‘I have always felt different’
A paper in this month’s edition of the Journal of Pediatric Nursing describes ADHD from the perspective of college students who have it and have learned to cope.
The subject is interesting for several reasons, not the least of which because it features 16 adults recalling how ADHD affected their lives as children. Plenty of research exists on child and adolescent ADHD, but there is little out there on how the condition affects and has affected adults.
The study, from the University of North Carolina at Greensboro and Wake Forest University, is poignant in interviewees’ descriptions of how it feels to have ADHD — being called “stupid” or “slow,” not having parents understand why things don’t get finished.
The study noted common feelings among the group of loneliness and isolation.
“Can’t anyone see I’m struggling,” one study participant lamented.
Common threads through participants’ lives were:
- Trouble getting along with parents
“In their view, children with ADHD have more trouble than others,” the authors wrote.
One’s adolescence is rough no matter what, “but it tends to be a little rougher on people with special needs,” a participant noted.
Another participant described the “mass chaos fights” with parents and siblings — often due, participants said, to failing to perform chores within an expected time frame.
“Because of their distractibility and hyperactivity, participants said that they had difficulty completing tasks, causing problems with their parents,” the authors wrote.
Some parents provided support, but it was tough for them as well.
“My parents did provide support … with homework; making sure I was on top of things. But it kind of got to the point where it was nagging, but that’s how they got the actual answer from me,” a participant recalled. “They had to play 20 questions. I wasn’t trying to withhold information; it just took 20 questions to get the full description.”
- Missing a lot of material at school
Trouble paying attention and hyperactivity affected participants’ ability to learn.
“In class, I had a kind of lag time, ’cause in-between me figuring out what had been going on, the entire class moved on, so I missed out on information. So that was one of the biggest things — missing out — taking a longer time to get the entire idea,” a participant explained.
Participants learned to cope: They allowed help from their parents, asked for more time on tests or took them in different formats, recorded lectures and re-copied notes after class.
- Feeling different
Children with ADHD felt different in school, and situations such as sitting still and grasping concepts quickly made these differences clear.
“Other kids at school would call them retarded, slow, or stupid, and then ostracize them,” the authors wrote.
As such, they often had trouble making friends, and wondered why people didn’t like them. Social difficulties sometimes persisted into adulthood.
“Not only do I have a tendency to interrupt … but the main problem I have is, you need to think before you say something that can offend other people, or when you ask too many questions … they’ll say it makes them feel uncomfortable,” one participant said.
- Feeling misunderstood
“Friendships for children and adolescents with ADHD were fraught with misunderstandings,” the authors wrote.
One participant described how her friends kidded her about her problem.
“I have friends who say, ‘Oh, it’s my ADD and I don’t want to do my work. It’s my ADD kicking in.’ … and they’ll say it in front of me when they know I have it … and I’ll have it the rest of my life. I’ve gotten very mad at them,” the participant explained.
One participant suggested those with ADHD find friends who understand and will call out their names or tap them on the shoulder when they’re “zoned out.”
In 2003, according to the Centers for Disease Control and Prevention, nearly 8 percent of school-aged children were reported to have ADHD.
I don’t mean to suggest that the themes in the study are unique to those with ADHD, but I do think the research provides a window into how adults with ADHD think and the difficulties they face.
Parents of children with ADHD ought to take a look at it to see what their kids may say about their upbringing a decade from now.
Check out a blog in The New York Times on the study here. To read the study, click here.
For health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.
Jeff Raymond, Medical Writer
Healthy Heart Fair
The Fifteenth Annual Healthy Heart Fair will be from 9 a.m. to 1 p.m. Saturday at the Oklahoma City Community College Union Building, 7777 South May Avenue.
People from across the state are invited to have their cardiovascular health evaluated via a free health screening (fasting is not required for the screening) including cholesterol, blood pressure, glucose and body fat analysis. Attendees can also learn the signs and symptoms of an ailing heart while trained staff will be on-hand to give CPR classes.
An “Ask the Cardiologist” booth will be set up for those that need answers to their heart health questions.
Three one-hour presentations will also be given:
9:30 a.m.
Kris Mullins, M.D.
Heart Checkup: The Many Cardiac Tests Available at Integris Heart Hospital
10:30 a.m.
Terrie Gibson, M.D.
Herbal Medicines: Helpful or Harmful?
11:30 a.m.
Terrie Gibson, M.D.
Health Screenings: Which Ones to Get, Which Ones to Skip
The Healthy Heart Fair is sponsored by Integris Heart Hospital at Baptist Medical Center.
For health and medical news and commentary, visit The Medicine Bag blog at http://blog.newsok.com/health.
Jeff Raymond, Medical Writer
Tips for stuttering
Many people know someone who stutters or stammers — an embarrassing trait that can cause a lifetime of social misery and discomfort. They won’t raise their hand in class and they try to avoid painfully embarrassing situations. The Memphis-based Stuttering Foundation believes that if parents notice their child beginning to stutter, they should seek help as quickly as possible.
The foundation also offers these seven tips:
1 ) Speak with your child in an unhurried way, pausing frequently. Wait a few seconds after your child finishes speaking before you begin to speak. Your own slow, relaxed speech will be far more effective than any criticism or advice such as “slow down” or “try it again slowly.”
2) Reduce the number of questions you ask your child. Children speak more freely if they are expressing their own ideas rather than answering an adult’s questions. Instead of asking questions, simply comment on what your child has said, thereby letting him know you heard him.
3 ) Use your facial expressions and other body language to convey to your child that you are listening to the content of her message , and not to how she’s talking.
4 ) Set aside a few minutes at a regular time each day when you can give your undivided attention to your child. During this time, let the child choose what he would like to do. Let him direct you in activities and decide himself whether to talk or not. When you talk during this special time, use slow, calm, and relaxed speech, with plenty of pauses. This quiet, calm time can be a confidence-builder for younger children, letting them know that a parent enjoys their company.
5) Help all members of the family learn to take turns talking and listening. Children, especially those who stutter, find it much easier to talk when there are few interruptions and they have the listeners’ attention.
6 ) Observe the way you interact with your child. Try to increase those times that give your child the message that you are listening to her and she has plenty of time to talk. Try to decrease criticisms, rapid speech patterns, interruptions, and questions.
7) Above all, convey that you accept your child as he is. The most powerful force will be your support of him, whether he stutters or not.
Jim Killackey, Medical Writer
Stroke guidelines at Baptist
The Integris Cerebrovascular & Stroke Center at Baptist Medical Center is participating in the American Stroke Association’s Get With The Guidelines–Stroke program.
The goal is to improve stroke treatment and prevent future strokes.
The program was developed to help hospitals employ “science-based treatment guidelines,” according to an Integris press release. The guidelines address stroke management and prevention, and the establishment of stroke centers.
“As a GWTG-Stroke participating hospital, Integris Cerebrovascular & Stroke Center at Baptist Medical Center is encouraged to develop a comprehensive system for providing rapid diagnosis and treatment of stroke when patients are admitted to the emergency department. This includes always being equipped to provide brain-imaging scans, making neurologists available to conduct patient evaluations and using clot-busing medications when appropriate,” according to the release.
Treatment and prevention of strokes includes use of statins and anti-platelet medications, treatment of atrial fibrillation and atherosclerosis, and management of weight, diabetes and cholesterol.
Through the GWTG-Stroke program, the American Stroke Association provides Baptist with training and staff recommendations, “care maps,” discharge protocols, standing orders, and data collection and measurement tools.
According to the stroke association, approximately 700,000 people suffer a stroke each year.
For health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.
Jeff Raymond, Medical Writer
Stay healthy this winter
With influenza season arriving in Oklahoma this month, Lauri Smithee, chief of the Acute Disease Service at the Oklahoma Health Department, offers specific instructions for avoiding colds, germs and infectious diseases. Many of which involve basic hygiene.
“If you get sick, it puts you out of commission and that’s no fun, especially if you are a caregiver of children or other family members. There are important steps we all should take,” Smithee said.
Her advice:
- Wash your hands – You’ve heard this before, but washing hands before eating, after visiting the restroom, after changing diapers, after blowing your nose — is the best way to avoid illness .
- Carry hand sanitizers – Alcohol-based hand sanitizers, particularly the ones that are not antibacterial, are good substitutes for hand washing until you get home or to a location where you can wash your hands.
- Watch what you touch – Try to avoid touching things like bathroom door handles (use a towel), escalator rails, elevator buttons (use your knuckle) and pens at checkout counters (carry your own).
- Stay home – When you start to feel bad, stay home. Do not go to work, church or school, and do not visit a nursing home or hospital. This is the time you are most contagious, especially if you have a fever.
- Keep it to yourself – Sneeze into your elbow, not your hand ; if you cough or sneeze into your hand, wash your hands immediately and throw used tissue into the trash.
- Stay alert when traveling – Get all recommended traveler’s immunizations in plenty of time for trip abroad in 2008; don’t drink untreated water; if you become ill when you return home, tell your doctor where you’ve been.
– Jim Killackey, medical writer
Tips to avoid holiday hangovers
Looking forward to imbibing a few this holiday season? The National Headache Foundation has a few suggestions:
-If you drink, do so in moderation
-Try to sip your drink slowly
-Mixed drinks containing fruit or vegetable juices will probably have less effect than straight alcohol
-Avoid red wine, as it contains chemicals that may cause headaches
-Reduce the number of alcoholic beverages you consume
-Eat some honey or drink some tomato juice
-Drink fluids containing minerals and salts
-Drink a cup of coffee
-Take ibuprofen
-Alternate beverages between alcoholic and non-alcoholic beverages
-Eat greasy food before imbibing
The foundation suggests trying this “champagne fooler.”
-1 1/3 cups apple juice
-1 teaspoon lemon juice
-12 ounces club soda
Chill four glasses. Mix together apple juice and lemon juice. Add club soda and stir gently to blend. Pour into glasses and serve immediately. Yields four servings.
Jeff Raymond, Medical Writer
Diabetes and the Cherokee
I spent a recent Monday in Tahlequah talking to Cherokee Nation staff about diabetes. As is often the case, I had to leave out a lot of stuff. So I thought I’d share some of it here.
If you need a refresher, the story is here.
Dr. David Randall, chief of podiatry for the tribe, estimated 5 to 10 percent of diabetics are at risk of developing foot ulcers, about one-fifth of which lead to amputation.
Randall also said he thinks many people in the tribe’s 14-county jurisdictional area see others undergo procedures related to diabetes or suffer from its complications, increasing awareness of the disease and how to take care of oneself. He pointed out the tribe’s employee wellness program and the positive signs he has seen among his patients, most notably a “significant decrease” in amputations.
Diabetes Program Director Teresa Chaudoin said practically every Cherokee has a diabetic in the family. When she came to work for the tribe in 2001, her focus was largely clinical — after all, it was the most pressing. Later, she dove into prevention. Now the tribe has dietitians at each of its clinics and reports more people are able to manage their blood sugar.
“We’ve worked here to build a comprehensive, integrated program,” she said.
Lisa Pivec, director of community health promotion for the tribe, emphasized that losing weight, stopping smoking, eating well and taking appropriate medications worked to reduce chronic illnesses other than diabetes. One of the tribe’s wellness initiatives, called Wings, began with walking and running but now includes bowling, stickball, dancing and other activities.
Wings members, of which there are more than 1,000, receive admission to 24 races a year. Members have reported a one-point drop in body mass index over nonmembers. Sounds like very little, but big health improvements can be in small numbers. Planned activities often suit the tribe’s rural citizens.
“A lot of our communities are very rural and they may need structured events,” Pivec said.
For health and medical news and commentary, visit The Medicine Bag blog at http://blog.newsok.com/health.
Jeff Raymond, Medical Writer
Diabetes is seldom alone
A recent study from the University of Michigan Health System and the Veterans Administration Ann Arbor Healthcare System found 92 percent of older diabetes sufferers have at least one major chronic condition in addition to diabetes, and nearly half have three or more diseases besides diabetes.
“The sheer number, and the severity, of these other conditions appears to decrease patients’ ability to manage their diabetes,” according to a press release, which suggested doctors learn to better treat “the whole person” rather than that person’s individual ailments.
The study was published online before appearing in next month’s issue of the Journal of General Internal Medicine. Researchers used data from a nationally representative sample of 1,901 adults with diabetes who were 55 years old or older in 2002.
The researchers looked at the influence a range of medical conditions had on participants’ ability to manage their diabetes and whether the conditions were linked to diabetes.
“Patients are dealing with these issues day to day, and they’re affecting the way people prioritize and manage their own self-care,” author Dr. Eve Kerr said in the release. “Meanwhile, we physicians talk to patients about their diabetes, but not about how their heart failure or their hypertension is affecting how they manage their diabetes. These results show that we need to be treating the whole patient, but we don’t yet have systems designed to do that.”
The more diseases a person had along with diabetes, the study found, the more they prioritized the other conditions ahead of diabetes. Participants also often didn’t associate the other conditions with diabetes, such as understanding how the metabolic disorder puts them at higher risk of heart disease and stroke. Lack of awareness of the association often means diabetes sufferers don’t put enough emphasis on controlling blood pressure and cholesterol, for example.
Jeff Raymond, Medical Writer
Last Integris drive-through flu clinic
Integris Pacer Fitness Center is offering its last drive-through flu clinic of the season.
Just drive up, roll down the window, roll up your sleeve and get vaccinated.
The clinic will be from 9 a.m. to 1 p.m. Saturday in the Integris Baptist Medical Center East Parking Lot.
The cost per flu shot is $22. A pneumonia shot is $30. Medicare will not be accepted.
Jeff Raymond, Medical Writer
Depression by job
As I looked through the 1,200 e-mail messages I accumulated during my vacation, I ran across this.
According to data from the National Survey on Drug Use and Health released last month, full-time workers ages 18 to 64 in the “personal care” and “service occupations” had the highest rates of depression, followed closely by food service. The survey used 2004-06 data to determine depression rates by occupation.
During this time, an annual average of 7 percent of full-time workers ages 18-64 experienced a “major depressive episode” in the past year.
For women, the highest rates of depression were in food preparation and service occupations — 14.8 percent. For men, the highest rates were in arts, design, entertainment, sports and media — 6.7 percent.
The unemployed had higher rates of depression than did those employed full time and part time.
U.S. companies lost an estimated $30 to $44 billion a year because of depression-related lost productivity, absenteeism and low morale, according to a press release on the study.
And, of course, depression rates vary by occupation and industry. Seems obvious, but it’s interesting to see research bear it out.
Occupations with the lowest rates of depression were engineering, architecture and surveying; life, physical and social sciences; and installation, maintenance and repair.
As this is a health care blog, 9.6 percent of health care practitioners and technical personnel reported being seriously depressed.
I have one observation to make on the men’s end: Many people wind up in arts-entertainment-media jobs straight out of college, with stars in their eyes. When they find out how little money they’ll make, and realize how incredibly competitive the job markets are, they get down.
Take, for example, a dream job as a trainer with a professional sports team. Now imagine having to deal with the debt of a master’s degree, frequent travel, little respect and a paltry salary. That’s just one example I’m personally familiar with.
Wanna talk? E-mail me at jraymond@oklahoman.com.
Jeff Raymond, Medical Writer
