Posts in month: March, 2010

I’ve been talking a lot lately about the med changes my 8 year old son Max has been going through.  To accomplish this we needed to find a new psychiatrist.  For us this process was fairly simple.  We belong to a program recommended by our local Department of Mental Health.  We are working with a Family Therapist, Child Advocate, and Play Therapist who are all part of this group.  Since they already had a psychiatrist connected with them we decided to check him out.   However, problems can arise when psychiatrists have different philosophies.

History
When Max started showing signs that things weren’t quite right.  We saw him as a discipline problem that we had to address.  However, it wasn’t long before we realized that it was something else that was causing our issues with him.  But, like other parents, we had no idea where to look to get help.  Friends were pointing out what they thought was obvious and recommending drugs.  We did a lot of research; every time we found a symptom list we would say things like:  “He has that one but he doesn’t have this one.”  We were diagnosing him ourselves and not having a clue whether we were right or wrong.

His Pediatrician
Then it dawned on us that we should be talking to our pediatrician.  They are generally an excellent start in locating problems and how to address them.  In Max’s case, his doctor is considered one of the best in the state so we were comfortable taking his advice.

His conclusion was that Max has ADHD.  He prescribed medication that vastly improved his situation.  My son was able to go through kindergarten without any more problems.  During the summer he went to camp and was a model camper.  This was a vast improvement over the previous year when the owner kept threatening to throw him out.

We saw only wonderful things in the future.

The First Psychiatrist
During the second half of Max’s kindergarten year, at his doctor’s recommendation, we took him to see a psychiatrist to get a more clear diagnosis.  This woman observed him at play in 3 sessions over a 3 week period.  Her conclusion was that he was not only ADHD but he was also PDD/NOS, OCD and had sensory issues.  The second one, she told us, was because she believed that he fell into the autistic spectrum but she couldn’t determine exactly where.  He seemed to have bits of everything.  She decided not to change his medications because they seemed to be working well.

Hospital Psychiatrist 1
In the fall Max entered first grade.  September went very well but then everything fell apart.  He became very aggressive and uncooperative.  As a result he was suspended several times and they were threatening him with expulsion.  His pediatrician told us that his problems had progressed beyond the doctor’s expertise and he recommended we take him to a specific hospital emergency room.  The idea was that it was connected to their psychiatric ward and they could help him immediately.  Ordinarily it can take up to a year to get a child tested by a psychiatrist and we wanted to get help as soon as possible.

They suggested putting him into their psychiatric hospital for a few days so they could diagnose him properly.  So at the recommendation of Max’s doctor we agreed.  This was a horrendous experience for my boy that I hope he never has to go through again.  The psychiatrist abruptly removed him from his medications; we have since discovered that he should have been weaned off of them gradually.  Then he observed him for the next few days before coming up with an added diagnosis of Bipolar Disorder.  The new meds he recommended however were for emotional issues and didn’t really address the diagnosis.

Hospital Psychiatrist 2
The we spent next few weeks finding a new school because his old one felt that he required special help that they were unable to provide.  During that time we felt like we were in limbo;  Max wasn’t any better but he wasn’t any worse either.  Within 6 weeks however, he was behaving so poorly he needed to be hospitalized a second time.  The psychiatrist in this hospital added yet another diagnosis while agreeing with all of the others.  So not only did Max have ADHD, Bipolar Disorder, OCD, PDD/NOS, and sensory issues he now had ODD.  This doctor changed his meds and also recommended we start watching  “Super Nanny” and the “Dog Whisperer” to learn out to deal with the ODD.

And, oh by the way, all of these doctors seem to switch back and forth between calling Max PDD/NOS or Aspergers.  I’ve gotten into the habit of using them interchangeably.

Regular Psychiatrist 1
After Max was placed into a special school and was following a new recommended med plan we found him a permanent psychiatrist who, we believed, would keep an eye on him and change medications as needed.  What we got was someone who believed that there was only one protocol which was to stay on a certain medication for life.  The only deviation from this was to increase the dosage over and over again as the situations warranted it.  He did not believe in observing the child; he acted only on what the parents told him about his or her behavior.  As a result he became a “rubber stamp”, writing prescriptions based only on what he heard.

In the beginning this was enough to get Max through first grade but he had a lot of problems again in summer camp.  This time I decided he would not be going back because I did not like the treatment he was getting there.

Regular Psychiatrist 2
He did really well in second grade.  When summer rolled around we kept him in school which made him very happy.  The first half of third grade was okay but when he was moved into the fifth grade class he started doing better.  The problem we had though was with the psychiatrist.  All we ever saw was Max’s meds being increased.  The man had never spoken to him except to say “Hi”.  I was also becoming more and more convinced that Max was being overmedicated.  We needed something different.  At the recommendation of our family therapist and child advocate we decided to try their office doctor.

He initially seemed to be a good choice.  He spent more time with Max and advocated a med change;  the first step being to take him off his ADHD medication.  This doctor believes that a Bipolar child will not also have ADHD; the stimulants only aggravate the bipolar condition.

Regular Psychiatrist 3
We were in the middle of weaning Max off his stimulants when the doctor abruptly left.  Apparently he was only temporary and his contract ended.  It is this office’s policy to only keep doctors for short periods of time and then bring in new ones.  We were disappointed that this happened right in the middle of the med change but unlike any of the psychiatrists before her the new one seems to be taking a real interest in Max himself.  She will talk to him directly instead of through us so that she can see first hand where he is at.

But, yet again, we have a difference in philosophy.  She believes that ADHD and Bipolar Disorder can coexist.  As a result she is reintroducing the stimulants.

Conclusion
Whew, that’s a lot of doctors!  It wasn’t until I sat down to write this that I realized how many.  Is there any way to find a good doctor before ending up working with so many?  From my observations I’ve come up with some suggestions:

1. First thing is to find psychiatrists that your insurance will cover.

2. After compiling a list it is a good idea to find out how quickly they can see your child; if they have a good background in your child’s area; and if they are flexible in their treatments.  Your child’s pediatrician may be able to help.  Remove the ones that won’t work from your list

3. Use the first couple of visits to check out a doctor; start with ones on your shorter list.  Make sure they can work with your child.  How well do they get along with him.  Does she respect your child?

4. Start with one doctor that you like and try his treatment suggestions.  Make sure you are comfortable with the way things are proceeding.  Are you happy with the results?

5. If one doctor doesn’t work, try another one.

We can’t give up.  Maybe we need to see more than the ones we’ve gone through all ready or we might be very happy with the most recent one.  All psychiatrists are different and unless we do our research, testing, and observing we probably won’t find the best one for our child.

I had a crazy dream early this morning.  I was in a company parking lot looking for my car.  All of a sudden a man started running wildly through it; he appeared to be in his twenties.  He was attacking people at random but it didn’t appear like he was trying to hurt them.  It seemed more like he was trying to get himself noticed.

The problem was that he was hurting them and no matter how much we tried to tell him this he ignored us and kept on with his play.  It got so bad that someone called the police who arrived and took him into custody.  They stayed long enough to question us before dispersing everyone. Afterwards the police left and I found myself alone.

Well, not alone, it seemed like the man had been forgotten.  But he hadn’t stopped playing; he continued running around the parking lot.  Now you could see how much fun he was having.  He was laughing as he started smashing things in his path.  I pulled out my phone and called 911.  When it was answered I told them what was happening.  They were very interested and started asking me questions.  I answered that we needed the police and for some reason when they were here before they did not take him with them.  This surprised them and they questioned me some more.

All of a sudden I had to interrupt the conversation; the man was now lifting up windshield wipers and snapping them off as he moved from car to car.  I spoke to him several times but it was if he couldn’t even hear me.  He then started running up the street and yelling exuberantly.  I tried to get the people on the phone to commit to sending another police car but they were still interested in asking more questions.

“Are you awake?”

It was my wife coming into the bedroom.

“Um, yeah, ” I muttered.

“I’ve been up since 4:30 with that boy.  Can you take him now?  It’s 5:30.”

I struggled out of bed still groggy.  I went downstairs to find him watching a video on the computer a friend had sent him.  Max is 8 years old and has been diagnosed with, among other things: adhd, bipolar disorder, and asperger’s syndrome/pdd-nos.  He is also very high energy; but this is not surprising since each of these disorders includes this as a symptom.  And we never know when he is going to get up in the morning; it can be any time between 3 and 7:30.  But when he does we expect a wild time until his meds start working.  This can include screaming, swearing, smashing things, or just happily doing marathons in the house.  Coupled with the med change he is going through right now, this has led to some hectic times.

By the time I got up he was calm and enjoying the video.  When it was over we moved to the living room to watch a fun movie starring Jackie Chan called “The Forbidden Kingdom” before he got dressed and headed off to school.

The dream has stayed with me this morning; does it have a meaning?

Like this man, Max likes to:

• Get into people’s space.

• Smack his Mom in the butt as he passes or run at me and bounce off my stomach while saying “Fat Daddy!”

• Toss things around but doesn’t expect them to break.

• Be noticed.

• Ignore people when they are talking, as if he is deaf.

• Run exuberantly around the house or down the street while yelling.

It seems like that this man could be the future Max.  However, I was talking to Max’s therapist this morning and I told him the dream.  He says that, even though this could happen, we still have time to change things.  The frontal lobe in his brain is still forming.  In boys it doesn’t become fully developed until they are 25.  We, as parents, will be taught the skills we need by the therapist to help develop it.  We will do this by helping Max learn the coping skills he will need later on in life to survive in the world.

What is the frontal lobe?

It is the part of the brain that is at the front of the head.  Scientists believe it may control the personality, emotions, and long-term memory. If it is damaged at all it can affect problem-solving and reasoning abilities.  Disorders such as adhd and bipolar disorder appear to be symptoms of this problem.

Why is this where we concentrate our efforts?

It seems that very young healthy children learn problem-solving and reasoning through play; this in turns develops the frontal lobe.  However, this result may be inhibited in children with a disorder.  If we teach Max these skills it will help it mature more properly.

Will this cure him?

Probably not but if we do our jobs correctly then Max won’t become the man in my dream.  He will have learned to control the behaviors that can cause these outbursts.

How is this going to work?

Max’s training started several months ago with his therapist and child advocate, and we have seen some changes.  But this is our first day of training.  As we continue to learn and apply our new skills I will write more about how it is progressing.

I’ve been talking about my son Max’s med changes lately.  I mentioned one of the side-effects of taking him off of his stimulants.  I touched upon his behavior a little bit too.  But I’ll tell you, we still have a way to go before he is off his ADHD meds but I wonder sometimes if we will live through it.

Parents with ADHD kids know what I’m talking about.

It seems like every day Max has been getting wilder and wilder.  He has been running around the house a lot; swinging his arms around kind of like airplane propellers, and yelling exuberantly.  Today he added something new…he has been smacking his Mom on the butt when he passes her.  As you can imagine she hasn’t been terrible thrilled by this.

I don’t want to discount the good things that have come out of this:

• Max hasn’t been as anxious as he was.

• Tantrums have been lasting minutes rather than hours.

• Swearing has been reduced.

• He still gets upset if Mom goes anywhere without him but within 5 minutes he goes on with other projects.  Before, he would be on the phone calling and begging her to come home.  She would end up turning off her cell.

• When he is angry he goes into his toy room, closes the door, and sits for awhile.  He used to scream and break things.

• He can be outside on his own for more than 3 seconds.

But this wildness can be unnerving.  Last night, for example, we went swimming in the YMCA pool.  He was like an octopus, climbing all over me constantly.  I kept peeling him off but he would come back and attach himself again.  Don’t get me wrong; I love being in the pool with him.  We generally play tag.  I toss him in the air so he can splash down into the water.  Sometimes I need to bend my leg like a chair seat so he can sit and fix his goggles when they get water in them.

This is different.  Imagine hands grabbing everywhere and legs wrapping themselves around yours.  Every time you take one off, it immediately finds another place to latch on to.  It feels like harassment and the more he does it the more built up I get.

When he is acting like this he cannot hear what is said to him.  Or he can, but the words are not part of his world at that moment.

“Max, stop it.”

“Okay, I’m sorry.”

“Max, stop it!”

“Oh yeah, sorry.”

“Max…”

And on it goes until I send him off into a corner.  Later I will sit with him and explain the problem.  He appears to get it but it isn’t long before he is at it again.  Someone asked me if I thought he might be afraid of swimming so he holds on.  Sorry but that doesn’t work.  He is 8 now and has been swimming since he was 6 months old.  He is more comfortable in the water than even I am and I’ve been swimming for close to 50 years.

I’m not really complaining.  I understand a little bit about what he is going through himself.  He doesn’t have control and he doesn’t know why.  He just knows he’s having fun and he’s confused about why other people, meaning his Dad, aren’t having fun too.

This is just another aspect of his med changes.  As he goes through it the more his Mom and I learn.  Just today I saw an interview with Curt Schilling, the former Red Sox pitcher, and his wife.  She just wrote a book about raising their son who has Asperger’s.  They showed a video of their boy playing soccer.  He was running and flapping his arms a lot like Max does.   They talked about the wonderful things they have learned as they deal with each day.  And as they said, some days are going to be harder than others.

And it is true.  Some days are so difficult as he struggles to deal with our responses to his actions.  But without my son I wouldn’t be doing half the things that I do like swim, mountain climb, run, bike ride.  The list is endless.  Oh, and the most important things like read with him, cuddle with him, and laugh with him.

As I sit here there is a rare moment of quiet.  Max is staring out of the window waiting for his ride to his afternoon program.  I’ve got to enjoy it while it lasts.  Nope, there it is:

“Where’s the ride???!!!”

He jumps up and down.

“Where is he??”

Children that are on medication for mood disorders such as ADHD, Bipolar Disorder, or Asperger’s syndrome have to be watched to see how they are reacting to the drugs.  Each one has side effects that parents have to be aware of.  ADHD medications, for example, can cause stomach upsets, weight loss, or insomnia.  Not only that but mood changes have to be monitored.  Quite often the prescribed dose will stop working over time and will either have to be changed or a different medication must be prescribed.

When making a med change parents must be aware of the procedures that need to be followed.  Some medications cannot just be stopped; they need to be weaned slowly over a period of days or weeks.  Similarly, other drugs may have to start at a smaller dose and then be increased to the required one.  Always follow your doctor’s recommendations.

My 8 year old son Max is in the middle of getting a med change.  In his case he is being treated for both ADHD and Bipolar Disorder.  He had been having large mood swings that were interfering with his relationships so something had to be changed.  His psychiatrist does not want to make any changes to the bipolar meds until he is weaned off of the ADHD stimulants so that he can see what changes can be made.

The doctor suggested doing it slowly.  We have reduced the stimulants from 3 doses per day to 2 so far.  Consequently we are seeing much wilder behavior but another change we have noticed has been in his eating habits.  Other recommendations for his ADHD medication have been:

Before all of this started Max was a very high energy kid and thin as a rail.  He exercised constantly and was proud of his “washboard” stomach or, as he calls them, his “6-pack Abs”.  His weight has always fallen into the low end of his height and age range.  This is a result of his suppressed appetite.

But as we decreased his stimulants we noticed that he was starting to eat more.  We have also increased his bipolar meds a bit and now he can eat voraciously at meals.  Where before we were practically begging him to eat, we are now doing the reverse: “No more food Max!”.

And over the passed few weeks we have also noticed that he is filling out.  My mother says that he is starting to look like a regular kid.  But I’ve that his cheeks are becoming fuller.  We are now going to have to watch that he doesn’t put on too much weight.  He won’t want to lose those abs!

Whenever our children are taking meds like this, especially if long term, we have to watch to see how their bodies and moods react.  It is not enough to say “Okay, got them on their meds, now I can relax.”  It doesn’t work that way.  As their bodies adjust, changes may have to be made.  One here or one there can cause wild changes in moods.  It can cause obesity or weight loss.  Some meds even require blood tests on a monthly basis to watch for possible liver damage.

We always have to be vigilant.

My wife and I have been recording the new show “Parenthood” each week and watching it on Sunday nights.  One of the children has Asperger’s Syndrome and because of his disability he was expelled from school.  The bottom line was that the school didn’t know how to manage a child like this and in fact didn’t want to.  As a result the boy’s parents spent most of the show trying to find another school that would take him.

But what was the infraction?  The child was being disturbed by the bubbling in the fish tank.  He asked the teacher to turn down the noise.  Rather than discuss the situation with him or even understand that this was a sensory issue for him she told him to stop talking and continue with his work.  But the bubbling continued and he became more and more agitated until he ripped his paper with his pencil.  He jumped out of his chair, ran to the fish tank, and started staring into it.  The teacher’s response was to keep insisting that he return to his desk.  We later discover he finally reached his limit and smashed the tank.

This really struck a chord with us as it probably did with many parents that have a child with bipolar disorder, aspergers, or another disorder.  Sadly, even though more and more children are being diagnosed, schools are finding themselves way behind getting the training required to work with them.  This boy’s teacher could not recognize the signs that he was in trouble; she tried to give standard responses to this out of the ordinary behavior.

My son Max was 6 years old when he was first suspended from school.  Just as with the boy in the television program it happened as a result of the teach not understanding the situation.

“Max, do as you’re told!”

“I will in a minute.”  Max was trying to finish up what he was doing.

“You will do it now!”  They attempted to remove what he was working on.  It tore.  He had a major meltdown where, they believed, they needed 5 teachers to hold him down.  When my wife got there she was angry with them.  At 5’4″ and 113 pounds she was still better able to take control of our son faster than the 5 teachers.  Even though they were wary about his reactions they finally released him into her control and she took him home.

Now, should Max have become that violent that all these people needed to be involved?  Depends on who you talk to.  Some people will say the disorders making him do this.  Others will say that he still needs to learn to control himself.  And still others will respond that he needs medication.

It since appears that all are right.  His disorders caused him to lose control but as we have learned since, changing his meds helped control his outbursts.  In the passed 2 years we and others have been working with him to help him channel his anger into more productive ways to resolve his issues.

But back to “Parenthood”, the child’s parents needed to find another school to take him in because once he was expelled the first one didn’t want anything more to do with him.  In our case Max was not expelled but he was suspended several times before the school decided it was time to find him someplace else.  To their credit they did not force us to do it on our own; they worked with us until we found a good special school for our son.  They are hoping at some time to have Max absorbed back into the town schools once he learns the skills he needs to manage his disorders.

In Max’s new school they understand who he is because they deal with other kids just like him every day.  He loves where he is now.  Each day they track his behavior and he takes pride in always being at his best.  In fact, he is very disappointed if he loses any of his points for that day.  He has had some issues in this school as he has had in others but we all take the days one at a time and help guide him to make better choices.

How about your children?  Have you had problems with their schools?  Have they been expelled or suspended?  How was it handled?  Are they now in special schools?

There is a real need for support for all of our children both in and out of school; not just for the kids that don’t have any problems.  Times are tough right now and many places are cutting back on their services; but these are our children, we need to make sure that all the tools are in place to take care of them.

It’s a part of every parent’s bad dreams.  You are out somewhere with your child when you get separated.  You hear a scream.  You rush to their defense.  The cause can be anything from falling to kidnapping.  Your heart beats faster and the adrenaline flows.  You stop thinking and you jump into action.

This happened to me yesterday.  My son Max and I had gone shopping for a birthday present for his Mom.  I warned him that he should get her something that she can actually use; not a toy that will just sit on a shelf.  Last year he bought her a Barbie doll.  I don’t even know where that went; I don’t think I’ve seen it since she unwrapped it.

Don’t get me wrong, he puts a lot of thought into his presents and they are wonderful.  He just hasn’t gotten the concept that an adult may want something that they can use rather than a child’s toy.

And as I thought would happen he directed me to a toy store.  Inside he found something he thought she’d like; it was a ring.  I convinced him to look at other things instead of choosing the first gift he finds.  Okay, so we wandered the store for 20 minutes and each item he found was more outlandish that the last.  We finally decided that the ring would be the best choice.  We bought it and headed out of the store.

When we were back in the car he asked if we could go over to the mall; they have a wind machine he wanted to show me.  Apparently it is like a wind tunnel; you stand inside and get blasted.  That was okay with me so we headed over.  We pulled into the lot and parked.  Max got out of the passenger side of the car; I got out of the driver’s side and locked the doors.  I turned to look for him but he never came around.  I heard a scream.

“Daddy, help I’m stuck!” he wailed.  I ran around to his side of the car.  His thumb was caught between the door and the frame.  Of course he couldn’t open the door; it was locked.  He screamed again!  I dropped the keys that were in my hand and started pulling everything out of my pocket.  I threw them on the ground.  You cannot use a key on that side of the car, only the remote.  I found it and got the door open.  Tears were streaming down Max’s face; this had to be bad, he never cries.

His thumb was black behind the nail.  Through the tears he said “I’m okay, I’m okay”.  This is code for “I really hurt but I’m not going to tell you and look like a baby”, he is, of course, 8 years old…soon to be 9.

“Please Daddy, can we just go home?”  Of course we can.  I packed him into the car and headed out.  He kept whimpering and wailing.  As a parent you know that I am very shaken about what has happened.  Later that night when I told the story to a friend he asked if this sort of thing happens often.  That is, does Max get distracted a lot resulting in hurts like this.  No, even though he tends to be a daredevil this is the first time it has ever happened.

I couldn’t wait to get him home and he kept asking for his Mommy.  I don’t like using the phone when I am driving but I knew she was doing errands.  I didn’t want to get home and find she was still out.  I called over and over but she had the phone shut off for awhile.  I finally got hold of her and suggested she be home when we get there and I told her why.

“Daddy, am I going to lose my thumb?”  I told him that that wouldn’t happen; he wanted to know how I knew.  Well, it is because it happened to me too.

“How old were you?”  I was his age.  This seemed to bother him more, “It hurts so bad!”  I told him we’d give him “Children’s Advil” when we get.  “Is that all?”  And maybe an ice pack too.

When we arrived home he got his medicine and within 15 minutes he was ready to go out and play.  He didn’t have the best night; he was up several times.  This morning he showed me his thumb; the nail was black and yellow but he seemed to be okay.  My wife is worried that it might get infected.  I know we not only have to look for that but we also have to watch for the nail falling off.

He initially swore he would never get into a car again but he later compromised by saying that he just would never close the door ever.  That is okay with me; I don’t ever want to hear that cry again.

This morning the school nurse called; she doesn’t think Max’s thumb looks too bad but she wants us to call his doctor.  She has two reasons:

• Some pediatricians want their kids on antibiotics as a preventative measure for infection.

• Others like to drill a small hole into the nail to relieve the pressure.

Max’s doctor doesn’t believe in prescribing antibiotics for this.  He does suggest, however, that if the swelling looks bad to bring him in to be checked out.  The doctor won’t drill the hole if he believes it is warranted; we will have to bring Max to a hospital emergency room to do this.

When Max got home from school we checked his thumb.  Though it looked bad it turns out it is only bruised.  He is not interested in seeing the doctor he has too many projects to do this afternoon.  He even suggested as he got off the bus that the two of us check out that wind machine.  It still bothers him and if it gets any worse we will take him to the doctor but for now we’ll be giving him some loving care.

Yes, even this is part of being a good parent.  Not just the good stuff.  Not just the discipline stuff.  But also the hurt stuff.  I guess I’m going to have to get used to it.

As soon as I finish this post I will be going to the YMCA to swim with my 8 year old son Max.  Once he sinks his teeth into something we have to do it constantly until he finally gets bored.  For example, on February school vacation we spent 4 hours a day at the Y playing basketball and then cooling off in the pool.  Since then he hasn’t had any interest in it.

But a couple of weeks ago he rediscovered swimming.  As a result we have been getting into the pool any afternoon he is free.  What I mean by this is that my son has many diagnoses such as bipolar disorder, adhd, aspergers, and odd.  Several days a week someone works with him on his issues:

• Mondays he works with a counselor and other kids to learn how to interact in social groups.  Many children who have one or more of Max’s diagnoses, like him, have problems being with others their own age.  They get together to find out how get through them.  We have time to swim after the class is over.

• Tuesdays we swim.

• Every Wednesday he has a half day from school so in the early afternoon he works with a play therapist.  Later on he goes to a science/dramatics class with other kids like him.  It gets out late so there is no time to swim.

• Thursdays after school he meets with his child advocate.  After it is done we can swim for awhile.

• There is no swimming on Fridays.  He spends the afternoon with his mentor and they get done late.

As you can see this allows us 3 days.  When he is in the pool he divides his time between playing and doing laps.  He can swim the length of the pool round trip over a dozen times.  Before and afterwards he is an octopus climbing all over me.  Or perhaps “jellyfish” is a better description.  It can get annoying at times.

In the long run it doesn’t bother me.  We will keep going until this obsession wears off and he goes after something else.  And you know what?  I will keep enjoying it until the time comes because if it wasn’t for my boy I wouldn’t get any exercise.  You see, I’ve never liked to do any physical stuff.  This isn’t because I’m lazy, though I might be a little.  It is because I have multiple sclerosis; I always found it an effort to do the physical things required to keep me healthy.

That’s not to say I don’t do anything.  I found early on that if I skipped all exercise that I very quickly get to the point that I have difficulty walking.  I have also gone through periods when I cannot use my hands.  This happens when I have been ignoring what I should be doing.  So I generally make it a point to at least to walk as much as possible.

This is where Max comes in.  He has a lot of anxiety so he doesn’t like to do things alone.  He has difficulty making friends so Daddy is generally his playmate.    I have to force myself to do the things that he likes so much like biking, running, hiking, mountain climbing, and anything else that requires a lot of energy.  I cannot just stand around and watch; to be with him I have to do all of these things too.

Just like anyone else the more I keep moving, the easier it gets.  It has made me realize that what I have been doing happens to a lot of other people with MS and perhaps other diseases and disorders.  We make excuses to justify not doing what we need to.  I’m not suggesting everyone does it but certainly I’ve been doing it around exercise.

Much as I enjoy doing the cerebral stuff, like writing, physical work is fun and I have to keep doing it.  My wife is always after me for just sitting in my chair all day researching and typing.  Thankfully Max comes home from school and drags me out the door to get some fresh air.  Because of him my arms and legs are solid and my exacerbations have diminished.  Not only that I’m getting my daily dose of Vitamin D from the sun!

Though I don’t like the fact that Max has to deal with all of his disorders the upside is that we both keep physically active and are healthier because of it.

I know several people with Multiple Sclerosis that will read this and say that it is alright for me but they cannot do it for this reason, or that one, or something else.  But my answer to this is, don’t give up!  In my PCA work I have a couple of clients with MS.  Neither one can do the things that Max and I do but both have physical therapists that help them keep their muscles toned and strengthened as much as possible.  At the same time it keeps them in good spirits.  How well I know how depressing it can be when I’m not moving at all.

The bottom line is, don’t let excuses get in the way.  Don’t give up and keep moving!

“Who are you?”

“My name is Goatbelly”.

It was obvious that this weird little man before me was a leprechaun.  He had black patent leather shoes on under a pair of yellow trousers.  Over that was a long knee-length green coat with a gold zipper to hold it closed and white cuffs and collar.  On his head he wore a green derby and on his forehead was a shamrock.

He did a little jig for me but refused to come close.  You see, I am human and we are known to capture the wee folk and insist on a pot of gold to let them go free.  I leapt out of my office chair and chased him through the house.  I caught him in the back yard and insisted on my prize.  He struggled a little before promising to lead me to its hiding place but as we went across the lawn he escaped into the bushes.

I’m not as dumb as I seem and I was able to get the drop on him as he emerged from a different location.  This time he brought me to his secret hideout and handed over the gold.  It was contained in an old chest left over from his pirate days.  As I took it and let him go he laughed and skipped away.

“The gold is now gone; ye chest is empty!”  I shook it but could hear rattling, “What ye hear is the memory; the gold has disappeared.”

I frowned and said “Okay, so since a Leprechaun’s job is to make shoes, how about making me a pair.”

He came to me and pointed to my feet, “There you go, brand new shoes.”  But sadly, they looked like the ones I came in with.

We spent the next half hour playing “elf ball”.  This was a lot like “dodge ball” with a little bit of war thrown in.  After that it was “fairy ball”.  This was a cross between soccer, baseball, and golf.  The mailman had a good laugh as he watched us play.

Then just after his play therapist arrived the leprechaun changed into his green basketball shirt ready to enjoy the warm weather.

This is my son Max.  He is 8 years old and has a powerful imagination which he puts to good use in his many projects and outdoor activities.  But as you would find if you spent a lot of time with him his thoughts are fleeting.  Before 8 o’clock on a Saturday morning he can go through 10 costumes and they can be as simple as his basketball shirt, football gear, or even his baseball uniform.  They can also be as complicated as his soldier uniform, grim reaper outfit, and of course, his leprechaun suit on St Patrick’s day.  At Christmas he is Santa Claus and Thanksgiving wouldn’t be the same without a pilgrim showing up on our doorstep.

And quite often when there are no ready-made costumes to fuel his imagination he will make his own.

These changes of clothing are so important to his life that not long after he starts a new school they adopt a “no costume” rule.  This is because they find it to be too distracting to the other children.  I don’t see a problem but there was a time I was a little nervous about him going places in costume.

This seems to be one symptom of his Aspergers.  I’ve noticed that so many Aspergers adults have either made costumes for themselves or others, or even worked in costume shops.  One article calls Aspergers “the Eccentric Child Syndrome” and “they dress according to comfort and not style, and their preference in clothes often adds to their oddness”.  Temple Grandin, Ph.D. is quoted in the article as saying “If you cured Asperger’s, you would have no musicians, you would have no scientists,” she adds. “[You would have no] famous people like Mozart, Van Gogh, Darwin, Carl Sagan, Thomas Jefferson, Einstein.”

I love my son’s imagination, his intelligence, and his quirkiness.  And you know what?  I am just as likely to dress up with Max and join in his games.

And today I was the silly human only interested in his gold.

I was just reading a post by the ADHD Hunter called “A Hunter Walks in the Woods“.  I found that it put a lot of things into perspective that I have been thinking about for awhile.  It begins by saying “I am sure many of you have heard of studies indicating that time spent outdoors in a green environment can substantially reduce symptoms of ADHD.”  It goes on to explain his reasons behind all of this; one of which is that people with ADHD see the world a little differently than everyone else.

This explains why I have always felt more comfortable in the woods.   I spent a lot of my growing up years getting lost in them, hearing the noises, seeing and imagining different things, and camping out on a regular basis.  I never realized how calm and happy I was whenever I was there and then became sullen and unhappy upon returning home.

Today I am 54 years old and I work constantly at a desk.  Over the years I have spent more and more time indoors and, I realize now, have become more unhappy.  Over the past couple of years I started making a practice of wandering through the local forests at least once a week knowing that I was more relaxed on those days.  But I didn’t have a complete understanding why this was true.

My 8 year old son Max lives to be outdoors.  He doesn’t like to watch much television or play indoor games.  The world is his playground and he will do just about anything out there like climbing trees and rocks, bike riding, running, and even raking leaves.  He finds it very stifling being indoors and his stress levels are always in flux.  He was really in his element the time we hiked up Mt Monadnock in New Hampshire; it was 5 hours of pure bliss for him.  When we got home he was very relaxed, but not nearly as tired as his old man.  In fact he was still ready to play.

Just last week he had the day off from school because of a teacher professional day.  We walked 3.5 miles to a friend’s house.  Once we got there we found that no one was home and had to return.  On the way back we stopped for lunch.  The trip took 3 hours but resulted in a happy dad and a happy son.  This certainly wasn’t through a forest but it was the next best thing.  The road we took was bordered on one side by stretches of woods between houses and the grassy town common on the other.  At one location we noticed a boardwalk disappearing between the trees; a great spot for more exploration on another day.

But as is always the case at the end of our trip Max was ready for more activity while dad wanted to sit for awhile.

I can’t imagine my son at an indoor job when he grows up.  If he does he will probably end up like his dad: unhappy and sullen sitting at a desk.  I am reminded of the son of an old college chum who is at the university by his home.  No desk job for him!  He has spent the last few years walking the Appalacian Trail and is now studying “Outdoor Education” with an eye towards working in the wilderness.  This is actually something I can see Max doing.

As his dad, my goal is to help Max grow up to be happy and well adjusted though he is bipolar and has ADHD and Aspergers too.  We will be spending a lot more time outdoors.  I’ll be planning another mountain trip.  Maybe I can get my friend’s son involved.  Later on perhaps Max will look into “Outdoor Education” as well.  I know all of this does wonders for him and certainly makes his dad much happier.

My son Max has been going through a medication change.  We haven’t completely cut out his stimulants yet; we have been trying to wean him off of them slowly at his psychiatrist’s recommendation.  When it is complete we will start working on balancing his bipolar meds.

As he comes off we have been seeing a lot of different changes with him.  For example:

• He has been very exuberant.  He laughs a lot now.

• He is finding more things exciting; he is enjoying life more.  It has been a lot fun taking him places.

• When he has a melt down it is easier  to separate himself from a situation so that he can calm down.

• Mornings before his meds have started working have not been nearly so stressful.

• He has been volunteering a lot more in school and in other places.

But with all of his joy we have seen more screaming, both bad and good.  Right now he can’t seem to do anything in moderation.  It’s either screaming with joy or screaming with anger.  He has to speed through every project.  We can’t go fast enough!

But Max has been finding so much more to do.  Two weeks ago we had a big storm; our basement was flooded.  He had to help me clean up.  He loves to clean!  This passed weekend there was a bigger storm. It started raining on Friday night and it is still going on Monday afternoon.  Luckily we were able to get a pump last time otherwise everything would probably be destroyed right now down there.

We haven’t gotten to the cleaning stage yet but he has been throwing on his rubber boots and splashing around in all of the water. I must admit I haven’t been as fun loving through this.  I haven’t been enjoying all the work:

“Max, stop all the splashing!”

“Okay, sorry Daddy.”  He would then try to tiptoe through the water but then:

“Max, I said stop all of the splashing!”

“Oh, I forgot.”  And again he would try to tiptoe.  I finally shut up; he’s just having fun.

His classroom results haven’t been the best at all right now though.  His teacher keeps telling us that he has to be spoken to a lot.  He can’t always settle down and get his work done.  Even though this is a special school they don’t seem to understand what he is going through.  Before he started coming off the stimulants Max was able to stay focused and get his work done.  Now he wants to do anything but his work.  The school is convinced he is not only trying to manipulate them but also after the big jump he took from third grade to fifth grade recently the work has been a lot harder for him.  Our response is that it wasn’t harder for him before the med changes and he was able to stay focused.

One final issue that I have noticed recently is the disrespect.  Last night he was sitting on the couch eating a bowl of ice cream while watching television.  In the process a few drops landed on a pillow and also on the cushion he was on.  I suggested he grab his napkin and wipe them up before they dried.  Rather than do it quickly he saluted me with both middle fingers and swore like a sailor.  I just shrugged and shut off the TV.  This really set him off and he left the room; but not before kicking me in the shin.

It took only a split second for me to wipe up the few drops.  As my wife said, at this time of day there was no way he was going to focus long enough to do it himself.  Perhaps not but the reaction was uncalled for.  He stayed in his toy room for a time out while throwing a couple of toys and continuing to swear.  When he was done letting off steam he was able to come out and apologize for his reactions.

Our first step in dealing with school and the disrespect is going to be to talk to his psychiatrist.  We want to know if:

• we should continue his med changes during the school year or should we wait until summer so that his work doesn’t suffer.

• will regular discipline resolve the disrespect that has been surfacing during this process.

Recently  I wrote a post about the new show “Parenthood”.  On the most recent episode we find the dad learning to accept some of his son’s issues.  Some parents may recognize this one, my wife and I certainly do.  The boy likes to wear costumes to school; in this particular case he was a pirate.  At first dad was adamant that he change into regular clothes but by the end of the show he was dressing as a pirate too.  “Avast ye lubber.  Get out ye sword and fight me!”

With all of the things Max is going through right now he doesn’t need his school and his dad sniping at him as he tries to adjust.  I think it is time we both dress as pirates and get into his world a little bit.