Josiah’s pediatrician’s office called last week.  His most recent blood work shows elevated prolactin levels, most likely due to the medication Risperdal. Prolactin is a protein that in humans is best known for its role in enabling female mammals to produce milk,  It can also cause breast tenderness and enlargement.  Josiah is not female. We really don’t want this boy wearing a bra or producing any milk.

We were instructed to call his psychiatrist who prescribes and monitors Josiah’s medications to see what needs to be done.  A few days later, the psychiatrist called me directly to discuss the situation.  I was quite impressed he took time from his busy day to consult with me. This is Josiah’s first elevated level which seems to indicate it’s not a grave concern.  However, Josiah hasn’t had blood work done in an extremely long time.  Maybe the levels have been high for a while and we’ve just not known until now?

The Dr. asked if we had noticed any physical changes in Josiah in the breast area.  I hadn’t but I hadn’t been looking for any either and wouldn’t have even thought to check quite honestly, So the first thing I did when Josiah got home was to check for breast buds. The second thing I did was to ingest the remainder of his bottle of Risperdal.  Might help move me up from an A cup to a B.  Totally kidding!  I would never take a prescription medication not my own.  But believe me the thought crossed my mind.

Josiah still looks male, no shopping for training bras for this kid. We are safe so far.  Now we just need to make a decision.  The psychiatrist mentioned 2 options: decreasing the dosage of Risperdal and adding in another medication to make up for the shortage, or switching completely to a new medication, Abilify. When I asked his opinion as to the best course of action, he suggested I search the internet for information on both drugs, discuss it with my husband and then get back to him with our decision.

I was stunned.  I greatly appreciate the opportunity to be so involved in the decision making process for Josiah’s medications, however guidance from someone with a medical degree would be a bit more comforting. Rick and I are just the parents.  We don’t have all the answers.  Truth be told, half the time we make stuff up as we go along.  I highly doubt we are the ones to be driving this decision.

I want to know what we are signing up for, what the benefits and side effects will be.  I want someone with first hand knowledge to enlighten us.  I want to know how long it will take to see positive changes and whether it will decrease aggression or increase appetite.  I have so many questions.  The internet is a wealth of information, but not so sure it’s the best place to look when making such an important choice. This is my child’s emotional and physical development we are talking about.  Some informed guidance would be so very helpful.

When talking with the psychiatrist, I mentioned Josiah’s behaviors have been escalating recently.  He’s been aggressive, destructive and self injurious. He’s not sleeping well AGAIN and extremely hyper.  Poor guy can’t really control all the energy surging through his body. In light of that information, I asked, “Do you have a recommendation as to which path we should take with Josiah’s medication?”  He said, “Either option would be fine. Talk with Dad and let me know what you guys want to do.”

I talked with Rick.  We want the same thing my friend wants for her Autistic daughter when her behaviors become challenging and difficult to deal with.  We want what any parent dealing with an child ‘out of control’ wants. We want it to stop! So, next week, at Josiah’s psychiatric appointment when asked what medication option we chose, I will speak the words my sweet friend told her daughter’s neurologist.  I’m going to lean across the desk, stare him right in the eyes and simply say, “Fix him! I don’t care what you do, just FIX him. We are not taking him home til you do!”

And then, I’m going to medical school.