To Medicate or Not to Medicate... Is No Longer a Question

Yesterday was a terribly long day.  I lived in dread of the meeting with our youngest son's neurology team after work and school.  We had some very difficult decisions to make.  They were decisions that we had been putting off for some time.

Our son's primary neuro developmentalist is someone we trust implicitly.  He is extremely knowledgeable.  His focus is always on the individual child, not the diagnosis.  The physician assistant (PA) we have been working with is also extremely knowledgeable.  In addition, she is one of the most down to earth, personable people I've ever worked with.  She hears your concerns and knows just how to address them.  Her advise is practical but empathetic.  We trust what they advise.  I just didn't want to hear what they advised.

As I have alluded to in recent months, our son had been going through a difficult developmental stage.  He was seeking independence and the limitations he encountered made him extremely frustrated.  The behaviors we were experiencing were a direct reflection of that frustration.  Starting the new school year in the midst of that developmental stage, paired with some administrative and staffing changes at his school resulted in a pretty explosive little guy.  Thankfully, our son's therapy team had remained unchanged.  These angels know our son well and love him dearly.  They took the lead in educating his new team at school on the quirks and behaviors that are particular to our son.   His Title I reading teacher shared the behavior system that she had successfully implemented with our son last year.  This system focused almost exclusively on his successes.  As a team, we implemented this system both at home and at school.  The changes in his behavior and frustration have been amazing.  His behavior has improved and his frustration levels have decreased.  Things seem to be coming more in line with the little man that we all knew and loved previously. 

We are fortunate that the behavioral difficulties we were experiencing have diminished greatly.  Unfortunately, as his behavior has improved and returned to an expected level for a little guy his age, it has made other areas of concern more blatantly obvious.  People will often say that our son lacks focus.  I would argue that the opposite is true.  Our son is intensely focused, just not on the things he is expected to be focused on.  He can not determine what is important stimulation in the environment and what is not.  The guy running down the road is just as important, if not more, than his Father telling him to please not point the fork in his hand at his eye.  He zones out to a degree that he fails to acknowledge the new stimulation coming at him, whether important or not.  I could give you dozens of examples of nearly avoided accidents or minor injuries that have occurred within just the last week or so.  One night this week, within two feet of his father, in less that one minute of turning around and turning back, he ate his brother's bedtime allergy/asthma pills.  Not because he wanted them but because they were there and he mindlessly put them in his mouth.  It was an unconscious impulse.  Only through constant, diligent supervision do we manage to keep him safe from himself.  It is exhausting.

Our son has been bringing home great grades from school.  He is doing very well academically.  Unfortunately, the degree of difficulty and complexity is coming at a faster pace.  Our son is struggling significantly with multi-step processing type activities.  We have to break them down into simple steps, build upon them, and combine the processes to help him reach the conclusions that they want him to reach.  For most kids, it is supposed to be a quick homework activity.  It is becoming more of a challenge for us to look at what is involved; identify what is the root activity or processes behind the assignment; then break it down to the level that he can manage.  He cannot make the jump to those higher level processes yet.  I know he will if given enough time.  They move forward before he is at that point though.  He is just beginning to be quickly getting left behind.  If not resolved now, it will only get worse.

His neurologist told us he is a prime candidate for medical therapy for several reasons.  One, he has no aggressive, unexplained angry tendencies.  He is a sweet natured guy.  Two, he has a behavior system in place and his behaviors are now well maintained.  Three, communication and cooperation between the school and home are in place and well utilized.  Finally, in light of all the other points, he still struggles with impulsivity and distractability to a degree that it is impacting his education and his safety.  We had to agree.  It was the best decision for his education, his safety, and the sake of our family.  We cannot continue to maintain this level of hyper vigilance to try to stay on top of everything.  It is taking it's toll on all of us.  I don't know how much longer we could continue on the path we were on.

With that said, last night was a long night.  Our son fell asleep on the way home from his appointment and didn't wake up even after being carried to bed.  He was exhausted.  I'm grateful.  Throughout the consultation, I had held it together but I couldn't hold it in any longer.  I don't want these chemicals in my beautiful baby's body.  What if it changes who he is?  What if it takes away his sparkle, that light that is the core of who he is?  I could never forgive myself.  I cried and cried and cried.  Not big sobbing boohoos but silent, uncontrolled tears rolling down my face.  My husband kept asking what was wrong.  All I could say was "I don't know.  I'm just so sad."  I knew our decision was logically the right one.  It just wasn't the one I wanted to make.  So I gave myself a night to feel sorry for myself, for us, and for the situation.  I gave myself a night to cry and feel sad. 

Today I woke up, put on my "big girl pants" and did what needed to be done.  I emailed the team at school and advised them of our decision.  We filled the prescription.  Tomorrow morning, I will start him on his new journey with his new medication.  I will monitor how things go; ask questions as needed; and do what needs to be done.  There is no other choice.  There is no giving up or giving in.  It's not an option.  He's too important for less than my best.  In the meantime, I will pray.  I will trust that the Lord has a plan.  He keeps bringing me to these places in life that I don't want to go but every time he does, it better prepares me for the mission I'm on.  I will trust that he will do the same this time as well.  My little man is one of the biggest challenges in my life but he is also one of the GREATEST joys in my life.  I had my night to cry.  Now I pray and kick butt when needed.  We've got a journey to go on!

When Your Best Just Isn't Enough

Admitting defeat doesn't come easily to me.  Recently, I have had to admit failure in two areas that I hold closest to my heart.  One area is at work with the girls that I love.  The other is at home with my youngest son that I love.  Both failures weigh heavily on my heart.

A phrase that is commonly used in our home is "A job isn't worth doing if it isn't done well."  We try to live by those words.  Doing a job well is easy when you love what you do.  I do.  Most days, I love my job.  I teach court committed female offenders.  Some of them have been committed to our program by children and youth services because of family issues or conflicts.  Others have been committed by juvenile probation for committing a crime of some sort.  For fifteen years, I have worked almost exclusively with teenage female offenders.  I love them.  They are my girls.  The way I feel about them doesn't excuse the choices they have made in the past.  It doesn't excuse the mistakes they will probably make in the future.  Instead, it sees down into the heart of who they are, a lot wounded, a lot angry, a lot lacking in basic life and social skills.  I love them.  They are my girls.

There are days I think I'd like to quit my job to become a Wal-Mart greeter.  It might be easier than trying to teach seventeen and eighteen year-olds with fifth grade reading levels subjects that hold no interest for them.  It might be easier than trying to get girls who are supposed to be seniors earning twenty-four credits to graduate when they only have eight or nine earned.  They lack the credits to graduate and lack the skills to pass the General Equivalency Diploma (GED) exam.  I'm supposed to motivate them to want to attend school when they know in their hearts that there is very little they or I can do for them.  Ironically, somehow, I often succeed and they try.  They try to do work that they see no purpose in.  They try to work towards a goal when they know they are going home to the same situations that led them to where they are.  It's these girls that keep me motivated to keep trying to reach one more girl, to make a difference in one more life.  Who knows where her life may lead?  She may become something phenomenal.  She may become the mother of someone that changed all our lives for the better.  Wouldn't I want someone to care that much for my child?  It just so happens that I do.  I want that for all of our children.

I have recently faced some disheartening challenges.  I have had several girls fail at our program that I had invested considerable time, energy, and love into.  They had to leave for more restrictive placement because they couldn't make the changes that were needed for them to succeed.  These failures weigh heavily on my heart.  My last words to the one girl were "I love you."  She replied "I know.  I love you too."  It broke my heart but it's been broken many times by many girls. 

We have had to face the fact that our sons impulsiveness, unpredictability, and inability to focus has worn us all down to almost nothing.  We've implemented behavior plans, shared information with the school, and maxed out our resources.  His behavior has shown some improvement.  He's bringing home almost all As on his classwork.  Things have even gotten better on the bus.  None of that changes the constant need to supervise him to ensure his safety from his own impulsive choices.  None of that changes his inability to focus.  None of that changes the anxiety symptoms he is beginning to display from constantly trying to do what is expected of him when his body and mind aren't prepared or capable of doing what is being asked on him.  In light of the summer and fall that we have faced, we've asked for a consult with his neurological team.  They want to gather information from everyone involved but have forewarned us that they are strongly leaning towards the need for medications to help him gain a measure of control over his impulsiveness.  I do not want to put chemicals into his body.  It is one of my biggest fears.  There are too many "what ifs".  Unfortunately, barring any new ideas or recommendations, we feel we may have maximized our resources. 

We are all exhausted.  Very, very exhausted.  I've had to put them in the Lord's hands.  I can give all of myself to my girls and to my son.  I can guide and lead and love.  Ultimately, they must choose the paths they will follow.  I have to trust that the Lord will be there if and when I fail them.  I have to have faith that something bigger than myself is at work.  Please Lord, watch over my kids.  They need your intervention and love.