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Tyler’s Dr. Appt

Today we met with Dr. Shoptaugh and discussed Tyler’s sudden drop in appetite and what is probably rather minor bouts with being unable to fall asleep, as well as my big concern: He is beginning to express obessive or paranoid thoughts that no one likes him, that everyone picks on him, etc. He and I have talked it through, and I’ve also spoken with his teacher and the staff at his after school program, in addition to doing a little observation on my own. Tyler is far from ostracized, and no one else has noticed any kind of major conflict. When I talk through a situation, it often boils down to the fact that he had a relatively minor conflict with ONE individual, but to hear him tell it, his whole class ganged up on him. He also suddenly became fixated on a scary story he’d heard at his after school program in October, and came to me several nights because he was afraid to be in his room. He has never in his life been afraid of the dark, and although we reasoned out several times that ‘RedRum’ was just a spooky story, this lasted close to a week. Since Tyler is at a higher risk for depression and other mood disorders, I took that pretty seriously, especially when his dad reported no insomnia, fears, or problems with appetite over Tyler’s (unmedicated) winter break.

Some good news first: Since July, Tyler has gained 1.5 pounds, which is a good gain in that time frame. Not huge, but substantial and he wasn’t at a flatline or losing as I’d feared. Dr. Shoptaugh thinks that the eating/sleeping problems are definitely related to the Adderrall and scaled his Rx back from 20mg to 15mg. I talked to her about the (very preliminary) research I’d done on dopamine/norepinepherine balance/imbalance and coupling stimulent meds with a non stimulant, like Strattera. She was familiar with the practice, but said it was very, very new practice that still had kinks to be worked out (like everything else LOL). She said that out of 30 patients, she hasn’t had one stay on strattera. She’s also not sure that his obsessive thoughts/fears are definitely related to medication. She wants us to take Tyler to a behavioralist. She does want to work with us as far as balancing out these chemicals, she’s just not sure strattera is going to be the solution, and that she wants to work in conjunction with someone who specializes in this area. I was once again so impressed with her as a medical professional; I wasn’t sure she would be comfortable with the med combo since I know she’s not a strattera advocate. I was really prepared to have my inquiry squashed and find myself back to trolling the listings for a psychiatrist. So even though she wasn’t comfortable making that Rx, I definitely didn’t feel like I was on my own.

Unfortunately, there are only two “behavioralists” ; Dr. Melmed of the Melmed Center (which I’ve heard of, they offer classes for parents, teachers, and kids in addition to counseling), or Dr. Kessler of the Arizona Child Study Center. Thankfully, Dr. Kessler is an in-network providor for my insurance. I’ve done a little reading and he’s got a REALLY impressive bio, with special interests both in ADHD and nutrition. Now, I’m not sure if we’ll actually see him, or someone in his practice… but I am so much more comfortable getting this referral than taking whatever random person my EAP would provide. I called this afternoon and it’ll be a four-five month wait; Dr. Shoptaugh had said to expect three. So the school year may be close to over before he’s seen by them. I have to fill out a packet about an inch thick before they’ll even schedule the appointment, but I went and pickthed it up this afternoon and I’m already about half done.

Since I knew it would be a while trying to make do in the meantime, I gave his teacher a heads up and also spoke with the principal at his school. When we had the 504 meeting last year, the only accomodations we had written in were for testing, because he was doing so well. I noted a concern at the time if we ever reached a point Tyler can’t take meds, we would have to revisit. His principal thanked me for letting her know what was going on and said she’d touch base with the school social worker about classroom accomodations. So I may be having another 504 meeting before too much longer. His teacher is a nice lady, but I don’t really have a rapport of any kind with her and while I believe she’s passionate about gifted education, I don’t really get the impression she’s incredibly in tune with Tyler. I don’t think she’d be nearly as proactive in addressing his special needs as his 2nd grade teacher was, especially since she’ll be going on maternity leave soon. Which is another worry; there are going to be a lot of changes in the classroom… she’ll go on maternity leave sometime in February and then return just a few weeks before school lets out. I wonder how Tyler will handle those transitions, how a sub will handle Tyler, etc. I guess only time will tell.

I also made an appointment for myself with a therapist for next Tuesday.

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