My Road To and Through ADHD

When Thing 1 didn't sit still ever, I didn't think anything about it. He was my first one. He set the standard. He was good at daycare, he was busy at home...no worries. He was a boy. Boys were supposed to move constantly, right? Boys weren't supposed to know how to clean their rooms, right? Boys were supposed to just cause chaos everywhere, right? He knew his alphabet, he could count, he could write, he was fine. He was just busy. It had always been a joke that The Husband had ADD, because he couldn't sit still without falling asleep, and while Thing 1 had The Husband's need to be busy, he was complete opposite when it came to going to sleep. No just sit and sleep for him--it was a nightly battle of the wills to get Thing 1 asleep. I didn't realize how much of a battle it was until Thing 2 came along and for the first 6 months of her life, she slept all night every night. Thing 1 never did that. But then soon enough, Thing 2 stopped doing that too. And bedtime battles were back to being our norm. Thing 2 also behaved similar to Thing 1 in the busy department, but she added a whole new level of insanity to it as well. Where Thing 1 would be busy running and sliding down the hall, Thing 2 would be busy trying climb on top of the fridge. She had no fear. So the joke became Thing 2 was way more male than Thing 1 ever thought about being. And that Chuck Norris feared Thing 2. 

It didn't seriously occur to me that Thing 1 could have an issue until he started Kindergarten (Thing 1's ADHD Story). I'd started wondering what was up shortly after The Husband deployed and we started interacting more with other families who had kiddos Thing 1's age. Whenever we'd have a play date, they would all start cleaning while Thing 1 bounced from toy to toy, not really cleaning. He would only start cleaning if you sat there and said "okay now that, and that, and that", but he never cleaned his room either, so I had always assumed it was an age thing. It wasn't until I saw other kids his age actually cleaning that it made me wonder why mine didn't clean. Then he started having trouble at school and while the other kids would be sobbing messes about their yellow days, he was all "yah, I had a yellow day...can we have a snack now?". Taking away toys, play times, etc didn't change his behavior. I started asking other mommies for advice and still no luck. 

At this point, I was so frustrated. I was frustrated with his lack of remorse about his school behavior. I was frustrated that he couldn't complete a simple task that by this time I'd seen other kids perform and knew that it was age appropriate to expect him to be able to complete tasks. I was also embarrassed to have 'that' kid...the one that was always all over the place while the other kids were sitting calmly. I knew that deployment was wearing on me and so instead of thinking that something might be off with him, I assumed something was wrong with me. I went to doctor and explained I was just tired, anxious, and frustrated all of the time. He prescribed medication and while the medication helped a bit, it wasn't nearly the help that I hoped it would have been. The Husband's homecoming didn't alleviate the frustration either. It was just another person in the house to yell at Thing 1 about how easy it is to clean up 1 thing from his room or how easy it is to sit and listen to the teacher.  

So when Thing 1's doctor said "Oh yah, he has ADHD, no doubt" it was as if a giant weight had been lifted off of me. I wasn't a bad parent. I wasn't completely failing across the board. We just had an extra hurdle in our normal lives. I never thought "oh why me?!?! why Thing 1?!?!". I was actually grateful to know that there was actually an issue instead of him choosing to not listen and misbehave. It was comforting to know there were extenuating circumstances. 

And while it was nice to have an 'excuse', I didn't ever want Thing 1 (and Thing 2 after her diagnosis--Thing 2's Journey) to use his ADHD as an excuse. It was very important to us to say to them, yes you have ADHD, but that doesn't mean you get to act like a flippin idiot. It doesn't mean there is something wrong with you. It means you have to work extra hard to focus and stay calm. It means we'll help you work extra hard and we'll be more understanding, but it's not a free-for-all bing-bongy fest. It was also important to me to not label them. Yes, we discuss it with his teachers, but it's up to them to talk to anyone else about it. We discuss it with teachers because during the school year, their teachers potentially spend more awake time with them during the week than we do. They need to be in the loop. I'm always surprised at how not bothered they are to talk about their ADHD too. Thing 1 discusses it with his piano teachers when he gets a new one (and we're up to our 3rd new one since arriving here) and Thing 2 is all blase about it. So, I take my cues from them. If they're not worried and their teachers aren't worried, then I'm not worried. 

I don't spend a lot of time googling all of the options we have for treatment, because our option is working. I don't spend a lot of time googling anything about ADHD for that matter because of the differences between Thing 1 and Thing 2. They are similar in some of their ADHD stuff and complete opposites in other ways, so that says to me that there isn't a way to say all ADHD kids respond to xyz. There isn't a one size fits all ADHD. Consequently, the available information is incredibly conflicting. One report says a change in diet works, one report says a change in diet doesn't work. One report says one type of medication is the best and one report says that holistic treatment is the best way to go. There's no one thing that works for absolutely everyone. There does seem to be an excessive amount of judging by other mommies of the best course of treatment, which just makes me all kinds of cranky. 

Here's my opinion if you're headed down this road, or you might be worried about that you're might be headed down this road. You know your kiddo the bestest. Listen to their teachers. Listen to your kiddo. Listen to you. Listen to your doctors. And pray about it. It's not the end of the world. It's just ADHD. No biggie. 

Oh, and if at all possible, have your non-ADHD kid last. If I'd had Sam-I-Am first, I would've had the other two diagnosed at birth. It's been so surprising to discover 2 year olds can do simple tasks. I'm always surprised when I tell the 2 year old "go put your shoes in the bin and your socks in the laundry" and she actually does it. :)  

Our Second Trip Down the ADHD Road ~ Thing 2's Journey

Please read Thing 1's ADHD Journey, first. :)

Thing 2's journey down the ADHD road has been different than Thing 1's by leaps and bounds.

Thing 2 behaved just as Thing 1 in certain ways and completely different in most ways. She didn't sit, she was constantly into anything and everything, she was quick on her feet and scared of nothing. When Thing 1 was going through the diagnosing process, I realized we'd probably be doing the same thing again when Thing 2 started school. In fact, when Thing 1's doctor asked "does he do impulsive things or things without thinking, you know like would you say that he's likely to jump off the roof to see what it's like to fly?" and I replied "No, but his sister would". So instead of being incredibly confused by her behavior, I felt like it was just a waiting game. I believed that ADHD couldn't really be diagnosed until the child started school, so we were just waiting and trying to survive until she started school. She started Kindergarten in August 2010. Her teacher was one of the senior Kindergarten teachers and she was awesome. She believed in strict rules and she had expectations of her students to follow them. She was the drill sergeant type teacher. I explained that I expected Thing 2 to have issues. I explained how she has some behaviors that are exactly like her brother, but that she also tends to be impulsive, so I wouldn't be surprised at all if she has behavior issues in class. Her teacher was appreciative of the heads up and said she'd keep an eye on her. It was mid-September before I was scratching my head trying to figure out why my textbook symptom impulsivity ADHD kid wasn't having ANY trouble at school. At the first round of parent teacher conferences, I told her I was just so confused because Thing 2 wasn't having any trouble. She laughed. She said Thing 2 sometimes has trouble with talking, but it was completely age appropriate. She explained that she keeps all of her students on a pretty short leash too, so Thing 2 didn't really have too many opportunities to get into trouble. By this time, Thing 1 was meeting with his counselor, so I discussed the issue with her. She said it sounded like Thing 2 had ADHD, but probably a different kind than Thing 1, so maybe not as severe and whenever we wanted to get her evaluated we could. I felt really conflicted about having her evaluated without her having trouble at school. It was as if it was okay for her to be insane at home, as long as she was sane at school. But then during Christmas break, I came into the living room to see Sam-I-Am (18months old) sitting on the floor by the coffee table crying, and Thing 2 running past me. When I asked Thing 1 what was going on, he explained that Thing 2 had been standing on the coffee table, spinning Sam-I-Am around, until she just let go of her and Sam-I-Am bounced off the couch onto the floor. This was the first time that Thing 2 had taken Sam-I-Am into her insanity and I was no longer concerned about having her evaluated too soon.

Her evaluation went smoothly. Vanderbilt surveys filled out by me, a family friend, and her teacher. A meeting with psychiatrist, psychologist, and then a diagnosis of ADHD, Combined Type. We decided to use Concerta for her as it worked so well with Thing 1 and we again started low and slow. Her reaction was different though. Whereas Thing 1 could sit and focus, Thing 2 stopped being excessively dramatic. Turns out all of those quirks we'd been blaming on just being a girl were actually symptoms of her ADHD. The psychiatrist laughed when I said "well, she's really agreeable and that's new and awesome." when she called to check on her. She told me that part of Thing 2's ADHD is also associated with Oppositional Defiance Disorder (yah, we had a good time with that acronym) and so when the Concerta treats the ADHD, it helps with the ODD. So no more "but I DON'T WANT TO PUT MY SHOES ON!!!!" hysterical sobs/body flings as we're trying to get out the door. Thing 2's dose has remained smaller than Thing 1's dose, but she too has a bedtime dose of Clonidine.

It's been interesting to see the difference in reaction to medication between the two of them. Where Thing 1's meds helped him focus, so his teachers noticed more of a difference than we did, Thing 2's meds help chill her out more, which is more obvious at home then at school. But we have the same discussions with her teachers as we do with Thing 1's teachers at the beginning of each year and any conferences we have. Thing 2's teacher this year is kind of hit & miss, so that's been a bit of a challenge in regards to making sure we have the right dose of medication for her.

And again Thing 2 doesn't think there's anything "wrong" with her. She's never been embarrassed by her ADHD. She's also matter of fact about it. It's just a part of her life, not her whole life.

Our Road To and Through ADHD~Thing 1's Story

Our road to and through ADHD has been an interesting one that I just realized I've never really written about before. I've noticed it's something that a few people I know are going through and I thought I'd share our journey.

Thing 1 was a busy kid...busy baby, busy toddler, busy busy  busy. He never really sat still for long. Never. It didn't occur to me that it was odd that he didn't sit still until he was 3. The Husband was going to college, I was working and Thing 1 was going to daycare every day. Every time I'd drop him off to a room full of sitting 3 year olds, I'd think that daycare had some kind of superpower that could get my kiddo to sit still and I was silently irritated with them. His teachers talked about how helpful he was and how he did really well on days when they were super busy. I chalked it up to him having The Husband's DNA, as The Husband doesn't sit. Ever. Then Thing 1 started Pre-K. His Pre-K teacher was an older woman who wore 80's leggings *before* they came back into fashion. I questioned her sanity pretty much daily, but she sang Thing 1's praises and said all of the things his previous daycare teachers had said: "he's so busy, but he does fine". She also added things like "oh, he's just a boy...boys don't sit". At home, Thing 1 never really sat, but he also had trouble with simple things like cleaning his room and bedtime. Both were very, very long processes that usually ended with my blood pressure through the roof. So then he started Kindergarten in August 2007, at a different school with an established teacher. The first week went well with all green days, but shortly after that things started going downhill. He started coming home with yellow days for talking, not sitting in his seat, interrupting his classmates, etc. My first inclination was that the teacher was a bit more strict than any teacher he'd had before and that she needed to chill. I tried to communicate the importance of paying attention and being quiet to Thing 1 and he seemed receptive, but then he'd come home with a yellow day. ARGH! So then I tried punishment for yellow days--he lost toys, playdates, anything that could bring him joy, etc. And it was the same "okay, Mommy, I'll be better" followed by another yellow day. At the first parent-teacher conference in October, his teacher sat down in front of me and said "Thing 1 does not sit." and I smiled and said "no, he's never really sat though". And she looked at me with this puzzled look and said "He has to sit. He should be able to sit for at least 20 minutes at a time at this age.". And my awesome mommyness replied with "Really?". She just looked at me like I was insane. I laughed and explained that Thing 1 is my oldest and he's *NEVER* sat still and so while his behavior is abnorm to her, it's all I've ever known. So then she explained to me what my 6 year old should be able to do...sit, listen, follow 3 step directions, etc. I was floored. Who would've guessed you could give a 6 year old more than 1 task at a time?!?!? Who knew that he should be able to sit for at least 10 minutes?!?!? So we talked about how we could work together to get Thing 1 on task and focused. We also discussed that The Husband was deployed and that might effect Thing 1's behavior and lack of concern about his yellow days. We decided to touch base again after The Husband came home. So late February 2008, after The Husband was home, Christmas Break had come and gone and things were back to being "normal", Thing 1 was still bringing home yellow days and his lack of concern about it had gone considerably downhill. At this point, I was worried. Nothing seemed to motivate him. I started doing some research and one of the things that came up repeatedly was ADHD. Sensing his teacher was getting a bit more frustrated with him, I requested the school counselor to observe Thing 1 in the classroom for a few days. I wanted to 3rd party verify that Thing 1 was the issue, not the teacher or the 24 other Kindergartners that she had. About a week later, I had a meeting with teacher, school counselor and vice principal. They were all very careful with their words, as if they were afraid to say "okay, so we think your kid has ADHD" and I let them walk around it for a while before there was a pause and I had the opportunity to say "Ummm, so based on the review, what his teachers been telling me for the last year and what I've observed at home, it looks like he's a textbook case for ADHD/ADD and I'll make an appointment with his doctor to discuss options and we can go from there?" and I'll never forget how they all just looked at me for a minute. I don't know if they were waiting on me to break down sobbing or start yelling at them or what. But after reading the review by the counselor and realizing that for the last 6 months, Thing 1's teacher had been redirecting him every 10 minutes for every day, I knew that it was ADHD and it wasn't life ending, just a bend in the road. I turned to his teacher and told her how sorry I was for not catching this earlier. And she just laughed and said how grateful she was that I wasn't angry with their evaluation. And it was at that point that I realized if Thing 1 did have ADHD, his teachers and I would always have to have open communication about everything.

Thing 1's doctor was a pretty matter of fact kind of doctor, which I love. I'm all about "okay, here's the problem, here's how we can fix it" kind of doctors. So I brought in Thing 1 and his school evaluation and waited to find out what the next step was. Doctor read through evaluation, chuckled a bit here and there and then sat down next to Thing 1 and asked a few questions about Thing 1's behaviors. "How long can he sit still?, Does he do things without thinking?, Is bedtime a chore? Can he clean his room when there's more then 3 items on the floor?" We determined he didn't have the impulsive jump off the roof type ADHD, but he did have ADHD. Okay. So how can we fix it? Doctor recommended Concerta, it's a one pill a day type medication. We decided to start low and slow and see how it went. Almost immediately, we noticed a difference. He took a pill when he got up and it would take about 30 minutes for it to kick in. After the pill kicked in, he actually sat still. I remember just watching him sit and zone on the tv and thinking "ohhh, this is what they mean when they say plopping your kids in front of the tv all day!". One of the side effects of the medicine was appetite loss, but with Thing 1 it was exact opposite. For the first time, he'd actually sit long enough to eat ALL of his food. It was amazing. His reports from school were better-he'd do really well until lunch time. At our 2 week check up, we discussed that with doctor and doctor recommended moving up to the 36mg dose. So, we did and within a week, he started having green days at school. The 36mg dose would get him from the time he got up until about 3:30pm (around the time school got out), so during the week we didn't notice too much of a difference in his behavior, but on the weekends it was awesome. The biggest unexpected perk was checkout lines...no more "don't touch that, stand here, don't touch that, don't sit on that, stand here, don't mess with that, don't stick your finger there, stand here...ARGH!!!". It was exciting to be able to explain to him why we were doing things a certain way and to have him understand it because he wasn't distracted by some sparkly thing that went by while we were chatting. And as much as we were excited and relieved to see his behavior and grades improve, I think his teacher was 110% more excited to be able to teach him. But the most heart melting part of it was to watch Thing 1 be excited about how he could focus and pay attention. His ability to complete things, get good grades and just stay focused long enough to learn tons was amazing to watch. He was so proud of himself.

5 years later, Thing 1 is still taking Concerta without any issues. We added Clonidine at bedtime a little over a year ago. The Concerta would wear off around 5pm causing Thing 1 to get all wound up and bedtime became a nightmare. We did about 2-3 weeks of him not finally sleeping until 11pm, even though we started bedtime at 7pm, and then still having to get up at 6am for school before we'd both had enough. The Husband was deployed at the time and Thing 1 would use that as a reason why he couldn't sleep. The first week, I was all compassion and understanding...the second week not so much. So one day I told him if he wanted to talk to someone other than me about whatever his issue was, he could and he took me up on the offer. He started meeting with a counselor and that's when we had his ADHD defined as predominantly inattentive ADHD. As part of his counseling, we met with a Psychiatrist for his Concerta. We talked about his bedtime battle lately and she recommended Clonidine. It's actually a blood pressure medication, but it acts as a stimulant giving him just the boost he needs to relax his brain and go to sleep. So he takes it now about an hour before bed and no more battles and he's asleep by 8pm.

Thing 1 has never been ashamed of his ADHD. He's very matter of fact about it. We've always been matter of fact about it. So Thing 1 has ADHD, no biggie, we know it, we deal with it. It's not life ending, it's not the end of his world, it's just a bend in the road. He knows he takes a pill in the morning and a pill at bedtime. It's not strange to him, it's just how we do things. Every time he changes school, it's the first thing I discuss with his new teacher. I explain to them that we don't use ADHD as an excuse...he may not be bing bongy in class just because he had ADHD, but if he is being bing-bongy, I need to know so we can address the problem. All of his teachers have been very receptive and we've never had a problem with them. They've often introduced Thing 1 to things to help him with it that I would've never thought of--one teacher gave him word puzzles to work on when he was done with his work (to keep him from distracting others) and he loves them.

The one thing that has surprised me about this whole process has been the wide variety of reactions to the diagnosis, treatment, and behavioral expectations. The Grandparents are on polar opposite sides of the issues. My parents have always spent more time with the kids and they were just as frustrated as I was with Thing 1's behavior and just as relieved when we had a solution to the problem. They rejoiced in his accomplishments and continue to be supportive. The Husbands parents made (and continue to make) comments like "she just medicates them so she doesn't have to deal with them", regularly sigh and make disapproving noises when his medication is discussed, and remind us how their boys never had medication, instead they just "constantly reminded them of the things they needed to do" and "went to class with them when needed" to include some high school courses with their oldest. We've had to constantly justify why we chose to do medication to them. We chose to do medication because I believe he should be given every opportunity to succeed as soon as possible. He was struggling at everything and quickly giving up at everything. I was incredibly frustrated with his behavior and didn't know where to go. We have so many other variables in our lives that "normal" people don't have courtesy of the Army that given the opportunity to remove a hurdle, I will.

And that's what I feel ADHD is--it's a hurdle. It doesn't define Thing 1. It's just a part of who he is. It's just a part of who we are. It's just the way God made him...no biggie.