Saturday, July 25, 2009

Adventures in ADHD - Installment 1

NOTE: I hope to write many more posts like this one as we begin our adventure to getting Styles stabilized. I need a forum to share my frustrations, our successes, and what life has been like living with a child who has untreated ADHD.

Styles came into this world on August 18, 2001 as an 8lb, 13oz, healthy little boy. He had great AGPARs (10 and 9), could hold his head up the day that he was born (no exaggeration - I lived on peanut butter the last 3 months of my pregnancy and the doctor attributed his strength to my overdose on protein), and was all around an easy child. Except for nursing. From the get-go, I had to nurse in a completely quiet, dim room. There couldn't be anyone in the room, the TV could not be on, and I couldn't even talk to him. As soon as another stimulant entered our presence, Styles would unlatch and look for the source of the sound. This completely eliminated any hope of nursing in public or even in the company of others. I couldn't talk to him or coo at him or tell him how much I loved him while he was nursing. I endured for 9 months, when he finally went on a nursing strike because he just didn't have the time to work for his food anymore. He wanted it easy and NOW so that he could get back to playing and learning to walk (which happened when he was 10 months old - AAAHHHHHH!!!!). The nursing strike lasted for 2 weeks and I finally gave up after he lost .5 lbs. We switched to formula with a fast flow nipple so that Styles could eat and get on with his life. I attributed his behavior to being an inquisitive child. One that would learn quickly because of his desire to know all that he could about the world and its contents.

At 2 months old, Styles was taking one nap per day which was incredibly exhausting for me. Trying to entertain a 2 month old for the entire day minus his one hour nap (again, no exaggeration), was impossible. Hey, at least he was sleeping through the night. REALLY well through the night. Once he fell asleep, he was completely OUT. Almost like a ragdoll. An airhorn could be blown in the same room as he was in and he wouldn't even twitch. His sleeping was so deep that it frightened me sometimes. Then I learned to accept that that's just how he was and how he slept at night.

He has never been attached to any one thing, other than matchbox cars, I guess because of their speed. Nothing held his attention, even for a limited time when he was a tot. But again, I attributed it to his energy and desire to learn. I know, and am completely realistic about the fact that toddlers have very short attention spans and are super busy but there was something a little different about Styles. He had boundless energy. I used to call him my Energizer Bunny. He would go and go and go and go and go and go and go and then CRASH. He would play and entertain himself and rarely got into things that he wasn't supposed to. Styles was special in a way that went beyond motherly pride. He was wise. I never had a problem with him putting things in his mouth that he wasn't supposed to. I never had to worry about him playing with things that weren't his or with him sticking his fingers in electrical sockets. He found it easy to be in the presence of adults and always loved to be the center of attention. He was geniunely interested in the innerworkings of everything. When he learned to talk, his vocabulary expanded so fast that I couldn't believe it. And he hasn't stopped talking since.

With his excessive talking, has come some VERY irrational anxiety problems. Styles loves to please and when he thinks that he is not doing a good job pleasing someone, he breaks down into tears and talks about what a bad boy he is. Disciplining his decision making has proven very difficult. He takes everything very personally and offers to give himself some very harsh punishments. He worries about everything and everyone we meet. There have been countless times, after seeing a homeless person, that he begins inquiring about that person's life story. How they became homeless, where they sleep at night, where they get food, and whether or not we can help them. He worries about the weather; hurricanes, tornadoes and floods. Often when it rains, he asks if we are going to die in a flood. He won't let me out of his sight if it is thundering and lightening - not because he is scared but because he doesn't want me to get struck by lightening and die. His worried "what-ifs" are things that people with OCD usually deal with and it is horribly, emotionally exhausting for both of us.

Styles is a great conversationalist topic-wise but has a problem with his mouth being able to keep up with his brain. His brain gets so far ahead of his his mouth that he skips words completely and hasn't even begun to finish a topic before he is on to another subject. He talks faster than any Valley Girl I've ever met but can never seem to get his point across. His excitement when speaking is astounding and makes it very difficult to follow a conversation with him.

He sleeps like a LOG. If you ask him if he is tired, he ALWAYS answers, "NO!" and I believe him. He doesn't stop moving or talking all day long. He really is like a high-voltage battery who cannot find an outlet for his energy. He goes and goes and goes and goes so hard EVERY single day that when he lays down to go to bed, he crashes and no amount of noise or even shaking him gets him to wake up. I used to joke that you could drop him and he wouldn't wake up - it's the truth. I don't really joke about it much anymore because it's become rather frightening. Styles runs himself absolutely into the ground all day long that by the time he goes to bed, he becomes nearly comatose. Again, no exaggeration.

My philosophy on ADHD, since I was in High School and learned about it, has been that these were kids who needed a good spanking. These kids with "ADHD" had parents who overindulged them, used the TV as a babysitter, and let their kids spend way too much time in front of video games. They had no structure in their lives, they didn't discipline at all, they did not set boundaries, and they essentially let their kids run their lives. I also thought that these kids probably ate WAY too much sugar and that their parents let them have caffeine for breakfast, lunch, tea-time and dinner. I thought that they probably needed more fresh fruits and veggies, whole grains, and whole foods in their diets. I just KNEW that they needed to lay off the sugar, dyes, and processed foods. THOSE were my explainations for ADHD. My thoughts were that if they would stop giving into their kids and give them a good spanking or two and feed them appropriately, they would straighten out and the kids would be fine. I slowly began to let go of that philosophy about 3 years ago when Styles started Kindergarten. I am a disciplinarian. I have spanked, used time outs, routines and redirecting. Styles has good manners and is all-in-all well behaved. We ate a VERY low carbohydrate diet full of vegetables and whole grains. Breakfast for Styles was 2 strips of bacon, an egg and a piece of 100% whole wheat toast. We didn't eat packaged foods and his sugar came in the form of fruits and plain yogurt with honey. These things didn't matter in contributing to his behavior. He was super talkative during school and just couldn't seem to keep his mouth closed. His teachers said that he was up and down out of his seat more than the average child. He wouldn't (couldn't) focus on what was being taught in the classroom. The problem continued into first grade, where he couldn't seem to stay in his seat. His teacher joked about getting super glue for his chair. Then this last year, his teacher finally came to me and expressed a concern for Styles. She told me how incredibly smart he is and that she wanted him tested for gifted but she also felt like he had a bit of a problem. Not a behavior problem but a "battery and focus problem" - her words. She said that he was SO difficult to discipline because he was SO endearing but that he was very, very disruptive. Styles does not have the anger that all-too-often accompanies ADHD. Instead, he suffers with anxiety and being able to please people. He is so excited about life and wants to share with everyone he meets. He did not disrupt in an angry or selfish way, he just wanted to share the thoughts that were running, constantly through his head. The thoughts that he could not turn off. She recommended that we have him evaluated for ADD/ADHD. I all too quickly agreed. Homework had become a very difficult task. It always, ALWAYS, ended in tears and frustration on both sides. Styles insisted that he "couldn't help it" and that he was unable to just focus on the tasks at hand. He often made very carless mistakes on things that he knew inside and out. He would just NOT pay attention. Yelling didn't help, spanking didn't help, time out didn't help and making him sit there for HOURS certainly didn't help. I was at my wits end. After filling out form upon form releasing them to study him, he was evaluated. I received the evaluation shortly after school let out for the summer.

The evaluation was heartbreaking but all I could do was laugh because I could picture my sweet boy doing these things. It said that his teachers concerns were, "That he seems to have great difficulty with focus, organizational skills, and task completion. He appears fidgety and talks excessively. His written work is very messy." The observation included observing Styles for one minute during a lesson, then observing another classmate of the same gender for one minute during a lesson, for 20 minutes. His Observation evaluation looked like this:

Styles: Relevant work-time: 46% Unproductive time: 52% Disruptive: 2%
Classmates: Relevant work-time: 92% Unproductive Time: 8% Disruptive: 0%

"Styles unproductive (off task) behaviors included digging in his desk looking for materials, sitting idly, and rolling his pencil across his paper. At times, he appeared to look at his worksheets, flipping through the pages, however, he did not actually appear to be readng the items or answering the questions. Systematic observation in the classroom indicates that Styles' attention and behavior were SUBSTANTIALLY different from that of the same gender classmates during this observation" As you can see from the percentages above, ALL kids have some unproductive time while doing work. But Styles was spending a lot more time than the average kid being unproductive; his excuse? "I just have all these other thoughts in my head and they won't go away and I just CAN'T HELP IT." To which I usually replied, "But Styles, you CAN HELP IT!" I was always frustrated with him. I couldn't understand how he COULDN'T HELP IT. I just didn't get it. I've tried and tried to teach him self control but no lesson seemed to work.

As soon as Styles got back from his summer vacation, I scheduled an appointment with a Psychiatrist. She was SO sweet and observed Styles for an hour. After an hour's worth of observation, she said that Styles definitely has ADHD. I nodded, not too surprised with her diagnosis.

"But what does it all meeeeaaan, Bazzle?" She asked me if I knew much about ADHD and I told her about my skewed philosophy on ADHD - the discipline, the diet, etc... She politely smiled at me and told me that lots of people think that way. And that lots of people, even well meaning nutritionists are wrong. Our Psychiatrist is a D.O. She is schooled in natural healing and preventative medicine. She told me that sugar IS bad for kids with ADHD and that eating a balanced diet is something that everyone should do anyways, so out with refined foods and sugars for us again, which is absolutely fine with me - convincing Kyle will be a different story. But Dr. Chyu also explained to me what ADHD is, medically. Styles does not produce enough of a certain hormone in his brain. This hormone controls his activity and his ability to focus on things. It allows his brain to essentially run wild which is why he constantly has thoughts running through his brain. If he doesn't voice them immediately, they become forever lost in his abyss of thoughts. She said that people who do not treat ADHD with drugs have a much higher incidence of childhood violence, suicide, sexual activity at an early age, car accidents, and general trouble with the law. She said that there is a MUCH higher incidence of these people self-medicating with drugs, alcohol, food, sex, and many other addictions that "calm the thoughts". She said that you never grow out of ADD/ADHD but that as you grow you can learn coping tools to deal with your disorder and that SOME people, as they approach adulthood, can come off of the drugs as they learn those tools. But SOME people cannot ever come off of the drugs, because no amount of supplement, diet, or coping tools will fully help certain people. It convinced me, because of her broad spectrum of knowledge, to allow Styles to be put on a stimulant drug to help control his impulsive behavior.

Dr. Chyu explained to Styles that he does not need to tell people that he has ADHD and that he takes drugs but that he shouldn't be ashamed of it. She said that there were other kids that he went to school with that took medicine for the same problem but that he probably didn't even know it because it helped them act more appropriately. She told him that these drugs were very important to him and that they would help him focus better in school. He said, "Yeah, because I have all of these thoughts and they won't go away and I can't think about anything but these thoughts so I can't do my work at school." She very enthusiastically said, "Yes, exactly! And you can't control it!" He looked at me like he had just received a new car and then looked back at her and nodded his head and said, "I was just getting ready to say that! I can't control it and nobody believes me!" I almost burst into tears because for the past several years I have been SO mean to him. I haven't believed that he lacked self control in these areas and no amount of my changing his diet, or disciplining him had EVER helped enough to make a true difference. I was so excited to get his new prescription filled and to get him on the road to normalcy. I really hope that we are able to find a medicine that will help him focus on school and to do his work effectively. It really does break my heart that I have been so hard on him for something that he genuinely cannot control.

Today was day one of his new medication. I almost passed out when they told me how much it was going to be - $102/month...with insurance. But I didn't care when I bought it. I just wanted the key to unlocking the Styles that I KNOW is in there. The SUPER smart Styles who can do his work effortlessly, who can listen when we talk to him, and who can slow his mind down enough to let his mouth catch up when talking. I don't want to over-medicate him, and neither does his doctor. We want to find the most mild drug possible to make Styles able to operate at his fullest potential. I can't tell a huge difference today but he has 2 friends over. He is still very loud and talkative, although his speech does seem a little more controlled today. It might take a couple of days to see a difference and I was instructed to increase his dose to 20mg after 3 days if I didn't see a substantial difference. I explained to him that he has to start eating better again, no more sugary cereal in the morning, and whole grain and sugar-free everything. He was okay with that and understands that it is for his own good. He REALLY does want to be "normal".

I know I have so much more to write on this topic. I think that it is amazing how much my opinions have changed on ADHD in the last year alone. I also think that it is amazing at how strong people's opinions are on the topic (including my own prior to this), when they have never in their lives lived with a child with this disorder. It is heartbreaking and frustrating and well beyond the normal adolescent energy. Living with a child with ADHD is very difficult and nobody will EVER know what it is like until they experience it first hand. I am not sad that I am living with this. I hope that it will become yet another building block for my own character. I hope that in the future I can help other kids and parents who are struggling with ADHD. And I hope that somehow I can touch someone through our story and that we can save a life from self-medicating in an inappropriate way and convince them that there IS a real, safe solution. I look forward to this journey and finding something that works for us. And I promise, there will be more to follow.

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