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Focalin for ADHD

posted: Wednesday November 19th - 12:35pm

Does your ADHD child take Focalin? How does it stack up compared to other ADHD meds your child has tried?

Welcome to Day Four!

Of Natalie’s new ADHD medication, that is.

My consultation with Dr. Halbur resulted in a switch from the old reliable short-acting Ritalin to Focalin XR. Dr. Halbur described Focalin to this layperson as follows: It’s Ritalin with one molecule removed, and because of that slight difference, it’s less likely to cause irritability or to suppress appetite. Since we’re using the 12-hour extended release formulation, we’re hoping to see more consistent effects throughout the day to help with Nat’s concentration at school. The dose she’s taking should be equivalent to a small increase in dosage as compared to her Ritalin regimen.

We instituted the change on Saturday morning, so that we could spend two full days with Natalie while she adjusted. Then we sent her to spend the entire afternoon with her Other Parents. She went to Harry’s to play. Her O.P.s reported exactly what we observed that day—a slightly manic-y happiness and motor-excitement. We chalked part of that up to a thrilling new phenomenon — Bobby — joining Harry and Natalie for the day.

The most notable difference we’ve seen so far is Nat’s appetite building from day to day like an incoming tsunami. I worked until 9:00 last night, but Don said she ate a good supper, and then continued to eat all evening, right up until bedtime. This morning for breakfast she had a bowl of cereal, a bowl of ice cream, and a blueberry nutra-grain waffle. In addition to all that, she requested pancakes. Makes me feel like we’ve been starving the poor kid. Maybe she’ll be able to hold up those size 6X Slim jeans before long.

The jury’s still out on the overall success of this change, but I’m optimistic.

Does your child take Focalin? How does it stack up compared to other ADHD meds your child has tried?

ADHD and a Winter Prision

posted: Tuesday November 18th - 10:42am

Winter in Iowa must feel like a prison to my ADHD daughter -- our house can't contain Natalie’s excessive energy.

Natalie and I took a walk in the moonlight Saturday night. Well, I walked—hands in my coat pockets, shoulders hunched against the cold wind. She zoomed ahead of me on her scooter—dressed in her winter coat, hat, and mittens.

Why were we out after dark on a cold, windy, wintry night? Because our house could no longer contain Natalie’s ADHD energy. We busted out like two prisoners leaving solitary confinement.

That’s what winter in Iowa must feel like to Natalie—like prison. It’s dark by 5:00 or 5:30. Even when the sun’s out, the cold temperatures, wind, snow, and ice keep us locked inside most of the time. To a kid with Natalie’s energy level, being forced to stay inside constitutes cruel and unusual punishment.

Yesterday, Natalie and her friend Harry braved the cold for a short time. They rode Nat’s scooter and green machine for maybe 10 minutes before giving in and retreating back indoors. They spent quite a bit of the afternoon bundled up in sweatshirts in the relatively warm but drearily dark garage, building a rocket ship out of cardboard and duct tape—presumably to take them to a warmer planet—one with green grass, endless sidewalks, and outdoor swimming pools year round. (They called the planet Juniper. Harry’s dad speculated that the gin and tonics were probably excellent there!)

Even with this distraction, by 3:15, Don had developed a severe case of sympathetic cabin fever, and announced he was going to the McDonald’s Play Place. Did either of them want to come along? They were back before 5:00—four more hours to fill before bedtime.

God help us. It’s only November.

Indecision and Inaction

posted: Monday November 17th - 10:10am

I need some advice: When you feel overwhelmed do you completely shut down? How do you handle stress?

My whole identity has changed since I morphed into the mother of a child with ADHD. Just listen to how I describe myself—“Kay Marner is the chronically overwhelmed mother of two….” I’ve lived with ADHD-incited chaos for so long that it’s become part of my persona. I haven’t always been this way!

All mothers perform a juggling act: we manage work, parenting, our children’s activities, being a spouse, housekeeping, caring for aging parents—the list goes on and on. Throw in a child with special needs, and we deserve not just a pat on the back, but a free 90-minute, full-body massage complete with aromatherapy and hot stone therapy.

I’m thankful to have a couple of advantages many women don’t. First, I have a supportive spouse. Second, I work part time rather than full time, in a salaried position that pays just enough to balance between the job’s pros (paid vacation and sick time, IPERS) and the job’s cons (being required to work one evening per week and internal issues that I’m smart enough to keep my mouth shut about in this blog).

When I’m overwhelmed, my mind’s natural defense is to freeze up. To ignore; avoid; put off. That response has become so familiar that it feels like the norm, it’s no longer a response to the occasional acute crisis.

So, it felt so weird (good weird) when, two weeks ago today, I made a life-changing decision. I decided to quit my job. Those internal issues (that I’m too smart to blog about) had irrevocably shifted the balance. The job was no longer worth either the emotional investment or the money.

With this decision made, and my spouse in complete agreement, something inside me thawed. Suddenly, I had the energy to clean up the house. Why had it seemed so impossible, I wondered? I took care of some paperwork I’d been avoiding for months. I scheduled some appointments that were long overdue. I paid some bills. I sorted some piles.

My decision to resign held firm for a solid week. Then, sometime during the night before the morning that I was going to give notice, I changed my mind. I couldn’t do it. For now, at least.

But so far, even as the Iowa winter approaches, my internal thaw continues. The feeling of being too overwhelmed to act hasn’t returned.

Okay, women, here’s your cue to tell me I’m not crazy! Please respond, or I will never share anything this intimate again! Do you react to feeling overwhelmed by shutting down and avoiding taking the very action that could make you feel better? What helps you thaw when you are frozen into inaction?

My Non-ADHD Kid

posted: Friday November 14th - 10:33am

My ADHD daughter sucks up 99% of our parenting time and energy, and my independent and responsible son is left with the dregs.

Every Wednesday, Ames’ elementary schools dismiss early, at 2:05 pm, so the teachers have time for professional development. Instead of an early dismissal, the middle school has a late start on Wednesday mornings, for the same reason.

On Wednesday morning, I drove Natalie to school, and then returned home to wake Aaron, and send him off to meet his bus on time.

As I drove home, I realized: I don’t know what time Aaron likes to get up on Wednesdays. I don’t know what time his bus comes. I don’t know what time his school day starts.

This child is 12.

Aaron is independent and responsible well beyond his years. He’s had to be. His younger sister, Natalie, has ADHD. She sucks up 99% of our parenting time and energy, and Aaron is left with the dregs.

I’m proud of him—he’s smart, loving, responsible, and caring. But this isn’t the life I want for him. I want him to have a mother.

Remember when I whined about not getting enough mothering, because my mother died from breast cancer when I was 13?

I’m alive, but I’m little more than a ghost of a mother to my non-ADHD son.

ADHD Medication Dilemma

posted: Thursday November 13th - 3:35pm

I'm a firm believer in the need to treat biochemical brain diseases with medication, so why am I so afraid to add another medication now?

Later today I’m meeting with Natalie’s pediatrician to beg for more drugs.

Did I really say that? Did I really even think that?

Let me start over.

Later today I’m meeting with Natalie’s pediatrician to talk about whether or not Nat’s Ritalin is doing all it can to treat her ADHD, and in doing so, to help her succeed in school. I’ll agonize yet again about adding a med to help her sleep. I’ll ask, with trepidation, if we should consider treating the anxiety component of Nat’s difficulties.

I’ve been dedicating a whole lot of worry-time to the whole medication issue lately. As much as I joke about it, and even three years into doing so, it’s incredibly hard to be okay with medicating my kid!

In a way, it’s ironic that the use of medication is even an issue for me. I’ve long been a firm believer in the need to treat biochemical brain diseases with medication. I worked in mental health for 16 years, and witnessed, over and over again, the indescribable, miraculous difference the right medication can make in people with mental illnesses such as schizophrenia and bipolar disorder.

And, when it comes to treating Nat’s ADHD, the improvement in her quality of life on Ritalin is irrefutable. I’m convinced that without medication, Natalie wouldn’t be able to tolerate existing within her own skin.

So, why did cry for a solid week when we stared Nat on medication 3 ½ years ago? And why am I so afraid to add another medication now?

Spreading the ADHD Word

posted: Monday November 10th - 11:15am

As a mother of an ADHD child, I've feel a sense of responsibility to spread the word about dealing with ADHD children.

I was reading the minutes from a Project Smyles team meeting last week at work. Project Smyles is Ames Public Library’s early literacy outreach program serving kids from birth to age 6 in daycare and preschool settings.

One of our storytime presenters reported having trouble with a child who disrupted her storytimes because he can’t sit still. Someone from the team suggested she try giving him something to hold, like a puppet that goes with the story—a good idea.

I couldn’t resist. I had to stick my nose in where it didn’t belong.

Consider the possibility, I responded via email, that some of the kids we serve will eventually be diagnosed with ADHD. If that’s the case for this particular child, then getting him to sit still shouldn’t be the main goal. Try inviting the child to stand or pace behind the group, where his moving around won’t distract the other children.

If he has ADHD, he may actually get more out of the storytime this way. Moving around could help him focus. For more ideas, visit…you know the drill!

Whoa. I’d never really thought about how our children are treated pre-diagnosis. Aren’t most kids with ADHD diagnosed in kindergarten or first grade? Nat was diagnosed with ADHD and treated early—and her first teachers were unusually expert.

“Thanks for your email. That’s good information,” Linda, Project Smyles’ coordinator said.

“If it helps just one child, I’ll be happy,” I replied.

How can you spread the ADHD word?

Getting the Big ADHD Picture at School

posted: Wednesday November 5th - 3:45pm

Am I guilty of the very thing I suspected the school of — judging Natalie’s ability to function and succeed based strictly on her bad behavior?

Natalie and I met with her pediatrician, Dr. Halbur, last week, and I told Dr. Halbur that yes, the dosage of Ritalin Natalie takes to treat her ADHD is working just fine.

That was last week.

This week, it’s a different story.

Don and I attended Natalie’s school conference last night, with Nat’s second grade teacher, Mrs. Morken, and her special ed teacher, Mrs. Carter. They described a child who is a delight to have in class. Her smile brightens their days. She always tries her best. She wants to please.

But…

She’s really struggling academically. She’s easily distracted. She has trouble concentrating. Anxiety, or at least lack of self confidence, plays a significant role in her struggles. The gap between her and her classmates seems to be widening.

When Natalie was in kindergarten, I had a theory: Natalie’s behavior was good at school, and because of that, I believed, the school might be overlooking the fact that Natalie has problems focusing.

I’d sat in on enough one-on-one sessions with Nat and her occupational therapist, speech therapist, and special ed teachers to see how hard they worked to help her focus. How could she possibly be focusing in a classroom without an educational assistant? If she acted out, I theorized, she’d get the attention she needed. But if she struggled in silence, no one would notice.

At my request, a special ed consultant with the Area Education Agency observed her in the classroom. She found that Natalie was on task more than 90% of the time. I was impressed, and relieved.

Now, I have to ask myself if I’m guilty of the very thing I suspected the school of — judging Natalie’s ability to function and succeed based strictly on how often she behaves badly.

It’s only been a week since we saw Dr. Halbur, but it’s time to see her again. It’s time to describe for her the rest of the picture.

The ADHD Club

posted: Tuesday November 4th - 3:08pm

My daughter doesn't completely understand her ADHD diagnosis. But, thanks to her friends, she knows she's not alone.

In a recent post I wrote that although Natalie clearly understands how Ritalin helps her, I wasn’t sure she connected taking Ritalin with those four letters she hears me throw around.

You know the ones — A-D-H-D.

She does now!

Last night, Natalie and I attended a benefit for Children and Families of Iowa at Images by Ngaire, a local photography studio. Donate diapers, new towels, or something like that, the deal went, and receive a free 5 x 7 photo of your child with Santa. Somehow, Ngaire booked the real Santa for this gig! That woman has connections!

At an event Ngaire hosted a few months ago, I’d connected with Julie, the step-mom of a girl Nat knew from kindergarten. Julie shared with me that her step daughter had an evaluation scheduled with a psychologist.

They suspected she had ADHD.

Last night, after Natalie had been assured by Santa that she would, indeed receive a Nintendo DS for Christmas, but that he’d have to check with Mom before giving her electric clippers for shaving her head, Julie's step daughter bounded over.

“Remember me, from Mrs. Fisher’s class?” she asked. “Natalie! I have ADHD just like you!”

Nat stared at her for a moment, and then looked at me. “What’s that?”

“You know how you take medicine? Your friend takes medicine now too,” I said. The girl nodded.

“Does it help you concentrate? Does it help you slow down so you can make good choices?” I asked.

“Yes,” she answered, like it was the coolest thing in the world. Whoa! A little ADHD club!

Then Harry strode in, and the in-crowd got a little bigger.

What a perfect way for Natalie to assimilate her diagnosis.

Yes, Natalie, there really is a Santa Claus, and he worked a little self-confidence magic last night! Ngaire said he’s heading to Wisconsin next. I hope your child runs into him!

Catering to an ADHD Appetite

posted: Monday November 3rd - 10:35am

ADHD medications can suppress appetite, but good nutrition is so important to treating attention deficit. So I let Natalie eat standing up, and top off her waffles with ice cream. What do you do to pack in the calories?

"I had ice cream for breakfast," Natalie announced to Dr. Halbur, our pediatrician.

I about died! The little tattletale!

"That’s okay with me," Dr. Halbur answered, showing no sign of shock or indignation.

Huh?

Natalie takes Ritalin to treat her ADHD, and Tuesday morning she had her twice-yearly med check appointment. Since ADHD meds can reduce a child’s appetite, Dr. Halbur pays particular attention to tracking changes in Natalie’s height and weight. Today, the growth chart showed that Natalie had grown quite a bit taller, but her weight was lagging behind. Tell me about it! I’m the one who tries (and fails!) to find pants to fit Little Miss Skinny Butt Long Legs!

“Her appetite is actually pretty good,” I said. “She just doesn’t like to take the time to eat. She loves fruits and vegetables, but she won’t eat much meat.”

“Load her up with calories,” came the familiar refrain. “Peanut butter if she won’t eat enough meat. Nuts are good — put them into a trail mix for snacks. They’re full of nutrients, and they also contain fat. Lots of dairy products — cheese, yogurt. I want her to take a multivitamin with iron if she won’t eat much meat.”

And to Nat directly, “Natalie, I want you to eat as much as you can at lunch.”

I let Natalie stand up to eat, rather than trying to force her to sit in her chair. I leave food out so she can “graze.” And I really do let her have ice cream for breakfast, along with multi-grain waffles slathered in butter.

Any tricks and tips to share, moms? How do you help your child with ADHD load up on fat and calories?

(Dr. Halbur, will you be my doctor, please?)

Safe Haven for Kids

posted: Monday October 27th - 11:47am

It doesn't stretch my imagination to understand why the safe haven law may be effective.

My coworker, Betsy, and I listened to public radio as we drove home from a conference a couple of weeks ago. She’s 24 and single, and at this point, anyway, doesn’t see herself as ever becoming a parent.

A story came on about Nebraska’s Safe Haven law. I assume this story has made national, not just regional news—but here’s a recap: Nebraska’s Safe Haven law allows parents to leave babies at hospital emergency rooms—no questions asked, no fear of prosecution. Although intended to protect newborns, Nebraska’s law covers children ages 0-19. It’s being used not only by teenage girls who manage to deny pregnancy until they give birth in a porta-potty, but by parents or guardians of older children, many of whom have mental health or behavior problems. People are shocked. Betsy said she can’t imagine such a thing.

I guess I have an exceptional imagination.

In my world—in the global world--abandonment is real. I adopted my daughter from an orphanage in Russia. I’ve spent a lot of time thinking about the circumstances that lead birth mothers in other countries to place their children in the care of others.

And, I’ve had a small taste of what it’s like to parent a troubled child. I worked in a residential treatment center for emotionally disturbed kids when I was first out of college, then with adults with chronic mental illnesses like schizophrenia and bipolar disorder, some of whom were parents, some of kids with mental health or behavior disorders. Last but not least, I’m the parent of a child with (relatively mild) special needs.

Don’t misunderstand me—I’m far, far, far from wanting to take a road trip to Nebraska. But, what if…

…we weren’t financially stable?
…we had no health insurance?
…we were homeless?
…we had no support from extended family?
…one of us had a drug or alcohol problem, or a mental health problem?
…I had no spouse?
…we lost our jobs?
…there was a shortage of Ritalin?
…we lost our services?
…I wasn’t savvy enough to access the special services that are out there?
…the services out there weren’t good enough to make a difference?
…we had more than one child with special needs?
…Nat’s special needs were more severe?

What if several of those things were true? Problems like those don’t just add up—one plus one equals two. They compound exponentially.

Thankfully, I’m more likely to end up on a beach in Mexico than an E.R. in Nebraska.

But, unlike Betsy, I can imagine.

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