Someone Needs A Time Out

Okay, here’s a rant. I promise I won’t do this often, but sometimes you just have to let the steam out of the pot before the lid blows.

Boy has finally been diagnosed with ADHD. It’s not the end of the world, and in certain ways, it’s a relief. It’s sort the of feeling you might have if you’ve had a collection of symptoms like fatigue, appetite changes, excessive thirst, etc., and some doctor finally say, Oh, you’re diabetic. You need to be on insulin. It’s not wonderful news, but it explains why you feel the way you feel. Yes, it’s a problem – but there’s a solution.

Theoretically.

So, Boy took this battery of tests in February, and got a definitive diagnosis of Attention Deficit Hyperactivity Disorder in April. (Did I mention, finally?) Rev and I sat down with the neuropsych tester and went through the myriad ways Boy’s brain works differently from others’. There are certain things he cannot do – like, I don’t know, pay attention? In school? Or stay on task long enough to get an assignment done? So he can pass his courses? The report recommends certain school accommodations, cognitive behavioral therapy, and stimulant medications (which sound counter-intuitive for a kid with ADHD, but actually make sense once you understand the chemistry of the brain).

A lot to deal with, but okay. Step at a time, people.

I take the Assessment/Diagnosis Report to his pediatrician, an easy-going guy who has a nice way with my sons. He’s already got the Assessment (sent to him by the neuropsych tester), has read it, and thinks that medication is an appropriate way to go. Dr. Easy Going carefully (and quite skillfully) explains to us that ADHD medication is much like putting on a pair of eyeglasses: you can get around the world in a fuzzy way without them, but when you put them on, everything comes into sharper focus and it actually makes life easier. After a short discussion, we get buy-in from Boy to give meds a try. This is also in April.

By the first week of May, we meet with a behavioral therapist, a soft spoken, straightforward man who comes highly recommended from a couple of different sources. Boy begins to meet with him once a week. I like Dr. Straightforward because he seems like he “gets” Boy. Dr. Straightforward also agrees that meds, in combination with therapy, would be helpful. He can’t prescribe them, though, because he is a psychologist, not a medical doctor or a psychiatrist. Ask your pedi for a prescription, he says, or get him to give you a referral to a psychiatrist.

I realize, somewhat belatedly, that while Dr. Easy Going was cool with the concept of medication, he never actually addressed putting a plan in place to get it done. I’ll have to talk to him about that.

So off I go, dopily, to the pediatrician office’s website to send an email letting Dr. Easy Going know about Dr. Straightforward and giving him a heads up that I need to talk to him about a medication plan. (I know enough by now that a request to actually talk to the doctor, unless it’s a middle of the night medical emergency, will result in a few days of telephone tag.) The website says that Dr. Easy Going only communicates with patients and families using a “patient porthole,” which is a whole separate secure website for emailing physicians, getting test results, and the like. That’s fine; my own HMO uses a similar website, and it’s pretty handy. I click the link.

The website is used by many of the major hospitals in the city, and requires you to enroll, of course, by providing your child’s medical record number or Social Security number. I scour the kid’s annual health forms, but there’s no number on that. I put in Boy’s Social. Three screens later, the website is admonishing me that I can’t enroll Boy because he is not 18 years old.

Well, duh. It’s a pediatrician!

After a frustrating journey through the Frequently Asked Questions – Really? I have to use my mouse to click on the browser buttons? I wouldn’t have known that, never having used a computer before. Thanks, FAQs! – I am stumped. So I call the pedi’s office, and humbly ask for some guidance.

Her response: Did you fill out the paperwork?

[Needle on record scratch] What paperwork?

Oh, there are some forms you have to fill out before you can enroll. Would you like to come pick them up at the office, or should I mail them to you? (Just an aside: these are the same people who will, with a straight face, charge you a $20 “fee” for printing out a camp/school health form if you misplace the free one they give you at the end of your kid’s checkup. I’m not kidding. Twenty American dollars, for printing out one page. But these forms, she’ll mail for free.)

Okay, you know, as tempting as it would be to take time off from work to go to your office to pick up forms (1) which you could have given me back in April when I was physically at your office for my son’s annual pointless interview physical exam, or (2) which you could easily, in the alternative, make available in downloadable form on your website so parents could, I don’t know, download them and fill them out and send them to you, I’m going to go with door number two: have you snail mail them to me so I can fill them out and snail mail them back to you so you can do whatever vital thing you need to do with them so I can sign up for your Patient Porthole so I can talk to the pediatrician about ADHD medication we all agreed in April – two months ago – that Boy should be on, and which I don’t even at this point know if the pediatrician even can or will prescribe because I can’t email him to ask him because he only uses the Patient Freaking Porthole which – AAARGH!!!!!!!

I think I may be in the market for a new pediatrician soon – along with a behavioral therapist for myself.

Change ME

So, I’ve taken on a new job. It will eventually pay well, but not in money. It’s certainly a time investment, and, like all other jobs I’ve had over the years, it is starting out with me feeling not-very-competent.

It is the job of understanding my son’s special brain.

I wrote last time about Boy’s ADHD diagnosis, and the merry-go-round we’d been on until last month. How stepping off of that ride only led us to the current rollercoaster of ADHD. We’re not in Kansas anymore, Toto; we’re in the land of alphabet soup: ADHD, IEPs, WISC-IV, PAI-A, and the like.
Moms, at least those of us who are inclined to, pray for grace all the time. Please, Lord, don’t let me kill this child. Or, Please let his dad come home so I don’t have to handle this alone. Or, my personal favorite: Lord, DO something with this kid, will you?

Lately, however, I’ve been reminded of the much more powerful, more effective prayer. Change me, Lord. Change ME.

Although I’m very good at it, I don’t love to yell. I don’t enjoy getting a major attitude, or giving my teenager the silent treatment, or letting him know with every stiff, jerky movement of my body just how angry I am at him for whatever he has or hasn’t done. But that has been my go-to position for so very long, I am awesome at it.

Part of my new job is to rein that in. I finally realized that I’ve been doing the same thing for fourteen years, and it hasn’t worked – and isn’t that the common definition of insanity, doing the same thing over and over and expecting a different result? So I quit.

Hear that, world? I’ve given my notice. I quit being the hair-trigger bitch who snaps at the least mistake. Who fires off hurtful one-liners as if I were starring in a sitcom with a laugh track and timely commercial breaks. I’m done.

A few days ago, my son informed me at 6:00 PM that he had to write some poems for English class the following day. “How many poems,” I asked warily. “Thirteen,” he answered.

Now, understand that his computer account unlocks for his use at 7:00 PM and locks again at 9:00 PM, his bedtime. He had left himself a mere two hours to get this project done – despite the fact that he had just gotten off of April vacation during which he had insisted he had no homework. I began to steam immediately.

I unlocked the computer until midnight, knowing full well that he wouldn’t get enough sleep, that his poems would be utterly terrible, and that he’d have issues in school the following day.

Sure enough, his math teacher sent home a note saying that Boy had fallen asleep in Math class. Really. Imagine that.

That night, I sat down across from Boy, turning off the TV to get his attention, and . . . didn’t yell. Instead, in a calm and patient tone, I offered to help. “Boy,” I said, “I’d like to help you organize yourself so that you don’t have another last minute scramble like you did last night.”

“What do you mean?” he asked innocently. “My English teacher said my poems were ‘beautiful.’”

Not likely, I thought uncharitably. Aloud, I said, “But think how they might have turned out if you’d spent five days rather than five hours on them.”

He thought for a minute. “They’d be amazing,” he said quietly.

“And you might have been able to do some cool artwork to go with them,” I added. “But because you left it to the very last minute, you had to stay up way late, Daddy had to print them off early this morning, you were all stressed out with your wrinkled brow thing going on” (he laughed) “and you fell asleep in class.”

“Oh,” he said. “I guess you’re right. But I work better at the last minute.”

True, that, I thought. But I countered with, “What happens when you end up having two or three projects due around the same time? In high school, you’ll have more work, and when you get to college – well, your professors won’t know or even care what other class assignments you have. If you try to do everything at the last minute, you’ll run out of ‘last minutes’ and not be able to get everything done.”

You could almost see the light bulb go on above his head.

“So, I’d like to help you organize your time and your assignments so you don’t have to struggle like this again, okay?”

And, so, did it work? Depends on what your measure of success is. Do I expect him to be Mr. Super Organized all of a sudden from that one conversation? Of course not. The kid has ADHD, remember? It's going to take a lot of work to train his brain to get from point A to point C without a detour to Outer Mongolia in between. But I got buy-in from him to at least let me try to show him a better way.

But that’s not the success of the story. Remember, I prayed for ME to be changed. And for the first time, a botched assignment didn’t turn into a why do you leave everything to the last minute, haven’t I told you before, blah-blah-blah blame fest. Rather, I took a major step toward understanding Boy’s brain, and in return, he took a major step in understanding mine. And we ended the conversation without either one of us shouting, crying, stomping away childishly, or pouting in our rooms. Maybe next time he feels overwhelmed by an assignment, he’ll ask for help sooner rather than later, knowing that I want him to succeed. Maybe next time I see him flailing, I’ll step in kindly, with an offer of assistance rather than a declaration of impending failure.

I could grow to like this job. Maybe I’ll even get pretty good at it. I think it might have some pretty good benefits, after all.

Boy's Brain

I wish my son had a normal brain.

I’ve just finished reading a really great book called Delivered From Distraction, by Dr. Edward Hallowell, a very famous and very smart psychiatrist who studies and writes about and has Attention Deficit Disorder, or ADD. I read this book because my older son, Boy, has been diagnosed with ADHD (Attention Deficit Hyperactivity Disorder), and I went looking for some answers.

We probably knew all along that there was ADD/ADHD in the picture. Teachers have mentioned it over the years – along with other teachers who denied that Boy might have it. He didn’t always fit the profile. He can focus, sometimes, and other times, he can’t. We’ve brought him to therapists and counselors, sometimes at the point of pulling out our hair, trying to find out what was wrong with this kid? Why couldn’t he function like a normal child? They would talk to him, give him a few tests, and conclude, Meh, maybe he has ADD, maybe he doesn’t.

One kindergarten teacher told me, with sympathy in her voice, “I hate to tell you this, but your son may very well be a genius.” I cried about that. Another teacher scolded me, saying I’d better do something about his outbursts before my husband and I got sued by some other child’s parent. I cried about that, too.

And always, there was the sense that maybe it was just a discipline problem. If we structured his days, if we took away his privileges, if we punished him in just the right way, maybe he would straighten up and fly right. Sometimes it worked; mostly it didn’t.

Last year, I stumbled across a book about bi-polar disorder in children, and became very scared. A lot of symptoms described there were day to day occurrences in my kid.

Things came to a head this year, his eighth grade year, when he literally spent more time out of school – suspended for infraction after infraction – than he did in class. Rev and I took days off from work to stay home with him, or brought him with us to do his school work in an empty office. Finally, in February, I’d had enough, and on the same day I registered him for the public high school assignment process, I requested a transfer from his charter school to a public school. He would finish out the year in a regular high school, and probably repeat the grade before going on to high school. He was failing all of his classes, and was not even trying anymore. We got one day’s notice, and then he was going to another school.

A few days later, we took him for a five-hour neuropsychological exam (that had been scheduled since November). It took several weeks to get a result, but there we were, sitting with the psychologist, listening to her tell us that our son has ADHD. As I was soon to learn, Boy experiences the world through constant static. Sometimes he’s able to focus through the static and actually learn. Many times, however, the static takes over, and his mind drifts. As his pediatrician observed, he’s the ultimate multi-tasker; imagine how well he’ll do when the static goes away?

So what now? Now, I get on the merry-go-round of trying to find mental health professionals that are (1) accepting patients, (2) believers in both cognitive therapy and appropriate medication, and (3) covered by our insurance. In a “team approach” specialty – you can’t see a psychiatrist until you’ve seen a therapist, and only the psychiatrist can prescribe ADHD medication – you’re left trying to put together the team. Nobody says, Here’s a referral to a group; they’ll take care of you. You might as well just take out the Yellow Pages.

I’m supposed to entrust my kid and his special brain to some person I find on my own, through an Internet search or an advertisement in a parenting magazine or a list mailed to me by the pediatrician’s office.

Are you kidding me?

In the meantime, I’m reading Dr. Hallowell’s book and a few others, trying to figure out the day to day of dealing with my kid and his issues. I haven’t jumped on the oh, this is great, you have a magical brain, I wish I were that special! bandwagon that Dr. Hallowell espouses, but I’m also learning to cut the kid some slack. He’s fourteen, and there are some things that teenagers do: argue, procrastinate, sleep a lot, slack off on their homework, and so on. Friends of mine who have or have had fourteen-year-old sons have warned me about this toxic phase. But Boy is different, now. I have to help him find a way to be organized – because he never will on his own. I have to study his diet and sleep habits because there are things we can do to make his brain function better. And I have to remind myself, daily, that sometimes he’s dealing with a behavioral issue, not a discipline issue.

This is all new ground. I am happy that Boy is not bi-polar. I’m also relieved, profoundly relieved, that we finally have a working diagnosis, one that addresses both Boy’s strengths and his weaknesses (as opposed to years of being told only what bad thing Boy did each day). And I feel like I have a second chance to be a good mom, one who takes the time to take his side some of the time.

We’ll get him through this. We all need to learn some new tools, but eventually, he’ll be able to hear us clearly through the static. And then, who knows where that brain of his will take him?