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Keep looking out the windshield

Posted Feb 09 2012 10:05pm

"Well, I have to turn off the T.V. if you can't continue to get ready for school by getting dressed. You know the rule, no T.V. before school if you stop making progress on getting ready to leave the house," I say very calmly. I walk over, pick up the remote, and turn off the T.V.

"YOU GIVE THAT BACK! I'LL WATCH T.V. IF I WANT TO! GIVE IT TO ME RIGHT NOW!" Luke, my 9-year-old son with ADHD, SPD, and Learning Disabilities, is screaming at me. He proceeds to cross the living room and starts pulling on my arm, trying to rescue the remote from my possession.

The situation escalates and I decide to wrap him in a bear hug from behind, a sensory maneuver that often helps to calm him in similar situations. This morning, he was too deep in this meds-induced melt and it only made matters worse.

{Smack!} Luke shot his head up and back, ramming me in the mouth. My hands release the hug and reach for my face. This morning is not going well, not at all! 

"GET AWAY FROM ME! FAR AWAY FROM ME!" I yelled and I pointed across the room. Then I fled to my home office, and let the tears flow. Not only was I in physical pain, but this situation caused a tremendous amount of emotional pain too. How did we get to this place? How have we caused this very sweet-natured kid to turn this way? To purposefully hurt the mother he loves so much? 

This really isn't Luke. And I don't mean that in the this-isn't-my child's-will-this-is-the-disorder sense. I mean, this isn't a symptom of his ADHD or SPD or general frustration with having so many disabilities. This rage is medication-induced. That's right. We inadvertently caused this behavior by trying to help him with all those disabilities. That's the crux of my emotional breakdown as I continue to stand in the other room, trying to stop crying.

My upper lip instantly swelled. It didn't feel great but the sharp pain from the onset of the injury had subsided in a short time. And by noon, the swelling had subsided too. By the time Daddy got home from work, there wasn't any physical evidence of what had happened. And I decided not to bother telling him. He always makes it clear he has no answers, no ideas other than what I and our doctor come up with.

Ah! The answers! That's the real problem here -- no one, and I mean no one, has any answers for Luke.

As of last week, we've tried every single stimulant medication since his ADHD diagnosis 38 1/2 months ago. The amphetamine-based medications make this truly kind and fun kid turn aggressive and violent. The methylphenidates will work great for a few weeks and then loose effectiveness. The best of those was Concerta, the worst was Focalin, which made him literally scale the walls and stay awake all night. For the last week he's been on the Daytrana patch, theorizing that the transdermal delivery, rather than through the digestive tract, may make a difference. It takes over four hours to reach therapeutic dose for him, all the while exacerbating his symptoms (i.e., purposefully harming his mother) until the full dosage reaches his bloodstream. He's only getting about 6 hours out of it too, likely meaning the dosage is too low. Starting today, he is also taking a  5mg short-acting methylphenidate tablet with breakfast to attempt to bridge the wide morning divide until the Daytrana is working as intended. We'll see about that. This morning was definitely an improvement.

We've also tried many other medications, off-label. He's tried two anti-depressants. The SSRI caused a psychotic episode and was quickly discontinued. The tricyclic caused severe fear episodes, escalating until he couldn't be in a different room from me. It was quickly discontinued as well. He tried two mood stabilizers as well, one caused severe anger and the other caused suicidal ideation. Not only is Luke one of the 20% of individuals with ADHD that stimulants don't work well for, he's also one of the less than 1% who has the symptoms the black box on the medication label warns you about. This is one pharmacologically-sensitive kid!

I know what you're thinking, maybe meds aren't right for Luke, maybe you need to try natural remedies. Oh, believe me, we've been down most of those {dead-end} paths too.

  • He did Tomatis therapy and Interactive Metronome therapy in addition to over a year of occupational therapy. 
  • We give him omega-3 supplements every day. 
  • We tried a dairy-free diet with no change. 
  • We had him tested for food sensitivities and found him to be gluten and oats intolerant. He's been gluten-free for nine months now with no change in symptoms and no change in efficacy of medications. 
  • We tried half a dozen or more supplements from an integrative medicine doctor after an Organic Acids Test (OAT). No positive change from them either. One, which contained Tyrosine, actually made him angry. 
  • And just last month we did a Hair Tissue Analysis (HTA) to check his mineral and metals levels. Turns out, according to this test, he is extremely deficient in Magnesium, Potassium,  and Sodium, all of which work together in certain ratios for many systems of the body, but every ratio is way out of whack. He is also deficient in almost every single other mineral tested (18-20 out of 25-30). He has absolutely no lithium in his body -- something the N.D. said she's only seen twice, including Luke, and doesn't know what it means. And she found that he has a lot of mercury stored in his tissues, where heavy metals shouldn't be and never in this quantity. A large box of mineral supplements and an oral chelation supplement (if you have any experience with oral chelation, I'd love to hear about it in the comments please) is on it's way to us now to try to address these metabolic issues. 
As you can see, we have been thorough and diligent in trying to treat Luke's ADHD and SPD. We keep looking further, digging deeper, every time something isn't helpful like it should be. The first 2 1/2 or 3 years I was hopeful with every new potential treatment. This will be the answer! Each time my hopes are crushed. That has been a pattern for so long now that I don't hope any more. I have ordered this box of half-a-dozen supplements but I'm certain they aren't going to change anything. Why would they? Nothing else has. This is an emotional place I don't want to be in. 

When I think about it in those terms, about how I've lost hope, I am reminded of a talk I recently attended from a very wise man named Andrew Lacey. Now Andrew has nothing to do with the medical or mental health profession. He is actually a coach and motivational speaker for real estate brokers. Andrew teaches a program in which you contact people who want to sell their property and, very simply, ask them if you can help them. It is a program where the broker will hear "no" many, many times every day, which can be difficult to take. He was talking about keeping a positive attitude and said something that resonated with me, in relation to my life with a child with ADHD. 

"You must look out the windshield." If you are looking down (in sadness or defeat), how can you see where you are going? If you are looking back, you are sure to crash. But, if you keep looking out the windshield, you will have the best chance of safely moving forward. "Keep your eyes on the horizon in front of you," he says. And that's what I intend to do. Thanks for the reminder!

Penny Williams is the creator and editor of  {a mom's view of ADHD} . She is also a  freelance writer , real estate broker, wife, and mother of two living in Asheville, N.C. She has published several pieces in  ADDitude Magazine , the #1 national publication dedicated to ADHD, and has also been quoted in's Family Health Guide on ADHD  and  The High Desert Pulse article, When Ritalin Works.   When not writing, she can usually be found 
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