I think she's going to have to go back to her pill in the morning but stick to the lower dose patch. Dropping the dose didn't seem to make a difference in terms of reducing side effects anyway (although she still will be on a lower dose now than before). The other teacher didn't know if the pill made a difference but that was probably because she was reading in the morning when she got to school, so it wouldn't have. I'm saving all emails so I can show a history and so that I can use it when I make a case for whatever accommodations or services I think she should have. Honestly, I think she is bad enough that if she wasn't medicated at all she would need an aide, because she would do absolutely zero work.