ADHD - The Medication Decision

Enlarge Image Three and a half million children in the U.S. meet the criteria for Attention Deficit-Hyperactivity Disorder (ADHD). With such a large number of children affected, it seems that there are always reports and research projects under way to explore further the most effective treatments for this behavioral disorder. Many people make the assumption that children with ADHD are automatically treated with some sort of prescription medication, but of those three and a half million affected children, only about fifty percent of them are diagnosed and have medications as part of their treatment plans. So if your child is diagnosed with ADHD, what exactly are the options for treating it?

To begin with, parents should not make the assumption that simply because their child is high-energy or has a short attention span he or she has ADHD. ADHD is a behavioral disorder, and diagnosing it is a lengthy process involving a team of individuals working with your child, including, but not limited to, parents, teachers, caregivers, and pediatricians. Plenty of children will exhibit some of the characteristics of ADHD from time to time, depending on their age and maturity level: for example, having trouble taking turns is a fairly standard behavior for a three-year-old! A child with ADHD exhibits many behavior from a standardized list of expected behavior; the symptoms persist over time; and the child's symptoms create some level of impairment in two or more settings (both at school and at home, for example). Once a formal diagnosis is reached, establishing the proper course of treatment is the next step, so it is important to know what your options are.

With half of the diagnosed children out there receiving medication as part of their treatment, clearly medication may be one of the options you and your pediatrician discuss. Before making the decision to medicate your child for any condition, parents need to make sure that they understand why the medication is being deemed necessary; how the medication works in your child's body; and what are the possible risks and side effects of the medication in question.

The most common drug used to treat ADHD is methylphenidate (a stimulant, prescribed under brand names such as Ritalin and Concerta); there are also what are called "mixed salts", which is actually a blend of dexadrine and amphetamine, also stimulants. Stimulants can help to block the dopamine transporter (dopamine is a neurotransmitter that helps control movement, attention, and behavior), thus reducing levels of hyperactivity and impulsivity. Some other popular brand-name drugs used to treat ADHD are Adderall and Metadate. All of these drugs are considered Schedule II drugs, which means that they have a high degree of potential for abuse and require close medical monitoring and monthly office visits for prescriptions.

Parents who are considering using these medications face a daunting list of side effects; these can range from nausea, vomiting, weight loss, loss of appetite, increased heart rate, even death (there were 186 deaths from the use of methylphenidate between 1990 and 2000). Even one of the newest, non-stimulant medications, Strattera, comes with a formal suicide warning for users. Many parents (obviously, from the statistics, about half of them) feel that these risks are acceptable when they are weighed against the reduction of their child's symptoms and the resultant improvement in the child's quality of life, peer interactions, or academic performance.

For other parents, however, especially for those whose child has been diagnosed with a milder form of ADHD, or whose child is a borderline case, the risks far outweigh any possible advantages they can imagine. So what non-medical options are available to those children?

First, an open, frank relationship with your child's teacher is critical if you make the decision not to medicate. It's all well and good to say "I don't feel comfortable giving my child those medications", but you can't just leave it at that. Together, you and your child's teachers will need to come up with behavioral modifications, both in the home and in the classroom, and positive/negative reinforcement systems that will be used, and used consistently, to help manage your child's specific behavior issues in all types of settings.

Second, an open and frank relationship with your pediatrician is also critical. Sometimes the push to medicate originates with the parents, sometimes it originates with the school. There is no denying that medication for many children with ADHD can make them calmer, making it easier for the teacher to manage the classroom, but you should not let the school pressure you into making what is, at heart, a medical decision for your child. Having a pediatrician who supports your decision to pursue drug-free options for treatment can provide an ally for you if you should experience pressure from the school to medicate.

Third, be very sure of the diagnosis your child is being given. Symptoms of ADHD are shared by dozens of other conditions, many of which are easily treatable (hypoglycemia; allergies; learning disabilities; and thyroid, hearing, or vision problems are just the tip of the iceberg of things a thorough pediatrician should seek to eliminate as possible causes of your child's symptoms).

One other possible course of treatment parents should investigate (and there is a great deal of new research being done every day) is how your child's diet affects their level of hyperactivity or impulsivity. Recent research has shown that children who eat "whole food" diets, or diets free from particular dyes or preservatives, have a significant reduction in ADHD-type symptoms, leading many parents to discover that their child's problem may not be ADHD at all (or may be a milder form of it), but is, in reality, an undiagnosed allergic reaction.

The bottom line is, and always will be, that hyperactivity and impulsivity, when severe enough, can interfere with a child's ability to function on a day-to-day basis, and parents are willing to do whatever it takes to help their children. For some parents, that choice may lead them in the direction of medications, but there are other options to consider-the important thing is to do your research and make a well-informed decision that is right for your child and for your family.

Nausea and Vomiting after Eating

The most common cause of nausea after eating is of course owing to the fact that your body is unwilling to accept, accommodate, digest and excrete the food that you have just taken in. Vomiting and nausea are both, ways of the body to tell you that the food that has been sent in is not welcome. The problem with such symptoms is that the exact cause of the ailment can be very minor and at the same time serious.

In such instances, the rule of thumb that can be followed is that a chronic nausea and vomiting needs to be attended to. Serious symptoms such as stomach pain, fatigue, fever, diarrhea or any other such physical symptom which accompanies nausea and vomiting, if still persist even after 24-48 hours needs to be tended to. Hence rush to the hospital.

Nausea and Vomiting after Eating: Symptoms and Remedies

As mentioned above, nausea and vomiting after eating can be caused due to a wide spectrum of reasons with varying degrees of severity. Here are some of the most common reasons which can cause the feeling of nausea and vomiting after a hearty, or in some cases a non-hearty meal.

1. Indigestion
Again just like, nausea and vomiting indigestion has several causes, and in fact in most of the cases, indigestion is the accomplice of nausea and vomiting. Indigestion may occur as a result of overeating, irregular eating, abnormal sleep cycles, sudden dietary or climatic changes, acidity and heartburn, acid reflux, etc. In some cases many more severe and serious causes are also attributed, such as ulcers in stomach, gallbladder or liver dysfunction, cancer, etc. The difference is that in cases of more serious causes, the urge to vomit and nauseating feeling is chronic. Some lesser severe causes are however not chronic. Hence if you are suffering from indigestion for more than 2-3 days, it's time to go to a doctor.

2. Food Poisoning
In some cases also known as food borne illness, consumption of contaminated, poisoned or microbes infested foods and the presence of toxins often causes immediate nausea and vomiting, with a very short time span. The nausea and vomiting occurs as the body makes a quick attempt to eject the poison and infection. In case if the nausea and vomiting persists, there is a need to visit the doctor, as there is a chance that your digestive tract has been poisoned or infected more intensely. The basic treatment would be antibiotics and a lighter diet, till the digestive tract gets cured.

3. Stress
Extreme stress, anxiety and even fatigue, physical strain has been noted to be a cause of vomiting or feeling a certain nausea among several people. These symptoms can often be chronic and if it is intense and prolonged beyond measure, it is advisable and recommend that you visit your physician or a doctor.

4. Morning Sickness
Well, If you are suffering from morning sickness, you probably know it yourself, however, here's a further explanation. The hormones estrogen and HCG (Human Chorionic Gonadotropin) are usually on the rise which tends to lead to vomiting and nausea. In some cases, it is believed that the vomiting is a reaction of the body to release substances which might prove to be toxic to the fetus or the mother.

5. Motion Sickness
Again like morning sickness, you would probably know that the cause of your ailment is motion sickness. Motion for a prolonged time, is sensed by the vestibular system. The food and fluids inside the stomach tend to reflux slightly which leads the body to react to the unprecedented presence of food in a reversed manner, which later on leads to the vomiting.

6. Excess Eating and Alcohol Consumption
Excess consumption of alcohol or any kind of food which substantially exceeds the capacity of the digestive tract to hold and process food may also lead to severe upset of food within the system leading to a certain reflux or motion of food in a reverse manner. This can cause the sensitive esophagus to immediately react and throw out the food in the form of vomit. In some cases the digestive tract simply does not accept any more food or fluids which tend to get stuck in the esophagus. Hence it is always recommended to eat as per your needs and consume the least possible alcohol. Accompanying effects can include, heart burn, acidity, etc.

7. Other Ailments
There are a considerable number of other ailments that can cause the feeling of nausea and probable vomiting after eating. Some common ones include...

• Appendicitis: The inflation of the appendix often lends to frequent vomiting and an acute abdominal pain around the belly button and then shifting towards the right lower abdomen. Please note that such a condition is dire and if you see the symptoms, rush to the doctor pronto.
• Cough: While eating or just after eating, cough bouts may lead to a sudden reflux of consumed foods and fluids. Curing the cough is the best remedy in such a case.
• Intestinal Obstruction: Sometimes also known as a bowel obstruction, this kind of obstruction is caused as a result of a variety of reasons which include, inflammatory bowel disease, hernia, foreign bodies, atresias, etc. This kind of condition is quite dangerous and is often accompanied by pain in the abdomen, constipation and distension in the abdomen. If symptoms persist, it is essential that you visit a doctor as soon as possible.
• Ulcers: Sometimes commonly referred to as GI ulcers, the ulcers occurring in the gastrointestinal tract, tend to cause the symptoms of nausea and vomiting. Ulcers cause a substantial amount of pain and a severely discomforting feeling, as the eroded part of the digestive tract cannot bear the digestive acids and juices. Medication and a good changed diet, under the supervision of a doctor is the best remedy for such a condition.

As mentioned above, the rule of thumb that needs to be followed is that in case of any prolonged and chronic symptoms, that occur for a time period of more than 2-3 days should not be ignored. The digestive system is very sensitive and it is best to visit a doctor rather than face any prolonged effects. I hope that the elaboration on nausea and vomiting after eating is resourceful.

Foods High in Uric Acid

Uric acid is a by-product of purine metabolism. The human body synthesizes uric acid from the breakdown of purine bases that are present in the DNA, RNA, and the energy molecules. Uric acid is beneficial for the body. It acts as an antioxidant and helps in protecting the lining of the blood vessels. Under normal circumstances, excessive uric acid is eliminated from the body by the kidneys. However, if the kidneys fail to metabolize the purines, it would result in the accumulation of uric acid in the body. High levels of uric acid, also known as hyperuricemia, is a condition that can lead to the uric acid crystals getting deposited in one's joints, kidneys, sinews and other organs. This causes joint inflammation along with pain, swelling, and tenderness.

For those suffering from uric acid-related problems like gout and kidney stones, here are the foods to avoid completely, and those that can be had in moderation.

Foods to Avoid Completely
This list of foods high in uric acid contains approximately 1,000 milligrams of purine for every 3 ounces.

Organ Meat
Also known as Offal, organ meat is the internal organ of an animal. It has extremely high levels of purines in it, and can lead to an attack of gout.

LiverKidneyBrainsSweetbreadsSpleenMaws (stomach)
Meat Products
Red meat and game meat such as venison and duck are associated with high levels of purines.

BeefPorkVenisonGooseDuckLamb
Processed Meat Products

SalamiBaconBolognaSausagesDried Meat StripsPepperoni
Seafood
Seafood like tuna and mackerel are good for you as they contain essential Omega 3 fatty acids. However, they are extremely rich in purines as well, and hence, should be avoided.

MackerelTunaHerringAnchoviesScallopsSardinesMusselsLobsterShrimp
Foods High in Yeast
Foods which contain yeast such as breads, beer and alcohol beverages, contain large amounts of uric acid. Alcohol, in particular, is known to hamper the renal excretion in the kidneys, thereby resulting in high levels of uric acid in the body.

PastriesBrewer's YeastCakeBreadBagelsAlcoholic Beverages
Foods to Be Eaten in Moderation
Certain purine-containing foods can be eaten in moderation. These contain around 5 to 100 milligrams of every 3-ounce serving.

Vegetables
Vegetables are extremely healthy for everyone. However, some vegetables contain moderate amounts of purines, and should be avoided or eaten very less in order to avoid gout.

AsparagusCauliflowerMushroomsAubergineCarrotsRhubarbPotatoesPeasSpinach
Lentils and Beans

Lima BeansKidney BeansDried BeansLentilsNavy BeansSoybeans
White Meat

ChickenTurkeyQuail
Others

OatsJam and JelliesChocolatesCarbonated DrinksCommercial PicklesPackaged Fruit Juices
Lowering Uric Acid Levels
In order to avoid foods high in uric acid, the diet should be fashioned to eliminate all the high-purine foods, and instead include foods with moderate to low amounts of purine in them. The diet should include a liberal carbohydrate intake, such as pasta and rice, and foods low in protein and fats. Eating plenty of raw fruits, and vegetables such as tomatoes and cabbage that have a high water content have also known to be beneficial for reducing uric acid levels. Dehydration reduces kidney functioning, allowing uric acid to build up, and hence, drinking lots of fluids, especially water, will help keep the organs hydrated and dilute the amount of uric acid in the body. Juices made of black cherry, celery, birch leaf, and parsley, are very effective gout remedies that help in flushing out uric acid from the tissues.

One can effectively regulate the levels of uric acid in the body by making the necessary dietary changes. Those who have been diagnosed with hyperuricemia need to improve their dietary habits, and should also follow the treatment guidelines they have been given. The dietary changes should be made in conjunction with other changes in lifestyle, so as to relieve the body from the problems occurring due to a high concentration of uric acid.

Disclaimer: This Buzzle article is solely for informative purposes, and should not be used as a substitute for professional medical advice.

Treatment for Adults with ADD

If you think Attention Deficit Disorder (ADD) only affects children, you are gravely mistaken. There are numerous cases of ADD in adults, diagnosis of which has been overlooked during childhood. Because parents and teachers have the common notion that children have a low attention span and are generally hyperactive, they fail to recognize that these children may be suffering from ADD. As such, these symptoms continue into adulthood when they start interfering with their daily lives. However, there is no reason for worry because there are some treatment methods that help overcome the symptoms and tackle all the responsibilities one has to deal with. However, before looking into these, we will understand what ADD is by looking into its symptoms.

Symptoms

ADD interferes in the lives of adults because it prevents them from easily achieving what their peers may be achieving. For example, pursuing a career requires a strong threshold for stress, and impeccable focus and organization. For adults who have ADD, doing so may not be easily possible. When ADD has hyperactivity as a symptom, it is termed as ADHD or Attention Deficit Hyperactivity Disorder. Different individuals exhibit different symptoms, and these have been discussed here.

• One of the biggest symptoms of ADD is a short attention span or difficulty paying attention to anything for a long time period.
• Such individuals are easily distracted by several other things in their environment.
• They face a lot of difficulty completing tasks on time and without errors because they have trouble paying attention to detail.
• Those affected are likely to phase out where they go blank for short periods and are unable to pay attention to anyone or anything. Alternately, in some cases, they may also get deeply absorbed in different activities that they find very pleasing. This is known as hyperfocus.
• Forgetfulness is another common symptom. Individuals affected fail to remember conversations, and even little things like where they left their keys. On a larger scale, they also tend to forget their appointments.
• Because they are so overwhelmed by the multiple activities they are required to focus on, they are likely to be highly disorganized. This may show in the way they work and even the way they keep their desks.
• Another common sign is the tendency to assume that there is enough time to complete tasks and therefore constantly put off important tasks or delay them. They are also likely to be late most of the time.
• One of the symptoms of ADHD in adults is hyperactivity, a trait characterized by constant fidgeting when asked to sit in a place for long hours. This hyperactivity is also shown where they tend to speak without thinking and may appear as rude or insensitive.
• Because such individuals may be distracted, they may interrupt conversations without regard for the person speaking. It is a symptom and may not be a part of the individual's nature.
• Though they may be overwhelmed by the numerous activities they are required to perform, individuals with ADD may want to do everything at once because they seek excitement. This is one of the common symptoms where they tend to get bored very easily because of the short attention span.
• Such individuals may have low self-esteem because of the inability to complete the responsibilities assigned to them. They perceive themselves as underachievers.
• Adults with ADD are constantly agitated, have a short temper, and are prone to intense mood swings.
• They are prone to high levels of stress due to the multitude of situations they are unable to handle. This may also lead to depression and anxiety.

If ADD goes undiagnosed it can lead to several relationship problems, health problems, and trouble handling finances and leading a comfortable life.

Treatment

The first step towards treating ADD is getting the correct diagnosis from a professional. Also, while doing so, it is important that the affected individual be given immense love and support so as to bolster her/his confidence and self-esteem, and not feel lonely in this 'battle' she/he is fighting with her/himself. The following treatment options may be used.

• Medication: Psychiatrists may prescribe some medication to treat the aforementioned symptoms. The best medication includes antidepressants and medicines that calm the hyperactive part of ADD so that some clarity of thought may be attained. The type of medication administered may differ greatly based on the symptoms that an individual is exhibiting.
• Cognitive Behavioral Therapy: This is a form of therapy that intervenes with the set pattern an individual may have developed due to ADD, and attempts to change these patterns for the better. This includes changing the thought process from negative to positive, and then dealing with individual symptoms to improve them. This process may take several sessions but is known to be extremely effective for ADD.
• Group Therapy: Adults may also be required to undergo group therapy where several individuals affected with the same condition are asked to sit together, talk out their problems, and be given solutions to their problems. Group support always helps and doesn't make the individuals affected feel like they are the only ones suffering from a problem.
• Lifestyle Changes: Affected individuals are asked to make changes in their lifestyle to aid their treatment. This includes changes in the diet, which help them feel calm, healthy, and positive. Further, they are also asked to exercise to expend the excess energy. Exercise also releases hormones that are known to help them feel good thereby tackling the anxiety and depression that is known to accompany ADD.
• Personal Changes: Those with ADD are asked to make changes in the way they deal with their lives by starting off on a small scale. For instance, they may be asked to keep a diary to be able to list the tasks they are required to perform in a day and perform them one by one in order to be able to complete them.

Apart from treating the affected individual, therapy is also provided to the family to teach them how to deal with the individual, and what they can do to improve the effectiveness of the treatment.

All is not lost for individuals affected with ADD. As you can see, there are several methods of treatment. All it requires is faith and enough time to take effect. Things will definitely change thereon, and for the better.

Disclaimer: This Buzzle article is for informative purposes only and does not, in any way, intend to replace the advice of an expert.