How to parent a child on steroids
How’s that for a parenting book title? Or how about Sleepless parenting? Well, they obviously don’t exist. But they should. What I really need is a book titled Practical parenting advice for the sleep deprived parent parenting the sleep deprived sick child on steroids. Yup. That about captures our reality. Instead I’m left leafing through my library copy of Hal Runkel’s ScreamFree Parenting and feeling defeated. 
Being the calming influence in the household is a noble ideal, and I want to get there. But why is it that this, like all other parenting books I’ve skimmed, was apparently written for a family where everyone gets eight hours of sleep a night, has the time and bandwidth to read parenting books, and is otherwise healthy and content? (And why, for that matter, this book, like the majority of parenting books out there is written by a white male with a successful career built around parenting advice? In reality, how many fathers are the primary caretakers, dealing with most of the day to day challenges of parenting a child? I bet Mr. Runkel’s wife was doing the doing while he was (is) doing the writing and lecturing. But I’ll leave that for another rant.)
Let’s get back to our situation and that, I suspect, of many families of food allergic, asthmatic, refluxing kids. It’s a different ball game when you are dealing with a kid on steroids and other drugs who wakes hourly, five to six times a night (Annika’s record was every twenty minutes) in pain from acid reflux, coughing, snotty or wheezing or with (possibly drug side effect induced) nightmares. It’s your job to calm your hysterical, kicking and screaming child down, make them comfortable, soothe them back to sleep and do it all with patience and grace. And you do it once, twice, three times or more, night after night. But eventually you become so trashed from sheer exhaustion that one night you break down in tears and snarl at your spouse as you argue whose turn it is to deal. Worse, you do it in front of your child, adding to the trauma. That’s night time parenting at its finest. In the light of day (sometimes even just a few minutes later) you regret it and feel like the world’s worst parent and the world’s worst spouse.
There’s a reason sleep deprivation is considered a form of torture. It breaks you down. It makes you crazy. You can’t function and be a patient parent or a patient spouse or a patient human. You’re stuck at the bottom of Maslow’s Hierarchy of Needs like a hamster in a wheel. 
When you are sleep deprived to the breaking point you go into this brain stump mode and you say and do things you later regret saying and doing. And if you lose your cool you feel resentful and guilty for having most likely psychologically damaged your child. So it’s tantamount to get your child’s symptoms (asthma, reflux, whatever) under control so you all get some sleep at night. And so you medicate your child.
And that brings me to the daytime parenting challenge. When short on patience from sleep deprivation, how do you then gracefully parent and effectively discipline a child on drugs, and steroids in particular? Annika takes the standard asthmatic child cold season dose of two puffs of Flovent (Fluticasone) twice a day. I hate this drug. It has bad side effects. It causes children to grow more slowly. It may cause glaucoma or cataracts and increase the risk of osteoporosis in long-term users. And those risks are on top of a long list of side effects, which include headache, sore throat, cough, (ironically) shortness of breath, hoarseness and psychological effects such as depression and anxiety. 
I cannot know for sure what Annika feels, but while on Flovent or oral steroids like Prednisolone (one brand name is PEDIAPRED®) my sweet girl turns into the Tasmanian Devil on meth. She becomes contrary about every little thing. She challenges me at every step, saying “No!” no matter what she’s asked, and she pushes boundaries with gusto. She goes manic, tantrums, cries a lot and frequently goes into what we’ve dubbed “death and destruction” mode. She turns into a textbook ADHD child. She rampages through the house, grabbing and throwing random objects on the floor, banging things together, screaming and shouting loudly, ignoring every request to stop. She’s constantly hungry and wants to eat all day, all the time and tantrums when not given what she wants. She always gains weight after being on steroids for a week or more. After three days on Flovent she gets to the point where she works herself up into a frenzy and can be so out of it that she is not capable of making eye contact, never mind focusing or listening. She just whines and cries and trashes. In the midst of this she sometimes has moments of self awareness and covering her ears with her hands says “I can’t take this, I can’t take this” over and over again. It’s hard to watch.
So how to discipline a child like that without feeling (and often acting) like a bully? After all, it’s not really “her”, it’s the effect of the drug. But you have to do something since you are witnessing damage to property, sanity and risking injury. Annika in that mode has hurt herself, falling, tripping and running into walls and furniture. She currently sports a big bruise on her right cheek from hitting herself on a chair at the allergist’s office after tripping over while running all over the room. I often end up physically restraining her or yelling and then feeling bad about it. And then how to determine where the drug induced behavior ends and the “normal” three and half year old antics start? When I asked Dr. B. about this, she confirmed that most children experience behavioral side effects from steroids. And said that’s why they (the doctors) try to give them (the kids) “a break from the steroids over the Summer”. So effectively I’m expected to accept that my child will be like that for a minimum of nine months out of the year? That’s not acceptable.
So that’s why I’m on a mission to eliminate steroids out of her body and out of her (and our) life. And that means understanding all the alternatives and doggedly pursuing all the research out there on non-steroidal management of asthma. So if I seem obsessed about this topic, I am. I am pursuing better health for my child, better sleep for my family, and better parenting for me.
