The Medication Game

As you know, in addition to his Asperger, HistoryBoy also has ADHD. I should probably also add that he has asthma and horrible allergies, allergic to the world, excepting food mostly. He will never be able to eat a Reese's peanut butter cup as he allergic to both peanuts and chocolate without breaking out in hives but thankfully that is all the food allergies he has. However he is allergic to grass, trees, pollen, ragweed, dust, dust mites, pet dander, cats, mildew, mold. There is no *good* season for this child. But I digress. He takes meds for these conditions, specific meds for his allergies and asthma. But the ADHD is always a game to find what works.

When he was 5 and we decided to first put him on meds. We tried Adderall. It was a low dose and wore off VERY quickly. He didn't make it through 1/2 day Kindergarten on it. We switched him to full-day Kindergarten. It was amazing how much better he did in all day Kindergarten. I should say at this point he was about 95% for height and 80% for weight according to those little charts docs like to fill in each time the measure so he was a nice healthy kid size. :)

Now for first grade switched we had to switch the meds to the Adderall XR (extended release). The regular ones were seeming to wear off by lunch time and I was NOT for increasing the dose by a significant amount. He was so skinny already. He wears slims and if they are not adjustable waists, they still might be too big! There were only 14 students in his class and his teacher was amazing and she was OK with me not increasing his meds. She understood my concerns, thankfully. I kept him back in 1st grade so that he could mature. His social skills or lack there of were pretty obvious and I felt that he would benefit but staying back, by the end of the year we were still at 10 mg Adderall hoping not to increase again for a while. By the end of this year he was about 90% for height and 75% for weight according to those little charts.

In 2nd grade, it was a rough year for a several reasons I won't go into now. But we had to up his meds again, to help him cope with the classroom. I so now he is on 15 mg of Adderall XR, which seems to be working well but his Aspie symptoms are rearing their heads in the classroom majorly for the first time. But anyway I said I wasn't going into that now, that is my RANT for another blog full of choice words and goodness. HistoryBoy was in a self-contained class for 1st grade both times with the same teacher. He was in an inclusive class for 2nd grade. I WILL talk more about this another time. One of the teachers in the classroom kept wanting me to UP his meds again, saying he needed more medication. I kept arguing with her. I finally just started ignoring her. Note: It is not usually in your child's best interest to ignore one of his teachers. But anyway. By the end of this year he was about 75% for height and 50% for weight according to those little charts

For third grade, we need to increase the meds again. They are wearing off, but the increase to 20 mg is too much. He is a zombie. So we switch the meds to Vyvanse 50 mg which is supposed to be the equivalent to the Adderall dosage he was on. OMG it was a nightmare. When he came down off the med I thought Linda Blair had moved in and his head was going to spin! It was meltdown followed by tantrum followed by meltdown. I called the doc and said NO WAY. This med has got to go! So we lowered the dose to 30 mg which he said may not work as well since it was only supposed to be equivalent to 10 mg of Adderall XR. Just Great! But anyway. It does work. The vyvanse is longer acting and he makes it through the day and it is a lower dose! YEAH! But wait here comes the problem. Checkup HistoryBoy is now was about 50% for height and 25% for weight according to those little charts. Pediatrician says we have to do something with his ADHD meds. His weight is affecting his height now. Make a following up with Neuro and let him know what's up.

So we go. Neuro says two options, stop ADHD meds altogether. Um Hello have you met my son? You can't talk to him or get his attention with out medication? Unless I am planning on staying home alone with him ALL the time. THAT is not an option! I try to give him a break from medication in the summer if possible but if we have anything to do, there is no way we can go and NOT be medicated it is a recipe for disaster. He will lose his noodle. Or we can try lowering the dose. That one is tricky. He is doing well on 30 mg and to lower the dose at the end of a school year (end of 3rd grade) and keep him on it until he gains the weight they want him to. Not sure his teachers will like me too much. But we opt for option number 2. And it works out well for the most part. He has to work harder on controlling himself, which is good. He (well was 9) is 10 now and needs to work on these skills. He can recognize when the medication is wearing off. He can tell his teacher. I need to take a walk I am getting distracted.

In addition to lowering his dosage, I had to add fat to his diet. They suggested whole milk, I just give him more go-gurts. He will eat those things. I can't get more milk in him. Don't know why. Also, instead of the nice healthy snacks he loves after school like carrots, celery, banana or apples, give him butterscotch krimpets. If he wants ice cream, let him have it. Let him eat milkshakes. My son is a great eater. He eats the good stuff before the bad stuff and now I have to undo all that? UGH!!!

Now this year, fourth grade, he has been on Vyvanse 20 mg, which was working well (mostly well) until he reached about 75 lbs which appears to be his weight limit for this amount of med. So he has reached the weight they wanted him to reach he is about 50% weight, 50% height, but the med dosage they want him on no longer functions the way it should so we have to increase the dosage so we need to increase it. So a year from now, am I going to end up where we were a year ago?

I am glad my son is such a good eater and thankfully, eating Tastycake Butterscotch krimpets hasn't killed his love of bananas, apples and yogurt!

Feel free to leave a comment or email me at teenahope@gmail.com

stark.raving.mad.mommy (SHE ROCKS) has a great blog on this too

Doctor's Orders: More Nutella