After some more work with Zach's therapist together we decided to proceed with the testing for ADHD. She recommended that I make an appointment with a child psychiatrist. After I jumped through the insurance HMO hoops I was referred to one that was close to the house.
I came to this appointment prepared with statements from his therapist and occupational therapist. When I sat down with the doctor the first comment she made was about his small size. I confirmed that he was on the smaller side for his age, but nothing medically concerning. She asked me some questions about the problems we have been having, what his previous treatment has consisted of, and what we were looking to see happen. I explained all of the problems he has, and that he has been diagnosed with Sensory Processing Disorder but that I did not believe that was his main issue. The one thing that his weekly occupational therapist sessions can not change are his impulsive tendencies. She has helped him work through his "engine" level, which is getting Zach to realize when his "engine" is running too high for the situation. However his impulsiveness is his number one downfall. He doesn't have the ability to stop and think about something before he does anything which is what is always getting him in trouble.
The next thing she told me was that there was no medication "approved" for children under the age of 6. So I sat there and thought "Ok so we have to suffer through this for another year", and after a long pause she said but they did have one medicine that she could prescribe. She gave him the beginning dosage of Intuniv. It is a new medication that has only been released for ADHD as of November 2009.
That night I gave him his first pill, and the next day was hard for me. He was just not Zach. Granted he was much easier to handle, but he had absolutely no energy. It was almost sad. Zach can be a tough kid to handle from time to time, but to see him this way was just wrong. I did read all the warnings that the main side effect was drowsiness. This lasted for about a week, and then it seemed as if his body was getting used to the medication. After the "zombie" state wore off the typical impulsive Zach returned. He was on schedule to up the dosage as part of the original month of processing through his system. Of course with the change of dose came back the "zombie". However the worst part of all of this is the night terrors that have started. No one can tell me what part of the medication is causing this to happen, and it has been a very long few weeks dealing with it. On the one hand I am struggling with the hints of improvement that I am seeing, and but stricken with the side effects and wondering if it is worth it.
Zach of course has no recollection of these night terrors. They are by far the scariest thing I have dealt with as a parent yet. He is screaming and crying and calling out for me as I am standing right there. All of the research that I have done emphasizes not to wake them and gently guide them back to sleep. Some nights are manageable and others are awful with him having them 7-8 times per night. I think I have found that if he goes to bed by 8pm and takes a nap in the afternoon they are not as bad. I read that being overtired is usually a primary cause.
So this week my primary focus is to find him a new doctor to discuss the medication. I just did not get a great feeling from the first physchiatrist and would like to talk with someone who is going to work with me on this to find what is best for my little man.
I love him so much and so desperately want him to be able to have an easier time making friends. I want people to see the loveable HUGE hearted little boy that I see, and not a crazy nut that can't follow directions. This has been a very difficult struggle for me, and everyday I hope that I am making the right decisions for him and for our family. This is such a long road for him, and I want to make sure that I stand by him as the best support I can!
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