Saturday, January 24, 2015

Questions to Ask Your Doctor or Pharmacist

During #DrugsFactWeek, I have a special guest contributor: 

Guest post by John T. James, PhD, DABT

Patients must understand that accepting drugs into their body is an invasion into their body, no less so than serious surgery. Even though that bodily invasion leaves no external scars, drugs often have powerful and lasting side effects on patients, even when approved by the Food and Drug Administration (FDA). Patients must ask questions about any new drug they are prescribed.

The first question to ask is whether lifestyle changes might be effective rather than drugs. Many people report a “cure” from diabetes simply by major and sustained changes in diet and exercise. Likewise exercise and dietary changes can stave off the progression toward hypertension as we age. Now let’s suppose that there are no alternative to taking a therapeutic drug.

The most important question is to ask whether the drug is being prescribed to you off label – that is for purposes or populations of people other than the ones for which the FDA has approved it. The very young and very old are often prescribed drugs that have never been evaluated in these extreme age groups where drug metabolism and effects at the target organ are unknown. Many drugs are not approved for use in the very young and the elderly. Off-label prescribing by physicians is basically human experimentation with no formal oversight. Unless you enjoy being a guinea pig, you will know whether your drug is being prescribed to you off label.

If you determine that your drug is prescribed to you off label, then you must know why this has been done. Does your doctor have data showing that it is safe and effective for people like you? Does his personal experience with patients like you warrant a prescription for you? Does your doctor have a “close” relationship with the manufacturer of the drug? Does your doctor even know if he is prescribing it to you off label? Many won’t.

The second question to ask is how soon you will know the positive effects of the drug and how that will be known. Many drugs take weeks to exert the favorable effects they are alleged to provide. Likewise, you must know the potential side effects of the drug and how to report these if they occur in your case. You should also ask how the drugs you are already taking might interact with the new drug you have been prescribed. In general this is not going to be known by your doctor or pharmacist, but you should ask anyway.

The patient must know how long a new drug prescribed to them has been approved by the FDA. The FDA approves drugs based on quite time-limited data, so the full adverse effects of a newly approved drug may not be known for many years. Drug companies are slow to perform post-marketing, follow-up studies once they have gotten FDA approval for a drug. I would recommend not taking any drug that has been on the market for less than three years unless there is no other choice.

The patient needs to ask if there is a “black box” warning for the drug they have been prescribed. This means that the FDA has determined that the drug may be especially risky for certain types of patients. Ask if there is an alternative without such a warning. If you are taking a “black box” drug you must be especially vigilant for side effects and adhere strictly to the prescribed dosage.
If you are taking more than four drugs you should ask about medication reconciliation. This is a systematic process of reducing the number of drugs you are taking. Studies have shown that in elderly people a reduction of an average of eight drugs to an average of four drugs per patient provided remarkable improvement in patient wellbeing with no adverse effects.

Overuse of antibiotic prescriptions is widespread and facilitates the appearance of multi-drug resistant organisms. If you are prescribed an antibiotic, ask about the rationale for this. Perhaps your condition is due to a virus and not to a bacterium. Is the antibiotic specifically targeted to the type of bacterium you are presumed to be suffering from? Ask for a culture-and-sensitivity test if your physician is not confident that the antibiotic is going to be effective against the organism causing your illness.

The victims of overuse and misuse of therapeutic drugs appear by the hundreds of thousands at emergency rooms each year. Medication errors in hospitals are among the leading causes of lethal adverse events in hospitals. There are critical times in hospitals when patient advocates must be vigilant for drug mistakes. Were medications changed after admission and if so, then why? Have medications been mistakenly deleted? What is the purpose and risk associated with any new medication? At discharge, does the patient fully understand how to take any new drug she has been prescribed? Can the patient afford the new drug?

Each patient or their advocate must take responsibility for being fully aware of the rationale for the drugs they are prescribed. Unfortunately, the patient or patient’s advocate cannot depend on anyone else to do that.

Wednesday, December 10, 2014

Wood Creek Academy Formerly Spring Creek Lodge Opens

The  "hobbit" from Spring Creek Lodge. Teens were placed here for punishment.
Wood Creek Academy formerly Spring Creek Lodge, which was one of WWASPS's largest programs at one point - and home of the hobbit, is open for business again.

I can't believe it's been over 14 years since my nightmare with WWASPS.

Sadly I still receive emails from students struggling to overcome the emotional trauma they endured during their time at a WWASPS facility, as well as many simply looking for help in seeking academic credits.

Neither which I can help them with, however it never ceases to amaze me that there are so many victims that have been effected by these people -- yet they continue to close and open facilities in our country.

The blessing is that many parents are doing their due diligence and learning how to educate themselves before placing their child into a residential therapy school or program.  They are asking the right questions, and digging deeper into the past of the program.  If your gut is twisting - it's time to move on to another program.

It's not about "not" getting your child help, it's about finding the right help for your child and family.  Never select a program when you are at your wit's end.  Never get pressured into placing your child.

Wood Creek Academy, Red River Academy and any others that formerly have been WWASPS associates -- we can only hope and pray they are not using the same methods and tactics that have been used on the many, many students priors.  In my opinion - there are many programs in our country - make an educated decision.

After receiving a phone call from a parent that was suspicious of the marketing of Wood Creek Academy,  I called the Montana licensing bureau to confirm that Wood Creek Academy is formerly Spring Creek Lodge.   Unfortunately zebras don't change their stripes. 

If your gut tells you something isn't right - keep on searching for the right program for your child.  There are many quality schools and programs in our country.

Wednesday, September 24, 2014

Internet Addiction: When Teens Are Unable to Unplug

One of the most common concerns from parents of teens, behind drug use, is Internet addiction.
 
It would be difficult, if not impossible, to find a college campus or schools that don’t have Internet. College students and teens use the Internet for research, communication, and other educational activities. Of course, students also use the Internet for social media, news, and even online gambling, activities that can be fun and even enriching, but when overused, become a real problem.

Some college students suffer from Internet addiction, unable to step away from the computer or put down mobile devices even for a day. Eighty-four percent of college counselors agree that Internet Addiction Disorder is legitimate, but at the same time, 93% of them have not been fully trained to diagnose Internet addiction, and 94% have insufficient training for Internet addiction treatment. The result? Falling grades, physical problems, and even clinical addiction.

Internet addiction is a real problem for college students and teens today, and here are several trends that are worrisome.

1. Students have feelings similar to drug and alcohol addiction: Two hundred students were asked to abstain from all media for 24 hours, and were then asked to blog about their experiences. The words the students used to describe their feelings during the restriction period were typically the same words associated with a substance abuse addiction: “withdrawal, frantically craving, very anxious, antsy, miserable, jittery, crazy.” It seems that these students are addicted to media, particularly in its online form. This is disturbing, but not surprising, as studies have already shown that Google can actually change your brain.

2. College students are especially susceptible to Internet Behavior Dependence:A college student case study revealed that college students are a “population of special concern” when it comes to Internet addiction, and they are disproportionately vulnerable due to psychological and environmental factors in their lives. When faced with an Internet addiction, college students have a hard time forming their identity and building intimate relationships. Online, students can “develop relationships devoid of the anxiety found in face-to-face relationships,” and they “can take on any persona they desire, without fear of judgment on appearance or personal mannerism, and can avoid racial and gender prejudice.” This type of adaptive behavior tends to diminish the social capacity of college students, leaving them unprepared for the development of real world relationships.

3. Online poker is prevalent on college campusesOnline poker joins two addictions together: gambling and online interaction, so its use on college campuses is especially worrisome. The University of Pennsylvania predicts that over 20% of college students play online poker at least once a month, and you can typically see lots of students playing online poker on a college campus. Although it can be a fun game, and many students may be able to maintain healthy lives while enjoying playing online poker, some simply can’t. At the University of Pennsylvania, researchers noted that among college gamblers that played weekly, over half of them had a serious problem with the habit. In some cases, students fail out of classes or gamble their tuition away, even turning to crime to pay debts created by online poker.

4. Students can’t go 24 hours without the Internet:When 1,000 college students took part in an international study on electronic media, they were asked to go without media for 24 hours. But many students in the study were not up to the challenge. A majority of students did not actually go without media for 24 hours, giving in and checking in with their phones or email. Students confessed, “I sat in my bed and stared blankly. I had nothing to do,” and “Media is my drug; without it I was lost. How could I survive 24 hours without it?” The study revealed a physical dependency on media, especially Facebook and mobile phones. Students recognized that typing the address for their favorite sites had become muscle memory: “It was amazing to me though how easily programmed my fingers were to instantly start typing “f-a-c-e” in the search bar. It’s now muscle memory, or instinctual, to log into Facebook as the first step of Internet browsing.” Other students recognized physical signs of withdrawal, sharing that “I would feel irritable, tense, restless and anxious when I could not use my mobile phone. When I couldn’t communicate with my friends, I felt so lonely, as if I was in a small cage in a solitary island.”

5. Students are surfing, not studying: Students who spend a lot of time online are likely to neglect their studies. In many cases, students who performed well in school before developing an Internet addiction allowed their grades to crash, only then realizing the impact of Internet dependency. Counselors across the US have identified the problems of excessive Internet use, including: lack of sleep and excess fatigue, declining grades, less investment in relationships with a boyfriend or girlfriend, withdrawal from all campus social activities and events, general apathy, edginess, or irritability when off-line, and rationalizing that what they learn on the Internet is superior to their classes. Students may not realize the problem until serious trouble happens: “They flunk out of college. Their real-life girlfriend breaks up with them because all they ever want to do is play on the Net. Their parents explode when they find out their huge investment in their child’s college education is going to support all-night Internet sessions.” By then, it may be too late to recover the damage.

6. The Internet is everywhere: Ninety-eight percent of students own a digital device. This prevalence throws gasoline on a spark: students who are already susceptible to Internet addiction have access online in computer labs, their dorm, and other places around campus, and on top of that, they have the Internet in their pocket at all times. Knowing this, it’s not surprising to find out that 38% of students say they can’t go more than 10 minutes without using a digital device, contributing to an ever-present existence of the Internet on campus.

7. Internet use can physically change your brain: In a study of Chinese college students who were online for 10 hours a day, six days a week, morphological changes in the structure of their brains were noted. Scientists found reductions in the size of the “dorsolateral prefrontal cortex, rostral anterior cingulate cortex, supplementary motor area and parts of the cerebellum as high as 10-20%.” Although at the same time, there was an increase in the “density of the right parahippocampal gyrus and a spot called the left posterior limb of the internal capsule.” These changes happen to the detriment of short term memory and decision-making abilities.

8. Many students need intervention and treatment for their addiction, and it can lead to depression: We might joke about “Crackberries,” but for some, the Internet is truly a significant concern. A study published in BMC Medicine indicated that 4% of the students who participated in their survey met the criteria for having a problem with online addiction. But perhaps the more disturbing fact from this study is that there is a “significant association between pathological Internet use and depression in college students,” putting a population that is already at risk for mental instability in a precarious position.

9. Cyberbullies go to college, too:Although most of the news on cyberbullying focuses on adolescents, the fact is that cyberbullies exist on the college campus as well. It’s not surprising, considering how much time students spend online, and how much impact a college student’s online presence can have. In fact, a University of New Hampshire study reported that one in 10 students was abused online. College students have been the target of sexually violent rants, and one professor at BU had to persuade Facebook to remove his page, which he did not set up himself. Researchers believe that students are especially vulnerable to cyberstalking because “they live in a relatively closed community where class schedules, phones, and e-mails are easy to find.” And sites like Rate My Professors may be helpful for students choosing classes, but some comments may be hurtful for faculty members. Thierry Guedj, adjunct professor of psychology at Metropolitan College reports, “It really hurts faculty members badly when they read these things about themselves online. People have become quite depressed about it.”

10. Tech conditions can be dangerous to your health: College Candy’s list of tech conditions that can be dangerous to your health seems to be written as a joke, citing “Blackberry Neck,” and “Glazey Dazey Lazy Eye,” but these conditions really can be a problem. Using the Internet too much can lead to a sedentary lifestyle, a decline in physical fitness, and as a result, weight gain. Heavy users report carpal tunnel syndrome, eye strain, and headaches. Sleep disturbances can also stem from Internet addiction, as Internet use may lead to later bedtimes and less restful sleep. Additionally, researchers believe that the light from computer screens may affect circadian rhythms, creating a risk factor for insomnia.

Remember parents, you should always have access to these passwords. It is for your child’s safety.

Saturday, August 16, 2014

Back to School: Offline Parenting Helps Online Safety

As a parent, you know that school supplies today include more than notebooks and pencils. Among the “must-haves” for students are tablets, laptops and smartphones. Now that kids integrate technology into their daily lives, it’s more important than ever for parents to keep tabs on their kids’ activities.

These back-to-school technology safety tips compiled by AT&T can help you take the proper steps to make sure their children are using technology safely.

1) Get tech savvy. Talk to your kids about what sites they’re visiting on the Internet and what kind of social media they are participating in. You should even experiment with them yourself. This will give you a better feel in evaluating risks and potential abuses. Friend them or follow them.
2) Check privacy settings on social media, but emphasize there is no privacy. The more private, the less likely inappropriate material will be received by your child, or sent to their circle of acquaintances. But make sure your child understands that everything sent over the Internet or a cellphone is public and can be shared with the entire world, so it is important that they use good judgment in sending messages and pictures and sharing on social media.
3) Set rules for texting. Only allow texting at specific times - no texting at school, no texting until homework's done, no texting after a certain time at night, and for teens, no texting behind the wheel. Tell your child you have the right to monitor the texts that are sent and received.
4) Research what your carrier offers that can help. For example, some offer wireless parental controls, like Smart Limits for Wireless, that allow parents to block unwanted calls and texts from up to 30 numbers, set monthly limits on texts and mobile purchases and restrict texting, data usage and outbound calling during specified times of day. Most Internet service providers offer parental tools to block access to specific Web pages, as well as to services such as e-mail, instant messaging, chat groups and message boards. Since it’s virtually impossible to stay informed about all the sites kids want to visit, also check to see if your Internet Service Provider offers permission slips, which allow children to request access to unauthorized Web sites. You get to be the judge. Tamper controls are another helpful feature, alerting parents if children attempt to change the settings.
5) Set boundaries. A parent’s responsibilities in overseeing a child’s technology use are not much different than in other areas of daily life. Set clear boundaries on appropriate and inappropriate uses of technology. Make sure these rules and the consequences of breaking them are clear. And monitor use to make sure they are following the rules. Above all, don’t be intimidated. Even if you’re less savvy about the technology than your children, you have the tools to make your job simpler in an ever more complicated world.

If you have teens that are driving, remind them, #ItCanWait – #X Campaign.

Sunday, July 13, 2014

Summertime More Screen Time: Make it Safe Time

In the summer heat, it’s easy to  understand why kids (and their parents) don't want to be outside during the middle of the day. More free time spent inside during the summer, likely means more screen time for kids. 

Technology can help strengthen friendships and open a world of knowledge for our kids, but it calls for some limits during the summer months (and school year, of course). 

But where to start? AT&T's Anita Williams Weinberg has some great suggestions for parents in AT&T’s new Thread magazine.

Weinberg suggests parents arm themselves with some solid guidelines and use common sense to navigate the summer with teens and tech. She offers three simple rules to help kids get the most out of their screen time.

1. Be the gatekeeper: Set up parental controls that limit screen time and phone use, and designate which contacts may (or may not) be called or texted between certain hours. Most popular video game systems and computer operating systems offer parental controls.
2. Know where they go: Make sure kids understand that their electronics are not private. Know their passwords, and regularly scroll through phone and browser histories to spot red flags. Particularly with laptops and tablets, it’s important to keep the technology in a common area of the house — no hiding behind closed doors.
3. Share the fun: Make sure there are times when you can all enjoy tech toys and gadgets together, like family movie nights or gaming tournaments.

Read Weinberg’s full column here, then share your strategies for limiting screen time in the summer.

Friday, June 13, 2014

Summer Grade Recovery Program for Teens

Have you discovered your teenager failed a class or two?  Are they missing credits?

There are programs that can help them acquire grade recovery this summer. 

Maybe your teen is struggling with defiance, they disrespect you or are engaging in risky behavior.  You are not convinced that they warrant a full-time residential therapy.

Summer is a perfect time to explore a therapeutic boarding school that offers a summer program to determine if it is a fit for your teen.  It is important that it offers academics - since chances are likely your child is behind academically.  This can be part of their stress that brings on low-self-worth which feeds into making bad choices.

If you need resources please visit www.helpyourteens.com and fill out a quick form for a free parent consultation. 


Wednesday, May 14, 2014

Summer Teen Help Programs

Summer is almost here and parents are searching for summer programs to help their struggling teens.  Many hope that a good summer programs will make a difference in their negative behavior.

Today parents will complain about the following issues with their teenagers:

  • Underachieving.  Capable of getting A's yet satisfied with C's and D's.
  • Dropping out of their favorite sport or activity.
  • Smoking pot -- occasionally - though parents may blame it on the friends, please keep in mind, it is your child making the decision to inhale that joint or pop that pill.  
  • Drinking - again, it may be the friends you want to blame, but are they holding the bottle to your teen's mouth?
  • Sneaking out of the house
  • Defiance, lying, stealing
  • Maybe they have changed their peer group this year?
Let's face it, with a combination of any of these above, you could be traveling down a negative path.

Chances are very good a short-term summer program will not address a long term solution, however many parents need to give it a try.  It is better than not doing anything.

It can irritate me when I see parents get sucked into these very expensive Wilderness programs that give tell you they can turn your child around in 4-9 weeks.  Really?

I think if you interview most of the families that have dug deep  into their wallets and spent that $15K-20K on a Wilderness program (which is likely to have zero academics to get your child caught up), you will find that at about the 4 week point, the program is already prepping the family for the "next step" of a Therapeutic Boarding School or Residential Treatment Center (another $50K step).

Or if the family truly cannot afford, which I have spoken to many of them too, since they have spent their  last dime on this summer last ditch hope, they soon find that within 3-6 weeks after Wilderness, their  child is back to their old ways.  

What is the answer?  It depends on the child, but in most situations it is finding the right placement the first time around.  Not starting at one place - and "breaking him down" (aren't they already broken?) and breaking your wallet too, and then going to yet another to break your wallet again.

Most quality and qualified programs are designed to treat teens that come in with the anger and defiance.  There are excellent 6-8-10 month programs that can offer a complete package of academic's, emotional growth (clinical) and enrichment programs (which are so important to help stimulate your teen in a positive direction).

It is my opinion, and after almost thirteen years of watching parents and families in this big business of "teen help" get screwed (sorry for the slang) but until you walk my shoes and have taken the time to learn about what goes on behind the scenes - the word just about seems appropriate.

I firmly believe in getting our kids help, as a matter of fact, it is our responsibility as a parent to do that.  We also have to do our due diligent.

Google is not God -- the Internet has some very disturbing sites - and disgruntled kids, parents, employers. Yes, I was one of them, but I also have a lot of substantial legal facts behind my case.  I don't sit and rant.  As a matter of fact, I don't want to discuss it - I want to continue to educate parents about how they can find the best program for their child's needs.

I offer many great tips, questions to ask schools and programs and resources.  Visit www.helpyourteens.com.

If you are looking for a summer program, there are many out there.  Do your due diligence, it will be worth it.

Thursday, May 1, 2014

Crumpled: Your Words Matter

The power of a word is underestimated.

This is why we, as a society, have to take online harassment seriously.

Bullying doesn't discriminate. No one is immune to cyberbullying.

From schools to workplaces to playing fields to cyberspace -- at any age, you can become a victim of vicious keystrokes and harsh words.

Crumpled is the name of a video created by a group of students that are on a mission to Delete Negativity on Social Media with the #iCANHELP Campaign. The video speaks for itself, the message is powerful and one you need to pass on to others.

These students call themselves The Positive Warriors! It started when someone created a fake Facebook page to make fun of a teacher at their school. Instead of retaliating with cruelty, they decided to come back with kindness by spreading positive messages throughout social media and their school.

This crusade has spread through 100 schools in their state of California. Their goal is to go national.

Will it start with you? Talk to your school about it today.

Join #iCANHELP on Facebook and follow them on Twitter.
The movement can start with you locally!

To crumple or uncrumple, the choice is yours...

Words matter, keystrokes counts, use them with care.