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Friday, February 03, 2006

MIC and I might regard the medical community from disparate perspectives, but I don't think our opinions are all that different. I can't predict how different a parent I'd be if either of my kids was born with a condition that required constant medical attention. But I do think the best doctors are those who exercise restraint.

Like the time when OneBert, barely a month old, spiked a 101º fever. We bundled him into his sling and ran him over to the ER, and the nurses descended from all directions, prodding and needling and catheterizing. Even though he tested negative for bacteria (indicating that the fever was probably caused by a virus), hospital protocol dictated that he stay overnight on IV antibiotics (which are useless against viruses). The only reason we went home that night was that our all-star pediatrician intervened and authorized OneBert's release. This is why we will stay under his care as long as possible, even though he appeared on TV the other day looking like a stoned undertaker.

We are a culture drowning in pills but no cures, because the money's in the treatment. People can also be scared into believing that all germs are bad, so they'll wash with antibacterial soap and take antibiotics at the drop of a hat, unaware of all the SuperBugs (as opposed to Super Bugs) that are being created. When humanity is overrun by immense, viscous, amorphous, pathogenic pusblobs, I'll be over in the corner, wagging my finger and telling the world "I told you so."

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Yes, kids need exercise to burn up their enthusiasm for life. Sadly they often don't get enough. In the past 20 years, the number of overweight kids aged 6 to 11 and 12 to 19, has doubled and tripled, respectively. It's not clear if the problem is a result of a decrease in school-run phys-ed programs, because kids don't walk to school, or because latch-key kids watch a bunch of TV and play video games. It's also not proven that there's a link between a lack of exercise and ADHD. Post hoc ergo propter hoc. But it's worth exploring.

But until there is a definitive link, we can't say a lack of exercise is the problem. I don't know that Ritalin is the best way to treat ADHD or if the disorder is overstated. But kids have chemical imbalances in their brains just as adults do. If your child is diagnosed with ADHD, Ritalin is an option to discuss with your doctor. If you go for it and if you don't like the results, you can also stop giving it to your kids. Mostly, your doctor--not an Internet search--is the best place to get information about treating your kids' health.

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Wednesday, February 01, 2006

Goldberry's comment to my first post touched on another point about small children and the rising number of ADHD diagnoses: kids never exercise anymore. Nearly 40% of the nation's 16,000 school districts have either modified, deleted, or are considering deleting recess, because too many adminstrators think free time is wasted time. The CDC recognizes the value of something as simple as walking to school, but fewer than 10% of kids actually do. And after school, kids just can't run off to the park and burn off their Kiddie Kilowatts anymore. Overstructuring is partly to blame, but it also just isn't safe.

Preschoolers are exothermic little buggers, and if they can't get outside and bounce around all that stifled energy sets off their Spaz Reflex. But too many schools think that if a three-year-old can't sit still and patiently taste-test all the paste bottles on the craft table, his brain needs medicating. Are we parents supposed to trust these doctors after we read that kids are being used as guinea pigs for under-tested antipsychotics?

Our culture is confining our children, and we'd be a lot better off if we spent less time throwing pills at the problem and more time re-assessing its origins. Anything to help Crazy Old Tom get a little more sleep at night.

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Toddler in Chief's journey introduced me to a whole world of medical professionals and hospital wings that I did not know existed and never had any intension of familiarizing myself with—the NICU and neonatologists, cardiothoracic surgeons, and respiratory therapists, to name a few. That journey has left me on the opposite end of the medical-acceptance spectrum as LOD. 

Our minimal knowledge of heart defects and little time left us and TIC in the hands of strangers. Hours after TIC was born, he was packed up in a neonatal ambulance (which looked something like this) and transported 55 miles to another hospital without us. That experience solidified my trust in doctors. The difference is that TIC's condition is not up for interpretation. But both ADHD and depression are more difficult to diagnose because they are not evident through an x-ray, echocardiogram, or other definite test.

However, if doctors felt that TIC needed treatment for another disorder, I would be ready to listen to their advice. My experience does not mean that I accept what doctors say without thought or tons of questions. It does not mean I'm a passive patient. It does mean I have a lot of respect for their diagnosis and recommendations, especially when it comes to my son.

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Monday, January 30, 2006

Toddler in Chief gets a lot of drugs--blood pressure medicine, blood thinner, antibiotics, diuretics, iron. And medicine-time happens twice a day, everyday. None of it is optional. Most of the time it's a non-issue, but when TIC is feeling an extra surge of terrible-twos, we have to hold him down and shove it in. It's traumatic for everyone to go down that road, but that's just another day in the life of a kid with a complex heart defect.

A lot of times I wonder what it would be like to have a normal kid who just gets to play and live without the daily reminders of where we've traveled. I wonder what it would be like to go out for dinner or to the Giants game without our refrigerated sack of medicinal goodies, complete with oral syringes and pill crushers. So I'm not against medication--it keeps our kid alive. But I don't offer it lightly. I don't even like giving TIC over-the-counter stuff, mostly because introducing something new into his regiment is a challenge of massive proportions--even if it's gooey, sweet, and grape-flavored. It's also a huge hassle because I have to make sure it's compatible with his current list of heart medications.

While kids TIC's age can be diagnosed with depression and ADHD, we haven't been down either of those roads. If we are eventually faced with either, we'd make sure that he had several professional opinions--in addition to consulting with his pediatrician and pediatric cardiologist--before adding any medication to his regular routine. I would just want assurance that it's the right thing for whatever he's diagnosed with. I imagine that's what every parent aims for.

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Based on my position on inoculations, readers might conclude that I have an axe to grind toward the medical community. And I do, but not because of medical science. The science itself is glorious, and we've availed ourselves of it a number of times. When TwoBert got the croup last fall, he was treated with a steroid injection and an epinephrine nebulizer, and he was home gumming the couch in a matter of hours.

And though I don't suffer from clinical depression, I have seen firsthand the wonders of big-name anti-depressants that stabilize serotonin levels and help people live their lives--especially during the postpartum period. But these people have been adults with (presumably) fully formed brains and the ability to make their own choices. If anyone diagnosed my sons with ADHD and wanted to give them Ritalin, I would need a whole lot of convincing.

Doctors will see the "tell-tale" symptoms--difficulty paying attention, impulsive talking and behavior, and hyperactivity that often manifests as excessive fidgeting and squirming--and prescribe Ritalin to three-year-olds. That type of behavior in a three-year-old doesn't concern me, unless that kid is hurting others and/or climbing the walls with his fingernails. Altering brain chemistry is a big deal, and I would move heaven and earth--and even consider pulling my son out of school--before I relented to Ritalin therapy. It's a quick-fix solution to an overstated problem, and even the idea that websites like this exist has to give you pause.

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