I have a lot of patients that have run into similar situations as they transition to adult medicine. Around here a lot of family docs and internal medicine docs will not prescribe ADHD meds and require people to see psychiatry. So like others have said, I don't think they are necessarily targeting your son in particular. I don't know of any laws that require testing for Vyvanse or other ADHD meds. I do think some practices require it and if the doc is part of a large practice (especially a very large group like Privia or Kaiser) they may have a protocol he has to follow. I can't imagine what they are looking for with the lipid and CMP unless they are just looking for very general signs of liver damage from drug/alcohol use but Vyvanse shouldn't directly cause any effects on liver/kidneys. The drug screen is probably to look for signs of other drug use or I think some practices use it to test to see if the person is taking the med as opposed to selling it. Which is kind of stupid, IMO as Vyvanse is metabolized very quickly and you would only have to take it for a day or two for it to show up in your urine. So a scheduled drug test really does not prove you are taking it regularly. The EKG is more standard. About 10 years-15 years ago or maybe more there was a lot of concern about possibly arrhythmia with amphetamines due to a paper that came out. For awhile we screened everyone but that quickly was not recommended by most medical associations as more data came out. It is now thought to "unmask" arrhythmia so we only screen people with a family history and no longer screen everyone. But I know some doctors who are very worried about litigation and so screen everyone as a protection. I would ask if they can use the diagnosis from the neuropsychiatrist if you have that letter. Sometimes I do have people come to me saying they have the diagnosis. I usually do ask them to provide the information from the previous doctor rather than just prescribing. But if they have that data, I don't require retesting. If the practice at large requires these tests for everyone, it's not surprising that they just make it a blanket policy. I do think the requirements seem on the harsh side and possibly designed on some level to have people seek care for this diagnosis elsewhere.However, in some ways, it's better to not have the doctor judging who needs extra monitoring/information and who doesn't. Similarly, we require a pregnancy test on every teen girl we start birth control on even if they are not sexually active. Some get upset but I just tell them it's our policy. I know for some patients it seems we aren't trusting them but the sad fact is that people lie all the time to doctors. So instead of making the judgment that "this girl seems like she might be lying" and "this one seems like she's telling the truth" they all get a pregnancy test. And having it be practice policy does make it easier for me as an individual physician. And Vyvanse is definitely abused. It's not as easy to get a quick high as Adderall which is the most diverted (sold to someone who it isn't prescribed for) medication in the country but you can get high on it and people do abuse it. Doctors are very wary of being used as a way of getting drugs. And if it makes you feel less targeted...my 76 year old father has to go through similar hoops for Gabapentin which is also a controlled substance. He has been on it for 20+ years for neuropathy and he still has to go in and get the prescriptions and can't get it filled at all early, etc. And it drives him crazy.

This article recently was in The Washington Post. You can set up any iPhone to have assistive access which I think was more designed for people with cognitive disabilities but would work for kids to make it a bare bones phone. The article suggested it for this reason (kid) or for people who want to really have a less distracting phone. The only apps that will show up are camera, calls, messages, and maps. I think you can add others if you want. There will be a password needed to access. I'm not the most techy person but per the article it is more difficult to get around (I think more steps) than if you just set up a parental password or parental controls. https://www.washingtonpost.com/technology/2024/04/03/iphone-assistive-access-kids-seniors/

I was going to ask this also. Having two teenage drivers who I've driven with on lots of highways (and on the Beltway/highways around our home in NoVA) this is what I do. (Just to clarify...I don't do this when they are learning to drive but my oldest is now almost 21 and my second is almost 18. I would comment if I thought they were being dangerous or aggressive but I've realized it isn't their driving as much as my anxiety so I'm found it better to address the actual problem which is me rather than them.)

Yes, same here.

12 is a HARD age. And it sounds like you also have had other hard things going on. I would sit down with your son and talk about goals and what he wants and likes and dislikes. When I was homeschooling (my second two kids are in public school now for high school) I did that from time to time, especially when things weren't going well. The rules were that they couldn't just say "I hate everything". When he wakes up and doesn't want to "do" school what does that mean? Is it he wants to sit and play video games all day? Is it that he doesn't like formal things like workbooks? Is it that the work is too easy or too hard? Does he need more social outlets? At 12 he should be able to at least give you some ideas of what he likes and what he doesn't even if it might be like pulling teeth or interrogating a secret agent to get the information. I agree with Farrar that middle school is kind of an educational time to reset or just do what you want. I'd think of it in terms of goals. What do you want him to go into high school with? Can he read and discuss a book? Is he where he needs to be in math? Is he developing his own interests? And what do you want your relationship to be? And then think about ways to get to those goals rather than thinking in terms of subjects or what you have to do to mimic brick and mortar school. Pick the very very basics and talk about those being non-negotiable and then let him have a lot of leeway to do what he wants with the rest of his time. (Obviously within parameters...not all day on the computer or video games, not doing destructive things, etc).

This is true. My husband's father left their house to all four siblings. Sister strongly wanted to keep it and didn't want to sell. Others did. Luckily, the one who wanted to keep it was the one who had the best ability to pay for it (she's a single ER doctor). She ended up buying it from all three siblings but even though they had known this would be the plan well in advance and had it all written up and done carefully it was complicated and there were some hurt feelings for various reasons. She paid the siblings off at different speeds, which they agreed to as they had different needs and financial circumstances. With us we essentially treated it like she had a mortgage with us. We had a payment schedule drawn up, that included interest and she paid us each month for a few years. She paid off one brother fairly quickly as he had the largest need. And she paid off their sister second...she had kids in college and didn't want a influx of money coming that would affect their financial aid packages (she was also a newly divorced single parent who needed the financial aid even if she did get the money), then when the kids were out of college the money was useful to her. We were the most stable financially so got paid off the slowest, which was fine, it was kind of nice having the extra payment each month. But even though it was all fairly smooth as these things go...there were still issues. It think it's just always tough combining families and finances. There are feelings that make things messy.

Without knowing more about relationships...I'd try and not assume that your worth to your parents is related to the inheritance. My Mom had a smilarish situation with her parents. At the time of their death, her sister was given a house at the beach that their parents had bought but she lived in. My Mom was given the family home/land but with the contingency that it was only hers in her lifetime and would pass on to me (I'm an only child). My Mom was deeply hurt as she felt her parents didn't value her as a person and gave her "nothing". And I understood how she felt but I also could see why they did it. Her sister had been and alcoholic and drug addict and didn't really work and only really had this house, no kids and no family and not much else in life. She had been living in it and they left it to her to stay in. And my grandparents lived in a house that had been in the family for many years and had a lot of surrounding farmland. No part of the family had stayed in the area and I think leaving it in the will so it had to be passed down was his way of hoping that someone would come back. I thought it was shortsighted and hurtful but I also didn't think in anyway that it meant he valued her or loved her less. But she spend the rest of her life bitter over it. It sounds to me like your Dad appreciates the idea that the house and property are together and appreciates that your sister seems to value it as well. The will is still hurtful and sucks but may be more about the property staying together than the value is placing on individuals.

I think one reason for all the hype is that there are less and less big shared experiences, especially non-virtual ones. I think a lot of people just appreciate being able to get excited about something that other people are excited about and that isn't really controversial. I mean even the "controversy" of some people not getting the hype isn't the same as the amount of discord and venom over so much else in society. There really wasn't any harm in getting excited about it or harm in not being excited about it. So much else right now just feels heavy and like you have to pick a side and it matters. We are in an area that was at about 88%. I thought it was really cool. Our office blocked out a time when it was right before and at peak and we all went outside to see. There were lots of other people and just an atmosphere of people being excited. There were several people walking by that didn't have glasses and I offered them mind to see and they were really happy, including one elderly man who was just absolutely thrilled to have seen it. That was just a fun human experience. And it was fun to know that my kids were looking at it after school and my husband at his work and my son who was in totality and also all the other humans who were excited.

I feel for her and haven't personally really engaged in posting anything anywhere about her. But whenever this kind of thing comes up I do have the thought that the royals basically get paid to be public figures. That is their job, or at least a large part of it. I'm not British so if I'm wrong, I stand corrected. But I think it is somewhat difficult to ask people to respect the privacy of someone who is basically living a life of extreme privilege with the understanding that her job is to perform public "duties". I think the system is really messed up and I don't have a great answer for it...and I when I say I think it's difficult to ask people to respect the privacy, I don't mean that it's okay for someone medical to leak information. I mean that I've just seen so many ordinary people get shamed for having posted and wondered about this....but in reality that is what keeps the royals relevant- people are interested in their lives. I kind of feel the same about other celebrities. There are celebrities that have made very obvious choices to keep their kids away from the public, even though they themselves are very very famous. They seem to really live a professional life and a personal one. So it can be done, even at a high level of fame, but it probably takes sacrifices that some aren't willing to make. Bono comes to mind as one person who seems to have mostly kept his family very private until they were basically of age to choose for themselves. And then there are other celebrities that seem to post about their kids and their marriages and such but then get upset when people speculate about them or don't honor their privacy when they ask for it. Examples of those to me are more people who are social media celebrities and profit over their marriage/family. I don't know. There aren't easy answers. But it just feels like to me now that all the people jumping on the "shame bandwagon" for those who have speculated at Kate are kind of doing the same thing to those people that they are upset was done to Kate. It's a bigger issue that one individual woman.

1. A stethoscope. 🙂 2. A book, pretty much always. Also a notebook I use as my sort of peripheral brain. 3. Lipstick. 4. I often wish I had mints, but I always forget to buy them.

I like my Birkenstocks for the summer. I have had On shoes for walking and LOVE them. I recently got a pair of the On Cloud5 which have "speed laces" so you don't have to tie them. They aren't quite as slip on and go as something like clogs but it's pretty close and they are incredibly comfortable.

We have a lot of stuff on our walls, although I would have said I tend more towards minimalism. Our living room. It's been collected overtime. Frames don't match but we went with the black/white for cohesion. Our dining room has photos we've taken, in cheap black frames. We've had different themes but the current one has been up there a long time. It's mostly food related signs. Sorry, the photo isn't great. In one bathroom we have photos of the kids that are all water themed (swimming/beach/etc). We used cheap Ikea frames and switch out the photos every few years. In another bathroom we have photos taken from vacations, also loosely water themed. We have lots more art and pictures. One current thing I'm loving is just having these postcards from various places on a shelf in our foyer.

I don't know if it's seen as much in adults, but in kids we often see post-viral diarrhea. It's often a post-viral lactose intolerance. So when a kid has diarrhea that is persistent after a virus, I'll usually recommend them trying completely going off all dairy. If it is that, it should improve fairly quickly, within a week. And then we usually recommend them continuing for something like 4-6 weeks and gradually reintroducing dairy. I would also say that stool cultures/C diff testing seem warranted, plus a stool guac. All those are pretty easy to do. That all said with the knowledge that 75 years old are way different than kids. So take it with a grain of salt. 🙂 Also I can't think of any virus that would cause symptoms for months and then come back. And I don't know of any antivirals to take for diarrheal illnesses....but again, I don't see adults and adult medicine is very different.

My middle son was like this. What finally worked for us (at the recommendation of a LC) was to feed him sitting on the person's lap facing outwards, so not at all in the usual "feeding position". He would take enough that way to get him through. I worked about 8 hours at time twice a week and dh was home with him. Dh could get him to take just enough that way so that he was satisfied but he would eat a ton as soon as I walked in the door. He would never take the bottle from me or if I was in the house.

Yes, 100% agree. People forget in an emergency. People sometimes say things wrong. People don't define things the same ways medical people would. "I don't have asthma but I just always use an inhaler when I exercise or have a cold." That IS asthma. With the meds..the best is being told the colors. "A pink pill and a yellow one." Okay, well that narrows it down.

I was at an escape room once with five boys, all middle schoolers (two were my kids). They were all homeschooled or went to a small private school. They were all smart kids. One ended up scoring perfectly on the SAT math section, one is National Merit Scholar studying computers and robotics, one is a chemistry major, etc. I was only in there because this particular escape room required an adult. I kind of just stood there and let them solve everything, which they did- quickly and easily. Until they got to the combination lock. They knew the numbers from another puzzle but none of them had any idea how to do it. And combination locks really aren't intuitive if you haven't been taught. I opened it for them and rose in their estimation...it was like I had superskills in their minds. 😁

Two thoughts... -This reminds me a little of one of my least favorite phrases in the homeschool world "never do things for your kids that they can do for themselves". I don't know if it's still said a lot, but I heard it all the time when my kids were younger as a parenting "rule". And it used to really bug me and still does. I finally figured out (pun intended) that what bothered me about it was that I wouldn't treat other adults that way, including my husband, so why would I treat my kids that way? I do things for my kids all the time that they can do for themselves. I also do things for my husband that he can do for himself. Why? Because I love them. And they do things for me that I can do for myself. The problem, in my opinion, comes when you start doing everything for someone else so they don't/can't do it for themselves or if they expect you to always do it (especially in the case of a spouse). Balance is key. Similarly, I think, if you are always solving someone's problems, that's a problem. But if I know how to do a combo lock, why not just teach my kids how to do it? Some things they have to figure out how to navigate and part of figuring parenting out is to know when to help and when to step back but I do think it's fine and good to help your kids when they need it. -The OP reminds me a bit of the attitude a lot of doctors have about medical education. I was in the older generation that came through before a lot of the current reforms and it has changed a TON. And part of what kept it from changing was the attitude that "I had to learn how to stay up of 36 hours at a time and function, these kids can learn it too." There isn't value in doing something hard just because older generations had to do it hard. It's the "walking up hill through the snow both ways" kind of attitude. I had to figure a lot out myself when I was a teen because of family dysfunction (alcoholism, mental illness) and although I was able to do it, I am grateful for the people who did help me along the way and I'm really glad that my kids have more help than I did.

My kids can get a locker at their school if they want one. They don't have one. They said mostly it's kids who have an instrument to store or some large sports equipment but that most people don't have them. Their main raise is that they don't have feel like they would have time between classes. They also have only four classes a day max and they really don't have any textbooks to carry, pretty much everything is sources on the laptop or books they can leave at home or they use in the classroom. So they aren't carrying a ton of stuff with them.

I'm a pediatrician and yes, this is a huge problem. Some things we have had some people do that work (and yes I'm aware that not all of these are going to work for everyone or are great solutions...) -Switch to a different med. This isn't always ideal but sometimes the generic is available (or alternatively the brand) or sometimes you can make a switch to a different but similar med. Unfortunately, it is somewhat pharmacy and area dependent what is available so I can't totally say what to switch to but his doctor may know. For example, Focalin is the dexmethypenidate...if he hasn't tired it he might do well with the methylphenidate XR forms that are out there. The dosage isn't one to one and you'd have to play around to figure out the right dosage but it might be worth it if he's never tried it and it is more available where he is. -Mail order pharmacies. Sometimes these are more available, and often 90 day prescriptions are allowed by mail order even if your insurance usually allows 30..that at least diminishes the amount of times you have to have this battle. -I've had some patients ask for handwritten prescriptions and then they can physically take them to the pharmacy, that way when they find somewhere that has it they can get it filled instead of having to call and risk having the pharmacy run out while they wait for the prescription to get sent in. -Ask the doctors office if they know of pharmacies that do have the meds...we have a list we try and keep up to date in our office of what is in stock where so we can try and just send it in somewhere that has them.

We live in Northern Virginia, outside DC. The area as a whole gets dumped on a lot by people elsewhere and even by locals. There are a lot of things not to like (traffic, cost of living) but a lot of things to really like. As we have started to talk about where we might one day want to retire, we keep coming back to we like it here. -Four seasons -Lots of opportunities for culture (free museums, theater, any kind of performance of anything) -Ethnic food (one of our nieces lives in Wisconsin in a gorgeous resort kind of town and she really really misses the food here). This would be the hardest for dh to move away from. He would really miss not having an Asian grocery store to go to regularly. -Close enough to lots of other places...beach and mountains are two hours away, NYC is close. -Great community supports (libraries, community college system, parks/rec centers, trails)

You could definitely live in DC without a car. We also know people who lived in the closer-in suburbs like Arlington with no car, they just lived along a Metro. You can also use Zipcar which is a car sharing service. People I know use that if they mostly live without a car but need one for some reason. (Example, picking up furniture at Ikea or going on a day trip.)

Podcast: The Popcast when I just want to laugh. Pantsuit Politics is a close second when I want something more substantive. Book: Demon Copperhead. Purchase: On shoes. They have saved my feet. Life Hack: Getting two separate duvets and a king sized bed. It's like sleeping separately, but in the same room. I'd be ok in separate rooms, dh isn't. This is a great compromise and has revolutionized my sleep. Biggest Regret: Nothing major. Life Easier: Let other people do more and stopped micromanaging how they do it. High Point: Lots of performances: King Lear at Shakespeare Theater, Giselle by ABT at Wolftrap, Indigo Girls concert. But also just having my oldest home from college over the summer and all the little everyday stuff we did as a family when he was here.

I checked the first one but I think there is a difference between "tell everything that is in your head" and "bare your soul" and even "confess every sin". I think I can tell dh everything and he would forgive me. But I don't tell him everything that is in my head and I don't think he would want me to. Sometimes he annoys me or I'm bugged by him, I don't tell him that. And I wouldn't want him to tell me everything I do that annoys him. It's not that I couldn't tell him and he wouldn't love me...it's just that I don't think a relationship has to share every single detail to be healthy. Maybe there is a difference between hiding things because you are afraid of what the other person will think and just not sharing because you don't want to. When we were getting married the common advice was to "not let the sun go down on your anger." My pastor's wife at the time gave me great advice. She was a very outspoken and strong woman but she said her advice was "not everything in your head needs to be said aloud". She added "Sometimes, just go to bed and let the light of a new day shine on whatever it is." Those were great pieces of advice.

As a pediatrician, we see people up until 21. We'll see some young adults a bit after that depending on circumstances but we run into issues with insurance after 23 (they often won't cover them seeing a pediatrician) and I think they are better served seeing an adult doctor. If they haven't switched before we start talking to them around age 20 about transitioning to an adult doctor. I also have a lot of parents who ask in the teen years if they should switch and I always answer that I think it depends on the teen and what they are comfortable with. Some prefer to switch to a family doctor as they hate coming to the "baby doctor" but some feel like that they would rather see someone they know than someone new. I personally think they should do whatever the teen prefers. Specialists are a real problem for the kids who are 17-18. Most pediatric specialists won't see new patients who are 18 and older, and some won't make appointments if they even are about to turn 18. I don't know if it's an issue for them with insurance or it's just their policy. Most adult specialists won't see people under the age of 18. So it' snot an uncommon issue for me to have a patient who I need to refer who is 17 and 9 months. The adult doc doesn't want to see them yet and sometimes the pediatric person doesn't either, or they can't get an appointment with them before they are 18. I will say usually if I can call and talk to the doctor themselves and explain the situation they will make exceptions, it's just the front office usually has a policy they are told and they will stick by the age when the parents call. The exception is for people who have seen the specialists for years for a chronic condition or who have a disease that isn't seen as often in adults, sometimes due to typical age of survival. For example, a lot of kids who had complex cardiac defects continue to see the pediatric cardiologist well past 21. Kids with cystic fibrosis used to only see pediatric pulmonologists because there weren't many people who survived into adulthood so the adult pulmonologists weren't as used to seeing them, but that has changed. I have a patient with muscular dystrophy who will probably stay at the same muscular dystrophy clinic that cares for all ages. Same is true for complex genetic disorders.

-Yes you can go in some museums with backpacks. You have to go through security. A few museums will make you check a bag if it's big (usually the art museums) or carry it on your front. If they make you check it, it's free. -Very little requires advanced/timed tickets. The Museum of African American History does. Holocaust museum does. Some specific exhibits will, but I don't know of any right now that do (like when the Vermeer exhibit was at National Gallery you had to have a timed ticket for that but could go to the rest of the museum without it). -You could easily go to all free museums. The Spy Museum has a fee (and is worth it IMO). And then some of the art museums further afield (Philips Gallery) do. But the Smithsonian museums are all free. -Food is a little harder to find on the mall. It's somewhat overpriced. The museum cafeterias are kind of what you expect. The American Indian Museum and the African American Museum both have excellent food. You can find the menus online if you want to look. There are a lot of food trucks that park along the mall. if you venture away from the mall, yes it's very easy to find whatever kind of food you want. Vegan, gluten free, etc. You don't have to go far. It wouldn't be hard to take food outdoors, but March can be kind of iffy weather here and it might be chilly. We used to picnic on the mall all the time when my kids were younger.