Further lessons on medication and mental health
In part as a result of understanding my most recent medication issues, Matthew did some rethinking his current medications for his ADD.
Now he is doing MUCH better, too, on his new med, which is time release, but it's also a different med than his previous one, which was also time release.
We had been having SO many problems with him, with his remembering to do his homework and chores, with falling (not failing, but worsening) grades, and even not handing in his schoolwork, which I didn't get - how could he DO his in-class school work and fail to hand it in - don't his teachers ask the kids to hand things in? Parent-teacher meeting after meeting since late in 6th grade (he's in 8th now), the same damned problem, which NOBODY helped us really address - WHY is he forgetting to write down his homework on a daily basis? How am I as a parent supposed to KNOW what the heck his homework is if there is no mechanism for that except Matthew's remembering to write it down in school? I didn't/don't want to have to accompany the child to school (I actually threatened that), teachers and Gerry kept saying that Matthew just "needs to remember" "needs to be better organized", and they thought "he is just being lazy/irresponsible/forgetful" while I kept suggesting that MAYBE there was actually an organic problem, and his school, unlike some other area schools, does NOT have a website where we could check to see what the homework was each day.
After the first several parent-teacher meetings that we went to, someone finally suggested the bright idea that the teachers each sign Matthew's agenda book at the end of each class where he is supposed to write down his homework.
Me: "GREAT! Thank you! Let's do that then. Well, how would that work, exactly?"
THEM: "Matthew would come up to us at the end of class and have us sign where he wrote down his homework assignments, and if he had none he would write 'none' and we would sign it."
ME: "So, Matthew would have to remember to come to YOU?"
THEM : "Yes"
ME: (Face palm) "Um, excuse me - - - if he could REMEMBER to come to you to sign his book, he could REMEMBER to write down his homework - but the problem, you see, is that HE DOESN'T REMEMBER!!!" "Sigh."
So after hearing about my little saga, Matthew did some thinking about his issues, and he came to me and suggested that his medication was also a problem. He was increasingly having a really bad "bounce-back" time - when the med wore off (this was concerta, which he had to keep having bumped up due to his growing so much in the past 3 years since he got the ADD diagnosis and started on concerta back in 5th grade) - he had started saying many things which made me think he was depressed, he felt angry and irritable, then an hour later he'd come to me and say he didn't mean those things he'd said, it was the medicine wearing off.
He had been saying he "didn't care about school, didn't want to be in GT, just wanted to be in regular classes where he would NOT be challenged, that he hated school, that he didn't see how the things he was learning would matter to him in life after school, that he COULDN'T do the work, it was too hard," blah blah blah.
This had been going on for many months, actually over a year I think, since sometime late in 6th or early in 7th grade, I believe. He's in 8th now. And then he said he thought he needed to be on a higher dose of the medicine. And he asked to start the medicine earlier in the morning. He had what I'd call the same thing as I did - a sudden epiphany. "Mom, you know the 2 classes that I have the worst grades in - that got worse on this last report card? Those are my first two classes of the day. I don't think my medicine has kicked in yet."
So off we went to the pediatrician, whom we both hold in very high regard, Dr. Dan Sarko. And Dr. Dan said "We've already got you on a pretty high dose of concerta, and obviously it isn't working for you. I'd like to start you on a different ADD medicine, called Vyvance. It is basically adderall, but has an extra molecule attached, which makes it time release." He started Matthew off with a conservative dose of 50 mg, and after 2 weeks we upped it to 60 mg because Matthew said that the medication was wearing off too quickly after school before he could get his homework done, but he said that the bounce back was less extreme than he had on the concerta.
So after a week on the new med, Matthew has been really good at remembering to do his chores and homework first, mostly without being reminded, he says he feels much more alert in his first 2 classes because he's taking the medicine a whole hour earlier than he had been doing, and he said of his own accord "I want to try to get all As on my next interims". This from the kid who until recently said "What's wrong with getting a couple of Cs - it's not going to ruin my life - what difference does it make?"
Lesson learned - AGAIN. The right medication at the right dosage at the right time can make a HUGE difference in your ability to function and enjoy life. And that you really have to be vigilant about observing yourself when you're on medication especially, and evaluate how you are doing, so you can be your own best advocate in your health care.
Once again, there is a Nancy button for this: If it goes away when I remember to take my medication, it probably isn't a character flaw.
Now he is doing MUCH better, too, on his new med, which is time release, but it's also a different med than his previous one, which was also time release.
We had been having SO many problems with him, with his remembering to do his homework and chores, with falling (not failing, but worsening) grades, and even not handing in his schoolwork, which I didn't get - how could he DO his in-class school work and fail to hand it in - don't his teachers ask the kids to hand things in? Parent-teacher meeting after meeting since late in 6th grade (he's in 8th now), the same damned problem, which NOBODY helped us really address - WHY is he forgetting to write down his homework on a daily basis? How am I as a parent supposed to KNOW what the heck his homework is if there is no mechanism for that except Matthew's remembering to write it down in school? I didn't/don't want to have to accompany the child to school (I actually threatened that), teachers and Gerry kept saying that Matthew just "needs to remember" "needs to be better organized", and they thought "he is just being lazy/irresponsible/forgetful" while I kept suggesting that MAYBE there was actually an organic problem, and his school, unlike some other area schools, does NOT have a website where we could check to see what the homework was each day.
After the first several parent-teacher meetings that we went to, someone finally suggested the bright idea that the teachers each sign Matthew's agenda book at the end of each class where he is supposed to write down his homework.
Me: "GREAT! Thank you! Let's do that then. Well, how would that work, exactly?"
THEM: "Matthew would come up to us at the end of class and have us sign where he wrote down his homework assignments, and if he had none he would write 'none' and we would sign it."
ME: "So, Matthew would have to remember to come to YOU?"
THEM : "Yes"
ME: (Face palm) "Um, excuse me - - - if he could REMEMBER to come to you to sign his book, he could REMEMBER to write down his homework - but the problem, you see, is that HE DOESN'T REMEMBER!!!" "Sigh."
So after hearing about my little saga, Matthew did some thinking about his issues, and he came to me and suggested that his medication was also a problem. He was increasingly having a really bad "bounce-back" time - when the med wore off (this was concerta, which he had to keep having bumped up due to his growing so much in the past 3 years since he got the ADD diagnosis and started on concerta back in 5th grade) - he had started saying many things which made me think he was depressed, he felt angry and irritable, then an hour later he'd come to me and say he didn't mean those things he'd said, it was the medicine wearing off.
He had been saying he "didn't care about school, didn't want to be in GT, just wanted to be in regular classes where he would NOT be challenged, that he hated school, that he didn't see how the things he was learning would matter to him in life after school, that he COULDN'T do the work, it was too hard," blah blah blah.
This had been going on for many months, actually over a year I think, since sometime late in 6th or early in 7th grade, I believe. He's in 8th now. And then he said he thought he needed to be on a higher dose of the medicine. And he asked to start the medicine earlier in the morning. He had what I'd call the same thing as I did - a sudden epiphany. "Mom, you know the 2 classes that I have the worst grades in - that got worse on this last report card? Those are my first two classes of the day. I don't think my medicine has kicked in yet."
So off we went to the pediatrician, whom we both hold in very high regard, Dr. Dan Sarko. And Dr. Dan said "We've already got you on a pretty high dose of concerta, and obviously it isn't working for you. I'd like to start you on a different ADD medicine, called Vyvance. It is basically adderall, but has an extra molecule attached, which makes it time release." He started Matthew off with a conservative dose of 50 mg, and after 2 weeks we upped it to 60 mg because Matthew said that the medication was wearing off too quickly after school before he could get his homework done, but he said that the bounce back was less extreme than he had on the concerta.
So after a week on the new med, Matthew has been really good at remembering to do his chores and homework first, mostly without being reminded, he says he feels much more alert in his first 2 classes because he's taking the medicine a whole hour earlier than he had been doing, and he said of his own accord "I want to try to get all As on my next interims". This from the kid who until recently said "What's wrong with getting a couple of Cs - it's not going to ruin my life - what difference does it make?"
Lesson learned - AGAIN. The right medication at the right dosage at the right time can make a HUGE difference in your ability to function and enjoy life. And that you really have to be vigilant about observing yourself when you're on medication especially, and evaluate how you are doing, so you can be your own best advocate in your health care.
Once again, there is a Nancy button for this: If it goes away when I remember to take my medication, it probably isn't a character flaw.