Family emergencies? ADDiva goes into overdrive

It's been a rough couple of months. Some of you may know that my dad was killed in a car accident two weeks before Christmas. Not a good holiday season. I was once told by a dear friend that grief sends ADHD into overdrive; now I have proof of that. I walked around in a daze, forgetting my own name, bumping into furniture and feeling that someone had transported me to San Francisco on a foggy morning. I'll write more about that in another post. For now, I'll report the rest of the story...

A month later, I made one of my regular visits to my mom in central Illinois (I actually rented an apartment there since I was spending so much money on hotels - my dad was in failing health even before the fatal accident). I was determined to get her caught up on doctor's appointments, etc.

It was a sorrowful time. The eye doctor gave her a clipboard to update her information and she couldn't remember her address. I was puzzled, then realized that for the very first time she had to circle the word "widow" on the sheet. Awful. 

I knew she needed to be seen by her regular doc but on the eve of that appointment, the nastiest stomach flu struck. Although the doctor prescribed meds for her (other) infection, she never quite recovered from the stomach ache. Wasn't hungry, kinda lethargic, but she was still experiencing acute grief, right? Yes. And that wasn't all.

Two weeks ago, she began bleeding internally and was taken to the hospital by ambulance. She had a serious duodenal ulcer. Four units of blood restored her color but two days later the nightmare continued in the ICU. Docs did an emergency procedure to stop the bleeding internally, and it seems to have worked. Two more units of blood. It was dicey; many sleepless nights in the ICU and much worry.

Mom is out of the hospital after 11 days and is spending a brief time in rehab but I am flat out exhausted. After a week or so, I just gave into the situation and let myself float along without trying to make sense of anything. Just worry, sleep, food and more worry.

Ironically, my ADD kicked in during this emergency - we ADDivas do, after all, come to full alertness when there is a crisis. But this crisis lasted so long that my ADD eroded the edges of my life to the point that I was clueless about time or space or obligations (apologies and thanks to my patient clients who waited for me to regain some sanity).

Honestly, I feel like a truck ran over me (but my dad was killed by a semi, so that's not a good analogy). I can't quite grab ahold of reality yet. I can't find my underwear drawer on the first try. I don't know when to eat and when to stop. My brother and I are making so many crucial decisions about my mom's future and medical treatment that I am in the middle of that childhood merry-go-round watching the horses whiz by. I wonder if I should try to get on while it's whirling. But I'm immobile, watching in amazement that once-upon-a-time I actually rode those angry stallions with the wild eyes and frozen expressions.

I know I'll come back to life again. Heck, simply writing this blog post is part of that road to reality. But let me tell you, ADD has been part of this entire horrible experience. Not sure whether that's a good thing or not. I'll let you know in a couple of weeks.

In the meantime, I'll bet some of you have your own horror stories to tell. Drop me a note or leave a comment here. I'll be back to you, I promise.

Early hormone therapy cuts risk of Alzheimer’s by 30%

If hormone therapy (HT) is started within five years of menopause, there is a 30% reduction in the risk of Alzheimer's disease! These startling results were reported today in "First To Know," the e-newsletter distributed by the North American Menopause Society. (http://www NULL.menopause NULL.org/)The original study, published in the journal Neurology (October 30, 2012) was conducted with more than 1700 women in Cache County, Utah over a seven-year period. It showed that there was a small window of opportunity for HT to be effective against the onset of Alzheimer's disease - specifically, within the first five years of menopause. If hormone therapy is started after that five-year window, the risk of Alzheimer's disease is unchanged.

This validates some of the findings of the Women's Health Initiative (WHI), a fifteen-year study initiated in 1991. You may recall that one segment of the WHI was halted when researchers found that women taking HT had higher rates of heart disease. However, those findings were true only for women who started hormone therapy as much as ten years post menopause. The Cache County study reflects similar results for older women who start hormone therapy.

Even more surprising  was the news that unopposed hormone therapy (estrogen only) seemed to reduce the risk of Alzheimer's even more than a combination of estrogen and progesterone. And longer treatment with hormone therapy (as much as 10 years after menopause) apparently maintained that lower risk for Alzheimer's.

The authors of the study (Shao H, Breitner JC, Whitmer RA, et al)cautioned that women should not start or continue hormone therapy primarily to prevent Alzheimer's disease, since there are many other factors to consider. It does reassure me, however, that my extended hormone therapy may not be such a terrible idea after all. Of course, unopposed estrogen therapy has been shown to increase the risk of uterine cancer. But progesterone is one of the culprits that causes foggy brain, so I am not crazy about taking it.

Doesn't it drive you crazy that no one really knows what we should do? And when we should do it? Arrrrgh! I just want simple, clean answers and there are none. What will happen to me medically will happen, I suppose. I'd just like to improve my odds of staying alive and coherent as long as possible....

To read the entire article and decide what this study means to and for you, visit the NAMS e-newsletter site.  (http://www NULL.menopause NULL.org/docs/professional/news1112 NULL.pdf)The original study was published in Neurology, October 30, 2012 (http://www NULL.neurology NULL.org/content/79/18/1846 NULL.abstract?sid=79810f37-3949-4ebe-ae03-1d3a4e38985d).

Does NC really have more ADHD than any other state?

According to the Centers for Disease Control (http://www NULL.cdc NULL.gov/mmwr/preview/mmwrhtml/mm5944a3 NULL.htm?s_cid=mm5944a3_w)North Carolina has the highest prevalence of ADHD in the United States for youth ages four through seventeen (15.6%). Nevada, by contrast, reported only 5.6% prevalence of ADHD among the same age group. Does the population of North Carolina really have three times the number of kiddos with ADHD? Or is there something else going on here?

ADHD prevalence in US ADHD ever-diagnosed prevalence in US, 2007, courtesy CDC 

Dr. Stephen Hinshaw (http://psychology NULL.berkeley NULL.edu/people/stephen-hinshaw) believes there is more to the picture than statistics reveal. In a presentation at the 2012 CHADD conference (http://chadd NULL.org) in San Francisco, Dr. Hinshaw told an rapt audience that his UC-Berkley psychology lab showed that the highest prevalence of ADHD among children was found in states that had implemented achievement-based testing for promotion from one grade to another. 

In other words, when children were required to pass a state-mandated test to go to the next grade level, more ADHD was discovered by parents (as the likely culprit for failure). According to Dr. Hinshaw, most of those states were in the South. The states reporting the highest prevalence of ADHD were North Carolina, Louisiana and Alabama (15.6%, 14.2% and 14.3% respectively). And other southern states also showed high prevalences of ADHD as well (see chart).

So, ADHD diagnoses are not correlated to geography as much as they correlate to political influence on school testing. An interesting finding that has far-reaching implications for diagnoses for adults as well as children, since adult diagnoses are assumed to be residual aftereffects of childhood diagnoses.

Hmmm.. will we ever have accurate statistics about ADHD? Hard to say, but the stats are obviously misleading in 2012.

Study: Suicide more likely among ADHD girls

 Results of a major research study, released last week, show that adolescent girls with ADHD are more likely to attempt suicide and to inflict injury on themselves than non-ADHD girls of the same age.

The study, led by Stephen Hinshaw, PhD and published in the August edition of the online Journal of Consulting and Clinical Psychology, reports that these tendencies show up more often in girls diagnosed with primarily impulsive type ADHD. The majority of girls are diagnosed with combined type ADHD, which includes impulsivity as well as inattention, so many are at risk.

I am not surprised in the least. For years I have scoured medical journals and psychology websites for some evidence that ADHD produces a higher rate of suicide (or suicide attempts). I have found precious little research to support my suspicion that ADHD heralds a sobering proclivity to hopelessness. After years of attempting solutions that fail, some adults and children see no other way out but to take their own lives. I am sure they believe the world will be better off without them. I know I did.

Before I turned 30, I was contemptuous of people who flirted with suicide. I believed that they were weak and cowardly or that they were self-pitying, vying for attention. I was self-righteous right up to the day that an avalanche of events stole my optimism and I, too, crossed the line into suicidal thinking. It's not pretty, but there it is. It's happened more than once, I am embarrassed to tell you.

As with most research, the data stands alone, subject to interpretation. But Dr. Hinshaw has said many times that societal and peer pressure on adolescent and even elementary school girls, is so strong that it's almost impossible to avoid psychological damage. "At least one fourth of all U.S. teenage girls are suffering from self-mutilation, eating disorders, significant depression or serious consideration of suicide." (from Hinshaw's book The Triple Bind ©2009). Add ADHD into the mix and despair creeps in.

Don't think for a moment that this study doesn't apply to you because it was based on two groups of adolescent girls (ADHD and a control). My hunch is that the statistics would hold for ADHD adults, too. Research to prove it is a distant reality, though. I have casually surveyed groups of ADHD adults with ADHD about their close encounters with suicide. The completely unscientific ratio of those who have considered suicide vs those who have not is about 50-50. So not all ADHD adults are at risk. But some of us are.

Obviously I am still here, happy and healthy. There is a primal human lust for survival and I trusted it. But this new research on ADHD helps me remember those dark days in a diferent context. I may have been at the mercy of my undiagnosed ADHD. Would diagnosis and treatment have warded off the whispers of death? Perhaps.

Which makes it doubly important to treat your ADHD instead of hoping it will go away. It's vital to find a coach, a therapist, a non-judgment friend or a religious counselor who can muck around in your wild brain with you. It's important to take your medication if you choose that treatment. It's important to stay connected with other folks who understand from the inside out how it feels to have ADHD.

If you are in the crosshairs of several crises and your resilience has evaporated, know that you are not alone. You have an entire ADDiva community with whom to share your burden. We are here for you. Talk to us. We believe your life has value; there is a reason you are here on this planet at this time in this place.

You are not alone.

Travelin’ and memory lane

 Been on the road since Friday visiting family in Illinois which included attending my neice's wedding near Bloomington. Gorgeous, of course. Vineyards seem to be the "it' place to get married these days (who knew?).

In all the excitement of the ceremony, the reception and the morning after, I was feeling a little sad, for no apparent reason. After all, weddings are a GOOD thing. But I realized that I was back in my childhood environment. The flat Midwest corn fields are nostalgic for me (even when they are burned up by drought - awful). And I found myself in tears thinking about some vague events from years gone by.

So I took an early morning drive on the country roads (most of them 'hard roads' as we used to call roads with actual blacktop), feeling more than a little guilty about using fossil fuels for a joy ride. I realized as drove between those flat fields interrupted by little clumps of trees with small groups of buildings - house, barn, shed, grain elevator - that nothing had really changed in 40 years. Farmers were still worrying about rain. Kids were still swinging on rope swings. And hearts were still being expanded (as in weddings) and broken (as in divorces). 

There were both kinds of hearts at the wedding. Nick and Dorie, of course, were elated, even after spending the last 11 years together. Married is married. It's different.

My brother's newest girlfriend was suffering on the opposite end of the spectrum. Her ex was getting married to HIS new girlfriend the same day. Icky, even when they'd been separated for years.

And with my own son, daughter-in-law and granddaughter in attendance, it brought back my own semi-sweet memories of young love and divorce. I couldn't have fallen harder for my first husband and that's the truth. I suppose I should be over it 20+ after our final divorce, but it still pinches that life didn't turn out as we expected.

Ditto for life at home. My parents are older. My dad's heart that has survived many assaults over the years, is failing. My mom tells me the same story again and again. And I know that soon, very soon, death will lop off some of my dear family. 

So I think my nostalgia was intermingled with joy for Dorie and Nick, joy at spending some special time with little Lilly (who is a wonderful little three-year-old) and pre-mature sorrow for the life that 'once was" and the life that 'might have been."

There are a lot of family dynamics in play when I go home. They really don't know me at all. They think ADD coaching is trivial and unimportant. And by their measure (the amount of money I have in the bank), I'm not very successful. So why do I care? They think what they think. Yet I have this absurd little girl urge to do something that will please them, let them know that I'm OK before it's too late.

It's a weird feeling to go home again. On one hand, I am happy to be there, among people who have known me all my life - literally. And on the other hand, those same people know my failings. So while I love them beyond measure, I am also a tiny bit fearful that they will dredge up some awful truth about me that they think is important (and that i have tried to forget).

My overriding emotion is sorrow at my losses - those in the past and those upcoming. My instinct is to stay longer, try to hold on to what's left, to pin down that ethereal spirit we know as "Life." Yet what's ahead will happen without a push from me or a tug back on the reins from me. 

I'm rambling, I know. So what is it I want to say? That my tender heart get even more mushy when I'm here. That I feel vulnerable. That part of me yearns to go back to that young life of innocence and trust (which really wasn't quite so idyllic as I remember). And that my roots run deeper than the brittle corn stalks anchored in dusty soil.

This Illinois life is the foundation of who I am. And who I became. And yet, I am not this Illinois life any longer. That makes me happy...and sad. That's all.

The Book Award Journey

Was it sensational?
Yes.
Was it luxurious?
Oh yes.
Was it one of the best days in my life?
You bet.

My trip to New York for the Next Generation Indie Book Awards (http://www NULL.indiebookawards NULL.com/awards NULL.php) reception was a once-in-a-lifetime thrill. And I savored every minute of it. A brief recap:

Victor and I arrived at RDU (Raleigh-Durham International Airport) at 12:30 am Monday morning due to stormy weather in Denver (we had been on a weekend trip to San Francisco to celebrate daughter Heather's birthday). But my plane to New York departed at 10:40 that morning! It was a too-short night - unpacking, repacking and driving to the airport less than eight hours later.

I arrived at chilly, rainy JFK a little earlier than expected and took a taxi to Midtown - I had a one-night reservation at the Plaza Hotel (http://www NULL.theplaza NULL.com/), where the awards ceremony would take place.The Plaza is directly across the street from Central Park - lots of landmarks on the ride into town.

When I checked in, the quite nice young man at the desk cordially informed me that I had been upgraded to a junior suite. I didn't argue and used my key in the elevator to access the exclusive 18th floor. When I opened the door, I was take aback…the room was stunning.

Living room with Queen Annechairs, leather topped desk, huge flat screen TV and a bedroom with an ornate headboard, high thread count sheets and three closets! (you can see my four-minute phone video above).

I had a couple of hours before the reception but I was starved - I'd had no time for breakfast. It was past lunchtime in the Palm Room, but they were serving afternoon tea-- MY FAVORITE! So I went to tea. So elegant. So tasty. So civilized!

Then I went back to the room and bought  a ticket to "Rock of Ages," one of the few Broadway shows that has a Monday night performance. A single ticket is a lot easier to find than two together! Curtain time was 8:00 pm so I had plenty of time since the reception ended at seven.

I took a shower, fixed my hair (I'd had my hair cut in San Francisco by a terrific stylist) and makeup and made my way downstairs to the reception.

At 5:02 there was a line across the Plaza lobby and up the marble stairs to the Rose Club. We waited 20 minutes to register and make our way upstairs. Then it was a mad crush. So many people (so many winners -- some First Prize, some Finalists, some spouses and friends). Champagne flowed but I didn't indulge - I didn't want to fall asleep during the show later that night.

Finally, the awards ceremony began and the three grand prize winners were announced and they each made a brief speech. The rest of us were lined up in order of our categories and prize. By the time they announced the Women's Issues category (next to last in alpha order) people were chattering so loudly, you couldn't even hear them announce the name of my book! Ah well, I took my place in line to receive my award and have my picture taken.

At seven o'clock we were still in line. At seven-ten we were still in line. At seven-fifteen, I finally reached the front of the line and was draped with a surprisingly heavy "gold" medal on a red-white-and-blue ribbon (ala Mark Spitz for those of you old enough to remember). I hugged Marilyn Allen, the literary agent I had met earlier in the evening and was congratulated by Catherine Goulet, the awards chairperson (left).

Then I took off like the proverbial bat out of an awards reception to do a lightning quick change of clothes on the 18th floor and back downstairs to find a taxi. Of course, it was the precise time of day when taxi drivers were changing shifts, so I waited and waited and waited for a taxi that was available.
Finally the doorman flagged down one of those bright yellow cars and we took off like the proverbial bat out of the Plaza Hotel, screeching from one red light to another. We made it in record time to the Helen Hayes Theater (amazing how fast those taxis move in a pinch).

OMG. The line to get in was a block long, but that line was for people with tickets. The Will Call line was shorter. Much shorter. Like…no line at all. I picked up my ticket and walked in ahead of everyone else (that really wasn't fair, but I didn't make the rules).

The first half of the show was fair to middling. The second half was terrific and funny. By the end, we were all singing and dancing like it was a rock concert as "We Built This City on Rock and Roll" echoed through the building.

Then came the true test of my New York experience. I actually hailed a taxi and IT STOPPED TO PICK ME UP! So many times, the drivers whiz on by, but this was MY DAY … the first driver stopped and I made it back to the Plaza, music still ringing in my ears.

By that time, I was hungry again. So at 11 pm I ordered room service -- the Plaza chopped salad and iced tea. And took pictures of my medal nestled next to the food (OK I know it was hokey but I was a small town girl in the big city junior suite!).

When I finally fell into bed (neatly turned down by my private butler with my slippers beside my bed on a linen towel and a bottle of Fiji water on the bedside table) I was deliciously tired and happy.

In the morning, I took a bubble bath in the soaker tub, got dressed and said goodbye to my New York adventure. But what to do with the medal? I didn't want to crush the ribbon. So I put it in the laundry envelope from the Plaza to get through security at the airport. After that I wore it around my neck.

Only one person wanted to know what it meant - the girl behind the counter of the gift shop back at RDU. She even asked for my autograph. I signed my business card for her …

And that is the not-so-brief highlight of my book award and Plaza indulgence. Everyone should do it at least once!

Integrated Listening Systems (iLS)

For two years now, since I gave up my Adderall, I've done little to "treat" my ADHD, aside from trying to practice meditation occasionally and being aware of my own ADD-ish methods to Get Things Done.

And I'm not much for new-fangled miracle "cures." Especially in ADD-land, they are a dime a dozen and almost none of them effective. Yet, I'm still open to the next new thing that might have an impact on ADHD in general, mine in particular.

So I was intrigued by the Integrated Listening System (http://www NULL.integratedlistening NULL.com/) which uses normal sound waves plus "bone conduction" to supposedly stimulate the cerebellum (at the base of your skull) which in turn talks nice to the pre-frontal cortex (those of you who have read my book (http://confessionsofanaddiva NULL.com) know her as Ms. Prefrontal Cortex, the keeper of executive function and responsibility and planning, that sort of thing).

Lately, there seems to be some veering toward the theory (and they're ALL theories) that the ADHD pre-frontal cortex isn't as squirrelly as once believed. It may be that the neural messages sent TO Ms. Cortex are less frequent which can throw a wrench into the best laid plans. The iLS folks (and some other distinguished experts like Russell Barkely, Ph.D.) believe that the offending brain part that isn't sending "good"messages is, of course, the cerebellum. 

The iLS system consists of an old-fashioned iPod (click wheel variety) attached to a slightly larger and heavier box that is connected to the bone conduction device. The device resides in the top of the high quality headphones provided by iLS (Sennheiser, if you know your audio equipment) and presses against the top of your head. It's small - about the size of a small matchbox.

iLS

I probably once knew, but forgot that audio vibrations travel not only through our ear canal, but also our bones. When we speak, for instance, we don't hear much of what comes out of our mouths through our ears. We hear it through bone conduction. Wild, eh? I was skeptical until the iLS folks reminded me that I sound completely different on tape than I do to myself. To me, my voice is lower and more resonant. I was finally convinced when the iLS trainer asked us to try out the system and to turn down the volume on the iPod so no ear canal sound waves would be transmitted. I could still hear the music! I was stunned. 

I know it's a leap from hearing my voice through my bones to helping my ADHD, but I'm going to give it a try. The Concentration and Attention module is 40 one-hour sessions of mostly classical music that is "gated" to amplify specific sound spectrums. Which is supposed to shake the cerebellum into being a nice guy and sending better messages to Ms. Cortex.

It's a long shot. I'd like it to work. Right now I'm on Day Five. You listen at least 3-5 times a week and I want the full benefit quickly. I don't resist the sessions, unlike the working memory training (http://www NULL.cogmed NULL.com/) I did about 18 months ago (whose name I dare not mention for fear that the company police will hunt me down again). But you aren't allowed to work on the computer or watch TV during the music, so I am taking long walks with the dogs. 

Milli and Sophie (http://roggdoggblog NULL.com/) love iLS. We'll see how my brain reacts. I'll check in periodically -- maybe even regularly if it works!