Diagnosis

I wrote this post one week ago today. I was not ready to release it in the wilds of the internet quite yet. I needed time to think and to discuss with Gleek. She thinks I should post it so that it can help other parents who are going through similar things. So here it is:

I don’t want to be here. The knowledge washed across me like a wave when the doctor stepped out for a moment to request a copy of a document. The rational portions of my brain were in charge of this visit. I made the appointment. I filled out the paperwork. I pulled Gleek out of school. Then I listened to the doctor and spoke to the doctor. I asked all the smart questions. I weighed all the variables. I knew this course that I was on was the right one. I felt that rightness deep inside. The calmness and sureness was there, like an underground river deep in my soul. It was the river upon which my boat of logic floated. But I did not want the trip. Not at all.

The doctor and I are ten minutes into our conversation before I ask the question. I need to hear the words.
“So she definitely has ADHD?”
He answers yes and shows me the diagnostic forms which indicate it. Then he talks about tendencies, and possibilities, and why having ADHD can sometimes be a long term life advantage. He hands me piles of copied articles, pamphlets, and resources. I put them in my bag. Most of what he tells me I already know. The papers he has given me will be review, not new information. I’ve known the shape of Gleek’s challenges for a long time. This office visit contains no surprises. I knew what the diagnosis would be. I made this diagnosis for her myself years ago. But somehow, hearing it from a man who specializes in pediatric ADHD and mood disorders opens a small well of grief.
I knew what the answer would be when I asked the question, but I wanted to be wrong. I wanted to be told that she was fine.

I know that both the grief and the desire to be wrong are illogical, but they are there. I must acknowledge and process this grief so that it will not impact any decisions I must make. Why am I sad? The diagnosis changes nothing. Gleek is the same marvelous, strong, challenging person she was before the doctor said the words out loud. I am sad anyway; grieving because her challenges have been quantified; grieving because I am no longer able to pull a cloak of “maybe I’m worried about nothing” across the hard truths. She struggles, not all the time, not in every situation, but often enough that it hurts. The well of sadness has been filled up by all those thousands of small hurts seeping into it.

A diagnosis is a threshold. Sometimes what is on the other side is very much like what came before, other times the act of crossing over changes everything. Until one crosses, it is impossible to be certain which will be the result. Choosing to cross is difficult when things on this side are reasonably good. I have puttered around a long time making do with what I had. Then the calm river came to carry me over. I’ve done diagnosis before. I’ve had it be world changing. I took my non-verbal two and a half year old for developmental testing and embarked upon a decade of speech therapy, developmental research, and meetings with teachers. That same child in third grade was diagnosed with ADD/anxiety and I was transformed from a parent who would not medicate a child into one who does. I went to the doctor for an odd lump on my chin and ended up with multiple surgeries, radiation therapy, and daily thyroid medication. I know deep in my heart that diagnoses change things. All of the changes that have come to me via diagnosis have been ultimately good, but choosing change is still hard, even when I’m pretty sure what shape the change will take.

The doctor threw a ball to Gleek as he asked her questions. He put her through a variety of other little tests with a deftness which speaks long practice in working with high energy, high creativity children. She smiled and engaged with him happily, chattering about whatever lightning quick thought passed through her mind. She charmed both the doctor and the nurses. I was amused that the nurse commented on how active she is, apparently even in an office full of highly active children, she still stands out. I watched Gleek as she waltzed her way through the visit. I could see, though the staff could not, that she was nervous. She hoarded a little pile of candies, pictures, and prizes. The accumulation of small things soothes her. My heart was glad that everyone accepted her barefootedness and desire to touch everything as normal. No one scowled or scolded, even when she climbed atop the counter to perch.

We left the office with seven tootsie rolls, a sucker, a book mark, a pencil, a coloring page, a prescription, and my little well of sadness firmly capped for examination later. I did not take her back to school. Instead we went out for gelato. I just wanted to be with her exactly as she is. I don’t want her to change. She doesn’t want to change. Yet change is inevitable and much of it will be good.

The decision to medicate a child should never be undertaken lightly. I don’t take it lightly, not even after making this decision once before. Not even after seeing how medication removed Link’s chains and let him fly. They are so different these kids of mine and I can not apply blanket solutions. For all of Gleek’s years thus far, I felt strongly that medication was the wrong choice for her. Last Spring she shifted, I shifted, and I began to know that now is the time to see what medication will do. We need to know so we can make long-term decisions. I know the experiment will not do damage. It will not hurt her. Medication gave Link wings. Gleek already has wings, this time I’m hoping for a rudder. There is hope along with the trepidation.

The last step before filling the prescription was for Howard and I to sit down with Gleek and ask how she felt about medicine.
“I want to try.” she said. This is important. In order for medication to work, it must be her tool, not something I impose upon her. In the end my sadness and worries are irrelevant. I must not impose them upon Gleek nor burden her with them. Logic, her decision, and the calm river inside me say that tomorrow morning she will take medicine. So she will and I will observe. Then we will have more information than we have today, just as the diagnosis gave me more information than I had yesterday. This is a good thing.

Purchasing the medication was complicated by a trip to the Emergency Room for Patch, whose arm turned out not to be broken. Howard managed that little adventure, while I fetched the medication. Then I came home and lay on my bed in the solitude of my room. I had a small space to look deep into that well of sadness, to let some of it leak out my eyes. No grand explanations or reasons emerged. In the end I don’t suppose I need to explain it or rationalize it. As I move onward, as I heal, as Gleek grows, as I write, the well will empty out. It is much more empty now than it was this morning. Water drawn from a well of sadness can soothe other thirsty ground if I’m willing to leave the well open rather than capping and hiding it.

It has been a long day, a hard day, but not necessarily a bad one.