Hu...what?!

[Ktllc]

I asked for a copy of difficult child's evaluation's report from the behavioral and developmental pediatrician. I thought it might be good to start building a file and put anything that would be relevent in it (ie. doctor's report, preschool report...).
I started reading the whole thing (only 5 pages) and it seemed a pretty accurate summary of the visit, until... the section "plan of action". He had mentioned medication, but both husband and I said we did not want to go that route. We wanted to do evrything else (ie therapy, keep investigating until the diagnosis is conclusive..) and medications would be MAYBE talked about if difficult child was to become out of control and nothing else worked. medications would ony be for a do or die situation. That is our way of thinking and living. And we have the same approach for "regular" illnesses. My easy child had severe GERD and we only accepted medications when otherwise he would have been hospitalized, he is now on herbs.
Anyhow, first section of the plans: 4 lines of medications! It will be delayed, but than tenex will be used, that many mg, x times per day. Wait 3 weeks and then go up that many mg, x times per day if no results. I could not believe what I was reading. It even said and understood the plan! That doctor has never mentioned Tenex, or any dosage or nothing!!! I thought we were heard... I guess not. It is quite a disappointment. husband does not even want to see him ever again. The pb, we don't have that many ressources around here. And we need him for referrals and further investigations.
GRRRRRRR.

 

[Andy]

While talking with you, did the doctor mention a TYPE of medication route to go IF it ever came to that point? I would need to read that paragraph to be sure, but my take on this would be that the doctor is aware that at this point no medications are to be introduced but IF they were to be in the future, he would like to try this.

He put down in the plan medications that he feels might help if that route is ever taken. His documentations will help him remember what was looked at. It is a plan, not the actual steps being taken.

He may not have mentioned TENEX but he may have said something like, "We could try a __________." When you stated that you would rather find non-medicine ways than he didn't go further to say exactly which ____________ he was looking at.

Don't get too upset about this. On your next trip, bring it up as a question that you need clarification on. "Can you clarify this plan for me? Did you mean to have difficult child start on Tenex now?" If he says he thought he prescribed Tenex and you have been using it all along, then get worried. However, he may explain that was just part of the plan when/if you decided to medicate and if so, nothing to be upset about.

 

[LittleDudesMom]

I am assuming where you said, "it even said and understood the plan" you meant it said you and husband understood the plan? There wouldn't be a problem if the doctor had mentioned medications to you and husband and you expressed your desire not to go that route until after everything else was tried with minimal success and THAT was included in the report. I imagine that is your point?

I am surprised that a medication is specifically mentioned in the report was not shared with you when verbally reviewed with the doctor. You know the ODD diagnosis is often (not always but more usually) just a big umbrella diagnosis that describes a set of defiant or problematic behaviors. Many of us have found that once a more accurate diagnosis is given, treatment for that diagnosis can lessen the ODD behaviors.

There are many here, me included, who used medication as a last resort. I know that I knew difficult child had issues from a VERY early age (almost in-vitro!!!). It wasn't until we exhausted diet trials and behavior modification options that we entertained medications. It had gotten to the point where school was becoming a very difficult situation. Home was not a problem, we could deal with his issues at home - it was in that large social environment where he was required to follow a schedule, an increased amount of focus was required for longer periods of time, greater social skills were needed, and many of the adults around him were either not familiar with techniques that could prevent/lessen his behaviors or not interested in a "kid that didn't fit in their box". Medication really helped my difficult child when he was younger. By the time he entered middle school, we had removed all his medications but the stimulants. He requested, just three weeks ago, that we see how he does without his stims. Just got word on Friday that he passed all his state standardized testing and was excused from 4 of his final exams - all without stims (he is just finishing his first year of high school)!!!! Doesn't mean he won't take them again, just that he was able to self-modulate.

I tell you this story because I wanted you to hear from another parent who was very much leery of the medication issue. I wanted you to know that medications don't always mean a life sentence or negative experiences. Certainly we had our issues with dose adjustments and the best medications for difficult child - but it really was a life saver for my difficult child in that he was able to use medication to meet academic and social expectations until he was self-aware and mature enough to recognize the limitations of his disabilities and work hard to try and compensate on his own.

I would make sure that you spoke to the doctor so that he understands you and husband do not want to go the medicine route at this time. But make sure, especially for input in to the report, what other options of treatment you want to try so that you can use this report as you move forward.

Sharon

 

[TeDo]

The way I take it is that the plan is what the doctor recommends and when he says you and husband understand it means he has told you his suggestion. He may not have mentioned a specific medication like Andy said but rather made note of it for future reference. Also, since you and husband disagree with him on the medication issues, he could be covering his butt by putting his recommendations in writing.

Like LDM said, ask about it the next time you see him or, if it is really bothering you that much, call and ask for clarification. I really hate to assume anything for exactly this reason. I can get really worked up over something that turned out to be a non-issue. Get your answers THEN react accordingly.