Can I Get an Hallelujah?!

Wow, I haven't cried tears of relief in a while.  Usually when I leave a doctor's appointment with Noah, I leave in tears of frustration and anger at the world.  Praise God, today was full of blessings and completely different.  I didn't do any fist-shaking at the sky while yelling, "HE'S MY SON! LEAVE HIM ALONE!"  For me, that's a pretty darn good day.

I realized I wasn't getting anywhere with the developmental pediatrician we've been taking Noah too.  She hasn't been listening to me as Noah's mom, or accepting me as the expert on my child.  The medication he is currently on just hasn't been enough for him and I've known for a while that he needs a little more of a boost.  Noah has been struggling a lot with his ADHD symptoms, which weren't being recognized by this doctor.  I finally realized that we needed different help.  We already had the diagnoses, we needed to go elsewhere for the proper help.

I've been trying since May to get an appointment with a specific doctor at the center we went to today, which offers inpatient and outpatient treatment (Noah said, "Um Mom?  Why are all the doors locked?"  Oh geez....), but I finally just took whichever doctor we could get.  Turns out, we got a wonderful, thorough, dedicated specialist.  She spent close to 3 hours with us, one of those with just Noah, but before we even got started, she asked me exactly what I wanted and expected from the appointment.  When we left, I felt vindicated because she agreed that Noah's ADHD symptoms need to be treated.  We have a clear treatment plan, clear expectations and a clear path.  Whew.  What a HUGE relief.

As it has been explained to me, and from the reading I've done, ADHD can be difficult to diagnose and treat in Asperger kids.  Asperger is an all-encompassing syndrome, which can include OCD-like behaviors, depressive symptoms, anxiety, rigid behaviors, ADD/ADHD behaviors, anger and aggression.  For a professional to diagnose any of those in addition to Asperger, the behaviors/symptoms must go beyond what is encompassed within the syndrome itself.  In most Asperger kids with comorbid ADHD, stimulants are not the way to go, as they can exacerbate many of the Asperger symptoms, especially anger, aggression, depression and suicidality.  And that concludes your science lesson for the evening!


The problem with the developmental pediatrician was that she was not acknowledging that Noah exhibited enough ADHD symptoms outside of what Asperger includes.  Even with a second opinion that diagnosed ADHD, she would not treat him for anything other than his Asperger symptoms.

Today, the doctor agreed with the Asperger diagnosis.  She also felt that Noah scored high enough (this is one of those times when a high score isn't necessarily a good thing!) on the ADHD charts that it goes beyond Asperger and requires its own diagnosis.  Along with those two, she also agreed with the Generalized Anxiety D/O diagnosis, and added Depressive Disorder, also.  That's a lot for a kid.  It was hard to hear, but really, I don't think it was anything I wasn't expecting.  In a way, I was relieved to hear the diagnoses because it meant she was taking us seriously, listening so well and willing to follow through.  I didn't have to shout, yell or beg for her help and understanding.

She wants Noah to have some baseline bloodwork done first: Thyroid, liver function, Vitamin D and a few others.  We go back next week to talk medication.  She wants him to continue on the Zoloft because she is concerned about his anxiety and depression scores, telling us that it's possible his scores would be higher without it (again, high scores not being a good thing).  Noah told her that he does feel the Zoloft is working, so that's good.  She gave me two options to think about for ADHD treatment: Either Ritalin or Focalin, which are stimulants, or Intuniv, which is a non-stimulant.  I'm leaning towards Intuniv, but I understand it is often difficult to get insurance companies to pay for it if you haven't tried something else first.  As she was presenting ideas to me, she warned me that sometimes Intuniv doesn't always take care of all the symptoms, so to be prepared for that possibility.  She does not strike me as overly eager to prescribe medications for children and another comment she made helped me see that she is not about having children on more than two medications unless there is absolutely no other way around it.  Again, what a relief.


While I'm on the subject of How Do You Spell Relief, a quick note about Noah's teacher.  Have I mentioned yet how much I love this woman???  Oh my gosh, can we please CLONE her?  She is beyond understanding of Noah and his behaviors.  Beyond willing to help him and work with him.  Beyond capable of loving, caring discipline.  I know my child can be a difficult child to have around for 8 hours a day, especially when you've got 17 other students and a multitude of tasks to complete.  A teacher who says, "These are the things I've seen him trying to deal with during the day, but I don't blame him, I get why he does these things and we're working on it" deserves a medal.  And her sense of humor blends right in with ours!  Oh, she's good.  She's REAL good!


Thank you, Sweet Jesus, for hearing our prayers and answering them.  Thank you for these blessings today.