Tuesday, May 13, 2014

PWS Awareness Day 13: Allergies, Anxiety and "The Plan"

Oscar is suffering from allergies this year.  He sneezed and sniffed and wiped his eyes all weekend.  I'd never given him medication before -- I am just not sure how he will react.  Can he take an adult dose? Will it make him drowsy?  Or spacy?  I just kept hoping the sneezing would stop.

It didn't.  He was still sniffling and stuffy after school today, so I asked one of the staff, a homeopath, at our local pharmacy what he recommended.  He pointed me toward a homeopathic chewable for kids and proceeded to describe a dosage plan that included Oscar chewing tablets at intervals throughout the day.  Oscar was with me, and must have interrupted five times, getting more and more agitated. 

"I can take it at school by myself, at lunch and snack. I can do that!" he jumped in.

Most of the medicines for kids have some sort of sugar. They taste good, I realized, as his voice rose and his eyes flipped between me and the homeopath.  I needed to adjust his expectations.

"Kids can't give themselves medicine at school. That's the rule," I said and turned my attention back to the homeopath.

"So when am I going to take it then?" Oscar interrupted again.  "Will Dad know I need it at breakfast? How many should I take a day?"

The uncertainty was triggering his anxiety.  He fired these questions off at me before I could start to answer. 

[So here's where I'm tempted to make up what happened next. A little creative license. I can do that, right? Yeah, well, then you all would get some picture of me that's not very accurate.  So here's what really happened:]

"Oscar, STOP.  I am in charge of 'the plan'.  I will GIVE IT TO YOU when it's time." I raised my voice and over-enunciated, catching the attention of other shoppers.

He didn't stop.

"But how will I know?" he asked again, pleading almost.

I puffed up my cheeks and let the air out slowly.  Then I tried again, a little more calmly. 

"Ok, here's 'the plan'," I said, knowing this was what he needed. "I am going to give you one today, and then I have to see how your body reacts.  I need to see if your symptoms get better.  But I will give it to you when you need it, at the right time.  That's 'the plan'."

He finally relented.

For many years now we've been using the "the plan" as a way to create a structure and eliminate uncertainty in the environment.   We use "the plan" to convey a schedule on a busy day, when there is a change in routine, anytime there is anxiety, to deal with crisis moments.  Teachers use the "the plan" as a way to end arguing and gain compliance on non-preferred activities.  "The plan is we are going to run a 1/2 mile and then play at the park."  I use the "the plan" to get the laundry folded and the exercise in before screen time on the weekend.  We invoke 'the plan' multiple times a day -- it's not personal, it's not a punishment or a reward.  It creates a structure and definitely helps allay anxiety about what is happening next, as well as manage spiraling expectations, like at the pharmacy. 

I don't have a picture of Oscar red-eyed and sneezing, so here instead is one of him with Paul and A's pitcher Dan Straily at Fan Fest. Highly-anticipated days like these require creating "the plan" well in advance.

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