Tics on TV

Although the Tenex has done a great job of calming Max’s tics, save for the occasional head shaking, I still thought it was important to have him watch an HBO special than ran some months ago called I Have Tourette’s But Tourette’s Doesn’t Have Me.

Dave was concerned about making Max aware of yet another label; I thought it was more important for him to see that there are other kids just like him.

So we sat down to watch it. I explained that the movements his body makes sometimes are called tics and that the kids in this show had tics, too. He watched, intently, and when he saw a kid make a movement with his arms he said, “Hey, he does what I do!” There was such excitement in his voice, such a positive feeling of identifying with another kid, that you would have thought his excitement was over finding a fellow Star Wars fan.

He wasn’t able to sit through the whole thing, but that’s OK. So many times he’s expressed that he’s the “worst first grader” in the whole school or “whoever made me this way is dumb.” He’s more and more aware of his differences and challenges and it upsets him. But in those few minutes of watching this show, he found camaraderie with the children on the TV screen. And, hopefully, a bit of self-acceptance.

Tenex For Tics

Max is now taking a blood pressure medication called Tenex. Because it’s done such an amazing job of reducing both his tics and impulsivity, it’s actually succeeded in its originally intended purpose of lowering blood pressure.

Mine.

Since starting him on the new meds I’ve been successful at things that were once nearly impossible: getting Max to turn off his GameCube, eat something besides waffles for breakfast, and sit down to do homework for five minutes.

The highlight was the day I took him to Chuck E. Cheese and Toys R Us. I knew it was a risky move as both destinations are places where conflict is inevitable, whether it’s Max asking for yet more tokens, complaining that he doesn’t have enough tickets for a good prize, or demanding half the toy store’s inventory. But he was so surprisingly cooperative, polite and compliant that as we sat eating our lunch I couldn’t help but think: “This is what it’s like to have a normal child.” And then I corrected myself: “A neurotypical child.”

The Tenex has also eliminated the tics that were causing Max such distress. He seems to have acquired a new one in their absence – a head shaking thing – but it’s not nearly as severe or frequent its predecessors.

He still has his moments, of course. But it’s truly as if he’s a different child. We’re seeing a much bigger improvement than we did when he was taking stimulant medication.

His psychiatrist, Dr. K., indicated that Max may need additional medication – another round of stimulants to help him focus and an antidepressant to help with his anxiety and compulsive behaviors. The thought of him requiring three medications is overwhelming and frightening. I have no idea on how I’ll sell Dave on the idea considering how uncomfortable he is with Max on anything.

I’ll worry about it when the time comes. In the meantime, I’m just grateful for how much more controlled Max is these days. There are fewer outbursts and he’s much more compliant. the atmosphere in our house is much more relaxed.

That one small blood pressure pill has brought a calm to our whole family.

Tic...Tic...Tic...Kaboom

Four years.

That’s how long Max has been ticcing.

Had I been asked to guess, I would have said it was only going on for two years. Because they’re intermittent, Max will go many months without a single tic. But soon a new one emerges and becomes part of our everyday life, an unwanted visitor moving in and taking up residence in Max’s small body. Had I not consulted my journal I never would have known he’s been doing it for most of his life.

The tics have always taken a supporting role to the cast of behaviors and issues that are often in the spotlight. The eye blinks, hand movements and head jerks were always of little consequence compared to Max’s impulsivity, sensory issues, inattentiveness and basic lack of control over his executive function. Although they were sometimes distracting—and yes, I’ll dare say sometimes annoying—to us--they were never an issue for Max. It was one small saving grace given that just about everything else was an issue for Max.

But like the ever-evolving tics themselves, this has all changed.

I had picked Max up at school and within a minute after pulling out of the parking lot he was in distress. “My hands are bothering me,” he said, fighting the panic that was rising up. I turned around and saw his hands moving fast and furiously in a movement that looked as if Max was trying to open two imaginary doorknobs. He had never demonstrated this particular tic before; nor had he ever ticced with such intensity.

What was so frightening to me wasn’t just that Max had absolutely no control over his body at that moment—but that it frightened him, too.

“Do you think you can stop?” I asked.

“No,” he said.

“It’s OK Max,” I said, trying in vain to offer reassurance. “We’re going to the doctor right now.”

It was after 4 p.m. on a Friday and I still had to pick up Ari, but somehow the pieces fell into place and we got an appointment with our pediatrician. I gave Dr. N. the rundown and was surprised when she said she wanted to do a throat culture and check for strep. Max had shown no symptoms of strep or any physical illness for that matter, save his twitching hands.

And then Dr. N. reminded me of something I had read about years ago: PANDAS.

PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection. I know, not nearly as cute as the furry black and white variety. It basically refers to how some kids with OCD or tics can have their symptoms worsened by strep. Treat the strep and things improve.
Dr. N. wrote us a prescription for amoxicillin and suggested we follow up with Max’s neurologist.

I suppose this whole ordeal might have been all the more stressful if we didn’t already have a pediatric neurologist for Max. (Good thing we suspected petit mal seizures back when he was two-and-a-half; save us the trouble of looking for someone now.) Still, it was upsetting to see Max so completely out of control of his body’s movements. It’s overwhelming to try to keep up with the ever-changing neurobiological snafus taking place in Max’s brain. I can’t even imagine what it feels like for Max.

It seems every time we solve one problem, another one emerges. Max’s primary diagnosis may be ADHD, but there are so many related issues—anxiety, compulsions, tics, sensory issues--that you could probably flip to any page in the DSM-IV and find something he’s experienced.

Our goal for so long has been to improve Max’s impulsivity and focus. But with the tics taking center stage, it’s my focus that could use a little help. Which of the many neurological and psychiatric issues do I address first? I feel like I’m doing nothing but researching online and making appointments with mental health professionals. I’m moving as fast as I can to bring Max—and our family—some relief.

Why do I feel in such a rush? Max’s tic, tic, ticcing is not unlike the ticking of a bomb. If I can’t make it stop, you can damn well be sure there will be an explosion.

And it’ll be me who will have to pick up the pieces.