Category: Health

For me, it was an easy choice, but hard work

Posted on by Suki

My mother (Mary N. Wessling, who’s a medical researcher) pointed me to this article in MedPage Today: Are Physicians Too Quick to Medicate ADHD?

The article posits whether family physicians are prescribing ADHD drugs at a too high rate to kids they see, without referring them to a qualified mental health professional. Clearly, this is the case. And clearly, the medical establishment has abdicated responsibility for it.

When my daughter was a preschooler, I was told by a doctor that it was common knowledge amongst doctors that you can diagnose ADHD by giving stimulants to kids. “If the stimulants work to help them focus, then it’s ADHD.” I believe that this is still a common belief amongst physicians, even though it’s been proven without a doubt not to be the case. Look at the recent New Yorker article about how college kids are taking black market ADHD drugs so that they can focus better when studying for tests. These are not college kids with diagnosed ADHD: these are kids who have always done just fine in school and have never been diagnosed as hyperactive. And surprise, the drugs help them focus, too.

A while back I started to research various theories of behavioral problems. I would have had no problem getting an ADHD diagnosis for my daughter (many doctors fill parent requests for ADHD drugs without much investigation if the parents say the child needs them, especially if a school recommends them). But I didn’t want to drug her. I wanted to figure out what was going on. She was a hyper-smart, funny, loving, creative person who in certain situations (like school) completely lost it.

What I found in my research[1] is that there are two worlds out there: there’s the world of the psychiatrist we saw who didn’t question that she needed drugs; she just wanted to figure out which one. Then there was the other world: practitioners of all sorts of therapies from Western to Eastern, concerned parents, and some Western-trained psychologists were all asking the obvious question: Why do we have ADHD now and not before? What has changed?

The answer is one that any amateur sociologist could have given: Our lifestyle and culture have changed. Our expectations of children have changed. Where we live, what we do, and how long we do it for has changed.

This is how my mother puts it: “We give disease names to behaviors that previously have just been considered difficult. That is not to say that things were better–these children were often the recipients of damaging physical and psychological abuse called ‘discipline’. We now have many more resources  and information available.”

This is how the phenomenon is described by James T. Webb[2], a leading expert on gifted children (who are, he admits, often “quirky” and unusual): “I think our society has become increasingly less tolerant of quirkiness. Our schools, too. … In psychiatry and psychology, the number of diagnoses has proliferated increasingly. … For example, the unruly child is now seen as a diagnosable disorder, Oppositional Disorder . The town drunk now is an alcoholic and that’s a disease. There’s been a redefining. I think it’s been overboard.”

So this change has led to drugging children for what was once considered part of the normal continuum of human behavior. What’s shocking is not the research that revealed the success of therapies including diet change, having unstructured play time, and more time outside. What’s shocking is that our MDs just seem to have missed that boat. They are going happily along in their search for more and better drugs, and totally ignoring all the evidence that says that drugs are not the answer for many or possibly most of these kids.[3]

From the MedPage article: “Teachers and parents are looking for a quick fix,” added Mark D. Smaller, PhD, a psychoanalyst in private practice in Chicago who was not involved in the paper. “They’re reluctant to look at what’s behind that behavior, at what’s going on at home.”

The article cites child abuse as one possible cause of ADHD. Yes, that may be the case, but that rules out all the rest of us: the loving, imperfect parents who are just trying to raise their kids with the knowledge we have. And I don’t think that those parents would react badly if after explaining their child’s schedule to their pediatrician, the pediatrician suggested, “Perhaps you need to cancel tae kwon do one day a week and go for a long walk in the woods.”

Some of the alternative prescriptions for behavioral modification cost money: homeopathy, for example, is usually very expensive and not covered by insurance. Some of them take a lot of time: occupational therapy, for example. Some take a lot of change in the home: parenting changes, diet changes. But most of them are as cheap as a big bottle of fish pills from Costco. An hour walking in the woods with your child, finding out what he’s thinking about, giving him loving advice from the person he knows best.

But things that are hard are sometimes better. Yes, drugs are easy and cheap. But what does your child learn from drugs? That she can’t control her own behavior. That she can’t look at her environment and realize that it’s not good for her. These are not lessons I want my children to learn. I want her to know that she can make herself strong and healthy, that she can depend on herself and trust herself.

Last week one of the teachers in her homeschool program took me aside and said a few words about the changes she’s seen in my daughter.[4] One thing she said really hit me. “With a lot of kids who start behaving well in the classroom, you can see that they’re holding themselves back. They’re stopping themselves from doing things they’ve been told not to do. But your daughter has fundamentally changed. She’s enjoying her time in the classroom and she is doing what comes naturally to her now.”

Or she could be on drugs. I think we made the right choice. [5]

1. My article: Alternative treatments for behavioral problems

2.  My article about James T. Webb and the evolution of knowledge about the particular social/emotional problems of gifted children.

3.  I am well aware that there are children who desperately need medical treatments for real, difficult problems

4.  Some details of the changes we made in our daughter’s lifestyle, including diet and environment

5. My news article on this topic on the Gifted Children Examiner.

The many people our kids might be

Posted on by Suki

A friend and I were talking the other day. I will preface this to say that this friend is fun, funny, outgoing, sarcastic, smart, and a good cook. All the things I like in a friend.

I confessed to her that every time I take one of those personality tests to determine what I should do when I grow up (if ever I grow up), they say that I should be in the category with “rabbi, priest, social worker, therapist.” In other words, nurturing professions where you take care of other people.

What professions have I practiced or considered? Writing, teaching, graphic design, law, music. The only one that comes close to nurturing is teaching, but I should add that before I started homeschooling, I never, ever wanted to teach children! No nurturing for me: just adults who knew what they wanted to be when they grow up.

Back to my friend: She said, “Of course those tests say you should have one of those professions. You’re a people person!”

Back to my description of her: fun, funny, outgoing, sarcastic, smart, and a good cook. Of herself, she says, “I’m shy, I’ve had to learn all the rules of getting along with people as I got older and had to attain those skills.”

In other words, just like me.

What this leads me to thinking about (what else do I think about?) is raising kids. Parents these days (including myself here) are generally pretty analytical about their kids. They watch to see if their babies attain all the milestones, and ponder what it means if they do them early or late. They wonder about the effects of artificial coloring and wheat and high fructose corn syrup. They worry about whether their kids get enough screen time. In other words, they’re paying attention, closer attention than parents probably ever have on the whole. They have a huge amount of resources coming at them over the airwaves. They can find out how people in Tibet parent, how much screentime kids in China get.

We pay so much attention to our kids that we have a good sense of them, often, by the time the start crawling. (Or not crawling: my daughter — and her mother — never did!) We think we have them pegged by kindergarten and we evaluate their potential teachers by the fit they have with our kids’ learning styles. (This is another conversation I’ve had with multiple moms!)

But here we are: my friend and me. We were both shy. I don’t know if this is true of her, but I remember that sometimes when an adult addressed me, I burst into tears. Perhaps this is genetic. My son did, too. Unexpected things, things that made me undefinably uncomfortable. I have pale skin: when I blush, people notice. Sometimes this still happens — it takes me unawares. One time I was asked by another parent to lead a song at a school function; I’m a singer and I long ago got comfortable with the fact that I don’t have a perfect voice. So I said OK. And there I stood in front of all those people, and though I’ve done this on a regular basis since college suddenly I felt that sinking feeling, like I was 13 again and something I was doing just seemed Not Good Enough…

My friend said I’m a people person. And I believe her. But that is definitely not the way anyone would have described me when I was a child. (I recently got back in touch with a close friend from my teen years; perhaps she will confirm this!) I remember myself as awkward and unhappy. I remember that as I got older, I realized what was making me unhappy (self-consciousness and self-critical thoughts) and awkward (worrying about what everyone else was thinking), and I made a conscious decision to change.

And I did. Not 100%. As I said, I stood in front of all those adults, most of whom I knew, and those kids, many of whom I knew, and I had something like a 13-year-old flashback. But fundamentally, I have changed.

And our children can, too. This is what my thoughts led me to: My friend says I’m a people person, and thus I have fundamentally changed. I used to be a cat-person, and a book-person, and a music-person. I was a child who locked herself in a closet with a book and a flashlight. I was a teenager who dyed a lock of her hair pink. I was a 20-some-year-old teaching teenagers and wondering if I had anything to say.

I’ve been many people, while still being fundamentally the same. And our kids will be, too, no matter how well we’ve analyzed them at the age of three. This is my thought for the day.

Getting rid of…part 2

Posted on by Suki

Last week I wrote about cleaning out my closets, and I suggested that perhaps spring cleaning has moved to winter. Then I noticed that at least as far as my Facebook friends are concerned, spring cleaning is a thing of the past. What’s up here? Did the blue moon give us all cleaning out the nest instincts?

Last weekend we cleaned out our garage. Well, OK, we didn’t really clean it. Not wanting our cats to become coyote bait or bug us by banging on the screen door in the middle of the night, we lock them in the garage with a litter box, food, water, and a comfy blanket to sleep on.

They sleep on top of the cars, poop behind my husband’s motorcycle, and eat the moles they leave under the cars during the daytime. We try to make it into kitty spa, and they turn it into kitty skid row.

So OK, we didn’t clean the garage. I did scoop all accessible fossilized poop and stick it in the garbage, and we swept out the easiest to get dirt and leaves, but mostly what we did was organize and Get Rid Of.

What we got rid of: many, many cardboard boxes we were keeping for… uh…, a large bag of worn-out bath mats that we were keeping for… eh…, a bag of old clothing we were keeping to give to the Goodwill, a box of dishes we kept meaning to sell but ended up giving to our babysitter, a box of 8 place settings of a nice stainless silverware that had been discontinued and I couldn’t add to and kept meaning to sell but gave to our babysitter (starting to think you want to be our babysitter? Forget it — Vanessa is a saint for being able to keep up with Energy Girl for hours at a time).

What we didn’t get rid of: Hubby’s grandmother’s stand mixer, still works, still has lots of memories attached, lots of old sheets that we plan to use for, eh,… many boxes of books that I published years ago and can’t stand to throw away, two pieces of stained glass taken from a red-tagged building in New York City…

You get the idea. So I had the funny task today of calling a neighbor and asking if she would like, I mean, would be able to stand our putting lots of recycling into her bin. I went down the list of neighbors and decided not to call anyone with kids, the painting contractor, anyone who had a party lately… So luckily we have a single woman neighbor who said, Yeah, sure, bring me your garbage!

See, getting rid of even strengthens your bond with your neighbors.

We didn’t get rid of our skid row cats, but they found the process fascinating. Cats love any focused activity, though they personally choose not to do any work in their own lives. They’re great at watching and making rude comments, though.

“Hey, don’t get rid of that old rug! I like to pee on that!”

“What are you doing moving my favorite box that I sit in? Wait! Don’t crush it! How can I look cool sitting in a box that’s too small for me if you crush it?”

“Humans! They have absolutely no sense of what’s important.”

One of my Facebook friends asked if someone could come over and clean out her closets, but really, it’s no fun to clean out someone else’s old junk. How could you know what’s important? Frankly, the stuff we kept wasn’t all worth more than the stuff we gave away. I admitted to Vanessa today that the set of dishes was probably worth a fair amount of money. But ultimately, eBay just seemed like too much work and not at all as satisfying as passing on our old friend’s lovely pottery to someone I know who will love it.

Someday, perhaps, it will end up in her garage, and she can decide whether to keep or get rid of. And perhaps she’ll remember me, and our sorta clean garage, and our rude cats making comments.

“Ack. I wouldn’t even drink outta that bowl. Give it to the babysitter. She has a dog anyway.”

Mr. Know-it-all

Posted on by Suki

Before we had kids, my husband used to have a standard joke that he needed to get a business card that said “Mr. Know-it-all.” He has one of those encyclopedic brains, and he reads voraciously. So even though we don’t watch TV or listen to most popular music, if I say, “who is that person on the front of the Enquirer?” he’ll be able to answer. He knows the meaning to most any word we can find, though I have occasionally stumped him (and let me tell you, it’s thrilling when I do!).

Our son has inherited that particular characteristic from his father, but there is one big difference: His father was an only child, and he probably learned the various ways to offer corrections to people’s misinformation from other neighborhood kids and on the playground. You learn good and quick not to answer a kid’s boast with, “Well, actually, that’s not exactly true.” He learned that there are lots of situations in which correcting people is not polite, not socially acceptable, and a bad way to keep friends.

Our son, however, has a little sister. And like all little sisters, she says things that are fantasy, wish-fulfillment, or just plain not true. And unlike kids at school, his sister isn’t going anywhere. Perhaps he has largely figured out not to constantly correct his friends, but he sees no particular downside to correcting his sister… often.

I remember when I learned about autism. I was at college, and I read something about it, and how it manifests itself on a spectrum. I remember looking around myself and thinking, hm, I bet some of my friends are on that spectrum!

It’s fascinating how certain characteristics tend to bunch together. I went to Stanford, and so all my peers there had been very, very good students. But I am sure that for many of us, that came at a cost: learning social cues was more difficult. Kids who have books to love depend less on friends. And perhaps it’s a chicken and egg thing: kids who are predisposed toward using their brains more than their bodies are more likely to end up socially awkward. Or is it that kids who are socially awkward gravitate toward using their brains in a different way?

I knew people who’d gone to MIT, a place where the “nerdy” kids (mostly boys) were even more concentrated than at Stanford. And social skills were even less in evidence there.

Of course, you get those Tiger Woods characters: smart (he went to Stanford), personable (just look at that smile), and athletic. But they are clearly outliers when you look at the general trends among humans. Most of us are better in one realm of human existence than in others. And the more we apply ourselves in that direction, the less we have to give in other directions.

[*Tiger Woods actually came into my mind randomly, but I now remember that a friend suggested the other day that in order to get more hits on my Examiner stories, which pay by the click, I should write about Tiger Woods. Because I don’t watch TV, I am only vaguely aware of what’s been going on. But here it is, my almost gratuitous mention of Tiger Woods!]

So my husband and I have been experimenting with ways to get our son to stop critiquing every little statement his sister makes. So far, we haven’t come up with much. It’s gotten to the point that we can hear it coming, so we try to stop him and ask him to think about what he’s going to say. But he [honestly, I think] doesn’t think that what he’s saying is a criticism. It just hurts him to hear people saying things that aren’t true.

I know how he feels. I learned very early about not being a know-it-all at school. But I remember the feeling of sitting there listening to people saying things that were wrong and feeling this sort of discomfort verging on pain. I loved knowing things! Doesn’t everyone love knowing things? Don’t they want to know that they are wrong and fix it?

But I also know how my daughter feels. When she was little, I read that studies of kids find that first children are more likely to have imaginary friends — kids who have older siblings get teased out of that luxury. As soon as our daughter’s imagination started to blossom, I started to remind our son that he once had imaginary friends who lived in an imaginary world (an island near Japan, if you want to know), and we let him have that time.

Our son’s teacher said something to him recently that I think might be an appropriate metaphor. He said something like, “Don’t use your intelligence as a mallet.” You can’t — no matter how tempting it seems — bang knowledge into people’s heads. The most gracious people figure out other ways of doing it.

And if nothing else fails, at least you can look at yourself with humor. I’m thinking that perhaps I need to get my son Mr. Know-it-all cards. Then when his sister says something the is incorrect, he can hand her a card and offer her his services… when she’s ready to receive them!

Recognizing childhood asthma – do you know the signs?

Posted on by Suki

With this year’s entry into the flu season early, we’re already well into the yearly spike in hospitalizations for kids with breathing problems. Reflecting on a friend’s recent experience and our learning curve with our ten-year-old’s asthma, I thought it might be useful for parents who don’t think that their kids have asthma to educate themselves. If you have a child under five, I hope this helps you be alert to the possibility that your child will have breathing problems sometime during this flu and cold season.

What is asthma?

Asthma is when the air pathways from the lungs seize up due to a trigger: an allergen, exercise, or an infection. Asthma looks like the person is having trouble breathing in – it’s actually the case that the air has trouble going out. Asthma comes in many flavors, from an occasional bout with wheezing to a dangerous, persistent problem that follows the person through life. Some children outgrow asthma; others continue to have breathing problems as adults.

People with asthma may or may not have audible wheezing. They may or may not cough as a result of it. As in all things, each person’s body reacts slightly differently.

Recognizing asthma

Our son had a couple of bouts of wheezing when he was little before we recognized it for what it was. My husband had severe childhood asthma, but it just didn’t cross our mind that our healthy little boy had it. Then we ended up in the emergency room and spent the night in the hospital. That was enough to get us educated.

If your small child’s cold or flu always descends into a cough, pay special attention to her breathing. Here are some simple diagnostic techniques:

  • Watch your child breathe without a shirt on. The little indentation at the bottom of the neck, where the collarbone comes together, should not suck in visibly when the child is breathing. If it does, this is one possible indication of breathing problems.
  • Similarly, look at the spot at the top of the stomach where the ribcage comes together. If this spot sucks in visibly during normal breathing, take note.
  • Take note if your child is panting after normal exercise or gasping while talking.
  • Have your child take a big breath and blow out hard. Pretend that they’re blowing you over – this always goes over well with little kids. A kid whose lungs are seizing up will probably cough when blowing out hard.
  • Listen with the naked ear to your child’s chest. If you can hear noise, call the doctor.
  • Buy a cheap stethoscope. Ask your doctor or nurse to show you where to listen. Wheezing sounds like popping, creaking, or sighing noises in the lungs.
  • Always call the doctor if you think your child is wheezing, no matter what.

Treating asthma

Asthma is serious: over 4000 Americans die of its complications every year. When we brought our son to the emergency room, we checked in behind a man whose daughter was holding a bloody cloth to her head. She had fallen, lost consciousness, then thrown up upon waking. Who did they take in first? My son.

When a child is wheezing, it needs to be treated immediately. These treatments are therapeutic and stop the wheezing. The medicine is used to stop the reaction immediately so that air can enter the lungs.

Other asthma treatments are preventative. One therapy is to remove the triggers from the environment. When our son was small, we found out about a free asthma home visit program through the state. A wonderful consultant came and helped us set up the best environment for our son’s health. It was great, though at the time the program was being cut and I don’t know if it exists anymore.

The medication that has changed my son’s life is an inhaled steroid that helps his lungs from reacting in the first place. He takes a dose so small that it doesn’t even register on the longterm side effects chart, and it keeps him out of the hospital. I know that parents have reservations about steroids, but these drugs are well documented and are far less risky than rushing to the hospital in the middle of the night. It also changes your child’s life from a child who is sickly to a child that is well most of the time.

Who gets asthma?

When you were a child, asthmatic kids were probably those kids with other illnesses, especially severe allergies, who looked sick. These days, asthma continues to grow due to a large variety of factors. You can’t tell a child with asthma by looking at him. Even if both parents never had asthma, your child could have breathing problems. It’s worth watching and asking your doctor if you have any suspicions at all. It wasn’t until my friend’s daughter was hospitalized that she realized that her daughter had been showing symptoms. In the everyday busy life of a parent, these small indications might easily get overlooked until the situation is dangerous.

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