Posts tagged ‘medication’

It is Sunday; no school today. We had a very active and sometimes unhappy boy today though. As a result his Mom and Dad were totally exhausted by noon; and we still had a half a day to get through.

I’ve written a lot about how Max needs structure for things to run smoothly. Weekdays are great because he is in school which has a set program. He gets home around 3:30 but then he has counselors and mentors in to play with him. On the off days he may find a friend available to play with.

Weekends are always a problem since it is difficult to structure Saturday and Sunday for Max. This last Sunday nothing was set up so we were worried how it would go for him.

But the way things went you would think we had actually structured the day. This was Max’s schedule:

• 6 a.m.

My wife and I were startled awake by a scream and a jarring bounce on our bed. My son was awake and raring to go. We, of course, were groggy and not ready to roll out of bed. With a lot of prompting my wife struggled up to start the day. Fifteen minutes later he was after me to come into his room which I finally was able to do.

• 6 to 7 a.m.

We were subjected to a lot of screaming and cursing. Nothing was going right for him. Needless to say, there were a lot of time outs and more grumbling.

• 7 to 8 a.m.

Dad and son went down to the football field to toss and kick the ball around. I was not quite ready for this but Mom needed a little bit more sleep so off we went. We had a great time; he did all the running; he and I did all the throwing, kicking, and catching.

Several times Max asked me to dive for the ball but there was no way his old man was going to do something like that, especially that early in the morning.

• 8 to 9 a.m.

My wife and I realized that this would be a great time to take Max to get his blood tests. We called the hospital and they told us that since it was so early no one would be in the blood lab. Right now it is only available to patients but they would be able to fit him in.

But even though it was a great time it didn’t go without a lot of problems.

• 9 to 10 a.m.

Once we got home we finally had breakfast. My wife and I have been drinking these great fruit shakes. It is my job to make then. We sat and drank them along with some turkey bacon.

Max had a toaster waffle and watched a little bit of television.

• 10 to 10:30 a.m.

Now my son started screaming and whining again. What are we going to do until 12 o’clock? He knew that he had a playdate at that time but he was too anxious to wait.

• 10:30 to 11:30 a.m.

We put up with Max’s issues for awhile but then realized we would need snacks to take with us at noon. Dad and Max went shopping; we picked up a bag of veggie chips and a bag of red hot corn chips. But of course if Max had had his way we would have bought a lot more than that.

• 11:30 a.m. to 12 p.m.

There was more whining. Dad did his best to distract his son as Mom finished getting ready for the playdate.

• 12 to 4 p.m.

We met up with Max’s friend at the local pond. The boy was there with his brother and grandmother. My son met this boy in Cub Scouts. I’ve noticed that separately he and Max are both hyperactive. But together it was wild. Just watching them was exhausting.

• 4 p.m. to 7 p.m.

When the boys got tired of swimming we came home. Since it was still early we brought Max’s friend with us. Both boys showed up at the house still hyper. The first thing they did was ride bikes and later disappeared down to the football field to play.

The other boyfriend has ADHD like Max, and is very hyperactive too. Unlike my son he gets silly; we haven’t seen him angry. He is on meds though just like Max.

At one point he felt sick and wanted to go home but there was no one there to take care of him so we kept him longer. Very soon he was better and out skateboarding.

After he left my wife commented that it is wonderful to have playdates but we don’t think they should last 7 hours….

• 7 p.m. to 8 p.m.

We can’t forget that Monday is a school day so we wanted Max to have a shower before going to bed. But we would have had to hold him up and wash him ourselves because he was pretty close to sleep walking by then. We put him to bed and made sure he showered in the morning when he got up.

So this was our “unstructured” day. Originally we had only planned a two hour playdate but as you can see everything just fell into place to keep Max occupied all day.

It would be nice if every weekend day could be like this.

Do you have children? If so, do they take any medications for an illness or disorder? What is your opinion on drugs?

So far I have met people in several categories:

• There are the ones that do not believe in drugs of any kind. They don’t know what it is like to have a child taking medications or who needs them. One mother actually told me once that if even the school tried to force her to put her children on meds she would home school them. She didn’t know what that entailed but she knew that her kids would never get drugs. She had heard about the “terrible” things that they could do to children like destroy their minds and make them nonfunctional.

• There are the ones that have given their children drugs and didn’t like the results. One little girl had taken Ritalin for 2 and a half years and her mom hated the results so much that she took her off them. She said that her children would never be put on drugs again.

• Other parents give their children medicine wholeheartedly. The doctors and schools have told them this would be the best thing for their kids and after a lot of experimentation the parents agree.

• Another group is the one where the parents don’t like giving their children this stuff. However, they see how their kids are without drugs so they give them with a lot of misgivings.

We fall into the latter camp. My son Max has been diagnosed with ADHD, ODD, Bipolar Disorder, Asperger’s Syndrome, and sensory issues. We have seen how he functions without medication. He is explosive. He rages. He is violent. He is miserable.

When he is taking his medication he is happy. He plays with other children. He can do his homework easily. He loves life. His mind is “destroyed” when he isn’t taking his meds.

I am not happy that he has to take them. I have always believed in looking for natural alternatives first before taking medicine of any kind. If I have an illness that is treatable with antibiotics and there is nothing else available I take them. I would much rather Max was happy and loving life without them but that is just not happening.

He is working with therapists and psychiatrists and special education teachers to help control his moods. We give him as much healthy food as he will eat. We are helping him learn how to play with other children.

Last night I was talking to a woman who gave me a glimmer of hope. She says her son had the same diagnoses as Max. She had him on all of the drugs; he was also taking Ritalin. She said he told her that he wanted to be taken off of them because his mind felt like mush. He couldn’t function and he couldn’t remember what was happening from one day to the next.

She said when he hit puberty everything changed. His symptoms started to disappear. Wildness turned into quiet. His exuberance became introspective. She decided to wean him off of all of his medicines. When she was done she found that he was functioning as well as any other child. She said she never told the school that he wasn’t taking the drugs anymore and they never noticed a difference.

This sounds all well and good but after she told me this she got a phone call. Her son had just shown up after having been missing for several months. It turns out this happens a lot. I don’t yet know what other problems he is having.

So what is your opinion on all of this? Would you give or do you give your child medicines for disorders? Why or why not?

I have been writing a lot about my son Max’s medication and psychiatrist changes in the passed 3 months.    Though we have been listening to each doctor and following their recommendations we were not prepared for what has been happening.

As many parents will attest these changes are usually required because our children’s behaviors start to deteriorate and we need to find something to get them functioning better.  After 1, 2 or more adjustments the psychiatrist generally pinpoints the correct medication and/or dosage that will help for the time being.

Some changes can be easy and some can be difficult.  We went into this expecting, and seeing, more energy and some unhappiness as Max was weaned off of one medication while having his others increased.  I was reading one blog this morning that talked about adjusting the writer’s daughter’s meds yet again.  In it she says “Here’s a side effect of ADD/ADHD medications no one tells you about: the emotional toll it takes on parents. We get excited, hopeful, at the prospects of finding the exact right treatment, then feel the inevitable let-down of having to adjust a dosage yet again.”

Sunday morning Max woke up angry; everything set him off.  He had to change his clothes 4 times before church.  Usually this makes him happy, not that day.  He was angry because his allergies have been worse this year and he needed to take a shower to wash the pollen off. Nothing he wanted was in its correct place.  And the list goes on and on.  But these are things that my wife and I can handle.

The problem came when we got to church.  We were sitting in our seats when something he was expecting didn’t happen.  That is, there was no announcement early on for the kids to go to children’s church.  He loves going but because he didn’t hear anything he decided to kick his mother.  These weren’t gentle kicks; he was angry and she was getting hurt.

I leaned over and told him quietly that if he didn’t stop hurting his Mom I would drag him out of the building kicking and screaming in front of everyone.  He ignored me and continued his assault.  I stood up without a word and reached for his hand.  He lifted his legs to block me from leaving our seats so I stepped over him into the aisle.  As I held his hand he struggled so, as I promised, I picked him up and carried him out of the church.  All the way he was kicking and trying to bite me;  I didn’t say a word.

When we were outside things got pretty bad.  He threw himself out of my arms and attacked: hitting, punching, and kicking.  When he tried to run back into the church I grabbed him and headed towards the car.  All the time he kept yelling that he wanted to go back in.

This aggression hasn’t happened in a long time.  We had been working with him for months on controlling his outbursts.  He has had his child advocate and play therapist giving him tools to use to help him calm down.  As a result I was unprepared for the violence.  Where I should have been calm and assertive as I handled the situation I was angry and I think frightening to him.

By the time he climbed into the car he was crying.  I spoke to him very sternly and angrily.  By the end of the conversation, I mean, lecture he was saying he was never going back to church again because he didn’t want to face the people who had seen his outburst.  I told him I didn’t want to either because I was embarrassed but I was going back.  To his credit, Max decided he was going with me.

And you know what?  They were having children’s church that day; it was announced after we had left the building.  His mother took him over there while I marched back to my seat imagining everyone’s eyes on me.  Part of the pastor’s sermon seemed to address what happened and made things a little better for me.  He said that whenever any of the church members came to speak to him the first thing they would say is that they were doing things that were too terrible to talk about.  He went on to say that almost everyone sitting in that room had something they believed was bad…we are all alike.

After this happened Max was very good the rest of the day but in the evening he and his Mom took a walk around the block to see his friends.  Unfortunately they had to come back because no one was home.  My wife informed me that he blamed her and kicked her over and over again on the way.

I just looked at him and quietly told him to go outside.  I followed him out but then headed down the street,  “Follow me Max”.

“Where are we going?”

“It doesn’t matter; just keep walking.”

“I’m not going if I don’t know where we are going.”

“Just do as you are told,”  I said quietly.

As we walked I told him that I was not going to put up with his disrespect towards his mother anymore.  If we are outside and he does it, like at church, I will carry him kicking and screaming away from there.  If he does it at home I will just put him on the couch to sit quietly.  If he gets up or swears or tells me he won’t stay, I will just keep putting him back until he does.

I also told him I wouldn’t listen to any excuses he, or anyone else, gives me.  “My meds haven’t kicked in yet” or “it’s my disorder causing this” or “it’s so and so’s fault” or whatever won’t work.  The fact that he can come up with excuses means that he has the capability to control himself.  He must talk more to his advocate and therapist and continue to practice what they teach him.

Our walk took 20 minutes and as we returned home I looked at him, “Max, one thing you have to understand Mommy and I love you more than anything else in the world.  Because of that we cannot tolerate bad behavior.”

“Okay, Daddy.”

“Now what is the first thing you are going to do when you get into the house?”

“Apologize to Mommy.”

“And what is the second thing?”

“Treat her with respect for the rest of the night.”

And he did just that.

When he went to bed I kissed him good night and told him I wanted him to continue respecting her before he went to school in the morning…and he did.

What does this have to do with Max’s med changes?  His behavior was a direct result of them.  He had an appointment with his newest psychiatrist this morning.  After we described what was happening she nodded her head; she knew exactly what we were talking about.  At the last meeting she had prescribed Focalin XR, the time released medication.  She said that some kids experience the aggression Max has when taking it.  She changed the prescription to the regular Focalin which, even though it has to be taken more often during the day, should reduce the violence.

It would be so nice if our kids never needed a med change; just stay on one prescription.  Hey, it would be even nicer if they didn’t have to take the meds at all.  But the reality is that to keep them stable they have to keep taking their medications.  And making these changes are inevitable as their bodies change and they get older.

I can’t imagine ever getting used to this.  I can’t imagine the effect it has on my son either.

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’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.

We woke up this morning to a lot of noise outside.  A moving van was parked in the driveway next door and the men were moving out all of the furniture.  Our neighbors were moving.  It’s kind of sad; they only moved in a couple of months ago.  We knew from the beginning they weren’t here long.  They had sold their old house and had rented this one temporarily until the papers were passed on the new one.  They had been promised 2 to 3 months before it happened.

They were a nice couple with 3 kids all in their early teens…and a large friendly golden retriever.  I say it is kind of sad because we really didn’t get to know them.  I never actually met the parents though I saw them around occasionally.  We talked to the older 2 kids whenever we saw them around.  They are very polite and very nice; their parents have done a great job.

But there were several reasons that we didn’t get to know them better.  The first one is the time of year.  As I write this my wife commented that she is sad that we weren’t involved with them more.  She highlighted this reason: It is the middle of winter so people don’t get outside very often except those that like to play in the snow…but they go elsewhere to do that.

The second reason is our street has become distantly friendly.  When we first moved in 9 years ago the neighbors told me how they used to block of the street every summer for parties.  Everyone got involved; everyone was friendly; everyone helped to raise each other’s kids.  By the time we moved in that wasn’t happening anymore.

In our first few years here there were occasional parties that we would go to mostly a Christmas party here or there.  But now we just wave and yell “Hi” across the road.  So it was with this family; we would wave whenever we saw them but…

The third reason is their dog.  While I loved playing with him when he was out my 8 year old is very afraid of dogs.  Whenever he was around my boy would barricade himself within the house and would refuse to step outside.

And the fourth is really the number one reason.  Last week I wrote about how we are in the middle of making changes to our son’s medications.  It hasn’t been an easy task as we wean him off the stimulants.  We have realized that his bipolar mania has been masked for a long time.  In the passed few weeks he has become more and more manic laughing very loudly; screaming happily; and being more oppositional.

For a long time we had been circling the wagons as it were; closing ourselves off from the neighbors as we concentrate on Max’s issues.  This has also gotten in the way of work, groups that I belong to such as Toastmasters, and spending time with siblings and cousins.  Max has been our number one priority.  At the same time it has been very tough on all of us, most especially for him.  He doesn’t know why he is acting so differently lately and it has been difficult for him to understand the reasons.

But as we work that out we still have lost our neighbors.  The van is gone now and the kids have just stopped back this afternoon for a moment perhaps to pick up some forgotten items.  And I continue to push forward getting as much work done as I can before Max gets home from school and we have to deal with his mania again.

My wife just got back from the doctor.  This wasn’t her medical doctor; it was her doctor of alternative medicine.  Now there are many people who are going to read this and shake their heads, “why would we waste our time and money going to one of those?”  I get that all the time.

My answer to them is “why do you go to medical doctors?”.  A lot of people look at alternative medicine as snake oil, but I would like them to tell me what they get from their regular doctor that is better?  Why is it that a doctor will tell me they can find nothing wrong with me but I can tell that there really is.  Every day you read about people going to a dozen different doctors before finding out what is ailing them.

Now I’m not here to diss doctors; I have a primary care physician and I see him regularly, so does my wife.  We have found that there are some “alternatives” that can help when doctors can’t.  For example, my wife has had pain in her arm.  She has been to a number of doctors that have been telling her that she has bursitis.  Even though they have been treating it there have been no results.  She finally talked to our alternative doctor and he determined that even though the pain was coming from her arm, the actual source was in her neck.  He has given her several laser treatments and already her arm is much better.

I can hear the naysayers now, “that is just a placebo effect.”  Perhaps they are right.  But is this a problem?  Doctors weren’t solving the issue and it was costing us money.  Our alternative practioner took care of it and we paid a lot less for his treatment.

A lot of our medicines and medical procedures attack our symptoms; they don’t actually cure the original problem.  I just started using a cpap machine.  This helps me breathe properly at night so that I don’t snore, I don’t stop breathing, and I get better sleep.  Is this going to cure me?  Heck no, originally it was designed to be a temporary stopgap until a cure was found.  As time went on nothing was found so people are just using the machines long term because it helps breathing; it doesn’t solve the problem.

What does an alternative practioner recommend.  Perhaps some supplements but most assuredly he will tell you to exercise at least moderately and on a daily basis.  She will also probably tell you to start eating healthier.  Most often people that aren’t sleeping properly are fatter than they should be.  In my case for years I believed that I was slim; why even now I take a size 33 pant.  But when the doctors were testing me and measured my actual waist size, it is actually a 39; I tend to wear my pants lower.  To find out what your waist size should be take your height in inches and divide by 2.  You should be less than this.  I am 70 inches tall which means my waist should be less than 35 inches…not 39.

I have a choice here.  I can use the machine for the rest of my life or work with my practioner and get myself healthy enough so I won’t need it.

I won’t give up my practioner just because there are people that don’t believe in it.  I actually had one man shake his head, tell me not to waste my money, stick with medical doctors even if it means that I won’t get better.  He claimed to have done a lot of research and found that he is  right, I am wrong.  It turns out that his research came from reading books by people who don’t believe in alternative practices.  How about reading some objective books on the subject?

Anyway, I’m a lot like Doctor Andrew Weil M.D. who is a teacher in a medical school.  He believes that people should use both medical doctors and alternative practioners.  Look at both sides, find out what works best for you.  Don’t just ignore one way of doing things because you’ve heard it doesn’t work.

And yes there are snake oil salesmen practicing what they call alternative medicine but there are also dishonest medical doctors.  You have to do your research either way but remember there are also very good doctors.  And there are also very good alternative practioners; don’t ignore them.

“Why?” is the first question I get when people ask me about Max going into the hospital.  But then they really don’t want to hear the answer.

We had noticed for years that there was something not quite right.  Max was a wonderful, happy-go-lucky 3 and 4 year old. He loved meeting people especially young women.  When I took him to the playground he would see a young mom, pick a flower and run to hand it to her.  He would pretty much know everything about her before he moved on.

He was very good one on one but had a very difficult time with groups.  He would hang on the edge and do his own thing instead of joining in.  When he started kindergarten things were devastating for him.  Not only was he in a classroom of 26 students but the bright neon lights and the clutter had a major effect on him.  There was too much sensory input and he began acting up considerably.  He had a wonderful teacher that worked with him, the special ed teacher, occupational therapist, and us to determine what he needed to survive.  She put together a program of breaks, occupational therapy, and rewards to get him through the day which became his individualized education program (IEP).  About that time he was diagnosed not only with sensory issues but also adhd and pdd/nos.  He started receiving medication for these conditions.  As a result of all of this he had a wonderful kindergarten year.

Things started going really bad in first grade.  First month was fine but it then went down hill from there.  The school refused to follow the IEP put in place the previous year.  They insisted he was older now and things had changed.  “Trust us,” they said, “we have been trained.”

And they kept saying this even though Max got worse and worse.  When the school tried to physically prevent him from doing things such as continuing one subject when the class would move on to another he would become aggressive.  To stop this he would be restrained by 4 teachers and was suspended several times.  Max was 6 years old and small for his age and my wife who is small as well has always managed to calm him without extra help.

Max’s pediatrician suggested we take him to be evaluated for a med change.  Though he was very experienced with helping kids with adhd and sensory issues the doctor believed that Max may have other issues.  He pointed us to a specific hospital and told us to bring our son to the emergency room because the psychiatric department was connected to it and they would be able to do an evaluation right there.   The idea was to get passed the 6 months to a year waiting period it now takes to schedule psych exams.

The day after Christmas when Max was 6 we took him to the hospital.  It was a Thursday.  As with all emergency rooms we had to wait, and wait, and wait.    We were finally seen by a psychiatrist who was more interested in letting us know what bad parents we were than checking Max out.

A short time after she left a nurse came in and started talking to us about our situation.  He told us that it was going to take a lot longer than a couple of hours to diagnose Max’s condition.  He suggested we admit him to the hospital’s psych wing for a week to determine what was going on.  He made the place sound very wonderful.  Great staff, a lot of kids Max’s age, schooling and playtime every day while the doctors examined him.

When would he need to go in?  We were informed it would have to be right now, there was a bed available and he could go right up but if we waited another child would get the bed.  This was not something we had planned for, when Max was initially diagnosed we had taken him to Boston over a three day period and he always came home at night.

When we both did a gut check my wife and I were very bothered by this.  While the nurse went off to see if we were covered by our insurance we started making our own phone calls.  We called Max’s pediatrician, who was out of the country at the time, he didn’t like the idea but thought it was the best thing for him.

We called a family member who is a social worker.  She hated the idea but thought it was the best thing for Max.  We talked to a child advocate friend of ours who was also against the idea but again, she thought it was best for Max.  And we even called my wife’s therapist who had worked with Max a little bit and she had the same reaction.

As a result we agreed that it was best.  Then the nurse came back to let us know we were covered by our insurance.  Okay, he’s going.  I asked for directions to the ward which it turns out is in another town.  Nope that’s not the way it works, to get into the ward he would have be taken by ambulance.

Max and his mother were loaded up in the ambulance, and with me in my car behind, off we went.  It was dark and I almost lost them a couple of times, or it may have been because of all the water on my face at the time.

When we got there, we had to go through two sets of locked doors.  On one door was taped a sign that read “watch out for elopements”.  I thought that was curious but found out several days later that an “elopement’ is when one of the children escapes from the ward.

We were given a tour and saw only one other child, besides Max, a teenager.  Where were the others?  The children had checked out for the day to be with their parents since it was the day after Christmas, they would be back later on we were told.

Max loved the idea of an overnight, he had never been away from home and we left after signing all the papers and promising we would see him on Friday.

We are only supposed to be able to see Max between 6 pm and 8 pm.  When we asked about this on Friday night they told us they could be flexible.  Well I sure hope so; there were still no kids there.  Max tells us that he plays with the one teenager.  We stayed the two hours; we read to him and had dinner with him.  This became the routine for the rest of the time he was there.

What also became part of the routine were the hysterics when we got there, begging to come home while we were there, and hysterics when we left.  While we were at home we would get constant phone calls from Max begging us to come see him.  There never were any kids his age the whole time he was there but more and more teenagers showed up.  There was violence and a lot of foul mouths.  It was not a safe place for him.

On Monday I told them I wanted him out.  I did not like what was happening with him there.  And as far as I could see there wasn’t much evaluation going on, no medication changes, nothing!  The doctors tried to reassure me they were working hard to help him and this was the best way to do it.  No, he’s coming home!!!  They then showed me a line in the contract that says that once a request like mine is made the doctors can take three days to decide whether they will let him come home.

And Max would still have hysterics as he watched us through the window go home at night.  And the staff kept telling us this was normal.  And his Mom and I knew in our hearts that this wasn’t right and we wanted him out.

On Thursday they informed us we could take him home on Friday.  We got him!  Their diagnosis?  Same as what we had before.  Medications?  Made some changes.  Recommendations?  None!

And the results?  This happy-go-lucky kid was now quiet, moody, and had very high separation anxiety.  He didn’t like to play.  His medications still weren’t right either.  Since then he has never picked a flower for a girl in the playground.

To add insult to injury it turns out our insurance didn’t cover the hospitalization and a month later the bills started coming in.

Today, a year and a half later, Max is 8.   If you ask him what the best memory he has of the last 8 years it is when they let him turn on the juke box in that hospital.  What is his worst memory?  Being there!!