Dear Dr. House,

Dear Dr. House,

All the children have signed a petition.  They insist that it is time to give their youngest brother afternoon medicine.  In fact, this comes up just about everyday from around 5:00 pm until bedtime.

It came up a lot this afternoon as he was riding his bike from the front to the back door.  He would pop his head in and laugh maniacally, slam the door, and then race to the other door to do the same. Back and forth, back and forth, back and forth.

Personally, the kicker for me was when I walked into the hall after cub scouts and found him gagged and tied at the wrists and ankles.  I thought maybe the older boys scouts had reached their limits, maybe this was their form of a petition. 

I was not sure whether to be relieved or concerned when I found out J.J. had done this to himself.  He proceeded to show me exactly how one would go about gagging and tying oneself up with a piece of rope, his cub scout belt, and his Webelos scarf.  He was very excited.

You know, afternoon medicine has come and gone in our house.  At different times it has helped with anxiety because of racing thoughts, helped control over-stimulus, frustration, raging tempers, impulsive mouths, random full bodied attack hugs, it has even helped some of our brood get to sleep at night (including my husband, Mark).  Up to this point I have not considered his good-natured obnoxiousness medicine worthy.  As a whole he has been more comedic relief and entertainment.

Until recently, he has been able to reel it back in when reminded.   However, he came to me the other day and asked me to make an appointment with you for himself.  He said he is finding it really hard to control his thoughts and actions, he thinks he needs afternoon meds.  Regardless of the outcome, it is certainly time to address it.  Until then I have to go, he is riding off on his bike, with a wooden stake in hand, looking for vampires.

Thanks for your constant good care,

Lisa

* Dr. House is our psychiatrist. He is wonderful and can only be compared to the TV Dr. House in intelligence, otherwise his is just the opposite.  He is kind, compassionate, empathetic and my kids get jealous of each other when their siblings have an appointment and they don't.

Frolicking: The Return of the Boot

When I heard the cries of anguish from the front yard I have to admit I thought she was being over dramatic.

Rachel has always been  know as the highest ranking drama llama in our house.  As a young child we called her Sarah Heartburn.  She was always nigh unto death with some ailment or another.  Ironically, she's the healthiest kid of the bunch.  Rachel was ever trying to be the sickest and never getting ill.


When she was little all her younger siblings got the Chicken Pox.  All but the baby at the time had the vaccine.   All but Rachel got them.  She wanted them so badly she wore her sisters' germ ridden clothes, jumped in their old oatmeal baths, and rolled in their blankets.  She marked the calendar with the date that she would come down with them; then changed the date, changed it again, and again.  She even prayed for them.

Rachel's still waiting for those Chicken Pox.  I keep telling her that if she didn't get them then, it's just not happening.  She's still adamant they will come, though now she's sure they will arrive when she's nominated for a Grammy or on her wedding day.

Injuries are a totally different story.  She dipped heavily from the klutz gene side of the pool.  That would be my side.  ADD/ADHD is not the only genetic disorder floating around our gene pool.  There is also a benign form of Ehlors Danlos, which causes very loose ligaments.  Because of it, our kids joints pop in and out all the time.

Five of the six kids have ADHD and five of the six kids have Ehlers Danlos.  The odds of that happening in one family are very low.   Good thing we don't gamble. 

Start Ehlers Danlos, add a Klutz gene, plus a serious case of ADD/ADHD, and you have a recipe for disaster.  Those who have been following the blog for sometime will remember Rachel ruptured the ligaments in her right foot last April at her prom  (see posts:  All Roads Lead to the ER -- Even the Road to Prom and Black Boot and Bucket Lists).  She was in a walking boot for six months.  To her credit, Rachel worked tirelessly to strengthen her ankle after she was out of the boot despite her continued pain.

Now it's Spring, the grass is tall and green, the wild flowers are blooming, and apparently she felt the urge to "frolic."  Frolicking, by the way, was her own description of what she was doing.  She frolicked for a few steps into the tall grass in our front yard.  Then reality grabbed her by the ankle and down she fell.  See frolicking a field where the dogs lots dig holes; where the grass is beautiful and tall, is not a good idea.   

Impulsiveness won again.  She is back in the boot.  Now she looks back and realizes that if she had thought about her choice in frolicking locations she might not be hobbling around in that big old boot less than a year from the last time she injured it.

Isn't that just how it works with impulsiveness and ADD/ADHD.

Action, then thought, then regret.

From the outside, the consequences seem mostly physical.  It is, however, not lost on the mom in me that she adds this experience to a pile of other impulsive acts and regrets.  They add up and certainly can take a toll on self esteem.

Keeping their self esteem intact and helping them to feel empowered is one of the constant battles I fight with my children and for my children.  More than the average, these kids, our kids, stock pile mistakes and feelings of inadequacy.  If we don't take an active role in helping them learn to process these feelings they start to feel like they are broken.  That it is not just a ligament, that they are intrinsically broken.

Life can not be successfully navigated if you feel broken.

There is something about the way the ADD/ADHD brain functions that takes that stockpile of mistakes and regrets and magnifies them.  Then, at the least opportune moment, throws them all right back into the forefront of the mind.  Making it impossible to see anything but the inadequacy.

I never want my children to see themselves as incapable.  I do not want them to have an inflated sense of justification or unreasonable sense of perfection either.  Neither is a good place to be.  Both are easy to fall into, much like a hole covered by beautiful, tall grass. 

So, I apologized to her for thinking she was being over dramatic when it first happened.  For sending the message to hop on back up to the house.  For grumbling as I dug the crutches out of the hall closet.  I call off the sharks, who look a lot like her siblings, when they can't let her frolicking go with out teasing her about the results.  I remind them and her that we all make mistakes.

I make a point of taking time to let her talk about her feelings.  We try and teach her to recognize what is really going on and to talk herself off the ledge.  When it seems that the past regrets are starting to fall in on her we stop and make sure that she is on top of the pile not underneath it.  No more deep holes.

** I was a little late getting this up...we went to the doctor, got x-rays, wore the boot, went back to the doctor -- no more boot!  Not nearly as injured as last year, thank goodness! 

Social Skills, One of Life's Great Mysteries

I was sitting across the table from a teacher at my daughter's school.  He seemed more than a little shocked when I acknowledged so openly her complete lack of understanding of social skills.  I said to him, "Look, it is what it is.  How silly would it be for me to pretend that she doesn't have issues with social interactions?"  Still a little baffled, hesitantly he asked, "Does she know she has this issue?"

I laughed out loud, "Yes!  Just ask her, she'll be the first to tell you."

I am sure that there are times when people are thrown off by our openness and honesty about the collective struggles in our home.  They don't expect it.  We see no point in hiding or pretending these things don't exist.  How can you work on overcoming a problem you don't acknowledge?  How can a child measure progress or learn coping mechanisms if they can not recognize that there is an issue?

I have an even bigger concern, that if my children constantly see me trying to hide their issues or pretending they doesn't exist they will feel I am embarrassed or ashamed.  I would not feel embarrassed if they had diabetes or asthma, why should I be ashamed that their brain is wired differently than other peoples?  I do not want them to ever feel ashamed that they have ADD/ADHD or any of the other co-occurring disorders that have come with it.

For the record, that does not mean I have never been embarrassed by some of the choices they have made.  


I proceeded to tell him one of my favorite examples of her lack of understanding in social situations.  She was in junior high and one of her class mates made the mistake of asking her what she had done over the weekend.  She came unglued, unleashing her outrage.  How dare this person ask such a private question?  Why would she share such intimate information with someone that was little more than an acquaintance?  How could they pry like that into her private life?

It was hard to stop her mind from racing and calm her down.  Even harder was explaining the concept of small talk and polite conversation.  "Oh," she said.

She has worked hard over the years to at least respond appropriately to some of the more common interactions; but, she still has her issues. Communicating is something that she has improved on, by leaps and bounds but not something she has mastered by a long shot.  She is caught between not knowing what someone really means in a conversation and the right way to respond.  In between, is a space just big enough for the impulsiveness of ADD/ADHD to squeeze in.  She often acts before she has really considered what is meant and how she should respond.

Sometimes she realizes mid-sentence that she has said the wrong thing, occasionally she stops and fixes it before moving on.  Sometimes she just doesn't figure it out until it comes back around and she is shocked by the outcome.

Take today for example, it's Easter Sunday.  Her Young Women's leader is talking about Easter dinner and asks Mariah what our plans are.  She responds and never gives it another thought.

It was all good until her leader's husband showed up to invite us to their house, worried we had no food for Easter.  What?  I wasn't sure how he got that impression and then he explained, it all made sense in a Mariah sort of way.

See Mariah was not sure at all how to respond to her leader's question.  She wasn't outraged at the intrusion, progress for sure, but she was still a confused.  She opted for a conservative response. "Oh, we'll throw something together and call it Easter dinner."

This is only a couple hours after talking about roast and cheesy potatoes on the way to church.

We use these moments as teaching moments.  Trying to explain what people mean and how other people may take the communications and social cues she send out.  She hadn't seen the underlying potential for concern in her response.  That someone would think we had no food for a descent Easter dinner, that they might envision us eating PB&J.

As we talked about it she shook her head, "I just really don't get this stuff."