Doh!

On Tuesday, Jack had a well visit/ med check with the pediatrician. Poor kid- after a full year off of the stimulant meds, this kid went from being about 65 lbs to 95lbs. He's in the 90th+ percentile for weight for his age, as well as BMI. (He isn't obese, but he's definitely thickened up.. got some belly fat, for sure).

Discussing medication, well, it seems I may have inadvertently screwed things up. The Dr. had prescribed 2mg of Abilify per day.. to go up to 4mg a week later, if we didn't notice any changes. A week after that, we could go up to 6mg if necessary. So we got through the first week with more or less flying colors. There was a very good report from school, and minimal physical aggression towards staff. The second week was not so hot, with several incidents- the one resulting in multiple days out of the regular classroom (among other consequences), and the other with me having to pick him up a bit earlier after school from now on. Honestly I wasn't sure if this was just a bad week (since he does have those), or if this was a sign the medication wasn't good for him (was this behavior causing worse aggression?). I felt like since the doctor visit was only about 3 weeks away, I'd wait til then to get the Dr.'s opinion. Unfortunately, in doing so, this may have allowed his liver to metabolize (or totally adjust to) this 2mg as his base line. So that if I bumped him up to 4mg now, well it would be like starting over. That's not good. I don't want to have to keep increasing such a serious drug- not on my 10 yr old.

Because the Abilify was making him so sleepy at school, I moved the dose time to in the evenings. (This concerned me because of now giving him 3 meds that made him sleepy, all at one time. You'd think this would help him sleep better, but that isn't necessarily the case). What the doctor wants to try, before bumping up to 4mg, is to starting giving it to Jack again in the mornings. I guess a sleepy kid is better than a bad kid, right? LOL (It sounds like a whole lot of WTF, but the doctor fully admits that this isn't his area of expertise, and he's maybe as concerned about this medication and what it could do, as I am).

There is a local pediatric psychiatrist in the area who just started taking new patients again. I actually spoke with her on the phone a while back, when she wasn't accepting new patients. Just to try my luck. Unfortunately she doesn't even take our insurance. No doubt the cost to see her is high.. even with our insurance only covering I think 40% of out-of-network costs. With the pediatrician currently prescribing, and of course waiting around for this clinic to open up to see him, it doesn't make sense to try to get Jack in to see her. I really need this clinic to see him, so that they can look more in-depth at medical/developmental/etc.

Thank goodness I got word from Jack's service coordinator for the County that the neurodevelopmental psychiatry clinic has both reviewed and accepted Jack's case. (What an honor, right? "We deem you screwed up enough for us to see you". Oh well. At least maybe now we can get somewhere!). So I wait to hear from them directly, sign all of the release forms so they can talk with every professional in Jack's life, etc.. Fun!

In the meantime, Jack has another appointment with the pediatrician this coming Tuesday, to see how it's going moving the Abilify back to the mornings. If that doesn't work, he will probably suggest giving a dose in the morning, and a dose in the evening. I'm now thinking if I can get an appointment with Jack for this clinic ASAP, I'll hold off on upping the dose. He's going to have to wean off of both the Abilify and the Intuniv (or else there could be serious consequences). I'm sort of worried what behaviors we'll see when that happens. The Intuniv (3mg) is about the only thing we've found to keep him from being hyper as hell).