I never remember whether you call the calendar Gregorian, after Pope Gregory, whom I never liked much, or Julian, after Julius Caesar, who was worse in some ways and better in others. It must be Gregorian because of the time thing.
Oh, that time thing! It has been playing tricks on me lately.
Taxi Dog reminded me that I haven’t written a post in two weeks. Part of that is due to my mother’s contracting a wracking case of bronchitis. She was just coming down with laryngitis when I pitched her a curve by throwing her a gigantic surprise party for her 85th birthday. I’m sorry to say that she had such a good time that the infection got into her lungs and she got right sick with it. She’s better now, B”H (Baruch Ha’Shem=Thank G@d). But it took quite a bit of nursing, and taking care of Dad who is forgetting how to do a lot of things nowadays, and going to the grocery store and providing dinners.
My parents, who are 85 and 87, live at the end of a dirt road which is at the end of another dirt road which leads to a road that is not on most maps. They built their house out there when they were young and hale and romantic. Now they’re none of the above. Well, maybe some romantic. And my mom gets around better than many people 20 years her junior. She’s more than determined. Last year she climbed out the second story windows in order to sweep branches off the roof. But she was only 84 then.
Things keep falling off the house. One of the early symptoms of my dad’s dementia was that he developed an aversion to having anything repaired, because he had a delusion that they didn’t have enough money. And he was used to fixing things himself, even though he rarely actually did much of it. He was too busy dreaming and making astonishing art that bubbled up from the depths of his dreams. Now he still dreams, but he can’t do anything about it because his brain has betrayed him. And he’s given up trying to control things, so when, for instance, a big branch impaled the tin roof during a wind storm, my mom just called a roofer and had it repaired, just like that.
I have been struggling with foolish things, like trying to get the dishes done, making my bed, putting away the clean laundry. I get just so far, and then something else calls me, breaks my attention, and there you go. But it’s not ADD. Oh, no. Shrinks have dosed me up on stimulants and I have gotten a terrible case of the creepy crawlies. I remember that feeling from juvenile adventures with LSD that was cut with meth. Now why on earth would anyone take speed for fun? Ugh. Even my son, who really does have ADD, says the stimulants make him feel creepy, even though they help immensely.
He started Ritalin in second grade. It made the difference between a kid who cried a lot, got into fights, and couldn’t sleep, and a kid who enjoyed life, got straight A’s, and loved school. The problem was, he had a mom who often forgot to give him his morning dose. His teacher would call me at about ten o’clock: “Doctor, did you forget to give C__ his Ritalin this morning?” Luckily his school had a nurse who was willing to give him his AM dose as well as his after lunch dose (those were the days before time release), so he just went to the infirmary as soon as he got to school every day.
As a pediatrician, I often treated kids who were referred by the school or their parents for ADD. In those days there was still such a thing as sugar pills, so I’d give them a two week supply of sugar pills labelled “A” and a two week supply of Ritalin labelled “B.” They were to give medicine “A” for two weeks, then switch to medicine “B.” Both the teacher and the parent filled out daily questionnaires rating attention. Then they’d return to me with their questionnaires and we’d see whether the Ritalin had made any difference compared to placebo (medicine “A”).
Sometimes I’d get a kid who had a weird reaction to the Ritalin. Instead of becoming more focused and less frustrated, they’d become tearful and just fall apart. Those were kids with Bipolar Disorder.
In those days there were very few psychiatrists willing to diagnose Bipolar in a child under 16. Even fewer willing to treat with Lithium, because there was little research published, it was not FDA approved for under 16, and of course Lithium is a potentially toxic substance.
But if I had a kid who was moody and weepy one minute and aggressive and smashing things the next, or staying up all night playing Demolition Derby with Tonka Toys, you bet I treated with Lithium. I think I might have had four or five kids like this in my sixteen years of practice. It was magical to see these kids go from miserable and constantly being scolded to happy and relaxed, just being kids. And you can imagine how relieved the parents were.
I think about those kids from time to time, and hope their lives were smooth, and that the magic Vitamin L made everything all fine for them, Happily Ever After, The End. But I doubt it. Life is not that simple.
So: not all attention problems are ADD, or ADHD, as people like to lump things today. Bipolar Dis-ease can wreak havoc on your attentional abilities. Weeks can go by, and you can even forget that you are writing a blog. Thank G-d for friends from afar who are concerned enough to drop a line and say, “Are you all right?” Thank you, Taxi Dog.