Saturday, April 15, 2017

Medicating or not: Only stubborn people never change their minds...

Growing up, I used to hide under my mom's skirt.  I was shy, obedient, quiet. I never spoke up. I actually was fearful of authority.

I remember looking at classmates who were misbehaved with total incomprehension. How could they  be so disrespectful? I felt bad for the poor teachers.

It never occurred to me that maybe some of those kids could not help themselves.

And then I became a teacher. I was comfortable with using a very conservative type of class management. I like to think of the analogy of the iron fist in the velvet glove approach. Naive and convinced that my imposed discipline would prevent students from being defiant and misbehaved, I quickly woke up to the reality of the then mid nineties. Teachers training ill-prepared future teachers to deal with the more challenging cases: that was the job of special ed teachers. I remember the Ritalin parades at lunch time, before the longer acting version of the medication came out. It seemed epidemic to me. How could parents in their right minds put their kids on medication at such a young age? Never would I do that to my kids. After all, when you're the perfect teacher who can control a class, why wouldn't you become a perfect parent?

It never occurred to me that maybe some of those kids could not help themselves.

And then I became a parent, blessed with ''healthy and normal'' kids at first. Kids who behaved reasonably well, except for the occasional bacon strip in public. The perfect kids for the perfect teacher, always aiming to be the best mother.

I will never forget the comment the director of the orphanage jokingly made when I picked up my little Toan, back in 2011: ''a little handful!'' What did she mean by that? Shy little one year old Toan extended his arms towards me when I bent over the crib to look at him. A true charmer. Obviously, love at first sight. The perfect pair, mom and son.  An inner promise that I would always be there for him, no matter what.

Initially believed to maybe suffer from cerebral palsy which was quickly refuted, Toan was a quiet little boy, most likely overwhelmed by the new environment presented to him. Instantly the youngest of 7, we felt lucky that he adapted quickly to his new life. But not without tears. I was his buoy and he felt safe and secure as long as I was in sight. We became medical appointments buddies as we tackled his many issues including malnutrition, cryptorchidism, ptosis, clasped thumbs, speech therapy, and trying to put a name on the package: I felt the need to sum it all up with a label. The diagnosis took 3 years to come to light through genetic testing: Noonan syndrome.

Easy. For the physical part of things. Growth hormonal therapy would ensure the maximum growth achievable for him.

Around the age of three, we noticed some withdrawal on his part. He would make eye contact but would often pay more attention to objects than people. He would often be found playing on his own, by choice, in spite of having so many siblings. He became a ''collector'', taking things that did not belong to him and hide them. The notion of Toan's secret stash became the running joke in the family.  He also showed on several occasions that he had zero filter, putting his mommy in very embarrassing situations...! He became very impolite and would lecture us on a regular basis.

We went through autism testing twice. To my greatest frustration, both evaluators were not able to put him anywhere on the ASD.

His behaviour at home worsened. Aggressive, obnoxious to everyone in the house, spiteful, vindictive. Fit upon fit. Some lasting longer than others. Everyone took turn getting upset with him. And all along, I knew it was affecting him. I could feel there was a tornado inside of him.

It did occur to me that maybe my little guy could not help himself.

His paediatrician is the first one who mentioned ODD to me: oppositional defiant disorder. With ADHD she believed. I went home with questionnaires for Michael, the teachers and myself to fill out. Filling them out, both Michael and I were in fits of laughter as it seemed to describe our little boy to a T. At school, it came out more as an attention deficit. Is this what could explain his learning challenges? How could my boy ''hold himself'' for a full day at school only to lash out as soon as he got home?

I had a long talk with the doctor about treatment. Ritalin was an indication to treat his ADHD and hopefully help with his ODD.

I would become one of those parents. Did this mean I was no longer the perfect mother?

Luckily, I did not dwell too long. You see, adoption has been a true blessing for me as it rid me of a lot of superficial worries and guilt. When you are in medical survival mode with special needs children, you quickly learn that there are many good alternatives for the sake of your child's well being. What I used to swear by with my ''perfect healthy children'' ceased to apply in the care of my special needs beauties. And I also believe age makes you wiser...

We decided to try Ritalin a little over a week ago. It was an overnight change. At school, Toan is more engaged in learning. At home, he is a joy to have around.  And I bet his self-esteem benefits from the treatment as everyone, including him, is happier and more positive.

It is when it gets better that you realize how difficult it was.