The doctor is… Out!

This entry was written last month. Because of the strong emotions attached to it, it’s been hard to edit. My apologies.

Mr. C has been dealing with so many issues that I don’t know where to begin listing them. We have suspected for quite some time that he is dealing with attention deficit issues of some sort. I lean towards ADHD but I’m perfectly willing to accept an alternative diagnosis. All I know is that this kid needs help!

I’ve done my research and have read that the chances of having a second child with ASD (especially if it’s a boy) range anywhere from 5-15% greater if you already have a child on the spectrum. I’ve researched the symptoms of various challenges and everything I’ve read points to this kid having ADHD, Sensory Processing issues and probably more. When E started seeing a therapist, C and I would hang out in the waiting room. Occasionally, the therapist would spend a few minutes interacting with C. After just a few visits of seeing him for mere minutes, she identified him as 2E child.

Twice Exceptional  is defined thus:

“The term twice exceptional, often abbreviated as 2e, has only recently entered educators’ lexicon and refers to intellectually gifted children who have some form of disability.[1] These children are considered exceptional both because of their intellectual gifts and because of their special needs.

A 2e child usually refers to a child who, alongside being considered intellectually above average, is formally diagnosed with one or more disabilities.[2] The disabilities are varied: dyslexia, visual or auditory processing disorder, obsessive-compulsive disorder, sensory processing disorder, autism, Asperger syndrome, Tourette Syndrome, or any other disability interfering with the student’s ability to learn effectively in a traditional environment.[2] The child might have a diagnosis of attention deficit hyperactivity disorder, or diagnoses of anxiety or depression.[3]

For years, I have been watching C for signs of “issues,” always knowing that he was smart but probably delayed in some way. E is a 2E kid who deals with ASD, ODD, ADHD, SPD and anxiety/depression. C has been evaluated for autism twice and, while he does have a few red flags, it’s not enough to diagnose him as autistic.

Last year, after the doctors who were evaluating C for autism decided that he did not meet the criteria, we were given alternatives for evaluation. But, the referrals never came though and we were on our own to get them. We took C to E’s special doctor. We had been working with a doctor for some time to manage E’s meds and ASD. This doctor has been amazing for him. Anyone who asked me about who we saw would be sung his praises. I mean seriously, this guy has made that much of a difference for us. So much so, that we often joke that E is now our “easy” child.

He did so much good for E, he’s bound to help us with C, right?

In the spring, we had C evaluated by this doctor, and he didn’t feel that C had ADHD or any real issues other than behavioral. He mentioned the possibility of ODD but felt that it may be learned behavior from E. He recommended family group therapy as well as individual therapy for C each week. We were that told he couldn’t help us until the defiance issues were dealt with. So, we followed his suggestion. We arranged family and individual therapies. We made major adjustments at home in an attempt to modify the undesirable characteristics. Things improved overall in our home life but, he was still having issues. Often, he couldn’t make decisions, wouldn’t answer questions because he couldn’t get the words out, and so on. So, more individual therapy, and more frustrating days fighting with him about everything.

C seems to never engage in a project. He is constantly bored. His therapist described it as a pervasive dissatisfaction and negativity with life. It’s almost as if he is unable to engage in something long enough to decide if he enjoys it. Even everyday decisions like picking which shirt to wear or what food to eat becomes astoundingly difficult.

We tried charts with limited choices, bought specific clothing… basically we did everything that was suggested. Then in October, we got to the point of desperation. He was miserable and we were too. The house seemed to be in constant turmoil. No one was happy. I took a stand and said enough was enough. It was time for a change. So, I took C to our local family doctor and asked for a trial of ADHD medication. I provided proof of why we thought it was necessary and he readily agreed with us and provided a prescription.

Within 24 hours, we saw improvement. C was now willing to try again if he messed up on something, rather than cry and run off.  He would persevere at getting his thoughts out. He could sit and do school for almost two additional hours if asked. It seemed clear that we had our answer – C did, in fact, have ADHD. As we worked with the medication, we realized that C was having the same issues E had with these same meds. It’s metabolized rapidly and the patient needs to take increasing amounts to keep a stable effect. The problem is, as we played with his dose, he began to lose his appetite (which is a known side-effect). This kid just about lives to eat. He loves to snack all day long. He is always hungry (although honestly, he could be using food as a sensory input), so this change was a big red flag and we slowly backed him back down on his dose until we found a suitable one.

He has been medicated for about a month now and, although the medication helps, it isn’t quite right. Likely, a different medication would be better. Maybe, now that he can focus a little bit, we are seeing underlying issues that he is also dealing with. We don’t know the answers.

With the determination of a mother on a mission, I typed up our notes. Notes of symptoms we see, changes from the meds and even notes from the therapist. All things that support our need for help. Then I make an appointment with the doctor that E goes to on the same day that E had a follow-up. I knew that the doctor had already told us that C didn’t have ADHD but, things had changed. He was not defiant anymore. We had followed his suggestions and still needed help.

I don’t really know even what to say here except, I was wrong. The doctor invites me in and we started out with E because he, theoretically, needed less time. Then after quite a while, we move on to C. I explain what we are dealing with. I hand him a copy of the notes that I had typed for this appointment. He thanked me but did not even look at them. He then told me that he would not be able to help. He did not believe that C had ADHD. He might have ODD but not ADHD. I questioned the fact that the medication helped and was informed that the particular medication we were using could help anyone, regardless if they had issues. What? I asked about the inability to communicate and focus. I was told that C needed more behavior therapy rather than medication. Something like ABA Therapy would be just right. But, when I questioned how to get that therapy when it’s only available to patients diagnosed with autism, I was told that <shrug> it seemed like I was “stuck.” Then he told me that I, personally, needed to create a more regimented day for C with a strict schedule and to be more firm with the rules. Never mind the fact that we’ve done this to no effect. When we tell  C “No,” he can’t cope with his out-of-control emotions so he throws a tantrum that turns into a 20 to 60 minute meltdown, crying, pouting, moaning and throwing things, regardless of there being an audience or not. Sometime, he cries so hard and for so long that he vomits. In telling me about needing to better train C to behave, the doctor tells me to think about all the amazing things you can train chickens to do, and they practically have no brains. WHAT!? Are you comparing my child to a chicken or saying that that he has no brain? What the hell?

Inside, I’m mentally shutting down. I’m fighting the urge to cry at the unfairness of life. Fighting to regain balance so that I can defend my opinions. But, before I can get a grip on them, he brings both boys into the office. He directs E to step on the scale, takes his blood pressure and so on. He talks to E about how things have been going, and then he shows us the door. Wait. Didn’t I have an hour booked for C? Shouldn’t you at least take a moment to talk to him too? I know for a fact that most of our time was spent talking about E. I know, because I can read a clock, that he just used our appointment to catch up on his late schedule. As I stand to put my coat on, practically numb with disbelief, C pipes up: “Hey what about me?” The doc replies: “Well I saw you,” gesturing to C sitting on the sofa, and then holds the door open for us.

I’m an emotional person by nature and, let me tell you, I bounced from shock to anger lightning fast.  I was fuming. I whipped out my phone and called the hubs to rant about what just happened, all the while trying to moderate myself and hint at how I really felt because there were children present. The rest of my day was spent mentally raging, planning on what I would write in my scathing letter to that office. Oh! He was so fired!  Let’s not forget that, meanwhile, I’m trying to drag my kids through Costco, their most hated store. They, of course, are feeding off my bad mood and are reacting to it and the overstimulation of the store. Now we are all upset. Is it happy hour yet?

After nearly a week, I am still shocked at how I was brushed off by that doctor. I’ve calmed down and will not respond in kind, and I will not write my scathing letter of disapproval. I will however, be the advocate my child’s needs. I will start over from the beginning. I will hunt down the referrals I need to see the specialists and get the evaluations I need. I don’t know what we find, but I am confident that we will find some form of help for our little C.

That doctor is out, but another will soon be in.

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A Day in the Life  

I am a planner, organizer and, truth be told, a worrier. I am rarely late but I stress out when I am. I try to remain calm and hide my inclinations, and I especially try to hide the worry from my own little worry wart, Mr. E.

I want to share a little story about a day I had recently. To really appreciate this story, you need to understand that our life often revolves around travel on a ferry. To travel, you must make a reservation and be in line a minimum of 30 minutes prior to departure or risk losing your coveted, reserved spot. So far, I have lived with the ferry system for at least 16 years. I know the drill.

I used to love the slow, calm ferry ride in beautiful surroundings. And then I had kids. Granted, they aren’t totally responsible. When something becomes familiar, you often forget to stop and smell the roses, forget to appreciate the beauty around you. Ferry rides are now filled with activities, tablets, walks around the boat; anything that keeps the kids from making a scene and disturbing our fellow passengers. Most parents go through this but, with special needs kids, all these steps are overwhelming and, often, we just sit in the car. An hour or more in a cramped space with a sensory-avoider and a sensory-seeker. Oh! what joy!

In our 16+ years of marriage, my husband and I have learned the art of blitz shopping: You are going to “the city,” you have this number of hours until your ferry home and a list of things to get done. Ready. Set. Run!

Then we had kids. And now everything takes four times longer. Your list gets chopped down to what can and can’t wait. Then, add in the special needs. Many stores we go to are too busy, bright, crowded, etc., and cause sensory overload. We’ll spend way more than we wanted, buying pointless things just to keep them happy, keep them going, keep the peace. Don’t even get me started on eating out. “Oh, you like Chinese, Mexican, Indian, etc., well, too bad. The kids will only eat…” It’s so hard to remember that they are not spoiled or misbehaving kids. Their brains are just wired differently. You cannot force food or any other issue on them. You can offer and try but, 9 times out of 10 you will be in the same restaurant that you’ve been to twenty times before.

Okay, so now let me set the scene:

It was a dark and stormy morning. The kind of morning where, when the alarm goes off you hit snooze as many times as possible. The kind of morning when you would gladly let your cozy, warm bed keep you prisoner. As I lay there, forcing myself to wake up, I hear the rain drumming on the window, the gusts of wind shaking the windows. On the floor beside me is my ever-faithful mutt snoring like a hog running a chainsaw. I snuggle deeper into the covers and feel the warm body of the puppy snuggled up, stealing half my pillow, and the not-so-soft breathing of my sleeping hubby.

Finally, I drag my lazy bum out of bed and grab a shower. Today was one of our travel days. We have a very good set of local doctors but, as you know, no one ever has all the support service that they need in one place. So, we have a special behavioral/meds doctor and a pediatric dentist that are wonderful but in another city. Normally, we leave in the morning and come home on a late afternoon or early evening ferry. Today though, we have the dentist, and tomorrow, we have the doctor. Our morning progresses smoothly and all is well. The kids are up and dressed and have even eaten breakfast. I feel like I’m on a roll. Time to go and suddenly, my blissful blanket of peace rips apart as the boys start fighting over something stupid like who got their shoes on first. (Sigh) a normal day ahead. The kids run to the car and “forget” that they were asked to help carry things out. So, I struggle to load the ice chests and overnight bags into the car while avoiding the late-night land mines that Jack left on the driveway instead of in the grass.

Now we’re on our way and I feel confident that I can do this alone. I do appointments alone all the time. We’ve even done overnights without Dad or another adult and have done fine. I’ve chosen limited shopping today to maximize our play time and hopefully make this fun trip instead of boring and stressful. We reach the ferry in time and wait to get on the boat. The rain won’t let up, although the wind seems to have died down. As the cars start moving in the first holding lanes, I start the car so that it can defog the windows enough for me to see where I’m going… or at least, that was the idea. The car battery is dead. I have had this happen already once before in the past six months. The last time, I had turned off the car but left the headlights on. I’m not sure what it was this time but, there’s no time to worry about it. Without a thought of the torrential rain, I jump out of the car and run (run!) to the toll booth where I know that they keep a jump kit. I take the kit and run back again, quietly cursing my very out-of-shape self.

The rain is pouring and I’m trying to find the hood latch with visions of somehow getting my hand stuck in the grill… (a childhood story for another time) while trying to wave the traffic around me since I am now holding up the line of cars. It takes a moment for them to see me waving them around – maybe the rain was obscuring me as I stood there waving with one hand and trying to pop the hood with the other, while wearing only a thin black sweater for warmth. (Before you ask Mom, yes, I had a coat and a hat but, in my haste, promptly forgot them.) Meanwhile, the boys are freaking out that we are going to miss our ferry and hollering at me, asking what I’m doing and all the imagined pandemonium the comes with active imaginations and anxiety. I get the car started with the help of my new favorite black box and we’re off – the last car to board the ferry. As I sit and filter the boys’ questions, I realize just how drenched I am. My hair, which had been freshly washed, dried and styled, now lay limp on my head, literally dripping water. Drops of water run down my face and neck. I feel as if I’d just stepped out of the shower and hadn’t toweled off yet. My sweater, scarf and jeans are soaked. Thank goodness, I have an hour ahead of me to air-dry before facing the public again.

Needless to say, it wasn’t a fantastic start to the day. The rest of our time basically followed suit, with many meltdowns and issues. Ah, just another day in my life.

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