ADHD Can Impair Students Ability

To Concentrate, Behave in School

Now that school is well under way, children around the nation are busy with classes, homework, and tests. Parents expect their children to do well in school, but what happens when the teacher sends a note home citing inattention or disruption in class?

It could be a simple case of misbehavior, lack of discipline, or immaturity, but for some children, there is more to these behavioral problems than meets the eye. Acting up in class, daydreaming, restlessness, and excessive talking are common symptoms of Attention Deficit Hyperactivity Disorder (ADHD).

While ADHD is not epidemic, it is probably more prevalent than most people realize. One child in almost every classroom will be diagnosed with ADHD at some point between kindergarten and high school, not including those whose ADHD symptoms are overlooked or attributed to other factors.

ADHD is related to brain development, but not much else is known about this complex condition. It is often first apparent during preschool or early grade school, especially when hyperactivity, inattention, and impulsivity impair normal social functioning. Among children who are less hyperactive or those who adapt well, however, ADHD is sometimes not recognized until years or even decades later.

Generally, there are a few notable characteristics that distinguish children with ADHD. They are often easily distracted, frequent daydreamers, restless or fidgety, disorganized or forgetful, impatient when waiting their turn, and unable to stay focused or pay attention.

More boys than girls are diagnosed with ADHD, and their symptoms are often quite different. In boys, ADHD-related behavior often appears as overactivity, misbehavior, and impatience. Girls with the disorder are more likely to be excessively talkative, or described as daydreamers or as ditzy. The disruptive behavior typical of boys with ADHD is more likely to be noticed and addressed, which may account for why ADHD is more readily diagnosed in boys. The behavioral symptoms common in girls with the disorder, however, are more likely to be interpreted as normal for girls, often causing their ADHD to be missed.

Recognizing ADHD is particularly difficult in children and adults who have good coping skills. Some people are able to keep up by channeling an excessive amount of time and energy into being functionally focused and organized. ADHD in these highly adaptive people may not be noticed until later in life when their coping mechanisms collapse under the weight of greater responsibility or pressure. These breaking points can include going away to college, beginning a new, more challenging job, or becoming a parent.

ADHD is not something people outgrow. Studies have shown that up to 60% of children with ADHD continue to have related symptoms in adulthood. People diagnosed as adults likely had ADHD as children but either compensated well or ascribed their own difficulties to being lazy, unmotivated, or academically below average.

There are three subtypes of ADHD, defined by their different symptoms. The predominantly hyperactive-impulsive type exhibits impulsivity and hyperactivity without much inattention. This subtype is more common in males. The predominantly inattentive type, seen more often in females, has symptoms of inattention without hyperactive-impulsive behavior. This subtype is sometimes identified as ADD, or Attention-Deficit Disorder. Finally, the combined type displays all three symptoms: hyperactivity, impulsivity, and inattention.

ADHD is a complex condition that is often overlooked, misdiagnosed, or attributed to normal development or other medical conditions that overlap or coexist with ADHD. There are numerous effective medications and therapies to treat ADHD, but an accurate diagnosis is an essential first step. If you have concerns or questions about this disorder, talk with your CPC physician.

Source: Attention-Deficit Hyperactivity Disorder (ADHD), Aetna Intellihealth; ADHD, National Institutes of Mental Health; ADHD Common Behaviors and Symptoms, American Academy of Pediatrics; Is Your Daughter a Daydreamer, Tomboy, or Chatty Cathy?, ADDvance, A Resource for Women and Girls with ADD (all websites).

Early Immunization Offers Best Protection

CPC ordered over 5,000 doses of flu vaccine in in early 2004 in preparation for the 2004-2005 flu season.  Unfortunately,  only 1,100 doses were received prior to the suspension of the delivery of the flu vaccine in October.  All doses received by CPC have already been given to patients.  At this time we do not have any flu shots and  do not expect to receive any more this year.  CPC does have  some Flu Mist, a nasal spray flu vaccine. Flu Mist can be administered to patients who are between  5 and 49 years of age who do not have a history of respiratory disease, such as asthma, chronic bronchitis, etc. The cost of Flu Mist is $30. Some insurance plans pay for some or all of this cost and some do not.  If you elect to get Flu Mist, please remember that you are financially responsible for any portion of this charge not covered by your health plan.  Please contact your CPC physician’s office for an appointment or for further information.”

Nasal congestion, sore throat, headache, fever, and cough . . . flu season is upon us once again. You may not be able to avoid exposure to the flu, but you can certainly fight back with an annual immunization and prescription antiviral drugs. The vaccine is your best chance of staying flu free this season, but if you get sick in spite of your immunization, antiviral medicines offer an additional weapon for your anti-flu arsenal.

Immunization: As a first line of defense, there is no substitute for the effectiveness of an annual flu vaccine in providing season-long protection against the virus. The flu vaccine has a 70%-90% effectiveness rate, especially when taken 6-8 weeks prior to flu season. This is how long your bodys immune system takes to respond to the vaccine. Immunizing yourself in October or November allows you the greatest possible protection when the flu season is in full swing.

For best protection, early is best, but late is better than never. Because flu season lasts until March, even December is not too late to gain some protection. If you are exposed to the virus before your body has adequate antibodies built up from the vaccine, you may still get the flu, but your symptoms will likely be somewhat milder than with no protection at all.

Influenza vaccines are available either by injection (flu shot) or nasal spray (FluMist). Flu shots are inexpensive, widely available, and safe for most people. Because the vaccine is made of inactivated viruses, it cannot cause infections. For those afraid of shots, FluMist is a nasal spray that is equally effective but more expensive, often not covered by insurance, and recommended only for people between the ages of 5 and 50. Because it contains live viruses, it can cause mild flu symptoms and is not appropriate for everyone in the recommended age group, such as pregnant women.

Generally, everyone aged 6 months and older should be vaccinated, particularly those at high risk for infection or dangerous complications of influenza, such as the very young, the elderly, people with compromised immune systems, and those living or working in contagion-friendly environments, such as nursing homes and child care centers. The flu vaccine is not recommended for people with allergies to eggs or with a history of Guillain-Barr syndrome (GBS). Your CPC physician will help you determine whether you should get a flu vaccine and, if so, which is more appropriate for you.

Antiviral Medicications: Regardless of whether you get a flu vaccine, the prescription antiviral medications Tamiflu, Relenza, Flumadine, and Symmetrel offer a second line of defense against the flu.

Approved by the FDA in 1999, Tamiflu (capsule or liquid) and Relenza (inhaled powder) are effective against Influenza A and B viruses, but only if taken within 2 days of the first symptoms. Tamiflu is approved as a flu treatment in people aged 1 year and older, and for prevention in people age 13 years and older. Relenza is approved to treat people age 7 and older, except for people with respiratory illnesses, such as asthma.

Flumadine and Symmetrel are effective only against influenza A and are used for both flu treatment and prevention. For prevention, Symmetrel and Flumadine can be used in people as young as age 1 year. As a treatment, however, Flumadine is recommended only for adults. Both are associated with more side effects than the newer antivirals.

Source: Flu, Health Matters, National Institute of Allergy and Infectious Diseases, National Institutes of Health, US Department of Health and Human Services, April 2004 ; Questions & Answers: Flu Shot and Treating the Flu, Centers for Disease Control 2004 (both websites).

 Dr. Joseph A. Hooper to Join Central office in December

CPC is pleased to welcome Dr. Joseph A. Hooper of Elberton, Georgia, as the 16th family physician on the medical staff of Center for Primary Care. Currently practicing at The Medical Center of Elberton, Dr. Hooper will join the CPC-Central staff in December.

Having graduated from North Georgia College in Dahlonega with a bachelors degree in biology, Dr. Hooper received his medical education at the Medical College of Georgia and completed his internship and residency in Family Medicine at Rapid City Regional Hospital in Rapid City, S.D.

Dr. Hooper believes in the importance of patients taking an active role in their own health. My greatest satisfaction as a physician is when I have helped my patients understand they can take action to improve the quality of their lives.

Dr. Hooper, his wife Liane Renate Hooper, and their children, Jett Christian, age 4, and Leo Ellis, age 3, are looking forward to his work with CPC and their relocation to the Augusta area. Welcome all !

Low-Carb Diets Offer Quick Weight Loss But Carry Health Risks

The Atkins Diet is the most popular of a line of low-carbohydrate, high-protein diets that includes The Zone and South Beach Diet. Grocery stores are filled with new products to appeal to customers on these diets, such as low-carb pasta, ice cream, and sodas. While many people testify to the amazing results of these diets, others question the long-term benefits.

Low-carbohydrate, high-protein diets are rooted in severely restricting or completely eliminating the intake of all carbohydrates. Refined carbohydrates are found in white bread, white rice and pasta, sweets, and jams. Because these carbs are high in sugar, cutting back allows for weight loss and better control of blood sugar levels. Low-carb diets also restrict the certain healthier carbohydrates, such as those found in brown rice, whole wheat bread, fruits, and some vegetables. To compensate, dieters are steered toward high-protein foods, such as meat and eggs.

Research has shown that individuals on the Atkins or other low-carbohydrate diets are successful in improving cholesterol levels and losing weight six months into the program. However, the benefits of a low-carbohydrate, high-protein diet run out after a year, then proving no more effective at weight loss than a conventional low-fat diet.

There are also numerous health concerns associated with low-carb diets. The high protein and saturated fat intake increases the dieters risk of kidney stress, high cholesterol, and coronary heart disease. By consuming fewer fruits and vegetables, low-carb dieters also lose the benefit of these foods natural protection against cancer.

While advertisers and the flood of new low-carb foods on the market would have you believe otherwise, the amount of carbohydrates in your diet is only one factor in the weight-loss equation. The only proven way to achieve long-term weight loss is through a combination of proper diet and regular exercise. How much and when you eat and how much you exercise are all significant factors in a successful weight loss plan.

A low-carbohydrate diet may provide some benefits in the short term, but No diet is effective without exercise, says CPC physician Paul Fischer, MD. Balancing a healthy diet with physical activity not only facilitates long-term weight control but also reduces your chances of high blood pressure and stroke. The best approach to weight loss is always a balanced one. For more information on a healthy diet thats right for you, see your CPC physician.

Source: Low-Carb, High-Protein Diets, Aetna Intelihealth; Low-Carb Diets A Good Thing? WebMD; Low-Carb Diets: Are They Safe

Physician Profile: Robert Suykerbuyk, MD, CPC-North Augusta

Rob Suykerbuyks life is full of spontaneity and adventure, of impromptu decisions and persistent dedication. From the Army to graduate school to medicine and back to the military again, the path he has taken to CPC-North Augusta at the North Augusta Health Center is a testament to his both enthusiastic personality and committed character.

Born in the small town of Fremont, Michigan, Rob spent most of his childhood in Kentucky, returning to Michigan in time for high school. After graduation, he enlisted in the Army, a decision that was influenced in part by his grandfathers experience as a soldier in France during World War II. Growing up, Rob and his brothers John and Rich were enthralled by their grandfathers adventurous tales of military life and living abroad. When the time came, they all chose to serve but each in his own way: Rob chose the Army, John the Air Force, and Rich the Navy.

Rob had his own reasons for enlisting as well. He was determined to earn a college education, the first in his family to do so, and the Army would pay his way in exchange for his service. Barely a month after finishing high school, Rob was on his way to basic training camp, hoping that through the Army, he would be able to pursue his interest in computer technology.

Graduating at the top of his Army basic training and technical schools, Rob spent his first two years in the military as a tactical communications repairman, working at bases in both the United States and Germany. I walked away from that military experience with the reward of determination, he says. I learned that if you set your mind to something, you can accomplish it.

When his service requirement was up, Rob left with tuition money in hand and entered business school. Disappointed to find his accounting classes uninspiring, he transferred to a small Michigan community college with plans to become a math and science teacher. Unexpectedly, the required anatomy and physiology courses sparked his interest in the field of science and medicine, leading him to Ferris State University, where he won an academic scholarship to study genetics and biotechnology.

Rob set out to learn as much as he could about the field of medicine during his time at Ferris State. Asking physicians about their career choice elicited stories of frustration over the business aspect of medicine interfering with the practice of their healing art. On the other hand was Robs memory of his hometown physician – the quintessential community doctor whom everyone knew, liked, and trusted. When he weighed the evidence for and against a career in medicine professional advice, personal impressions, and his own experiences with the healthcare system during the births of his children, Michael and Jennifer – Rob knew what he needed to do.

In typical fashion, he jokes, I didnt listen to anybody. I woke up one Sunday and thought, I like this so much that maybe I should make it my vocation. Robs focus and dedication nurtured this thought to fruition. In less than 9 months, he took the medical school entrance exam, applied, was interviewed and accepted, and began classes at Michigan State University School of Medicine. During this hectic time he also applied for and won the Armys Health Professional Scholarship, which paid for his medical education in full.

Medical school provided the ideal application for Robs discipline to work. Michigan States curriculum called for a year of near-independent study, for which a textbook and weekly Q&A were the only resources provided. While many students found this methodology challenging, Robs military service had prepared him to succeed. You really have to be disciplined to survive that curriculum, Rob states. He also recognized the future application of this type of educational structure. It set a precedent for what I do in my practice now: education and reeducation and keeping up with new material.

Clinical rotations provider Rob with another test: choosing a specialty. He had entered medical school with plans of becoming a family physician but, with each specialty rotation he experienced, the choice became more difficult, as each specialty was interesting and challenging. After seriously considering several options (surgery, internal medicine and critical care, obstetrics), I went full circle and returned to family practice, he said. Family practice is the only choice that would allow me to incorporate all the other specialties into my patient care.

After graduation, Dr. Suykerbuyk moved to Augusta to begin his family practice residency at Eisenhower Army Medical Center at Fort Gordon, where he would complete his commitment to the Army in return for his medical education. It was at Eisenhower that Rob met Danielle Sanford. They were both medical residents, he in family practice and she in child psychiatry, but despite their demanding schedules, they made time for each other. After a 1- month courtship in 1998, they flew to Hawaii and were married on a beach in Maui.

Immediately after completing his residency in June 2000, Dr. Suykerbuyk was deployed overseas to Hungary to a starkly different working environment. Contrasted with the monitored, academic atmosphere of Eisenhower, he was now a senior medical officer in the region, requiring him to function much more independently. The transition helped plant my feet on the ground medically, he said. I started feeling more comfortable effectively triaging and simply practicing medicine on my own.

After seven months abroad, Rob retuned to the United States where he joined the teaching staff at Eisenhower. Over the next three years, he was active in teaching future family physicians, was deployed to Europe in support of the Global War on Terrorism, and led several clinical research studies. He began to branch out in his medical experience by also working part-time in Louisville and Madisons emergency rooms as well as providing weekend cross-coverage at CPC.

By this time, he was nearing the end of his duty to the Army and was looking to settle down. After meeting some of the physicians and staff at CPC, he knew he had found the right place. CPCs clinical model is how I had always pictured myself practicing medicine, he explains. The administrative staff covers the business aspects that physicians find so frustrating, allowing me to practice medicine the way I had intended. CPC has momentum and energy. It is growing, focused, and directed.

Of all the aspects of practicing medicine, including the application of technology to family healthcare, Robs favorite is interacting with patients. I enjoy working with people, meeting with people, talking to people. He also incorporates his fondness for teaching to his practice, educating his patients about healthy choices and disease prevention and management.

Rob and Danielle are equally adventurous and fond of vacationing around the world, especially Costa Rica, one of their favorite destinations. Right now, however, their attention is focused on an adventure of a different type. They are expecting their first child in January, and its likely their love for travel will be a distant second to the new arrival.

Dr. Robert Suykerbuyk brings unparalleled experience and a lively and dynamic element to the Center for Primary Care and is a welcomed addition to CPCs medical staff and the North Augusta community he is serving. To make an appointment with Dr. Suykerbuyk, call CPC-North Augusta at the North Augusta Health Center, 279-6800.