Wednesday, October 26, 2011

Stickers? Are you SERIOUS?

We're in the midst of appointment week.  (What, again?  Weren't we just here??)  Yesterday was our busiest day.  Jordan saw his psychiatrist and counselor in the morning, then karate, and then the older three got flu shots in the afternoon.  I made them all get the shot instead of the nose mist - for two reasons: A) the amount of paperwork was silly - checklists to fill out for each child   B) Owen can't have the mist because he has RSV and is prone to pneumonia, so he had to get a shot anyway.  We were in and out of that appointment in 17 minutes - which I think beats last year's record - I remember even posting a comment about it on Facebook.


I am getting increasingly frustrated with both the psychiatrist and counselor.  Jordan sees the psychiatrist, 'Dr. S' sort of sporadically.  Sometimes it's monthly, but when things are going well, it spreads out to two or three months.  Things have not been going well lately.  Dr. S prescribes all of the behavior modification meds that Jordan takes.  Each visit he talks with me (and Jordan) about Jordan's behavior, does a weight check and routinely orders a blood draw just to make sure that everything is copacetic.  Each morning Jordan takes 20 mg of Vyvanse as soon as he wakes up.  The first behavioral transgression (ie - he does something obnoxious) typically happens within 2 minutes of him leaving his bedroom, so yes - I, in a not-so-nice voice, tell him to go take his pill.  The pill is a twelve-hour slow release, and then he takes 0.5 mg of Risperidone and 2 mg of Melatonin about an hour before bedtime.  Both meds are to help him sleep and even out the highs and lows.  Before we tried the evening meds, Jordan would routinely stay awake until midnight, and not sleep well at all.

At boy scout summer camp this past June, Jordan brought his meds with him, and had to hand them over to the camp office for the week.  It was his responsibility to remember to go and take his meds each day.  He was able to do this just fine.  We liked that he was taking responsibility like that, so we continued with that routine when he got home.  He remembers about 60% of the time.  We use a day-of-the-week pill case, so that way he doesn't get confused about whether he already took his meds or not.  Jordan's attention span is such that if I ask him to take his meds in the morning, he will get distracted by 10 different things on the way up to the medication closet.  Half the time he forgets what he was supposed to do, and just gets in the shower instead.  So I have to make a concerted effort to watch him take it.

Our visit with Dr. S last month did not go well.  It was our first visit since early summer - when things were going well.  On the way to our 10:40 am appt., Jordan was being especially antsy in the car.  Uh-oh.  "Jordan, did you take your meds?".  "Uh.... no?"  Damn it.   Then again, I like it when his Drs. can see him in all his glory - then they know what we are up against.  each.  and.  every.  day.  Dr. S asked (again - can't he write it down??) when does Jordan typically take his meds.  I told him the same thing I always tell him - 8 am, unless he forgets to take it.  Dr. S asked what I meant by he forgets to take it.  I told him it was Jordan's responsibility to remember to take it - I just remind him when I realize he is bouncing off the walls and hasn't taken it.  Dr. S's face actually turned red.  Red!  He was livid that we would do that.  He said, "If my name is on that bottle - it is the parents responsibility to give it to him.".  Well.  okay.... geesh.

Then he brought up stickers.  We could do a sticker chart.  If Jordan remembers by a certain time that he needs to take his meds, then he gets a sticker.  Otherwise, at the appointed time, I am to give him his pill.  Really?  A sticker?  The boy is eleven, for Pete's sake.  E*L*E*V*E*N.  He doesn't 'do' stickers.  In fact - he never has liked stickers.  I don't know if he had a bad run-in with a WalMart greeter as a small child or what - but he does not 'do' stickers.  And we've covered this with Dr. S before.  Several times.  So, as I was saying, last month's appointment did not go well.  I brought Colin into Dr. S's personal office (two smaller rooms w/in the clinic - one room is the room with the chairs that the patients and family members sit in to chat, and the other room is where Dr. S's desk is).  Colin was everyplace, and that 20 minute appointment seemed to go on forever.  Dr. S has two small children of his own, yet even though I had to leave my chair 20 times to go retrieve Colin from his office (I eventually just stayed standing), he never once thought to close the office door to solve the problem.  He just sat there, clearly looking annoyed with me.  The man has children.  Yet he has no idea what 'having children' means.  People like that REALLY irritate me.  He should know.  I know plenty of moms (and a few dads) that just intuitively know how to help you when your children are giving you a hard time.  They plant their bodies in a certain position so that a toddler can't escape a certain area.  They lend a helpful hand, a tissue, a cracker... whatever is deemed necessary at the time.  This man clearly has no experience with this.

He validated my theory about his inexperience during this most recent appointment.  By stating, again, that a sticker chart would be helpful for Jordan.  (Again - doesn't this man realize that Jordan is eleven??)  I was asking for some concrete things to try with Jordan during those difficult evening hours between 5-9 pm, when the meds have worn off.  He came up with stickers.  I bet that during his clinical study years, he missed the class that offered concrete exercises to try with kids, yet attended the one on stickers.  Because that seems to be the only trick up his sleeve.  Stickers.  I even left the kids in the car, watching a movie, so that I could be fully present to discuss the issue and get something other than the suggestion of stickers.  He is still clearly annoyed with me and thinks that maybe my expectations for good behavior are a bit too high.

(What is it with people telling me to lower my expectations lately...?)

Here is my rant.  I am sick and tired of spending lots of time, energy and money (thank goodness for insurance) to go see these "professionals" who don't truly understand what it is like to live 24/7 with a child that has ADHD.  And not just the doctors... most everyone does not truly understand how mentally exhausting it is. Oh I know, I know.. harness the mental creativity and redirect it.  "ADHD is a gift."  Some days I truly feel cursed.  I go to the Dr.s not just for the drugs (because I concluded long ago that I could not go through another day of out-of-control spastic behavior, and take care of three other demanding children as well), but for the advice and counsel on how to help Jordan - yet there is none of that forthcoming!  The counselor offers no concrete suggestions for Jordan on how he can help himself when it comes to making and keeping friends.  The psychiatrist can offer no help or advice on steps Jordan can take to begin work on self-regulation other than a childish sticker chart.  I asked Dr. S for advice on a very specific thing: steps that Jordan could take during his weekly boy scout meeting (it occurs in the evening - not his best time of day) to help him minimize distractions and he suggested moving the meeting to a Saturday afternoon.  You've got to be kidding me!  Yes - I am just going to call up the entire troop and request that the 40 or so troop members switch things up so that Jordan's needs are met.  I can't even begin to wrap my head around the ridiculousness of this suggestion and that he actually posed it as a serious consideration.  He doesn't think Jordan is capable of any attempts to self-regulate yet.  Bullshit.  Children are capable if you give them a chance.  He has proven that he can memorize boy scout stuff- protocols for this and that and the other.  He can certainly memorize a protocol for what he needs to do to be able to get through a boy scout meeting with minimal distraction and goofing off.

See?  It's easy...

1. Sit at least 1 foot away from his nearest neighbor (he has issues with invading personal space)
2. Don't touch or talk to your neighbor.
3. Hold an appropriate 'fiddle' object - like a single Lego - it keeps his hands busy and his mind focused
4. Don't blurt out - keep comments to self and watch, wait and listen until it is time to talk
5. Keep repeating your question in your mind until it is okay to ask it.
6. Form pictures in your mind about what the Scout Master is talking about to help you stay focused.

Wow.  I am way better than a licensed professional.

1 comment:

Deanna said...

Just so you know, I don't think you should EVER lower your expectations for yourself. Who ever has told you that should f%#* off. I love your lists and organizational tricks. I WISH I were more like you, and I admire you.

I admire the mother you are to all of your children, particularly Jordan. I admire your loyalty and dedication.

And, I think you know WAY more than Dr. Stickers. I'm so sorry. I wish I could help more.