Another zoom meeting in 1 month after the last meeting with the Nurse Practitioner Ms. Elyse.
She followed up about the medication. I told her about his aggressive behaviors that I stopped giving it to him. She suggested another medicine; this time it’s a long acting one that will last from 6-8 hours. It’d give the same side affects like tummy ache and headaches and loss of appetite.
As Ms. Elyse, the Nurse Practitioner from Center of Autism, suggested to try the medicine (Methylphenidate HCL 5mg) on weekend because the side effects might be tummy aches, headaches, and lost of appetite for the first few days, I decided to let him have it on Saturday.
He was ok when I told him that he needed to take this medicine to help him focus. He took the medicine with no problem. After 10 minutes, he complained about the tummy aches, so I rubbed his belly, but that went away after 10 minutes. Other than that, he did not have headaches or loss of appetite at all.
After 1 week of medicine, I noticed he had more aggressive behaviors like slamming doors, kicking things he saw when he was upset. So I stopped giving him the medicine. His aggressive behaviors went away after we stopped the medicine so it’s definitely this medicine is not good for him.
It was Friday, we had a meeting at 10:00 with Ms. Elyse, the Nurse Practitioner from the Center for Autism as scheduled. I took a day off to take William to their office. I’ve been priming him about this appointment since yesterday, William was not scared at all, in fact he kept asking me “Can we go now?”.
They called me on Thursday to confirm the appointment. Upon checking in, they checked our temperature and asked a few questions about Covid-19: if we live/meet with someone with Covid-19, if we have fever, etc. Then they asked us to wait; the office is nice, big and … empty! I guess because of covid-19 they don’t bring clients to the office unless it’s necessary.
After 10 minutes waiting, we got called by a lady. William ran to her immediately. She asked William to take off sandals and step up on the scale; she measured him and took his blood pressure. William did what she asked without hesitation! Never seen him so excited in a doctor’s office before. She asked if there’s any reports that we need to give it to Ms. Elyse so I gave her the forms that filled out by Ms. Newmand and Mr. Casteneda.
Then she took us to a room and asked us to wait for Ms. Elyse.
Of course William could not sit still while waiting: he touched this and that, he opened the drawers, he tried to pull down the window blinds. Ten minutes after 10:00 AM, Ms. Elyse knocked on the door. She asked us to sit in the corner far away from her desk, which is understandable with the rule of 6 feet apart in this pandemic time.
She asked if Williams wanted some toys, “No, I don’t need it”, William replied. Ms. Elyse asked, “What do you think, mom?”. “Maybe some Lego” – I replied. Ms. Elyse left the room and came back with a small box of Lego blocks and gave it to William, she assured that these are sanitized.
Ms. Elyse had the forms in her hand; she said that based on the teachers’ ADHD rating scores, William indeed has the ADHD. She asked if I’m ready to discuss about medicine for William, I said “Yes”. Then I told her about William’s sleep issue, that he cannot sleep until midnight. From that moment on, to my surprise, her questions are about his sleep routine, what time he eats/showers/brushes teeth, does he watch TV in bed, etc. I told her William takes shower before dinner around 7:00 PM, finishes dinner around 8 :00 PM, then we do some homework in the bedroom before he sleeps.
Then she suggested that we moved the brush teeth and shower time to 9:30 PM, give him some Melatonin 3mg and by 10:00 PM has to be in the bed room, read some bed time stories and turn off the lights. She said shower might help him to relax and Melatonin takes some time to work; and TV/ipad/iphone/homework before going to bed will trigger his brain to work which is not good for falling asleep so need to avoid. “Let’s try that for 4 weeks!” – she said. “And no nap time!”
William during this time some times stacked up the Legos, some time walked around the room; One time he got up to Ms. Elyse’s desk but she immediately asked William to go back to his chair.
“Do you think improving his sleep routing will help with his being hyper?” – I asked. “Most likely!” – she said.
One hour passed by, the last few minutes she checked William’s heart beat; asked William to pull up his shirts and looked for birth marks. She said there’s one, very light in color on his right near the stomach. I did not think that’s the birth mark until she said so. Our time was up, she took us to a different way to exit the office.
Somehow I have the feelings that Ms. Elyse tries to avoid prescribing medicine for William. In the first meeting, she said she never prescribes medicine in the first meeting; and that we’d discuss in the next meeting. Now that we met the 2nd time, she focused on improving William’s sleep; and said that sleep might have negative affect on his focus. It’s not that I want William to be on medication, but I wonder why.
And I never saw she smiles, even just once! It’s so stressful to take care of an autistic boy, as well as all the meetings like this really bring me down. A smile can bring some comfort, I think! Somehow I remembered the first time we met the neurologist Le Thanh, he made the conversation fun and interesting. I wish we can go back to his office but our family doctor’s billing lady said Dr. Thanh is no longer in the network of our funding source. He’s such a nice man.
It was our first time to meet Ms. Elyse, the Nurse Practitioner. Due to the pandemic Covid-19, it was a zoom video meeting. She requested that we moved the camera so that she could see William’s whole body, not just the face. William as usual would not sit still: he kept moving around, jumped up and down on the couch. Ms. Elyse asked him some basic questions like his name, mom and dad names & phone numbers, our home address. William said “I don’t know” but with my help of telling him the first word, he’d finish the rest. He was sleepy (or bored?) that he ran into the bed room several times, I had to bring him back to the zoom meeting.
Ms. Elyse asked a lot of questions, most questions are similar to those in the intake application. Then she confirmed that William has Autism and ADHD. She suggested to meet William in person in 1 month to discuss about the medicine for ADHD if I’m interested. I said “Yes”.
She said to send William for blood tests: Genetics Chromosome and Fragile X (FMRT) w/ Reflex to Methylation Lavender.
She’s a very serious person, I don’t think I saw her smile at all during our zoom meeting.