What is the Right Dosage of Ritalin

June 20, 2016

We are in the process of determining the right dosage of Ritalin for my kid. We went in for another medication review appointment with a child psychiatrist.  I noted the improvements — there are two. She has been better about taking re-direction and there has been a noticeable decrease in emotional meltdowns at home. However, the non stop chattering, interrupting, and pestering remains the same. Likewise, her teacher noted she still has strong reactions to little things in the classroom to the extent of requiring a school staff person to be called in to help calm her down.  In her defense, the end of the school year can be difficult for a lot of children. It’s emotional.  The psychiatrist discussed things further with me — asking questions, asking for descriptive situations. The doctor recommended a slight increase in the dosage, a slight titration. We would meet for another medication review in a month.Right dosage of Ritalin

The bio-chemistry relationship involved with psychotropic drugs continues to fascinate me.  Could we have a little more of this so that we get a little less of that? A little more chemical input to decrease the behavioral output. I was hoping that once my daughter could pull in the reins on her running thoughts, I would be able to do therapeutic exercises to help her stop, pause, and make a good choice.  Maybe medication is similar to finding a fertilizer that works best on the yard — bringing out the desirable green grass, encouraging new growth, and suppressing the unsightly weeds.

I tried not to examine each blade of her existence. Yet, I wanted to carefully keep note of behaviors improving, antics remaining the same, or difficult ones increasing in frequency. We had a little of each. What a relief to have fewer emotional meltdowns over for example, “Please go play outside, it’s nice and sunny and your brother wants to practice his drums in the playroom.” Still the same ones of non-stop chattering and nonsensical arguing. And then the last one. More stealing and sneaking behaviors– taking notecards from my desk, emptying out brother’s emergency inhaler (placed on his bedside table), and climbing onto the counters to reach an item on a high shelf. I even tried out this one because I doubted her abilities. I climbed up on the countertop. I remained on my knees to account for her 42 inch height and reached my arm up high. Yup, it was doable. It was totally possible to reach the now consumed 8 pack hamburger bun package. Silly me for placing it there, for thinking that our family of five could have Sloppy Joes later this week. Instead we had pasta with meat sauce, a tangy BBQ flavored meat sauce.

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ADHD Medication

Waiting for the Effects of ADHD Medication

Week 4

We did not go away for Spring Break. Get the tissues out, boo-hoo. This happens for us with my husband’s career. I’ve been really supportive to his work and demanding hours. I get it. It’s just that sometimes seeing everyone around us pack up their cars, hearing everyone’s plans for the week off, and feeling the need for something different to our routine, I feel sorry for myself when we stay home during any of the school year breaks. This year I changed that.

My solution has been to rent a cabin for a few days about an hour away. We take the dog, we bring food for all the meals, and for two nights he is able to put work on hold. The boys take a respite from their electronic devices. They flip a coin over who will sit next to the pooch; the loser sits near her. My husband attempts to delegate duties of packing the car. This never goes well. He does most of it, huffing and muttering up and down the driveway. I opt to stay inside programming the auto-feeder for the cats. Every time we go on this kind of trip, we manage to leave an hour later than planned, our bodies are crammed into the vehicle, trash bags for suitcases stuffed in every space and my hubby annoyed that his guitar never fits. The excitement increases over car ride games. I pop in an old Pearl Jam cd. We’re off!

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Stealing Food

My Young Child is Stealing Food

Week 2

young child is stealing food

How about stealing time to play!

Stealing food from children. Really? That is how Mrs. M wrote it in her message. We are starting week two of medication or in other words, it is day eight. I know in my heart that I am uncomfortable with my child needing medication. But as I put it to her brothers, it’s like needing glasses. All that squinting, missing homework assignments written on the whiteboard, not seeing the lacrosse ball– my kid needed corrective lenses for better focus. Did this completely change his life? Yes and no.  The non-stimulant ADHD medication will hopefully change her life and ours for the better. After I had returned to our therapist for a consultation, after having a medication evaluation and after a few days of starting the medication, I got a long email from her kindergarten teacher. As soon as I opened it, I braced myself. Four paragraphs. What now?  Well, turns out that for the past 6 or so weeks food has gone missing from her students’ lunch boxes. And surprisingly while we were on a family trip for three days, nothing happened. Yet when we returned, the missing of items resumed. Mystery solved? Yes. Problem corrected? No.

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ADHD – Impulsivity

ADHD Impulsivity

Week 1

It was time. She was having rough days 9 out of every 10 school days.  Her impulsivity was significant — she was lying, stealing, and sneaking food each weekend. Every once in a while, we had that uneventful day. The last one still fresh in my memory.

“Isn’t it great I had a good day?” she asked me, her wide toothy grin in the rearview mirror. She has the look of wanting validation.  “Yes, it is. It’s a day you can have every day.”

ADHD impulsivity

Her special needs are not immediately visible.

Again, she revisited the topic. “Isn’t it so special! I had a great day! Are you happy, Momma?”  I answered, “Yes, I am. I know you can have lots of good days.”

The self-praises continued that afternoon. By dinner time she had revised once more, “I love having good days! I was so special today, right Momma?”  I made the silent coyote signal with my hand, gesturing for her to be quiet. Then I corrected, “It’s not special and you are not behaving special. Your teacher said it wasn’t a bad day. That’s what she said!”

And there it was, my words cutting through the glee. Yes, it is time. Our former therapist emailed me back with instructions to fill out the intake paperwork so that we can schedule a consultation with her. Within 18 hours, I had completed the hefty packet and hand delivered it to her office. I wrote her: when are you free?

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