Friday, June 7, 2013

Risk-Benefit Analysis

Taking a break from pushing my book (although it is still for sale) to talk about a family issue.  As I have disclosed in the past, my son has Attention Deficit Disorder (without Hyperactivity).  This is not an excuse for his behavior.  He is a very, very bright young man, but he simply cannot stay focused.  He twitches and fidgets, he stares off into space.  He loses track of what he is doing midway through the task.

Part of his difficulty is that he processes information slowly.  In fact, I think his brain is actually working in overdrive when he receives information.  He's considering it, studying it, and developing theories about it.  A great example is one his Kindergarten teacher gave me.  She is one of the best teachers ever, and she really understood how he worked, which is why she was such an efficient teacher for him.  They were going around the room doing letter sounds.  This was in the first part of the year, but Jake was already reading.  Jake picked the letter 'A' and just sat there.  She knew he knew what the letter was and what sound it made, but she could not figure out why he wasn't responding.  After giving him some wait time (also very important), she gave him a gentle prompt to tell her the letter sound. He finally said, "Well, A has two sounds.  It says "A" and "ah" because it is a vowel.  The other vowels are e, i, o and u."

Very basic, but you can see what I mean about his mind working in overdrive.  But because of this thought process, we think he strays off and forgets what the original question was.  If left to his own devices, he is a future absent-minded professor in training.  But that's not what I want him to be.  I want him to be pulled together.

After careful consideration, many inter-marital disputes, and an awesome data-collection by his teacher, we finally decided that Jake would probably benefit from a trial of some medication for his ADD.  Due to his slowness, it was thought that a stimulant might be the best type for him. Since February, he's been taking Adderall XR.  He started on a low dose, and has had one dose increase.  His teacher has commented that he is finishing work in a more timely manner, and needs less prompts to stay on task during lengthy writing assignments.  Jake asks to take it before school.  He has said that he notices a difference and that he feels better at school when he takes it.  He did say a drawback is that now he can pay attention, and the school stuff is really boring, so he just pays better attention to his daydreams.

But we are seeing some negative reactions as well.  Jake is a skinny kid to begin with.  There's nothing to him, and the Adderall has killed his appetite.  He's now complaining of frequent headaches and stomach pain.  He's had an episode or two of vomiting, although it is usually in the middle of the night.  We give him a break from the medication on the weekends, just so he'll eat better, and we're planning to take him off it for the summer to try and beef him up a little.  Even on the weekend when he hasn't had the medication, although his appetite is improved, he's still sick to his stomach a lot.

This is where I'm so torn.  I just received a call from the school nurse, because Jake was in there complaining of nausea.  He was probably just overheated, but I know he's feeling crappy a lot of the time.  I also know that academically, he needs this to help him succeed in school.  He's going to get a break from it, but I have a feeling we're going to be trying different medications out.

I know that with any pharmaceutical use, one needs to perform the risk-benefit analysis.  We know how important the benefits are for Jake.  I just wish the side effects did not impact him the way they do.  Not sure what we'll try next, or if we'll just give him the break and see if that helps.

I just wish I could fix him.

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