacher who has a son with ADHD. She's a big believer in behavior mod so we are giving it a try. I'm learning to change a lot about how I parent her. It's rough though. It took her 3 hours to do 20 minutes of homework on Monday because I'm no longer sitting next to her and constantly refocusing her and basically giving her the answers because she's quite manipulative. I'm giving it a few months and if she's still having trouble staying on task, lacks impulse control, and disrupting our family then I will try another med. The thing that sucks for my daughter is that she has Tourette's and stimulants will worsen her tics. At this point though I would take the tics over the ADHD.
My husband has a hard time with the idea of medicating her but my philosophy is that if it will make her feel better then why wouldn't we give it? My son has asthma and we never second guessed putting him on all the meds he needs even though they have side effects. Of course it's scary to put our children on a narcotic that changes their brain chemistry but it's worth a try if it makes them feel better. It seems you have pretty clear proof that your son needs the meds. All my best to you. I know what you are going through and it's not easy. Your right that dealing with this makes all the issues of their early years seem trivial.
BTW, I like the explanation that my daughter's neurologist gave her about her meds. He explained that the medication would be like a flashlight that would help her focus better on whatever needed her attention. It would help her tune out everything else going on around her.
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