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F8 Sunday, February 25, 2007
The Ritalin kids grow up
BY MELISSA HEALY
Los Angeles Times
For Devin Barclay, life with
attention-deficit disorder has
been a winding road. And seven
years after he quit taking med-
ication for the condition, “it’s
still winding,” he says with a
laugh.
But as the 23-year-old navi-
gates his way into adulthood,
he’s managed to pay the road-
side distractions a little less at-
tention. And he’s learned a
thing or two about getting him-
self from one destination to the
next without taking major de-
tours.
In 1990, when Barclay was 7,
he was diagnosed with ADD
and began taking Ritalin – a
stimulant medication that he
and his parents referred to as
“the thinking pill” – to help him
sit still and pay attention in
class. Over the next decade, al-
most 2 million American boys
and girls were similarly diag-
nosed, an unprecedented
growth of a medical condition
that, before 1990, had been so
rarely recognized that the na-
tional Centers for Disease Con-
trol and Prevention did not even
track it.
Today, the children on the
leading edge of a wave dubbed
by some “the ADD generation”
have reached the cusp of adult-
hood. And as they take on jobs
or college, care for themselves
away from home, enter into
adult relationships and become
parents, these newly minted
grown-ups are carrying out a
massive natural experiment.
It seems like only yesterday
they were fidgeting in their
seats, sprinting around their
classrooms and daydreaming
their way through addition and
subtraction. Most, just like Bar-
clay, struggled through elemen-
tary and middle school on
Ritalin as the practice of med-
icating attention problems in
children took off steeply in the
OUR ADVANCING WORLD
United States: Between 1990 and
2005, production of the two
stimulant compounds most
used to treat ADD
methylphenidate and ampheta-
mine – increased seventeenfold
and thirtyfold, respectively.
Now many are choosing to do
without the drugs that pro-
foundly affected their experi-
ence of childhood and school
and, in many cases, made it pos-
sible for them to learn alongside
other kids in mainstream class-
rooms.
It is one of the first decisions
of their adult lives. Mostly, it
was parents who dictated
whether and when they would
start medications to sharpen
their focus. But the decision to
stay on or go off these drugs is
one that these teens and young
adults have made for them-
selves – with little research to
guide them.
Whether the results will be
● See ADD / F9
Info
●Continued from Page F6
classroom attendance, the oppo-
site has happened, Fishback
said.
– The most important training
received in medical school, said
Dr. Tom Simpson, who has prac-
ticed medicine for 31 years, with
29 of those in Sterling, “was
learning how to study medi-
cine.”
“There is no expectation that
I learned all I would need to
know,” he said. “Anyone who
practices medicine understands
there is a constant learning
curve. Ninety percent of the
drugs we learned to use when I
was in medical school we don’t
use anymore.
“I read probably, conserva-
tively, six to eight hours a week
to keep up in the field,” he said.
“I’ve been doing so for 30 years.
It’s always been that way.”
Dr. Andrew Post, an os-
teopath in family practice at the
Medical Center in South
Hutchinson, said the Internet
was an important tool while go-
ing to school and since he com-
pleted his medical residency in
2005.
“There’s a service I use called
UpToDate.com that has the most
current research,” Post said.
“Basically, they have review ar-
ticles and expert opinion on the
most current medical diagnosis
and treatment. It has informa-
tion on the most cutting-edge
Hips
●Continued from Page F6
for people suffering with
arthritic pain or pain from a
labral cartilage tear.
While arthroscopic surgery
has been around since the 1970s,
hips have been one of the last
joints to come around for this
type of surgery, Severud said.
Before the development of
this procedure, few treatment
technology out there.”
He doesn’t just access the
service to keep up, but to re-
search particular questions that
come up during a patient visit
or diagnosis, Post said.
The Internet has also
changed the way some patients
interact, Post said, because they
can do their own research and
they ask many more questions.
Among the greatest advances
in the medical field for diagno-
sis and screening are in the field
of radiology and diagnostic im-
aging, several of the doctors
agreed.
“Diagnostic imaging allows
physicians to peer beneath the
skin without a scalpel and al-
lows a direct view of internal
organs,” said Dr. Curt Thomp-
son, an interventional radiolo-
gist at the Hutchinson Clinic.
Such screening allows doc-
tors to detect disease at an early
stage and to exclude diseases,
such as cancer, Thompson said.
It also allows a doctor to gauge
the extent of a disease’s
progress and its response to
therapy.
“We are able to visualize, to
see much more of what we used
to only guess at,” Simpson said.
“I think some of my younger
colleagues have an advantage in
that they’ve learned to read
some of these. I rely more on the
radiology people to help me.”
Which points to another won-
der in the changing world of
medicine, he said.
“If someone comes into the
emergency room in Lyons at
night after being in an accident
options for hip pain were avail-
able, and a hip replacement was
virtually inevitable.
Now, candidates for
arthroscopy include active indi-
viduals who just happen to have
painful hips.
Described as “minimally inva-
sive,” it evolved along the same
lines as arthroscopic surgery for
other joints of the body, particu-
larly knees and shoulders.
In hip arthroscopy, small inci-
sions are made in the patient’s
hip area. A camera lens is in-
The Hutchinson News
and we do a CAT scan to see if
there’s brain injury, we’ll send it
to a radiologist in New
Zealand,” Simpson said. “He’ll
review it and call me in 10 or 15
minutes and say ‘It looks OK’ or
‘There’s bleeding on the brain.’”
The clinic uses experts in
Hays during the day, Simpson
said, but goes overseas at night.
“Interestingly, some of the
better medical centers in the
world right now are in India,”
he said. “Medicine is becoming
global.”
His biggest concern about the
training physicians are receiv-
ing today, however, is that the
emphasis on technology is re-
placing exposure to clinical
skills, Simpson said, “laying
hands on a patient, making a di-
agnosis from taking a good his-
tory and giving a good physical
exam.”
Fishback, at KU Med, said he
couldn’t disagree, which is why
the school has introduced a lab-
oratory where actors play pa-
tients to help students learn to
listen and diagnose.
“The average six to seven
minutes a doctor has to see a pa-
tient in the typical practice is
not a lot of time to do a physical
exam,” Fishback said. “We have
relied for years on X-rays and
CT scans and MRIs and lab tests
to get past the physical diagno-
sis that older docs were taught
to do. We are trying to get more
hands-on, but the trend is awful-
ly hard to fight. Insurance com-
panies know a doctor’s time is
expensive, so they push this
technology pretty hard.”
serted, and the image is dis-
played. The doctor can visualize
the bone structure and deter-
mine the nature and extent of
the problem.
Severud can clean out the
frayed lining and inflammation,
which may prevent the deterio-
ration of the joint. The patient
will realize a reduction in pain
and won’t have a long recovery
because the procedure is not in-
vasive.
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