AD/HD in the News

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Trish White wrote:

Subject: AD/HD in the NewsDate: Mon, 6 Jan 2003 11:03:41 -0500From: "Trish White" To: AD/HD in the NewsJanuary 3, 2003NOTE TO READERS: The CHADD Communications Department monitors several news services forarticles referencing AD/HD. We scan for favorable and unfavorable mediacoverage. "AD/HD in the News" is routinely distributed to the CHADDstaff, CHADD board of directors and various CHADD committees.When and where appropriate, the national office (or other designatedboard member) responds to reporters/publications with notes ofappreciation and/or concern/disagreement.Happy New Year!Sincerely,Peg NicholsDirector of Communications & Media Relationspeg_nichols@...Winnie ImperioCommunications Associatewinnie_imperio@...____________________________ 1. What is the Perfect AD/HD Job?2. ADHD: Real and Treatable3. Karate Studio Teaches Discipline, Self-Control4. State Given List Of Patient Prescriptions, But Not For LawEnforcement5. New Drug Strattera May Help Child With ADHD6. New Teaching Approach Shuns Labeling Children7. Your Health8. New Laws In Effect As Of Now9. Spending on Childrens' Rx Rises Rapidly10. Questioning a Mercury Link To Autism11. Annual Checkup12. 'Friendly Fire' Pilots' Stimulant Use Examined13. Amphetamines Common in Air Force14. Lawyer Points Finger At Air Force15. Acupuncture: Straight to the Point16. More Than A Bump On The Head____________________________ Please note: CHADD Communications Associate Winnie Imperio is one of tenprofessionals featured in the following article.1. What is the Perfect AD/HD Job?ADDitude MagazineJanuary 2003EXCERPTWinnie Anne Imperio, 25Profession: Communications Associate, CHADD National OfficeRoute to Job: "I started out as a biology major with a knack forwriting; a rare combination," says Imperio, who later became a medicaljournalist after receiving her B.S. She then pursued opportunities inpublic relations, which led to her job at CHADD.Job Description: Composes and distributes news releases and otherinformational materials about AD/HD for the media and key legislators toeducate the general public and promote awareness of CHADD and itsservices.Job Advantages: "Working in Communications requires constantinteraction, which I crave, and my racing thoughts and listless braindefinitely come in handy," says Imperio. "This job does not allow forboredom, which is my worst enemy."Job Disadvantages: Organization and paperwork are "constant issues, bothat home and at work," says Imperio. "Often the mess is so overwhelming Ihave to take a break to sort through the piles." To help keep track ofe-mails, phone calls, tasks and notes, Imperio keeps one big notebookand draws a large box next to each entry so that she can check it offonce the item is taken care of.Advice to Others: "You have to know how to retrieve credible informationquickly," says Imperio. "And then you need to write, write, write!Writing skills are an invaluable asset."____________________________ 2. ADHD: Real and TreatableResearch shows that medication helps and doesn't harm brainCharlotte ObserverKay McSpaddenDecember 27, 2002Scan the medical or self-help aisles of any bookstore if you want to seethe extremes in American attitudes about the most extensively studiedchildhood mental disorder, Attention Deficit Hyperactivity Disorder, orADHD. Books claiming that ADHD is a fraud perpetrated by thepharmaceutical companies sit beside others which offer intensivetreatment plans. The research is evolving so quickly that the booktitles change regularly, and individuals who are struggling tounderstand the diagnosis are left to sort through conflicting claims.Is ADHD even real? Although a few popular authors claim it isn't,researchers studying the disorder agree that ADHD is very real.Testifying in September before the House Committee on Government Reform,Dr. Nakamura, acting director of the National Institute ofMental Health, explained why scientists have concluded that ADHD is abrain disorder and not an artifact of poor parenting, socialmaladjustment or willfulness.First, ADHD occurs in every human population, showing consistentsymptoms of inattentiveness and/or impulsivity and hyperactivity.Second, the disorder tends to run in families, suggesting a geneticorigin. Finally, the brains of people with ADHD show the same anomalies.A brain-imaging study published by NIMH in 1996 showed that as a group,people with ADHD have less electrical activity in the parts of the brainthat control impulsive behavior. In the Oct. 9 issue of the Journal ofthe American Medical Association, the NIMH brain-imaging team publishedthe results of a 10-year study which shows that the brains of childrenwith ADHD are 3 to 4 percent smaller than the brains of children withoutthe disorder, and the more severe the symptoms, the smaller the brains.As the research continues into the causes of the disorder, the treatmentprotocol has been tested as well. In 1999 NIMH published the results ofa comprehensive study that divided 600 children with the combined formof ADHD -- they were both inattentive and hyperactive/impulsive -- intofour different treatment programs. One group received medication only,usually methylphenidate, or Ritalin, a drug used for the past 30 years;the second underwent an intensive 12-week behavior therapy camp thatincluded their parents and teachers; the third group received medicationand behavior therapy; and the fourth group received no treatment.The two groups that received medication did the best, with additionalminor gains shown by the group which had medication and behaviortherapy. The group that received behavior therapy only and the groupthat received no treatment did not improve their ability to controlimpulsive behavior or to be attentive.Researchers are also beginning to provide measurable evidence thatRitalin affects not only behavior but brain size as well. In NIMH's10-year brain imaging study, the ADHD children who had never beentreated with Ritalin or similar medications had the smallest brains,while the children without ADHD had the largest. Children with ADHD whohad taken Ritalin or similar medications had brains almost the same sizeas the normal controls.Dr. Xavier Castellanos, the lead researcher of the study, said, "Thereis no evidence that medication harms the brain. It is possible thatmedication may promote brain maturation."The medications are effective for an estimated 9 out of 10 ADHDchildren, have been shown for three decades to be relatively safe, andaffect brain development in a positive way. Why, then, are some parentsand professionals reluctant to make use of them?On a recent PBS Frontline documentary called "Medicating Our Children,"Dr. Harold Koplewicz, vice chairman of psychiatry at New YorkUniversity, speculated about that reluctance."People have difficulty believing that their children can becomepsychiatrically ill. How could that possibly be the case? Children aresupposed to be happy. Children are supposed to be able to function.Childhood is just synonymous with joy."For a parent who says, `I don't want to give my child medicine,' Iwould say to that parent that they have to think very carefully aboutthe potential side effects of not taking that medication."Long-term studies show that kids diagnosed as ADHD had problems. Theydidn't do as well in high school. They didn't do as well ininterpersonal relationships. They had more trouble with the law. Butmore important are the kids who did do well. What made them special? Inthose cases, you see that most of those kids took medication longer."In his testimony before the House, Nakamura was careful to presentmedications as one part of a comprehensive treatment program, and heargued that despite public perception, stimulants are not beingoverprescribed. In fact, only half of the estimated school-age childrenwho suffer from ADHD are being treated at all.Part of the problem is our persistence in thinking of ourselves as amind separate from a body instead of treating the brain as part of ourphysical self, an organ like any other, susceptible to disease andamenable to treatment.However, we owe it to our children to study the research and tailortreatment plans based on that knowledge. Not to so do out of fear orignorance is an injustice for the children whose health depends on ourcare.____________________________ 3. Karate Studio Teaches Discipline, Self-ControlKansas City Star CruseDecember 28, 2002An Olathe martial arts studio that specializes in teaching childrenwith attention-deficit disorder (ADD) and attention-deficithyperactivity disorder (ADHD) has moved to a new home. Danny Mullane's White Horse Kempo Karate has moved from a studio insouthwest Olathe to a larger location at 2071 E. Santa Fe in theCrossroads Shopping Center at East Santa Fe and Mur-Len Road. Mullane increased the size of his studio from 1,200 to 1,850 squarefeet. In addition to teaching students as young as age 5, the newstudio also offers martial arts physical fitness classes for adults.Mullane described the adult class as a "high-energy workout designed tohelp adults get in shape and lose weight." Classes are offered in the evenings and on Saturdays. Prices range from$100 to $125 per month, which allows students to attend up to threeclasses weekly. Mullane has a decade of experience in teaching martial arts. Heinitially taught for the YMCA before opening his own studio about fiveyears ago. A registered nurse, Mullane also works at Two RiverPsychiatric Hospital in Raytown. Martial arts can be effective in helping children with behaviordisorders , Mullane said. "The discipline and training that goes along with learning a martialart can help students with ADD, ADHD and Asberger's improve theirconcentration and do better in school." Cheryl Brinegar of ee said her son Christian, 7, has ADHD withautistic tendencies. Attending martial arts classes has improved hislistening skills and reduced his impulsive behavior, she said. "White Horse was recommended to us by a child psychiatrist who thoughtit would help Christian with his self-discipline and self-control," shesaid. "I've seen definite improvement in his behavior since he'sstarted taking the classes.". Mullane has also added a program called "Bully Busters," which teachesstudents how to deal with aggression. "We do a lot of role-playing so the students learn how to deal withreal-life situations," he said. Tom Roskop's son Iain, 11, has been attending classes at the studio forabout a year. "I would say it's definitely improved his self-esteem," said Roskop, anOlathe resident. "Danny talks about real-life situations with thestudents and teaches them how to avoid conflict and walk away fromconfrontations." Dan of Stilwell said her 10-year-old son, Josh , hasbenefited. "Danny is super with the kids," she said. "He teaches discipline, butis patient and caring." Classes are offered from 6 to 9 p.m. during the week and from 9 a.m. to2 p.m. on Saturdays. Call for more information. Copyright 2002 The Kansas City Star Co.http://www.kansascity.com/mld/kansascity/4817561.htm____________________________ Please note: Reno CHADD Coordinator is quoted in thefollowing article.4. State Given List Of Patient Prescriptions, But Not For LawEnforcementLas Vegas SunCy and Judy Odierna January 3, 2003Every month Nevada pharmacists transmit to the state the names of peoplewho have purchased painkillers and other potentially addictive drugsprescribed by doctors -- and that information is available to lawenforcement officials.Nevada is one of 17 states in which police are able to collect theinformation under the auspices of a federal program that has pharmacistsfile regular reports that include patients' names, the names of theirprescriptions, the amount of the medication they receive and the namesof their doctors. The states' programs fall under the national umbrellaof the Prescription Drug Monitoring Program.Nevada authorities say their system is different from those of otherstates where the information is routinely funneled to police agencies."This is not used as a law enforcement tool," said Louis Ling, attorneyfor Nevada's Prescription Controlled Substance Abuse Prevention TaskForce.That 15-member task force tracks everything from hard-core narcotics toprescribed painkillers and anti-anxiety medication like the frequentlyprescribed Xanax and Valium pills. It is composed of representativesfrom boards that license doctors, veterinarians, dentists andpharmacists as well as physicians who specialize in the treatment ofaddiction. One member is from the Nevada Division of Investigations."Nevada is unique," Ling said. "These people (who are suspected ofabusing prescription drugs) don't need to be arrested. They need to betreated."In Nevada, use by law enforcement of the prescription drug informationis limited, he said. The task force turns over the data to police onlyafter it is verified that they have an open investigation of theindividual. That must be verified, Ling said."That doesn't take very much, does it?" said Alan Lichtenstein, generalcounsel for the American Civil Liberties Union of Nevada.Civil libertarians around the nation have said they are troubled by whatthey see as the "Big Brother" aspect of the reporting system and the wayit breaches doctor-patient confidentiality."We're talking about medical information that is supposed to be privateand giving law enforcement open access to that," Lichtenstein said.Ling said the Nevada task force is sensitive to those types of concerns."We are not snooping around in somebody's medicine chest," he said.There are fewer than 100 cases of police access a year, Ling said. Andthe federal Drug Enforcement Administration cannot get Nevada'sinformation about prescription drug users unless the DEA is working witha Nevada law enforcement agency, Ling said. of Reno didn't realize her children's Ritalin prescriptionrecords are reviewed by state authorities and could be turned over tolaw enforcement, but she said she's OK with it."It's a controlled drug, it should be monitored," said , avolunteer with Children and Adults with Attention Deficit Disorder. "I'mnot shocked that it happens. If the drugs are being abused it should bemonitored."People who are going to one or two doctors for prescriptions are notsingled out by the task force, no matter how many drugs they take, Lingsaid.The computer that holds this confidential information for the task forceis not hooked up to any outside line, so there cannot be anyunauthorized access, he said.The task force meets once or twice a year to decide how to use the datathat the state receives from about 2 million prescriptions a year. Lingsaid the primary mission is to identify those who might be abusingcontrolled substances. A doctor who is treating a patient can requestfrom the task force all of the prescriptions filled for that individualover the past six months or past year. The task force gets about 10,000of those requests a year.Ling said this helps physicians determine the amounts and varieties ofdrugs the individual is using and whether he or she is "doctor shopping"-- going to various doctors to get prescriptions and filling them atnumerous pharmacies."The doctors love this," he said.Lichtenstein said not all doctors love it, however. He said the systemkeeps some doctors from providing enough pain relief to their patients."A lot of people with terminal cancer or patients that are dying inagony are not getting the proper pain medication because doctors arefrightened about being investigated for being a drug pusher,"Lichtenstein said.Lichtenstein cited a national study that last month gave hospitals inNevada the lowest possible grade because they offered few painmanagement services.And in May 2000, the Nevada Board of Medical Examiners said a regulationwas needed to ensure that patients receive adequate drugs to easepersistent and extreme pain and at the same time protect doctors fromsanctions.Ling, however, said the task force does not investigate doctors ordruggists who appear to be over-prescribing. But it does provideinformation to the appropriate licensing board if such a board hasstarted an investigation of a doctor or pharmacist.Dr. Warren Evins, president of the County Medical Society, saidmany physicians are supportive of the program."I think it's a good program and I use it frequently," he said. "I thinkmost patients know that certain drugs are controlled substances and thatthe DEA regulates it. All physicians are aware of it. I would thinkpatients are aware too but I'm not positive about that."Tricia Leland, a program director with the American Cancer Society ofSouthern Nevada, said she believes the records that are under scrutinyare not those of terminally ill patients."They are actually targeting people who are not ill and don't need themedications; that's what they are trying to control," Leland said. "Idon't think it pertains to cancer patients."The task force does look for profiles of people who are going tonumerous doctors for prescriptions and having their prescriptions filledat numerous pharmacies to avoid detection. The records of such patientsare sent to the doctors and drugstores that are providing the drugs,Ling said. The task force finds fewer than 1,000 of those cases a year,he said.The goal in those cases is to get doctors or pharmacists to encouragethose patients to seek treatment for drug abuse. Ling said there havebeen many success stories in which individuals reduced the amount ofdrugs they were taking or kicked the habit altogether.Typically, those drug abusers are not recreational users but people whohave suffered from intense pain, Ling said. Among the most commonlyabused prescription drugs are OxyContin, Vicodin, Lontab and Narco,which are classified as Schedule III painkillers.Federal law breaks lists a number of controlled drugs on five"schedules." The schedules set control guidelines and regulations as tohow each of the listed drugs can be prescribed, as well as other controlmeasures.According to the U.S. Department of Justice, more than 1.7 millioncontrolled substance prescriptions were filled in 1997, the first yearof Nevada's prescription tracking program. Of those, 761,043 wereSchedule IV drugs such as Xanax and Valium.In 1997, 4,680 patients exceeded what experts considered to be normalamounts of the prescriptions but only 38 cases were referred to theNevada Department of Investigations. In 1998, 5,412 patients exceededthe drug threshold, but only 28 were referred to the Nevada Departmentof Investigations.All contents copyright 2003 Las Vegas Sun, Inc.l>____________________________ 5. New Drug Strattera May Help Child With ADHD People's PharmacyDeseret News (Salt Lake City)December 27, 2002Question: My son has ADHD. He was on Ritalin twice daily for about amonth, but we had problems with midday "crashes."He is now taking Concerta. So far the results have been favorable,except for loss of appetite and insomnia. As the dose wears off, he getspretty hyper and has trouble getting to sleep. He's 6 years old, and 10p.m. or later is just not an acceptable bedtime. Is there anything newfor ADHD?Answer: Concerta is a long-acting formulation of the main ingredient inRitalin. Such stimulant medications can cause side effects like poorappetite and sleeplessness. Ask his doctor if Strattera might beappropriate. It has just been approved and might become available nextmonth. Children as young as 6 took it in trials that showed Stratterareduces symptoms of ADHD.Although this medicine can also affect appetite and sleep, it is notconsidered a stimulant and works differently from Concerta and Ritalin.Side effects might include headache, irritability and stomachache.Certain asthma medicines and antidepressants like Prozac or Paxil mightinteract with Strattera.© 2002 Deseret News Publishing Companyhttp://deseretnews.com/dn/view/0,1249,450021712,00.html____________________________ 6. New Teaching Approach Shuns Labeling ChildrenNorth Jersey NewsMaia January 2, 2003You know the boy who can't sit still in class?Or the girl who fails the test no matter how much she studies?The teacher decides the first child is a troublemaker and the second isslow. The school sends them off to special education. And the childrenlearn they have a "disability," confirming their own secret fears thatsomething about them is deeply wrong.But a new teaching approach developed by a best-sellingauthor-pediatrician has a message for these educators and parents: Lookcloser.The boy might have a minor problem with attention, and the girl aproblem with short-term memory, according to Dr. Mel Levine, whosetheories are now being used in public and private schools around thecountry, including Clifton and River Edge.Give the boy a Nerf ball to squeeze so he can release energy to stayfocused, advocates of Levine's method advise. Let the girl takeopen-book tests while helping to strengthen her memorization skills.Most important, teach the children how their minds work to protect theirfragile self-esteem.Levine has popularized recent research showing that brains are wireddifferently. Rather than grouping children under broad labels such as"hyperactive," "learning disabled," or "attention deficit disorder," heurges educators to approach children, as one of his book titles states,"a mind at a time."Since 1998, his non-profit All Kinds of Minds Institute has trained11,000 educators to become classroom diagnosticians. Teachers who attendthe weeklong training and follow-up sessions, run in North Carolina andelsewhere, learn how to evaluate children's skills in everything fromattention to social interaction."There are a lot of different ways to succeed in life and many differentminds out there," Levine says. "We all have to strive to get to know achild very well and to make sure he doesn't grow up frustrated anddepleted of motivation because his mind isn't fitting with what it'sbeing asked to do."Teachers and school counselors say Levine gives a scientific basis totheir own best instincts. "It's not a cookie-cutter business," Clifton educator DeAgaziosays of teaching third-graders. "Sometimes you'd love for them all toact the same, but that's not how it is. They're their own individuals."Some schools that have embraced Levine's methods, including oneWoodbridge elementary school, have dramatically lowered the number ofchildren placed each year in special education, says -DeanBarringer, national director of the training program Schools Attuned.Clifton had reduced its yearly special-education placements bytwo-thirds even before some of its counselors and teachers receivedSchools Attuned training several years ago, said Barry Mascari,counseling supervisor for the district. Still, some experts worry thatschools might use Levine's approach as a way to cut special-educationcosts. "I'm afraid euphemizing disabilities may encourage parents to gloss overthe seriousness of their child's situation," says Jane Browning,executive director of the Learning Disabilities Association of America.Reducing special-education referrals is an "unintended outcome" ofSchools Attuned, not a goal, says Barringer, a former special-educationteacher. U.S. schools refer too many children to special educationbecause they fail to clearly understand their problems, she says.That failure also sometimes leads educators to rush to put children onRitalin and other medications, Levine says.Some children benefit from medication, but even they need specific helpin academic or social areas, he says. "To feel medication is going tocure someone is an illusion and possibly dangerous."Every year, DeAgazio at School 15 in Clifton has one or two students whoare struggling. A boy who turns in half-finished work might have troublecopying instructions from a blackboard, causing him to fall behind inhis assignment. His problem isn't with language, but with absorbinginformation through certain mediums, a function of attention, DeAgaziosays. Her solution? Allow that boy to copy from a sheet of paper instead ofthe blackboard, or have another child make a carbon copy of what's onthe board for the classmate.Some teachers resist making such accommodations, believing it gives thechild with the attention problem an unfair advantage.But Levine and his supporters say treating every student the sameinvites failure."Equal is not fair," says Joan Ferrara Millar, a consultant in Clifton'seducational-support program.Ilene Plotkin's son was one who got special treatment from teachers.The boy, whose name is being withheld at his mother's request, is abright child who has always made honor roll. But in third grade, hebegan talking back to his teacher. He got upset if he felt he didn'tunderstand an assignment. He began to constantly criticize himself.Michele Petrelli, an educational-support consultant in the district,found that the boy had certain weaknesses in how he interacted socially.She asked his teacher to carefully explain every assignment to him.Now, he is a happy and successful middle-school student, says hismother, who works for Clifton schools.Levine worries that once school becomes a source of humiliation,students might give up.He once felt such pain himself.Although he was a bright child, he was awkward in gym class, inept atorganizing his homework, and awful at art. He writes that he still hastrouble folding paper to fit neatly in an envelope. His fifth-gradeteacher regularly criticized him in front of his classmates. Supportiveparents helped him succeed in school.Now a professor of medicine at University of North Carolina at ChapelHill, he opened the All Kinds of Minds Institute with investor Schwab in 1995. Dunier, pupil-assistance counselor for the River Edge elementaryschools, took two Schools Attuned courses this year. When a child havingtrouble in school is referred to her, she first completes an extensivewritten neurodevelopmental evaluation. Parents and the child help in thediagnosis."The child can often tell you what's wrong as much as anyone if askedthe right questions," Dunier says.Once Dunier pinpoints the problem, she explains to children theirparticular strengths and weaknesses. "It makes them feel, 'There's nothing wrong with me,'" she says. "Thatmakes a great difference just in their wanting to come to school and toperform and to be motivated."*** Excerpted from "A Mind at a Time'' by Mel Levine, M.D.1. Know thy child.Know your children's strengths and weaknesses. How well, for example, dothey manage time, control their attention, write and read? 2. Respond to gapsIf you suspect your child is weak in areas that may cause problemslater, seek assistance from a professional. 3. strengths, knacks, talents, and interests.Help children pursue their passions. Playing sports is not enough.Children need both intellectual passions and recreational pursuits. 4. Try not to harmIf children feel they are disappointing their parents, they becomeemotional powder kegs. Give them lots of praise. Learn to listen withoutgiving canned lectures or sermons.5. Support educationFind out what the school expects and support your children in meetingthose expectations. Help children enhance their skills and knowledge offacts. Drill them on math, letter formation, basic vocabulary, orspelling each night at bedtime, the best time for storing information inlong-term memory.6. Maintain an intellectual life at homeShow a strong interest in what your child is learning at school. Limittelevision. Make sure children have free time to brainstorm, exercisecreativity, and engage in imaginary play.7. optimism and a positive view of the futureHelp children envision how they might use their strengths and interestsin the future. The vision of the future should help to keep themmotivated and ambitious.Maia ' e-mail address is davis@...Copyright © 2003 North Jersey Media Group Inc.____________________________ 7. Your HealthTri-State Neighbor (Sioux Falls, S.D.)The GraedonsJanuary 3, 2003Q: My daughter still wets the bed at age 6. She has been seen by aurologist who didn't find anything wrong. Needless to say, she isextremely embarrassed about this situation. She can't sleep over at afriend's house, and it's awkward to explain why.She has been taking Ritalin for Attention Deficit Disorder this year. Ithas helped her concentration, but I don't know if it contributes to herwetting the bed. Our doctor recently prescribed imipramine to see if itwould solve that problem. It seemed to help for a few days. I stoppedgiving it to her, however, because it seemed to make her irritable. Iworry that taking both drugs every day might have lasting effects onher. Is there an approach that minimizes medications?A: When Ritalin (methylphenidate) and the antidepressant imipramine aretaken together, blood levels of imipramine might be higher thanexpected. This could lead to side effects such as insomnia, nervousness,digestive upset and irritability.Sleep expert Scharf suggest reducing snacks and drinks(especially caffeinated soft drinks) in the evening. He also recommendsthat the child practice stretching the bladder by delaying urinating forgradually increasing periods during the day. Your daughter should go tothe bathroom just before bedtime, and then you should wake her an hourlater to go to the bathroom again.A wetness alarm (DRI Sleeper, Nature Calls, Wet-No-More) that sounds atone at the first hint of urine can be helpful. She should be rewardedfor each dry night but not punished for wetting the bed. Be patientsince it might take several months to see improvement.Copyright 2003 Tri-State Neighborng/news9.txt>____________________________ 8. New Laws In Effect As Of NowNews-Gazette (Champaign, Ill.)Kate ClementsJanuary 1, 2003EXCERPT Students. One new law clarifies that student prayer is legal as long asit is nondisruptive, student-led and in compliance with federal law andthe U.S. Constitution, while another new law prohibits a school boardfrom disciplining a student solely because his or her parents decline toadminister Ritalin or other psychotropic drugs to the child.© 2003 The News-Gazettehttp://www.newsgazette.com/story.cfm?Number=12983____________________________ 9. Spending on Childrens' Rx Rises Rapidly Employee Benefit News Kelley M. Blassingame January 1, 2003Employers that have targeted baby boomers and seniors for genericsubstitution and disease management programs to stem rising prescriptiondrug costs should also consider programs for children as well, newevidence suggests. According to the 2002 Drug Trend Report from Medco Health Solutions,spending on prescription drugs for children through age 19 increased 28%last year. By comparison, spending rose 23% for those between 35 and 49,and increased less than 10% for individuals over age 65. "We took a look at where drug spending has gone over a five-year periodand were shocked," says Medco Health Public Affairs Director Ann ."Children being the drivers of drug trend is definitelycounterintuitive. So it's a little bit of a wake-up call." Medications to treat infections, allergies, asthma, neurological andpsychological disorders (such as attention deficit hyperactivitydisorder) were most responsible for the increase in spending. However,even with the increases, children account for only about 5% of totaldrug spending in the United States, points out. At the same time,"when anything is jumping at 28% year over year, it doesn't take long tocatch your attention. We started looking at the good news, bad news andpossible reasons and solutions." The good news is that while spending on antibiotics and neurologicaldrugs such as Ritalin to treat ADHD has increased, usage has not,indicating only an increase in the cost of the drugs. This givesemployers hope that encouraging the usage of generics can make adifference. "Parents may be less accepting of generics for their child," says. "But employers can let parents know that generics are justas appropriate and effective for children as they are for adults." Some doctors say both classifications of drugs are simplyoverprescribed. In the case of antibiotics, they are often prescribed totreat viral infections (such as cold and flu) even though they areineffective at fighting such illnesses. Glen Stettin, M.D., Medco's vicepresident of clinical products says highly inquisitive parents hold thekey to eliminating this pattern. "Parents should be asking questions:Does my child really have this condition and is it being appropriatelytreated?" In terms of asthma medications, spending and usage are both up, Medcofound. However, the incidence of asthma among children is generallyincreasing, accounting for much of the difference, physicians say."Indeed, children are taking more medications for asthma, butnationally, hospitalizations are decreasing," says Stettin. "So from ahealth standpoint, it is good news. But from an employer standpoint, adollar saved somewhere is a dollar spent someplace else." More conditions targeted The bad news from the report is that children are spending 34% more timeon medication than they were five years ago, and also are taking drugsintended for adults. Medications to treat gastrointestinal disorders andheartburn skyrocketed 660% over five years, according to the study, duein large part to the nation's growing number of overweight children.Children are also taking medicines to treat diabetes more now than inpast years, says, a trend that is likely to continue. "We're predicting a diabetes epidemic in this country in the next 10 to20 years," she says. "And it's the children of today that are going tocreate that statistic." Employers can easily identify parents in their workforces to promotehealthy living among children. Informing parents of the likelihood thattheir child could be at risk for chronic illness due to an unhealthydiet and sedentary lifestyle can make a large impact. Also, says, "Employers can make sure that parents are goodexamples of a healthy lifestyle through wellness and disease managementprograms." But even for the healthiest among us, when Americans get sick they wantmedicine. "Culturally, Americans like taking a pill as a solution toproblems," Stettin observes, a trait he fears may be getting passedalong to children, and would only compound high utilization trends. "Are we creating a generation of quick fixers?" wonders. "If theirfirst response to an ailment is to go to the doctor and get medicine,how likely are they to continue that pattern as adults?" Stettin says employers should encourage employees to be informedconsumers - for both themselves and their children. "Promoting responsible consumerism is really the key. Ask, Do we reallyneed this medication?' What else can we try?' Is this the appropriatedosage?' And in many cases, medication may be the answer. But not everytime." Copyright © 2003 Thomson Financial, Inc. All Rights Reserved. ____________________________ 10. Questioning a Mercury Link To AutismIndianapolis StarDan BurtonDecember 30, 2002Your editorial of Dec. 11 accurately pointed out the growing disputeover whether there is a relationship between childhood vaccines andautism spectrum disorders. What is not in dispute is that there has beena shocking surge in the number of autistic children in the last decade,and nobody knows why.In 1990, Indiana schools had 116 requests for services for autisticchildren. Last year, there were nearly 3,800. A recent study inCalifornia showed that autism cases have tripled there. One in 10,000children used to be affected by autism; now the National Institutes ofHealth estimates that one in 250 is. Nationwide, as many as 1.5 millionAmericans are believed to have some form of autism spectrum disorder. Wehave an epidemic on our hands and must not stop looking at any possiblecauses, especially mercury, which is known to be a neurotoxic pollutant.The comments of the epidemiologist who led the California study, Dr. Byrd, are telling:"It is astounding to see a threefold increase in cases of autism with noexplanation. There's a number of things that need to be answered. Weneed to rethink the possible causes of autism."Your editorial stated that the scientific evidence supports the safetyof thimerosal, a mercury-based preservative that until recently was usedin many childhood vaccines. That statement isn't supported by the facts.Last year, the respected Institute of Medicine conducted a thoroughreview of the research on thimerosal and neurological disorders. The IOMdetermined that a connection was "biologically plausible" but that "theexisting evidence is inadequate to accept or reject a causalrelationship."The good news is that thimerosal has now been removed from mostchildhood vaccines. The bad news is that the Food and DrugAdministration waited so long to take action, resulting in exposure ofmillions of kids to unnecessary risk. In fact, the tremendous increasein autism coincided with the introduction of two additional vaccinescontaining thimerosal to the U.S. Children's Immunization Schedule inthe late 1980s and early 1990s.For those who consider thimerosal safe, here are a couple of interestingfacts. The FDA considered this mercury compound so unsafe that itordered it removed from over-the-counter topical ointments in 1985.Several European countries considered thimerosal so unsafe that theyremoved it from their vaccines in the early 1990s.And yet, the FDA waited until 1999 to begin removing thimerosal fromchildren's vaccines.A number of internal government documents uncovered by my committee shedsome light on the concerns about thimerosal that have developed over thelast 20 years.In 1980, an FDA advisory panel determined that thimerosal in ointmentsmay cause cell damage: "The panel concludes that thimerosal is not safefor OTC (over the counter) topical use because of its potential for celldamage if applied to broken skin and its allergy potential."In September 1998, almost a full year before the FDA did anything aboutmercury in vaccines, the FDA's Maternal Immunizations Working Groupnoted: "For investigational vaccines indicated for maternalimmunization, the use of single-dose vials should be required to avoidthe need of preservative in multi-dose vials. Of concern here is thepotential neurotoxic effect of mercury, especially when consideringcumulative doses of this component early in infancy."In October 1998, the FDA official responsible for reviewing allscientific literature on the safety of thimerosal in vaccines observed:"I disagree with the conclusion regarding no basis for removal ofthimerosal. (T)here are factors/data that would argue for the removal ofthimerosal, including data on methyl mercury exposure in infants and theknowledge that thimerosal is not an essential component to vaccines."In an internal briefing document from 2000, a government researcherstates: "Preliminary screening for possible neurologic and renalconditions following exposures to vaccines containing thimerosal beforethree months of age showed a statistical association for the overallcategory of neurological developmental disorders and for two conditionswithin the category, speech delay and attention-deficit disorder."It is unquestioned that overexposure to mercury in the environmentcauses neurological problems in developing children. Nobody knows ifmercury used in vaccines has caused autism or related disorders. Muchmore research needs to be done to resolve this question.It is very possible that a combination of factors is at work. Are somepeople genetically predisposed to vaccine injuries? Did mercury invaccines combine with mercury in the environment to have a cumulativeeffect on some children? Is there a combination of environmental factorscausing this epidemic of autism?For the sake of autistic children and the parents who are struggling toraise them, we need to make it a national priority to answer thesequestions. Until we do, let's not rule anything out.Burton represents the 6th District of Indiana in the U.S. House ofRepresentatives and chairs the Government Reform Committee.Copyright 2002 IndyStar.com. All rights reserved____________________________ 11. Annual Checkup Inland physicians diagnose 2002's biggest medical stories The Press-Enterprise (Riverside, Calif.)Mike SchwartzDecember 31, 2002What medical controversies surfaced in 2002 that made us wonder aboutthe best choices for protecting our health? What strides in researchwere taken last year? What were the most promising advances in medicaltreatments? Seven Inland physicians give their perspectives on the most significantmedical developments of the year just ending.OBSTETRICS/GYNECOLOGY Dr. Bert son Medical director of the Inland Empire Fertility Medical Group at San Community Hospital in Upland, with clinics in Palm Springs andColton * Human cloning. The most controversial reproductive technique - cloning- was in the news this year. In what may be reality or a hoax, a member of a religious sect claimedto have helped an American woman produce the world's first human clone.The infant, a girl, was born Dec. 26. In May, a maverick doctor in Italy said that he had impregnated a womanwith a cloned fetus. ''I have a real difficulty with that,'' son says. ''In cloning,things go wrong much more than right.'' * Hormone replacement safety questioned. A federal study released inmid-year found that the long-term risks of heart disease, stroke andbreast cancer outweighed the benefits of estrogen/progestin, the mostwidely used combination therapy for menopause. ''This isn't so cut and dry,'' says son. ''Quality of life also isa major issue.'' Hormone replacement therapy relieves hot flashes,irregular periods, weight gain and other symptoms of menopause. What's more, other studies show hormone replacement can reduce heartdisease by 50 percent, he says. Alternatives being debated include lower-dose combination therapy,stopping hormone replacement therapy after a few years and screening toidentify women at high risk for adverse affects. * More "geriatric'' pregnancies. A growing number of women arepostponing childbearing to age 40 or older. Many are professional womenor those who have remarried. INFECTIOUS DISEASES Dr. Lawrence Cone Director of the Genetic Research Institute of the Desert at Eisenhower Medical Center, Rancho Mirage * Life-extending HIV/AIDS therapies. A continuing drop in U.S. deaths -down 8 to 10 percent since last year - is a major medical triumph, Conesays. ''The impact since 1996 of highly active antiviral drugs has been a realbonanza in terms of reducing deaths,'' he says. RADIOLOGY Dr. Peggy Fritzsche President of the Radiological Society of North America and medicaldirector of the Riverside MRI Center and Comprehensive Medical Imaging in San Bernardino * Proliferation of screening CT tests. ''Not everyone agrees they're agood thing,'' Fritzsche says of these scans. The tests are appropriate for high-risk patients such as heavy smokersor those with family histories of cancer, she says. However, for seemingly healthy people, Fritzsche says, ''you're openingthat patient up to further invasive exams with the risk ofcomplications.'' * High-tech scanning techniques. Among the advances are CT machines thatcan scan a body from chest to pelvis in 18 seconds; high-intensity TeslaMRI scanners that display tiny brain structures and disease processes,and PET scans that allow cancer specialists to tell visually if a massis benign or malignant. FITNESS Dr. Lane Family practitioner at Kaiser Permanente in San Bernardino, athleticmedical director of San Bernardino Valley College and team physicianwith USA Wrestling * Exercise relieves menopause symptoms. Research shows that 30 minutesof moderate exercise daily will improve a woman's physical and mentalhealth and reduce most menopausal symptoms, including osteoporosis,abdominal weight gain and joint stiffness. ''It also will provide emotional stress relief, reduce hot flashes,night sweats and improve sleep,'' Lane says. HEART DISEASE Dr. Jutzy Chief of cardiology and associate professor of medicine, Loma University Medical Center and School of Medicine * Medication-coated stents. Several major clinical trials this year haveshown the benefit of these devices, Jutzy says. Stents are small, mesh-like metallic tubes implanted during proceduresto remove blockage in cardiac arteries. Stents support arterial wallsthat are damaged by plaque. While they have proven a milestone in treating coronary heart disease,in 10 to 30 percent of cases the stented area renarrows. Medicationcoating appears to significantly reduce the regrowth of tissue withinthe stent. According to Jutzy, the devices may be available in a fewmonths. * Inflammation and heart disease. Researchers are zeroing in on the roleof blood vessel inflammation in cardiovascular disease. ''Smoking is probably the biggest promoter of inflammation, but ithappens even in non-smokers,'' Jutzy says. ''We don't really know allthe factors. Probably just having high cholesterol promotes inflammationinside vessels.'' CANCER Dr. Mendoza Hematology/Oncology Consultants in Hemet, Sun City, Wildomar, Banningand Fallbrook * Screening mammogram controversy. Recent Canadian research suggeststhat screening mammograms for women don't save lives from breast cancer.Still, the U.S. Preventive Services Task Force recommends that womenages 40 to 74 get mammograms every one to two years. ''We know in practice that mammograms definitely save a lot of lives byallowing an early diagnosis of breast cancer at a curable stage,''Mendoza says. * Less toxic chemotherapy. In September the FDA approved anastrozole(Arimidex) as a treatment for early breast cancer in postmenopausalwomen. ''This is important because women unable to tolerate tamoxifen or forwhom tamoxifen is contraindicated now have another option,'' Mendozasays. Gleevec became widely available this year for treating chronic myeloidleukemia, which had been curable only with a bone marrow transplant. ''It has minimum side effects and can be effective 85 percent of thetime,'' says Mendoza. PSYCHIATRY Dr. Dey Founder of the Dogon Psychiatric Medical Group and the Dogon PartialHospital Program in Riverside * Schizophrenia gene discovered. Israeli scientists have found a genethat plays a major role in the development of schizophrenia. ''We've known for years that schizophrenia is more common in identicaltwins, but we've never been able to isolate the gene before,'' Dey says.The goal, he says, will be to figure out the biochemical problems causedby the gene and engineer a medication targeted to that problem. * Long-acting medications. New extended-release drugs are a boon topatients with attention deficit disorder. While Ritalin must be takenevery 2-4 hours, drugs such as Concerta last about 12 hours, Dey says. ''Many kids take Ritalin in the morning, but by lunch its effects wearoff. So they act up in class and must go to the nurse. That carries afair amount of stigma,'' he says.©2002 Belo Interactive Inc.____________________________ 12. 'Friendly Fire' Pilots' Stimulant Use Examined Reuters Shalal-EsaJanuary 3, 2003Washington - Two US F-16 pilots charged with manslaughter in the April"friendly fire" bombing of Canadian troops in Afghanistan that killedfour soldiers routinely took amphetamines that may have impaired theirjudgment, a lawyer for one of the men said on Thursday.An Air Force spokeswoman said US pilots have used low doses ofdextroamphetamine while flying long missions since World War II, butinsisted use of the drug was voluntary and safe.Illinois Air National Guard pilots Majs. Harry Schmidt and Umbach face a possible court-martial for dropping a laser-guided bombnear Kandahar on April 17 because they thought they were being fired onfrom the ground.An Air Force investigation determined the pilots "demonstrated poorairmanship" and ignored standard procedure by not making sure there wereno allied troops in the area.Lawyers for the two men will argue at a Jan. 13 hearing at Barksdale AirForce Base in Louisiana that the accident could have been averted if thepilots had been told about ground exercises in which the Canadiansoldiers were taking part.They also say the Air Force forced the pilots to use the stimulant "gopills" because they kept the pilots on an erratic schedule, flyingmissions some days and some nights, and did not tell them about awarning from manufacturer GlaxoKline, about the use of the drug,Dexedrine."The manufacturer specifically counsels doctors to tell patients theyshould not operate heavy machinery or engage in potentially hazardousactivities while using this drug. No pilot was ever told that," said Gittins, a former Marine Corps pilot and lawyer who isrepresenting Schmidt.Gittins said his client flew seven 10-hour missions during his severalweeks in the region, and used the "go pills" on every one because he gottoo tired without them."My client had to take them every mission to complete the mission. Theyovertasked the pilots in theater," Gittins said."The one time he tried not to use the pill, he nearly had a collisionwith a tanker," he said, noting that the manufacturers' warning was notincluded in a voluntary consent form provided to pilots by the AirForce.Schmidt, 37, and Umbach, 43, are former full-time military pilots andnow serve in the Illinois Air National Guard, where they were called toactive duty to help the United States in its war on terrorism.AIR FORCE SAYS PILLS VOLUNTARY, SAFECol. Alvina , chief of Air Force media operations, confirmedthat Schmidt and Umbach did take dextroamphetamine before the Aprilmission, but said the drug had long been used to combat fatigue duringlong missions of eight to 12 hours, or if pilots were flying duringnormal sleeping hours.She said the pilots always tested the drugs on the ground before usingthem while flying, and the decision to use the medicine was strictly upto the pilots. also said pilots typically took a 10 milligram dose of the drugdexedrine, half the dosage routinely given to children who haveattention deficit disorder.Moreover, said the Air Force had never received any report ofthe drug contributing to an accident, whereas fatigue was cited as afactor in nearly 100 mishaps."The fact of the matter is that these stimulants are strictlyvoluntary," she said. "No one is forced to take these drugs."But Gittins said use of the drug was commonplace during the time hisclient was in the region, despite a decision after the Gulf War todiscontinue its use after the Air Force learned pilots were becomingdependent on the narcotics routinely taken to counter the effect of the"go pills."Gittins noted that neither Navy pilots nor commercial pilots arepermitted to use amphetamines, and Air Force pilots would face acourt-martial if they used them while driving. said the Air Force encouraged pilots to use other techniques tocounter fatigue during long missions, such as adjusting their sleepschedule and in-flight exercises.She could not say how many pilots used the amphetamines.Copyright 2003 Reuters Ltd.http://www.reuters.com/newsArticle.jhtml;jsessionid=GMELGXRKK5Z0SCRBAEOCFFA?type=healthNews & storyID=1987823____________________________ 13. Amphetamines Common in Air Force CNN Connie Chung TonightKyra January 2, 2003Military analyst says go pills are common in long air missions but areseldom abused. KYRA PHILLIPS, CNN ANCHOR: We begin now with a red flag over go pills,amphetamines. The U.S. air force allegedly pushes to its combat pilotsfacing long and grueling missions. The allegation comes from a lawyer for one of the two pilots who face apossible court-martial for accidentally dropping a bomb on Canadiantroops in Afghanistan back in April. Four Canadians were killed. The lawyer says amphetamines can impair judgment and are not recommendedfor people doing potentially dangerous things. For insight, we turn to CNN military analyst and retired air force majorgeneral Don Shepperd in Tucson, Ariz. Good to see you, General. MAJ. GEN. DON SHEPPERD: Hello, Kyra. PHILLIPS: What do you think? Do these pilots have a fair case or is thisa cop-out? SHEPPERD: a -- Kyra, I'm sorry. We have to give some context to this. These are lawyers seeking toprovide the best defense possible to their clients, who are facingserious charges. This is nothing new and nothing exotic and nothing that has not beenwell tested with a lot of research behind it. I've taken these pillsmyself on long missions. The idea behind the pills is to manage your rest cycles and to be alertif you need to be. They are amphetamines, and so they definitelyincrease your awareness. They work through your nervous system and whathave you, but I have never felt that my judgment was affected by themnor known anyone. On the other hand, this clearly will be a factor in this case andsomething that will be brought up in the pilot's defense, Kyra. PHILLIPS: Did you ever see pilots that you might have flown with or beenin the same squadron with, do they ever become addicted to these pills? SHEPPERD: No. Not at all. They're carefully monitored; they'represcription drugs. The idea is when you change time zones and havetrouble managing your rest cycles. For instance, if you have to go intoflying at night and during the day, lots of noise during the day keepingyou awake, you've got sleeping pills that can help you with sleep. The same thing with these go pills. Basically, you can take them,they're voluntary. You can take them if you think you need them on themission. I'm not aware of people that take them regularly, I never was.I'm aware that people took them occasionally when they thought theywanted to be particularly alert during that particular phase of amission. Again, I've done it myself and never known anyone that was addicted tothem or felt they had a problem with them, Kyra. PHILLIPS: General, according to an investigation done by 20/20, thesepills are not approved by the FDA to combat fatigue. Does that concernyou? Did that ever concern you? SHEPPERD: Taking any kind of pill always concerned me. I think itconcerns anyone with their head on straight. On the other hand, the military has done a lot of research on this,before they did it, before they approved them. They've been approved foryears. I don't know this particular pill that they were taking, butthere's been a lot of research on it. And they're approved by thesurgeon general. So I'm just going to have to let this play out by experts that aremedical experts and psychological experts, but, again, it's part of thedefense of these pilots by their lawyers. PHILLIPS: All right. General, there is a statement from the air force Iwant to make sure we point this out. The statement says that these pills are used as a fatigue managementtool. The use of pills is voluntary and the effects have been thoroughlytested. Now, in this lawsuit, the pilots are saying they were forced to takethese pills. Did you ever see pilots forced to take these pills? SHEPPERD: I'm not aware of anyone that was ever forced to take thesepills at all while I was on active duty. I don't know what's happeningnow, but I'd be very surprised if that's the case. I can understand a doctor suggesting strongly that this is a good way tomanage and make sure you're not fatigued when you reach a particularpart in the mission that demands a lot of attention, but I'm not awareof anyone ever being forced to take them. PHILLIPS: All right. My final question to you, General, this came outfrom the Centcom report. It said that the go pill is intended to be usedonly in conjunction with other fatigue management measures. What otherfatigue management measures are we talking about? SHEPPERD: I assumewhat they're talking about there, Kyra, is also sleeping pills so thatyou're on a regular cycle of these things, so you can manage both yoursleep and your wakeful hours, as well. These missions over there, flown from the Gulf area, were very longfighter missions, a single guy in the cockpit flying 8-, 9-, 10-,12-hour missions. So they're very fatiguing; they're very drying in thesystem. You've got to stay hydrated. So the idea is to manage your restcycle and make sure you're rested and attentive when something demandsyour attention, Kyra. PHILLIPS: And I've seen those pilots. I've been over in the PersianGulf, and you're right. They've told me, and I've seem them up in theair up to 10 hours. General Don Shepperd, thank you so much. So what exactly is dexamphetamine? Well, it's commonly known asDexadrine and it's commonly prescribed for children and teens diagnosedwith Attention Deficit and Hyperactivity Disorder. Its side effects can include insomnia, dizziness, over-stimulation,nausea, hallucinations and addiction. Content and programming copyright 2003 Cable News Network, Inc. ____________________________ 14. Lawyer Points Finger At Air ForceCBS NewsJanuary 2, 2003New Orleans - A lawyer for one of two U.S. pilots who released a bombover southern Afghanistan in April, accidentally killing four Canadiansoldiers, says the Air Force pressured the pilots to take amphetaminesthat may have impaired their judgment during the mission. Majs. Harry Schmidt and Umbach face a possible court-martial fordropping the laser-guided bomb near Kandahar on April 17. An Air Forceinvestigation determined the pilots "demonstrated poor airmanship" andignored standard procedure by not making sure there were no alliedtroops in the area. But Umbach's lawyer, Beck, said he would show at a Jan. 13 hearingon whether to court-martial the pilots that the Air Force routinelypressures pilots to take dexamphetamine, a prescription drug also knownas "go pills." He said the drug can impair judgment and is notrecommended for people operating heavy equipment. Beck said the Air Force prevents pilots from flying if they refuse totake the pills. Air Force spokeswoman Lt. Ferrau acknowledged the pills areused as a "fatigue management tool" to help pilots stay alert throughlong missions. But she said use of the pills is voluntary, and thattheir effects have been thoroughly tested. "There have been decades of study on their efficacy and practicality,"she said. "The surgeon general worked very closely with commanders onthis." Beck and W. Gittins, Schmidt's lawyer, said the Air Force'sinvestigation is full of errors. Beck said the pilots were not told inadvance that allies were holding combat exercises, and that Schmidtdropped the bomb in self-defense after seeing gunfire on the ground. "What happened was a terrible tragedy. You don't honor (the victims) bywrongfully prosecuting these pilots," Beck said. "This is politicalappeasement of Canadians who are angry." Ferrau said Air Force officials would not comment on specifics of thecase. On the night of the bombing, 15 Canadian soldiers were practicinganti-tank attacks with live ammunition at Tarnak Farm, a former al-Qaidatraining camp. A Canadian report said the soldiers were using firearmsranging from sidearms to shoulder-fired anti-tank weapons. Schmidt and Umbach were flying F-16s toward their base after six hoursof a mission in which "no significant events occurred," the Air Forcereport said. Just after midnight, they spotted gunfire on the ground and reported itto flight controllers. One of the pilots asked for permission to firehis 20 millimeter cannon and was told to wait, according to the AirForce investigators' report. Sixteen seconds later, Schmidt reported surface-to-air fire and said hewas going to "roll in," or attack the shooters. "I've got some men on a road and it looks like a piece of artilleryfiring at us," Umbach said, according to the report. "I am rolling in,in self defense." Schmidt released the bomb, which landed about three feet from a Canadianmachine gun crew. Killed instantly were Sgt. Marc Leger, Cpl. AinsworthDyer, Pvt. Green and Pvt. . The Air Force report said Schmidt soon asked controllers, "Can youconfirm that they were shooting at us?" The controller did not answer, but said "friendlies" could be on theground nearby, the report said. The controller told Schmidt and Umbachto return to their base. Air Force investigators concluded that Schmidt and Umbach should haveleft the area when they spotted gunfire to allow time to determine itssource. Remaining in the area led to the pilots' misperception that theywere under attack, the investigators said. But the pilots' lawyers said Schmidt and Umbach had good reason tobelieve they were being attacked. Beck said it's unusual for troops toconduct night exercises in a combat zone. "How dare you do a training exercise at night in a combat zone?" Becksaid. "And how dare you not tell the pilots?" The deaths, Canada's first combat fatalities since the Korean War,sparked anger among many Canadians, some of whom questioned theircountry's role in the American-led war on terrorism. Beck said Air Force officers should take the blame, because theircommunications system did not inform the pilots that the gunfire camefrom allies. After the hearing, a recommendation on whether to court-martial thepilots will be delivered to Lt. Gen. Bruce Carlson, commander of the 8thAir Force, who will make the final decision. Schmidt and Umbach face charges of involuntary manslaughter, aggravatedassault and dereliction of duty. If convicted of all charges, they facea maximum of 64 years in military prison. Amphetamines are used in treating attention deficit, hyperactivity andnarcolepsy. The FDA warns, "this medicine may cause some people to feela false sense of well-being or to become dizzy, lightheaded, or lessalert than they are normally." Among the side effects that have been reported are irregular heartbeat,dizziness and, in rare cases, blurred vision. ©MMIII, CBS Broadcasting Inc. All Rights Reserved.____________________________ 15. Acupuncture: Straight to the PointWBAY-2 (Green Bay, Wisc.)January 3, 2003Ten-year-old Elena has Tourette's Syndrome. A year ago, her doctor saidProzac was the only way to treat her full-body tics. Instead, she triedacupuncture and the tics went away."I don't understand it, but it sure has worked miracles for our family,"says her mother, Beth .Eleven-year-old does not like needles, so she tried acupressure,using magnets instead of needles. It worked. The migraines she used toget several times a week since she was five are now mostly gone.According to ancient Chinese medicine, energy, called Qi (pronounced"Chee"), flows through 20 channels in the body. When the Qi getsblocked, it can cause pain. Acupuncture is supposed to help the Qi startflowing again, which in turn relieves the pain."Western doctors are skeptical because you cannot draw a blood sampleand say, 'Your Qi level is such and such, and therefore it's down, it'snot normal,'" explains Dr. May Loo, an acupuncturist and author of thecollege textbook Pediatric Acupuncture.Some Western doctors may be skeptical, but even so, acupuncture iswidely practiced in the U.S. The National Institutes of Health report an"explosion" of interest and a 1995 study from Harvard University showsabout 1,500 practitioners in the U.S. perform five million acupuncturetreatments each year."A lot of people have been very skeptical," says Dr. Loo. "They say 'Oh,I've tried everything else, I've tried medication, and now I'm ready togo to surgery, but just as a last try, let me see if acupuncture isgoing to work' and then acupuncture took the pain away."In her textbook she describes acupuncture treatments for 22 pediatricproblems including colic, asthma and attention deficit disorder.Loo says acupuncture works whether patients believe in Qi, or not. Andwith her headaches mostly gone, , for one, agrees. "I used to be kinda sad and depressed, but now I'm all happy, and I feela lot better," she says.More for ParentsPediatric acupuncture is a very new field of treatment. Few licensedacupuncturists specialize in children and there is little research onchild acupuncture. Laws governing required training for acupuncture varywidely from state to state. Pediatricians counsel:Conventional treatments be used before trying acupuncture An acupuncture procedure that works in adults will not necessarily workin children If you are looking for a licensed acupuncture practitioner, the NationalInstitutes of Health recommends you:Check a practitioner's credentials. Most states have training standardsfor acupuncture certification, but requirements vary from state tostate. Check treatment cost and insurance coverage. Your acupuncturepractitioner should be clear about the cost of treatment and frequencyof visits (several days or possibly weeks) required. Make sure yourinsurance covers acupuncture treatment for the condition you are havingtreated. Check treatment procedures. Ask specific questions about procedures tobe used, likelihood of positive outcome and use of sterile needles.© Copyright 2000 - 2002, WorldNow and WBAY____________________________ 16. More Than A Bump On The Head Lincoln (Neb.) Journal Star Andersen December 31, 2002Shari Worman forgets to return phone calls, give messages and keep dateswith her friends. She messes up large orders she takes at Arby's fast-food drive-through,prompting her boss to say:"Clean out your ears and pay attention." Her grades have slipped. She cries easily. She's distracted. Tired. Suspicious. Emotional. On the outside, Shari, 16, looks just like she did a year ago --attractive, vivacious, together. But a year ago she never settled for any grade less than a B. She washer mother's right hand, helping raise two toddler brothers. She was anenergetic teenager who never seemed to tire. That Shari is gone -- perhaps forever. The Shari who dreamed of college and a nursing career now sets hersights on community college and a secretarial position. The sweet Shariwho made friends easily now can be unwittingly rude and offensive. TheShari who "put everything before sleep" now takes to bed for 12 hoursstraight and battles chronic tension headaches. In the early minutes of 2002, Shari rang in the New Year with a bump onthe head when the SUV she was riding in thumped a parked car. The bump wasn't even hard enough to "star" the windshield. But it washard enough to make Shari's brain bleed in four areas -- killing cellsand stretching connective synapses in the front, back and middle of thebrain. It severely limited her ability to remember, problem solve andcontrol her emotions. And the Shari who emerged from the hospital four days after the minorcrash was far different from the one who spent New Year's Eve at achurch festival. Doctors call her condition "mild traumatic brain injury" -- mild TBI forshort. In the spectrum of brain injuries, such bumps and the damage they cancause seem minor. But they can change almost everything, and coping with the challenge istrying -- not only for the injured person but for his or her family andfriends. Lori Terryberry-Spohr, a neuropsychologist at Madonna RehabilitationHospital, sees the transformations daily. She watches and helps peoplego through the grieving process -- the same denial, anger, bargaining,depression and acceptance that follows death.And she offers hope andhelps people discover the strengths that can be used to overcome thebrain's weaknesses. Equally important is her work with patients' loved ones. "It can be very difficult on a family member. ... They say, `This is notthe person I married,'" Terryberry-Spohr said. "It can wear on peoplewhen this person functions at a different level." Once upon a time, physicians believed a concussion was nothing more thana bump on the head. About 60 percent of people will suffer a concussionsome time in their lives. Typically, it was not a huge worry, because bydefinition a concussion meant short-term effects while the bruised brainhealed. Today, professionals recognize that anywhere from 5 percent to 40percent of people who suffer a concussion experience lifelong effects. "Ninety percent of mild TBIs won't show up on an MRI or CAT scan,"Terryberry-Spohr said. And research shows that chances of suffering subsequent concussionsmultiply with each knock on the head, and the effects of thoseconcussions increase exponentially, she said. So who is affected and how is tough to answer. Most winners don't realize they won. Because they are unchanged. Fourteen-year-old Josh Mertlik is one of the winners. In October he tooka header into the boards during an indoor soccer game. It knocked himsilly. He was disoriented and lightheaded. His vision hazy and blurred. "I got one of those headaches you get when you eat ice cream reallyfast," Josh recalled. Then he started vomiting. He went to the hospital where a CAT scanrevealed no bleeding or bone fracture. Josh was sent home and told to take it easy until the headaches stopped.He was not allowed to take physical education classes for one week, andhe was benched from contact sports for two weeks. Today he is back on the field, back in school and back to normal. He feels like his old self. Typically, mild TBI is diagnosed only after a patient complains thatthings "just don't seem right." "A common way it is described to me is: `I don't think as well as I usedto.' `I feel like I'm in a fog most of the time,'" Terryberry-Spohrsaid. That's when she starts testing to rule out such causes as sleepdeprivation, chronic pain syndrome or attention deficit disorder. "My job is like detective work," she said. Brain injuries are as individual as the people who suffer them. Itaffects people cognitively (thinking skills), physically andemotionally. It can leave one person volatile and angry, another apathetic andunemotional. It can knock a person's vision off kilter, or leave someonewith incessant ringing in the ears. It can make one person morecautious, and another impulsive. Typically, mild TBI victims suffer extreme fatigue and debilitatingheadaches. And virtually all have one thing in common: They look normal. "If you break a bone, it heals," Terryberry-Spohr said. "A mild TBI isdifferent. Your brain will heal, yes, but it may not go exactly back tothe way things were before." Psychological changes Of all the difficulties Shari Worman's brain injury caused, theuncontrollable and unpredictable roller coaster of emotions is thehardest for others to accept. "I cry just about daily," Shari said -- at commercials, a cross look. "Little things set me off." She excuses herself to the school nurse's office when a teacher asks aquestion she cannot answer. "My math teacher will ask me for an answer and I'll have no answer. Ifeel really really dumb,"Shari said. And then the paranoia sets in. "I feel like he put me on the spot in front of the entire class. ... Ifeel like he is looking for a way to make me look dumb," she said. Logically, she knows that's ridiculous. But her injured brain won't lether consider logic. "Your perceptions change," she said. So has her personality. "I argue with people. I get upset quickly. And if I find out thatsomebody lied to me -- that just sets me off," she said. "Making friends used to be so easy. Now I'm always afraid people don'twant to talk to me. I fear being rejected. I never used to be that way."Shari's salvation is her sense of humor -- she laughs at herforgetfulness, her ability to muck up even the easiest joke and thatuncanny knack for pulling the wrong word out of her head. It doesn't cure the frustration, but it helps her move on gracefully,said her mother, Lori Mallory. Still, life's curve balls can knock her flat. "Shari sees everything as all or nothing," Mallory said. When her pursewas stolen at school, she would say she was leaving Lincoln SoutheastHigh School for good. Early on, Mallory fell into hysteria. Now she takes a deep breath andasks: "What do we need to do to help you get through this?" The personality changes have brought mother and daughter closer. Butthey have cost Shari a lot -- her frustrated friends don't understandwhy she can't "just get over it" and she and her boyfriend are on theouts. "He gets mad whenI cry, and I cry all the time," she said. "I can't helpit. All I do is cry." It's who she is now. "I'm a very emotional person," Shari said. "And bawling my eyes out isjust a normal day for me." Cognitive losses The most common complaint from mild TBI victims is the lack of clearthinking, said Terryberry-Spohr. Physiologically speaking, the brain can no longer operate asefficiently. It relies on reserve energy to do tasks that once requiredfar less brain power -- hence the exhaustion. People with TBI feel foggy and "dumb" because they cannot rememberthings that happened minutes earlier. They feel as if they are moving inslow motion. They cannot follow multiple directions. They can't thinkthings through, or control their impulses. Often cognitive deficits are evident within 12 hours of the knock on thehead, Terryberry-Spohr said. Other times -- especially with children -- the problems may not becomenoticeable for years. "Kids' brains are still growing and developing. We don't expect them todo things until they run the developmental process," she said. "Kids canhave a brain injury at an early age, and until the brain is supposed todevelop that function, we may not see the effects." Such is the case with 12-year-old Trey Summerlin, who at 6 smacked hishead into the gym wall during a relay race. He remembers the trail ofblood and the five stitches. "And I remember seeing my reflection in the (hospital) window andthinking, `Wow, that must have hurt,'" Trey said. No one in his family remembers any talk of mild TBI. In fact, Trey wasnot even diagnosed with a concussion. And there was no fogginess,emotional outbursts or physical difficulties common in concussions. "We were told to give him Tylenol and that was it," said TerriSummerlin, Trey's mother. And as quickly as his cut healed, the family forgot all about it. Trey, a bright, energetic and precocious child, thrived. He was placedin the differentiated (gifted) curriculum. He earned good grades, andcompleted school work in a snap. When he got to fourth-grade, homework was tougher. By fifth, Trey wasseriously struggling. "He had always done so well in school before," recalled his dad, GeneSummerlin. "But it got to the point where he came home from school (and)he spent the rest of the day (and night) trying to get his homeworkdone. "I thought he was being lazy. I thought he wasn't motivated." The Summerlins tried to motivate Trey by taking away TV, radio, videogames -- and, finally, baseball. He was stuck in his bedroom while histhree sisters and friends played within earshot outside. Then the Summerlins tried rewards -- money for completed assignments. His parents looked deeper. Trey seemed unable to pay attention. He hadtrouble following multiple-task directions, his dad said. "He had always been an easy-going kid,"Terri Summerlin said. "Now he wasgetting frustrated and getting into arguments." The family pediatrician said Trey's symptoms sounded like attentiondeficit disorder and offered to put Trey on Ritalin. The Summerlins balked. ADD symptoms typically are noticeable fromtoddlerhood on. Why, they wondered, did Trey's suddenly occur at 10. Atthe doctor's suggestion they got a second opinion from aneuropsychologist, who gave Trey a three-hour cognitive test. The doctor noticed his problems were tied to functions controlled by thebrain's right frontal lobe: long-term planning, sequencing, high-levelthinking skills, problem solving, memory retrieval. He asked if Trey had ever hit his head, and determined Trey did not haveADD, but a mild TBI. Trey remembers thinking: "Cool, I've got brain damage." He preferred the diagnosis over ADD. "Mild TBI sounds like I'm a hockeyplayer." Further examination discovered Trey's first-grade knock on the head alsoknocked his vision about 6 inches off center. A few weeks in bifocalsreshifted his eyes and fixed the problem. But his brain injury is permanent. He will never be a mathematician,which is fine by him. It means he may have to study differently. He takes the same curriculumas his classmates, but because of his brain has trouble retrievinginformation he takes multiple choice exams that help trigger his memory.Teachers provide him with an outline of their lectures so he can followalong and organize his notes. And his parents, like Shari's, accept that he will not be top in theclass like before. Shari, a high school sophomore, struggles to make Cs. With her lack ofshort-term memory, she is particularly worried about geometry, whichbuilds upon previous math lessons. "I think differently. My brain processes things differently," she said.Ask her what time is, and she is just as apt to try to explain how aclock works as she is to say 4 p.m. "I get distracted so easily. I get tired of trying to pay attention." She worries how these changes will affect her in college, whereinstructors may not be as accommodating as her high school teachers.Lori Mallory worries her daughter will not be able to overcome thebarriers, and that she may give up. "I feel sad to have changed," Shari said, but she knows she can't fixher brain. All she can do is change the way she does things. Forging ahead The worst thing a person with mild TBI -- or their families -- can do isgive up. Mild TBI is not a death sentence. It doesn't rule out finishing school,going to college or even landing a successful career in a prestigiousfield, Terryberry-Spohr said. People with mild TBIs can achieve their goals -- but sometimes it takesunconventional avenues and working around the injured brain'slimitations, she said. Her job is to figure out how. "I look at what has changed in the brain function and what they have interms of strengths and weaknesses. What strengths do we have to buildon?" There is help even years after a brain injury, Terryberry-Spohr said. "We are aware that the brain may not be healing any more, but thatdoesn't mean it can't function better by learning better strategies. "The most important thing is these people still have a life to live. Weneed to help them figure out, how they are going to do that." Reach Andersen at 473-7217 or eandersen@....Copyright © 2002, Lincoln Journal Star. All rights reserved.http://www.journalstar.com/local.php?story_id=10701Carol SadlerCoordinator, Cherokee/Cobb County, North Atlanta & Central GA CHADD(Children & Adults with Attention-Deficit/Hyperactivity Disorder)http://communitylink.accessatlanta.com/groups/chadd CHADDer e-newsletter: GA-CHADDer-subscribe ADHD Parent list:GACHADD-ADHDParentSupport-subscribe ADHD Adult list:GACHADD-ADHDAdultSupport-subscribe