Could You Have Adult ADHD?

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Life was chaotic for Alyson English. “My mind constantly raced from one thing to the next. I assumed that’s how it was for everyone,” says the 33-year-old mom from Huntsville, Ala. Indeed, that’s how it was for English’s son, too, when he was diagnosed with attention deficit hyperactivity disorder (ADHD) at age 6. “While researching his diagnosis, I realized I had the same symptoms when I was a child, and I still had them,” says English, who was finally diagnosed with ADHD when she was 31.

An estimated 9 million adults have ADHD, and that number is expected to grow thanks to better diagnostic tools and a heightened awareness about the disorder in both kids and adults. “We weren’t as aware of ADHD decades ago, which means many adults were never properly diagnosed when they were children,” says Zinia Thomas, M.D., a psychiatrist in St. Louis. While kids with the disorder are thought of as fidgety, hyperactive, impulsive and inattentive, ADHD looks different in adults.

Signs of Adult ADHD
Distractibility
“The lives of adults with untreated ADHD are littered with half-finished tasks,” says Dr. Thomas. That’s because they procrastinate, underestimate a project’s scope or get easily sidetracked.
Poor organization
Adults with ADHD have rooms and work spaces that are strewn with papers; their keys and important documents “vanish;” and bills and appointments often get overlooked.

Rudeness
Poor impulse controls manifest as interruptions, excessive talking and inappropriate, sometimes volatile, reactions.

Accidents
Adults with ADHD are four times more likely to be in a car crash because they’re easily distracted.

Relationship Woes
Adults with untreated ADHD are twice as likely to be divorced or separated.

Work Struggles
Frequent job changes and poor performance reviews are common because it’s difficult to manage tasks and stay organized.

Family History
One-fourth of kids diagnosed with ADHD have a parent with the disorder.

Via: Could You Have Adult ADHD?

How to Take the Stress Out of Caregiving

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Scout out a geriatric M.D.

Sometimes a family physician won’t have the expertise needed to diagnose or treat an aging person’s tricky health problems. “Both of my parents struggled with Alzheimer’s disease for over a year before they were even diagnosed,” says Jacqueline Marcell, 58, author of Elder Rage. “By the time they got help, my dad had became violent toward me, and my mom had almost died due to his inability to care for her. It was a nightmare.” If you think a specialist’s care could improve your loved one’s life, ask for a referral to a geriatric physician. “All of their training and focus is on the elderly, so they’ll pick up on subtle things that a general physician might miss,” says geriatric physician Linda Rhodes, M.D., author of The Essential Guide to Caring for Aging Parents. “They also understand how medications work differently in aging bodies and can make sure your loved one gets safe, effective prescriptions.”

Check the drugs

“My mom’s dementia had gotten so bad she couldn’t finish a sentence, but then she switched doctors and the new one insisted on seeing every single med she was taking,” says Jackie Larsen, 52, in Toronto, Canada. “Turns out she was on two different antidepressants, two different diuretics, three different narcotics...it was ridiculous. He weaned her off most of it and now she’s so clear-headed we can actually chat!” Seniors take more drugs than any other group in society, and many of these meds interact with each other, causing nasty side effects or even permanent harm, say UCLA researchers. To prevent this type of mishap, keep an up-to-date list of everything your loved one takes and make sure that every doctor they see reads that list before prescribing anything new. “Scrutinizing a long list of meds encourages doctors to be more thoughtful about what they prescribe and more aware of possible interactions,” says Dr. Rhodes.

Make the paperwork easier

A medical history, a contact sheet, an up-to-date list of meds...it’s incredibly helpful to have information like this at your fingertips. If you take 10 minutes to fill out some basic forms, you can save yourself hours of searching, writing and frustration later on, says Rhodes. (You can download everything you’ll need at LindaRhodesCaregiving.com). “Give completed copies to your family membersand keep extra copies on hand for doctors and other health professionals, so you’re all on the same page,” says Rhodes.

Help them want to eat

It isn’t about putting healthy, pre-made meals in front of them, it’s about finding out why they’ve lost their interest in food in the first place. “When ill people stop caring about eating, it’s often because their self-esteem is waning -- they no longer think they’re worth being fed and cared for,” says James Huysman, Psy.D., co-author of Take Your Oxygen First. “Another huge appetite-killer is depression, something 50 percent of elders struggle with.” A trip to a kind-hearted counsellor can help suss out the underlying problem and help find the most effective remedies.

Focus on their Zzzs

At least one in four people over age 65 has trouble sleeping through the night, and for folks with dementia, the situation can be even worse. That’s because many of them struggle with “sundowning,” a condition in which they get more restless, confused, anxious and agitated as the night wears on. If your loved one can’t sleep, a surprising solution could be available at your local health food store -- melatonin. This calming hormone is the same one your brain produces to put you to sleep at night and 12 different studies suggest that taking three to nine milligrams each evening helps reduce (and sometimes erase) sundowning symptoms for 70 percent of Alzheimer’s patients within three months. It can also ease garden-variety insomnia in as little as two weeks! Talk to your loved one’s doctor about it.

Don’t sweat the small stuff

Caregiving can involve an unending stream of little aggravations that can drive you batty, but if you pick and choose what you’ll get upset about, you’ll spend less time feeling stressed, irritable and edgy, and be less likely to burn out, says Rhodes. The bizarre things they sometimes say, the grumpy moods they slip into or the quirky little habits they pick up over time? Just shrug them off. The risky behaviors that could endanger their safety, like leaving the stove on or wandering outside at night, is where you should focus your energies. “I would have loved to add variety to my dad’s diet, but he got to the point where his morning routine had to stay the same or he’d get completely stressed out,” says Nicole Risdall, 39, in Los Angeles, Calif. “So I’d cook him the exact same breakfast and lunch every day and set everything exactly the way he liked it on the table. It made him comfortable and it just wasn’t worth worrying about.”

Tackle driving issues with care

Here's when Jackie Larson knew her mom needed to stop driving: “The day she pulled onto the highway going the wrong way, then kept driving into the oncoming traffic, thinking she’d eventually find an off-ramp!” says Jackie. At some point, your loved one probably won’t be safe behind the wheel of a car, either. But how do you bring that up? You don’t!

“When someone’s ability to drive is taken away, it’s very symbolic and very painful -- they’re losing their freedom and the messenger tends to get blamed,” notes Huysman. So take your concerns to a physician and let her tell your loved one it’s time to get off the road. “Then you can plan ahead and schedule transportation so he or she doesn’t miss any activities,” says Huysman. “You’ll be seen as the loving and supportive child, not the bad guy who made this happen!”

Move slowly 

Whether you’re heating up food for your family’s supper or helping an ailing relative get out of the tub, try to slow down, relax and focus on what you’re doing, suggests Jeanne Dennis, director of the Visiting Nurse Service of New York’s Hospice Care program. “It sounds obvious, but just moving more slowly and calmly can really reduce your risk of accidents.”

A surprise perk: According to researchers at Logan’s State University of Utah, even when people fake that they’re feeling serene (by moving and speaking more calmly) their brains produce a surge of serotonin and endorphins, the hormones that dampen stress in as little as five minutes.

Reminisce

“My mom had a couple of keepsake drawers in her dresser; one day I pulled out a photo and asked her to tell me about it,” says Henry Winkler, 67, actor and author of 23 books for children. “It was really fun to watch her light up as she talked about the people in the picture, so I started regularly holding up treasures and asking her to tell me stories.” Memories do matter and they take on even more importance as a person’s health slips away. Encourage your loved one to talk about how she lived, who she loved and what lessons she learned. It will be enormously comforting and a great way for the two of you to connect.

Remember, you’re the kid

Every once in a while, my mom would look me in the eyes and say, “I’m your mother, and you’re my daughter,” says Annelie Rudlaff, 43, in Woodland Park, Colo. “That said a lot. Yes, she needed my help, but she didn't want to be treated like my child.” Emotionally, it can be tough on the entire family when a person who used to be strong and capable starts losing the ability to function -- but it’s essential that even as your roles change, you keep reminding yourself that you’re still the kid, says Rhodes. “That will help your loved one maintain dignity, and it can reduce the friction between you, too.”

Sample support groups

True, connecting with new people can seem daunting if you’re already feeling pressed for time. But joining a support group can provide a surprising amount of stress relief and support. “Getting advice from people facing the same day-to-day challenges means so much more than being told what to do by well-meaning friends who don’t really get what you’re going through,” says Rhodes. Not sure where to begin? Your local hospital, senior center or adult day center can point you in the right direction. And if going out is a struggle, try an online support group, instead (Caring.com has a good selection).

Get away

Caring for an elderly or ill family member can be enormously rewarding, but it can be physically and emotionally draining as well. You need time to rejuvenate. Whether it’s just a few hours each week to run errands or a few weeks each year to take a much-needed vacation, don’t feel guilty about carving out some time to keep your own life in balance, says Dennis. You’ll come back refreshed and better able to handle the challenges of caregiving, she says.

Meditate

According to Harvard researchers, as many as 20 million Americans tried meditation in the last 12 months -- and classes are springing up in YMCA’s, community centers and hospitals around the country.

In a recent UCLA study, meditating for just 12 minutes daily dramatically improved the mental health of caregivers, cutting their blue moods, depression and anxiety levels in half within two months. Meditation is easy to learn and easy to practice.

Say what you need to say

“When people is aging fast or have a serious illness, it’s important to talk to resolve old wounds, thank them for what they’ve done for you, and tell them how much you love them,” says Dennis. “Those words are incredibly meaningful and powerful to a person who’s ill -- it’s a real gift to communicate those feelings while he or she is still able to fully appreciate them.”

Focus on the good

“My mom and I got into a really nice routine. Every morning I’d read a positive, uplifting story to her from the Bible or from a Christian book, and I’d post fun pictures on her bulletin board for her to look at during the day,” says Rudlaff. She also loved watching pastor Joel Osteen on TV, and her favorite phrase was “I’m too blessed to be stressed!” adds Rudlaff.

Via: How to Take the Stress Out of Caregiving

Colonoscopy Cuts Advanced Cancer Risk by 70 Percent: Study

MONDAY, March 4 (HealthDay News) -- A new study finds that getting screening colonoscopies may reduce the risk of developing advanced colon cancer.

In average-risk people, screening colonoscopies were associated with a 70 percent reduction in risk for new, late-stage colon cancer, including hard-to-detect cancers on the right side of the colon. Advanced colon cancer is the least curable form.

Although colonoscopy is widely used as a screening test for colon cancer, there is little research that proves it is effective in reducing colon cancer deaths, according to the study authors. The researchers wanted to answer a simple question: If you ended up with late-stage cancer, were you more or less likely to have had a screening colonoscopy as many as 10 years before the disease was discovered?

The study authors also wanted to show whether a colonoscopy is able to evaluate the entire colon, including the right side, which is harder to adequately cleanse before the test, more difficult to reach, and often has pre-cancerous areas that are tougher to spot and identify.

"Colonoscopy has the ability to identify both left- and right-sided colon cancers before they have progressed to an advanced stage," said lead study author Dr. Chyke Doubeni, associate professor in the department of family medicine at the University of Pennsylvania.

The researchers also discovered that screening sigmoidoscopy, a less costly procedure that enables a physician to look at the part of the large intestine closest to the rectum, was linked to a significant reduction in late-stage disease in most of the large intestine, but not in the right colon.

However, the study does not show that colonoscopy or sigmoidoscopy is better than the much easier, far less expensive "fecal occult blood test" (FOBT), which is done at home by swiping a tiny amount of stool onto a card for three days, said Doubeni. "There is strong evidence showing the effectiveness of the [fecal occult blood test] when done annually. There is no reason, based on the knowledge we currently have, that you should switch to a colonoscopy if you're getting a FOBT every year," said Doubeni.

If simpler tests are effective, why are patients encouraged to undergo a colonoscopy? "Let me just say there are other factors beyond the evidence that are driving the use of colonoscopy in the U.S.," said Doubeni. "No other country uses colonoscopy for screening purposes as much as the United States, although Germany comes close," he noted.

The U.S. Preventive Services Task Force recommends that people 50 to 75 years old be screened for colon cancer in one of three ways: a home fecal occult blood test every year; a sigmoidoscopy every five years combined with a home fecal occult blood test every three years; or a colonoscopy every 10 years.

A colonoscopy examines the inside of the large intestine with a camera-tipped tube. The test enables the physician to remove any precancerous growths -- adenomatous polyps -- which sometimes develop into cancer. Colorectal tumors are a major cause of death from cancer in the United States, with about 137,000 new cases and 52,000 deaths every year, according to the U.S. Centers for Disease Control and Prevention.

For the study, published in the March 5 issue of the Annals of Internal Medicine, the authors reviewed health records of more than 1,000 average-risk adults between the ages of 55 and 85 who were members in four health management organizations (HMOs).

The researchers identified 474 people with late-stage colon cancer and then looked back 10 years to see if they had been screened for the disease with colonoscopy or sigmoidoscopy. They compared them to 538 "control" patients and used additional information from state or local tumor registries to see whether there was an association between having had a colonoscopy or sigmoidoscopy and developing cancer.

Dr. David Bernstein, a gastroenterologist at North Shore University Hospital in Manhasset, N.Y., said the study had a critical design flaw. "Making assumptions that any cancers that were found would have been seen 10 years prior doesn't make sense," he said. "It doesn't prove that these cancers didn't occur two years ago."

A key part of effective colon screening is getting the tests at the recommended interval, experts say. To better understand what might be effective in prodding people to get screening, another study published this month in the same journal found that people who were mailed a letter, a pamphlet and a fecal occult blood test kit completed recommended screening twice as often and for less cost than those who were not reminded or got automated and other reminders by nurse coaches.

Doubeni recommends something far more simple: doing the fecal occult blood test every year right around the time of your birthday.

Via: Colonoscopy Cuts Advanced Cancer Risk by 70 Percent: Study

The Fast Diet: More Proof the Brits Are Bad With Food

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The Fast Diet was published in January and has quickly become the go-to diet for all of Britain’s weight-loss hungry. According to authors Michael Mosley, M.D. and Mimi Spencer, you can eat whatever you want five days a week and lose 20 pounds. Who wouldn’t bite? For the other two days a week, you are limited to 500 calories a day. But still, sounds like the dream diet!

Only, nobody seems to acknowlege that during those 500-calorie days, you probably won’t be doing much of anything except sleeping. You’ll be light-headed, anxious, shaky, dizzy and super tired -- Imagine what you are like when you eat lunch late and multiply that by 100. You definitely shouldn’t drive, operate machinery, take care of young children, perform surgery or basically anything else that might put yourself and others at risk. You might pass out! And even if you don’t, your body doesn’t have enough energy (calories) to let your body function properly.

When you deprive yourself of calories or nutrients, you throw a wrench into the turning wheels of your cell processes and metabolism functions.

“The Fast Diet's premise of eating and drinking whatever you want for five days and then followed by two days of fasting may sound euphoric but it probably is not healthy for anyone; especially from an emotional and behavioral standpoint,” said Rose Green, R.D.

Further, these "fasters" are ignoring what it means to live a healthy lifestyle, which is being at peace with your activity level and creating a synergy between the way you think, feel and react to their food choices -- on a daily basis; always; not just twice a week.

Green adds, “It is crucial for anyone serious about shedding excess pounds to develop a sensible eating lifestyle and to change one's self destructive eating habits. Fad diets like this one never will help you achieve permanent weight loss, since you really have not learned to create new healthy eating patterns.”

What’s worse: If you don’t consume enough calories over the five “eat whatever you want” days, the body may go into ketosis from lack of carbs [causing bad breath) or starvation mode, which is when the human body begins to slow metabolism and hoard fat since. So while the British are kissing their water-weight goodbye with smelly breath, they run the risk of storing the fat they are so desperately trying to lose.

That’s not even counting all the unhealthy fats, carbs and calories the fasters must consume on their eat-whatever days. Let’s be honest here. Who chooses the salad with dressing on the side when they are at a buffet? Dr. Mosley was eating a cookie during his New York Times interview. What diet condones cookie eating?

Via: The Fast Diet: More Proof the Brits Are Bad With Food

Survey Tallies Menopause Symptoms' Toll

FRIDAY, March 1 (HealthDay News) -- Women who suffer severe hot flashes during menopause may be less productive on the job and have a lower quality of life, a new study suggests.

The study, by researchers from the drug maker Pfizer, Inc., is based on a survey of nearly 3,300 U.S. women aged 40 to 75. Overall, women who reported severe hot flashes and night sweats had a dimmer view of their well-being. They also were more likely than women with milder symptoms to say the problem hindered them at work.

The cost of that lost work productivity averaged more than $6,500 over a year, the researchers estimated. On top of that, they said, women with severe hot flashes spent more on doctor visits -- averaging almost $1,000 in menopause-related appointments.

Pfizer researcher Jennifer Whiteley and her colleagues reported the results online Feb. 11 in the journal Menopause.

It's not surprising that women with severe hot flashes would visit the doctor more often, or report a bigger impact on their health and work productivity, said Dr. Margery Gass, a gynecologist and executive director of the North American Menopause Society.

But she said the new findings put some numbers to the issue. "What's helpful about this is that the authors tried to quantify the impact," Gass said, adding that it's always good to have hard data on how menopause symptoms affect women's lives.

For women themselves, the findings give reassurance that the effects they perceive in their lives are real. "This validates the experiences they are having," Gass said.

Another gynecologist who reviewed the study pointed out many limitations, however.

The research was based on an Internet survey, so the women who responded are a "self-selected" bunch, said Dr. Michele Curtis, an obstetrician and gynecologist in Houston.

And since it was a one-time survey, Curtis said, it provides only a snapshot of the women's perceptions at that time. "What if they were having a bad day? Or a good day?" she said.

It's also hard to know for sure that hot flashes were the cause of women's less-positive perceptions of their own health.

"This tells us that bad hot flashes are a marker for feeling unhappy," Curtis said. "But are they the cause?"

Still, she commended the researchers for trying to estimate the impact of hot flashes with the data they had. "It's an interesting study, and these are important questions," Curtis said.

Like Gass, Curtis said the results also validate women's experiences. "You're not crazy for feeling bad," she said.

The findings are based on nearly 3,300 women. Most said they either had no hot flashes and night sweats, or mild symptoms. But almost 500 said they had moderate symptoms, while nearly 150 rated them as severe.

One-quarter of employed women with severe symptoms said the problem hindered them at work, compared with just 4 percent of women with mild hot flashes and 14 percent of those with moderate ones. Curtis pointed out, however, that the percentages are based on small numbers: just 43 women with severe hot flashes were employed.

When it came to day-to-day activities, almost one-third of women with severe hot flashes felt held back, versus 6 percent with mild symptoms and 17 percent with moderate ones.

The good news is there are ways to make your hot flashes less frequent or less intense. For severe symptoms, Curtis said, the most effective treatment is hormone therapy -- usually a combination of estrogen and progestin. For now, it's also the only treatment approved by the U.S. Food and Drug Administration specifically for easing hot flashes.

But doctors and patients have been wary of hormones ever since a U.S. study a decade ago linked the therapy to increased risks of blood clots, heart attack, stroke and breast cancer. The general advice now is for women with hot flashes to take hormones at the lowest dose and for the shortest time possible.

For women who cannot or do not want to take hormones, there are other options. Gass noted that some antidepressants have been found to help relieve hot flashes. Certain blood pressure drugs and anti-seizure medications also are sometimes prescribed.

If your menopause symptoms are milder, some lifestyle changes may be enough, including turning down the thermostat at night or dressing in layers so you can remove some when you feel a hot flash coming on, Gass said.

If you need more relief, though, Gass recommended talking to your doctor about your options.

Curtis said it's also important to be sure your hot flashes are the result of menopause, since other conditions -- most commonly an overactive thyroid gland -- can cause the symptoms too.

Study funder Pfizer markets drugs used to treat menopause symptoms and depression.

Via: Survey Tallies Menopause Symptoms' Toll

Low-Income Patients Often Have Trouble Reaching Doctor Via Email

FRIDAY, March 1 (HealthDay News) -- Many low-income patients want to communicate electronically with their doctors but can't because the clinics they use generally do not offer such services, a new study finds.

An increasing number of health care systems provide online services to patients in order to manage care outside of office visits, and this includes enabling patients to communicate electronically with health care providers.

But this is not available to many poorer patients, according to the study from researchers at the University of California, San Francisco.

The researchers surveyed more than 400 patients in six San Francisco Department of Public Health community clinics serving primarily uninsured and underinsured patients. Fifty-four percent of the patients said they use the Internet in their daily lives and 60 percent said they use email. Many also said they use text messaging.

Although 78 percent of the patients expressed interest in electronic communication with doctors and other health care providers, only 17 percent said email contact with health care providers was a part of their care, according to the study, which was released online recently in advance of publication in an upcoming print issue of the Journal of General Internal Medicine.

"Patients were largely in favor of using email technology for health, and agreed it would likely improve overall clinical communication and efficiency," lead author Dr. Adam Schickedanz said in a university news release.

"Our work makes it clear that lower-income patients from a wide variety of backgrounds want to be part of the health information technology revolution," he said. "The question is whether they will be afforded the opportunities to take part in the same way as their middle- and higher-income peers."

A recent national study found that about 75 percent of patients were interested in electronic communication with health care providers, but there has been little research to measure interest among low-income patients, as they are less likely to have access to computers and the Internet, according to the study authors.

Future research should examine the preferences of a wide range of patients for allowing electronic communication with health care providers, including how to provide access for patients with various levels of language and literacy skills, the authors noted.

Via: Low-Income Patients Often Have Trouble Reaching Doctor Via Email

Volunteering May Boost Teen Heart Health

FRIDAY, March 1 (HealthDay News) -- Helping others is good for teens' hearts, a new study suggests.

Canadian researchers looked at 106 students at a Vancouver high school who either volunteered regularly for 10 weeks or remained on a wait-list for volunteering. The 10th graders in the volunteer group spent one hour per week working with elementary school children in after-school programs in their neighborhood.

The body fat, inflammation and cholesterol levels of all the students in the study were checked before and after the 10 weeks. The University of British Columbia researchers also assessed the students' self-esteem, mental health, mood and empathy.

At the end of the study period, the students in the volunteer group had lower body fat, cholesterol and inflammation levels than those in the wait-list group, according to the study, which was published Feb. 25 in the journal Pediatrics.

"The volunteers who reported the greatest increases in empathy, altruistic behavior and mental health were the ones who also saw the greatest improvements in their cardiovascular health," study author Hannah Schreier said in a university news release.

She conducted the research during her doctoral studies at the university and is now a postdoctoral fellow at the Icahn School of Medicine at Mount Sinai in New York City. Although her research showed an association between volunteer work and improved heart health, it did not prove a cause-and-effect relationship.

"It was encouraging to see how a social intervention to support members of the community also improved the health of adolescents," Schreier said.

Cardiovascular disease is one of the leading causes of death in North America. The first signs of the disease can begin to appear during the teen years.

Via: Volunteering May Boost Teen Heart Health