Monday, July 7, 2008

Developmental Pediatrician

Thursday we ventured to KC to take Payton to the developmental pediatrician. This was our first visit with this doctor (Noel referred us to him) and he was wonderful. He spent two hours with Payton, just observing her, going over her records, and asking questions. I felt very comfortable with him-and ofcourse Payton did too. Nothing was off limits with him and he basically wanted us to just let Payton be. Instead of me reprimanding her for getting into his drawers, papers, etc - he did his best to just watch what she would do in the environment. His synopsis: very impulsive, adhd, and anxiety. As her mom, I knew she was impulsive and anxious - but was unsure of the adhd. While we were eating at Hardee's before the appointment I told my mom that I was assuming she was adhd because she couldn't even sit still to eat - anyone that walked in, walked by, any amount of food on the floor, etc. distracted her way too easily. And, I remember when she was younger her therapists thought she was having petit mal seizures because she would just stare off in space (I always thought she took herself out of the situation when things became too difficult) but I guess even then it was adhd.

Dr. Hoffman went over the medication options with us and my stomach still felt ill regarding any medications for her. I explained that I want to see her deal with situations better and be more capable of handling situations but yet part of me still felt sick about giving her medication for it. So, he thought starting out he would give us a prescription for an anxiety drug that she can take for atleast three days in a row (only once a month) when we know she will be in a situation that will cause her extreme anxiety. My mom had mentioned to the doctor that Bob's family lived about three hours away and it's been way too much for Payton to handle the trip because of the anxiety of traveling (driving next to semis, the sound of koen crying, being out of routine,etc). He said this would be a perfect example of when to give Payton the medicine. He said if we like what we see while she's on the medicine, he would try her on zoloft or xanax. Ofcourse, the side effect of these meds is the adhd getting worse and I would hate to see that happen. Because she's not in school yet (and will only be going to preschool for half a day) I feel like this is the right direction to take for Payton right now. It's also easier for us because she is our oldest and we aren't meeting ourselves coming and going with any sibling activities yet. We generally stay home and it seems to suit her very well. Obviously when she starts school things may change. He wants to see her in April of next year before school and will be in contact with us over the phone to make sure any medication she's on is fitting her needs.

As far as sleep is concerned, I explained that we gave her melatonin and that it helps her calm down to go to sleep but she doesn't stay asleep - many times waking up and screaming for a couple of hours straight. He wondered if she was possibly not on enough prevacid, so he increased her prevacid to see if that would help any. Then, he called us back at 9pm on Thursday evening and also told us to increase the amount of melatonin she was taking - saying that most ws individuals have sleeping issues because their brains do not produce enough melatonin (I hadn't been told that before??). My husband is crazy about this doctor because he took the time to call us of an evening.

For now, we are just going to do fish oil for the adhd. Again, because she is not in school full time yet, I felt I had time to wait on this. I hope I don't regret any of my decisions - and the fact is, I guess I can change my decision at any time and the doctor said he would run with it. His goal for Payton was the same as ours - to see her happy - along with the ability to focus. He did recommend her seeing a special needs psychologist because of her aggression. I explained that her aggression usually does not reach past family - it's always with the people she's around most. But he said eventually this could move on to her teachers, therapists, and friends and before that happens he would just like to get the psychologists point of view to make sure we've covered everything. The fact is, he said it would be hard for her to make friends as it is, but if she's aggressive and voilent with others, they simply won't have anything to do with her at all. And - that's the last thing I want for her.

My favorite comment the doctor made: "Well, she obviously has adhd....I mean, look at my room, it's demolished!" I started laughing and I think he almost thought he hurt my feelings because he started apologizing and I just explained that I completely agree with his comment. That's what she does to my house. I leave the room for two seconds and come back to paper scattered and torn, picture frames broken, cd's everywhere, etc. It's easier for me to leave Koen alone in a room than Payton :) I just get tickled because if I give Payton a piece of paper and a pen to write with she will tear the paper in pieces and take the pen apart - usually breaking it. Give the same things to Koen and he really does try to scribble. Anyways, the doctor visit was great - and even though it wasn't a 'fun' trip I really enjoyed the extra time with my mom.

Here's a couple of pics from the 4th......the slip n slide was a hit with the kids.


Kerry said...

Wow, I agree with your husband - this doc sounds AWESOME. He really listened to your needs and addressed your concerns.

Every minute counts.... said...

I am so glad that you liked Dr. Hoffman. He is really nice and takes the time that so many won't take. I am with you on the medication decision. I hope that the short term meds works for those trips to grandmas!!

Sending hugs your way!

Julie said...

Wow he sounds awesome. I have learned so much from this. Thank you. Noah has the same issue with the melatonin. It gets him to sleep but doesn't keep him there. Please keep me updated on what works. I am very curious. We have never updated Noah's prevacid. He doesn't show many signs of reflux, but the last time I tried to wean him off of it didn't go well. I give him 1/2 teaspoon of melatonin 2.5 mg. I can take him as high as 3 mg but haven't since it did work to put him to sleep. This is the best part of this blog, learning from each other. I will pray that you guys make some progress. Oh yeah by the way Noah is very destructive. His new favorite is climbing the back of the couch to get my Willow Tree figurines. He has broken 2 so far. I have nicknamed him the Terminator.:)

Heather said...

Caleb's nickname was Mr. Destructo!
Paper everywhere! Ugh,boy it seems like it was just yesterday. Oh wait! it was yesterday! just kidding. He is obsessed with books though and just has stacks and piles of them everywhere.
Well Tara if you decide to only go the fish oil route at least make sure it is cod oil. that is what I was told by a guy who works in that area. He said cod oil is the best for adhd. Tell you the truth though, I have been giving Caleb fish oil and haven't seen ANY difference at all.Caleb's adhd and implusivity are severe. I don't know what we would do without his adhd meds. I know it is a tough decision and you will know when the time is right, just like we knew. He couldn't even get through 3 hrs of preschool, so yeah, it was time. The other day he was spending the day at my gramma's house. She forgot to give him his noon dose. She said he seemed really "excited" and started getting to the point where he was frustrated and crying and couldn't control himself. She gave him his med and a half hour later she said "i believe Caleb is feeling better" He just smiled at her and said "whew!" He just feels better.
I was so against medication for my precious little destructo, but i have never regreted my decision since we started. They haven't hurt him. His heart is fine. It just took awhile to find the right one. At this point I have no desire to change anything for once!
I am so glad you found a good doctor to work with. We go to the dev. ped. on Aug. 11. This will be our first visit with one since he was about 4. I am a little nervous.
Thanks for the tip about the melatonin. I had no idea, but new that breaking the 3mg in half wasn't always cutting it. :) HUGE HUGS TARA!!!!! Heather

Katie said...

That doctor sounds GREAT!! Its so important to find somebody who actually cares :)
Meds are a scary road to travel but at least you have people here in blog land to travel it with.
And i have lost count of the amount of pens Jai has taken apart LOL him and clicky pens are like my dog and squeaky toys!
That pic of Koen slip n sliding is so cute!
take care

Mandi Miller said...

Sounds like a great time at the doctors. I am so glad you got some good results and a GREAT DOCTOR! Brad and I are sold on my OBGYN because he called me on Thanksgiving (when I was pregnant with the twins) to see how I was doing and if I was having any more contractions. It was amazing to know he cared that much! I know you feel that way with this doctor already. It's so nice to have one that pays attention to detail with his patients! Congrats on finding that in him!

We love you and keep praying for you!!!!!

Michelle said...

Wow! What a visit! He sounds like a really great guy to have on your team. I tried the fish oil with Ari and it really aggrivated her's like drinking a tablespoon of olive oil ...same thing but fish. So I finally found something that works and its
called SEA BUDDIES CONCENTRATE - FOCUS FORMULA. I give her 3 caps a day. I open them up pour the powder into her juice or milk and hit it with a handheld electric mixer for a few seconds to make sure it's blended well. The results have come over time and they are not astonishing but I see definate improvements. I just wanted to let you know because I tried so many other "fish oil" products and this is the only one I can sneak in and actually works.
Glad you got to have time with your mom! Sorry this was so long winded.