The Absent-Minded Drug Dealer

I had to go out of town unexpectedly for two days this week so Dave would be handling the tasks that usually fall under my job description – making lunches for the kids, talking with their teachers, going over homework sheets and of course, giving the kids their medicine. (Ari requires asthma medication occasionally; Max is on a stimulant, daily.)

I plastered the bathroom mirror with so many notes one might think I was leaving the children with a brand new babysitter rather than their own father. But between Dave’s faulty memory and my neuroticism, the notes were necessary for my peace of mind.

I left at an ungodly hour on Monday morning and called to check in that evening. That’s when Dave made his confession.

“I forgot to give Max his medicine,” he said.

It was my biggest fear – realized. Because despite a year of therapy and countless behavior modification plans, it was that single blue capsule that had the most impact on Max’s improved behavior. After living with world-class outbursts, thirty-minute tantrums, hitting, spitting and verbal assaults, not to mention an attitude way too big for any six-year-old for more than year, we were finally seeing improvement. Our home was no longer filled with non-stop screaming. Max and Ari’s interactions were no longer limited to aggressive acts against her. Things were more in control. Max was more in control. Now that we had found something that made such a dramatic change for the better, I shuddered at the thought of spending the day with an unmedicated Max.

And here Dave was, sending him off to school.

Truth be told, Max spent the first half of kindergarten without the benefit of medication and did just as well as the second half when he was taking a prescription. Yes, he had trouble managing his time and was often the last one to finish a given task. But he wasn’t what you would call a standout student – he didn’t bounce off the walls, get into arguments or help himself to the teacher’s computer the way some of his classmates did. Whatever internal struggles he was dealing with, Max always managed to keep it together at school; Dave and I were the only ones who suffered the fallout at home.

So I wasn’t surprised when Dave told me that he emailed Max’s teacher to find out if there were any problems and she reported none.

I was surprised, however, when Dave – intentionally, this time – didn’t give Max his pill the next day. “As an experiment,” he said.

Dave reported that, off the meds, Max fell asleep faster, slept longer and ate much better. No surprise, since we knew the stimulant was affecting his sleep and his appetite. And he didn’t have any major meltdowns at home.

Are we taking Max off his medication? I don’t know. It’s not something I imagined doing anytime soon because the benefits had outweighed the problems, as far as I was concerned. But Dave was never comfortable with the idea of medication, despite his own admittance that it has made a big improvement, not only in Max, but in everything we do as a family.

About a month ago or so I had started supplementing Max’s prescription with fish oil capsules – essential fatty acids (EFAs) – to help even out his moods. EFAs are still being studied but there’s tons of anecdotal evidence from parents who have given them to their children for a wide range of conditions – speech disorders, autism, ADHD and others – and seen improvement. Max’s therapist even told me about a client who was successfully being treated for bipolar disorder with EFAs alone. So as long as the major outbursts don’t return, I’m willing to see how Max does on just the fish oil.

So today, on my first day back home, I sent him to school without giving him his blue capsule. It was no accident. I just hope it doesn’t turn out to be a mistake.

Beauty and the Batman

Driving Ari to school the other week…

Ari: Maria’s in my morning class?
Me: Yes. Who else is in your morning class?
Ari: My Batman friend.
Me: Who’s your Batman friend?
Ari: Ryan.
Me: Who are you when he’s Batman?
Ari: Sleeping Beauty. We get married.
Me: Oh? That’s very nice.
Ari: He loves me. I kiss him on the ear.
Me: Did Ryan like that?
Ari: Yes

The Pronunciation Puzzle

People who didn’t know Max when he was younger are often surprised to hear that he has a speech disorder. I imagine it’s because one of Max’s current problems is that he can’t stop talking.

But back when he was only two-and-a-half, and had just been diagnosed with apraxia, he was extremely frustrated by his limited communication abilities. I was, too. Trying to understand what he was saying was like solving a puzzle; he’d give me a small piece, maybe only part of a single word, and I’d reach back into my mind to recall the days events and see where this piece fit in. If I took too long to figure it out – or was unsuccessful – Max became very upset.

That was almost four years ago. Today, Max’s apraxia is considered “resolved” in that he talks easily and is easily understood. He does, however, have resulting articulation problems. Many kids with apraxia have trouble with their handwriting and learning how to read. At only six years old, I don’t yet know if Max’s scrawls and labored reading attempts are simply typical for his age or a result of the apraxia. Only time will tell.

Since his speech has been pretty much caught up to speed, we don’t have too many puzzle solving moments. Now that he can communicate so well, he’s able to give me more pieces if I do have trouble understanding a particular word. So I was caught off guard the other day when he calmly started telling me about his day at school and ended up a hysterical mess.

He was telling me about something his teacher gave the class. “Our fertick—you know what I’m talking about,” he insisted. I had no clue. I asked him to say the word slowly. It sounded like he was saying, “fertickverstick.”

It quickly became clear that repeating “fertickverstick” wasn’t going to help me solve the puzzle. “Can you give me more information?” I asked him. “What does this have to do with?” My questions only agitated him more. He carried on, calling me names, until we got home. His tantrum continued until he went to his room to play his Game Cube – it’s something that usually settles him down. I went into the kitchen to empty lunch boxes and go through backpacks when I stumbled upon the answer to the puzzle. Inside his school folder was a yellow piece of paper with the words “Outstanding Behavior” written across the top.

Fertickverstick. Certificate.

Am I the only one who finds it amusing that Max’s reward for good behavior resulted in a world-class fit?

In the Path of his Wrath

For longer than I care to admit I have been involved in an abusive relationship.

On any given day, I expect to be – and typically am – yelled at, called names, hit and sometimes, spit upon. I suspect if a friend described such a situation I would advise her to end the relationship immediately.

But what do you do when the relationship is with your six-year-old son?

Max was diagnosed with attention deficit/hyperactivity disorder toward the end of last year. And while he has many of the characteristics that define this disorder (such as difficulty sustaining attention, not appearing to listen, talking excessively and acting as if driven by a motor), it is perhaps the mood instability that has caused the most difficulty for our family.

He is highly impulsive, often irritable, and always impatient. He has a lot of trouble transitioning from one activity to another; without sufficient notice, he melts down. If I don’t make his peanut butter sandwich quickly enough, he barks at me. He has trouble stopping himself from doing things he knows he’s not supposed to: hit his sister, open the car door before it has stopped, and just about anything preceded by “don’t do that again.”

As well versed as I thought I was in ADHD, I had no idea, until Max’s diagnosis, that mood instability was a component. The intensity of his anger, the duration of his rages and the unpredictability of his triggers seemed more in line with a bipolar diagnosis – which he was in fact given by the first professional we consulted.

Three mental health experts and a half a dozen diagnoses later, we learn the source of Max’s problem behaviors is in fact ADHD. Considering the overlap of characteristics between ADHD and bipolar, I understood the misdiagnosis. But it left me questioning and analyzing Max’s every move – “Is this an ADHD behavior or a bipolar behavior?” I asked myself after every one of his episodes.

I’m sure most parents have, at some point, been yelled at, called names, hit and spit upon by their child on occasion. But for parents of special needs children, these behaviors occur, unfortunately, on a regular basis. My husband Dave and I are learning how to better respond to these behaviors and, in turn, Max is getting better at controlling them. Still, there are times when I want to scream back at him and I admit, not proudly, there are times I do. There are days – usually the ones that start at 5:30 a.m. (People with ADHD don’t sleep very much…and neither do their parents.), when it takes every ounce of my strength not to throttle this kid. I find a self-imposed time-out can work wonders.

I’ve said, many times, that if it were my husband treating me this poorly, I’d be out of there. The decision would be easy. But you can’t leave your own child.

When Max loses control of himself, it’s as if he leaves me. He’s someplace else where he can’t hear my calm, quiet voice trying to reason with him or remind him he’s making a poor choice. It’s at these moments when I put him in his room so he can regain control of himself.

When he does, he comes out of his room and he comes back to me.

Of Pudding and Prescriptions

You know you’re the parent of a special needs child when you willingly give him chocolate pudding for breakfast – and would do the same with a bowl of sugar -- because it’s the only way he can get his medicine down.

You also know you’re the parent of a special needs child when one of the “firsts” you celebrate is the first time he’s able to swallow a capsule.

I was thrilled the day Max was able, finally, to swallow a pill. He felt proud and victorious…and I looked forward to never again fighting with him because he could still see a granule from his capsule peeking out from under pudding or yogurt. One might think hiding medicine in food is a simple enough procedure. Those would be the people who never had to get prescription medication inside their own child.

Every morning I would gather my tools: cup of milk, yogurt or pudding, a single capsule, one small spoon, one baby spoon. And every morning I would put just enough yogurt on the spoon so the granules had something to cling to. Then, using a baby spoon, I would put a carefully measured amount of yogurt on top. Too much and Max would start screaming at me. Too little? Max would start screaming at me. I couldn’t stir the yogurt and medicine together because the granules would show and -- guess what -- Max would start screaming at me. I had to carefully layer – yogurt, medicine, yogurt – as if I was preparing a trifle for some new Food Network game show that challenged parents to come up with the best way to get medicine, vitamins, vegetables or anything other than French fries into their kids with minimal protesting. The winner would get the services of a professional chef in their home for a year.

He just better know how to make peanut butter sandwiches with the crust cut off.

My Posse of Ph.D.s

You know you’re the parent of a special needs child when you discover you have a personal relationship with the experts at a medical conference.

I had stumbled upon the AD/HD conference in my area in the local paper and knew I had to go. I checked out the local CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) website (www.chaddmi.com), downloaded the schedule and laughed at what I found: not one, but two of Max’s therapists were speaking at the conference: Dr. S., who co-led the social language classes Max took last year, and Dr.I., Max’s current psychologist and the man to whom I owe my sanity.

I was interested in attending their panels but then thought better of it. What was I going to learn in a 90-minute lecture that I couldn’t (or hadn’t already) after a year – and thousands of dollars – of one-on-one therapy sessions? I love Dr. S. and Dr. I. but I already have their expertise on my speed-dial. So I checked off the little boxes of some other experts who were leading sessions I thought would be most helpful.

Is it weird that I feel like I’m cheating on them?

Less of Me

I head into the extended care room at Ari’s school to pick her up and as I do, I pass one of the teachers. “There’s less of you here,” she says to me. I pause, unsure of how to respond. Yes, I spent all last year beating myself up over the fact that I wasn’t able to be at the school as much for Ari as I was able to do for Max when he was three. When he was three, she was just an infant – I had no other place to be. But when she was three, Max started kindergarten – at another school. I was always dropping her off late or picking her up from extended care. I didn’t really get a chance to know her classmates or hang with the moms or set up playdates the way I was able to for Max. I felt she was getting the short end of the stick and I hated it. I didn’t want the same thing to happen now that she was four and starting a new school year. But today was only Ari’s second day of school – there haven’t been enough school days to say I’ve been around less. And then, the moment of clarification:

“There’s less of Tracey, too,” she said, referring to the extended care teacher who had lost weight over the summer. Ohhhh. She noticed that I had also lost some weight.

I wonder if I’m the only guilt-ridden, overextended, mushy mommy brain mother to interpret a compliment as a reprimand.

SLP in Training

"Use your words, Ari."

I've said those three little words -- to both kids -- hundreds of times over the years. But today, they came from Max.

Tired after a long holiday weekend away and bored by the drive home, Ari could only muster "uh uh uh." But after Max's suggestion, she did, in fact, ask for water.

It's not the first time that Max played speech-language pathologist.

Some months ago when the kids were in the bathtub, Ari held up a bath toy and said, "It's a shark." Clear as a bell, but incorrect in species, Max corrected her," It's a whale."

Then, like any good speech therapist, he prompted her.

Max: Ari, say whale.
Ari: Whale.
Max: Say firetruck
Ari: Firetruck
Max: Say fireman
Ari: Fireman

I don't know what a firetruck has to do with a whale. But I do know that Max has been in speech therapy for three and a half years and in addition to learning how to speak, he's picked up on how to help others learn to speak.

Wonder if his services are covered by our insurance...

Kids are Trouble

It was already after 8 this morning as I got ready to step into the shower. I knew we might be late getting Max to school if I didn't hurry it up but I was riveted, listening to his conversation with his father in the next room.

Max: Can I live here when I'm a grown up?
Dave: No, you'll live somewhere else when you're a grown up
Max: I want to live here.
Dave: Well, that depends how many kids you and your wife have. Maybe this house would be too small for you.
Max: I'm not having kids. They get into trouble.

A part of me found this exchange amusing; a bigger part of me worries about Max's self-esteem. Even though his behavior has improved over the last year -- after years of difficulties -- and we're continuing to learn the best ways to deal with his issues, I fear that the only thing he has learned from us is that kids are trouble. Are there so many reprimands in his life that they override the hugs, kisses, words of praise, ice cream, video games and trips to play miniature golf?

I know the kid's only 6 years old and his opinions are subject to change. Just because he's eating grapes today doesn't mean he'll like them tomorrow. His favorite movie changes daily. Still, this exchange with Dave disturbs me a bit.