Tag Archives: psychiatrist

Psych Visit #2

I’ve been a little lax on posting because I haven’t felt well most of the week. Yesterday, I finally called into work and went to see a doctor.  Everything checked out – just a bad case of allergy issues – so I got a shot of steroids and an Rx for antibiotics should things not improve.

The upside of being off yesterday was that yesterday was our follow up appointment with Dr. L, so I was able to go with Rick and Colin. Our appointment was at 12:45pm. Rick and I picked Colin up from school at noon and he wound up eating most of his lunch in the car on the way there.

Unfortunately, the good doctor was running about an hour behind, so we had some waiting to do.

Colin got anxious. He kept tightening his lips and looking around. He’d press his fingers on his throat and say he was thirsty. He wanted the TV turned off. He took about seven trips to the bathroom. Rick offered to take him outside for a bit, but Colin declined. He was very quiet…and incredibly nervous. He finished his juice box and wanted more to drink. The water fountain was back by the doctor’s office, so we told him he had to wait.  He stayed quiet, still looking around, wide-eyed, pressing his throat.  I’m wondering if he was having flashbacks to his butterscotch swallowing from the last visit.

The TV show that was on ended and a soap came on.  I could tell the voices on the show were starting to stress him out further.  At one point, someone on screen yelled at someone else and Colin’s eyes went wide and he rocked a bit.  I went to the receptionist and did something I rarely do – I asked her to change the channel.  If anyone should understand, a psychiatrist’s office should, right?  She glanced up and told me someone must have changed it because they never allow soaps. She quickly changed it to PBS.  I asked Colin if that was better.  “I just want it off, please,” he said, so politely.  I explained I couldn’t do that.  He asked a few more times over the rest of our wait, but never got upset.

After our hour of waiting – and a few more trips to the bathroom with Rick – we were called back.

Dr. L asked how the clonidine was working for us.  We explained that the .05mg dose wasn’t working, so we went up to the full .1mg dose after a couple of days and that seemed to help.  For a while, he was waking up earlier and earlier – as early as 4:30am!  But now that seems to have tapered off.  He’s waking up between 6-6:30am, which is wonderful.  I need that 15-20 minutes on my own in the AM.  Before, if I woke up earlier, so did he.  The slightest sound woke him.  He seems to sleep more deeply now. I can shower, let the dogs out, etc, and he doesn’t wake up.

As a result, we’ve been watching a lot more Animusic. Small price to pay!

Next up during our visit was discussion of his ADHD meds.  Rick and I both would like him on something longer lasting.  One of the biggest issues Colin faces are the highs and lows.  He’s on a roller coaster all day – he gets his morning pill…crashes…slowly amps back up until noon when he gets his afternoon dose….back down again…slowly amping back up.  Repeat. 

Therefore we discussed what we and the doc felt were the best options – Concerta or Adderall XR.  Concerta is essentially the same medicine he’s on now (a methylphenidate stimulant – i.e. Ritalin).  Adderall is an amphetamine stimulant.  Dr. L said that with the high dose of Ritalin Colin is already on, it may be a good idea to try a stronger drug like Adderall. He suggested we start with the short acting medication so that we can determine where he needs to be, dosage-wise, and then change over to the XR once we know how he reacts, how much he needs, etc.  We’re making the change this weekend – Saturday will be his first day on Adderall.  Fingers crossed. We’ll start with 5mg in the AM and then 5mg at noon.  If that doesn’t seem to be helping, we’re to give him a full 10mg in the AM and another 10mg at noon. The only real concern I have is that Dr. L said the crash from Adderall can be worse than that from Ritalin. I hope it’s not too traumatic.  I hope he reacts well and that this is a good change.  I’m nervous as hell.

As a side note, I think it’s interesting that Dr. L seems to possibly be on spectrum himself.  His mannerisms and the way he presents things… little things make me think there’s a high probability that he might be.  What really convinced me was yesterday during our session when Colin said, “What’s that noise?” 

I didn’t hear anything.

“It’s the speakers in the hallway playing music,” Dr. L answered.

I listened closer – oh!  I could hear it if I really concentrated!  But to Colin and Dr. L, I have a funny feeling it was the most annoying sound on earth.  He knew exactly what sound Colin meant.  Little moments like that make me feel like this is a good doctor for us. He’s not just someone who’s read a thousand books… he may very well be living through it as well.

Fingers crossed for this weekend.

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