Can't focus? Try Concerta

Last week I began and completed my first job as a real nurse. Save the fact that medications and a small dusty clinic were involved; the experience could not have been much more different than my time in Haiti.

The job was posted on my school's list serve "RN needed for 1 week camp. Salary negotiable" on Monday. By Tuesday at 8am, I had rented a car, printed out Google-map directions, and was heading down the Mass Pike towards the Pocono Mountains. I had brought my bathing suit, a bunch of knitting, two good books and an attitude of adventure.

The week turned out to be less than a week of vacation and adventure. I played both nurse and pharmacist - bagging up hundreds of kids medicines a day (Zoloft, Zyrtec, Abilify, Allegra, Ritalin, Concerta, Singulair, etc.) and distributing the little coin-envelopes at breakfast, lunch, dinner and bed time.

In the time between the busy meals I saw tummy aches, scraped knees, fingers with splinters, unidentified back pain, black and swollen eyes, some stomach bugs and a whole handful of headaches. I pretended that I knew what I was doing sometimes, and knew others, and always gave a confident smile, checking the med recs for possible allergies before I distributed Advil. Amidst it all, there was little time for reading and knitting and the rain rendered my bathing suit all but useless.

The phenomena of medications at camp are a strange statement about our society. Perhaps only when we separate kids from their families, and put them in a group, do we see how truly medicated our children are. Here is a list of stats, printed by the NY Times this summer that puts some hard facts to the overwhelming numbers of pill bottles I encountered. What these numbers don't show are the amount of kids that take 4, 5, 6, or 10 prescription medications a day.

Total

One or more Daily prescription medications: 40%
Asthma/Allergy: 20%
Most prescribed medications:
Zyrtec (allergy)
Allegra (allergy)
Singulair (allergy and asthma)

Attention-deficit disorder/Attention-deficit hyperactivity disorder: 8%
Most prescribed medications:
Concerta
Strattera
Adderall

Depression/Anxiety: 3% (yes. I handed an 11 year old Zoloft each morning, not to mention the 15, 16, 17 and 18 year olds. I thought that adolescents’ and teenage years were supposed to be difficult....)
Most prescribed medicines:
Zoloft
Paxil
Prozac
Wellbutrin

Antipsychotic/Mood disorder: 2% (We had a slightly higher percentage. I think about 3-4% of our kids had 'mood disorders.' I made the mistake of giving one young woman on abilify her pills a few hours late. By that time she had already had a break down. Some are teetering on a scary edge of normalcy)

Most prescribed medicines:

Most prescribed medicines:
Clonidine
Lexapro
Risperdal
Depakote

Add the next category - in my camp - anti anxiety drugs. Trazadone, Clonopin, Xanax. Yikes! They're only 11 years old....

Bed-wetting: 1% (We had only one kid who used a pharmaceutical for this problem. I assume it didn't work like it was supposed to - as this kid showed up to use the washer dryer one morning - an embarrassed look spread across his face as he clutched a plastic bag of wet bedclothes.)

So that was the week - in a nut shell. It illustrated a pharmaceutical crisis that is overwhelming children. When I tried to confirm the appropriateness of doses with my Palm, many of the medications stated that they had not been tested on children. I can not help but repeat my new mantra of 'we don't know what it's doing to kids. We have no idea of the long term effects.' Weight gain, increasingly unstable moods, a rise in autism, and (perhaps worst of all) the concept that "whatever the problem, I will just swallow a little white pill and it will all be better."

Scary thoughts. But, now that the envelopes have been thrown away, and pill bottles have been sent home with kids, a good and challenging week over all.

Delayed cord clamping

A zen concept. Perhaps slower is better.

http://www.slate.com/id/2146483