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Great Article in ADDitude

Feb 1, 2019

Rarely do I come across something that is so perfectly said that I don't feel the need to put it in my own words. Please check this article out: 6 Reasons ADHD treatment fails


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Great med research opportunity

Jan 22, 2019

See attached: 

Here are the details as emailed to me from the doc.

Participants can either be diagnosed with ADHD or ADD or have symptoms and need to be evaluated.  The medication is a long acting methylphenidate product (same as Ritalin or Concerta) but it lasts all day and into the evening so it should be very helpful for people who need coverage from morning to night.  It would be especially good for college kids (rather than giving them short acting stimulants that are more likely to be abused) or for men and women who need longer coverage during the day.  Methylphenidate is FDA approved for ADHD but this formulation of methylphenidate is being studied because of the unique delivery system. 

Participants will receive a very extensive evaluation and testing (that is above and beyond what is done in ADHD clinics) and includes a physical, labs, IQ testing, SCID-5-CT diagnostic interview, tests of concentration and accuracy levels, and lots of rating scales, etc. plus observation by trained clinicians and raters during the visits.

There are 2 simulated workplace days (held on Saturdays-one half day and one long day) in which their symptoms will be assessed throughout the day by trained clinicians and raters (and on the long day into the evening).  They will play group games that are fun and then take a 10 minute math test to assess their concentration and accuracy multiple times during those days.  The math tests are just addition and subtraction and are adjusted to the person's ability and comfort level.  We make the days fun.  Most people enjoy the day and interacting with staff and other people their age with ADHD.  We provide breakfast, lunch, snacks and drinks (and dinner on the long day) on the Saturday visits.  Anyone who wants to stay at a local hotel, so they don't have to drive far in the morning, will be provided with a hotel room on the Friday night before the 2 Saturday visits.  All medications and study visits are free of charge.  

They will be reimbursed $1125.00 for their time.

 Anyone interested must meet the following criteria to participate:

  • Be 18-60 years old, 
  • have no MAJOR medical problems such as high blood pressure or heart problems, etc. 
  • Be able to come to the clinic weekly for 8 visits, then come to a classroom/conference room site for 2 Saturdays (one half day and one  long day).
  • Be able to take simple addition and subtraction (10 minute) math tests.
  • have no Major CURRENT psychiatric diagnosis (MDD, anxiety, etc in past is fine as long as it isn't very impairing currently).  Schizophrenia is an exclusion.  
  • not be on any other psychotropic drugs, other than ADHD medication during the study.

It's ok if they are on an ADHD medication but they need to be willing to switch to the study medication (a methylphenidate compound with a longer duration of action) during the trial which is 10 weeks.

Participants will all be on the actual study drug throughout the trial but during the last week of the study, 50% will be on a placebo for 7 days.

If you have someone who is interested, please have them call 781-837-8833 as soon as possible or you can send me their name and phone # and I will have someone call them right away.

Thank you for your help.

**I will send the IRB approved advertisement/flyer as soon as I have the phone number updated on it.  Jodi's number is on it and she is out on maternity leave.

Great med research opportunity

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Thanksgiving schedule

Jan 18, 2019

I've often posted my daily schedules as a visual aid. Having gone over scheduling with several new clients recently, I thought it was time to post another one. But this one is pretty specific. This is my schedule for Thanksgiving Day for 2018. Bear in mind that I am a former professional chef. So, I do a pretty legit spread even though it's only for seven people. 

So I'm pretty sure I"m posted a prep list before. But this is a really good illustration of how a list of what you have to do is an amazing start. But actually scheduling time is the best way to get things done before a deadline. In this case, I wanted dinner on the table at 5:30. Thus, I had to do all this stuff before then. 

Key points: I made an initial list separated by day the previous weekend. Because there were things that I had to do ahead of time, like pick up the duck, butcher it, cure the legs, and make the stock. I also like to bake the pie the day before so I don't have to worry about that. I also made this schedule the day before to make sure I had time to actually get everything done. If it looked like I wasn't going to have time, I would have done more on Wednesday.

Try not to get too overwhelmed by this schedule's sheer number of things to get done. Remember that cooking puts me in my element. Put the principle is that whatever your "thing" is, you can use the same technique to manage very complex projects in real time. 

By the way, dinner hit the table at exactly 5:30! 



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


 
Thanksgiving schedule

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My tattoo rule of thumb, part 2.

Jan 11, 2019

I've posted about this once before... when I got my first tattoo about 2 1/2 years ago. I'm a punk rock kid at heart. I had my hair dyed orange and twisted up in spikes into my 20's. I had 4 piercings until I had to take them out for culinary school and subsequent jobs. Why do I tell you this? Because I've always wanted a tattoo. But I didn't want to go all ADHD and get something that I would regret. So I made a rule for myself: I wouldn't get one until I had something that I loved and still loved it 5 years later. When my son was born I realized he was it. But it took me 5 years to really decide exactly what I wanted and to come up with a design that suited his personality, and then a bit longer to find the right artist. 

Then my daughter was born almost 5 years ago. I started plotting her tattoo then. I pulled the trigger a few month earlier than 5 years, but the rule still applies. I "marinated" on several design ideas and color combos and waited for her distinct personality to emerge. So I have two great pieces of ink that I love and will never regret. It just took some planning and a whole lot of patience. 



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

My tattoo rule of thumb, part 2.

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Accomodations, pt. 4: Fewer classes & free periods

Dec 20, 2018

I was an English/History kid. But I'm also not the fasted reader, writer, or processor. That made it really hard to take honors/AP classes in those subjects. I had to make tough decisions about how to allocate my time. (I guess I still do.) It was pretty clear that I couldn't take the classes that I wanted to and still carry a full load. So, my parents and I had a discussion before my freshman year about how to handle that. The basically asked me if I wanted to do high school in 5 years or take something during the summer to lighten the load during the academic year. That was an easy choice for me. I wanted to graduate with my friends. So we decided that I would take my sciences during the summer. I took Bio after my freshman year and took Chem after my sophomore year. I think I just sleep for two month after surviving my junior year.

Of course that was one few class to have to worry about. Less homework, etc. But, it also gave me four extra blocks during the week to... do what? That's the question. Back in the day at Newton North, underclassmen weren't allowed to have free periods. So they wanted to stick me in study hall four more (total of six) periods a week. When I think about the idea of being in a classroom with 20 other kids who don't want to be there and may not be so quiet trying to do work and having to mostly sit still, I think I'd rather be in science class. What I needed was to go find a quiet place, put on the discman (yes, I'm old) and do whatever I needed to do to survive high school. Sometimes that was staring at the wall, sometimes it was homework, sometimes it was playing chess with a friend, sometimes "hanging out" with my girlfriend who I shared a free block with my senior year. 

The bottom line is that I may not have used those periods strictly to do homework. I may have used them as down time. But that down time allowed me to conserve energy and attention throughout the school day to get work done at home. And, being able to move around and not be sitting and chair probably helped me pay attention better during my actual classes. If your kids aren't prone to getting in trouble or just being glued to their phones, they will probably use the time "better" without having to report to a study hall. At least that was the case for me.



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


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Medication journal

Dec 14, 2018

I may have more accomodation posts, but I wanted to talk about the importance of a medication journal today. What, you may ask, is a medication journal? It is just a record of medications, dosages, changes, and symptoms. Finding the right medication is usually a process of trial and error. I think this is especially the case with ADHD meds. Or, perhaps I should say that the changes and effects happen so rapidly and there are so many options that the number of changes in a short period of time can be extensive. 

I've been on the same stimulant regimen for almost 20 years. So there isn't an issue there. My current antidepressant gets adjusted from time to time, but that's only one variable and the effects are pretty obvious and rapid. My son's meds are also pretty straightforward. So I've never really needed to keep track of them in a detailed matter. My daughter is a whole 'nother story. I won't get into detail about her journal, as it's kinda personal. But it did prompt me to write this. So let's start with the macro.

Especially with our kids, who are constantly growing and changing during the period of time when we are responsible for their meds, it is extremely important to keep track of what meds, what dosages, what age/size, when, and for how long. Often parents will tell me, "he took Stimulant A when he was in 3rd grade but I don't remember how much and I'm not sure why we stopped that one." This is not meant to criticize those parents. In the moment things seem so obvious and memorable, but six years later when that kids is in 9th grade, how likely is anyone to remember all the details. Specifically, one reason this is important is that as we get older, we tolerate medication much better. I've had many a client who's tried a med at 8-years-old and "hated it" for some reason. But, with a more mature body and a different outlook at 14, that medication is magical. However, if there was a serious side effect of it really didn't work at all, it's nice to remember that so as not to repeat the missteps of the past.

The following are the things that I would consider tracked as much as possible:
  1. Date's of Dr.'s appointments with a brief description of what was discussed and any decisions made.
  2. General trends in symptoms/behavior. You observations of results. 
  3. What your child is saying about how they feel. I can't tell you how many kids have said, "It makes me feel weird." Don't brush that off. Help them find the words to explain what "weird is." For one, that will empower them to take charge of how they feel and help them buy in to the treatment by making them feel heard and helping them process their feelings. Second, weird can just mean different. Read: stick with it and see how it goes while continuing to talk about it. Or, weird can be not good at all. Read: don't force it and consider changing something.
  4. Dates of changes in dosage.
  5. Dates that you start a new prescription bottle if the manufacturer has changed.
  6. Dates you go from generic to name brand or vice versa.
  7. Any potential side effects in frequency and severity. (Even if it isn't listed as a know side effect.)
Don't feel like you have to write a novel. Quick bullet points are usually enough to jog your memory. But having this detailed data can be invaluable when trying to figure out what is going on with you child... your yourself!



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






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