Medication Skepticism

Sandis had his psychiatric assessment today. The whole psychological evaluation/psychiatric evaluation thing to me is a tad confusing. I'll explain so you can be confused and somewhat frustrated with me. The psychologist does all of the evaluations. She will distribute standardized surveys and questionnaires to teachers, caregivers, day care staff, and parents to try and gather information based on a the standardized psychological axes. She (the psychologist) will spend quite a bit of time in interaction with the child and has an EXTENSIVE interview with the parent discussing concerns and behaviors, and again, doing a standardized survey and questionnaire. After the many hours you and your child spend with this psychologist, they assess the surveys and standardized questionnaires and intersperse that information with their own observations garnered from time spent with the child and what was discussed in the parent interview. The psychologist then makes an educated guess as to what they believe the diagnosis to be. They are not qualified to actually make a diagnosis, but they ARE qualified to recommend a diagnosis based on all of the information they have gathered and quantified.

The psychiatrist, then, takes the written evaluation summary from the psychologist, spends five minutes one on one with your child, and has limited conversation with the parent. After this short and usually long-awaited visit, they pull a diagnosis from their hat which from here on out will be this child's official medical diagnosis (ie. diagnosis from a medical doctor, EXTREMELY IMPORTATNT!)

Does this seem backwards to you? I mean, I don't mean to discredit all of the psychiatrists out there, but it seems to me that they read a bunch of information about my son gathered from other people, and basically they can say yay or nay to diagnoses recommended by the psychologists (you know, the folks who spent any real time with my son) based on their limited exposure to my son.

Pfft.

Anyhow, medical diagnoses are absolutely necessary to qualify for disability medicaid programs, SSI, and most other services that are obtainable from government sources. So this psychiatrist visit is absolutely necessary to ensure that all services Sandis needs are able to be provided.

Today's visit wasn't bad at all. The psychiatrist handed over the PDD-NOS primary and ADHD-NOS secondary without batting an eyelash. He did mention that Sandis's ADHD is atypical as it is not constant and is prevalant in certain situations that are predictable. Well, I could have told him that anyway.

Then came the drug pushing......

I am skeptical about medicating my child. When I was 23 I was assaulted and my neck was injured. I endured constant pain for a couple of years, and I was "medicated" for my pain with narcotic pain meds. I was also treated for Generalized Anxiety Disorder. One medication led to another. I followed the doctor's orders. I took the medication as prescribed, but the pain persisted as did the anxiety. Over the course of a few years one med tacked on top of another med tacked on top of another. The true sources of my problems were never treated, only the symptoms. I ended up in drug treatment for fentanyl addiction two years after this medication journey began. It was a horrible experience. Coming out from the depths was excruciatingly painful. What I put my family through during the worst of my addiction is more than shameful. I do not intend to lessen my part in my addiction with this, but I truly wish that my doctors had first attempted to help me with a solution other than the solution that is found on a prescription pad. Not a quick-fix, but a solution to help me manage my pain (other than addictive meds) and a plan to help me manage my anxiety. Granted I didn't ask for this, but only coming out of the depths of an intense drug addiction did I ask for something different. I remember all of this, and because of my experience, medicating my son is not going to be my first option. It also won't be my second, third, fourth, or fifth. It will be my last and it will more than likely be a choice made in desperation. Well, maybe not that bad....but it gets my point across how low on my list of treatment options medication is.

So the psychiatrist feels that perhaps Risperdal would be a good option for Sandis. The most common side affects are: gain of 15% of body weight, in-alertness (isn't that what it is supposed to be helping?), lack of energy.....He said that risperdal is one of the only medications studied in treating children on the autism spectrum. (That is fine, but why does it fit my son?) He said that it has been shown to help improve transitioning, improve adaptability, reduce aggression, and reduce disruptive behavior. Granted, my son needs help in ALL of these areas. The psychiatrist also told me that even though I am loving and tolerant of Sandis's ineptness in social situations, for the most part other people will not be tolerant and this will cause Sandis many painful problems in the future. I understand that too. Although that is a painful thing to think about, I think it is my responsibility to address the pros and cons of this treatment.

I told the psychiatrist that as of yet Sandis has had no IEP interventions at school (we are working on that) and will start Occupational and Speech therapy in January. I told him that I feel the most comfortable waiting until Sandis has had an opportunity to be in OT and ST and have his IEP up and rolling and see if things improve. I stated that I would be willing to re-evaluate my stance on medication in the future, once Sandis has had an opportunity to have other interventions.

The psychiatrist seemed okay with that, but I did go home with about 15 pages of information on...................Risperdal

Ya well, I had to humor him eh?