Showing posts with label Concerta. Show all posts
Showing posts with label Concerta. Show all posts
Monday, February 23, 2009
Concerta success
Five days now on the increased dose of Concerta (27 mg), and things are going exceedingly well. There's a marked improvement with Daughter's hyperactivity at home. Her attitude has shined. She did a great job with an extra sheet of homework ("mommy homework" not even school homework, just some math I wanted her to practice on) and some speech we did. She also did great at her Bible Quiz Tournament over the weekend. I truly am noticing a difference. YAY! It does my heart good to see my happy little girl.
Sunday, February 22, 2009
What a difference a day makes ...
In my last post, I was so concerned about Daughter's mental heath and felt like we were making no progress at all. And then Friday happened. On Friday, she seemed to turn the ship around. Several wonderful things happened on Friday. First of all, may I shout from the roof tops that Daughter got a C+ on her math test! We have been living in the land of "Fs" for a couple of months now, so this is nothing short of miraculous. There are a couple of factors that might have contributed: one, her teacher started allowing her to take math tests in the library. Daughter gets so frustrated by distractions in the room during tests, and this especially hurts her during math. She has literally cried about the "loud" sound of other children writing and erasing ... if that doesn't sound like ADHD, I don't know what does. Her teacher first let her try testing at a table at the back of the room and she liked that better. But when she allowed Daughter to test in the library, she really hit the jack pot. The library is Daughter's "happy place." Everything about the library suits her. So that was a great move.
Also, we had a really great homework session on Thursday evening. And her Friday morning tutoring also went well. Both of these I attribute to her attitude. I wish I knew what it was that turned her attitude around. But sadly, I do not. If I knew what button to push, trust me -- I would push it every time. BUT ... is it a coincidence that we started the new, increased dosage of Concerta on Thursday morning and had these improvements? It's a little too soon to know for sure, but I'm going with it for now.
Friday was also Daughter's 4th Grade Spelling Bee. Daughter is a fantastic speller and has qualified for the Spelling Bee every year since second grade. She finished 9th out of 18 kids, which was a disappointment to her (last year she was 3rd). But we were very proud of her. Also, she turned her disappointment around rather quickly and didn't dwell on it all day -- didn't let it derail her math test, for example, so I think that is a real victory.
Since my husband and I were at the school for the Spelling Bee, we scheduled her annual speech IEP for the same day. She does not qualify for an educational IEP, only speech, but this year the IEP meeting was really different because of the new ADHD diagnosis. I found it to be a really positive experience. The OT who recently evaluated her joined us, as well as the speech teacher, her regular classroom teacher, and the process coordinator for the school. There was a great deal of brainstorming among the group on things we could do to improve Daughter's functioning at school. I'll talk about some of these things in future posts.
Also, we had a really great homework session on Thursday evening. And her Friday morning tutoring also went well. Both of these I attribute to her attitude. I wish I knew what it was that turned her attitude around. But sadly, I do not. If I knew what button to push, trust me -- I would push it every time. BUT ... is it a coincidence that we started the new, increased dosage of Concerta on Thursday morning and had these improvements? It's a little too soon to know for sure, but I'm going with it for now.
Friday was also Daughter's 4th Grade Spelling Bee. Daughter is a fantastic speller and has qualified for the Spelling Bee every year since second grade. She finished 9th out of 18 kids, which was a disappointment to her (last year she was 3rd). But we were very proud of her. Also, she turned her disappointment around rather quickly and didn't dwell on it all day -- didn't let it derail her math test, for example, so I think that is a real victory.
Since my husband and I were at the school for the Spelling Bee, we scheduled her annual speech IEP for the same day. She does not qualify for an educational IEP, only speech, but this year the IEP meeting was really different because of the new ADHD diagnosis. I found it to be a really positive experience. The OT who recently evaluated her joined us, as well as the speech teacher, her regular classroom teacher, and the process coordinator for the school. There was a great deal of brainstorming among the group on things we could do to improve Daughter's functioning at school. I'll talk about some of these things in future posts.
Wednesday, February 18, 2009
Follow up with peciatrician today
ME: My husband and I took Daughter back to the pediatrician today. We covered quite a bit of ground. Let me just break down into the major categories:
Medication
First of all, her weight is holding steady. We haven't had any negative side effects with the Concerta, but we told the doctor we don't really feel like it's helping either. He said that is likely because he has her on such a low dose--in fact he said the 18 milligrams she has been on are really about half what he thinks she ultimately needs. But because she reacted so poorly to the Daytrana, he had wanted to start her out very low on Concerta. The bottom line is that we're upping the Concerta to 27 milligrams. We'll start that tomorrow. It does make me really nervous to change her medication on a week day when I can't be with her to see for myself how she's reacting. But I know that her teacher will watch her closely and let me know how it goes.
Anxiety
We discussed our concern for her anxiety level over the last couple of months. Even her teacher says it seems that anxiety is a bigger factor than the ADHD right now in her behavior. She gets very upset if everything isn't just so ... just how she expected it to be. He basically just wants us to keep pursuing that issue with her counseler and he wants feedback from the counselor on what's going on. He indicated that we could use some medication if we needed to. But he would rather -- and so would we -- try to deal with it in counseling. We still need to get to the bottom of what is causing the anxiety.
Occupational Therapy
I showed him the report from the O.T. at the school, and he really wasn't concerned. Given her history with O.T. and P.T., he said the results weren't different than what he would expect and they didn't raise any red flags for him. He offered to refer us to an O.T. if we wanted, but at this time we're not going to bother with that. She's already missing enough school for counseling appointments, and I just don't want to put anything else on her. I really just needed to know that the doctor wasn't concerned about the results.
I guess for now I don't know much more than I did before going in, other than having a new medication dose to try. As the doctor explained (and I know from the research I've been doing), ADHD treatment is not an exact science. We just need to keep working it until we find the best balance for her.
Medication
First of all, her weight is holding steady. We haven't had any negative side effects with the Concerta, but we told the doctor we don't really feel like it's helping either. He said that is likely because he has her on such a low dose--in fact he said the 18 milligrams she has been on are really about half what he thinks she ultimately needs. But because she reacted so poorly to the Daytrana, he had wanted to start her out very low on Concerta. The bottom line is that we're upping the Concerta to 27 milligrams. We'll start that tomorrow. It does make me really nervous to change her medication on a week day when I can't be with her to see for myself how she's reacting. But I know that her teacher will watch her closely and let me know how it goes.
Anxiety
We discussed our concern for her anxiety level over the last couple of months. Even her teacher says it seems that anxiety is a bigger factor than the ADHD right now in her behavior. She gets very upset if everything isn't just so ... just how she expected it to be. He basically just wants us to keep pursuing that issue with her counseler and he wants feedback from the counselor on what's going on. He indicated that we could use some medication if we needed to. But he would rather -- and so would we -- try to deal with it in counseling. We still need to get to the bottom of what is causing the anxiety.
Occupational Therapy
I showed him the report from the O.T. at the school, and he really wasn't concerned. Given her history with O.T. and P.T., he said the results weren't different than what he would expect and they didn't raise any red flags for him. He offered to refer us to an O.T. if we wanted, but at this time we're not going to bother with that. She's already missing enough school for counseling appointments, and I just don't want to put anything else on her. I really just needed to know that the doctor wasn't concerned about the results.
I guess for now I don't know much more than I did before going in, other than having a new medication dose to try. As the doctor explained (and I know from the research I've been doing), ADHD treatment is not an exact science. We just need to keep working it until we find the best balance for her.
Sunday, February 1, 2009
Concerta vs. Daytrana: Mommy's perspective
MOMMY: If you read Daughter's post last night, you know we had a considerably better first day on Concerta. Whew ... what a relief to both of us. What a curiosity as well. Why would two drugs based on the exact same ingredient (methylphenidate) have such vastly different effects on her?
The only thing I can figure is that the Daytrana Patch is not metabolized through the stomach and is absorbed straight into the system, thus giving her a stronger bolt of the drug. The Concerta though, which is an extended-release pill, is designed to be released slowly from the stomach. I'd think the patch would release slowly as well. But there must be something about the metabilization through the stomach that changed the way it is absorbed into her system. That's just doctor/scientist mommy talking. (And by the way, she's actually taking a few more milligrams of the Concerta than the Daytrana, so it can't be that she was getting more of the methylphenidate through Daytrana...)
Anyway, all I can say is that the two drugs had the complete opposite effect on her. The Daytrana Patch zinged her up like she was literally on speed, and that rapid heart beat and breathing scared us to death. Plus she was so wired she didn't sleep all night. But with the Concerta, she was really rather subdued all day (the desired effect). And she fell asleep easily. Good. Good, but weird.
We still dealt with her tummy hurting and difficulty eating, but she did eat more yesterday than she did last Saturday. I even took her out for ice cream, and she ate the whole sundae and said it really tasted wonderful - even though she had been afraid it would be difficult to eat (she hadn't been able to get down more than two bites of ice cream the week before). The appetite-suppressant issue is going to be a big one for us. Her doctor will take her off of the drug if she loses weight for more than two months because of her current size, so I am actively working on this issue. Here is what I'm working on:
1) I have to see that this helps her and that the good outweighs the bad or I'll take it off her it myself, but anyway ...
2) We're eating a very hearty, nutritious breakfast before taking the pill so that at least breakfast is not affected by the drug.
3) I'm trying to get in really nutritious snacks -- yesterday she did a great job snacking on raw veggies and ranch throughout the day, even though she did a rather poor job with lunch and dinner. I'm even going to send some snacks to school, and I think the teacher will be cooperative about letting her have these at recess. She loves cashews, so I think they should make an easy and nutritious, calorie-dense snack for school.
4) We're having Ensure shakes before bed at night. She really enjoyed one last night. So that worked pretty well.
We'll just figure this out as we go! But I sure do feel more hopeful today
And to answer your question yesterday, Good Fountain, yes, it's one pill a day. Thank you so much for reading and caring.
The only thing I can figure is that the Daytrana Patch is not metabolized through the stomach and is absorbed straight into the system, thus giving her a stronger bolt of the drug. The Concerta though, which is an extended-release pill, is designed to be released slowly from the stomach. I'd think the patch would release slowly as well. But there must be something about the metabilization through the stomach that changed the way it is absorbed into her system. That's just doctor/scientist mommy talking. (And by the way, she's actually taking a few more milligrams of the Concerta than the Daytrana, so it can't be that she was getting more of the methylphenidate through Daytrana...)
Anyway, all I can say is that the two drugs had the complete opposite effect on her. The Daytrana Patch zinged her up like she was literally on speed, and that rapid heart beat and breathing scared us to death. Plus she was so wired she didn't sleep all night. But with the Concerta, she was really rather subdued all day (the desired effect). And she fell asleep easily. Good. Good, but weird.
We still dealt with her tummy hurting and difficulty eating, but she did eat more yesterday than she did last Saturday. I even took her out for ice cream, and she ate the whole sundae and said it really tasted wonderful - even though she had been afraid it would be difficult to eat (she hadn't been able to get down more than two bites of ice cream the week before). The appetite-suppressant issue is going to be a big one for us. Her doctor will take her off of the drug if she loses weight for more than two months because of her current size, so I am actively working on this issue. Here is what I'm working on:
1) I have to see that this helps her and that the good outweighs the bad or I'll take it off her it myself, but anyway ...
2) We're eating a very hearty, nutritious breakfast before taking the pill so that at least breakfast is not affected by the drug.
3) I'm trying to get in really nutritious snacks -- yesterday she did a great job snacking on raw veggies and ranch throughout the day, even though she did a rather poor job with lunch and dinner. I'm even going to send some snacks to school, and I think the teacher will be cooperative about letting her have these at recess. She loves cashews, so I think they should make an easy and nutritious, calorie-dense snack for school.
4) We're having Ensure shakes before bed at night. She really enjoyed one last night. So that worked pretty well.
We'll just figure this out as we go! But I sure do feel more hopeful today
And to answer your question yesterday, Good Fountain, yes, it's one pill a day. Thank you so much for reading and caring.
Saturday, January 31, 2009
Pill
ME:Today I swallowed a pill, the pill. See my mom has been helping me learn to swallow a pill in the past few days. Today she gave me the new ADHD pill. It was hard to swallow at first but soon it went down. It was better than last time but I couldn't eat my lunch. It hurt, my stomach couldn't take it. And before dinner my stomach hurt and I felt awful. I had some trouble eating dinner too. But compared to the patch it was easy.It made me do better in my bible study too. It really helped. I feel good about starting this pill, really good.
The role of prayer
MOMMY: I know that Daughter is in God's hands. I have prayed for wisdom. I have prayed that we are getting the right advice for her. I have prayed that she will not be hurt or hindered in any way by any medication that we give her. I'm going to give her the Concerta today and believe God will show me if I am doing the right thing for my daughter.
Friday, January 30, 2009
Ready for Concerta
MOMMY: Daughter has done a fantastic job swallowing pills all week. We even tried something different this morning, as the Concerta pills are a good deal larger than the Zyrteks. So I gave her one ibuprofen pill. I know it's not generally wise to just randomly give ibuprofen, but one pill wasn't going to hurt her--and I needed to know if she could do it. The last thing I need tomorrow when I give her the Concerta is to have her gagging and freaking out over it. It went down fine, so we both feel good about it now. Pill swallowing officially learned! If nothing else, I'm glad we have conquered that little life milestone. (One thing we did learn, for anyone looking for advice on how to do this, is that the pills go down much easier with juice than they do with water. Juice and a dollar. That's my magic formula for pill swallowing.)
Regarding tomorrow, I'm pretty nervous (now, how to keep Daughter from reading this post for the next 48 hours or so?) If the Concerta does to her what the Daytrana did to her, we are so done with medicine. I'll be looking for non-medical options to deal with this. On the other hand, I've had a lot of time to work with her one-on-one this week with homework and studying because we've been cooped up with snow/ice days, and I've really seen how very much she needs help. I desperately want this to help, but I desperately want it to help without any ill side effects. Are those mutually exclusive desires?
Regarding tomorrow, I'm pretty nervous (now, how to keep Daughter from reading this post for the next 48 hours or so?) If the Concerta does to her what the Daytrana did to her, we are so done with medicine. I'll be looking for non-medical options to deal with this. On the other hand, I've had a lot of time to work with her one-on-one this week with homework and studying because we've been cooped up with snow/ice days, and I've really seen how very much she needs help. I desperately want this to help, but I desperately want it to help without any ill side effects. Are those mutually exclusive desires?
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