Pandora's Box

Last week's topic in my MNT (Medical Nutrition Therapy) class was pharmacology.  We read up on what sorts of drugs may have direct interactions with foods we eat, and also what side-effects drugs may have that involve our nutritional health.  So for the weekly assignment, I was supposed to look for two research articles that involved a drug of choice and discuss its effect on food consumption, absorption, etc.  While this is pretty easy to find, I didn't want it to be easy, I wanted to look at something new that I hadn't researched before.  And didn't I manage to open Pandora's box.

So I looked into weight loss associated with ADHD (Attention-Deficit/Hyperactivity Disorder) because I had seen individuals lose significant amounts of weight when their medication for this was adjusted.  Granted the people I had seen were adults, so the weight loss might not have been as serious as it would be for a child.  I wanted to look at the kids on these meds.  The first article I came across showed significant weight loss and height loss in the first year of ADHD medication use.  The greatest losses were for the heaviest and/or tallest kids (as expected).  What the study did not and could not show was whether these losses prevented these kids from reaching their expected height/weight in adulthood.  This concerned me.  The prevalent use of ADHD meds as of late hasn't yet had enough time to show what the long-term effects are in this realm.

I investigated further.  No not into more information about what the drugs can do, but what the alternatives might be.  Along came a different study that followed kids who were newly diagnosed.  Each of these children were also evaluated and found to have very mild cases of OSA (obstructive sleep apnea).  Does that mean all children with ADHD have OSA?  Who knows, anything is possible.  So the parents of these children were given the option to not treat the ADHD, treat with medication, or treat by giving the child an adenotonsillectomy (removal of the adenoids and tonsils).  What did they find?  Well the kids who received no intervention, showed no improvement.  The kids who received medication or surgery both showed significant improvement in their symptoms, but those who received the surgery showed even greater benefits over those who received medication.  Oh, and the ones who received surgery weren't having to deal with possible medication side-effects!!

This put a lot of thoughts into my head.  First, wow sleep is so important.  Look what lack of sleep or poor sleep is doing to our kids!  Second, if there is a way to correct this problem without the use of medication, why wouldn't everyone use this?  So I went to visit a friend to pick her brain about it.  She has a child who takes medication for ADHD, and also a husband who had recently undergone surgery to correct his sleep apnea.  I asked her, when she visited the medical clinic and her child was diagnosed with this condition, if he was ever referred to a sleep clinic or an Ear/Nose/Throat (ENT) doctor.  And ask I suspected, he wasn't.  The diagnosis of ADHD was arrived at with a 20 page questionnaire completed by the parents and a short visit with an over-worked physician - I imagine their circumstances for diagnosis weren't unique.  As my mind began to wander I came across one thought:  Do you remember how removal of the tonsils was like a right-of-passage when our parents were kids?  Everybody had them out.  These days it's not the case but look at what a large number of kids could possibly benefit from it. 

Now where do I take this information?  I have absolutely no idea.  I don't work at the local medical clinic.  I can't change their protocol and have a sleep clinic or ENT consult occur before medication prescriptions are given out, but what I can do is put the word out here.  We, as parents, are our child's best advocates.  A lot of people are not aware that there are alternatives for some children with ADHD.  If your child was recently diagnosed or had been diagnosed a while ago, ask your doctor about a referral to rule out mild obstructive sleep apnea.  It's just one more doctor's appointment that could provide incredibly valuable information if your child is affected by this.