<p>First let me say that this is one of those times where I feel like a terrible mother. Son is very ADD and takes lots of Concerta. The Concerta lasts about 12 hours and everyone in the family can tell when it wears off.</p>
<p>Son is a choir kid, but has never made All State. This was his last chance. He has no 1st period classes, so he normally takes his Concerta at about 8:30 am, so it lasts until about 8:30 pm. On the day of the second round of auditions, the teacher had a special early morning rehearsal for the kids auditioning, meaning he took his Concerta at about 6:30 am, wearing off at about 6:30 pm. </p>
<p>Can you tell where this is going? At the first round of auditions, he got a 92% on sightsinging; the audition was at about 11 am. At the most recent round of auditions, he got a 33% on sightsinging; the audition was at about 8 pm. Son said, “I totally lost focus.” </p>
<p>It dawned on me that had we thought through the day, he would have taken his Concerta at the normal, later time…had that occured, I’m pretty sure he’d have aced the audition. This hasn’t occured to him yet. I don’t want him to always blame his problems on ADD, but I do think that in a few days, when he’s less emotional about it, I need to tell him. He really needs to be conscious of this for other big events of his life.</p>
<p>As someone who has dealt with All State and other auditions…it may not totally have been the meds wearing off. The second round of auditions typically raises the bar…everything is harder including the sight reading. I’m quite sure he was NOT doing the same passage, and likely this second one had more difficult notations as well as rhythms. Where I am, sight reading is one component of the All State audition and in fact, in this state, you can actually do a somewhat awful job on the sight reading if you do a terrific job singing your audition piece (and you will make the All State chorus…or band or orchestra for that matter). </p>
<p>Not saying that concentration didn’t have an impact too…but it may not be the only thing different.</p>
<p>In four years of various rounds of auditions, he’s always aced the sightsinging. (The problem in prior years has been with his ever changing adolescent male voice.) The judges must have been just dying behind the screen, because he said he did it perfectly during the 1 minute practice time, then lost focus entirely during the actual audition…the poor judges probably couldn’t believe what they were hearing the second time around (the time that counted.) When he’s off his meds, Son is The Most Distractable Person on Earth.</p>
<p>I can so sympathize. My son takes Concerta too. His new insurance won’t cover it and he has to use plain generic Ritalin. He said it hardly works. I don’t know if it contributed to poor midterm grades, when he worked so hard for them. Sigh. </p>
<p>I think you should tell him in a few days, as part of a general conversation about coping and living with ADD.</p>
<p>So sorry he had difficulty with the later audition, missiepie. I defer to thumper’s wisdom ont he difficulty level of the auditions, as I have no experience with this, but I would suggest you sit on your thoughts about the meds impact on his performance right now. I am sure you feel really bad about that (and you realize it wasnt your fault)… but there can be many variables at play, as thumper said. I suspect the Concerta wearing off was part of it. It lasts about 12 hrs, but it can vary, ant its half-life is such that its efficacy tapers off, so he still had some meds in him at 8, though probably not as much as would be beneficial to him. I’d suggest, if he starts to beat himself up about the second tryout,you might then consider mentioning that he may have had some trouble attending later in the evening, with his meds wearing off. He was probably also nervous-- I am sure that doesnt help. How well can he concentrate on his HW when his meds wear off at night (and he doesnt have the anxiety/pressure of a tryout). That may help you gauge how he can function when his meds wear off (just for your own information, as you think this through). Hopefully you will get good news about the tryout and it will be a non-issue!! Good luck!</p>
<p>Did his drug coverage change when he turned 18? When we first got the prescription years ago, the pharmacy had it under Husband’s name and they called and said they could’t fill that presciption for anyone over 18. Now that he’s approaching 18, I’m remembering that. Note to self: Figure out Son’s meds and doctor situation pst-18th birthday.</p>
<p>Is there any way you can let the judges know what happened so maybe they can give him special consideration under the circumstances? I agree that you have to tell him what you think happened – it sounds as though he already realizes it, though. If a similar situation presents itself in the future, does he have a prescription that is not as long-lasting?</p>
<p>Also, this occurence does not in any way whatsoever make you a terrible mother. You sound like a wonderful mother. We can’t always think through every variation of our children’s lives.</p>
<p>Just want to clarify, when I asked if he had a prescription for medication not as long-lasting, I meant so he could take that if he needs to be focussed after the 12-hour medication stops working.</p>
<p>I am sorry that this might have effected his performance. Related to cheshire’s post, one thing I am curious about is how he does in completing homework after 8:30? I have not seen any hs kids who manage to get their homework done this early! Is this something that should be discussed with his dr before he starts college when his studying schedule may change quite a bit from what he is used to now?</p>
<p>Call your insurance company and find out. I did before D1 went to college couple of months ago. There were lots of changes during past a few years regarding the policies of insurance coverage. I do believe most of them cover prescriptions beyond 18 years even with ADD medications. Every insurance company is different though. Mine (a PPO) covers children up to 23 years old (to 12/31 of the 23rd birthday year regardless of students status), which I never knew before. Both my kids have January birthdays, which means almost 24 years of coverage under my policy.</p>
<p>Our insurance company paid for ADD medications for those under 18 with no problem. For those over 18, they still pay, but has to be preapproved. Lots more paperwork and sometimes delays filling the prescription.</p>
I agree with this advice, but you might even want to wait longer before having that conversation. If he doesn’t make the choir, you might want to let the sting of that wear off and fade a bit before bringing it up.</p>
<p>*How well can he concentrate on his HW when his meds wear off at night (and he doesnt have the anxiety/pressure of a tryout). That may help you gauge how he can function when his meds wear off (just for your own information, as you think this through). *</p>
<p>He has close to zero concentration on his HW at night when his meds wear off. It’s always been a race against the clock to get it done…what would normally take 30 minutes takes hours and hours.</p>
<p>The audition results were posted that night. He’s in the terrible position of being an Alternate, meaning he goes on if someone fails a class or otherwise becomes ineligible, meaning he was extremely close to making it.</p>
<p>When I was in high school, I was the first alternate for regional band, and there were only two people playing that instrument in the band. One of them did drop out. So it can happen.</p>
<p>Boys seem to be more likely to fail a class than girls, but it’s a bad thing to hope for. The alternates generally hope for someone to get a bad cold or something similar.</p>
<p>Yeah, maybe the Jonas Brothers (who live nearby) will want to adopt a 4th “brother” for their act, and they’ll find one of the boys who ranked ahead of Son.</p>
<p>Missypie- it might be a good time to talk to the prescribing dr about trying some new meds and also to the disabilities person at some of the different colleges for advice.
My son during senior yr played around with different meds and combinations of meds. After trying several different meds he settled on Adderall XR during the school day. He also was taking a night class at the CC one night a week. On those nights he took regular Ritalin in a small dosage so he could concentrate through the class.
Another option my son’s Dr tried was the Daytrana patch which is the same drug as Ritalin delivered through the skin. Once you pull the patch off it wears off fairly quickly. That way it doesn’t effect the ability to fall asleep at night.
We have had no problem with the insurance company covering any of the standard ADD meds. They did have a problem with the Daytrana patch and with the newer form of adderall (starts with a V- the name is escaping me right now). What did change was that they no longer covered the psychiatrist visit at the same rate. Prior to 18 they paid almost the whole visit. After 18 they considered it the same as their mental health benefit which they only pay 60 dollars. Huge difference. For that reason we are don’t encourage to many visits with that particular MD.
Also college courses are on such a different schedule then high school. It takes some ADD students some time to figure out how to schedule classes, studying and when to take the meds for maximum benefit. A student might have a class at 9 am but also a class that meets from 4-6 in the afternoon/evening. Better to figure out the med issues now and discuss different scenarios.</p>