New to group...blended family, so much stress

[smallworld]

Let's take a look at those medications.

Strattera is dosed by weight. I don't know how much your difficult children weigh, but here is a chart to make sure they are being dosed correctly:

http://www.johnswank.com/strattera_dosing_chart.htm

Your difficult child I is taking Strattera for ADHD and Zoloft (I assume) for anxiety or depression. medications like Zoloft are dosed based on clinical response, and the maximum recommended dose for Zoloft is 200 mg. If he's acting spaced out on 200 mg, it could very well be too high for difficult child I. Furthermore, Strattera has been known to cause mood swings in kids and make them irritable and angry. And he's on two antidepressants (Strattera is an antidepressant), which may actually be exacerbating mood issues. Something to ask the psychiatrist about.

Your difficult child II is on two medications for ADHD: Focalin and Strattera. Why two medications for ADHD, and why is Zoloft being added?

Your difficult child III is on one medication for ADHD -- is it working? And why is Zoloft being added?

I personally would not go to a GP for heavy-duty medication management because it's not their expertise. I have on occasion consulted our pediatrician because he has general knowledge about these issues, but he was the first to say my kids' issues were beyond his expertise (the sign of a good doctor). Your kids' issues sound complicated, and I honestly think you need to find the best doctor around to manage their medications.

 

[AllStressedOut]

I keep seeing IEP on posts, but I don't know what it stands for. difficult child III is a 504 student, which means he can be in a regular classroom, but for him to have a good day, he has special circumstances, mainly his diet, that have to be closely watched. The 504 status just puts his diet in writing to be sure the school doesn't give him food we don't send. Its what our school district deems a plan for success.

When my husband and I first got married, the only one on medication was difficult child I. He was on adderall then and would cry uncontrollably. I don't believe medication is always the answer either, but I do see it helps in some cases. I also didn't want my beliefs to keep my children from thriving. If they needed medications, I wanted to be sure they got them, now I just want to be sure they are on what is right for their body. I took difficult child I off adderall the first summer we were married and watched him. Then we took him to a new psychiatrist, but they didn't have much time for him. They prescribed straterra and then from that point on, he received that prescription from his pediatrician. Last year, when we finally had all medical rights to all 3 boys, we took them to this new psychiatrist. Prior to this his bio mom had veto power on everything and used it on everything, including therapy. The new psychiatrist supposedly had a scientific test to determine ADHD. The chart went up to 6 and difficult child I tested 7.25, difficult child II tested 7.5 and difficult child III tested 6.5, so according to the new psychiatrist, they were all off the charts ADHD children. We started them on medications then and when we had our first checkup, we spoke to the Dr about the youngest sneaking sugary food. Not just one or two things, but on one morning, an entire family size bag of starburst, a Sam's size box of peanutbutter/chocolate treat bars and a bunch of Snickers. He asked about diabetes in the family and since there is, he recommended the youngest be tested with a 6 hour glucose test. He went through the test only to find out that his blood sugar levels spiked and dropped, spiked and dropped, each hour. So they diagnosed him with reactive hypoglycemia. The doctor explained that this means eating something that tastes sweet puts him into a hypoglycemic state. So he put him on this strict diet. After being on the diet for a week, it seemed as if the miracle cure, hes been on it for a year now. The diet stinks though and we wish we could ease up on him. As the diet became his everyday life, he went back to sneaking tons of sugary treats, so now we've had to lock it all away. We still want to be able to give him treats at times, but when he sneaks, he sneaks the entire bag or box, not just one. And if we let him have some, he can't sleep and he has a harder time behaving. They see this psychiatrist every month to discuss behavior and medication, but so far, it seems they've added foclin to the younger two and just upped the dosage on all 3 as they deemed necessary. My middle difficult child just isn't the same though, he used to be the sweetest kid in the house of all 6. He would do anything for you or for his siblings. The only problems he had were academic. In the last year he has become very argumentative though and doesn't seem to be the sweet kid he once was. As I was reading other posts, I thought it might be the staterra. I've talked to husband and we think we may take him off and watch for changes. My concern for this is when school starts. Before straterra he was struggling, everything was so hard for him to figure out. Math was impossible. After straterra he went to not only straight A's, but high A's, 95 and above in all subjects. I'd hate to take that success away from him, it makes him feel good about himself to achieve those grades.

The problem with not caring about what the school says is they like to get involved when they think parents stink. We think the one who said our house was similar to a concentration camp filed a CPS claim on us. Nothing was found, this was years ago, but having someone think you're abusing or neglecting your children hurts. Now that difficult child III is on this strict diet, we think it was a parent who felt we were being hurtful to him and filed a CPS claim on us. It seems they came and had lunch with their child and their child chose mine as the friend they wanted to sit with and they discovered he eats healthy food all the time. His diet consists of mostly proteins and vegetables, so at school he typically eats leftovers from dinner, like chicken , green beans, meatloaf, broccoli and so on. We also send two snacks with him for through out the day, to keep his energy up. He gets a bag of nuts as a morning and as an afternoon snack. It seems she thought this was abusive/neglectful of us and filed a CPS claim on us, again, nothing was found, but its still a scary process to go through and it really hurts to think someone thinks this of you. I've changed my life for my 3 difficult child's. I have become a person who lives by schedules and runs things by menus, when I use to be easy going and let things happen as they may. I love my kids, all of them, easy child or difficult child, they're mine and I'm proud of them. So its very hard to just let it go when a teacher or another parent thinks I'm not doing what I can for them. I'm doing everything I know to do for them and if I don't know to do it, I'm trying to find out what else I can do. I just wish they were better trained in dealing with kids like ours. Maybe if they were trained, they could help other parents like me as time goes on. I can't be the only parent with difficult children that doesn't have all the answers. We have so much on our plates as it is, just dealing with our everyday life. Adding this type of stress makes life more unbearable. I wish someone out there could make them understand. I wish I understood it all.

 

[smallworld]

Do you know the name of the "scientific test" used to diagnosis ADHD? As far as I know, there is no such animal . . .

 

[AllStressedOut]

Looking at that staterra chart tells me difficult child I is dosed too high, but granted, hes lost weight. It still seems extremely high, he weighs 83 lbs. We only gave him 200 mg of Zoloft for a week or two a few months ago. We have told the psychiatrist more than once we felt it was too high. difficult child I was having outbursts with his teachers and at times arguing with us. He seemed angry, but maybe we described it wrong. He also doesn't have friends and doesn't make friends. The psychiatrist said he felt he had SAD. He felt the Zoloft would help ease both of these problems. He started out at 50mg, but was still having outbursts at school, so they gradually upped the dosage. When he got to 200 mg and he seemed so spaced out is when I told the psychiatrist it was too much. If straterra is the problem, what medication works for ADHD that doesn't cause the emotional problems? This psychiatrist seems stuck on the same regimine of medications, but hes been the only psychiatrist in our experience to want to see the kids monthly to regulate medications. This seemed like a good thing to us. Their pediatrician also said the medications were out of her realm. Which again, seemed good to us. We just can't find a psychiatrist with time to see 3 kids regularly besides the one we see, that is in our plan and we feel good about. Thats why I was hoping for a referral, which we got by two people, but the guy is out of our plan. What we have found, in our plan, is they don't specialize in children, they aren't taking new patients or they can't see us for a few months.

difficult child II was put on foclin first, but only because insurance wouldn't cover straterra until he tried other drugs. Foclin wasn't doing much for him it seemed, so they added straterra and insurance covered it at that point. The mix seems to do great for academics, but he doesn't seem like the same sweet kid. Zoloft was just added when we went to the Dr this week and it was added because he seems angry. After reading posts though, I think its the straterra.

difficult child III's foclin doesn't really seem to do anything, but he started it in the summer, so maybe it did make this school year easier and I'm not sure since the diet also started in the summer. The diet seemed to make the most change in him. Although if I compare school years, he did have a better school year this year. I'm just not sure what part of that is medications, maturing/age or parenting. The Zoloft was added this week as well because of his outbursts at school before summer started. He was throwing fits on the floor when asked to change to a new center. He chased a kid with scissors because they were annoying him (per his words). So the psychiatrist thought he needed Zoloft for his anger issues. Do you think this is the wrong conclusion?

 

[AllStressedOut]

The test was called a QEEG test. If I understood it correctly, bare with me, its been a year, but basically it measured focused and unfocused brain activity. Again, if I understood it correctly. My husband is much more knowledgible of the scientific side of all of this. I have to have it dumbed down for me.

 

[AllStressedOut]

I goofed on one of my posts, I said they added foclin, thats incorrect, they added straterra.

 

[BusynMember]

I have to go back and read all the posts. I read something that caught my attention. There is NO scientific test (none, nada, zip) for ADHD, bipolar, Autism Spectrum Disorders (ASD), anything. Anyone who tells you that there is is feeding you misinformation and I'd call the doctor a quack. The Connors test can indicate ADHD traits, but kids with bipolar and Autism Spectrum Disorders (ASD) will also score off-the-charts on that test. My son even took a computer test for ADHD, which is supposed to be most accurate, and he flunked the test (meaning he SHOULD have ADHD), however ADHD was not his core problem--he is Autism Spectrum Disorders (ASD), which always includes a heavy dose of impulsivity and inattention. To date, the problem is that we can't know for sure what a child has. A lot is response. I am no doctor, never claimed to be, but since ADHD medications aren't doing squat, why even use them? They can be dangerous in the wrong kids. And I had to laugh that your poor child got Zoloft for anger issues. Both stimulants AND things like Zoloft can CAUSE anger. The last thing I'd do is allow my psychiatrist to prescribe an antidepressant in a violent child--not without trying an antipsychotic or a mood stabilizer first. I've had to get a layperson's knowledge of medications because I have bipolar and have experienced most of the drugs--I learned I had to arm myself by educating myself before taking anything. I had numerous bad to horrendous reactions before getting help. My son did too--son is now medication free. He didn't even need medications. You aren't doing your kids a disservice to discontinue medications THAT DON'T HELP OR MAKE THEM WORSE. Stims are not the answer to every disorder or every child, and my son couldn't take them OR antidepressants. *I* need an antidepressant, however it was a long trial and error and only one works for me. I'm always shocked at how casually doctors give out medications. It's like "try and see." I wish they'd do a more careful job of diagnosing...they can. They just don't.
I would not allow a GP to either diagnose or monitor medications for a psychiatric or neurological disorder. They don't have the training. Do you have a neuropsychologist in your network? If so, I'd go there next. in my opinion and experience they actually test better than Psychiatrists and tend to cover both psychiatric and neurological disorders. While t here is no blood test or guarantees, they do a lot (LOTS) of testing that point to certain disorders and, in our case, a neuropsychologist was the only one who got my complicated son correct. He had been so terribly misdiagnosed. I would not trust any Psychiatrist either who would give a child both stimulants and antidepressants at the same time...wow. That's a rush-and-a-half. I'm pro-medication, but I believe you first have to be 95% comfortable that the diagnosis is correct and then you see if the medications work. If, within the right span of time, they don't work, I have always had the psychiatrists discontinue the medication. Be proactive, educate yourself on the various disorders and medications, and be a partner with your doctor. The more you know, the more you can advocate for your kids. An IEP in school is very important for school success, but it won't cure the problem. I'd get thee kids to a neuropsyche :smile: Take care. PS--Since school teachers, administrators, and even school psycologists tend not to be the brightest bulbs on the Christmas Tree regarding childhood disorders, I wouldn't tell them what you do at home or the treatment they get from private doctors. It's none of their business. The fact is, high structure is great for kids with ADHD/bipolar/Autism Spectrum Disorders (ASD) and, if they don't know that, it's because they don't have the right education and knowledge. You are doing the right thing, no matter what they say. I'd ignore the school people and tell them "we have them in private treatment." When it comes to the IEP time, after they are re-evaluated, you can bring the results and recommendations, but you don't need to tell them everything, especially not what you do in your home. I've learned not to tell them much because they really don't tend to "get it."

 

[AllStressedOut]

I think I'm seeing my problem, I'm trusting the doctors to know more than I could find out. I need to do more research. I'm on page 84 of the book and I see some things in my kids, but they don't seem as severe. Although, if I did direct comparisons to how they were when my husband and I first married, then yes, its them to a T.

I did the research and thought our youngest difficult child was ODD and the psychiatrist agreed. I researched his problems, because as stated in my signature, he is my most difficult difficult child. psychiatrist thinks that there really isn't any medications for ODD and you can only treat symptoms. My middle difficult child has never had serious problems besides academics, until he started staterra, then academics weren't the problem, attitude/personality was. My oldest difficult child has improved greatly, but is still having outbursts in class. He improved while just on straterra though, so maybe he should just take that? He was angry long before straterra, but now arguing/disrespect seems to be his major issue. All other issues I could handle. One thing in him that bothers me is his outlook on life when things don't go his way. His response is "My life sucks, I want to die, life is unfair, etc." But when things are going fine, he thinks life is wonderful.

I appreciate all of ya'lls input and advice. It really helps me understand I need to take more of this on myself and not depend so much on the psychiatrist opinion in 10 minutes with each kid each month. When you put that in writing it seems stupid to think 10 minutes a month is enough to fix it all.

 

[meowbunny]

Can't tell you a thing about medications. My daughter did one trial, it didn't help. After several conversations with her therapist, we decided to not try again.

However, in my opinion a 504 plan is useless. Schools and teachers are not mandated to follow the suggestions and guidelines. An IEP, to put it simply, is a federally mandated 504. The school and teachers are supposed to follow it. Of course, you'll discover they don't. Since my daughter was out of school when I found this Board, I haven't gone to the education section but I'd suggest you go there and see what information they have for you.

A lot of what your oldest is saying is pretty typcial for a middle schooler. When things are great, the world IS wonderful. When things aren't, the world truly sucks. It takes time and maturity and a leveling of hormones to discover that the world isn't all good or bad at any given second. As long as he isn't making specific plans and statements on how to leave this world, I'd take his comments with a large grain of salt and agree with him that sometimes the world does suck but it will get better.

 

[BusynMember]

I learned the hard way to question everything and read about every disorder. ODD rarely stands alone. You usually see another disorder alongside it. I hope you find the right answers, but it often takes a while, which is a strain on the family. I have a few mottos because of my long years with my son.

1/If it ain't broke, don't fix it (don't change medications that work)
2/If it's broke, fix it (Don't continue using medications, or similiar medications, that do nothing or make things worse)
3/Mom gut matters. Trust your own instincts.
4/Every single psychiatric and neurological disorder is only the professionals best guess. Question everything if a child is not improving.
5/Don't see a therapist first. Start at the top: The guy with the big MD, Psychiatrist, and the neuropsychologist who does such intensive testing
6/ Until your child is stable, never stop searching for other possible answers/explanations
7/Doctors aren't Gods or infallible
8/If you don't think something makes sense, it probably doesn't
9/Never go to a clinic or a doctor who specializes in one disorder. Avoid ADHD Doctors, Bipolar Doctors, Autism Doctors--they will see THAT disorder in every child.
10/Educate yourself. You can't know too much, only too little.
11/A long wait for an appointment often means the professional has helped a lot of kids, but not always. Ask other parents who helped their difficult children.
12/Join support groups in your area
13/Unlucky 13: TAKE CARE OF YOURSELF. "If Mom ain't happy, ain't nobody happy."
This is just a guideline of mine and only my own personal opinion.

 

[flutterbee]

An IEP is an Individualized Education Plan. If a child is found to be a child with a disability, the SD (school district) is required by law (called IDEA 2004) to provide them with a Free Appropriate Education (FAPE) in the Least Restrictive Environment (LRE) that is designed for that child's needs. Phew...that's a mouthful. However, this process is often a battle in itself as the SD counts on parents being uneducated re: this law and, in my experience, many of the SD employees are uneducated re: it as well. There is a Special Education board set up for just this reason on this site. Martie and Sheila moderate that board and are a wealth of information, having been on the front lines themselves. You can also check out the Special Education Archives for a lot of valuable information.

I didn't mean to imply in my previous post that I'm anti-medication. That's not the case at all. I'm just anti- throwing-medications-at symptoms-and-wait-to-see-what-happens. You are right, though, in that you have to educate yourself in order to be able to work with the doctors. You live with your difficult child's. The doctors see them for a few minutes a month. Research, research, research.

Your oldest difficult child sounds like my difficult child when it comes to black and white thinking. If everything is going her way she is wonderful, but if one little (and I do mean little) thing goes awry, it suddenly becomes the worst day ever. In regards to your oldest difficult child's attitude, etc., he's also entering puberty and you're going to see normal puberty stuff magnified by his GFGness. What fun, huh?!? :hammer:

 

[AllStressedOut]

What classifies as a disability? ADD, ADHD, ODD, SAD, all of the above? I'll check out the education forum. Thanks for the tips.

My oldest child is considered easy child in this group and while he certainly has the pre-teen attitude, he doesn't ever say he wants to die. This is something my oldest difficult child son has always used when expressing himself when hes upset. This doesn't seem like typical easy child pre-teen behavior. It does however seem to be typical difficult child pre-teen behavior to me. I might be wrong, I certainly don't have much experience with pre-teens, but so far, it doesn't seem the typical behavior of one of my PCs so it worries me. Its not that I think he is going to hurt himself, I know he needs to show signs of a plan for that to be the case, but I don't like that it is that severe. Which I guess goes along with the black and white of things. This is the black side.

In the book so far I see mostly my oldest and youngest difficult child. My youngest has tantrums at school, not at home. They usually occur when switching tasks. My oldest is very argumentative. He doesn't say bad words, but his tone is very disrespectful and he is very defiant when he is sure he is right. I wish I had this book before this year, I think both of their teachers would have gotten alot out of it. I just wish there were a list of things to do that would make it all better. For now I'm trying to make their environment easier by setting up a schedule for everything and everyone. My thinking is that if I keep them busy and they are busy doing their own thing, they can't have meltdowns with their siblings. During the summer, arguments over which tv program to watch, what game to play etc. seem to be the route of most of the problems. Idle hands don't help either. If anyone has any suggestions on how to make the daily life easier, I'd love to hear them.

by the way, I emailed the local chapter of NAMI asking about support groups in our area for parents with children who have MI, but haven't heard anything back. Are there other groups that I can look into?

In the past we have heard that Straterra is not a drug you need to ween off of. Does anyone have experience with this? We're thinking we want to stop it for now and see how it goes. Does anyone know how long it takes to notice a change? I'm going to google it now and see what I can find.

 

[smallworld]

Because Strattera is an antidepressant, you DO need to wean from it. Please get medical advice about how to do it. Sometimes it takes a few weeks or so to get a read on baseline behavior without medications because removing the medication can stir things up.

All of the above conditions qualify as disabilities for an IEP AS LONG AS the disability causes significant educational impact. Tantruming at school qualifies as educational impact.

I would take it very seriously that your difficult child is saying he wants to die. That is not normal pre-teen behavior. It indicates he is hurting emotionally, and it needs attention. It could be from the medication he's on (suicidal ideation), or it could be depression that is not being addressed properly. You definitely need to pay attention to this symptom.