It’s a Lengthy One. You Can Trudge Through It!

The last time we met, I had my panties in a bunch over a note my son’s teacher had sent me about Doodicus and an upcoming field trip and how we could make it a more enjoyable trip for all. On my blog, I tried to present her in a neutral light, but I admit on Facebook I was an indignant and defensive attention whore and threw her under the school bus.

As instructed, all correspondence between me and the teachers when it comes to Dood’s behavior is to be copied to Dr. Rita. Of course, I forwarded the note from the teacher to him and by the next morning I had this response:

· Very clear, concise, specific expectations (for instance, [Dood] need to keep hands to himself, stay within arm’s length of the teacher, etc).

· Frequent feedback on those expectations (“[Dood], you are doing a great job staying with the group”, “Remember to keep hands to self”).

· Clear and specific consequences that can be applied on the field trip (“[Dood], if you touch things you are not supposed to touch, you will have to hold the teacher’s hand for 15 minutes”).

· On the bus, set [Dood] up for success. Assign him to sit next to a peer he will do well with, and have that assigned seat close to the teacher who can provide regular feedback when [Dood] is doing well meeting expectations.

· Give him incentives to look forward to on the trip. It sounds like this event lasts all day. When he does well on the bus on the way there, he gets to be the first one off the bus. When he does well staying with the group during the tour, he gets to be the first one to have lunch/decide where he or the group sits, that kind of thing. There are lots of small, cost-free ways to reinforce behavior. And the more the behavior is reinforced, the more likely it is you will see it.

Please let me know if these suggestions make sense. Also, if there is a specific concern they have, please let me know and I will do my best to provide additional suggestions.

It wasn’t until the note from the teacher did I actually have any concerns about how Doodicus was going to be on the trip. Since students were given the OK to bring something to occupy themselves on the bus (two-hour trip! One way!), I knew that his nose would be buried in a game and quite an easy traveler. But now I was stressing.

Between the scheduled field trip and exchange of notes above, we had an appointment with Dr. Rita, the psychologist as well as our first appointment with the psychiatrist to discuss possible med changes. I remembered to bring a notebook this time because when Sparring Partner asks me about the appointment, I find it difficult to summarize a 90 minute appointment in a five to ten minute discussion. Bullet points, it is! This has proven to be especially helpful when two weeks later, SP is doing something that the doctor has advised us not to do (or conversely, NOT doing something we should be), and SP defends himself with, “You never told me that!” “Oh, but I did, dear husband. Right here.” And hand over the notebook.

Our appointment with Dr. Hairy, the psychiatrist was enlightening, if not endlessly, …well…ENDLESS. Bedside manner is not his forte, but he asked dozens and dozens of questions. I would try to let Dood answer the questions and only interjected when necessary (how was the pregnancy? Birth? Baby diet, etc., etc.). In conclusion, the medication Dood had been taking (the Daytrana Patch at 20mg/day) was not doing its job effectively. It may have been sufficient at one time, but it’s possible to build up “immunity”. The new medication is Vyvanse and it’s been a nightmare getting it approved through my insurance company (Coventry). To complicate matters, our employer has switched back to BCBS on May 1st. To date (May 3rd), Coventry has not approved the prescription and I now have to get it approved with BCBS, too. As for out of pocket, the Vyvanse is less expensive than the Daytrana; however, when you are going from $275 to $230/month, it’s not significant.

On the first day of the Vyvanse, which was the day before the field trip, he complained of sharp stomach pains and nausea in the morning. In the days following (it’s now been one full week), he’s mentioned some nausea these past couple of evenings and that his arms hurt. The nausea thing could be one of his stalling tactics, since he usually feels just fine up until five minutes AFTER we’ve told him to get ready for bed. The aches might be growing pains? A valid suspicion if I was to factor in the recent appearance of pimples on his forehead. PIMPLES. ON MY TEN YEAR OLD. AAAARRRGGGGHH!!

Behavior-wise? He is a whole new child, according to his teacher. She actually described him as almost somber during the field trip, but that was before he confessed to discovering he had lost the $20 bill we had given him to spend (which was found by another teacher!). While I’m excited over the initial results, his behavior before the medication and at the end of the day are, simply worded, explosive and unpredictable. What’s most remarkable about these unfortunate events is that he feels remorse over them later. THAT has never happened in the past.

There’s less than two weeks to go in school. We will have to make a decision soon about where his education will continue next fall, but quite frankly, I have all but formally announced to Doodicus and to his parochial school that he will not return in the fifth grade, and that we will instead enroll him in the public school system.

I had been procrastinating the writing of this post because there just seemed like there was so much (TOO much) to write about, but I have to get this out there. The little details flit from my memory like moths out of a blanket getting snapped in the air. Which reminds me! I had requested Dood’s office notes from his visits with his therapist from 2008. The first time I had left a phone message with both the doctor and the therapist, I was ignored. My second voice mail messages I left were not so gentle, but were returned. I was informed that Dood’s mental health records could not be released to me, but only to a treating physician. I confirmed this information on-line (no thanks to Nebraska Health and Human Services (NHHS) endless links to more links and even MORE links) before actually reading that mental health providers and their patients’ notes cannot be released to the patient nor their guardian. Just an FYI.

As for the empathy displayed towards my teacher, I still feel a bit raw about it. As a parent, even to a child who I know can test the patience of a saint, I expect everyone else to think he’s perfect. Said with a certain level of wryness. Before you go too soft for the teacher, here are some excerpts from more recent emails (this first one is pre-new medication):

While [Dood]\’s day yesterday was \"better,\" this morning started out on the not-so-good side! The first full hour was a struggle for both of us. He was incredibly fidgety, inattentive, disruptive, noisy (actually humming nervous tunes and noises), uncooperative (didn\’t get Math book or practice book out when directed to do so…neither with the class nor when personally asked to do so), couldn\’t find Math homework (refused help to find it, saying it was \"at home\"), even a little argumentative. The afternoon is going a little better!

I have his assignments in order for being gone tomorrow and he has taken his Spelling test…got an 84%.

Perhaps you have an appointment set, but I\’d recommend a haircut soon. He\’s starting to play with his hair, dragging his fingers through it, and the bangs are in his eyes more often than not.

Here’s the response to our (mine and Dr. Rita’s) request to have a behavior-tracking-with-points form completed each day (emphasis is ALL mine):

I have given the charts to [Dood] and we’ll see how it goes! I think it might be tedious, but we’ll give it our best shot! I’m going to give him a certain folder (on MY desk) to hand his work in as it’s finished.

And then this:

Please clarify for me again…am I expected to chart this information? Would it not be as easy for him to do it? Also, I wanted to let you know his day seems to be going very smoothly! I’m anxious to see what a whole week looks like for him!

And finally:

Okay, Mrs. C. and I will do our best, but surely you understand that we have many other students and things to keep our minds occupied. This is a particularly challenging group of students, many issues, etc. However, as I said, we will make every effort to complete this task daily. I’ll keep the charts in a folder at my desk and there will be no need for concern by anyone else.

Aaaaaand, discuss (said with a waved flourish of my hand)!