My Son has Diabetes--He Couldn't Possibly have ADD too!
by Robin Nobles
When my son, Ryan, was 8 years old, he was diagnosed with diabetes. We immediately were thrust into the "fun" tasks of checking his blood sugar four times a day, giving him two shots, monitoring everything he ate, carefully watching his exercise, and the list goes on and on.
Before he was diagnosed with diabetes, I strongly suspected that Ryan had an attention deficit. He had all of the "classic signs." But, I refused to put him through the tests and let them medicate MY son. I'd seen what the medicine did to other kids--how they became perfect little zombie's. I liked my "all boy" son, and I wanted to try it without the medication.
Then diabetes hit, and there was no way I would consider putting him on medication for ADD. Diabetes presents enough problems as it is, and adding anything to its already complicated scenario was unthinkable. Besides that, Ryan already had ONE major problem in his life. It was inconceivable that he could possibly have ADD on top of it. Surely I was wrong.
Throughout elementary school, I worked with Ryan every night on his school work--fought with him every night too--and I finally resorted to hiring tutors. He barely passed. His self-esteem was non-existent. He thought he was dumb, and he totally quit trying.
So, I finally gave in and had him formally tested for ADD. Ryan was 12 years and 3 months old at the time. He tested as a 7-year 11-month old child--in other words, he was operating as a 7-year old in class, trying to keep up with 12-year olds, and failing miserably.
Not only was Ryan diagnosed with "severe" ADD, but he was also diagnosed with "severe" dyslexia. In fact, we were told that if we didn't get him special help, he would have to go to a language disorders boarding school in New York. (We live in Mississippi--no way would we do that!)
So, his ADD doctor put him on Ritalin. Now here's where it gets fun. Ritalin is an appetite suppressant. Ryan has to eat at certain times because of his diabetes--not to mention the fact that he was a growing boy. Not only that, Ritalin causes the blood sugar to go up.
Throughout all of this, we constantly had to monitor his diabetes to make sure the medicine wasn't creating too many problems. Actually, I found that in many ways, the appetite suppressant aspect of Ritalin counteracted the fact that it caused his blood sugars to go up, so we were really okay, for the most part.
For a while, Ritalin worked beautifully. It was as if Ryan "woke up" to the world, and all of a sudden, he started participating in class, even offering to help other kids. His teacher said it was like teaching a totally different child. We discovered that Ryan doesn't have severe dyslexia, because the medicine worked. If he had had severe dyslexia, the medicine wouldn't have worked. Then, as his body adjusted to Ritalin, even after increasing the dosage, it quit working as it had in the beginning.
We tried several different medications, and we honestly couldn't seem to find one that worked as well as Ritalin had in the very beginning. Then, the doctor put him on Dexedrine. The positive thing about Dexedrine is that the time-released pills are taken once a day, so he didn't have to take medication at school. It seemed to work better than most, but still not as good as Ritalin did in the beginning. This went on from 6th to 9th grade.
Ryan is 16 now and in the 10th grade, with raging hormones and typical "teenage-itis." This isn't a pleasant time any way. But, if you add diabetes to the scenario, it really becomes tough. Add ADD, and it's a true challenge. He failed the first half the year. I couldn't get him to take the medicine. He would tell me that he'd taken it, but I would find pills in his pockets, behind a chair, and in the trash can. He wouldn't tell me how he felt, whether the medicine was working or not when he did take it, so there was no way I could help him.
After he failed 4 of his major subjects for the first half of the school year, something clicked with Ryan. All of a sudden, he wanted help. We had accommodations in place, but the teachers weren't following them, partly because he wasn't trying. After Christmas, though, we met with all of his teachers to point out the accommodations and to make sure they were being followed.
Ryan started taking the medicine regularly, but he knew it wasn't working. He was on 45 MG of Dexedrine once a day at that point. The doctor had read this highly documented study of a group of kids who had been failing everything. Doctors in the study started putting them on massive dosages of medication, and it was a complete turn around. These kids were getting between 150 and 200 MG of either Ritalin or Dexedrine a day. So, when Ryan's medicine wasn't working, I raised his dose to 60 MG (4 timed-released capsules). We tried that for a while, and then Ryan said he needed more. I thought I had more playing room with the medicine, so I raised it to five--75 MG, not realizing that this was a particularly high dose.
However, you can't imagine the turn around that Ryan went through. All of a sudden, he started making all A's and B's. His self-esteem sky rocketed, and he tried harder in school. The teachers began helping him, and he saw how it felt to succeed.
When it was time to call the doctor for more medicine, the doctor told me that Ryan was taking over the recommended dosage. I had no idea. But, when I told him how unbelievably well he was doing, and considering the study that he'd read, he decided to give it a try, but we had to monitor it closely.
Ryan made all A's and B's for the 3rd 9-weeks at his school. He recently received mid-term grades and he has all A's in courses that he'd failed for the first half of the year. Please understand that the grades themselves aren't what's important--it's the fact that Ryan can now focus and learn. His self-esteem is what's important--his willingness to try and work hard to succeed.
When I took him to see the doctor again, he couldn't get over the change. The bottom line is, that dosage enabled Ryan to focus and to learn. Coupled with the fact that he began to see results, and the fact that the teachers are cooperating, he was able to turn it around to where he's doing exceptionally well.
How has this affected his diabetes? Everything affects diabetes! But, we've started giving him 3 shots a day, and we're testing his blood sugar more often. Because Dexedrine is an appetite suppressant, and because Ryan is on a major dose, he's never hungry--not until around 9:00 at night. So, I reduced his insulin dosage. Ryan is prone to having seizures over low blood sugars, so I have to be very careful. We don't give him the Dexedrine on the weekend or during holidays, and he won't be on it in the summer.
In the study, many of the kids lost a lot of weight when they were on the massive dosages. Ryan lost a few pounds, but not much. He's thin, but he's not overly thin. Other side effects are headaches in the middle of the afternoon (the "crash" effect of the medicine) and difficulty sleeping at times. We've found that after a long holiday, we can't immediately go back to 5 capsules a day. Instead, we have to work up to it to prevent additional side effects.
The doctor asked Ryan if we could reduce the dosage--if Ryan could really tell the difference between 4 and 5 capsules a day. Ryan said he definitely could. He said that at 4 (60 MG), he still talked in class, couldn't pay attention, and couldn't do his work. But at 5, he can really focus and get the job done.
My point to all of this is that I would never have put him on medication if it wasn't a necessity. Virtually all medication affects blood sugars in some way, and I didn't need the aggravation or worry of it. But, it became a necessity. When the medication works, it really works. Sometimes you have to play with dosages, which is a scary thing to me because of the diabetes. Ryan has to know how he feels at all times, so he'll know when he's getting a low blood sugar. But, even at the dosage that he's on, he knows exactly how he feels, and there's no problem. He's far from being a zombie. In fact, he's a typical 16-year old that you'd like to wring his neck most of the time. The medicine simply allows Ryan to focus and to pay attention--and to learn. It's a life saver for us, and it's turned his life and schooling around.
Last Updated: Wednesday March 16, 2005 16:44:54
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