Monday, May 30, 2011

A Medication Vacation

When you think of a vacation, you usually think of relaxation, maybe a beach or a historical landmark.  There's sun, sand, and postcards.  And someone else makes the bed.

But that's not the kind of vacation we've been on.

It happened, really, by chance.  A week ago Saturday, the first day after the last day of school, I had to run off early in the morning for a work event leaving RockStar to bring Dylan to a birthday party.  Who forgot to give him his medication.  By the time I found out about it, it was too late to do anything and, at least, it wasn't like sending him off to a final exam. 

But still I worried.  A roomful of hyped up kids.  Presents that weren't for him.  Too much excitement.  All of these could be triggers for a major melt down, and neither of us were going to be there.  When my work event finished up, I drove to pick him up with more than a little trepidation.

Where I found that all was well

There he was, on top of the water slide, laughing.  Other kids were calling to him and he was interacting easily.  If there had been a meltdown, there was no obvious residual effect.  And when I finally got him (easily!) into the car to head home, he reported that he had had a great time with no conflicts. 

Well whaddya' know?

The next day, we decided to go to a festival.  Since Saturday had gone so well, we figured we'd go without meds again.  It wasn't the kind of festival that you have to pay to get into, and since it was just the three of us, we figured that if it didn't go well, we'd just come home.  And while he was a little whiney and not entirely into it, overall, he was well behaved with nothing close to a meltdown. 

Now, taking a day off from meds is not unheard of for us.  If we have nowhere special to go, we frequently forgo meds.  But when activities with kids are involved, experience has told us that 30mg of methyphenidate will help Dylan maintain self control in social situations. 

When Dylan was first on medication - which at that time was the Daytrana patch - we routinely skipped it on the weekends, that is until we noticed more and more problems.  One weekend scout camping trip in particular made us reconsider the weekend patch break.  On that trip, Dylan was argumentative non-stop.  He had frequent issues with other kids.  He got mad at us for just about everything, from mosquitos in the tent to losing a treasured stick.  It was not a pleasant experience and we realized that social events go better when he has more self control. 

It was over Christmas vacation, after disastrous experiences with family staying with us, that we made the decision to make medication a daily event, weekends included. 

So we were surprised when this impromptu medication vacation started off so well. 

On Monday, Dylan stayed home with RockStar, with no major plans on the agenda, so it was easy to extend the medication break to a long weekend.  But it was on Tuesday, when Dylan came to work with me, that we really made the leap of faith.  I mean, how pleasant would it be if Dylan lost his cool in my office, around my coworkers.  But, as I said, things were going so well, so we decided to commit to a real vacation.

He was at work three days - Tuesday, Wednesday, and Thursday - and was remarkably well behaved all three days.  Polite to my coworkers, if still a tad shy.  He kept himself busy and relatively self-sufficient on our family laptop, watching movies and playing computer games.  One day he even took a break with a visiting coworker who was actually on vacation. 

Friday, he was again home with RockStar so it was easy to keep the vacation going.  And on Saturday, I was home without much of an agenda, sending the vacation into the beginning of a second week. 

Yesterday (Sunday) was the first day that we began to see chinks in the armor of Dylan's self control.  Here we were, at another festival (this is New Orleans, so there's a festival almost every weekend) and we were reintroduced to a boy who complains a lot.  Who sees himself at the center of the universe with the rest of us as incompetent servants to his needs. Who wants what he wants when he wants it.  

It was unfortunately, really.  We had almost begun to forget why we were originally driven to seeking medication.

Of course, the main reason for seeking help was not to control a self-indulgent little boy.  We wanted him to be able to manage school and all that entails - tests, homework, and social situations. But it was the meltdowns and arguments that really helped us see that this wasn't just a maturity issue, something he would grow out of.  Just before our first visit to the psychologist, we had gotten to a point where Dylan argued absolutely everything.  If you said that it was going to rain, he would argue - vehemently - that it wasn't going to rain.  If you tried to get him to go to bed, he argued, and cried, and demanded to be carried.  Birthday parties were just opportunities ripe for hurt feelings and tears.  We were walking on eggshells and no one was very happy.

Mainstream media likes to paint the picture of ADHD meds as aspirin for self-indulgent parents who just want to keep their kids quiet.  They make it seem as though it's not only an easy decision, but one that parents go looking for.  But our experience and the experience of any other parents I know of who have kids with ADHD is far different.  Parents agonize over the decision to medicate.  They go to the doctors - psychologists, psychiatrists, neurologists, and pediatricians - as a last-ditch effort and they don't want to hear that medication is the best course of action.  They want an alternate answer.  They want to hear that if only you do this, your child will stop behaving that way, and if you feed him that, he'll suddenly be able to pay attention and do well in school. 

Oftentimes, if they have the means (time, energy, support), parents will try alternatives.  And I've heard that for some kids, alternatives do work.  But they can take all those means - the time, the energy and determination, and the support of all the caregivers and people in your life - to make them work.  Not every parent has these means, and even if they do, sometimes they are in a position where they need more immediate results. 

Medicating is never, ever an easy decision.  But many times, it works wonders.  

It isn't easy to find the right med right out of the box.  I've heard that one day, by using brain scans, doctors may be able to determine what the best medication for each child might be.  That would be wonderful.  But in the meantime, the decision to medicate is only made all the more heart wrenching by having to play trial and error.  You feel as though your child is a pediatric science experiment. 

Our medication vacation will soon end.  Dylan starts his first camp of the summer tomorrow.  It's a chess camp and being able to focus, pay attention, and concentrate is mandatory.  In fact, I won't deny that I'm a little bit nervous that the medication won't be enough, at least not enough to last until 3:00pm in the afternoon. 

Since this vacation went so well, however, we may consider other vacations.  He starts a 3-week run at another camp next week.  He's familiar with this camp and they keep them pretty active, with a new activity almost every hour.  Maybe the combination of familiarity and frequent change could make it easier for him to maintain that all-important self control  

We've enjoyed seeing him graze food throughout the day, instead of barely eating lunch, although I can't say if he's gained any weight.  It's been wonderful to have him fall asleep in five minutes without a nightly dose of melatonin.  If these little breaks also keep his body from getting used to the medication, so much the better! 

Happy summer vacation, y'all!  Hope any breaks you may take (whether they are by car, plane, or of the medication variety), go well for you and your kids. 

1 comment:

  1. You are brave to try a medication vacation but I think it is a way to try out new options for your son. You know your son better than any doctor so follow your instincts. Moms do know best!

    Pragmatic Mom