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Why don't we treat ADHD all the time?

Sep 13, 2019

I've probably written a similar post in the past, but I've recently had a thought that makes me feel it is worth revisiting. Can anyone think of a medical condition that doctors only treat sometimes? Is there anyone with diabetes who only monitors their blood sugar during the work day? Is there anyone who is epileptic who only takes their medication during the school week? Is there anyone with high blood pressure who takes a break from treatment over the summer. Is there anyone who wears glasses or contacts who doesn't wear them on the weekends? Anyone with depression who stops dealing with that after 5pm?

I'm better the answer is NO to all of those questions. So, why is that our societal approach to ADHD? Now, I understand that ADHD meds are complicated and some people can't take them all the time. But what I see is that many doctors don't even consider medicating kids and adults in the evening or in the morning before work. And many doctors give up way to easily when side effects get in the way. Again, I'm not saying that there is a 16 hour solution for everyone, but don't prescribing doctors owe it to their patients to be aggressive in at least trying to find one before giving up?

I have ADHD all the time. It has been my experience that other who have it, have it all the time too. We need to get past the notion of medicating for school or work only. I'm raising two kids and can tell you that parenting time and household time is just as demanding, if not more so than my work day. Keeping the house clean, getting dinner ready, staying on top of everyone's schedules and activities, getting the oil changed, finding the time and energy to exercise and practice other self care... All that stuff takes attention. 

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The benefits of exercise for ADHD and anxiety

Aug 22, 2019

So I started to write last week about exercise and ended up writing more about patience. Let's get back to the exercise! 

Here's what I noticed when I had to stop doing any cardio:
  • I wasn't falling asleep as well or staying asleep as well.
  • I was more on edge and generally cranky.
  • I was far less patient with the kids.
  • I struggled to muster the motivation and attention to do more administrative work.

But I realized even more when I was able to work out again. There was a definite point in my slow work back up to my previous exercise when I crossed the 30 minute threshold of sprinting on the spin bike when things changed. It was like the clouds parted and sun began shining. All of the above things got almost instantly better. Though some of those things are somewhat nebulous, my sleep improved in a concrete manner and so did my anxiety. I don't think I've take an ativan during the day more than once or twice in the last three weeks.

One other really interesting thing that happened related to my learning the drums. I'm a late bloomer. I started taking lessons last year at 39. I am very much a novice. But I enjoy it and focus on getting a little better every week... which I usually think I do. But there was a time about 6 weeks ago when I actually contemplated quitting. I wasn't making any progress and felt like I was actually regressing. I was struggling very simple counting exercises and basic rudiments. I realized that my attention was the main culprit. But I didn't realize that it had to do with exercise. 

My lesson 3 weeks ago, right before I hit my "feel good point" in my rehab was probably the worst that I had ever had. I couldn't get anything right and was really anxious and self conscious in front of my teacher. (And he's a really nice guy who doesn't put any pressure on me.) Then I hit that point in my rehab and all of a sudden I could pay attention better, enjoy my practice time, and had a great lesson last week that didn't stress me out at all. I think the drum situation is particularly important to think about. Many people only think about controlling their attention in regards to work or school. But attention is key to every aspect of life. 

I've had enough experience with how important exercise is for me that I'm not going to forget that I need it. But it was really powerful to have such a black and white, before and after situation to reinforce what I already know. Exercise is not the whole solution. My medication is a much larger part of the solution. But the exercise is also an important piece of the puzzle.

Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please excuse and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. In my humble opinion, an imperfect post posted is infinitely better than a perfect post that goes unfinished.

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The power of exercise in my life & learning to be patient

Aug 15, 2019

If you know me or read my blog regularly, you'll know that I'm a huge proponent of exercise as an important part of the overall treatment plan for ADHD, anxiety, and depression. (All of which I deal with.) And, you would know that since I got myself back on the exercise wagon after a late 20's/ early 30th that were taken up by illness, injury, and a brutal lifestyle in the restaurant industry, I have worked out pretty much every day for at least three or four years, since my last surgery on my left knee. I rely on that exercise to keep me focused, even, and as mellow as I ever get.

About three or four months ago I started having pain in my right heel. To make a long story short, the pain got worse to the point that walking was hard the day after I ran. Then it got so that I couldn't run without pain. Then I couldn't ride the spin bike. I'm not a total idiot. I'd been experimenting with short periods of rest in terms of cardio and doing more lifting. I iced, toke ibuprofen. I went to PT. I did my exercises. I even had my PT "dry needle" my heel twice. It was worth a shot... but still the most excruciating pain I've ever felt in my life and didn't fix the issue. 

Eventually, my PT said that I probably needed a cortisone shot so I got a referral for a foot doctor. I met with him and he gave me the shot on July 12th. It was like a miracle. Sure the shot hurt, but after that I've had no pain at all. I guess my first takeaway is that being in pain was affecting my mental state, my attention, and my overall functioning. So, there's that right off the top. I was also feeling pretty down about not being able to work out with no real end in sight, before the shot. 

Of course, once I had the shot I had to face down my ADHD kryptonite. I had to be patient. Even though I had no pain at all, I wasn't allowed to to any weight-bearing cardio for a fell three weeks, no matter what. I could still lift every other day. But no bike, no running, no jumping, no trampoline park with the kids. It was brutal. But I guess I've learned to delay gratification and think about doing what is best on a much longer timeline. So I made it through those three weeks as well as could have been expected. 

Then I saw the doc again and he explained to me how slowly I had to get back into cardio. I had to start with the bike. No more than 15 minutes, sitting down the whole first session and standing no more than half of the session after that. I was allowed to start doing the elliptical machine a week after that, also starting at no more than 15 minutes. I hate the elliptical. But apparently it is an intermediate step to running again. And, I'm not allowed to do the same exercise on consecutive days at first.

So far, in six minute increments, I've worked my way up 54 minutes on the bike doing my pre-injury interval sprinting that's almost all standing or sprinting. NO PAIN! And, on alternate days, I've worked my way up to 30 minutes on the elliptical. NO PAIN! One more week and I can start jogging on the treadmill for 15 minutes, alternating jog/walk each minute. It is a far cry from the 5 miles I used to do three times a week at around a 7:20 mile. But apparently slow and steady keeps me pain free. 

Not overdoing it or pushing myself to hard, not listening to that voice in my head that says, "you feel fine, just do another 10 minutes," not convincing myself that I know better than my doctor, as all part of these amazing things called patience and perspective that seem to finally be sticking now that I've turned 40.  My advice to my fellow ADHDers is to start by admitting how difficult it is to 'play the long game.' We have to work much harder to hold the long term goals in our mind than a 'normal person' does. It is so tempting to find a way to justify our instant gratification need so that we can do the thing we want to do now. But, with work and mindfulness, it is possible to win that internal battle and hold out for the thing we really want in the end.

I even had to make some compromises I didn't want to make. I have always been a guy who doesn't wear running shoes as a regular everyday shoe. No offense to anyone who does that, but I've always been a punk rock kid and done more of a skate shoe/ fashion shoe. But no more. Check out the new Asics I'm rocking. They're okay... and MY FEET DON'T HURT. I hate how much life is a compromise!

I think I'm actually going to split the into two entries. I didn't realize I had so much about the rehab process to write about. So, I'll leave it here and pick up next week with the amazing benefits of exercise.

Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please excuse and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. In my humble opinion, an imperfect post posted is infinitely better than a perfect post that goes unfinished.

The power of exercise in my life & learning to be patient

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Great Wondery Podcasts

Aug 9, 2019

Hey y'all. Here's a quick, light post for summer. I like to regularly post some of my favorite podcasts. You can find those in the "library." Here are some more. There are a few podcast "networks" that I tend to like. Wondery is probably my favorite. I know I've mentioned some of their ongoing shows in the past, like Business Wars and American Innovations. I've also recommended some of their limited run true crime shows like, Hollywood & Crime, Young Charlie, Dirty John, The Wonderland Murders, and Accused. Here are a few more that I've recently blown through. 

Dr. Death. About a neurosurgeon in TX who seems to have missed part about "first do no harm." Fascinating study of a system that might be broken. I listened to most of these 7 or so episodes in one day of yard work and garage cleaning. Ironic that a story about insanity helped keep me same doing that boring "life stuff." 

I'm currently rocking "The Shrink Next Door." Also fascinating so far. I'm only two episodes in, but it got me through my food prep for the week and cleaning the kitchen. 

Up next I"m going to check out, Gladiator: Aaron Hernandez and Football Inc.

Happy listening... and whatever you can get done while listening!

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The best laid plans...

Aug 1, 2019

If you are a regular reader of my blog, you know that I often post my daily schedules as a way of showing how I make them and how helpful they are. I don't actually make written schedules that often anymore. I've internalized the process to a large extent. But there is usually one day or so a month where I don't have much on the calendar but need to get a ton done, when I do take the time to write out the schedule. I did exactly that on Tuesday. So when I post my schedules I tend to post ones that have gone according to plan. The goal isn't to toot my own horn, but to demonstrate the power of consistently doing the schedule over time. You can get really, really good at it. But it has occured to me that always posting a schedule where I nail it may seem like an unattainable goal for some. Perhaps it might be equally as helpful to post one where things did not go as planned and talk about how I handled that. Because, yes, I've gotten really good at this. But the vast, vast majority of schedules I've made in my life have not gone according to plan. Half the battle in terms of progress is accepting that fact, but also recognizing that you're still more productive with the schedule than you are without it.

So, check out my schedule for Tuesday. It was 95'ish degrees and humid that day. And, unfortunately, most of what I wanted to do needed to be done outside. That is one of the main reasons that I made a schedule for Tuesday on Monday night. I new that I had to get outside and get some stuff done before the day got even hotter. I had to wake up with purpose and with a plan. 

Basically, I needed to weed my garden beds. The last time that I had done that it took me about 45 minutes. But the weeds were more out of control this time, so I budgeted one hour and 15 minutes. After that I planned to clean out the garage at rental property and install a MacGyver'ed bike rack for the new tenants. The most important thing I needed to do was call my friend and contractor to see if he or one of his guys could help me swap out an above the stove microwave and vent fan in the rental. Other than that, I had some office work to do, lifting at the gym, practicing the drums, and I really wanted to try to get back to working on my book on executive functioning that has been on the back burner for several months. 

Here's what happened. My buddy, Rob said that he could actually come over and do the microwave that day around 2:30. So as of 8:30 a.m., my schedule was already shot. But that was fine. That was a high priority item that would be awesome to have done that day. You'll note that I didn't bother to rewrite the list. 

The second thing that happened was that weeding the garden turned out to be a herculean task. I only did about 50% of the beds, walkways, and "yard" and it took me one hour and 45 minues. And, I was exhausted by the heat by the time I was done. So, again, the schedule is totally shot. Or is it? Mentally, what I did was simply recognize that I wasn't going to get the garage and the bike rack done. Neither were live or die items and I didn't want to do them in the heat of the day anyway. So, if you ignore those items... I was basically on schedule. Rob ended up coming over earlier than expected, but I still got 30 minutes of drum practice, a hour at the gym, all the work stuff I needed to get done, and worked on my book for about 45 minutes. 

My point is that you could look at this day objectively as a failure. I didn't get many things done that were on the schedule and I hardly did anything in the projected order. Many of my clients fall into this trap. I would suggest that this day was a stunning success. I got something done that was a high priority that wasn't even on my schedule; I got half the weeding done and gathered valuable data about how long that task actually takes at this time of year; I accomplished my self care goals; I listened to a webinar about ADHD and anxiety in kids while weeding; and I finally got back into writing my book. 

One of my favorite saying is an old military truism: No plan survives contact with the enemy. My schedule did not survive contact with Tuesday the 30th of July intact. But it was a manageable framework from which a solid day was executed. I'm hoping that your takeaway is the same as mine, that having a plan/schedule is always better than not having one... even if things go awry. 

Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please excuse and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. In my humble opinion, an imperfect post posted is infinitely better than a perfect post that goes unfinished.

The best laid plans...

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When clients get it!

Jul 26, 2019

I had a great moment yesterday with a relatively new client. We were talking about his To Do List and scheduling. I pointed something out by using myself as an example. I'm currently writing a book. By "currently" I mean that I've written about one third of it during one week in the late winter and haven't had the time and/or focus to work on it since. I mentioned to the client that I have "work on book" on my To Do List, which is way to vague and that what I need to do is take a look at where I left off and break it down into specific goals on my list. To which he responded that I should put that step on my list. He was 100% correct. That is a change I will make today and maybe even get that thing done because it is now accounted for and actionable. 

Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please excuse and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. In my humble opinion, an imperfect post posted is infinitely better than a perfect post that goes unfinished.

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