Author Archives: Trudy

ADD in Adults

by Janice Rutkowski, M.D.

add-160ADD & ADHD* are similar disorders that often first present in childhood, but can extend into adulthood as well. It is estimated that a full third of children with ADD will continue to be affected later in life. Since this disorder was not well understood in the past, many individuals were un-diagnosed. But the onset of the internet and better understanding of disordered human behavior, have helped many patients realize they may have a problem.

Most adults with ADD find they have difficulty with organization and planning, are easily distracted, feel a sense of restlessness or anxiety, and lack ability to resist impulses to stray from a task or project. Unfortunately, this inability to stay on task can lead to problems at school, in the workplace, and in personal relationships. Serious consequences such as divorce, job loss and substance abuse can be more common for those with ADD/ADHD.
However, there are several treatment options to help! The first step is talking with your doctor. While there is no one test to diagnose the condition, detailed information from the patient and sometimes family members can be very useful. A physical, including blood work and an EKG, should be done to ensure there are no other health issues causing the symptoms.

Treatment is usually very effective with a combination of diet, behavioral therapy and stimulant drugs, such as Adderall or Ritalin. There are many newer medications as well and your doctor will work with you to find the most effective. Some drugs come in extended-release form so you do not have to take multiple doses during the day, and some non-stimulant drugs are also available. Side effects may include sleeplessness, loss of appetite, mood changes or heart rhythm abnormalities. But most patients tolerate the therapy quite well and are amazed at the difference in their work and home life.

So, please talk with your doctor if you are concerned you might have ADD or ADHD- or the symptoms- so you can work together to treat it effectively.

*ADD stands for Attention Deficit Disorder. ADHD is Attention Deficit Hyperactivity Disorder.

Janice Rutkowski, M.D.Dr. Rutkowski is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Internal Medicine. She received her medical degree from the University of Limoges in 1981 and completed her residency program in Internal Medicine at Maryland General Hospital in 1984.

New Test Identifies Heart & Stroke Risk Earlier

MPCP Cardiologist, Dr. David Kim Explains CIMT

We’ve made great strides in understanding the risk factors for heart disease and stroke. And we try to prevent them by eating well, exercising, controlling our blood pressure and cholesterol and avoiding bad habits, like smoking. But many people still suffer heart attacks and strokes despite these efforts. What if there was a way to identify a person’s risk earlier- and non-invasively? A new testing method, called Carotid Intima-Media Thickness- or CIMT- is doing just that.

CIMT testing utilizes ultrasound to examine the inner lining (i.e., Intima and Media layers) of the carotid arteries in your neck. These layers are known to gradually thicken over the years as part of the normal aging process. But if this thickening is accelerated, it suggests that that person may be at higher risk of eventually developing full atherosclerosis (“hardening of the arteries”) –the step that often leads to a heart attack or stroke. Indeed, multiple research studies have shown that premature intima-media thickening identifies those at a higher risk for a cardiac event even more than previously thought. Knowing your CIMT may be very useful in formulating a more precise strategy of prevention that is targeted for you.

CIMT testing is most appropriate for individuals between 40 and 70 years old, especially in those with a history of smoking, diabetes, high cholesterol, high blood pressure, or family history of heart disease. This test is NOT recommended if you already have a history of coronary artery disease (such as previous heart attack, bypass surgery, or heart angioplasty/stent), previous stroke, or known peripheral arterial disease.

CIMT testing is quick (about 20 minutes), non-invasive and pain-free. Because it uses ultrasound technology, there is no exposure to any harmful radiation. No special preparation is needed.

CIMT testing is available at our MPCP Columbia Cardiology practice. It costs $99 and is not covered by insurance. After the completion of the study, a result report with detailed explanation will be mailed to you and your health care provider(s). Your CIMT result can then be used in conjunction with known cardiovascular risk factors to more precisely assess your risk of future cardiovascular events.

If you have any questions, or would like to make an appointment, please contact the Columbia Cardiology office at 410-740-0789 or visit our site page.

David Jackson, M.D. Dr. Jackson is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Internal Medicine in both Cardiovascular and Internal Medicine. Dr. Jackson is a graduate of Harvard College in Cambridge, MA. He received his medical degree from Mount Sinai School of Medicine in 1980 and completed his residency program in Internal Medicine at St. Luke’s Roosevelt Hospital Center in 1983. Dr. Jackson completed his cardiology fellowship at Norwalk Hospital, an affiliate of Yale University School of Medicine, in 1985.

 

David Kim, M.D.Dr. Kim joined Maryland Primary Care Physicians, LLC in 2012 and is certified by the American Board of Internal Medicine in both Cardiovascular and Internal Medicine. Dr. Kim is a graduate of Duke University. He received his medical degree from State University of New York at Buffalo School of Medicine in 2002 and completed his residency program in Internal Medicine at Washington University School of Medicine in 2005. Dr. Kim completed his cardiology fellowship at the University of Rochester School of Medicine & Dentistry in 2008.

Easing Back-to-School Anxiety

By: Jamie Harms, M.D.

It’s hard for most of us to see the more relaxed days of summer come to an end. For our children and teens, back-to-school time can be exciting, but it can also create anxiety and stress. Here are a few tips to make this transition easier for the whole family:

  1. Map out the morning routine. Discuss how the mornings will work, from wake-up times to setting out clothes the night before to whether your child will be making lunch or buying it at school, etc. Do a practice run—show them how long it takes to walk to the bus stop, or drive to school so they are prepared the first day.
  2. Early to bed. Kids need 9-11 hours of sleep every night, depending on age. Once you know how early they need to be up, plan a regular bedtime and start sticking to now so the first week of school is easier.
  3. Healthy food fuels the body and mind. Let your kids help you shop for healthy foods they enjoy and encourage them to start the day with a good breakfast, especially one containing some healthy protein.
  4. Prepare a “homework space.” Clear out a designated area, complete with supplies of pencils, markers, tape, etc. so your child has space to work. Depending on his or her age, you may want to make this space in a common area of the house so you can be available to help with homework.
  5. Be a bit empathetic. Adjusting to a new school, trying to make friends, dealing with a heavier work load—all of this can be very stressful for kids. Try to be a support during these first few weeks of transition back to school.