WEIGHING IN

Some days it hits me like a bolt from the blue that we administer a controlled substance daily to my son. A drug that addicts have killed for – have died for. Methylphenidate, the active ingredient in his patch, produces many of the same effects as cocaine or the amphetamines.1

It was one of many reasons we were reluctant to start XBoy on meds in the first place. The side effects, like most drugs, can be frightening and it amazes me that so many kids are on ADHD and ADD drug therapies. I would think many parents would decide against it for fear of those affects.

It’s easy to forget and to take lightly the fact that we keep a dangerous and addictive drug in our home (yes, it is locked up and away from both kids), especially since it’s kept in such an innocuous form like the patch. It’s not injected. It’s not swallowed. It’s just a matter of peeling off the plastic layer and sticking it to his skin. Bu sometimes we are careless. Sometimes I find a tiny triangle of that plastic on the floor. Just the right size, and oh so tempting piece of shiny for ZGirl to pick up and put in her mouth. I don’t know how much residue is on it, but when your doctor and the drug company specifically warn to wash hands after handling, it’s enough to be measurable.

XBoy experiences many of the common side effects from the patch. When we first started the therapy, he was an emotional wreck. For example, he would cry if there were only 3 pickles instead of 4 on his hamburger. His teacher called us in to meet with her after his first week of treatment to discuss how he teary and sad he’d been recently. It was only then that we told her about starting him on the drug as we didn’t want him to have that stigma – just another kid on Ritalin. Keeping it from his teacher allowed us to find out if there was a change in his behavior without anyone suspecting why.

He has since adjusted to the dosage, and while we still find he overreacts on occasion, he’s better. Now my concern has focused from his emotional response to the physical. Last year at this time I was worried about his sudden weight gain between his 6 year check-up and the first time I took him to the ped to discuss his behavior, which was almost 10lbs in six months. The clothes I had bought for school were too tight even before he wore them once. In August I was scrambling to find him uniform-wear in husky. And by the time he was weighed by the school, he was up 14lbs to the grand total of 64lbs. He peaked at 65lbs, which we discovered when he started wrestling and had to weigh in. It was also when he started his meds. That was January.

It is the beginning of June, which means he’s been on the daily patch for a solid four months. The other day he came to me and complained that he now weighed only 58lbs after using our bathroom scale, and frankly, that scares me.

I knew he was losing weight. Pictures from last summer show a round, full face. He sported a bit of a “pot” belly in his swim trunks. He was squeezing on his favorite pair of sweatpants. Now? The belly is gone. His collar and shoulder bones are prominent. He is not gaunt, but thinned out considerably. He’s still in a normal weight range for boys his age and height, but for how long?

In the morning, when he doesn’t want breakfast – “I’m not hungry!” – it takes all my willpower not to say, “If you don’t want to lose any more weight, you’ll need to eat breakfast!” since I can only imagine that since he’s already suffering from a chemical imbalance that produces ADHD, he would be just that much more susceptible to experiencing an eating disorder of some kind or another. So I say nothing, but encourage him to at least drink a glass of milk. Paranoia is my master in parenting decisions, apparently.

It’s not like his eating habits have drastically changed. He definitely doesn’t eat as much, but the kid could really put it away a year ago and of course then I worried that he was eating too much. But I watch more carefully when he takes his plate to the sink with food still on it. I don’t grouse as much when he asks for a treat (a brownie, chips, candy, etc.) because I welcome the chance for him to put calories – even empty ones – into his body.

I worry to the point of going sleepless about what will happen in a year knowing that he will still be on meds. I worry about the future in five years; ten years from now. Many kids “outgrow” ADHD. Will he? What if he doesn’t? What long-term emotional affects will he have from a decade of stimulant use? What about the physical? I’ve had family and friends wave away my concerns like I’m making a big deal of out nothing. “Lots of kids have ADD/ADHD,” they say dismissively. I always find it funny how the ones who tell me this don’t. 

1 http://www.usdoj.gov/dea/concern/methylphenidate.html

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16 thoughts on “WEIGHING IN”

  1. Wow…that was really intense to read. I’m sorry you have to go through that worry and issues involved. Parenting is hard enough with “normal” every day things to worry about, but when you add a drug into the mix with side effects, it must be so much harder. Thinking about the foil with residue reminded me how my FIL came to visit and dropped a blood pressure pill on the kids playroom floor(they were staying downstairs) and my son found it and gave it to his sister who brought it to me. I was a wreck thinking about what could have happened. I can’t imagine how hard that must be dealing every day with the what ifs of medication, because as careful as you are, accidents can happen.

    I think its great that you’re thinking about all the what ifs and not wanting to put any extra pressure on him. Kids do go through spurts and his weight loss could just be from normal kid stuff…growth, running around, changes in food choices…but you are aware that it could be from medication and it sounds like you’re handling it well and watching out for any signs. This is such an emotional age for kids already that its gotta be hard to tell whats drug related and whats age/body/hormone related.

  2. I’m sure, as with any of these behavior modification drugs, that it can affect weight. My brother (14 years my junior) has ADHD and has been taking meds for at least 6 years. That kid is night and day depending on if he’s been taking his meds like he’s supposed to. He is a skinny thing but healthy, he has muscle. Part of it is his family history since none of the men in his family are bigger set, they’re all bean poles.

    Since XBoy is still developing, just remember that they also grow differently. Their body takes turns growing out, then up. But you’re right about the meds affecting his weight, they most definitely will make him want to eat less.

    Talk to the doctor about it and see if they have any advice. I think you are handling it really well and being a great parent for looking out for any possible ED issues.

  3. It IS a really tough thing – we are still on the fence about whether to give Zachary his meds over the summer. Every other summer since he started his meds, we took him off, since he doesn’t have to focus like he does in school. Consequently, he gets into a lot more trouble. He has a lot more of an attitude, he says a lot more hurtful things, and man…the energy. I just sent him outside to play and he’s STILL bouncing off the walls.

    On food, he goes through phases. Right now, he’s not really eating much, and not taking his meds, so it’s not really related at the moment. In a week or two, a growth spurt may kick in, and he’ll eat us out of house and home. Literally – the kid is 8 and he can eat more than his dad. SO – I don’t know that XBoy’s weight changes are entirely due to the meds.

    The doc did ask us to put some weight on him last summer, and we were able to put on 10 lbs in about six months when he didn’t really feel like eating by sneaking calories in. Carnation shakes with whole milk for breakfast, milkshakes here and there for dessert.

    It is a tough thing. Hubs and I are trying to have this conversation ourselves. Hubs is on meds for his ADD, our second daughter is on the same meds for her ADD, and our youngest son is on a different med for his ADHD. None of them want to take a pill every day. None of them want to be on meds for the rest of their life. But the inevitable fact is, my husband can’t function at work without it. My son can’t function in school without it. So unless they can find a school or jobs that work with the way their brains work, there isn’t a whole lot of choice.

  4. As you know, I too am blessed with a 7 year old. He, too, no longer wants to eat. He is growing taller and eating less. I think that he gets bored while eating, and he would rather play. It is difficult to accept. I even have started to put chocolate milk in his lunch because he will drink it, not every day of course.

  5. A. start reading some more of the books and magazines on this, they have dozens or articles and tips on this stuff and will help.

    B. The drugs he is on do not have the same effect as street drugs, because they are specially formulated to be medication and the chemical effect is dramatically different. Those stupid warnings are written by lawyers, and usually have zero medical basis, but are only about protecting clients from getting sued. I know, my husband law partner used to write them and crack jokes about how he just blanket banned everything, for kicks.

    Did you know that the original treatment for ADHD was caffeine? And that to this day lots of adults self medicate with it at Starbucks? (One double espresso has the same brain response as 20mg of ritalin.) They get a poor treatment response because of the highs and lows, but it’s no different. Don’t let all these asinine media/govt. reports freak you out.

    C. As for weight, our solution, which you will find somewhere on my blog near the beginning, is to have a protein heavy breakfast, as soon as you can after giving the meds. It doesn’t have to be traditional breakfast, as long as it appeals to him. Add in a good multivitamin and some extra D and zinc. (Meds can make the body lose minerals sometimes, which then affects appetite.) Then before bed, every single night, one cup of homo milk, plus one tablespoon of Quik, he picks the flavour. It’s the exact nutritional equivalent of pediasure, but it tastes wayyyy better and is much much cheaper.

    Load him up on calorie dense foods, and zinc and he will be fine on the meds.

  6. I can’t fathom the choices that you’ve faced, but I appreciate the difficulties that you are wrestling with right now (and will, no doubt, continue to wrestle).

    I agree with Suz up there. It seems to be about trying to strike a balance in life – his behavior, his social interactions with peers, meeting adult expectations, and while I don’t know what his weight was relative to “norm” at school, I’m guessing that most kids would rather be in the norm than the husky on a daily level at school.

    It has to be hard, but you are making the choices as the come to the best of your ability. Just remember that, please.

  7. I worry constantly that one of mine will develop a mental illness like mine prior to puberty, and I’ll need to have them on drugs.

    I don’t like the idea. But knowing what my life was like before meds, I know it may be necessary.

    It’s hard when they’re young-because it could just be normal growth and changes too. It;s such a crapshoot…

  8. Oh hun, I know it’s hard… all the second-guessing, and wondering if you’re doing this right- if you should do that.

    My daughter is AMPED- not quite enough to be on medication (yet- we’re still in the “attempt alternative treatments” category), so I understand your decision to medicate. I also understand the worries about weight issues- and I can say this from the perspective of a mother, AND an ex peds nurse- DON’T WORRY ABOUT IT!!

    If he is eating healthy, and he is active, and he is not sick- let him be. Weight is just a number, and doesn’t mean a whole lot!

    Hang in there!

  9. Ah, DD.

    The worry never stops, does it? It’s never nice to have to put your child on long term medication..

    xx

    g

  10. Of course, there are lots of reasons why he needs a good breakfast. Maintaining a healthy weight is just one of them. You can always give him the other reasons.

  11. I observed a little boy recently whose mother forgot to give him his meds. It was amazing to me how quickly they took affect, as grandma answered her plea for help and brought his meds to the pool. It’s a big deal, in my opinion, and I don’t blame you for being concerned. You are doing what is in his best interest, and that’s what moms do. But it doesn’t keep it from eating us up inside.

  12. There’s no right answer unfortunately. It sounds as if you chose meds to help Xboy get control which he lacked before meds. I think you should monitor the weight thing, but don’t make a big deal about it. Also talk to your doc about this. That’s what they’re there for… use them you pay them to do this. Hang in there… as a mom who frets about what her son puts in his mouth and his weight I can relate, just in a different way. He knows you’re doing what you feel is best for him and that’s the part that matters.

  13. It must be so very hard to decide what to do and when but you are doing your best and you can’t do more than that. I have no worthwhile assvice as I have no experience of the drugs or ADHD but could you persuade him to have those protein milkshakes? I know nothing about wrestling but is there an incentive there to keep weight up?

    1. Wrestling season is over at school, and I don’t know if he enjoyed it enough to do it next year. He got whipped pretty bad b/c he had to wrestle in his weight, which meant wrestling kids who were usually older and more experienced. If he wrestled longer, at the lower weight, he might have won a match or two, which sadly would have been incentive to NOT eat.

  14. It’s a hard road – and a damned if you do, damned if you don’t situation. You have my sympathies. I hope that he will grow out of it. My question is, how do you know? That’s the really scary part.

    You’re doing your best, though. He’ll know that.

  15. It’s all a matter of risk/reward. I’m assuming since he’s still on them you’ve found that they work for him. Where would he and your family be today if he HADN’T started meds? What do you think he’d be like in 5 or 10 years with all the stress and pressure of not having meds to help and having to deal with unmet expectations of his behavior from his parents and teachers?

    If the benefit he’s getting is outweighing the effects, try not to second guess your decision. You made a tough choice with his best interest and well being in mind.

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