Important Information about ADHD and Cardiac Risks (taken from ADD Warehouse newsletter)

Cardiac Risks for Stimulant Meds?
	Last week, the American Heart Association (AHA) announced a recommendation that will affect the way children and teens with ADHD who are either taking stimulant medication or who are thinking of getting started on stimulant medication. The AHA believes that children and teens with ADHD should receive a careful heart evaluation, including an electrocardiogram (ECG), before they begin taking any of the stimulant drugs commonly prescribed to treat ADHD. Studies have shown that these medications can increase heart rate and blood pressure. While these adverse effects are generally insignificant for most children with ADHD, they become important to consider when a child or teen has a heart condition. In a study done by the AHA, up to 2 percent of healthy school aged children had potentially serious undiagnosed cardiac conditions identified by an ECG. Certain heart conditions increase the risk for sudden cardiac death (SCD), which can occur when the heart rhythm becomes erratic and doesn't pump blood through the body. Data from the Food and Drug Administration showed that between 1999 and 2004, 19 children taking ADHD medications died suddenly and 26 children experienced cardiovascular events such as strokes, cardiac arrests, and heart palpitations. For the past year, the FDA has required all manufacturers of drug products approved for ADHD treatment to develop Medication Guidelines to alert patients to possible cardiovascular risks. "After ADHD is diagnosed, but before therapy with a stimulant or other medication is begun, we suggest that an ECG be added to the pre-treatment evaluation to increase the likelihood of identifying cardiac conditions that may place the child at risk for sudden death," said Victoria L. Vetter, M.D., head of the statement writing committee and Professor of Pediatrics at the University of Pennsylvania School of Medicine in Philadelphia. The medical workup currently done by pediatric and psychiatric practitioners who are prescribing stimulant medications for children and teens with ADHD includes a screen for cardiac disease, although the medical workup is often not as extensive as suggested by the AHA. ECG is not a standard evaluative tool administered by physicians before prescribing stimulant medications. However, the AHA found using ECG screening in this specific population of ADHD children and teens is medically indicated and reasonably priced. Vetter also said doctors should evaluate children and adolescents already taking these medications if they were not evaluated when they started the treatment. Those with known or suspected heart conditions should be routinely monitored by their physician for side effects related to taking stimulant medication. This can mean a simple, routine blood pressure and heart rate check. Children who are suspected of having heart problems after the screening evaluation is done by their pediatrician or psychiatrist should be referred to a pediatric cardiologist to get clearance for using a stimulant. Once stimulant treatment begins, these at risk children should have their heart health monitored periodically, with a blood pressure check within one to three months, then again at routine follow-ups every six to 12 months. "While we feel that an ECG is reasonable and helpful as a tool to identify children with cardiac conditions that can lead to SCD, if, in the view of their physician, a child requires immediate treatment with stimulant medications, this recommendation is not meant to keep them from getting that treatment," said Vetter, who added that some children may not have access to a pediatric cardiologist who can evaluate an ECG or perform a cardiology consultation. The statement writing committee of the ADHD said its recommendations were not intended to limit the appropriate use of stimulants in children with ADHD. Their intention was to provide the physician with some tools to help identify heart conditions in children with ADHD and help them make decisions about the use of stimulant medicaitons. The goal of the committee was to reduce cardiac risk of stimulant products in susceptible children.
	For more information see the link below.

WHAT AMERICAN IDOL TEACHES US ABOUT SELF-ESTEEM

We all have a little bit of the stars of American Idol in us, even if we can't sing. Not Kelly Clarkson, not Chris Daughtry- instead, we have Simon, Paula and Randy, the infamous judges. You only need to watch the show a time or two to see what the judges are about. Simon, the sharp-tongued Brit, is cocky, rude, and famous for bringing contestants to tears with his harsh comments. Such comments as "That was absolutely dreadful!" or "It sounded like karaoke- terrible karaoke" . While he is often accurate in his disapproval, the way he so ruthlessly communicates his judgement raises concern. Paula on the other hand, is the anti-Simon. No matter how retched the performance, Paula finds a way to tell the contestant with kind words ("I'm sorry sweetie, but your pitch was off"). She typically finds some nice words to leave them with ("You look beautiful" or "I love that outfit"). Sometimes she can be sappy and sugary sweet and at times it seems like she has nothing bad to say about anyone, but she is always sensitive to the contestants feelings. At times she even publicly berates Simon for his lack of sensitivity. Randy is a combination of the two. He isn't afraid to tell someone he didn't like them, but he does it in a kinder way than Simon does ("I'm sorry dawg, that wasn't good").

So how does this relate to self-esteem? We all have the voices of the judges inside our heads. Unfortunately, some of us have far too much of the hyper-critical Simon and far too little of the sensitive and caring Paula. Even less of us have the sensible and realistic Randy. Every time we make negative comments to ourselves ( "I'm fat", "I'm not good enough") we are channeling Simon. Would we ever talk to the contestants with the same disdain that Simon uses? Then why is it okay to talk to ourselves that way? How often to we channel Paula? If we could learn to talk back to our inner-Simon the same way that Paula does- to tell him to shut up and stop being so negative, this would do wonders for our self-esteem. If we could learn to be more like Randy- to be realistic yet kind- we would feel better about our selves. The next time your inner-Simon says "I'm such a loser", let your inner-Randy talk back and say "I made a mistake but I will learn from this" or let your inner-Paula find the good in what you've done ("You tried really hard and deserve credit for trying")

Pay attention to the American Idol judges in your head. Simon Cowell might help Fox get the ratings but he doesn't help your self-esteem. Talk back to your inner-Simon!