Pebble it sounds like you are doign everything right, good for you! 4myson is so right about the importance fo routine and it sounds like you are doing that. By having fun on the weekends you are not disrupting things. You have to live life and have fun with him too.
My daughter was always a terrible eater (still not GREAT), you can only do what you can do, sounds like you are.
Our doctor has pretty much always told us to give things about 2 weeks before we started deciding if things were working or not. Keep working together as a team with yourself, the doctor and therapist. It's like wading through mud. Sometimes we dont realize things are better until we look backwards. While adjusting meds especially we tend to hyper focus ourselves on their behaviors. Unless things take a turn for the worse, try to write all behaviors down for 2 weeks and look back on it and see if things have improved, if not talk about it. Dont settle if things are not right. I am all for using meds (we use them), but why medicate if you are not seeing optimum results.
Hang in there most of us have been there and dont hit the right med and/or dosage on the first try and totally understand what you are going through.
The boy I see at home is impulsive and, well, whiny. The therapist says that the whining is part his inability to control himself; just another side of impulsivity.
I've spent entire days with him while he's on the medication, but he's still semms whiny and impulsive. I don't see the improvement his teacher has.
But, we really don't have a set routine on those days. Could that be why I'm not seeing any improvement?
my guess is if you do not see improvement or side effetcs it may be time to increase the dose. It is probably too low. You always start low and conitnue to increase slowly until you see symptom relief without side effects. If you are not seeing symptoms improvig and he is not having side effects then I would increase.
My son is seeing a therapist twice a month, and we are doing behavioral therapy. We do have a routine for weekdays, bedtime, and normal daily activities. But, weekends are always different. Sometimes the grandparents are visting us, sometimes we visit them, sometimes we just stay at home and do chores, sometimes we go to the zoo, the children's museum, swimming, or some other fun activity, and so on. This weekend, for example, Daddy took DS to the library and the park so that I could finish painting our baseboards. Tomorrow, we're taking him to the air show (he loves planes).
Can I form a routine when we do different things with different people? We do warn him of these activities ahead of time, so he's aware of how they affect him.
We haven't tried to change his diet. He's a very picky eater, and, right now, we're just trying to get him to eat a better variety of foods. Fortunately, he eats most fruits and a few vegetables. He won't eat cheese. The only meats are Chik-fil-e chicken and hotdogs, but he does get protein from milk and peanut butter. He eats most crackers, but not bread, noodles, or potatoes. We only let him have sweets for dessert - usually it's 1/2 cup of ice-cream or cookie. His favorite drinks are milk, water, juice, and the occassional root beer.
I didn't mean to suggest that my doctor was pushing the meds. The therapist is telling us that the meds in conjunction with the therapy would help DS right now.
The lack of a change in behavior at home is making me nervous of our decision. But, maybe I'm being impatient. He's only been on the Focalin for a little while (just 2 days on the higher dosage).
How long does it normally take to see a difference once Focalin is started at the right dosage?
Diane may be right but I still think consistency and some form of routine can make a difference, too. Pebble, with time, whether you add more med or change way you are handling your son at home ...routine or whatever may be the necessary step, things will be calmer and get somewhat easier.
Have you tried play therapy or some form counseling with your son? This made a huge difference for my son.
I really believe in the whole picture. Not just meds, but diet changes, therapy, constructive routines at home, exercise, etc...I have my son on meds but we have used all of the above and we never have had to increase dosage. It has been over a year now and my son, is doing quite well. I think finding a doctor that deals with more than meds is also important. One that sees a balance and works with you and not just a med pusher. Hope this makes sense.
I hope Focalin is the right med for your child. Is he taking the XR version? That's the extended release.
It can take awhile to find the right dose. While on a low dose, I'd look for small changes and not expect massive improvement. As you raise dose, you should see greater symptom control and it may last for more hours.
It might help to keep a log of what you're seeing, noting behavior and the time (if you can, context also is good info.). It might help you see some patterns in what's going on. I agree with pp that sometimes it's easy to assume the med. isn't working, but later on, you figure out that the main issues are before the med. has kicked in or after it's wearing off. Also, like I said, on a low dose you're still likely to see ADHD symptoms, but hopefully they'll be milder.
Going back to your original question, here's my child's experience with Focalin XR. We seemed to need to increase the dose every few months, but when it worked right, it was AWESOME for ADHD symptom control. Also, it worked for 10 hours once he was on a higher dose, so that was great. His appetite was suppressed during the day, but he made up for it at night after the stimulant wore off. His weight gain continued to be fine. He recently changed to Metadate CD, though, because the Focalin XR made him too flat for a couple of hours in the morning.
Mom2ADHDboy39293.2778472222My son was recently diagnosed as ADHD combined - inattentive, impulsive, and hyperactive. He just started Focalin, and he hasn't had any side effects on 5 mg dosage.
His teacher says he's more agreeable, calmer, more patient and less impulsive. But, it's still difficult to get and keep his attention.
So many people have mentioned changes that are dramatically different. But, I honestly don't see any difference in his behavior! Of course, I've never seen the extreme problems that he shows his teachers, either.
Is this typical?
It is normal to start low and increase slowly to the most effective dose. The good news is that you are seeing positive effects. You just need to continue the dose titration process that the doc prescribes. When is your next appointment?
My kids are on 15 (11yo, 73lbs) and 20 (12yo, 120lbs) mg per day and do great. We saw only a little effect at the lower doses until we got the the effective doses that they are on. We will start school med free to get a new baseline and see what their current needs are.
The pediatrician just increased the dosage from 5 mg to 10 mg, since his teacher is starting to see some positive effects.
Today was his first day, and he still seemed pretty much the same to me.
Is it posible that you are only seeing him before the med taked affect and after it has worn off? [QUOTE=Pebble]
His teacher says he's more agreeable, calmer, more patient and less impulsive. But, it's still difficult to get and keep his attention.
I am a teacher, and quite honestly his teacher needs to give him some more time. She needs to realize that prior to meds he had developed behaviors that now need to be redirected with the help of meds and time. I am a firm believer that we need to educate the public including teachers more on the issues concerning AD/HD. We need to have patience. Change isn't going to occur over night. Hope this makes sense.
As far as your not seeing changes... I found, I had to relax and not be a "helicopter" parent. I, in the beginning "hovered" over my son and didn't allow him to be himself. I guess because I was a teacher, I was wanting my child to be the perfect model kid. With the help from my son's play therapist, I was able to give him some breathing room and low and behold he rarely gets in trouble at school for attention issues or anything else. We have our moments at home but they are much less and pretty typical to most other parent/children incidences.
Is he perfect at home all the time? Not really. Is this a problem, sometimes... but if I take a deep breath during these times, I am able to handle the situations better. I found books like, Love and Logic to be very helpful. I'm not perfect but I just try to remain calm because I know this will help him in the long run. I establish realistic expectations and work to stay consistent with him. This seems to help in our household. My son's counselor recommended I use a journal to make observations of my son. Record when I see him most out of sinc. Record what happens just before he has a moment of relapse. Etc... this really helps me. Usually I just found we got out of routine. I guess in a nutshell what I'm saying is, learn to read your child.
Hope this helps you. Good luck and hang in there.
[/QUOTE] 4myson39290.8988541667
Yes, DS is on Focalin XR.
I think we're starting to see the "flatness" in the morning now that he's on the 10 mg. He's just... subdued. He does answer when spoken to, but he's very quiet. On the drive this morning, he was just staring out the window. When I asked what he was looking at, he just said "nothing". Normally, in the car, he's either asking questions "what street is this?" or playing with his cars. It's scary to have him so quiet. It's been like that the last few days, but it seems to wear off around noon.
Is that what you meant by "flat"? I'd assumed it was simply him adjusting to the new dosage, so I was planning to tell his pediatrician at the next checkup in a couple of weeks. Do I need to tell the doctor sooner?
DS was on the lower dosage for 2 weeks. There was some improvement (per his teacher - we didn't see anything), but we also didn't see any "flatness" or other side effects.
Yes, that's EXACTLY what I mean by flatness. Your description could have been my child when on Focalin XR. Focalin XR doesn't release the medicine as evenly as Metadate CD does, so that's why we switched to a med. with more even release.
Given how short your child has been on the medicine, I'd give it a few weeks to see if the flatness goes away. It could just be the body adjusting to it. If it persists, then it isn't the right med. That's my opinion, obviously consult a dr.! Also, make sure you are slowly increasing the dose. The slower the increase, the less likelihood of side effects. How long did he stay at the lower dose before raising to the current level?
Mom2ADHDboy39295.2768981481The "flatness" seems a little better, but, on weekends, he seems less excitable. On the one side, that's probably good. There are fewer arguments. He's not complaining about following the rules. On the other hand, he seems less excited about good things. DS is the type of child that will run and hug us for no reason. He jumps up and down with excitement when we do something fun together or we eat his favorite foods.
Well, the past two weekends, when he's with us all day, I'm just not seeing that.
Is this typical? Is this the price of meds? To control the bad impulses - hitting/arguing - we lose the good ones, too?
Or, is this an indication that the medicine isn't at the right dosage?
Hi Pebble,
Give him time to adjust to the meds. He needs to get used to self reflection and other things that are new to him. Discuss it with your doc and set a time table for how long to allow before trying a different med. You may need to try a few meds and pick the best one for his needs. It can take time to find the optimal med for a person but it is well worth it.
vickie39299.3077893518