I made an appointment this week to discuss the sleep and behavior issues again with my pediatrician, whom I love and trust and have been taking my kids to for over 10 years. I have mentioned them off and on over our other visits, but I scheduled this one specifically to discuss them. Essentially, ds3 is still not sleeping well. Giving him melatonin at bedtime has shortened the time it takes for him to fall asleep from 2+ hours to about 20-30 minutes, but then he is up 4-6x a night "needing" something--a bottle (I cannot manage to night wean him as it causes inconsolable tantrums that do not decrease), a kiss, hold my hand, to tell me good night. Refusal to anything causes longterm tantrums. We are going on over 1 1/2 hour one right now because his bottle was too cold, he doesn't want it, he wants it, it's too something, I need a kiss, cover me up, I can't find my bottle, my bottle fell, I can't find my brobree, I'm cold, I'm coughing, the dog won't leave. Basically anything he can think of. [ETA note: he finally went to sleep with much coaxing and tucking and retucking on my part at just over 2 hours] Like his tantrums during the day, he is inconsolable, can't calm himself, and although he wants me to calm him, it frequently does not seem to help. Eventually, he will wear himself out, day or night, and go on to something else or hopefully to sleep. Melatonin throughout the night still leads to almost the same number of wake ups (not usually as long although it descresed them for the for the first couple of weeks, and a morning wake up at 3:30/4 am. Calms forte resulted in 2 stretches of pretty good sleep, with 2 hour night terrors in the middle, every night he took it. He goes to sleep around 7:30, is up between 530-630, and takes 1 short nap most days.
He was adopted and came home at 1 year, and has never slept well. We had a sleep study done when he was about 17m old, as he has a craniofacial anomaly that likely impairs his breathing. While the results were abnormal, they were not unsafe or really treatable, per his ped, an ENT, and his plastic surgeon. So there is nothing to do on that front at this point. They all described it as like sleeping with a cold, not wonderful, but ok. He has some severe LT food allergies to egg, sesame, and tomatoes, but nothing else. We had extensive allergy testing from an allergist specializing in toddlers, so no other allergies lurking out there. Reflux is not an issue, even if it was he gets thickened milk and an elevated bed due to his swallowing disorder, that may or may not be related to the CF issue.
During the daytime, he has huge impulse control issues, like a very spirited 12-18m old. If it crosses his mind, he does it or says it, without regard to the consequences. He pushes limits, he hits, he yells, he talks back. I have had more broken toys and household items in the 3 years that he has been home than a lifetime of my other 2 boys (ages 12 and 5). My other boys and dh and I have been hit with flying trains, cars and other toys during temper tantrums or just when he doesn't want to do something (share. clean up, etc.). He cannot sit still, often even for a full (quick) meal of favorite foods. He cannot stay in a chair or my lap without wiggling or squirming. He also is prone to running off. I had a lightbulb moment when I realized that I planned to pay to send him to our daycare's preschool program next year because he can refuse to participate/get up/play elsewhere in the room, etc. as long as he doesn't disturb the lesson versus our excellent school district pre-K that is free but requires table activities and sitting still. It is affecting his academic option at this point, and he is not able to sit still to learn Kindergarten readiness type skills. I don't see that changing before August when he official enters whichever preschool. While I know there are differing opinions on school readiness/age/homeschool, he has to go to preschool/daycare because of our financia/job situation. So right now, those are my two choices. I don't want to debate that, please.
So anyway, that is the long backstory. Our ped wants to send him for a neuropsych exam for sleep issues and ADHD, although he told me he's not sure exactly sure what that will involve for someone his age. He is expecting to do a medication routine, and already laid some basic groundwork and reassurance. I am casually familiar with the head neuropsych he is referring us to through work, although we will likely have someone in his office rather than just him. He is good, thorough with my adult patients, and I liked him when I met him, he was compassionate and looked at family systems/effects rather than just the patient in isolation. We have done every behavioral intervention I know of, and sensory issues do not seem to be the problem. Our ped feels like we have gone above and beyond--his words were "you have tried more than any other parents I know would, it's time to take this next step."
We have got to get a handle on whatever this is, it is causing serious damage to my family and my marriage. My other kids don't get enough attention as we are always in crisis mode/catnapping. Dh is at a loss how to handle things anymore. We are severely tired, and don't have the patience or strength to deal with living in crisis mode 100% of the time. I have always been pretty opposed to behavior meds for especially young kids, and feel they are over used for ADHD. But we have got to do something, and I think we are to that point. That I am ready to consider it speaks volumes to me about how difficult this situation is. And he can often be funny, charming, sweet, so I try to focus on that, but... So reassurance, advice, experience, questions to ask?
He was adopted and came home at 1 year, and has never slept well. We had a sleep study done when he was about 17m old, as he has a craniofacial anomaly that likely impairs his breathing. While the results were abnormal, they were not unsafe or really treatable, per his ped, an ENT, and his plastic surgeon. So there is nothing to do on that front at this point. They all described it as like sleeping with a cold, not wonderful, but ok. He has some severe LT food allergies to egg, sesame, and tomatoes, but nothing else. We had extensive allergy testing from an allergist specializing in toddlers, so no other allergies lurking out there. Reflux is not an issue, even if it was he gets thickened milk and an elevated bed due to his swallowing disorder, that may or may not be related to the CF issue.
During the daytime, he has huge impulse control issues, like a very spirited 12-18m old. If it crosses his mind, he does it or says it, without regard to the consequences. He pushes limits, he hits, he yells, he talks back. I have had more broken toys and household items in the 3 years that he has been home than a lifetime of my other 2 boys (ages 12 and 5). My other boys and dh and I have been hit with flying trains, cars and other toys during temper tantrums or just when he doesn't want to do something (share. clean up, etc.). He cannot sit still, often even for a full (quick) meal of favorite foods. He cannot stay in a chair or my lap without wiggling or squirming. He also is prone to running off. I had a lightbulb moment when I realized that I planned to pay to send him to our daycare's preschool program next year because he can refuse to participate/get up/play elsewhere in the room, etc. as long as he doesn't disturb the lesson versus our excellent school district pre-K that is free but requires table activities and sitting still. It is affecting his academic option at this point, and he is not able to sit still to learn Kindergarten readiness type skills. I don't see that changing before August when he official enters whichever preschool. While I know there are differing opinions on school readiness/age/homeschool, he has to go to preschool/daycare because of our financia/job situation. So right now, those are my two choices. I don't want to debate that, please.
So anyway, that is the long backstory. Our ped wants to send him for a neuropsych exam for sleep issues and ADHD, although he told me he's not sure exactly sure what that will involve for someone his age. He is expecting to do a medication routine, and already laid some basic groundwork and reassurance. I am casually familiar with the head neuropsych he is referring us to through work, although we will likely have someone in his office rather than just him. He is good, thorough with my adult patients, and I liked him when I met him, he was compassionate and looked at family systems/effects rather than just the patient in isolation. We have done every behavioral intervention I know of, and sensory issues do not seem to be the problem. Our ped feels like we have gone above and beyond--his words were "you have tried more than any other parents I know would, it's time to take this next step."
We have got to get a handle on whatever this is, it is causing serious damage to my family and my marriage. My other kids don't get enough attention as we are always in crisis mode/catnapping. Dh is at a loss how to handle things anymore. We are severely tired, and don't have the patience or strength to deal with living in crisis mode 100% of the time. I have always been pretty opposed to behavior meds for especially young kids, and feel they are over used for ADHD. But we have got to do something, and I think we are to that point. That I am ready to consider it speaks volumes to me about how difficult this situation is. And he can often be funny, charming, sweet, so I try to focus on that, but... So reassurance, advice, experience, questions to ask?
He woke me again at 7 screaming, and I was up 2 more times in between when I finally got to sleep around 4 and then. Did I mention I'm sick and Rick is out of town?
