Ryan's Medication

Ryan has always been my most active child. As a baby, he would wiggle and squirm at all times. If he was ever still, he was asleep. During church it was like holding onto a bucking bronco. All the other babies in the mothers lounge would relax and fall asleep while nursing. Not Ryan, he would kick and swing his arms and wiggle the entire time! At home, he began walking and then RUNNING at 9 months old and he could climb ANYTHING! Before his first birthday he could climb in and out of his crib in matter of seconds. He would build scaffolding to climb anywhere he wanted to go, including ON TOP OF THE FRIDGE... several times... before he was 18 months old! I literally feared for his life.

Because he was ALWAYS in a hurry, he didn't take the time to complete, or steady, or perfect most things he did. We was a very wobbly walker/runner, but rarely fell 'cause he was always moving so fast. He has been in speech therapy since age 4 because he didn't take the time to pronounce the sounds/words properly as a child and now needs to reprogram his brain with he proper sounds. His handwriting has always been messy (along with his desk, bedroom, etc). It was all something we hoped he could learn to control on his own. We strongly believe he needs to learn how to adjust his struggles to fit in the world, not make the world adjust to fit him.

In school, it has been something he has been able to control for the most part, so we didn't intervene. He is very bright and has been able to complete his work without much struggle (he is usually on the honor roll) while still being very active. This year has been different. Third grade curriculum is more challenging than previous years for most kids because they are starting to build skills leading into Jr High and High School. Ryan was having significant trouble focusing and completing assignments, even though he fully understood all the concepts. His teacher has been very understanding and worked with him and us, but we were all getting very concerned with the unfinished work he had in addition to homework etc. He was falling behind. He wasn't finishing assignments or turning in assignments he had finished. By mid-term he had all A's and 3 F's, due to zero's and incomplete work. We contacted the academic counseling department at school as well as his Dr. to help. Over the last month we have been working with his Dr, teacher, special ed dept, and others around him to evaluate Ryan's struggles and gather as much information as possible.

We met with Ryan's Dr yesterday. Based on the information gathered he diagnosed him with combination form ADHD, meaning he has both inattentive symptoms and impulsive/hyperactive symptoms. They usually outgrow the impulsive/hyperactive form as they begin puberty, but the inattentive problems tend to last into adulthood which causes difficulties in school/college, socially and maintaining a well paying job (employers are less understanding when they can't focus or complete a project).

The Dr recommending starting him on medication within the month, beginning with a low dose and gradually increasing until we find the right dosage for Ryan. He also recommended not telling people exactly when we begin the medication so we can monitor the changes and see if others notice the change as well. The Dr recommended Concerta, which is a 12 hour extended release medication, but our insurance needs preapproval first. So we will start him on Metadate initially, which is only a 8 hour extended release medication. It should help with school, and hopefully completing his homework and other activities before it wears off (which is why the Dr recommends the 12 hour Concerta instead). Once the Dr can show a history on the Metadate he can switch him to Concerta.

While we believe this will ultimately help Ryan focus and concentrate, there will be some side effects to watch for. Appetite loss is the most common, it will be important for him to get enough protein when he eats. Initially headaches, stomach upset and difficulty falling asleep may also occur, but should go away quickly. Our bigger concerns are zombie-ness, additional hyperactivity, blurred vision, dizziness, lightheadedness, and irritability. We want him to be the same person, just able to hold still and concentrate when appropriate (making him much happier).

We appreciate any feedback (good or bad) you notice, since different people interact with him in different ways it helps us build an overall picture of how he is reacting to the medication. If it isn't helping him, then we need to try something else. Positive comments to Ryan would really help him continue working hard to improve.