Unfiltered

Younger Son has a doctor’s appointment tomorrow.  A check-up and physical.  No big deal, except that as luck would have it, he’s seeing the doctor whom Leah saw in sixth grade.  The one that started her on Concerta for her ADHD.  We haven’t seen him in at least a year, because I started requesting female doctors for Leah as she got further into her teen years.  Part of me is wondering if he will recognize the last name and ask about Leah.  And because my mind never stops, I’m playing out how that conversation would go, if I didn’t worry about manners or propriety (in other words, if I weren’t such a compulsive people-pleaser).  Here’s how it goes, in my head:

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Doctor Niceguy:  “Hi Luke Lastname…  and Mrs. Lastname.  Oh you’re Leah’s mom… how is she?”

Me:  “Uh, she’s actually at a therapeutic boarding school.”

Dr. Niceguy:  “Oh?” (looks uncomfortable, but appropriately concerned)

Me: “Yes, for extreme anxiety and depression.  Turns out, she doesn’t have ADHD.  It was all anxiety.”

Dr. Niceguy: “That so?”  (looking more uncomfortable, clearly wanting the topic dropped.)

Me:  “Yes.  That is what they concluded after she spent a month in a research hospital being tested and assessed for a whole host of possible psychological issues.

“Did you know that giving a Stimulant – as you did – to a person with anxiety will only serve to make that person MORE anxious?  That even though you explained to me and my daughter that Concerta would simply cause the “little executive” in her brain to take charge and help her focus, what it actually does it STIMULATE whatever is going on in her brain – intensifying whatever thoughts and feelings she is having?  Did you know that?  Because I did not know that, but I relied on YOU, as her PRIMARY CAREGIVER to give us a good accurate picture of what Concerta would do to my child.  In fact, I remember telling you that I was extremely nervous about putting her on medication, that I worried about her not eating (which, in fact, happened) and becoming “like a zombie”, losing the joyful bubbly part of herself (which also, in fact, happened).  But you assured me that we could mitigate the eating concerns by giving her lots of fattening shakes (and thereby putting me in charge of my adolescent’s eating habits at a time when she needed to be taking ownership of them) and that the zombie concern was overblown.”

Dr. Niceguy: “Yes… well… uh…” (eyes dart around the room, fixes on Luke and makes it clear he wants to move on to the patient in front of him.)

Me.  “I wonder, Dr. Niceguy, What would you call it when a child gets out of bed at 2am and writes an expletive-laden letter for her parents before walking out the door and wandering TWO MILES into the forest, without a flashlight in the dark of night, in search of, and I quote, her ‘coyote family’?  Would that qualify, do you think, as zombie-like behavior?”

Dr. Niceguy: “That’s extreme behavior, certainly.  But perhaps there were other mental or emotional issues…?”

Me:  “Yes!  Certainly!  The sorts of issues one ought not to stimulate, wouldn’t you agree?”

Dr. Niceguy: “There are always risks with any medicine…”

Me: “True.  It would have been good if you had mentioned those risks.  Though frankly I doubt you were aware of them.  I wonder, are you also unaware of the fact that people who have or are at risk for Bipolar Disorder should not take stimulants?  That a stimulant, such as Concerta, could trigger a manic episode, or even psychotic behavior?  A number of psychiatrists have told us that it is possible that is what happened to our child.”

Dr. Niceguy: (Becoming defensive while still clearly trying to placate the crazy woman) “She did not have any of the symptoms for bipolar.  It does not typically onset until much older.”

Me: “Actually, Pediatric Bipolar Disorder is often misdiagnosed as ADHD.  Did you know that?  There’s a whole host of emotional and mental disorders that share symptoms with ADHD.  And since it’s the Favorite Diagnosis of Schools and Pediatricians everywhere (to say nothing of the Drug Companies making insane amounts of money off of ADHD meds), it’s likely that a number of your patients whom you have diagnosed as ADHD do not in fact have ADHD.  Did you know that?  No?  Because it’s easier just to look at the symptoms and jump to the most popular and easiest to medicate disorder, isn’t it. After months of testing, we still don’t know if Leah has a mood disorder – but the risk is clearly there.  And given that you spent all of ten minutes asking me about her adhd and the panic attack that brought us to your office, it’s obvious you never even thought about such a possibility.  Doesn’t that seem a little irresponsible to you?”

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…  Only one problem with this scenario:  Younger Son needs a physical.  Also see above re: terrible people-pleasing tendencies.  However, I must say, I feel a little better just typing it out.  And maybe, just maybe, someone in the big wide internet, will gain some knowledge that will prevent another kid from being mislabeled and mis-medicated.  A girl can dream, anyway.