It was nice while it lasted

[firehorsewoman]

Well the meltdowns and defiance have returned since we started the Focalin again about three weeks ago.

I am so discouraged. After three months of peace and tranquility in my home when difficult child was taking lithium alone we are back to the screaming, meltdowns, blaming everyone for his behavior, etc.

He is focusing better at school. His teacher says that his behavior is better at school. His father says that he is doing okay at his house. Ugh. So, has the hell returned to my home first and will generalize to his dad's and school soon? Or is it just me and my home? He starts about ten seconds after getting into the vehicle after I pick him up. His dad was smart and came back out of the house last week right after difficult child got in the car. he caught difficult child in the act of starting at meltdown. It was really good for him to see it for himself. He told difficult child to knock if off and that worked temporarily. I think mostly because difficult child was caught off guard.

His next psychiatrist appointment is Nov 9th. That will give us another ten days of information.

Was the three months of peace and tranquility just a dream? figment of my imagination? Not fair to tease me with what could be only to return back to this hell.

 

[BusynMember]

People with mood disorders often can't take stimulants, even with a mood stabilizer. Is it really necessary, do you think?

 

[firehorsewoman]

People with mood disorders often can't take stimulants, even with a mood stabilizer. Is it really necessary, do you think?

Without the stimulant he was having lots of troubling concentrating at school. Also, his conduct grades have improved (so far) at school since starting back on the Focalin. But if it were totally up to me I would say no to the stimulants. Our quality of life at my house is so poor when he is like this. I honestly did not think life could be anything but like this until this past summer when he was on lithium by itself. Although difficult child was still a difficult kid, the peace and tranquility around here was amazing.

But if the problems are only reported at my house I am once again facing that uphill battle of trying to convince his father and doctors that the stimulants are not a good idea.

I would like to try something else for the focus....at this point I don't know what... anything but the stimulants. If the ex-husband and psychiatrists don't agree I am going to suggest difficult child just live with his father 100% of time. I have suggested that in the past (before his father's epiphany in July which led to the change in difficult children diagnosis and lithium) and his father refused. It is just not fair that I have no control over what medications he takes yet have to bear the brunt of the effects. But that is the reality of the situation.

 

[Bunny]

Personally, if difficult child's meltdowns have returned since he started taking the Folacin I would talk to the doctor about stepping him off of it. We've had to take difficult child off of two different medications because they made him very mean, nasty, and aggressive. While they did a great job helping his anxiety, the side effects that the rest of the family had to live with were not worth it.

 

[firehorsewoman]

Another option is not giving him the Focalin on days that he is going to be at my house since the drug is so fast acting both in and out of the system. Actually, I didn't give it to him this morning since he doesn't have school today. I just want to see how it goes. Will talk to his psychiatrists about all options but once again, if his dad and me are not on the same page, they are really challenged by how to help us.

 

[BusynMember]

I understand your dilemma with husband. I wouldn't care about school. They have no say in what medications your son takes. I actually prefer interventions in school rather than medications for ADD. My daughter has it and just hates the stimulants. She is old enough to express how cranky and hyper they make her. We have tried her on them several times. Each time she eventually refused to take them and her grades did not change when she stopped. Interventions in her 504 plan helped her a lot. So did maturity.

This is just my opinion and I'm sure others have their own.

If it's a toss up between focusing better at school and going ballistic at home, I'd choose to let him focus less well at school. There are other ways to help kids who have attention deficits. Some do great on stimulants. Others can not take them often because of co-morbids, such as mood disorders. I can not take a stimulant without getting so moody and (in the end) depressed that it scares me to think about it. I am sure that in the mess of disorders I have, ADHD is in there somewhere , but considering how bad the medications make me feel, I'd rather go without them (ADHD medication).

Does your son have an IEP in school? My daughter has supports in place to accomodate her poor memory and attention span. I may add, as she gets older (she is now a junior) she is finding it easier to compensate without outside help.

 

[firehorsewoman]

I understand your dilemma with husband. I wouldn't care about school. They have no say in what medications your son takes. I actually prefer interventions in school rather than medications for ADD. My daughter has it and just hates the stimulants. She is old enough to express how cranky and hyper they make her. We have tried her on them several times. Each time she eventually refused to take them and her grades did not change when she stopped. Interventions in her 504 plan helped her a lot. So did maturity.


This is just my opinion and I'm sure others have their own.

If it's a toss up between focusing better at school and going ballistic at home, I'd choose to let him focus less well at school. There are other ways to help kids who have attention deficits. Some do great on stimulants. Others can not take them often because of co-morbids, such as mood disorders. I can not take a stimulant without getting so moody and (in the end) depressed that it scares me to think about it. I am sure that in the mess of disorders I have, ADHD is in there somewhere , but considering how bad the medications make me feel, I'd rather go without them (ADHD medication).

Does your son have an IEP in school?

My son has a 504 plan at school which includes having him sit near teacher and in a single desk as opposed to sharing with another student, allowing him to stand at back of room and move around as needed, individual test taking-allowing him more time, place to be by himself, etc.

What specific accommodations/interventions helped your daughter?

 

[BusynMember]

Does your son have problems with memory too?

My daughter could not read at age eight so she was transferred to Learning Disability (LD) class for reading and math, which was quieter and she got more help. Also helped her focus. When she was dismissed from Learning Disability (LD), she was put on a 504. She does not have trouble sitting still, but she does need extra time for tests at times and can go to the library if she needs it to be quiet. She works a lot with the people who stay before/after school to help kids with their work. If she doesn't understand something, she finds it helpful to work one on one with an educator.

These interventions are way, way less than when she had her IEP and ADD/Learning Disability (LD) diagnosis. She actually has learned to practically deal with her problem on her own. She is getting B's and C's in school now. I think it's important to teach our kids how to compensate with their disabilities beyond just taking medication.

To burn off her mental energy, daughter is VERY involved in both sports and other school activities, such as student council and year book. She has a lot of trouble doing nothing and needs to be busy in order to be happy.

 

[JJJ]

I would get him off the stims. Tigger cannot take the stims and was later able to tell us that they made him feel horrible inside. Tigger is doing great on Clonidine. Have you tried it? It is not a stimulant; it is actually a blood pressure medication. By lowering their blood pressure, it helps calm them.

(It is nice that his dad was willing to walk back in and catch him and support that he needs to behave for you. Is communication going better with you?)

 

[firehorsewoman]

My son works above grade level in all subjects, does not have Learning Disability (LD) which is why the schools have never even entertained the idea of an IEP. Of course those of us here on this forum can debate this but I am not up to fighting the school for an IEP now and can live with his 504.

He does not have problems with memory and is pretty much a walking encyclopedia on most subjects but mostly sports.

We keep him very active in sports too and this helps but does not seem to make a dent in his energy level.

 

[firehorsewoman]

I would get him off the stims. Tigger cannot take the stims and was later able to tell us that they made him feel horrible inside. Tigger is doing great on Clonidine. Have you tried it? It is not a stimulant; it is actually a blood pressure medication. By lowering their blood pressure, it helps calm them.

(It is nice that his dad was willing to walk back in and catch him and support that he needs to behave for you. Is communication going better with you?)

I'm pretty sure that Clonidine is very similar to Tenex which did not make a difference for difficult child at any dose. Yes, things are slightly better with ex-husband. The bone cancer scare that we went through with difficult child as well as the big break through we experienced at the tdocs and psychiatrists (when difficult child was suicidal in July and also right after ex was threatening to send difficult child to boarding school) helped ease the tension between us this past summer. thanks for asking

 

[BusynMember]

Hmmmmmm. Has he ever had a neuropsychologist evaluation?

 

[buddy]

Go with your gut on this if you think school should step up alternatives or do more. Does Focalin have a rebound like ritalin? If you decide its needed maybe the dosing can be changed like if he gets 2 doses make the second dose lower so there's less rebound. Or a half hour before the end of the school day take a small dose (again IF rebound is a possible issue ) just ideas to try.

 

[firehorsewoman]

difficult child has had two neuropysch exams.

Takes only one dose of Focalin in the am. Skipped it today!

 

[Wiped Out]

My difficult child goes crazy on stimulants of any kind; we're talking holes in the walls and major violence. I have to say we tried tenex with no results but the clonidine has been a godsend for him (along with the other combo of medications).

 

[buddy]

Same here tenex did nothing. Clonidine has made the most difference. But if I think a medication is causing aggression or meltdowns mine is off it.too. I think that is what your gut is saying. Great plan to see how he does off it.

The big test will be if after holding it together at school he does well with you. I admit there have been times where I adjusted doses but didn't tell school because they showed a pattern of expecting good or bad days based on medications. Dr always knew but not the school (for a short time just to control variables, not to keep them out of the loop for good ).

 

[firehorsewoman]

I'll be sure to ask the psychiatrist about trying Clonidine during our appointment on Nov 9th. Thanks for the information about that. difficult child was less agitated and had no meltdowns today, got into plenty of trouble and was very hyperactive but no violence....not as peaceful as previously but better today without Focalin on board. His dad has him for the next week. Also, difficult child is still having complications from the antibiotics he is on for the bone infection so we need to call the infectious disease doctors. Probably won't address the Focalin issue until psychiatrist appointment because of this.

Buddy that test you describe is how I determined that lithium was really working for him. He would come home from school or transition from his dad's house and I would not get hit with the usual explosion I had become accustomed to. That was really, really, nice. He was having problems at school but my home was so peaceful. I agreed to trial the stimulants again because his conduct at school was so bad and difficult child kept complaining that he could not focus. He has not been suicidal nor depressed so I think that the lithium on board is helping with that but feel like I am back to pre-lithium days since he went back on Focalin.

 

[InsaneCdn]

Focalin is a form of methylphenidate. Therefore, I'd expect rebound to be part of the problem.
Is he on standard Focalin? or XR?
If he's just on standard, then... he's getting a boost for about the first 4 hours, and then the effect declines - and the rebound effect kicks in. He may need a lunch dose - and maybe even a small after-school dose - to be effective.
If he's on XR, then it's wearing off about the time he gets home and he's into rebound mode. A transition dose may be beneficial.

That is... if Focalin is the right medication in the first place.

Other challenges... if he is really bright, then with the extra focus, he may be getting bored - especially at home. It may be to the point where he hates coming home, and the transition is killing him. (no, can't leave him at school, sorry... )
What is his after-school structure like at your place, as compared to at dad's?

 

[firehorsewoman]

Focalin is a form of methylphenidate. Therefore, I'd expect rebound to be part of the problem.
Is he on standard Focalin? or XR?
If he's just on standard, then... he's getting a boost for about the first 4 hours, and then the effect declines - and the rebound effect kicks in. He may need a lunch dose - and maybe even a small after-school dose - to be effective.
If he's on XR, then it's wearing off about the time he gets home and he's into rebound mode. A transition dose may be beneficial.

That is... if Focalin is the right medication in the first place.

Other challenges... if he is really bright, then with the extra focus, he may be getting bored - especially at home. It may be to the point where he hates coming home, and the transition is killing him. (no, can't leave him at school, sorry... )
What is his after-school structure like at your place, as compared to at dad's?

He is on the XR version.

The after school routine is pretty much the same at either house and involves some sort of sports practice. His meltdowns have historically started from the second he gets into my vehicle...and this probably says that he has trouble with transitions so I usually have a favorite book and snack ready for him. But the meltdowns continue and do not really have a pattern (as I have tried to track them for years.) He basically acts agitated and like he has a short fuse all of the time. These behaviors and attitudes disappeared 99% when he was on lithium alone. We had three months of peace and tranquility and now I am back to walking on eggshells. Sometimes I think I should change my name to "Eggshell Walker" since I have been doing this for almost nine years now. But Firehorsewoman suits me well too.

thanks for trying to help!