invincible summers

in the middle of winter I at last discovered that there was in me an invincible summer. (albert camus)

Medicating grief isn’t the answer April 28, 2009

Filed under: change,hope,news — clementine @ 12:46 pm
Tags: , , , ,

We need more doctors like this. From an op-ed at the Boston Globe:

ON A RECENT episode of the HBO series “In Treatment,” a CEO of a major company describes with complete absence of emotion the death of his 16-year-old brother when he was 6. When Paul, his therapist, suggests that his panic attacks may be related, he leaves the office, saying he will ask his doctor to prescribe medication now that he has a diagnosis. Paul gently suggests that they continue the important work they have begun. I am eager to see how this plays out. I am quite certain, however, that in the real world, the CEO would find many doctors to prescribe medication, enabling him to eliminate the symptom without the hard work of grieving.

This episode reminded me of a case in my pediatric practice (with the details changed to protect privacy). A 5-year-old girl was referred by her kindergarten teacher for evaluation of attention deficit hyperactivity disorder, with a strong recommendation that medication be considered. Her behavior had been disruptive since preschool, but was now affecting her ability to learn. There was concern that she might not be able to move on to first grade. Before I even saw the patient, armed with standardized forms and psychological testing, I was quite sure that she would meet diagnostic criteria for ADHD and that medication would be a reasonable consideration.

I met with her parents, who described classic symptoms of ADHD, including prolonged battles at home around such simple tasks as getting dressed for school. About halfway through the visit, I began to ask, as I always do, about past history. “How was your pregnancy with her?” There was a pause, during which the parents exchanged looks. “Actually, I’m not her biological mother.”

Now it was my turn to pause, as I was quite shocked to receive this important piece of information so late in the evaluation process. With some reluctance, they went on to tell me that the girl’s mother was seriously mentally ill, had been intermittently involved in her life, and had disappeared completely two years earlier. But, they assured me, she never talked about her mother and it wasn’t an important issue.

This story has a happy ending. I agreed that medication could be helpful, but, building on the trust they had developed with me as their pediatrician, I suggested that the loss of her mother was actually very important and needed to be addressed. They accepted my referral to a therapist. I am fortunate to have an excellent colleague across the street who accepts their insurance. He wisely explained to them that children do grieve, and now the whole family is engaged in working with him around this painful and difficult task. This child is now thriving in first grade.

For this one positive outcome, there are hundreds that do not end this way. Children who have experienced terrible loss do not have the opportunity this girl had. They are aggressive and disruptive, and their symptoms are medicated away. They continue to struggle, often failing in school. Some of the reasons this path is chosen are lack of time, limited access to mental health services, and resistance to doing this hard work.

I recently received a letter from the state with the alarming statistic that 37 percent (nearly $190 million) of the MassHealth pharmacy budget is spent on behavioral health medication. The letter asks for input regarding possible ways to improve patient care while reducing costs.

I proposed that we as a society recognize that grief and loss cannot be medicated away. As one friend who recently lost her husband so eloquently put it, “Grief is a powerful release that validates your loss, relieves stress, and helps you heal.” Certainly medication may be an adjunct, particularly when people are so incapacitated by their symptoms that they are unable to function. But if we as a culture validate the experience of grief, if we offer the time and space and resources to support people through the difficult process, I am quite certain that in the long run we will not only spend less on medication, but will help people to heal and return to being productive members of society. It is with children that this investment will have the greatest return.

Dr. Claudia Meininger Gold, a pediatrician, practices in Great Barrington.

 

Joe Pantoliano on mental illness stigma April 27, 2009

thanks to Van for posting on this-I’ve been out of the loop and missed it although I am familiar with what Joe has been doing lately.

Joe Pantoliano (The Sopranos, Memento, The Matrix, The Goonies) started an organization called No Kidding, Me Too! He has a documentary coming out with the same title. I want to start off my saying, I commend him for this. Stigma is a real problem in America and throughout the world. We must bring an end to it!

This is Joe’s message at his website:
We are ready for the fight and we ask you to please join us in the revolution and help us educate souls all over the world to “Remove the Stigma!”

Mission
No Kidding, Me Too! is an organization whose purpose is to remove the stigma attached to brain dis-ease through education and the breaking down of societal barriers. Our goal is to empower those with brain dis-ease to admit their illness, seek treatment, and become even greater members of society.

The Goal
Make Brain Dis-ease cool and sexy. We want a normal conversation in America to be:

“I have bipolar disorder/schizophrenia/insert dis-ease”

“No Kidding, Me Too!”

Who Has The Stigma:
Those suffering from brain dis-eases including anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, specific phobias, depression, bipolar disorder, schizophrenia, anorexia nervosa, bulimia nervosa, binge eating, pyromania, kleptomania, compulsive gambling, addictions, paranoia, multiple personality disorder, gender identity disorder, Down’s syndrome, psychosomatic disorder, tic disorders, and others.

How Will NKMT Accomplish This?
h Create strategic partnerships with members of industry, academia, organizations and government to ensure a broad-based spectrum of support and input.
h Organize the creative talents of our industry professionals to generate messages for various media and use our celebrity status to ensure these messages are heard. The messages will be of empowerment and acceptance and can include topics as basic as giving job opportunities to those with a brain dis-ease.
h Coordinate, participate in and generate interest for national and regional educational events consistent with our goal.

He has an impressive list of Advisory Board members, some of whom I greatly admire in the industry Joey and I share: Robert Downey, Jr, Ed Begley, Jr, Jeff Bridges, Edie Falco, Marcia Gay Harden, Ang Lee, Robin Williams and many more.

At his website there are photos of Joey from the screening of the teaser at the Democratic National Convention with people like Tony Goldwyn, Dana Delaney, Bobby Kennedy, Melissa Etheridge and Tom Fontana.

Here’s the teaser to his documentary:

Under the resources section at his website-the very first resource listed is NAMI. ahem. I wonder if Joe has researched Big Pharma’s influence at NAMI? Is he aware that Sen. Grassley is investigating NAMI’s funding? I am a registered Democrat and I’m becoming increasingly frustrated with this party, a party who is ignoring the corruption of Big Pharma and anyone linked to Big Pharma mainly because of their involvement with them. They are looking out for themselves and those that financially support them instead of the PEOPLE. Senator Grassley is all alone and that is sad.

At Joe’s website he links to several articles, letters, humorous videos and some of this favorite quotes, here’s a sampling:

To Fight Stigmas, Start With Treatment

Call for New Home to Address Health Disparities for Mentally Ill

FDA Approves Depressant Drug For The Annoyingly Cheerful

some of Joey’s favorite quotes

The teaser for his documentary opens with the statement:
1 in 4 Americans suffer from mental illness
4 in 5 Americans are affected by it

And then throughout you see more statistics on the screen:

87 million Americans have been diagnosed with some form of mental illness
There are over 350,000 diagnosed cases of PTSD resulting from the Iraq war
18 of our American heroes are committing suicide every day

And statements like these:
There is a fine line between madness & creativity
Mental illness is the only DIS-EASE which you can be diagnosed with, and get yelled at for having

Joe went public with his illness after he was hired to do a film. (FYI: one of the first things required for actors and directors before they start filming is to see a doctor and production schedules a physical for insurance purposes) He had done this over 70 times but in this case he told the doctor the two medications he was currently taking, one for depression and one for heart disease. His lawyers were then informed that the production company/studio could not insure Joe because he was taking an antidepressant. They were told Joe could sign a waiver basically saying if he had a ‘breakdown’ he would be financially responsible for the loss of work or a shutdown. Joe’s real problem and awakening was simple: they were willing to cover his heart but not his brain. That is stigma. We all know it and it’s something I’ve been fighting and living with for countless years. It’s heartbreaking.

However, in a separate (lengthy) taped discussion with Joe he discusses a number of topics, mostly stigma, his films, politics & mental illness. He also talks about the fact the he quit drinking and has started practicing yoga, he exercises, etc. He believes in the theory that mental illness is genetic. I believe he mentioned his mother was diagnosed bipolar. Now, I haven’t seen his documentary but when his teaser states 87 million Americans suffer from a mental illness-I doubt (and I hope I’m incorrect) that he mentions why we have this false statistic. This number has increased drastically simply due to Big Pharma’s influence and a bunch of doctors started diagnosing people for a variety of reasons: more money in their pockets, get the patient in and out as quickly as possible, falsified data and studies…the list goes on and on. Instead of dealing with the true issue at hand, whether it be trauma or dysfunction, it seems Joe has partially bought into the quick fix system. And he’s using his celebrity status with people in the government in hopes that his message will be heard. That would be all fine and good except there are many flaws in his message. I agree with ending stigma but ‘his message’ goes much, much deeper than that.

In chapter 15 of the discussion linked above someone asked him if he’s tried alternative treatments like acupuncture and he states that he does practice yoga and meditation, he partakes in talk therapy, 12 step groups, etc. He seems to be all over the map and that is fine. It is his path. But it will truly disturb me if he does not mention Big Pharma’s influence within our modern psychiatric world (doctors, NAMI, etc) in his documentary, No Kidding, Me Too!

 

happy post

Filed under: fun — clementine @ 12:01 am
Tags: , ,

Maru-the box kitty. ah, I love cats!

 

compassion April 26, 2009

I’ve been wanting to write about my beloved dog, Foxy, for quite sometime. She passed away a few years ago although she’s still here with me in my heart. She had been in my life for 12 years, since she was a sweet puppy. She was a Shetland Sheepdog and one of the kindest pets I have ever had. When I lived with my parents, she usually slept with me or nearby. Her coat and features were not as “attractive” as her husband, our other Shetland Sheepdog, but her beauty inside is what made her so special. I told Foxy things I felt I could tell nobody else in fear of receiving the standard response, “Cheer up, move on and forget about your past!” It wasn’t until I started this blog and then got married that I was able to ‘open up’ and express my feelings fully to human beings. But, for the longest time, Foxy was pretty much my only true friend and confidant.

She had a real gift with people. At one point, we were living in a small town and I remember bringing her to a local nursing home over the holidays. The sight there was horrific. I overheard nurses mocking their patients and complaining about cleaning up “their messes” and well, you get the picture. I wish I had reported them because I saw some very ugly things. However, at that moment in my life I was very lost and depressed and I simply wanted to share my dog’s love and gift with others. I would dress her in a santa hat and scarf and we would visit very lonely patients. I was shocked how many of them never received visitors from their own families. They had been sent off, forgotten and left to die alone. It was tragic and an eye-opening experience for me at that point in my life. When I would enter a room with Foxy, I would watch the patient’s eyes light up. She would kiss them and love them-it was such a beautiful thing. They always looked forward to her visits. It is my hope that she brought beauty and love into their lives or reminded them of the beauty and love in life before they passed on. And, oh how I miss her so.

I was recently reminded of Foxy while watching the tail end of an Ellen Degeneres episode. I do not watch much network television but when I can, I do watch Ellen. I adore her. She had Sirdeaner Walker on her show whose 11-year-old son, Carl Joseph Walker-Hoover, committed suicide on April 6th after being bullied by fellow students at his school. This story is heartbreaking and his mother is an amazing woman.

Here’s the interview:

Anyway, Ellen said something that has stayed with me:

“I feel like there needs to be a class taught every single day in school that’s compassion. You have History, you have Math, you have English, you have Compassion. Every single day kids should be taught kindness to other kids.”

Ellen’s words are so very important. Compassion does need to be taught in schools, especially when so many children are not taught this at home. Compassion is a very powerful thing and without it, we are nothing.

So, I’m dedicating this post to my sweet Foxy who was very compassionate, to Ellen Degeneres, to Carl and his mother and to all of the compassionate human beings in this world.

Memorial contributions for Carl Walker-Hoover may be sent to:

Carl J. Walker Trust Fund
c/o Hampden Bank
19 Harrison Avenue
Springfield, MA 01103

 

quotes

Filed under: inspiration,peace — clementine @ 2:39 pm
Tags: ,

peace

peace quotes by kids:

flowerpowergun555x444
Let the sun shine in the night time and please no more dying.
Please let us have peace and no more fighting. People are dying.

Southwest Elementary
San Antonio, TX, US
++++++++++++++++++++++++++++++++
Peace remained by my side until I understood
what she wanted from me—that I be free

Parque Ecologico
Porangaba, Brazil
++++++++++++++++++++++++++++++++
Why destroy when we could create,
Keep the peace, erase the hate.

Normal Community West High School
Normal, IL, US
++++++++++++++++++++++++++++++++
Let it blow in your direction
Let it touch you, melt you and mould you

SOS-Hermann Gmeiner International College, secondary school
Tema, Ghana

 

7-year-old commits suicide while taking psychiatric meds April 25, 2009

This story at the Miami Herald saddens me. It also infuriates me. When are doctors and the FDA going to wake up? What will it take? How many more lives will be lost before this madness stops?

From the article:

Weeks before his death, Gabriel Myers, the 7-year-old Broward boy who hanged himself in the shower of his foster home, had been prescribed a powerful mind-altering drug linked by federal regulators to an increased risk of suicide in children.

In all, Gabriel had been prescribed four psychiatric drugs, two or three of which he was taking at the time of his death, said Jack Moss, Broward chief of the state Department of Children & Families. Moss said he is not sure which medications the boy was taking because Margate police took the foster home’s medication log as part of an investigation into Gabriel’s death last week.

Three of the psychotropic drugs carry U.S. Food and Drug Administration ”black box” label warnings for children’s safety, the strongest advisory the federal agency issues. Three of the medications are not approved for use with young children, though they are widely prescribed to youngsters ”off label” — meaning doctors can prescribe the drug even if not formally approved for that use.

Gabriel had been prescribed Symbyax, Lexapro, Vyvanase and Zyprexa. Again, three of these meds are not approved by the FDA for use with young children. And of course, prescribing them nonetheless is not uncommon, doctors must be held accountable.

Four feet tall and 67 pounds, with short-cropped brown hair, Gabriel was a bright, charming and often sweet little boy, those who knew him say.

But he already had a sad past hinting at a troubling future. Records obtained by The Miami Herald show Gabriel may have been molested by an older boy while he was living with grandparents in Ohio, while his mother was in jail.

On Thursday, Gabriel locked himself in a bathroom and hanged himself with a detachable shower head after arguing with the 19-year-old son of his foster dad about his lunch, Moss said.

this screams trauma. and yet again, another precious child did not get the help he so desperately needed. Instead he got the “quick fix”-medicate. medicate. medicate. so very tragic.

Myers said the boy’s pediatrician had discontinued all psychotropic drugs while Gabriel lived with him, and the boy did well, earning A’s and B’s at the Hollywood Christian Academy.

”We did not have any issues with him having tantrums,” Myers said. “He would get upset, like little boys do.”

A week or two before Gabriel died, his grandfather in Ohio expressed concerns that the boy sounded overmedicated. ”My father said that the last conversation he had a couple of weeks ago Gabriel sounded like he was too drugged,” Myers said. “He sounded like he was doped up.”

Gabriel’s doctor, Dr. Sohail Punjwani, said he did not recall Gabriel. This statement sums up part of my problem with modern psychiatry today. Dr. Punjwani, since you seem to have forgotten your patient-here is a picture:

573-5241272embeddedprod_affiliate56
What a sweet face. Rest in peace, Gabriel. Let this picture be a reminder to any parents thinking about medicating their children with dangerous meds like Zyprexa. Do the research on these medications before you think about filling that prescription. Unfortunately in today’s modern psychiatric world, your child’s life and well-being is rarely your doctor’s concern.

 

pregnancy and antidepressants

Thanks to Gianna at Beyond Meds for this. And I agree with Gianna, Vogue is definitely a mainstream magazine so maybe a few lives will be saved. That’s all I’ve ever wanted.

Back in 2005 GlaxoSmithKline sent a warning letter to doctors, advising that the antidepressant Paxil may be linked to a slightly higher risk of birth defects in babies exposed to the drug during the first trimester of pregnancy.

From the FDA Public Health Advisory:

* In a study using Swedish national registry data, women who received paroxetine in early pregnancy had an approximately 2-fold increased risk for having an infant with a cardiac defect compared to the entire national registry population (the risk of a cardiac defect was about 2% in paroxetine-exposed infants vs. 1% among all registry infants).
* In a separate study using a United States insurance claims database, infants of women who received paroxetine in the first trimester had a 1.5-fold increased risk for cardiac malformations and a 1.8-fold increased risk for congenital malformations overall compared to infants of women who received other antidepressants in the first trimester. The risk of a cardiac defect was about 1.5% in paroxetine-exposed infants vs. 1% among infants exposed to other antidepressants.
* Most of the cardiac defects observed in these studies were atrial or ventricular septal defects, conditions in which the wall between the right and left sides of the heart is not completely developed. In general, septal defects are one of the most common type of congenital malformations. They range from those that are symptomatic and may require surgery to those that are asymptomatic and may resolve on their own. It is of note that the data in these studies was limited to first trimester exposures only, and there are not currently data to address whether this or any other risk extends to later periods of pregnancy.

The Vogue interview can be viewed here.