Things with Ashton have been calming down, and he’s become a lot more pleasant to be around. There are still some lingering issues; mainly having to do with sleep (too much during the day, and the lack thereof at night) as well as some lingering OCD issues. He’s also got some major attention/impulsivity issues, but who knows what is tied to the Autism or what is manifesting itself as ADHD or OCD.
Anyways …. this doctor, is the director of Psychiatry at Children’s Hospital of the King’s Daughters (CHKD). All I knew is he has a specialty in pediatric psychopharmacology (big, fancy term for dealing with children and medications that are used to treat mental diseases and/or disorders).
I went into this knowing that this isn’t a long-term care type place. They help you sort out the issues, treat them, and get your child “evened out” so to speak, so you can go back to your regular doctors and have them manage your care. We get there and they do the whole basic thing of checking Ashton’s weight (87.2lbs) and height (4’7″) and blood pressure. He was absolutely fine through all of this. It does bare mentioning that we had his portable DVD player (thanks Grandma & Grandad for that Christmas present!) as well as a boatload of snacks. Since Ashton is GFCF, I tend to take a lot of snacks since you never know how long you’re going to be gone and what foods will be available.
Then, the doctor comes out and asks to speak to Ashton, by himself, first.
Ok, I admit it… at this point I’m wondering …. what exactly does this doctor hope to gain from talking to my autistic child, by himself? Not to mention, what was Ashton going to do without me in there? …..
Oh mommy of little faith….. he did just fine. Turns out, it’s pretty routine. He wanted to get an unbiased feel for Ashton’s personality. He only had him back there for a few minutes. The doctor then came and brought Ashton back to the waiting room (my wonderful mother-in-law went with me) and it was my turn.
We then spent about forty-five minutes going over Ashton’s medical history, developmental history, our current problems and issues, etc. He actually listened! Now, I don’t mean to say that other doctors haven’t listened (you hear me Dr. Madren….. you too, LISTEN! ;)) but then after listening, he actually explained medical things in easy to understand ways. We talked about different medications, side effects, what medications work for what conditions, etc. It was just a different knowledge-set that he can better explain since pediatric psychopharmacology IS his specialty. He then had me go back to the waiting room while he looked over all of his notes, my notes that I had taken in, and came up with what will be our initial game-plan. We then talked another thirty to forty-five minutes talking about family history, what our issues with medications have been, what we need to prioritize as our most important concern, and came up with a game-plan.
We’ve decided to move Ashton’s morning dose of Abilify to the evenings. It seems logical that the Abilify might be what’s causing the morning sleepiness and extended day-time naps at school. Since he’s also not sleeping through the night on a consistent basis, (but seems to nap on a consistent basis) the hope is that the Abilify will help him sleep at night. Well, for the last two days, he hasn’t fallen asleep during the day. He’s a tad more irritable, but then again, his schedule was messed up yesterday with no school and then a pretty lengthy doctor’s visit. But, the best news is….. HE SLEPT ALL NIGHT from 9pm-6:30am! Yes, I typed that in really little letters… I just hope this sticks and works! I am to call him back next week with an update, and we’ll go back for a follow-up appointment in April.
The hope is, if the Abilify works to help him sleep at night, that we can decrease (or eliminate) some of the other medications he takes to help him sleep. Now granted, keeping him on Abilify for sleeping issues, long-term is not ideal. Abilify can have some pretty serious side-effects (weight-gain, increase in cholestoral and sugar levels, etc) We’re considering doing a sleep-study to get a better idea of Ashton’s sleep patterns and see if we can possibly figure out why he wakes at night. We’ll discuss those at our April appointment. We need to figure out if the stress that the sleep study might cause Ashton will be worth the knowledge we might gain from it.
We have a check-up with Dr. Madren in a couple of weeks, so that’ll give us a good couple of weeks to completely sort things out and hopefully get Ashton on a better sleep schedule and routine. Hopefully we have better news for Dr. Madren at this upcoming appointment rather than the news we had at our last appointment in January (when we were in the thick of things with the aggression, mood issues, defiance, etc).