Is Intuniv Causing Weight Gain?

I learned a new word this year, communited:  a fracture in which bone is broken, splintered or crushed into a number of pieces. Observe my lovely clavicle.

This is just one of the many reasons I haven’t blogged for a million years. Moving a few times has something to do with it too.

But this blog is my own personal record of the kids’ medications, doses, timelines, etc., and since we’ve changed Luke’s meds, I’ve got to get it on the record. 

The impetus for me feeling like we should consider changing meds was his weight. He started wrestling this year, and I was surprised when he weighed in at more than most kids his age. In the last half year or so, he has gone from a pretty skinny kid to the 92 percentile on the weight scale for his age. Such a quick gain didn’t seem healthy. I don’t think there’s a significant difference in how much he has stared at screens. He’s always had as much video, computer, and television as I would possibly allow him, but I’m pretty strict. I could only think of two things that could be the cause: school lunch or Intuniv.

Kinda skinny, right?

I’m really not a fan of school lunch. I used to buy it for the kids only once or twice a week. But things have been so hectic, I’ve succumbed to the easiness of an online payment. And I’m still doing it, despite my concerns! Gotta get life under control here and make lunches…

Here we have a mountain man in the 4th grade history play. Not quite as lean, and I don't know why. Could this just be his body changing in prepubescence? (I've always hated that word.) Changes that might go unnoticed by others always have a way of freaking me out because I'm paranoid about having my child take drugs. Yes, they help him, but in the back of my mind, the worried dialogue careers. Wait a minute, I've noticed a change!! Is his body composition changing?! Is he more lethargic?! Is something bad happening to him?! Aaaahhh, save the neurotic mother and the lab-rat child.

I knew that weight gain was a side effect of Intuniv, (not listed on the official Intuniv web site but on other sites), so I decided to talk to our pediatrician about it. I have also felt like Luke has become more and more lethargic and wondered if that was a side effect from Intuniv. It is an antihypertensive (lowers blood pressure) after all.

So our pediatrician suggested we try a stimulant again. I busted out my records and told him that even with the smallest doses of Vyvanse, Focalin, or Daytrana, Luke was completely buzzed and wouldn’t fall asleep. So we talked back and forth trying to decide on a new treatment that might work better. We decided on trying a teeny, tiny dose of Vyvanse in the morning and keeping the Intuniv but at a smaller dose and giving it to him at night before he goes to sleep. Intuniv is supposed to last for 24 hours, so the time you give the dose shouldn’t really matter, but my pediatrician explained that there is an arc to the release of the drug, building up in the system and tapering off. So he told me to just give it a try. You know, experiences with infertility, cancer, and ADHD have taught me that that’s what medicine comes down to anyway—give it a try. I’ve probably mentioned that before.

So Luke is now on 5, yes, 5 mg of Vyvanse a day. The smallest pill available is 20 mg, so I have to open a capsule and divide it into 4 parts. It ends up as barely a breath of white powder in the bottom of a cup. It seems almost ridiculous, but I have read that some people can metabolize medicine so quickly that they can only take small doses. Maybe that’s true for Luke.

We tapered the Intuniv down from 3 mg to 1.5 mg (half a pill) and have been giving it to Luke before he goes to sleep. We also give him a dose of melatonin. He does have a hard time falling asleep if he doesn’t have the Intuniv, so I don’t know that we can completely eliminate it.

I haven’t noticed a ton of difference in his behavior, though his school teacher thinks he is doing better. He has still had some meltdowns at school but fewer. That’s where we are for now.

Interesting Autism Research--May Relate to ADHD

Here's one of Izzy's illustrations for a school report on fairy bluebirds. She loves to do 3-D illustrations with paper. I love to see what she comes up with. What she's lacking in social skills, she makes up with creative skills!! 

My friend has a son with autism and she is super active in finding new treatments and alternative treatments, researching, and doing all that it takes to help her son. ADHD is not an autism spectrum disorder but has many similar symptoms and perhaps similar causes. I thought I'd post this article that she sent me. It's really interesting. I'm always fascinated by anything twin-related, too.

Study: Environmental Factors May Be Just as Important as Genes in Autism

By Alice Park Tuesday, July 5, 2011 

Autism is undeniably influenced by genes, but a new study suggests that environmental factors may also contribute significantly — more than researchers previously thought — to the developmental disorder. In fact, environmental factors may play at least as big a role as genes in causing autism.

Dr. Joachim Hallmayer, a psychiatrist at the Stanford University School of Medicine, and his team report online in the Archives of General Psychiatry that shared environmental influences may account for as much as 55% of autism risk, while less than 40% can be attributed to genes.

The study modeled risk, but did not specify which environmental factors were at play. But other research has implicated increasing maternal and paternal age, low birth weight, multiple pregnancies and any medications or infections to which an expectant mom is exposed during pregnancy.

Autism, which affects at least 1% of children, is a complex disorder, so it's no surprise that both environmental and genetic factors contribute to its development. But in recent years, experts have focused intensively on the genetic components of autism; with the availability of more sophisticated tools to analyze genetic changes and development of disease, researchers have identified important clues about autism's roots in DNA.

But the rise in autism spectrum disorders has occurred too quickly to be explained fully by genes. And scientists know that genetic changes don't occur in a vacuum. Such aberrations, combined with non-genetic factors, may offer a fuller picture of what causes the disorder.

To determine how much either factor may contribute to autism, Hallmayer's group analyzed identical and fraternal twins, in which either one or both were diagnosed with autism or an autism spectrum disorder. Identical twins share identical genetic makeup, while fraternal twins are only as genetically similar as any two siblings. So by comparing the prevalence of autism between the two groups, the scientists were able to determine with relative assurance how much genes and shared environment contributed to the twins' conditions.

The study found that the likelihood of both twins being affected by autism was higher among identical than fraternal twins. That suggests that genetics plays a key role in the disorder. But importantly, the chance of both twins being affected by autism was not low among fraternal twins, which is counter to what would be expected if genetics were the dominant factor.

The study also found that autism rates among both identical and fraternal twins were higher than in the general population. That further suggests that environmental factors, probably shared by the twins as early as in the womb, contribute significantly to causing the disorder. "The fact that both groups have elevated rates suggests that something is making the two groups of twins similar to each other," says Neil Risch, director of the Institute for Human Genetics at University of California San Francisco and senior author on the paper. "Whether it occurs in utero, during childbirth or soon thereafter, we can't differentiate. But it suggests that something environmental is causing the twins to be alike."

Risch notes that the results do not discount genetic factors by any means. "It's not either-or in terms of genetics or environment," he says. "We're not saying autism isn't genetic, because the huge majority of twins don't have autism. Obviously something is priming the risk, and it looks like that may be a genetic predisposition. So a genetic base and environmental factors together may explain autism better."

The risk in twins with a genetic vulnerability may be triggered by being a multiple, for instance; something about the more crowded uterine environment may contribute to a greater chance of developing the disorder, Risch notes.

The good news is that as researchers better understand the environmental factors that are responsible for autism, the more some of these factors may be modified to help lower the risk of the disorder. A fuller picture of the spectrum of both genetic and non-genetic contributors to autism may also help lead to more effective ways to treat it.

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• Read more: http://healthland.time.com/2011/07/05/study-environmental-factors-may-be-just-as-important-as-genes-in-autism/#ixzz1RFCA4jKQ

The Fun of Moving

He fell asleep with the fish still biting his fingers.

I haven’t written anything for a couple of months. We are moving in 2 weeks and life is hectic. Has it been hard on my kids? Let’s see, Luke was suspended one day for hitting, and the next week I found myself on a conference call with the principal, his teacher, and the teaching director because his behavior is tanking and they don’t know what to do with him. His teacher is amazing. When she can’t deal with him, I know something is wrong. So what did I do? Sent him to Grandma and Grandpa’s for a few days. I’m just lucky he has amazing grandparents.

I have lots of stuff to blog about that I’ve been learning lately, so I hope I’ll get back to it soon. For now, I’m just going to share a Luke quote that Grandma shared with me.

Luke was running around and got all sweaty. He wiped his brow, looked at Grandma, and said, “I’m sweating like a sinner in church.” Where does he get this stuff?