“To Medicate or Not to Medicate?”
It is the question no parent welcomes, “Should our son take medication?” And even after we grappled with our son’s diagnosis and treatment, it lingered in the air as we worked through hormonal changes, side effects, and doubts. Here is where we stand today.
I’m in the bleachers at Isaac’s football game, and I’m watching him raise his arms up to the sky for the infinity-th time. “Isaac!” I shout, “Knock it off with the arms thing and get your head in the game.” In the distance, I see his helmet nod “yes.” Then after the next play, I see the same helmet turning back and forth to the left. “Isaac!” I shout, “Knock it off with the neck thing.”
I take a step back and reflect that the boy has had tics since I can remember. At any time, he’s had at least a couple that he rotates or replaces with another; sniffs his nose, cricks his neck, clicks his tongue, clears his throat, shrugs his shoulders, rolls his eyes, blinks his eyes. “You’re doing that blinking thing again, Buddy,” and he shakes his head as if awakened from a dream. “Sorry about that,” he says, and then he starts doing the thing with his thumbnails.
“What are we going to do?” I ask Laurie.
“I don’t know,” she says. “But I’m embarrassed for him. If the kids in school aren’t giving him a hard time about this already, eventually they will.”
We did a little research, and realized the tics are involuntary and probably due to anxiety. The poor kid is also hyperactive, which we’re pretty sure went hand in hand.
I remember discussing these issues with a co-worker who told me his son had been on various medications for years. “We’ve had medications change his mood,” he told me. “On one medication, he lost his appetite and started losing pounds. Another medication made him really sullen and lethargic, and later he told us he had suicidal thoughts.”
I relayed all of this to Laurie while trying to hide my panic. “This world is too scary,” I said. “I will do whatever it takes to shelter him from this. I’ll quit my job and homeschool him myself. Better yet, we can sell the house and move off the grid. I’ll learn how to raise chickens and you can learn to make your own laundry detergent from scratch.”
Laurie said, “How about we talk to a doctor first?”
Our pediatrician gave us a referral to a neurologist, who talked me down further. He listened closely as we shared our concerns, asked a lot of questions, and gave Isaac a diagnosis of ADHD and Tourette’s Syndrome. He explained all of Isaac’s behaviors stem from the root cause of anxiety.
“I’m going to treat him with the lowest dose of a couple of standard medications, and I’d like you to closely monitor any changes in his behavior. Call me anytime if you have any concerns, and let’s make an appointment to see him again in two weeks and discuss his progress.”
“That couldn’t have gone any better,” I told Laurie as we left.
We filled the prescriptions and followed the directions to the letter. Almost overnight, the tics vanished. Isaac became more settled without becoming sullen or withdrawn. At the next parent-teacher conference, his teachers and guidance counselor noted the improvement in his behavior, grades, and overall demeanor.
However, the effects of the medications began to wear off after a few months, and Laurie and I began to worry again. We pushed up our next neurology appointment, and within a few days we were back at his office. “He’s gained five pounds and grown a couple inches since I first saw him,” the doc noted. “I’ll bet he’s hungrier than usual and his clothes aren’t fitting anymore. He’s going through a growth spurt. Let’s continue with the same medication but I’d like to increase the dose and see you back in a few weeks to discuss the progress.”
We had noted the growth spurt, the hunger, and that he had almost skipped an entire clothing size, but we hadn’t done the math on how this could impact his medication. It made total sense, and again we left the doc’s office relieved.
This cycle has continued for a year now. The neurologist has moved offices at times, and we have followed him to each. The medications and dosages have changed as Isaac’s growth and development have changed. He has a cell phone now and has taken a lot ownership over his medication. He asks questions and offers his opinion on the doc’s recommendations. He sends texts to his mother and me. “I forgot my medication this morning and I’m obsessing about what time football practice is tonight.”
“Same time as it is every night, bubs.”