twenty-nine: low and slow

Here’s the cycle that follows for the next several weeks:

Dr. Ivy increases Dora’s ADHD medication dose eversoslightly. “The guiding principle on dosage increases is low and slow,” says Dr. Ivy, too many times to count.  She hyper-articulates “low and slow” as if she is on Sesame Street teeing up a song about things that are low and slow, like snails or a bad pitch. 

After the increase, Dora becomes our wonderful, beautiful, happy little girl again.  

It’s been many years, or maybe never since we’ve seen our calm, sweet, “in-control” kid again and I am elated.  Elated.

On the seventh day, Dora becomes increasingly irritable for the next two days until she is riding the mechanical bull of irrational emotions.  

These “tantrums” are entirely new and they go to eleven.  They involve the kind of anger and snark you might expect from an irritable fifteen year-old, not a nine year-old.  They involve tears and a clammy forehead and “not feeling well”. They involve anger and sadness and anger again and sweating and needing to lie down. 

Wow, look at the bullet we dodged when she was little, I marvel to David, This must be what kid ‘tantrums’ look like! 


After an hour, the tantrum ends like a fiery plane crash in a mess of sadness, exhaustion and wet-cheeked sleep, after which I leave an urgent, after-hours message for Dr. Ivy.  

The next morning Dr Ivy returns my call, reminding me of her phone consultation fee at the start of each discussion before assuring us that Dora’s behavior is “completely normal” and instructing us to increase Dora’s dose again.  “We’ll go low and slow until Dora reaches an efficacious dose,” at which point “her behaviors will level out.”

So we increase the dose ever so slightly, rendering Dora an instant-sweetheart for the next seven days, until she isn’t.  

Lather, Rinse, Repeat.

But oh, when times are good, they are extraordinary.

I can see her, my Dora. I can see her very clearly, right through the noisy interference of those chaotic ADHD signals.  My Dora is Well and she is focused and she is in total command of her body. She no longer looks like she’s constantly being lightly poked with pins. 

With each cycle, the crashes are less severe. <—-  This is what I tell myself. 

We are leveling out, I tell myself, and David, and my mother.  I say it confidently, like an airline pilot announcing our up-and-out climb from that little pocket of turbulence over Salt Lake City. 

I refuse to believe otherwise because I can see the future.

I see what my beautiful, Well Dora looks like, and I aim to keep her there through the miracle of modern chemistry.

It won’t be long now until we reach full efficacy.







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