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Fairly Odd Mother

Frantically waving my magic wand to make wishes come true.

Monday, July 26, 2010

Drug-free zone

For the past week, I've driven my oldest child back and forth to a day program for kids with a whole host of issues: anxiety, anger, separation issues and one kid who likes to see people in pain (ouch). The purpose of this program is to "stabilize her" and teach her coping skills so that when she feels anxious, she knows how to deal with those feelings.

Did you see my quotes around "stabilize her"? That's because "stabilize her" is another term for "let's see how she's doing on the drugs we prescribe".

When I sat down to talk to a therapist on our child's first day in the program, I was told that we'd both be meeting with the doctor that day. He would evaluate our child and tell us whether or not she needed drugs.

What percentage of children does he recommend medicating?, I asked with the same trepidation I felt when asking a doctor for his c-section frequency.

90%, I was told matter-of-factly.

Pffffff. Surely, he'd take one look at my daughter, talk to her a bit and realize she was in the 10% that doesn't need a thing. She's anxious, not jumping out of her skin. She has tantrums, but doesn't punch holes in walls or hurt family members. He'd see she is just a little girl who could use some help finding her way.

I was wrong.

After 20 minutes of conversation with her, and a quick meeting with me, I walked out with a prescription for Risperdal and about 10,000 more questions, which I proceeded to ask this doctor over the course of the week.

Why this medicine? (it will stabilize her mood.)

Does she really need drugs? (not sure. maybe! it's worth trying.)

What about these crazy side effects? (we have her on the lowest dosage possible. maybe she won't have any side effects. thoughmaybeshewill.)

Shouldn't we try therapy first? (um, yeah, in a perfect world, but insurance wants kids to be "stable" before we do therapy)

But this isn't an anxiety medication! (I really have to get going. . .)

In all fairness, the doctor was very understanding of our hesitation, though when my husband called him with a similar list of questions, he heard the frustration coming through loud and clear. I don't think he wants to talk to us anymore was the text I got that afternoon.

But, starting on Day 2 of the program, I was asked Is she taking her meds? from the therapists as soon as we walked in the door.

Nooooooooo. . .not until we're sure she needs it, I'd lamely reply, not sure if I'm doing the right thing at all.

Our pediatrician backed me up though, so I didn't feel totally alone. I filled the prescription and put it on top of my refrigerator in case we decide to use it, but I just can't do it so early in her treatment.

And, here's the thing: I'm not anti-pharmaceutical. I take five drugs to manage my asthma and allergies every single day. Some of the drugs I've taken have side effects that make me hesitate, but they work, and I can breathe. My kids are vaccinated and take OTC meds when needed. I know wonderful, smart people whose wonderful, smart kids have benefited greatly from medication.

But, to prescribe something after a 20 minute meeting with my child seems too quick. As my pediatrician said as I fumbled around to justify my decision: You are her mother. No one knows her better than you. No one is going to make a decision in her best interest more than you. Do what you think is best right now.

Though if someone came up to me with a little pill that promised to instantly turn her back to her old self without any side effects, I'd snatch it up in a second.

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Blogger Life As I Know It said...

Good for you - follow your parenting instincts, no matter what you decide to do. Too many people DON'T ask all those questions that you asked.
Hoping your little girl gets better soon.
Hugs to you.

7:11 AM  
Anonymous Anonymous said...

Holy cow - that medication seems pretty full on for so early in the treatment process. Wishing you and your child all best!

7:21 AM  
Blogger Reff said...

I think we're going about this the wrong way. Maybe WE are the ones that need the drugs.

8:08 AM  
Anonymous LB said...

Are there any other therapist options in your area/covered by your insurance? You don't sound 100% comfortable with this doctor. There's nothing wrong with getting a second opinion or dumping a doctor.

8:18 AM  
Blogger Tracey - Just Another Mommy Blog said...

I KNOW how scary it is to give your kid meds for a 20 minute diagnosed anxiety/attention issue. It isn't something to take lightly. Take your time and trust your instincts.

9:16 AM  
Blogger Deb said...

NINETY Percent?!? Jeez. That's disconcerting.

I would do the exact same thing in your shoes.

Personally, I prefer to begin at the Least Invasive treatment and escalate if necessary. Starting meds right off the bat doesn't sound Least Invasive. And if it's not even a medication geared toward treating what she has been diagnosed with...?

I'm with you, dude. Go with your gut. No one cares more than you. And good for your pediatrician in backing you. We don't give Mommy Intuition enough credit in this society.

10:13 AM  
Blogger The Mom said...

Yikes, that's a powerful antipsychotic. Good for you not putting her on it. You need a second and possibly third or fourth opinion on this. Dump this guy quickly.

11:13 AM  
Blogger Melani said...

I have been out of the loop in reading/blogging for a while, but now I am caught up.

Good for you! Go with your gut. I will say prayers for you and your family, that your daughter gets better and soon.

12:18 PM  
Anonymous Sherri said...

Hi, Fairly Odd Mother, I have been reading your blog for a while now. I tend to be a reader and a thinker rather than a commenter (though I strongly dislike the blog term "lurker"). This post resonates with me. As a child growing up in the seventies, I was a happy and social enough child, but I definitely suffered some anxieties. If I got nervous or anxious, it would always manifest in a stomach ache. Sleepovers:could not make it through the night without missing home and my family dearly, often resulting in a teary-eyed call home with a request for a pickup in the middle of the night. Back then when we did not turn immediately to prescription drugs to fix a "problem", I was thought of as a quiet, sweet, home-body of a child. I agree with the previous comments from others. Trust your mom instincts and don't let the medical community make you second guess yourself. As parents we are the ones who know our children best and are the ones who truly are their advocates. Good luck to you and your family through this rough patch. Sending love and strength your way!

1:05 PM  
Anonymous Julie B said...

Your Momma instinct has been right in the past and I bet its right now too. Trust your instincts, you'll know when and/if she actually needs some meds.

1:17 PM  
Anonymous Sherri said...

After publishing my comment, I realized perhaps I should clarify that I did not intend to imply that your child may not suffer an illness that could benefit from medication. I just find it interesting to think that the anxieties that I experienced in the 70's as a child might be medicated if I were growing up in our society today.

1:30 PM  
Blogger Issas Crazy World said...

I think that at some point you will know if you want to try it, or not. Hopefully therapy will do wonders.

I wish I had some magic words for you friend, but sadly I do not. Just know, I'm here. Willing to listen.

ps. It took me years to be willing to medicate Morgan for ADHD. There have been pros and minuses with it. No matter what, it's not a magic fix.

1:49 PM  
Anonymous Anonymous said...

risperdal, and its other forms in other names, can cause permanent tardive dyskinesia. not trying to scare you, but some docs are very, very quick to prescribe drugs, please consider finding an online posting board for parents of kids with anxiety disorders, lurking and reading, perhaps a yahoo group, you need to gather info from various sources like other parents who aren't trying to sell you or convince you of something. wishing you the very best.

3:56 PM  
Blogger margalit said...

I'm not. A doctor, nor do I play one on tv, but I'm pretty much an expert on psychiatric meds and whomever you saw is not up to date on what meds are correct for an overly anxious child. Risperdol is a second line antipsychotic given to kids who have violent outbursts and serious control issues. It causes severe weight gain and can cause permanent ticks. No way would I ever give it to my son, especially when there are newer and better meds like ability and invega. However, those meds aren't going to help a young child with anxiety either.

I'd suggest going into town and seeing someone in the psych dept at childrens or McLean. The latter is much better but way harder to get into.

I'd also recommend finding your local mental health center and if they have a parents group, join it. You will get the best information and advice from other parents who know all the dogs, hospitals, and programs available to you , and they will help you work the system to your advantage.

This could be a very long path with many up and downturns and the best advice I can give you is to keep asking for help. Don't quit fighting for your child.

4:20 PM  
Blogger Jessica said...

I'm planning to reply to our SOTW conversation--thanks for the excellent info--in the meantime, I believe you should trust your mama instinct.

When a drug is prescribed this early in the game I don't see how the therapy will ever have a chance to work.

Assuming she learns to deal with her anxiety using tools learned in will those tools be effective if they are fighting against synthetic, pharmacolgically-induced emotions?

Not to mention, beginning a drug like that at such a young age, how will your sweet girl know when she feels it is appropriate to stop taking it?

I'll try to get in touch w/ you tomorrow--if not, after my surgery (Wed)...always know I'm thinking of you all! :)

5:36 PM  
Blogger Fairly Odd Mother said...

Thank you guys so much for the comments and thoughtful discussion. Some replies:

LB: yes, we did, in effect, "dump" him in being discharged from the treatment facility in which she was going daily. I don't have a new psychiatrist but will definitely find someone new if we go the medication route.

Sherri: you've said it! Times have changed a lot. The dr (who really wasn't a bad guy) said that, 20-30 years ago, kids like my daughter would have been given months of daily play therapy, all covered by insurance. But, now that insurance sees that they can get kids "under control" quicker and cheaper with meds, they aren't going to approve that kind of long-term, intensive therapy. It's sad, but that's "progress".

Anon and Margalit: thanks---yes, that particular med scared the crap out of me. We do have a pysch at Children's we met and liked and she's been helpful.

And, just an update: I met with a new therapist yesterday who may be a good fit---she's had a lot of experience in this area and picked up on some things I was saying. Belly meets her today. Wish us luck!

6:17 AM  
Anonymous Aunt Barb said...

Good luck today to Belle and to you.

9:23 AM  
Blogger Patois said...

I really hope the new therapist turns out to be that pot of gold we all deserve to find when our kids our in trouble.

5:55 PM  
Blogger Mom101 said...

You are a fabulous mom. It's incredibly hard to advocate for our kids and go with our guts in the face of "medical experts" (ha, see how I use quotes there?) and their "strong suggestions."

So glad to see in comments you've found someone new. Jeez. And hope she's doing better.

5:17 AM  
Anonymous Cara said...

I'm having serious trouble posting this - buggy - but my point is I wish we'd tried food based intervention (no dairy, no gluten, no food dyes or additives, supplement w fish oil and b vitamins) before we tried the meds. He probably would have still needed the meds, but perhaps less, or perhaps later (he was suicidal at 9)

11:37 AM  
Blogger Little Miss Sunshine State said...

When we were in a similar situation with our son, we were so hesitant to try meds.
Finally, I sat in front of 5 doctor's at Children's Hosp in Boston who said "You have tried every other thing we have suggested and there is nothing else to suggest you try.
At that point we were comfortable with starting meds, knowing that we had tried everything else and he still needed the meds.

Risperdal seems like a strong med to try in the early stages. You live with her and you know her better than anyone. You'll make the right decision when it feels right.

5:52 PM  
Anonymous Anonymous said...

YIKES. 90%!!

I'm a big believer that meds are a tool to assist in resolution of anxiety/phobia/behavioural issues, but they need to used in conjunction w/ (not in lieu of) long term therapy.

Glad to read in your post script that you've found a new doctor. Finding a doctor is kind of like dating -- you can't settle for anything less than your ideal.

I'm keeping you in my thoughts.

12:55 PM  

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