Teenager & medication?

[SunSetDreaming]

My 15 yr old has a serious medical condition, they require tablets to be taken with all food.

If they don’t take the medication, short term consequence is diahorea (which is near constant at the moment). Long term consequences could be severe inc. infections, having to have a feeding tube etc.

Their Dad (my ex) thinks we need to monitor every meal they have & every tablet they take including counting how many tablets he takes to school for lunch & counting them every evening.

I think (but don’t know if IABU) that at 15 I can’t monitor this, as to me it’s something like brushing his teeth - I can’t continuously check he’s done it or force him to do it.

I do encourage, nag, remind but don’t think I should be counting / evidence checking at every meal.

AIBU? What would you do?

Has she got CF? At that age she should be managing it herself. Presumably with those side effects she's not going to miss them out.

Is there any reason to think she isn't taking the medication appropriately?

Him sorry. If he's managing the regime successfully then clearly he doesn't need monitoring. If he isn't then he may well do in the short term, but with a view to not needing to longer term.

Is there any reason why (such as having a learning disability) she can't do her medication herself?

My approach would probably be similar to yours. Your ex's approach may be well intentioned, but I think a 15 year old would probably push back and object if treated like a much younger child.

My DD1 had a friend who had CF. I knew the mum reasonably well too. By the time the girl was in her teens she could manage most things related to the condition herself. I remember when she would come to tea at our house (while they were still in the infants at school) and I would have to make sure she took her meds before eating. I would expect a teenager to manage that themselves, although I probably would just ask them if they had done so.

Actually, I think your ex has a point.

Your teenager isn't managing his health well and is having early symptoms of that. You both need to find a way to work together with him.

Is there an alternative method of getting medication into your teenager? Another med that can be taken once a day? Is it worth booking a review with a Dr (GP, specialist, whoever manages his care) or practice nurse etc?

I should add to my previous post:

If, as you say, your DS has almost constant diarrhoea at the moment, that could potentially indicate that either he hasn't been taking his medication properly (or maybe at all) or possibly that the dose needs to be reviewed by the doctor?

I don't know how schools manage this sort of thing with teenagers, but maybe it would be worth asking them about it? Some secondary schools may have a nurse or someone with some basic medical training who takes charge of things like that. The school that two of my three DDs went to did, and the youngest of those is not quite 20 yet.

It's a difficult age for this sort of thing - we've also had difficulties with a 15 year old not quite managing her own self-care (although we're lucky enough that it wasn't a chronic condition). At one point she did concede that yes, she did need the reminders even if she snapped at us when we nagged her. Our practice nurse was good with her - asked to see her at one point (having had a telephone appointment with me and a photo). I felt terrible for not having monitored more closely, but the nurse understood that with a 15 year old, they need to take on the responsibility themselves, and used the opportunity to put the frighteners on her a bit.

If he's taking the medication, then it sounds like it might be worth an appointment to discuss the diarrhoea; if he's not, then maybe that appointment is an opportunity for GP/nurse to put a bit of pressure on, either for him to find a system or to agree a system for you to remind him. If he's really messing up on taking them, maybe a reminder in his phone and he texts you when he's taken them - and once he's managed a month of doing that reliably, review whether the texts are necessary.

All DD's initial medical appointments since covid have been "someone will call you", and they've just spoken to me without needing to speak to DD. That's possible while they're still 15, but I would guess that it's not once they turn 16 - I think that's the point at which parents are not entitled to know what goes on between them and the doctor. So if he's nearing 16, I would do something now!

Personally I dish out the meds to my 15 year old at the correct time. But then my younger dc has previously attempted suicide with an overdose so all meds are kept in a locked safe now. I do encourage my 15 year old to have an alarm on his phone and ask for the meds himself to try and encourage independence.

My child has had this medication from birth & it has to be taken with every meal so no option to change the way it is taken.

As a child we, as parents, obviously managed all their meds but they’ve been successfully doing it by them self since about the age of 10.

Now as a teenager, they’ve just stopped bothering. Literally can’t be arsed.

We know they’re not taking them as have found discarded pots of tablets & without going into too much detail - it’s obvious by the state of the toilet.

We have clinic with a paediatric consultant every two months where the message is constantly reiterated that this medication is vitally important.

They just don’t care!

Your ex is right - if your child can't be trusted to take his medication, you need to be micromanaging.

But you're both missing the big picture. Your child has stopped taking vital medication. They are well aware that doing this long term could have devastating impacts on their health, and yet they still don't take it. That to me says mental health crisis. I think you need to take drastic action here and get your son in front of a therapist ASAP as he's basically self harming by not correctly following his medication regimen.

In that case I think your ex is right. The medication is more important than parenting correctly.

Good point from malificent.

They do need to be monitoring their condition and taking meds themselves at 15. The problem is that they aren't- their consultant or more likely a specialist nurse needs to get to the bottom of why they aren't taking them, explain why they are taking them and potentially look at other options now they can consent themselves - in 15 years new options could be available.

It's tough, I have a dd whose non compliant on meds, very different reasons for needing meds.

I’ve just had a conversation with them & read out a few of these responses.

I think mental health crisis is definitely off the cards.

Basically, they’re fed up with all of the medical intervention, they don’t want to bother. They said it’s because of “forgetting” but when pushed (I said I could text reminders or set up a timer), they’re just not interested.

I just think at 15, they don’t care about the long term impact & just don’t want to have to do it anymore.

It sounds like they just want to be "normal" which is totally understandable.

Have you had a chance to explore the psychological impact of a chronic condition for a teen? It's possible you'd is about independence and being the same as their peers.

By way of example:
parentandteen.com/teen-chronic-illness/

I'm actually beginning to think that your ex has a point here, having read your last update, although it will be very hard with a teenager, who will probably push back and try to find ways to wriggle out of things, perhaps trying to hide evidence as they go.

See if you can get any help from the school to ensure he takes his lunchtime dose. You'll have to supervise breakfast and evening meal doses yourself. This will have to be done until your DS shows that he can again be relied upon to take care of himself.

Is he embarrassed about having to take medication with his school friends around? Has he been teased about it and maybe about what it is for, so now he has stopped taking it? That is something that school should help to deal with.

I would think too that it is also worth having a word with his doctor or consultant. They can impress upon him again how important it is to take the medicine at every mealtime and what will eventually happen if he just stops it without proper medical supervision.

If he still doesn't even seem to care then he might be having a mental health crisis of some sort and could need help there. A referral to CAMHS etc.

Not caring about the long term impact (IE debilitating infections and severe interventions) is absolutely a mental health crisis. Apathy to that extent is often a symptom of depression. Assuming the condition is cystic fibrosis, it is only to be expected that at this age, your son has realised the full significance of his illness - he'll be on medication every day for the rest of what is likely to be an unfairly short life, populated with a disproportionate number of hospital visits. That is a fucking miserable thing for a teen to realise. He has a life limiting illness. He really needs to see a specialist therapist to help him come to terms with this.

MolliciousIntent - what experience do you have of CF?

None directly but a relative has it and went through similar as a teen - helplessness and rage and grief all coming out as adolescent IDGAF.

@SunSetDreaming though this was many years ago and the prognosis may now be much better - I'm sorry if I spoke out of turn there, my phrasing was harsh and I shouldn't have been so blunt.

@MolliciousIntent no worries, it’s a tough topic. Just trying to gauge opinion.