Just left school after a battle to get him to take medications. I cannot keep doing this.

[rdland]

I am just so mentally exhausted! I spent 2 hours trying to get all his medication in him and at 9am I took him to school with it so he would not be late. I did this one other time but I hate doing it. I was up there for 1 hour and they finally told me just to go home. He is with the nurse, his para educator, the guidance counselor and now the principal trying to get him to finish it. They suggested that I get permission from his dr. to have the nurse give him his medication daily at school in the morning to help. The thought process is him having a medical professional instead of mom doing it. I don't know if I like this idea as I "try" to keep the school out of this as much as possible because I am not thrilled with how they handle things. I hated taking him up there today but he cannot miss any more school and I had no choice. I also was not thrilled with the young nurse who went in the room 5 minutes with him and comes out to tell me I need to set up some consequences with him because he is acting up too much. She said he is not taking it seriously and he is jumping around and not sitting still. I told her, "that is perfectly NORMAL behavior for someone with ADHD who has not taken all of their medications!! (he had about 50% in him before we left the house) She just said, "well he needs to be given consequences or he will never take it." Can you say clueless!!! She is not the one who is normally there thankfully but I did tell her that we have tried consequences and I rattled off that he was not allowed to the go anywhere last week on break, lost the TV for 5 days, lost toys and IT DOES NOT MATTER!! At that point I walked away from her and went back with the others trying to help. She also did not understand that she cannot leave him alone in the room with it because he will dump it out. As I said, thankfully she is not the normal one there and his normal nurse has a perfect personality to deal with him and I love her! This little thing was clueless!!

We are also worried because he is having some really negative thoughts the last few days that were not happening before while on the medication. Every evening he is telling us he is stupid, worthless, a dummy, horrible person and does not deserve to have anything, ect, ect. This is new for us. He is also hitting him self in the head telling us his head is making him act like this and he starts back up again on how stupid he is and so forth. Him blaming his head is not new as he is acutely aware that he has challenges and has always said his cannot control his actions because his head keeps him from changing his behavior. What is new is hitting himself in the head and calling himself dumb and so forth. He has also had a couple violent outbursts this week too. I am concerned that 3 weeks in to taking the vyvanse his reaction to it is now turning very negative. This was not happening the first 2 weeks and is a complete change for him. He is extremely depressed and tearful in the evening all week with us. He started doing some of it at school yesterday too which concerns me even more. Of course while I was sitting there with the guidance counselor and she was telling me about it happening there yesterday I told her it is worse at home and new for him. She said, "it is not new!" This is exactly how he acted before the medications when we wanted you to put him in the hospital. Yeah, ok! I guess the 3 doctors who disagreed with you are all wrong! I told her then why did none of this happen when he was at the school at the acute partial hospitalization program??? When he was monitored by professionals THE ENTIRE SCHOOL DAY!! I will tell you why! Because YOU kept asking him how he felt and to draw it for you EVERY DAY!! Even our counselor who sees him at school that has a contract with the school says that she thinks they were leading him to draw those things and say those things. What he is saying now is different and happening while ON the medication while before on the medication he did not get depressed at all. She would not even consider that it could be the medication. Whatever!! Hopefully when I hear from his counselor today she can let them know this is new and a concern for us. I really hate this guidance counselor and I hate bringing them in on anything. I hated her being apart of the medication this am but I had no choice. She thinks she KNOWS him because he sits in her office and draws pictures of his feelings. I asked her if he had been saying this stuff or drawing these pics the last 2 weeks and she said no. BINGO!! Unfortunately he likes her too.

So I left with the principal taking him into her office to try to get him to take it. I honestly was about to lose it crying at that point so I did not fight them and left. I really needed a sanity break and I was afraid I would start crying in front of them due to my concern and frustration with him. So I went and cried in the car on the way home. I will say he drank about 50% of his medication before I took him to school and it should have kicked in to where he would be thinking more rationally...but instead it was not working at all and as I left he started talking about how stupid he is for not taking it and getting down on himself. I will say we never say those words to him about taking it so this is not something he has heard from us. Something is not "clicking" with him with this medication any more. WE see the dr on Monday.

Would you consider letting the nurse give it to him daily?? (only if the normal nurse is there) I don't like the idea. If I do keep doing it at home what do I do when it is 8:50 and school starts at 9am and it is not taken??? I really don't want to take him up there like that any more. I will certainly let his psychiatrist know all this and see if we can find a solution. I am also going to push to try a different medication with all the knew behaviors. I have 1 month before I can get more testing done on him to find out if there are other things going on too. (that will be when our new insurance starts that will pay for neuropsychologist, Occupational Therapist (OT) and whatever else is needed...I am calling today to get appts set up)

I am just so mentally drained and it is all starting to really affect me in a negative way. My husband works every day and is at a new job so I cannot pull him out of work to help right now. He tries to help in the evening but he does not have very much patience to deal with this stuff....though he is trying and getting better. He was REALLY against medications when this first started in August but he has since realized they are necessary. I just need to keep myself sane while trying to help my son but it is getting really hard....

 

[InsaneCdn]

Would I consider having the school nurse give my kid daily medications?
No.
Period.

Even IF it works (I'd give it less than 1% chance of not creating more problems than it solves), what happens on weekends?

This is a reaction, not a thought-through plan.

And yes, lots of medications have side-effects that don't show up until you've been on them for a while. I am not familiar with the medications your child is on.

 

[Chaosuncontained]

I *think* I would let them give the morning medications. For a few reasons. Maybe he is balking at the medications thinking he gets to stay home. Give the medications at school and he will soon realize he's going to school anyway. Maybe he knows or feels he can "con" you easier into giving in. The staff at school may "last" longer than you would. Plus (and this is my experience from working as a daycare/preschool teacher) I have found that I always have more patience with kids who are not my own. What I mean is...I could put up with a lot more from a child who wasn't mine and still have the musical tone to my voice than I could with my own. Five minutes of hanky panky from MY kids gets a stern voice and a threat of grounding. I couild last considerably longer (and still have my hair) with someone elses child. And my final reason? YOU DESERVE A BREAK! They are asking to help you, it is ovbiously taxing on you. Take the break... HUGS

 

[buddy]

I have done that. But if you have people who might have to fill in when she is gone, ones that might screw up....then I don't know.
I think he got TONS of attention today for that and they made a huge mistake not just having him go into one of their offices, sit quietly and the person (whoever you trust to do the right thing) can give it when he is ready. I know HE wont be quiet, but they need to be.

That little nursie is way too clueless to be believed. And as for the counselor, I am having the same issues with our psychologist at school...in terms of not knowing if it is even good for him to see this guy. They really cant without our permission so if she is leading him to negative thoughts then she needs to butt out. Trust your gut on this one. I did tell the teacher I was done with our psychiatric. having any 1:1 with Q. I am still ok with his facilitating peer time, but alone...nope.

There is no patch form? How is he with other eating and drinking? Is it the taste? Gosh, I know you described it before, but I forgot, sorry.


just wondering...do you have a time limit you are trying the medication for? when will you decide that it maybe IS the medication causing more issues? or of course decide you think it is helping. I usually dont withhold medication info from schools, but with doctor blessing I have held off a couple of times for a few weeks, to see if they are making objective observations. When they know of a reduced or discontinued medication, I tend to get more phone calls even if it is not related to things that medication should have affected anyway.

 

[rdland]

The patch that can be used for ADHD ia not covered on our insurance right now. It is the taste and the feel of the medication in his mouth that bothers him. The contents of the capsule have a strange feel in his mouth. He has always been a picky eater too.

I have done that. But if you have people who might have to fill in when she is gone, ones that might screw up....then I don't know.
I think he got TONS of attention today for that and they made a huge mistake not just having him go into one of their offices, sit quietly and the person (whoever you trust to do the right thing) can give it when he is ready. I know HE wont be quiet, but they need to be.

That little nursie is way too clueless to be believed. And as for the counselor, I am having the same issues with our psychologist at school...in terms of not knowing if it is even good for him to see this guy. They really cant without our permission so if she is leading him to negative thoughts then she needs to butt out. Trust your gut on this one. I did tell the teacher I was done with our psychiatric. having any 1:1 with Q. I am still ok with his facilitating peer time, but alone...nope.

There is no patch form? How is he with other eating and drinking? Is it the taste? Gosh, I know you described it before, but I forgot, sorry.

 

[pepperidge]

don't know if you have tried this, but we wake up our kids in bed in the morning about 1 hr before they have to get up and give them their ADHD medication. While they don't fight taking it, they are basically still asleep and then go back to sleep for a while. The advantage is that when they get up they are a bit more cooperative about everything else. Then they have the medications on board when they go to school (we live only10 min from school so they don't have a long bus ride or whatever to wake up).

Might be worth trying.

the other thing that comes across in your email was something similar to my son. when we tried to impose consequences because he was fighting school so much when he was young (didn't want to do work, wasn't fighting people) he got to the point where he said life isn't worth living, you take away everything that is good in my life. He was a pretty depressed kid even before that--and all the struggles only added to his sense of himself as worthless. So keep an eye on whether you think he might be depressed. And don't go to an SSRI (like Prozac or Zoloft) without checking in with this board first!

Hugs.

 

[buddy]

The patch that can be used for ADHD ia not covered on our insurance right now. It is the taste and the feel of the medication in his mouth that bothers him. The contents of the capsule have a strange feel in his mouth. He has always been a picky eater too.

My son takes two medications not covere by his insurance AND his patches are dispensed as written becasue the generic are HUGE and cause tons of skin breakdown.

So, you may have already tried this, but your doctor can help you do an override, or preauthorization or whatever they will call it to try to get a medication that is not on their formulary. There should be procedures on the insurance website or via a phone help desk. Just if you want to, of course, I am suspecting you have tried already so just posting in case, smile!

 

[pepperidge]

you might want to think about the side effects of the medication. When we put our 6 year on Concerta, it raised his anxiety level, he perseverated about things and basically became a tearful mess. It was a dramatic difference. Now at 14 he is on it, but when he was younger he couldn't tolerate it. We tried a low dose of Abilify for a few years with some success.

Our other son did get a bit more aggressive on Adderall, but it had such a dramatic positive effect we thought it was worth it. A low dose of Risperdal in the evening really helped even out things, helped him sleep better.

The right medications can make a big difference to some kids.

 

[BusynMember]

As one who has taken almost every medication under the sun, when a new medication has been introduced and the behavior deteriorates at the same time or shortly after, I always look to the medication first and see if the child is better off of it. I would ask psychiatrist to see if he can wean him off of it and see if things improve. If not, you can always put him back on it, but Ritalin made me fly high as a kite then I crashed like a plane and was so depressed for months and months afterward. Maybe your child doesn't want to take it because he doesn't like the way it makes him feel. I've had plenty of medications that made me worse than my problems did. I'm not a fan of adding medications until you try to remove the offending medication. My motto is "The less medications, the better." I do need to take medications, but I keep them limited to two. I am VERY medication sensitive. Is he doing better on the medications, is he doing the same or worse?

My son, who is on the autism spectrum, got mean and aggressive on every single medication given to him. Who diagnosed your child? Are you satisfied that the issue is ADHD and not something else too? Many of our kids are wrongly diagnosed or, frankly, the psychiatrists have no real idea what is going on and are just taking guesses. If your child is on the wrong medications, consequences likely won't help change his behavior or make him any happier or more productive. been there done that...unfortunately. Many times.

 

[Andy]

I would also start with the medication. As others have said, medications are different for everyone. The doctors do their best to figure out which one to prescribe but can not usually know how it will really effect the person taking it. If you have a good doctor, he/she will listen to you for clues on what is and is not working. He/She should be open to your concerns and work on finding something else. Some effects do take time to show and the effectiveness of some medications can change over time (work to start with and then stop working).

I am also wondering if your difficult child is having trouble with swallowing the medication? It may be starting to dissolve before it is actually swallowed. Have you tried giving it with applesauce (if it is o.k. to give it with food)? or buried in a spoon of pudding? He is so young that he might not have the swallowing of pills down yet? I know it took me forever to learn how to swallow a pill. Ask the doctor or a nurse for suggestions on helping him learn how to better swallow so it gets down before starting to dissolve - if that is part of the problem.

As you have observed, consequences do not work in this type of situation. They usually just set up the power struggle scenario that he is trying to participate in on his harder days. When their feet are set against something, no consequence in the world will matter, in fact, they are usually a more pleasent way of getting out of doing something that is truly hated. He is just as frustrated with this as you are and feels helpless in the whole situation. He hates the medication and knowing he has to take it every day is a huge negative for him. He hasn't accepted it and is trying to find ways to avoid it. If the medication is contributing to his worse behavior, he also has picked up on that and wants to refuse the medications though he is too young to understand it enough to put it in words.

I am glad you have a doctors appointment on Monday. If your difficult child's doctor is as wonderful as my difficult child's doctor, you will come away on a different path and feeling confident again. Try to keep things as positive as possible so your difficult child will be more relaxed and draw his strength from you. Find a way to make him understand that you are in this with him and that together you can get through this but he needs to work harder on doing his part - a very big task for such a young person. Spend time each day (especially mornings) pointing out positive things so that his day doesn't revolve around the taking of the medications. (In his mind, that is what mornings are becoming to be all about).

 

[buddy]

oh, I must have gotten that wrong, I thought it was liquid since she said she got part of it in him.... either way it could be mixed...but I am trying to remember. Your last post said that you had tried a bunch of tricks already right? sorry I forgot. i should go look.

Maybe it is just not a good medication and he knows that on some deep level...some of the other kids here have had that. I am sure it is not the usual reason for kids not wanting it, but if it makes them feel awful? Chances are it is taste and behavior mixed I suspect.... but doesn't really matter. If you can't get i t in then you can't. I hope the doctor can fight for you for an override of a patch medication.

 

[Methuselah]

Rdland, I am sorry you had such a horrible morning.

Some medications can be compounded into a topical gel which can be rubbed into the skin and not swollowed. Check with your pharmacy to see if they compound drugs, not all do. Walgreens compounds the one I need. Also, research online if the drugs can be compounded, so you can push the pharmacy to find the recipe, if one exists. The hospital pharmacy and my daughter's medical staff had no idea the drug she uses could be compounded. If I hadn't found the info myself, I would still be where you are.

Good luck.

 

[buddy]

very interesting methuselah ..... thanks for sharing that! some medications are needed so early but if I wake my guy he is UP so that could be very useful.

 

[rdland]

oh, I must have gotten that wrong, I thought it was liquid since she said she got part of it in him.... either way it could be mixed...but I am trying to remember. Your last post said that you had tried a bunch of tricks already right? sorry I forgot. i should go look.

Maybe it is just not a good medication and he knows that on some deep level...some of the other kids here have had that. I am sure it is not the usual reason for kids not wanting it, but if it makes them feel awful? Chances are it is taste and behavior mixed I suspect.... but doesn't really matter. If you can't get i t in then you can't. I hope the doctor can fight for you for an override of a patch medication.

It is a capsule that I pour the contents into liquid or food....but in food he does worse. I had it in juice yesterday which is the best way he takes it.

I spoke to his counselor who works in the group his psychiatrist is in and asked if we could stop the medication due to the scary depression and aggression that has popped up the last few days and she agreed it is best. He is MUCH better today off it! He is happy, hyper, and un-focused but that is just fine! So he is back to acting like he did at home before we started medications. He did have 2 episodes this am where I really thought he was gonna lose it but I was able to calmly talk him down and it did not escalate. Now last night while on medication I was NOT able to talk him down at all and he got pretty scary. I realize it will be days before all of it is out of his system but we already see the sparkle back in his eyes. Now to see what medication we try next!

I am dreading telling the school Monday he is medication free as I know they will have an opinion but whatever. I am his mom and it is my job to make decisions not theirs!

Got the report for all the evaluations for his IEP. As I knew he qualifies so once I sign we will start meetings to do it. Interesting that his main teacher that I do not like scored him harshly on some things and his reading/language/spelling teacher who I love scored much lower. I am also not thrilled with the guidance counselors write up on the chain of events as she makes it seem like we were harming him for not having him admitting at a psychiatric hospital the 2 times we refused. Never mind that the psychiatrist at the acute partial hospitalization program said it was not needed AND the 2 other psychiatrist we saw in that time frame said is was overkill and not needed. I just hate this woman!!

 

[rdland]

We are working to make this a good weekend for him. He is already much better now off the medication.

The medications I was giving was a capsule I opened and poured the contents into juice that he drank. He cannot swallow pills and is terrified he will choke on it if he tries. (I got him to try 2 times and that was it)

We see the psychiatrist after school Monday and I know she will write for a different me. She is really great about listening and working with us. Last visit she said if this medication was not the one we would try focalin next. Now she may change her mind based on what we tell her but that is the one I think we will get. We will see!

I would also start with the medication. As others have said, medications are different for everyone. The doctors do their best to figure out which one to prescribe but can not usually know how it will really effect the person taking it. If you have a good doctor, he/she will listen to you for clues on what is and is not working. He/She should be open to your concerns and work on finding something else. Some effects do take time to show and the effectiveness of some medications can change over time (work to start with and then stop working).

I am also wondering if your difficult child is having trouble with swallowing the medication? It may be starting to dissolve before it is actually swallowed. Have you tried giving it with applesauce (if it is o.k. to give it with food)? or buried in a spoon of pudding? He is so young that he might not have the swallowing of pills down yet? I know it took me forever to learn how to swallow a pill. Ask the doctor or a nurse for suggestions on helping him learn how to better swallow so it gets down before starting to dissolve - if that is part of the problem.

As you have observed, consequences do not work in this type of situation. They usually just set up the power struggle scenario that he is trying to participate in on his harder days. When their feet are set against something, no consequence in the world will matter, in fact, they are usually a more pleasent way of getting out of doing something that is truly hated. He is just as frustrated with this as you are and feels helpless in the whole situation. He hates the medication and knowing he has to take it every day is a huge negative for him. He hasn't accepted it and is trying to find ways to avoid it. If the medication is contributing to his worse behavior, he also has picked up on that and wants to refuse the medications though he is too young to understand it enough to put it in words.

I am glad you have a doctors appointment on Monday. If your difficult child's doctor is as wonderful as my difficult child's doctor, you will come away on a different path and feeling confident again. Try to keep things as positive as possible so your difficult child will be more relaxed and draw his strength from you. Find a way to make him understand that you are in this with him and that together you can get through this but he needs to work harder on doing his part - a very big task for such a young person. Spend time each day (especially mornings) pointing out positive things so that his day doesn't revolve around the taking of the medications. (In his mind, that is what mornings are becoming to be all about).

 

[rdland]

Out pharmacy does not do that but any ideas how to find one that does??

Rdland, I am sorry you had such a horrible morning.

Some medications can be compounded into a topical gel which can be rubbed into the skin and not swollowed. Check with your pharmacy to see if they compound drugs, not all do. Walgreens compounds the one I need. Also, research online if the drugs can be compounded, so you can push the pharmacy to find the recipe, if one exists. The hospital pharmacy and my daughter's medical staff had no idea the drug she uses could be compounded. If I hadn't found the info myself, I would still be where you are.

Good luck.

 

[Andy]

Totally frustrating not to have everyone at the school on the same page as you. You do know your child best and personality conflicts between teacher and student should not indicate need for medications or hospitalization. I often wonder if doctors take that into consideration when looking at the scores. A teacher who is not able or willing to be creative and positive in thinking out of the box in reaching a child will give harsh scores to a student who does not follow his/her agenda to the "T". Doctor's don't know the teachers completing these forms and though they are to be completed using professional insight, I am sure there are teachers out there who can not separate their emotions from the object of the questions (aka - can and/or will not be fair in assessments). Maybe you are allowed to review these results so that you can comment on your concerns based on how the teacher chooses to discipline or teach, what that teacher's expectations are and if those expectations are unrealistic. "I noticed that Teacher X's comments and input seem harsher than everyone elses. I believe she expects too much from difficult child. She and difficult child have still yet to figure out how to communicate with each other." (don't need to be too harsh yourself, just a small note that you don't always agree with this person)

I am so glad he is feeling better today. Good for both of you that he maintained control with your help. Remind him how proud you are that he did so well today.

Stay strong with the school. It is your job and you are doing it well to make the decisions on when and if medications are needed. Just tell the school that the medication he was on was not right for him and you will be working with his doctor to decide what the next step is. Staff there who really are looking out for difficult child will notice the positive change.

Don't worry too much about the counselor's write up. Your doctor knows best and is well aware of why difficult child was not hospitalized. The doctor is also taking note on how well you are participating in helping your child through this. He/she will trust your instincts and respect your input and decisions. If anything, the write up will show the psychiatrist what you are up against at school. You can talk to him/her about the pressure the school puts on you and ask him/her what you can say to the school to get them to understand that you are doing what is best for difficult child even though it does not include the drastic steps the school thinks you should take.

 

[Methuselah]

This is where I would start:

The easiest way to locate a compounding pharmacy is to contact one of the following associations:

Professional Compounding Centers of America, Inc. (PCCA)
9901 S. Wilcrest
Houston, TX 77099
TEL: 1 800 331 2498
FAX: 1 800 874 5760
PCCA - Professional Compounding Centers of America - Chemicals, Devices, Equipment, Supplies, Consulting, CEUs, Management, Marketing, Training for Compounding Pharmacy

International Academy of Compounding Pharmacists (IACP)
PO Box 1365
Sugar Land, TX 77487
TEL: 1 800 927 4227
FAX: 1 281 495 0602
http://www.iacprx.org

National Association of Compounding Pharmacies (NACP)
4015 River Road
Amarillo, TX 79108
800 687 7850 (tel)
800 687 8902 (fax) *

 

[buddy]

our doctors laugh at the schools and really dont take them as being as credible as my word, but they know Q and have known him since he was little (except the psychiatrist, I am still a little on guard about her). It sounds like they are not being very professional and I truly know how that feels.

Is there some reason you have to tell them he is not on medications? How about just letting it go for a day and then, OH I forgot to tell you the doctor told us to take him off of that. Wait to see what they notice. It would be hysterical if they assumed you got the medications into him, then thought he had such a great day. I actually have done that, not to make fools of anyone but to get a more objective view of how Q is on a medication or off a medication or at a different dose, etc. Of course if they have a dose to give at school then you have to tell them not to do it, but .......just a thought. It really is not their business. Of course for the long run it is best to tell etc. but for a day or two??? might be interesting. Regardless, they are to use appropriate techniques and behavior with your son.

 

[DammitJanet]

About the compounding. Look up in your phone book "Compounding pharmacies". Or...go to your city and state and enter those key words on the computer. Of course, asking any pharmacy would most likely get you the needed info because they would know who does compounding in the area. My little mom and pop pharmacy actually does it.