Living Well Families

a special publication by

dec 2014

A Publication of the

December 2014 ~ living well families

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living well families ~ December 2014

a special publication by

A publication of the

publisher Mark Heintzelman

missoulian.com

People in Missoula and western Montana want to feel good, look good and live well. Available at more than 150 newsstand locations throughout the area, Western Montana Living Well is well suited to more than 30,000 readers monthly who want health tips on fitness, nutrition, family, financial advice, wellness, therapy and beauty.

graphic design Adam Potts Krista Ness Bob Jacobson

No part of the publication may be reprinted without permission. ©2014 Lee Enterprises, all rights reserved. Printed in the USA.

Western Montana Clinic

SERVING YOU SINCE 1922

CHARLOTTE KUTSCH, MD

contributors Sarah Bass Rick Bavaria Torrie Cheff Richard Friedman Trinda Rieck

The opinions, beliefs and viewpoints expressed by the various authors and forum participants in this publication do not necessarily reflect the opinions, beliefs and viewpoints of the Missoulian or Lee Enterprises. The author of each article published in this publication owns his or her own words.

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December 2014 VOL. 26

in this issue

child spinal care pg. 6

at the heart of family practice pg. 10

families

your child’s education pg. 12

car seat safety pg. 24

natural fix for ADHD pg. 18

health tip page 34

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living well families ~ December 2014

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living well families ~ December 2014

Something your OB/GYN and pediatrician does not check for Dr. Torrie Cheff

H

aving an extensive background in health, I am continually surprised about how one of the most essential systems of the body go untested, sometimes until after decades of our life have already been lived. Could you imagine never getting your teeth checked by a dentist until you were 20, 30 or even 50 years old? What if you waited to get your teeth cleaned until you were in pain from all the decay or never took your child into the dentist until they were full of cavities? This is very similar to how people view and apply spine health, mainly due to lack of knowledge.

Your spinal bones protect the brain, spinal cord, and nerves. However, if your spine is bent, twisted, or moved out of position it will block the information coming down from the brain through the spinal cord and nerve fibers to the rest of the body. This is often responsible for giving children asthma, allergies, hyperactivity, infections, and other childhood disorders. The majority of people wait until they have so much damage throughout a lifetime that his/her back literally starts hurting them and limiting them from doing normal daily activities. For parents, unless your child has a pain or their school nurse or gym teacher tests them for scoliosis, they have no chance of having their spine checked before it is too late. Meanwhile, they can be developing disease within the body asymptomatically.

I contribute this missing health factor as being a big reason why U.S children are ranked one of the unhealthiest groups of people compared to other industrialized countries. They have named our generation of children “Generation Rx� due to the way they are injected, medicated, and put on rounds of antibiotics from the day they are born. For the first time in history, December 2014 ~ living well families

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this generation is predicted to not outlive their parents if we do not change this!

Rates of diabetes, cancer, and heart disease are skyrocketing amongst our youngsters, all of which are almost completely preventable in many cases.

Many parents do not know that regular spine care is much more effective and less dangerous than any medication or antibiotics.

Dr. Feltoen, M.D, Ph.D, from the University of Rochester School of Medicine states that, “nerve fibers go into virtually every organ of the immune system. We found that if you took the nerves away from the spleen or lymph nodes, you virtually stopped immune responses in their tracks.� Thus, restoring nerve flow through adjustments allows for some of the healthiest kids I know and take care of.

Prevention comes in the form of 5 Essentials to health: maximized mindset, maximized nerve supply, maximized nutrition, maximized oxygen and lean muscle, and minimized toxins. Find out more on each at www.maximizedlivingdrcheff.com. My practice, Missoula Family Chiropractic, focuses on family health utilizing all 5 Essentials of Maximized Living.

I am currently eight months pregnant and about to bring a child into the world. As I receive advice and care from my midwives and doctors, I see that there are no tests being done that detect how my nerves are functioning, a vital component to health. Had it not been for my education background, I would not have known how to make sure my own brain and spinal cord are functioning at its best. Pregnancy is a vitally important time to be adjusted. The balance and alignment of the pelvic and lumbar vertebra are essential for normal development and delivery.

In fact, subluxation (improper alignment of the spine) has even been linked to the inability to get pregnant. I personally have my spine checked once per week in order to make sure I am in proper alignment and my baby and developing organs are getting the proper nerve supply for development.

Feeling very fortunate for my education, I realized I also would not know to have my baby checked immediately after birth. Birth is the first trauma to 8

living well families ~ December 2014

A New Twist on your old pill box

the spine and can cause lifelong developmental, nerve, and immune system problems. Traumatic Birth Syndrome (TBS) occurs when drugs are used during labor, an epidural is used, labor is induced, the baby is in a difficult position during pregnancy and/or delivery, labor is long and difficult, or procedures such as vacuum extraction, forceps, or C-section are used for delivery.

These spinal injuries caused from the birth process may go undetected and show no signs or symptoms for years.

They do, however, cause interference to function and healing causing many health problems including colic, ear infections, asthma, allergies, constant colds, hyperactivity, and poor health and vitality in general. Left uncorrected TBS can lead to premature spinal aging, postural problems, and affect your child’s health future.

According to Dr. Towbin from Harvard Medical School, “Research indicated that the major cause of spinal subluxation in infants is childbirth. Stressing the need for correction from birth so that irreversible subluxation degeneration changes do not occur. Nerve system injury through cervical spine trauma at birth causes: abnormal function, abnormal behavior, and early death (SIDS).”

The Human Engineering Spine Posture Institute in Japan also found that misaligned spinal bones narrow the passageway for nerves to pass through and disrupts nerve flow out to organs setting your child up for infections, allergies, asthma, and hay fever. 92 percent of these patients, after having their spine realigned greatly improved or had total correction of their conditions. Chiropractic care is the only field of health care that restores your spine and nervous system back to normal.

Many parents ask if it is safe for a child to receive an adjustment. The answer is: Yes. Although much different adjustments are given throughout stages of life, it is best to get checked as a newborn and throughout a lifetime, much like taking care of your teeth over a lifetime.

When you consider it, a young child falls enough times in a day to hospitalize an adult, making evaluating children essential. It is actually unsafe for them to go unchecked throughout a lifetime.

Screening your child is pain-free, simple, and noninvasive. A chiropractic exam must include a posture exam, spinal palpation, range of motion testing, and diagnostic technology such as thermography or gravity weight assessment. Now that you know what to do, it is up to you.

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Family it’s all about medicine

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living well families ~ December 2014

the stories

By Trinda Rieck

I

remember going to see our family doctor when I was growing up in rural Maine. All five kids would pile into the 12-passenger van and head to Dr. Dow’s office. The Doc would ask my mom how the farm was, how my dad was and how the football team was doing. In the office we would talk … about all kinds of things, not just a quick blood pressure check and a listen to the heart. Careful care was taken with each of us; girls, boys, toddlers, mom and, lastly, dad (when my mom could convince him to go). It was truly family medicine at its core.

These days the average face time with a doctor is seven minutes. As the landscape of family practice care continues to dissolve into the corporate world, we have moved away from a personal relationship with the person we entrust with our health care needs. The corporate-driven movement to provide care on a quantity-based perspective leaves genuine quality care receding and face-to-face time diminished. An attitude of volume versus true human connection is sadly becoming the norm and an increased profit and larger bottom line have become the goal.

In this changing landscape of medicine, what is family medicine? I believe that family medicine is giving patients time to talk, doctors time to listen and families the opportunity to receive nonjudgmental care in a safe, friendly environment.

Family practice is all about the stories. Whether good or bad, the story is what brings the patient into the room. The stories drive all encounters, and without them one is just diagnosing and attempting to treat symptoms and diseases, not people. This model of care, tailored to individual needs, though endangered, will never go extinct because people want individual and creative care from someone who knows them as more than just a number.

Family medicine should be community driven, encouraging us to work together to provide health care for everybody and the whole body. It should be about empowering patients by presenting them with all the information they need to participate in their own health care choices. When I take my son to the doctor and we are referred to an outside specialist, I want to know that my primary doctor cares enough to send me to someone they personally trust with the well-being of my child. Within a community driven inclusive model of family medicine I can feel confident that the continuity of my child’s care has been communicated outside of the office walls.

Some things have changed since I was a kid. I am still rolling in a van, upgraded from the Dodge 12-passenger, but still a van, and my family looks a little bit different – I chose one child as opposed to five. What hasn’t changed is the kind of care that I want and expect from health care providers. I did inherit the desire for quality, homegrown, family medicine for my own family. My mom took all of us, herself, and my dad, to the same doctor until they moved away from that small town in rural Maine. My hope is that my family and all other families will have this opportunity: homegrown, quality, nonjudgmental care under one roof until it’s time to move on to the next adventure.

Trinda Rieck is the Advancement Director at Blue Mountain Clinic in Missoula.

December 2014 ~ living well families

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Navigating today’s concerns with your child’s education

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living well families ~ December 2014

What does Common Core mean for your child?

Homework is always a struggle, how can you help more effectively?

By Dr. Rick Bavaria

December 2014 ~ living well families

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Common Core

he new Common Core, rigorous education standards rolling out in the majority of states, has become – as so many other aspects of American life – a political debate even after a smooth period of development.

More rigorous education is good, as the old ways don’t cut it anymore. Raising standards to keep pace with the rest of the world is an improvement.

Common Core requires kids to learn more quickly and independently. Skills they used to learn in third grade, say,

may very well show up in first. Middle school students will learn algebra and problem-solving skills. High school students will read more nonfiction and write cogently about it.

I prefer to focus on children’s learning and leave the politics to others. So, what will Common Core mean for our children, and what can we adults – parents and teachers – do to ensure our kids are learning while also keeping them above the political fray? Here are four ideas to consider.

It will mean more critical thinking. HOTS are hot. “Higher Order Thinking Skills” go beyond memorization. It’s the kind of thinking necessary in the workplace, in higher learning and in the trades. Parents need to make sure their kids are learning facts, sure, but then are able to think critically and analytically when using those facts.

It will mean we’ll need to monitor progress carefully. Since kids will be learning more, learning faster and learning in different ways, we’ll need to watch them closely to make sure they’re on track. For example, learning will take on a more “real world” look, with kids in work groups that require them to participate, take active roles, and think creatively, just as older students do in higher education or job training, or as adults do at work.

It will mean we must keep expectations high. There’s no better predictor of success than parental expectations. That’s been true forever, long before Common Core. So, from their earliest ages, we must let kids know we expect them to do their best. Kids love to impress us. We can help them by establishing healthy routines, from bedtime and mealtime to study time and playtime. We can also encourage helpful friendships and study buddies. By recognizing that school may bring some struggles, we can also show that success after a struggle means more than success after an easy assignment.

It will mean we recognize that all kids can learn. Surely not in the same way and not on the same day, but they’re all capable of learning. Some kids are fast. Others need more time to process.

Some kids learn through the arts and some with lots of physical movement. Some need alone time. Others need the stimulation of their classmates. Some will need an extra leg up, like tutoring. We’re going to have to make sure our kids are given plenty of opportunities that allow them to learn in their preferred ways as well as to stretch to learn in new ways.

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Homework

omework. I’m in favor of it.

I know it can be a pain. Sometimes it’s inconvenient and time-consuming. Sometimes homework can be a family hassle. However, all that pales when it’s assigned thoughtfully, done right and leads to more learning.

We teachers give homework so kids can practice what they learned yesterday, review what they learned today and get ready for what they’ll learn tomorrow. There’s simply not enough class time.

Establish a homework routine.

Kids need routines. They feel safe with routines, know what’s expected of them and know what comes next. Create a homework routine for your family and expect everyone to stick to it.

Check homework. Even if it’s been years since you’ve studied quadratic equations or the causes of the War of 1812, you can still check homework.

I recommend routine but random checks. This keeps kids on their toes.

I like to ask, “Really, this is your best effort?” They roll their eyes, sure, but they always come up with ways to make it better. When all else fails, insist on neatness.

We give homework to show that learning takes place everywhere, not just in the classroom. We give homework to build organization and time-management skills, to establish strong work and study habits and maybe even create a little struggle. Mastering a skill you’ve had to struggle with creates confidence and pride.

Here’s a short list of homework tips – what to do and what not to do to help your child with homework – that I’ve seen work in homes and classrooms.

Have a homework zone, an established place where kids can complete their homework. It doesn’t have to be fancy-schmancy, just a place where they have their supplies and materials. Organization saves time and eliminates stress.

Let kids see you doing your homework. I’ve seen plenty of families where homework time means homework for everyone. Cell phones are off. Moms and dads take care of the work-related tasks they need to get done. Show kids how you keep a planner and break down big tasks into more manageable smaller ones. They notice.

Don’t make derogatory comments.

If you have a problem with short- or long-term home assignments, take it up with the teacher. Bad-mouthing teachers and homework in front of the kids shows adult disunity and gives implicit approval to shrug off responsibility.

Don’t minimize homework’s importance. Show kids that learning is one of your family’s most enduring values. Homework allows them to sharpen their skills, deepen their knowledge, and extend their curiosity.

Support homework. Even if it’s an occasional hassle.

Dr. Rick Bavaria is the senior vice president of Education Outreach for Sylvan Learning.

Don’t do homework for them.

Seriously, you think we can’t tell when you write that report or build that science fair project? Please. You’re not doing anyone any favors.

December 2014 ~ living well families

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How to help teens, others who are

considering suicide Assoicated Press

Never stop talking!

Suicidal thoughts can happen on more than one occasion, and the stigma surrounding these thoughts stops people from seeking treatment. At times, individuals who are suicidal feel like their friends, families, teachers, counselors and physicians do not know how to help them. Encourage them to never stop talking until they find resources that work effectively for them.

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ne of the groups with the highest suicide rates is that of teenagers, making suicide a major public health concern for this population. The Center for Disease Control reports that one in five teens considers suicide, and that suicide is the third leading cause of death for individuals between the ages of 10 and 24.

Here are ways we can all help:

Causes of distress

Teen years are often filled with difficult life situations that create emotional pain teenshave not learned to cope with. Some of those difficult life situations can be stressful living and social environments, a painful loss or change, sexual orientation, rejection by peers, death of a loved one or friend and bullying.

Bullying has caused so much distress in teens that it has been identified as a major public health concern. Studies report that 20 to 25 percent of teens have participated in or experienced some form of bullying. Bullying can take many forms, including physical, verbal, written and cyberbullying, which can lead to individuals wanting to harm themselves or someone else to make the emotional pain go away.

Warning signs

Some warning signs that a teen is in distress, an emotional crisis or suicidal include: • A major change the teen’s attitude or behavior • Talking about wanting to die or kill themselves • Having or expressing feelings of hopelessness or not having a reason to live

• Difficulty in school • Creating plans to harm themselves • Talking about being in emotional pain that they cannot escape from, being a burden to others • Use of drugs or alcohol • A change in sleeping habits • Extreme emotional mood swings, withdrawal and isolation

How you can help

Most people are uncomfortable talking about suicide and avoid the topic. One way you can help is by believing the idea of suicide is real for that person. Whether their emotional pain would cause you to react in the same way or not, be willing to listen to their thoughts without judgment. Help that person address their thoughts of suicide by providing them with a listening ear and places where they can go for further assistance. For teens younger than 18, notify their parent and involve them in a conversation about the concerns and treatment options.

Treatment

Immediate treatment is available at Centerstone Crisis Center or a local emergency department, where the teen and their family can meet with a counselor for an emergency assessment and brief counseling services 24 hours a day, 7 days a week and 365 days a year. In addition to local resources, the National Suicide Prevention Lifeline can be called at 800-273-TALK. Long-term treatment can be provided at local behavioral health agencies.

December 2014 ~ living well families

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A natural fix for ADHD

By Dr. Richard A. Friedman

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ttention deficit hyperactivity disorder is now the most prevalent psychiatric illness of young people in America, affecting 11 percent of them at some point between the ages of 4 and 17.

The rates of both diagnosis and treatment have increased so much in the past decade that you may wonder whether something that affects so many people can really be a disease.

And for a good reason. Recent neuroscience research shows that people with ADHD are actually hard-wired for novelty-seeking – a trait that had, until relatively recently, a distinct evolutionary advantage. Compared with the rest of us, they have sluggish and underfed brain reward circuits, so much of everyday life feels routine and understimulating.

To compensate, they are drawn to new and exciting experiences and get famously impatient

and restless with the regimented structure that characterizes our modern world. In short, people with ADHD may not have a disease, so much as a set of behavioral traits that don’t match the expectations of our contemporary culture.

From the standpoint of teachers, parents and the world at large, the problem with people with ADHD looks like a lack of focus and attention and impulsive behavior. But if you have the “illness,” the real problem is that, to your brain, the world that you live in essentially feels not very interesting.

One of my patients, a young woman in her early 20s, is prototypical. “I’ve been on Adderall for years to help me focus,” she told me at our first meeting. Before taking Adderall, she found sitting in lectures unendurable and would lose her concentration within minutes. Like many people with ADHD, she hankered for exciting

people with ADHD are actually hard-wired for novelty-seeking – a trait that had, until relatively recently, a distinct evolutionary advantage

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Having a sluggish reward circuit makes normally interesting activities seem dull and would explain, in part, why people with ADHD find repetitive and routine tasks unrewarding and even painfully boring.

and varied experiences and also resorted to alcohol to relieve boredom. But when something was new and stimulating, she had laserlike focus. I knew that she loved painting and asked her how long she could maintain her interest in her art. “No problem. I can paint for hours at a stretch.”

Rewards like sex, money, drugs and novel situations all cause the release of dopamine in the reward circuit of the brain, a region buried deep beneath the cortex. Aside from generating a sense of pleasure, this dopamine signal tells your brain something like, “Pay attention, this is an important experience that is worth remembering.”

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living well families ~ December 2014

One man’s reward

The more novel and unpredictable the experience, the greater the activity in your reward center. But what is stimulating to one person may be dull – or even unbearably exciting – to another. There is great variability in the sensitivity of this reward circuit.

Clinicians have long known this to be the case, and everyday experience bears it out. Think of the adrenaline junkies who bungee jump without breaking a sweat and contrast them with the anxious spectators for whom the act evokes nothing but terror and dread.

Dr. Nora D. Volkow, a scientist who directs the National Institute on Drug Abuse, has studied the dopamine reward pathway in people with ADHD. Using a PET scan, she and her colleagues compared the number of dopamine receptors in this brain region in a group of unmedicated adults with

ADHD with a group of healthy controls. What she found was striking. The adults with ADHD had significantly fewer D2 and D3 receptors (two specific subtypes of dopamine receptors) in their reward circuits than did healthy controls.

Furthermore, the lower the level of dopamine receptors was, the greater the subjects’ symptoms of inattention. Studies in children showed similar changes in dopamine function as well.

These findings suggest that people with ADHD are walking around with reward circuits that are less sensitive at baseline than those of the rest of us. Having a sluggish reward circuit makes normally interesting activities seem dull and would explain, in part, why people with ADHD find repetitive and routine tasks unrewarding and even painfully boring.

Psychostimulants like Adderall and Ritalin help by blocking the transport of dopamine back into neurons, thus increasing its level in the brain.

Another patient of mine, a 28-year-old man, was having a lot of trouble at his desk job in an advertising firm. Having to sit at a desk for long hours and focus his attention on one task was nearly impossible. He would multitask, listening to music and texting, while “working” to prevent activities from becoming routine.

Eventually he quit his job and threw himself into a startup company, which has him on the road in constantly changing environments. He is much happier and – little surprise – has lost his symptoms of ADHD. My patient “treated” his ADHD simply by changing the conditions of his work environment from one that was highly routine to one that was varied and unpredictable. All of a sudden, his greatest liabilities – his impatience, short attention span and restlessness – became assets. And this, I think, gets to the heart of what is happening in ADHD.

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Historical purpose

Consider that humans evolved over millions of years as nomadic hunter-gatherers. It was not until we invented agriculture, about 10,000 years ago, that we settled down and started living more sedentary – and boring – lives. As hunters, we had to adapt to an ever-changing environment where the dangers were as unpredictable as our next meal.

In such a context, having a rapidly shifting but intense attention span and a taste for novelty would have proved highly advantageous in locating and securing rewards – like a mate and a nice chunk of mastodon. In short, having the profile of what we now call ADHD would have made you a Paleolithic success story.

In fact, there is modern evidence to support this hypothesis. There is a tribe in Kenya called the Ariaal, who were traditionally nomadic animal herders. More recently, a subgroup split off and settled in one location, where they practice agriculture. Dr. Dan T.A. Eisenberg, an anthropologist at the University of Washington, examined the frequency of a genetic variant of the dopamine type-four receptor called DRD4 7R in the nomadic and settler groups

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December 2014 ~ living well families

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of the Ariaal. This genetic variant makes the dopamine receptor less responsive than normal and is specifically linked with ADHD. Eisenberg discovered that the nomadic men who had the DRD4 7R variant were better nourished than the nomadic men who lacked it. Strikingly, the reverse was true for the Ariaal who had settled: Those with this genetic variant were significantly more underweight than those without it.

So if you are nomadic, having a gene that promotes ADHDlike behavior is clearly advantageous (you are better nourished), but the same trait is a disadvantage if you live in a settled context. It’s not hard to see why. Nomadic Ariaal, with short attention spans and novelty-seeking tendencies, are probably going to have an easier time making the most of a dynamic environment, including getting more to eat. But this same brief attention span would not be very useful among the settled, who have to focus on activities that call for sustained focus, like going to school, growing crops and selling goods.

the kind of work they do so that it better matches their cognitive style and reward preferences. If you were a restless kid who couldn’t sit still in school, you might choose to be an entrepreneur or carpenter, but you would be unlikely to become an accountant. But what is happening at the level of the brain that may explain this spontaneous “recovery”?

To try to answer that question, Aaron T. Mattfeld, a neuroscientist at the Massachusetts Institute of Technology, now at Florida International University in Miami, compared the brain function with resting-state MRIs of three groups of adults: those whose childhood ADHD persisted into adulthood; those whose had

Rising prevalence

You may wonder what accounts for the recent explosive increase in the rates of ADHD diagnosis and its treatment through medication. The lifetime prevalence in children has increased to 11 percent in 2011 from 7.8 percent in 2003 – a whopping 41 percent increase – according to the Centers for Disease Control and Prevention. And 6.1 percent of young people were taking some ADHD medication in 2011, a 28 percent increase since 2007. Most alarmingly, more than 10,000 toddlers at ages 2 and 3 were found to be taking these drugs, far outside any established pediatric guidelines.

Some of the rising prevalence of ADHD is doubtless driven by the pharmaceutical industry, whose profitable drugs are the mainstay of treatment. Others blame burdensome levels of homework, but the data show otherwise. Studies consistently show that the number of hours of homework for high school students has remained steady for the past 30 years.

I think another social factor that, in part, may be driving the “epidemic” of ADHD has gone unnoticed: the increasingly stark contrast between the regimented and demanding school environment and the highly stimulating digital world, where young people spend their time outside school. Digital life, with its vivid gaming and exciting social media, is a world of immediate gratification where practically any desire or fantasy can be realized in the blink of an eye. By comparison, school would seem even duller to a novelty-seeking kid living in the early 21st century than in previous decades, and the comparatively boring school environment might accentuate students’ inattentive behavior, making their teachers more likely to see it and driving up the number of diagnoses.

Research

Not all the news is so bad. Curiously, the prevalence of adult ADHD is only 3 to 5 percent, a fraction of what it is in young people. This suggests that a substantial number of people simply “grow out” of it. How does that happen?

Perhaps one explanation is that adults have far more freedom to choose the environment in which they live and

we should help young people that are a better fit for their

remitted; and a control group who never had a diagnosis of it. Normally, when someone is unfocused and at rest, there is synchrony of activity in brain regions known as the default mode network, which is typically more active during rest than during performance of a task. (In contrast, these brain regions in people with ADHD appear functionally disconnected from each other.) Mattfeld found that adults who had had ADHD as children but no longer had it as adults had a restoration of the normal synchrony pattern, so their brains looked just like those of people who had never had it.

We don’t yet know whether these brain changes preceded or followed the behavioral improvement, so the exact mechanism of adult recovery is unclear.

But in another measure of brain synchrony, the adults who had recovered looked more like adults with ADHD, the MIT study found.

In people without it, when the default mode network is active, another network, called the task-positive network, is inhibited. When the brain is focusing, the task-positive network takes over and quiets the default mode network.

This reciprocal relationship is necessary in order to focus.

Both groups of adult ADHD patients, including those who had recovered, displayed simultaneous activation of both networks, as if the two regions were out of step, working at cross-purposes. Thus, adults who lost most of their symptoms did not have entirely normal brain activity.

Finding a better fit

What are the implications of this new research for how we think about and treat kids with ADHD? Of course, I am not suggesting that we take our kids out of school and head for the savanna. Nor am I saying we that should not use stimulant medications like Adderall and Ritalin, which are safe and effective and very helpful to many kids with ADHD But perhaps we can leverage the experience of adults who grew out of their symptoms to help these kids. First, we should do everything we can to help young people with ADHD select situations – whether schools now or professions later on – that are a better fit for their noveltyseeking behavior, just the way adults seem to self-select jobs in which they are more likely to succeed.

In school, these curious, experience-seeking kids would most likely do better in small classes that emphasize handson-learning, self-paced computer assignments and tasks that build specific skills.

This will not eliminate the need for many kids with ADHD to take psychostimulants. But let’s not rush to medicalize their curiosity, energy and novelty-seeking; in the right environment, these traits are not a disability, and can be a real asset.

with ADHD select situations novelty-seeking behavior

Richard A. Friedman is a professor of clinical psychiatry and the director of the psychopharmacology clinic at the Weill Cornell Medical College.

December 2014 ~ living well families

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Drive safely with your newborn by following these tips

By Brandpoint

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living well families ~ December 2014

B

abies change everything. Their arrival means that new parents need to become educated quickly - on cribs, strollers and most importantly, child-safety seats and all their rules. And as federal recommendations on car seats continue to evolve, parents have one more thing to stay on top of.

The family car safety experts at Cars.com, in partnership with Toluna QuickSurveys, recently conducted a poll that asked parents what they worried about most when bringing a newborn home from the hospital. Results revealed that 93 percent of new parents listed the fear of other drivers on the road as a top concern when driving with a newborn.

“Every new parent wants to cover the car in protective bubble wrap when driving with their baby. I know my husband and I did,” says Cars.com editor and expert mom Jennifer Newman. “That isn’t realistic, but there are a few things you can take control of that will help ease your anxiety when driving with your newborn.”

Instead of bubble wrap, Newman suggests: Car seat check: Make sure a certified child passenger safety technician inspects your car seat installation before the baby arrives.

Practice safe driving: It’s going to be tough, especially if your newborn starts wailing, but remember to keep your eyes on the road. If you can’t stop yourself from turning around to check on the baby, pull over and then make sure everything is OK with your wee one.

Keep the baby in the car seat: If one parent rides in the backseat with the baby, remember that it is never OK to remove the child from a car seat while someone is driving. The safest place for a baby - even one that’s screaming - is in a rear-facing car seat when the car is moving.

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Make sure you’re using a car seat that meets the latest federal safety requirements and t he height and weight of your child.

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living well families ~ December 2014

Keep your car properly maintained: Take your car in for regular, scheduled maintenance to ensure everything is in working order and all fluids are topped. Keeping a safe car can create a safer ride for your little one.

In addition, Newman also suggests parents skip using items such as a baby mirror in the car. Mirrors and other items like toys that hang from a car seat’s handle can become dangerous projectiles in a crash and harm your child or you.

Proper installation

Since the majority of newborns spend multiple hours in the car, knowing how to properly install a car seat is essential, and all too often done incorrectly. Seventy-five percent of children ride in car seats that aren’t properly installed, according to the National Highway Traffic Safety Administration. Although car seats (and the children in them) are all unique, Cars.com editor and expert mom Jennifer Newman offers these simple steps that are generally applicable to most car seat installations: * Once you purchase a car seat, perform a car seat check in your own vehicle to see if your new car seat and car are compatible. Some stores will even let you try it out in your car before you buy. * Make sure you’re using a car seat that meets the latest federal safety requirements and the height and weight of your child. * Read both the car seat’s owner’s manual and your car’s owner’s manual to make sure you’re following the recommendations regarding installation. * Locate your local child car seat inspection station, offered throughout the country to teach parents, both new and experienced, how to properly install any car seat. * Car seats can be installed with either the latch system - the lower latch and tether anchors often found in the backseat - or with the seat belt. Use whichever is easier for you but never use both at the same time - this setup hasn’t been crash-tested and it could put too much stress on the car seat. * After connecting the seat, using either method, make sure to push down on the seat as you tighten the latch straps or seat belt. The seat shouldn’t move more than an inch at the belt path. * Register your car seat with the manufacturer and sign up for recall emails to ensure your child is not riding in a defective car seat.

“Even seasoned parents should take some time to learn how to properly install the new car seats on the market. This will lower the risk of any injuries and will help keep your child protected if you ever get into a car crash,” Newman says.

Although many precautions should be taken by any parent before driving with a child, new parents should not be worried to take their child for a ride. By taking the proper steps parents should feel comfortable and confident while driving with their newborn so they can focus on the road and keep their child protected.

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living well families ~ December 2014

Living with

chronic illness

By Sarah Bass

I

f there is anything that a person living with chronic illness can tell you about, it’s changed plans. This can be especially true around the holidays when life is busy, stress is high, and family demands seem to increase. However, a flare-up doesn’t have to ruin your holidays or your time with friends and family. Over the past five years, while living with Ulcerative Colitis combined with rheumatoid like joint pain, I have learned some strategies and attitudes that have eased the stress of a flare-up and helped me to adjust my plans and expectations. It has been my hope that what I have learned can help someone who is newly facing a diagnosis or is supporting a loved one who is.

When I first received my diagnosis, I handled it in an unhealthy way. I rebelled. I told myself that I was stronger than the disease and that I could push through it. I believed that beating it meant carrying on about my routines as though I felt healthy. When exhaustion and a hospital stay finally demanded that I slow down, I found myself rethinking my perspective.

The first thing that struck me was how tied to time I had become. My first response to the news that I was being admitted was “I don’t have time for this,” Of course, this had been my default response to all things UC related. I don’t have time to be sick. I don’t have time to rest. I don’t have time to eat right.

Suddenly, in the hospital, I was forced to “have time for this.”

I suppose my habit of being tied to time was

something that I had formed a long time ago, perhaps one that we all have developed to some point. It’s something that I hear all the time, from the sick and the well. People with the flu wail out “But I don’t have time to be sick!” Parents feel they are failing because the laundry is not done. Workers eat lunch at their desks because they have GOALS to meet. Mourners express regret for the things they had meant to do with their departed loved one.

My relationship with time had to change. I began to understand that time spent differently than planned is very often still time well spent. Often, when we do not meet our own expectations for the time we are using, we feel like we have lost something. But in reassessing, we usually find that we have used that time for things that were equally as important.

Perhaps you did not get your laundry done today, had to skip the gym, or missed a day of work, but your took care of your body, mind, and spirit. Even on our well days, this is important to remember. Time spent differently is still time well spent. Dinner may be late, but did you enjoy that extra hour with your favorite book? The trip you planned with your departed loved one may not have happened, you still made memories that will serve as a shield against grief. In looking back, we often find that what we have done is enough and that it was meaningful to those who shared that time with us. It’s far too easy to forget the valuable things we have done with our time when we focus on what we have not done.

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I

nterestingly enough, I also had to learn that procrastination doesn’t pay. I make my periods of wellness productive and organized. If I get sick, it is less stressful when I know that my work is well organized enough that anyone in the office can find it and take care of anything that needs to be done in my absence. My daily routines are eased because I have kept up with chores. This doesn’t mean that I never get behind, but I don’t live in constant anticipation of chaos.

I have also learned to accept the gifts that people give.

People don’t always show their love to us in the way we would prefer, but they do show it in the ways that they know how. This can sometimes show up as giving advice, lecturing you on your diet or habits, over-assisting, or staring at you worriedly. Accept the gift for the spirit in which it is given. Resenting the gift creates stress, for you and on the relationship with the giver. If you really can’t accept what they are offering, let them know what you need. Most of the time, people want to help, but don’t know how. I keep a list of things that I need to delegate to others at work should I be absent and a list of opportunities for people who offer to help. I rarely have to use the lists, but it eases the stress of anticipation for me and creates clear choices for those who support me.

Another important thing that I learned was to separate my identity from the disease. In the beginning, the UC was always in my mind. I felt unfamiliar with my body because, now, it wasn’t what I had always thought it was. Perhaps I wasn’t who I thought I was, either. I struggled with fear of 30

living well families ~ December 2014

the future, depression related to my self-image, and a sense of betrayal. It took a while for to re-align my self-image and realize that I was still me. I have a friend who says “I have MS; it doesn’t have me.” She is aware of the disease, but is aware of herself outside of it. She’s a weaver, a creator, a mother, and a blogger. Her MS is there, but she is the identified one. I have learned to identify myself through who I am rather than what my disease has given to me.

This change came with acceptance. Acceptance isn’t something that we are naturally inclined to follow, but it is something that is necessary for our growth and health.

“It is what it is,” has become one of my favorite sayings.

Through this, I accept the days that I must do less. I accept the times that I must take medications that are inconvenient. I accept that perhaps some of my goals must be re-evaluated. Today, I am sick. I cannot live this day as though I were well. I must accept the limitations that are put upon the day. Resentment, denial, and disappointment will create stress for me. Acceptance frees me to reassign my energies to where they will be most useful. I won’t be mowing the lawn, but I may refocus energy into healing, spiritual restoration, writing cards, reading a book, talking to a friend. Just as time spent differently is not time wasted, energy spent differently is not energy wasted.

One of the most important things that I learned was not to waste the experience, but to use it for good. Rick Warren, Pastor of Saddleback said something following the sudden suicide of his son that has stuck with me. He said, “I’m certainly not going to waste this pain. One of the things I

I “ have new friends.”

believe is that God never wastes a hurt and that oftentimes your greatest ministry comes out of your deepest pain.”

It may be that a chronic illness changes little in your journey; it may be that it changes the entire course of your life. It may mean new career choices, new living arrangements, loss of particular dreams and goals. Here is where you can let the disease kill your spirit or you can turn it into a source of strength. Those who thrive have chosen to use the experience for good. There is an old saying that I have applied to my life “Those who cannot do teach.” I have taken it as a challenge and an opportunity, rather than the insult that we usually intend it to be. Are you unable to enjoy certain hobbies or contribute to your community the way that you want to? Teach someone else what you have learned. The world is looking for teachers, mentors, and supporters of ambition and your experience has equipped you uniquely to give, serve, and teach.

In the large things and the small, be gentle with yourself, patient with those who surround you, and grateful for the good things- even the ones that come in disguise. Set new goals that align with your capabilities and stay busy. Accept the days as they come and use your energies wisely. Find something to contribute to your world, remembering that a giving person cannot be anything but a grateful person. You will find that you can say along with my friend “I have this illness; it doesn’t have me.”

Sarah Bass is Marketing Director of the Goodman Group.

“My life is better.”

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living well families ~ December 2014

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December 2014 ~ living well families

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health tip Get the recommended amount of fruit in your daily diet

N

o one questions that fruit is an essential part of the diet.

But did you know that more than 70 percent of Americans do not eat the recommended amount of fruit? One hundred percent juice is a convenient way to help you get the important fruit nutrients you need.

Juice doesn’t just taste good, it also fulfills an essential part of the daily diet. Nutritionist and registered dietitian, Diane Welland of the Juice Products Association provides information on what’s so good about juice.

How does juice fit into a healthy diet?

Because the majority of Americans aren’t eating the recommended daily amount of whole fruit, they’re missing out on many important nutrients. Fruit juice is an easy way to make sure you’re getting key nutrients like potassium, vitamin C, folate, magnesium, riboflavin and niacin. Some 100 percent juices are also fortified with vitamin D and calcium.

How much juice should a person drink each day?

Recommended serving sizes vary with a person’s age. The American Academy of Pediatrics recommends 4 to 6 ounces of 100 percent fruit juice for children ages 1 to 6 and 8 to 12 ounces for those ages 7 to 18. As an alternative to whole fruit, the USDA’s Dietary Guidelines for Americans consider onehalf cup of 100 percent fruit juice to be equal to one half cup of whole fruit.

Does fruit juice contain sugar?

There is no added sugar in 100 percent fruit juice – it contains only the natural sugars found in whole fruit.

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living well families ~ December 2014

Does drinking juice contribute to weight gain?

Fruit juice is definitely part of a healthy eating plan.

New scientific studies show that juice drinkers have better quality diets than those who do not drink juice. Other studies indicate that children and adolescents can drink juice in appropriate amounts without gaining weight.

“I recommend that parents follow the guidelines of the American Academy of Pediatrics, when it comes to serving sizes,” Welland says.

Welland suggests adding fruit and fruit juice into your diet in subtle ways like incorporating juice into traditional recipes. Fruit juice can add new flavors to any recipe from snacks like ice pops to savory dinners.

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It scared me when Jessica wasn’t feeling well last night and I had no idea what to do.

Community Medical Center’s new 24-7 Nurse on Call will give you the answers you need to help you breathe easier.

Our registered nurses will help determine if your symptoms require emergency care or whether they can be handled by your primary care provider tomorrow. We’re your local, trusted resource to check symptoms fast. Call us at 406-327-4770.

For the care you need, when you need it, of course it’s Community.

Community Medical Center is an independent, local, non-profit hospital.

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living well families ~ December 2014

communitymed.org