meds& making friends-so upset!

Hi everyone! Long time lurker, first time poster! This seems like such a great place to go for support and I could really use some extra support right now!

I have 3 boys, 8,6, and almost 4, and my 8yo is ADHD. He was diagnosed at 5 and is taking Focalin XR 20mg daily. The meds work great in that they help him control himself for the majority of the day(usually wears off around 4:30pm or so-about the time kids play with their friends after school), etc, but we struggle with the loss of appetite and sleep problems that are pretty common with these types of drugs. He also takes Melatonin for sleep.

So, my husband got laid off back in May and we have moved for a new job but we lost our health insurance and cannot afford to keep him on the Focalin XR at $200+ a month, so we are looking at maybe switching to a Ritalin extended release or something...I don't know. I am TERRIFIED of playing around with his meds...we currently have enough Focalin to make it halfway thru January so we do have some time...but we are so limited in what we can AFFORD now...

Also, I am concerned about the move. Andrew is having such a hard time making friends here. He made friends with 2 neighbor boys, but their mother has called me a couple of times to discuss problems they have had with his attitude (he is very impulsive and will talk back to adults if he is being scolded...trying so hard to fix that...) and then last week he got into a physical fight with her younger boy and punched him in the stomach (he says the kid threw sand in his eyes...). We grounded him from playing with the other kids for a week (pretty mcuh the other mom's suggestion) and now the kids don't want anything to do with him BUT they want to play with his younger brothers!

Every time my kids go outside they are out there and he winds up feeling rejected...the look on his face breaks my heart!...I don't want to tell my younger boys they can't play with these boys, but I don't want them to play with these kids and have Andrew feel totally miserable every day either. I'm just not sure how to balance his needs with the needs of my other kids. I TRIED to have them come over to our house where I could supervise and it only made things worse. Andrew wound up fighting with them almost the whole time (arguing-not physical) and it made me so stressed out to know that he was ruining the playdate...and pretty much any chance that he can play with these kids again. (They are the only kids in our neighborhood within safe walking distance, and they are ALWAYS playing outside. I have gotten to the point where I don't even want my kids to go outside anymore b/c it is so stressful!)

I was hoping he would make some friends at school and we could invite them over, but he hasn't made any. His teacher says he's "SO quiet". I am worried maybe the meds are calming him down TOO much. I've seen him at school and it is so obvious that he isn't like the other kids. I know the kids can pick up on stuff like that. I just hate for him to be the "weird" kid, KWIM? There was one kid he told me was his friend (b/c I ask him "Have you made any new friends at school?") and we ran into him and he barely acknowledged my son, so I think maybe he just made it up to make me happy?

Wow-thanks for reading this far. I feel like such an emotional mess right now and I am trying SO hard to hold everything together and to make this transition easier for him, and I just feel like such a FAILURE. Any advice/thoughts/prayers welcome!

< =text/>_popupControl(); Holy crap, your 'scrip is expensive!  My son takes the same thing, same dose for $137 a month.  Contact the manufacturer and see about an assistance program. It could happen.

The only advice I can give for making new friends in a new school is to keep the contact short in a supervised situation, i.e. going to a movie, making shrinky-dinks at your house, etc. Limit it to one kid so no one gets excluded. Listen for the signs of disagreement about what to do and be prepared with a timer and then institute the thirty minute rule. "So-and-so picks first, then I set the timer. After thirty minutes you guys switch to what the other person wants to do."  It's very constructed, but your son and his friends are young enough that they'll go along. After about two hours, it's time to go home. Make sure that there's some kind of treat because you want to be the fun house with good treats. After a history of success (and that could be months or even longer), the parents will be used to hearing from their child that they like your house, your child, and you, and things should get easier. It sounds like work and it is, but it is so worth it.

Wow, you have a lot on your plate!  Trying to deal with an ADHD kid and managing the meds is hard enough without worrying about how much it costs!  I feel for you!

I agree, contact the manufacturer.  Maybe they can help.  How about the health department? 

As for the problem with the other kids...it sounds like he needs a "booster" of the short acting type of medication in the afternoon.  It's hard though because if you can't get to the doctor then it's hard to make any med changes.  I wonder if your old doctor would help you out if he/she knew your situation???

I know I'm not much help-sorry! I just hope you can find the help you need.  Hang in there!

Have you considered a booster dose of meds after school when your 8 yr old has stuff going on (usually 5 mg)?  My son is on 15 mg focalin xr and I know that many docs feel 20mg is the max but talk to your doctor--the booster dose can really help a kid regulate after being dosed all day at 20 mg.  As far as making friends, I have to agree with the other posters about setting time limits and keeping a close eye on the situation. Can you have playdate outside the house?  Sharing toys and video games is very hard.  Playing outdoors can remove some of the barriers.   It must be very hard when you have two younger sons to watch.  My 10 yr old is very social yet has not been able to establish the wide network of friends that I would like to see happen.(I simply have to stop thinking that life for my son is like the PBS show Arthur)  You are fortunate in the sense that your kids have one another to play with.  This is the hardest part of the journey.  Also, what about a pm dose of a med like clonidine?  This helps my son fall asleep and countereffects the focalin xr. 

Your son may surprise you.  My son (king of the missed social cues) is pals with a boy who has Tourette's and OCD and anxiety issues.  While in a perfect world I would like to my son have a ton of friends calling him for playdates, this other boy and his parents 'get it' about our situation. 

Where you are is really hard.  The cost of meds has got to be a killer.  Anything you can do maintain his meds is a consideration.  We had to choose between hot lunch and morning care at school.  It stinks that finances figure so much.  But any advantage you can give your son, it will be worth it.  For the record I did see a monumental growth/change in my son between 8 and 10.  I hope that you continue to visit the forum for guidance and support.  I have gained so very much from being a member of this community. 

YOur post breaks my heart. I feel for you. We have discussed moving and my son will say oh so I won't have any friends where we go. It is really hard. It can go one way or the other.

Have you tried guanfacine/tenex? it helps with impulse control.

My adhhhhd'er is on that and concerta. The two work like a charm.

I don't think that this med is that expensive out of pocket.

Can't your prescribing doctor direct you to where you can get assistance for a child with these meds?

I would think the pharm. companies would at least help children with insurance issues and parents being laid off, especially with what is happening all over the country!!

I actually have had my son play inside when he was younger. I had to protect him!!

He was labeled early, by a nasty neighbor who spread rumours about our family as we were building a house (bigger than hers) so my kids were labeled mean. She turned out to be nothing but a gossip, jealous problem, who moved and ran away because we wouldn't back down!

And then to boot, my son is adhd and not medicated, he was only turning 5 at the time. So he had a double whammey, this nut of a neighbor spreading rumours about all of us, and his adhd. Small town gossip, which is usually lies and far from the truth!

I would talk to their teacher and ask if she can help your son. There may be an adjustment counselor in school who can assist. Also, what about sports or hobbies like chess, book clubs etc. Any outside activities will help his self esteem. We need to remember his self esteem. Does he qualifiy for a 504 or IEP plan?

Thank you all so much for responding!

The quote I got of the $200/month was from CVS Caremark. I had complained about the cost of the meds WITH insurance a while back and asked how much they would be WITHOUT insurance (b/c of course it was not a formulary drug)and that is what they told me. I do know that they tend to charge insurance companies more, so maybe I need to check around and see what it would be for self-pay. I also was checking into the links on the meds forum and think we may be able to qualify for some type of assistance, but it takes time. I do think we need to adjust his meds. He was on 15mg Focalin XR and 5-10mg of Methylphenidate in the afternoons, but the Methylphenidate didn't work and so we increased the Focalin to 20mg. I do believe he has grown some since then so probably time to adjust again. I hate to have to add another dose in the afternoon and worsen the sleeping problems though...We have not found a ped. here yet.

Thanks for the advice about playdates. I think a lack of structure is the problem. He does much better in a structured situation...the "free play" time is when he gets into trouble, and yes sharing his things is very difficult for him.

I am looking into enrolling him in karate here. He has been wanting to do that for a while now, and his old ped. thought it would be good for him, but then we moved. I do worry so much about his self-esteem. Hoping to find something he will like and be good at and hopefully make friends at...we tried team sports in the past and it didn't work out so well...Also, I am thinking my other 2 could go play with the neighbor kids while he is at karate, so that would help a lot.

His teacher is very kind and helpful. His grades are decent so I don't think an IEP is in order. Really he is fine at school, except for the social part. It makes me so sad b/c he had 2 really good friends in our old school; both really smart, well-behaved kids who were a good influence on him. We all miss them a lot...

Thanks again for all the replaies. I guess it is time to find a new pediatrician...

This is one of the biggest reasons we don't move. We are afraid that our adhd'ers will be without friends, so isn't he!!

I am so sorry.

Any chance you can move back??? Can the friends visit?

I think the tenex idea is a good one only because we had the same type of evening issues when Wyatt was coming down off of the meds.  The tenex really leveled him and also helped with the sleep issues.  I know this may not be a popular suggestion but could you appeal to the mother next door? She's a mom just like you and if you tell her your heart is breaking, what the issues are, and ask for her help, she may respond.  Of course I don't know her at all so you'd have to judge for yourself if you think she'd be receptive.  My neighbor was. She always includes Wyatt.  If he has a melt down she just quietly sends him home to relax. If it was left up to the kids they really would just invite my other son over.  It's not perfect but it helps that she knows.

No, moving back isn't an option...we do visit the friends periodically. Their family travelled 6 hours away to see us 2 months after the move. SO SWEET! We plan on seeing them at least twice a year.

I did explain things to the mom next door and she was "fairly" understanding, but said that at this point she didn't feel like she was being a good mom if she put her son in a position where he could get hurt/she couldn't protect him -can't remember her exact words, but basically she is scared Andrew will hurt her son (the one that got punched in the stomach). Understand that he is generally a good kid, but if he gets angry he tends to over react/not be able to control himself. I totally understand her position, but it still hurts. :( I did suggest that her OLDER son maybe come over sometime for a playdate by himself (since it's the younger son that seems to set him off). She seemed agreeable, but I tried it the other day and couldn't split the kids up (younger brothers wanted to play with the older ones-this is the day they came over to the house and Andrew was fighting with them the whole time). I'll keep trying.

I was able to send him with my DH on Sunday to watch football at a friend's house. They have a 13 yr old ADHD son and he gets along great with Andrew, so they got to spend the whole day together and it made us all feel a lot better. Plus then my younger boys were able to play with the neighbor kids all day (I noticed that their mom went on and on about how well behaved they were at her house.).  My DH did mention though that the 13 yr old had matured a lot since the summer (when we saw him all the time) and might not always want to play with an 8 yr old (but probably OK here and there). UGH!

I'll look into the Tenex-is it a stimulant as well?

I just wanted to comment on that your neighbors coming to visit and you as well going back to visit is so awesome for you all, especially your son. Maybe as the kids get older then can spend summers together as well. Your son only needs one friend remember that AND he has at least one!!

I am also glad that the neighbor is working with you. At least she is trying. I do understand that she has to protect her son, but things happen with kids,even those who do not have adhd. So that was also nice to read.

Keep us posted as to what is going on with you guys!!

[QUOTE=BETHANN]No tenex is not in the stimulant family. It is a blood medication, that slows them down and relaxes them. Google it!!  [/QUOTE]

You're right about the Methylphenidate and Tenex going hand and hand. I didn't think the Tenex was doing much, so we stopped it. I couldn't believe how impulsive my son became. We quickly went back. It's also cheap. We get the generic Guanfacine at Walmart for $4.00/30 day supply.

Good to know-I will check into the Tenex. I think I am going to make an appt with his old ped over Christmas break and just make the drive one more time. I'd rather have the Dr I am comfortable with make changes, rather than start with someone new, KWIM?

Good news! I checked our local Walgreen's and signed up for their prescription plan and his Focalin is only going to be $135/month-which really is only $20 more than we were paying WITH insurance! WHEW! Amazing how much stuff gets marked UP for insurance purposes.