Ha! You thought I'd spelled that wrong didn't you, tics? But I wasn't referring to the insect variety, as in wood ticks, but more alarming nervous tics.
This was the first summer I had ever worked full time since Katie was born. There was no way she and her 13 y.o. sister Melanie could be home alone together all day, every day, so I enrolled Katie in a park program 3 days a week, ED-Venture Club. She enjoyed it very much as she is truly a social butterfly & is dead bored without other kids to play with.
I believe I've mentioned before Katie's occasional problems with extreme, painful constipation. At the very end of the school year or early summer she had one of these occasions just before we left for the drive to her Dad's house (an hour and a half away). She tried and tried to go for nearly an hour after school, grunting and groaning and crying, but without success. Declaring herself unable to go at the moment, we loaded up on Miralax and set off on the drive. All the way there I kept hearing little whimpers, grunts, or "hm"s from the back seat as she struggled with her discomfort.
When they returned, I continued to hear her making the the little "hm" noises, and assumed she was still having trouble. But no, she had relieved herself at her dad's (w/lots more Miralax) and had been going regularly since. I asked if she was sure, coz she was making that little noise like when she has to go, but she assured me she didn't. I continued to hear it randomly, and once or twice asked her why she'd just made that noise, but she either didn't remember making any noise, or didn't know why she had. I wondered if this was some sort of tic (I have an aunt with a throat-clearing tic) or just a habit, and decided to ignore it so as not to reinforce it. It did become very annoying for a while though, like someone next to you sniffling repeatedly.
A couple weeks later she told me that she had been nodding her head at summer program and the teacher told her she shouldn't do that so much/or so hard, that she was going to hurt her neck or head. I found this odd and couldn't imagine what she must've been doing. Pretending to head bang to some music on the radio? But once it was mentioned, I started to notice it myself. She was nodding her head randomly, and rather hard/forcefully. I'd seen her do this now and then in enthusiastic agreement about something, maybe she was agreeing with some internal monologue in her imagination? Or something more? The "hm"-ing had stopped though.
Finally one night there was another behavior that couldn't be chalked up to anything else. I'd seen it once or twice, but this night my mother asked Kate if there was something bothering her eyes, because she kept blinking, rather rapidly. When I'd noticed before I thought maybe her hair was getting in her eyes. It was a bit of a shaggy cut and the bangs were getting long-ish. That night I had her get a headband to pull all her hair back, but the blinking continued. She said nothing was bothering her eyes, she didn't know why she was blinking so much, and went on playing. I quietly observed her and was alarmed to see she was blinking, hard, over 30+ times a minute. A definite tic. A hard blink that was almost a grimace, pulling up the corners of her mouth as well.
I called her pediatrician the next morning and they were able to see her right away. That morning Katie complained that her eyes ached, like they were bruised. I'm sure the muscles were tired from such forceful overuse.
Dr Edward's first thought was that the ADHD medication could be causing it, though Kate had been on the Concerta for over a year, so it seemed strange that this would start now. I was concerned that the Concerta may be dampening her appetite anyway, so we agreed to take her off ADHD meds for 2 weeks to allow it to fully leave her system and see what would happen. Two unmedicated weeks sounded daunting, but she really did much better than I feared, not too wild. And boy did her appetite rebound!! Suddenly she couldn't get enough. I knew then that the Concerta was largely responsible for her low weight and decided we were done with that for good!
Two weeks passed unmedicated and the tic was greatly reduced, but still definitely there. We started her on Vyvance to replace the Concerta. The nurse said tics are tricky, they can seem to pop up out of nowhere and sometimes they just don't find a cause. Most likely it was related to anxiety. So, for the time being we just tried to ignore it. I'm not terribly disturbed by it, though I admit I don't like the way it looks when she does it. It looks weird, and that's not easy for a mother, but I don't mention it. I just don't want it to become an issue with her peers, if they start to notice it and she ends up teased about it.
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