Update on Intuniv and some new considerations...

Last Thursday I mentioned that we had been noticing some disposition changes in our son who has been taking Intuniv for his ADHD since January 2010. I did speak with the nurse on Friday afternoon, and she said she would ask the doctor about some of our concerns.

She called me back yesterday afternoon and had some questions from the doctor. He said that the Intuniv should not be changing his personality. He was wondering if he had been sick (no) or if things were changing at school (he is homeschooled and he has been done with his formal schoolwork for a couple weeks now). He thought it would be okay to try to ween him down to 2 mg. especially since it's almost summertime when schedules are more relaxed anyway.

But I shared with her about his meltdowns this last weekend (after some junk food which seemed to affect him adversely), and thought that I would rather keep him where he is at the 3 mg. for now. We have an appointment with the doctor on the 7th of June anyway, so I thought we could wait and discuss more of what has been going on when we see him then.

So, as we continue down this road of raising children with learning differences and ADHD, I'm realizing the truth in treating this difference has to be multi-faceted. There's no easy "fix", no magic red button you can push that will make everything disappear and go back to normal.

I truly believe that this issue takes a change of heart, a change of perspective, a change of expectations, a change in diet, a change in environment/routine, and for some the addition of professional advice. I'm beginning to think about that last element for our family.

We're progressively working on changing the foods we eat, we've changed up the lay-out

of our home for a better homeschooling experience, we've completely changed homeschool

curriculums, we've added melatonin at bedtime to facilitate better sleep, my husband and I are

working daily to better our parenting and discipline techniques, and we've seen doctors to help us see things that we weren't seeing. We are now using the medication, Intuniv, to also

unmask the great parts about our son that we have not been able to see in awhile.

But I think that with all this done since last August, we now could benefit from some skills training in living with and training the ADHD child. It's hard for siblings living with the irritations that constantly come with this. Disciplining or enforcing consequences is often so difficult and just plain hard work. We need to know techniques, new ideas, fresh voices. It's often just not as easy as giving a spanking. With a child who has anxiety issues and hyperactivity challenges, spanking usually makes things much, MUCH worse. So anyway, we're considering some counseling, not only for ourselves, but also for our son. I'm wondering if an outside voice could help him learn better how to cope with the things that so often frustrate him. I'm just thinking, and I'm talking to others who are in a similar situation.

A few observations since starting Intuniv....

1. My 7 yr. old son has been taking Intuniv (medication prescribed especially to help manage the symptoms of ADHD) since January 14 of this year. We're up to 3 mg. once a day. He takes a full pill first thing in the morning.

2. I've been asked what some of our cues have been that this is the right dosage for him. Intuniv is prescribed in 1 mg., 2 mg., 3 mg., or 4 mg. pills. If or when we ever have to bump up to the 4 mg., that is the highest level of the medication available. From what I've researched, most children do best at 3 or 4 mg., while some respond well at a lower dose. For us, we noticed very little effect at 2 mg., and a tremendous effect at 3 mg. You take each level of medication for one week before you can bump up to the next level. For us, it took a little over three weeks to notice a measurable change in our son's behavior. We saw little things, like sleepiness in the afternoon, but it would wear off after a couple days on the higher dosage. One place I read (here) confirmed one of the cues we noticed in our son: if he lays down to watch TV around 4 pm, he is still likely to dose off for about a half hour or so and it will not affect his sleep at night. In fact, I still give him half of a 3 mg. pill of melatonin just before bedtime to help him relax and sleep better. He's usually asleep within 20-30 minutes. When he doesn't get the melatonin, there is much more horse-play in the bed with his little brother and it takes him longer to fall asleep, though he sleeps well all night.

3. Another cue we've had is that he still will sit cooperatively with me in the morning time and complete a couple of workpages neatly before he needs a few minutes break. When he gets upset about something, his "calm-down" time is still much shorter than before the Intuniv, and my husband thinks that some things that used to set him off are no longer causing him an issue. I have also observed that he plays outdoors with the neighborhood children for much, MUCH longer than he used to before running in crying that somebody was teasing him.

4. A couple weeks ago, my husband purchased an Xbox gaming system for the family. The first day we had it, my son was off-the-charts irritable. It's almost like you can feel how it makes his brain go haywire with all the stimulation, and then he can't stop without getting livid. So we learned QUICK that we had to put some kind of controls in place right away. The next day I told him he couldn't play the Xbox until 4 pm when all the schoolwork was done and chores were done. It has worked beautifully. I've tried letting him have time earlier in the day on Saturdays, but it's back to the same crazy behavior. When he plays games with his Dad, he does much better too. This past Monday, he had had some extra time on the Xbox because Monday is usually our day off/clean-up/catch-up day. I thought since Dad was home and he had extra down time, we would try letting him have a little time. Nope. Super huge meltdown in the afternoon full of ranting and raving and disturbing the whole family. I promptly grounded him from the Xbox for a full week, and remarkably he hasn't asked to get on today nor did he argue about this penalty either.

I don't know how this medication works, but it definitely takes the edge off of him without making him crazy moody or have serious appetite changes or any other side effects at all.

I told my husband the other day that we are so fortunate that ALL our son has to take is one little pill and it really helps him. I know some children have to be on several different kinds of medication for several different issues, and we don't take for granted that this has really been a positive step toward returning the harmony and peace to our home.

5. The last thing that I have observed is that the cute little tic my son had going on with his left eye winking when he was in highly stimulated activities has virtually disappeared. We used to see it every day at different times of the day under different circumstances (whether when being corrected or highly agitated or nervous), now we RARELY see it. When I do notice it, it's when he's been playing the Xbox for over 1/2 an hour. I don't know if the decrease in the tic is because of something the medication does to control that, or if being on the medication has helped him see that what used to be stressful to him isn't stressful anymore. Either way, it's something that we consider a great thing for him.

Update on INTUNIV....Day 3

So Day 3 was a little bit harder. What I mean by that is we saw a lot of what we're used to seeing in Grant before he started this medication. He was up at his normal time, fooling around and bothering people. He had a hard time controlling his temper and being respectful towards me.

On a positive note though, I can still tell that he calms down easier/softer than he was prior to INTUNIV, and I do have to mention that he did not get as much outside time today due to rainy/cold weather. Any child has a hard time under those circumstances.

I also noticed that I'm finding him sitting at the schoolroom table by himself playing with little nonsense toys fairly quietly more often than I've ever seen him. He seems to be calmer and able to sit there without being asked to for longer periods of time before he moves on to the next thing. He also sat with me in a quiet room in the evening after getting ready for bed and read an entire little reader book with very few helps from me. He was calm as he tried to figure out the words, and just politely asked me to help him with a few words instead of getting frustrated. It was so pleasant, and I could tell he was trying so hard. It was a lovely moment!!!

He is sleeping fine all night, though I still have been giving him his regular 1.5 mg. pill of melatonin before bed. (If you've never tried melatonin with your child, and he/she has trouble falling asleep or staying asleep, you should try this. It's great for the sleep issues that come along with ADHD!!! I buy a bottle of 120 3mg. pills at Wal-Mart for $6. I cut it in half and give one-half to Grant and the other half to my oldest daughter who has inattentive-ADHD and the most sleeping issues, and they are asleep for the night within 20-30 minutes!!)

We are currently on just 1 mg. of the INTUNIV, and will continue to be until day 7. Then we will step up to 2 mg. and see if what benefits that offers us. I can tell you, I'm already looking forward to that.