An Ode to a Pediatric Follow Up

Who are we kidding here?  I’m not writing an ode.

But?  We did have a follow-up appointment with Spuds’ pediatrician, and I love her now more than ever.  First, I should tell you that Spuds has been off all of his meds except one for about two weeks now.  The one he is still taking is at half the dose he was on when he came to us.  So, you know, that’s a big reduction in medications in my book.  And?  If anything?  His behavior is, on the whole, calmer now than it was when he first came home.

I realize the calmer behavior could have little to nothing to do with the medications and everything to do with the fact that he isn’t as ramped up because he is no longer in a brand new home.  He’s still in a new home, relatively speaking, to be sure, but it isn’t brand new.  Also, the behavior changes could have something to do with the fact that he gets to go outside and just. play.  Every day.  He gets to ride his bike, ride a scooter, roller blade, dig holes, ride horses, play in the sprinkler, play on the massive play set.  We go swimming at the lake, he goes to cub scouts, we pull weeds as a family, we have friends over, he “washes” cars with his brothers.  He gets to just be a kid for the first time ever.  I really think that, more than anything, is helping him relax.  There is something about letting a kid be a kid, you know?

That’s not to say he’s always calm, because he isn’t.  He’s an eight-year-old boy, after all.  And?  The slightly excessively not-calm times are pretty predictable.  For instance, any time guests come to our house, I know he is going to go a little bonkers.  I can get him under control without adding meds, however.  Any time we go to the doctor (you know, all two times now), he starts to go a little bonkers.  But?  Again?  I can get him calmed down without additional meds.  When McH comes home from work every evening the energy level goes up, but it’s manageable.  And . . . umm . . . that’s pretty much it, really.  Three hours of church on Sundays?  He handles it better than kids who have been doing it their whole lives and have never been diagnosed with any kind of behavior disorder.  Sitting through a movie?  They don’t make meds that can keep him that still.

So, The Greatest Pediatrician In the World cut his dose in half again today.  He’ll take that dose for two weeks, then he’ll take it every other day for two weeks, then he’ll be done.  He’ll be off of everything.

“I think you’ve got the right idea,” the doctor said to me.  “Kids need to be able to go outside and play and go to bed at night tired because they wore themselves out being kids.  They don’t need to be stuck in a “cell” so that mom and dad can both go off to work.  They need to play and do chores and be kids.”

I know that statement will anger any feminist who happens to stumble across this blog, but all I can say is:  THIS DOCTOR IS A WOMAN.  In no way was she saying women shouldn’t work.  She was just saying that someone needs to be willing to stay home with kids, especially kids like Spuds who have a difficult, hurtful history, so that they can be kids, they can be carefree, they can burn off energy, whether it’s physical or emotional energy (or both) so that they don’t need pharmaceuticals to calm them down or make them sleep at night.

I’ve talked to Spuds several times about what we are doing with his medications.  When I first broached the subject with him very soon after he came home to us, his response was, “I don’t know, I might go crazy again.”  I told him at the time that I didn’t think he would.  I told him a lot of that would depend upon whether or not he wanted to act crazy.  We’ve talked a lot about choice and taking responsibility for one’s actions.  He’s eight.  We’ll be talking about it a lot more for years to come.  At our first visit with The Greatest Pediatrician in the World, she told him basically the same thing.  “Listen to your mom and dad.  Do what they tell you, be good, and you will be fine.”  He and I have discussed her advice a few times as we’ve talked about the changes in his medication.

The other night, as I was telling him that we would be going back to the doctor today and explaining that she would just want to talk to him to make sure everything is going okay before cutting his dose again, I asked him if he remembered what he first told me when I presented the idea of trying to get him off his medications.  He had no idea what I was talking about.  I reminded him about his comment that he might go crazy again, and I asked him if he still thought that might happen.

“I don’t know.  No,” he said.

I asked him if he remembered the times when he “went crazy” and asked him what he was feeling when those times happened.  He looked at me warily. He really doesn’t like to talk about his past (though he did tell me more about the scar on his knee the other day, how he got it and who was wielding the cigarette lighter that left it).   “You don’t have to tell me what happened,” I explained.  “I’m just wondering how you were feeling when you went crazy.  Were you scared?” I asked, “Or angry?  Or something else.”

“The first one,” he said.  “The first one.”

That didn’t surprise me at all.  He recently told me that he can remember being taken away from his birth mother’s house.  It kind of seems like a stretch since he was not yet three when that happened, but he told me he remembers the police being there, and he remembers the police putting him in the back of their car and taking him away.  “But they didn’t put handcuffs on me,” he said.

“Well, of course they didn’t put handcuffs on you,” I said.  “You were a toddler, and you weren’t being arrested.”

“I wasn’t?  I wasn’t arrested??” he asked.

“No, you weren’t arrested.  Didn’t anyone ever explain that to you before?” I asked him.

“No,” he shook his head slowly.

I explained to him that he was removed for his own safety, the police took him because other people were doing bad things, but he had done nothing wrong.  I know he’s good at making stuff up, but this one?  I think he really believed he’d been arrested.

So the times when he “went crazy”?  Many of those times occurred when he had been sent to his bedroom or sent to the “safe room” at school.  Basically, his behavior got RAD-like when he was sent to kid jail.  Seems like more than a coincidence to me.

Anyway, our goal is to help him feel safe.  At this point, I think the behavior issues will be minimal as long as he isn’t constantly overstimulated by a gazillion different people, programs, and procedures being lorded over him and as long as he feels safe.

Every night we close his closet door for him.  Every night we sit outside his bedroom until he falls asleep.  Every evening I give him a basic idea of what the next day will bring.  Every morning I remind him of the basic plan for the day.  We want him to feel safe.

As we were walking out of the doctor’s office today, Spuds and Quinn walking a bit ahead in a race for the door, the doctor put her arm around my shoulders, gave me one of those sideways hugs, and said, “You are doing a great thing for him, Mom.  You just keep it up.”

“Thank you,” I said.  “So far it’s going so well, but I know the honeymoon could still end.  I hope it doesn’t, but I know it could.”

“And if it does,” she said, “and you need help?  I’ll be right here.”

I literally fought back tears.  I am so used to having to fight for what I know is best for my kids any time an outside entity (mainly the stupid public high school) is involved in our lives, and so used to having to explain and defend our decisions to people who are just people and really probably don’t deserve the explanations, that I was joyfully overwhelmed by somebody actually being supportive.  I used to be surrounded by supportive women, then we moved.  And then we moved again.  I’d be lying if I said I felt surrounded by supportive women in the past seven years.  God bless that doctor.  I am going to send her a Christmas card, because I don’t think we are going to need to see her again before then, and I want her to know how Spuds is doing and how much I appreciate her kindness.

Tewt the Newt thinks it’s too early to be thinking about Christmas and fully supports the deportation of all illegal elves, jolly or otherwise.  Vapid newt.

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