Things are looking up. J. has been on Intuniv 2mg after being on 1mg for a week. The 1mg towards the end of the 7 days was showing signs of effectiveness. When we started the Intuniv, J. had come down with a cold. So watching his behavior and telling wether or not the Intuniv had any effect was difficult to say the least. After giving J. the 1mg Intuniv one night (being that Intuniv can cause drowsiness), and the .05mg Clonidine, he had fallen asleep before 6:30 p.m. This was, in a way, a nice thing. He had not been getting much sleep with the other medicines. However, I went into his room to check on him and I tried to move him to position him more towards the middle of the bed as J. has a tendency to fall out of bed. It was a bit scary at how J. was like dead weight. I could hardly wake him. The two medicines had completely knocked him out.
I checked his heart rate since the two medicines work to lower the blood pressure. I would have checked his BP, but I did not have ability. Too bad the one in the toy doctor's kit wouldn't work. J.'s heart rate was 78bpm. That is on the low side, but not a risk. In any case, I was not comfortable with the effect of both the 1mg Intuniv and the .05mg Clonidine. So J.'s mom and I decided that we would no longer give him the Clonidine. We also decided that if we were to give J. any Clonidine at all, it would be .025mg. Which is just enough to settle him down and help him get some sleep when he needs it. This helps with his crankiness.
We sent J. back to school last Wednesday after being sick. Since we have been sending a small notebook to school so his teacher's can write a note about how he behaved in school, J.'s teacher said he was perfect and they had a great day. Thursday, he again had a great day until the last 30 minutes or so. On Friday, he again had another great day. J.'s teacher has been employing some of the techniques we and his previous teachers often used. J. has a hard time with transitions. So when J. is given a warning that in five minutes and then in two minutes he needs to stop what he is doing and get ready to do the next task, he transitions without problem.
We took J. and the rest of the family to Toy Story 3 on Ice. No problems at all. J. even stood still in front of the ridiculously expensive light up toys, etc stand. I simply said "let's stand her and wait for everyone else" and I did not even have to hold his hand or anything. J. and his sister R. stood there staring, likely wishing and hoping I would say they could have one (but come on $22 for a cheap light up/spinning Buzz Lightyear) at everything and every kid who was getting one. I could not have been more pleased with his behavior.
We are currently on 2mg Intuniv and .025mg Clonidine (as needed). Curious to see if or what effect the 2mg Intuniv will have on his behavior. There has been room for improvement. However, all in all, it has been pretty good. R. keeps annoying J., who gets very irritated and despite the Intuniv, etc, J. still has a hard time dealing with R. After all, she is 3 and is always interested in what J. is doing or playing with.
She loves her big brother. It is obvious J. loves her too. J. even held R.'s hand in line at Busch Gardens at the Roller Coaster in the Sesame Street area. J. loves R. so much, I think, that it is the reason J. is always so concerned with what R. is doing wrong. Almost as if J. doesn't want her to get in trouble. But at the same time, they compete for getting to do anything that the other wants to do. Like who gets to open the door when we are getting ready to leave. It has become such a competition that R. has learned to ask immediately upon learning that we are going to go somewhere in 5 hours from now. LOL. R. is too funny.
All in all, we have been experience positive results with Intuniv. Let's see what the next week or so brings. Moving into our new house will be an exciting time for everyone. Hopefully it will not be a negative effect on J. with his ADHD. Emotions can run high in children with ADHD. In fact everything is attached to emotions. Hence, why they have what appears to us, as incredible memories. The attach memories to emotion. We all do that, but they do it to the extreme. Not a bad thing, but don't try to trick them by promising something hoping they will forget in a few days or so, because they DON'T. Then you have to do it. :-(
-Dad2ADHD
Saturday, September 25, 2010
Friday, September 17, 2010
In The Beginning
J. is 5 years old and we now know he has ADHD. He has struggled with being hyper and controlling his impulses for a while now. He is the oldest child of 3, so his mother and I had no frame of reference on how a 4 and 5 year old should be behaving. J.'s mom had a feeling something was not right about his behavior. I on the other hand, chalked it up to just being a boy and likely a phase he will grow out of.
He was enrolled at 3 in preschool for a few days a week and the teacher there could not or did not want to work with him. At 3 years old, he did not like school. That is very difficult to handle as a parent. But nonetheless, he went on to the 4 year old class and he had a much better time, since the teachers there were great. They really put the effort in to working with him and find out what works for J. Things like making him sit up front in circle time and giving him a 5 minute warning about the next thing the class was going to do to help him with transitioning to the next task, etc. We found that it helps him at home as well. Something like "Okay J., in 5 minutes it's time to get ready for bed."
Over the summer break, we worked on getting him diagnosed. It was clear to the psychologist J. was ADHD. By this point it was obvious to us as well. J. was given an I.Q. test and tested off the chart in the Perceptual category. In most other areas he is above average as well. The child is almost too smart. It is hard to trick him sometimes. And he has a memory like an elephant.
Eventually we got him on 10mg of Adderall. It controlled his heperactivity, but made him very, very irritable and we saw what has come to be known as 'Adderall Rage.' He would get very angery over the simplest and smallest things. Of course they were very big things to him. So we quickly had his medication changed. His Dr. prescribed 18mg of Concerta, which had almsot no effect at all. So she bumped it up to 27mg. Again no effect, just more irritable. However, we gave it a try anyway. Finding the right medicine is not a science but rather an art. We scrambled to find the right medicine before school started back. Unfortunately, we were not able to do so.
However, this year do to various reasons, J. had to go to a new school. This school is one of the best private schools in the area. However, the teachers in his class are not trained (why would they be) to work with ADHD. So the first week was a tough one. Of course the first week was viewed by the teachers as getting used to everything, so they let a lot of things slide. The second week, we were called at home by the teacher and the next day he was sent to the office to sit until school was over. The time at the new school was almost all on the Concerta.
One of the things with these stimulant types of medicine is that you should see some improvement or at least effects at some level or another within 30 - 45 minutes. However, with the Concerta that was not the case. And with most of the drugs, there is no generic brand so it costs us $25 a pop for a 30 day supply in which we were using only 4 - 5 pills/capusles before switching. So within a two week period, we had spent $75.
Finally, I spent some time talking with J.'s Dr. and she decided it would be best to try the newest and very promising Intuniv. She provided us a 'Starter' kit with enough medicine for two weeks and a $50 coupon.
Intuniv is a 24 hour non-stimulant unlike most extended release stimulants that are only up to 12 hours. We started J. out with the recommended Intuniv 1mg dose at around 6pm as the Dr. suggested. Intuniv can have a drousy effect. J.'s Dr. also prescribed .05mg Clonidine to help with the behavior until Intuniv begins to work, which can be up to 2 weeks. Clonidine also has a drousy effect. However Clonidine has not been approved by the FDA to treat ADHD. But many doctors use it to treat the side effects of ADHD medicine such as the irritablity.
Intuniv looks like it can be promising in J.'s case. We are praying that God helps him out and this medicine works. J. really loves school but has a hard time. J. even told us that it is too hard for him to be good. He is loved by all his teachers and everyone who gets to know him. J. is a really sweet and loving boy. He loves his baby Sister N. and even tolerates his younger sister R., who is almost 3 and she lives to annoy him. I guess that is what siblings do. I know I annoyed my older sister. Since J. has been on Intuniv he has not been fighting with R. much at all. Still has occasions, but no more than any 'normal' siblings. Probably less.
-Dad2ADHD
He was enrolled at 3 in preschool for a few days a week and the teacher there could not or did not want to work with him. At 3 years old, he did not like school. That is very difficult to handle as a parent. But nonetheless, he went on to the 4 year old class and he had a much better time, since the teachers there were great. They really put the effort in to working with him and find out what works for J. Things like making him sit up front in circle time and giving him a 5 minute warning about the next thing the class was going to do to help him with transitioning to the next task, etc. We found that it helps him at home as well. Something like "Okay J., in 5 minutes it's time to get ready for bed."
Over the summer break, we worked on getting him diagnosed. It was clear to the psychologist J. was ADHD. By this point it was obvious to us as well. J. was given an I.Q. test and tested off the chart in the Perceptual category. In most other areas he is above average as well. The child is almost too smart. It is hard to trick him sometimes. And he has a memory like an elephant.
Eventually we got him on 10mg of Adderall. It controlled his heperactivity, but made him very, very irritable and we saw what has come to be known as 'Adderall Rage.' He would get very angery over the simplest and smallest things. Of course they were very big things to him. So we quickly had his medication changed. His Dr. prescribed 18mg of Concerta, which had almsot no effect at all. So she bumped it up to 27mg. Again no effect, just more irritable. However, we gave it a try anyway. Finding the right medicine is not a science but rather an art. We scrambled to find the right medicine before school started back. Unfortunately, we were not able to do so.
However, this year do to various reasons, J. had to go to a new school. This school is one of the best private schools in the area. However, the teachers in his class are not trained (why would they be) to work with ADHD. So the first week was a tough one. Of course the first week was viewed by the teachers as getting used to everything, so they let a lot of things slide. The second week, we were called at home by the teacher and the next day he was sent to the office to sit until school was over. The time at the new school was almost all on the Concerta.
One of the things with these stimulant types of medicine is that you should see some improvement or at least effects at some level or another within 30 - 45 minutes. However, with the Concerta that was not the case. And with most of the drugs, there is no generic brand so it costs us $25 a pop for a 30 day supply in which we were using only 4 - 5 pills/capusles before switching. So within a two week period, we had spent $75.
Finally, I spent some time talking with J.'s Dr. and she decided it would be best to try the newest and very promising Intuniv. She provided us a 'Starter' kit with enough medicine for two weeks and a $50 coupon.
Intuniv is a 24 hour non-stimulant unlike most extended release stimulants that are only up to 12 hours. We started J. out with the recommended Intuniv 1mg dose at around 6pm as the Dr. suggested. Intuniv can have a drousy effect. J.'s Dr. also prescribed .05mg Clonidine to help with the behavior until Intuniv begins to work, which can be up to 2 weeks. Clonidine also has a drousy effect. However Clonidine has not been approved by the FDA to treat ADHD. But many doctors use it to treat the side effects of ADHD medicine such as the irritablity.
Intuniv looks like it can be promising in J.'s case. We are praying that God helps him out and this medicine works. J. really loves school but has a hard time. J. even told us that it is too hard for him to be good. He is loved by all his teachers and everyone who gets to know him. J. is a really sweet and loving boy. He loves his baby Sister N. and even tolerates his younger sister R., who is almost 3 and she lives to annoy him. I guess that is what siblings do. I know I annoyed my older sister. Since J. has been on Intuniv he has not been fighting with R. much at all. Still has occasions, but no more than any 'normal' siblings. Probably less.
-Dad2ADHD
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