Pajama Monster had his depakote level blood draw last Thursday. The level was 40, with a normal range starting at 50. We were advised to increase the dose to 2.5 pills for 3 days, then up to 3 pills. We started 3 pills Sunday. Over the last several days things have seemed better. Pajama Monster has crying/panicked fits over seemingly trivial things, but can be calmed down with patience, especially if I catch it early. I've also been working to really minimize any unexpected changes. I'm not talking about large changes. We've always prepared him for large changes. I mean the small ones such as me throwing away his empty yogurt container after breakfast or vacuuming his room. He seems to need extra warning for these changes or else they can start a crying fit. Other times he hardly seems to notice them. Apart from that, things have been better. We haven't had a poo or urine incident in 2 days. I'm hoping and praying that this will make the difference. He's continuing on the Adderall as the ADHD does seem to be a consistent struggle for him. I'm not expecting that Pajama Monster will have "perfect" behavior. He's a 4 year old little boy. I don't mind that sometimes he gets mad or doesn't want to listen or won't share. That's what I expect. He's 4 (and I realize he'll still do things I don't want him to at any age. He's his own person.). I just want to be able to do the things most other families can do. I want to be able to go to the park and go grocery shopping and let the kids play together in the yard. I want to be able to check on him when he sleeps without being afraid of what I'll find.
If this is enough to stop the destruction and poo smearing and seemingly random defiance then I'm done adding meds. I know many kids have a very complicated "cocktail," but I'd rather handle the crying and need for very very gentle handling around changes without any additional meds. He can function like that, and so can I. That's no judgement against parents who have their children on more complicated cocktails. You have to provide your child with what is appropriate for his or her specific neurology. I'm just hoping that we won't need more. I'm afraid of the impact on Pajama Monster's development with all these meds, but I see the impact of growing up completely unable to function in normal society as worse. As long as he can function, the rest comes down to parenting, as my husband says. I know I'm getting far ahead of myself, but I'm hoping so much that this time the med will help and it won't just be another piece of a mood swing that we're seeing. Our pediatric psychiatrist wants Pajama Monster to continue on the 3 pills for 2 or more weeks and then consider increasing to 3.5 or 4 pills if no side effects appear. We will also do another blood draw to check levels. Oh Please work! Please! Please! Please let this all be over!
The last blood draw was no problem at all. Pajama Monster handled it better than most grownups. I'd laid the groundwork by mentioning there is a policy (my policy) that states: Kids who get blood draws get to go to McDonald's afterwards. Pajama Monster actually began asking if he could get a blood draw so we could go. The actual blood draw caused no more than an "ouch." We of course praised him up and down and then went for lunch at the McDonald's play place. I'm not normally a fan of feeding the kids fast food, but in this case one small McChicken and a few french fries made a terrible ordeal no big deal.
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