An ADD Journey

You put what, where?

noreply@blogger.com (Bob) — Wed, 02 Dec 2009 19:02:48 PST

Yesterday morning my almost 3-year old daughter woke me up at about 6:30. She was hungry so I poured us both some cereal. After we were done, I saw the cereal was still on the counter so I went to put it back in the cabinet.

I opened the cabinet door and saw the gallon jug of milk right where the cereal should be. Luckily it had only been there a couple of minutes.

Man, I am ADD.

Sleep strategy

noreply@blogger.com (Bob) — Sun, 19 Jul 2009 23:50:44 PDT

I had an appointment with my doctor to discuss the problems I've been having with the Vyvanse. Or what I thought was being caused by the Vyvanse anyway.

At one point I had gotten up to a 50 mg dose. After I passed my comprehensive test for my degree, I found that was too much. A few weeks after the test, I went down to 40 mg. That became too much as well. So I started adjusting the dosage between 40mg and 30mg. That is still too much.

So, I am now down to 30 mg. The headaches are pretty much gone but the insomnia remains. My doctor put me on clonidine at night to help me get to sleep. My wife also went out of town for a week so there was no one in bed to keep me up.

And guess what? The insomnia is still there. I even forgot to take my Vyvanse yesterday and still had problems with sleep. I was asleep by midnight (early for me even on normal nights because of my evening work schedule) but woke up at 3:00 am and couldn't get back to sleep for more than 2 hours.

So the 30 mg seems to be working. The insomnia is still here and I'm working on doing relaxing things at bed time.

I am so freaking tired

noreply@blogger.com (Bob) — Sun, 12 Jul 2009 04:59:01 PDT

I'm still having problems with the Vyvanse. Switching up on the dosages has helped the headaches. The insomnia is back though. Last week I had two night in a row of getting only four hours sleep. That is a killer for ADD. When that happens, it doesn't matter what meds I take, it won't help.

Two nights ago it happened again. The lack of sleep was so bad I felt like I was drunk. I literally could not walk straight. I had to take the day off from work.

Drinking orange juice or cranberry juice before bed hasn't been working for me either. I have also tried taking vitamin C but the insomnia is as bad as I've had since I started.

Last night, I was able to go to sleep by 12:45 am. That is actually early for me. I woke up at 3:45 am and haven't been able to get back to sleep. It is not coming up on 6:00 am and I see the sun is up. I am so screwed. I have stuff I need to do but I already feel mentally exhausted.

Mixing it up

noreply@blogger.com (Bob) — Wed, 01 Jul 2009 01:16:04 PDT

My doctor says the morning-after headaches I'm having with Vyvanse are not unusual. Could be a hydration problem. Vyvanse is known to dehyrdrate people. Steady intake of water is import. Dehydration might be the cause of the headaches.

The headaches could be from a buildup of Vyvanse. He told me that research has found out that Vyvanse does not all digest as quickly as originally thought. That means over time, it is staying with me and could be why I only get the headache after 5 days or so. Skipping a day or lowering the dose helps my body get rid of it.

The problem with skipping a day is that I am totally inattentive that day. The pattern is so clear that my wife has gotten pretty good at telling when I missed a dose (on purpose or not).

So my doctor and I came up with a new plan. I going to stick with the 40 mg dose. When I get to the point of getting a headache, I will go down to 30 mg that day. I take the dose with protein usually a couple slices of deli ham. My doctor also says drinking it with a bit of a protein shake would work but I don't care for those.

My other problem is getting to sleep. I do tend to get insomnia. Exercising during the day is one way to help with that. The doctor also suggested drinking something with ascorbic acid like orange juice, cranberry juice, apple juice, or even lemonade a couple hours before going to bed. A vitamin C tablet would work too. The ascorbic acid neutralizes Vyvanse which is why you can find information warning you to avoid those drinks while taking it, unless you want it neutralized - for instance when trying to go to sleep.

Thing is, I went for a pretty long walk/run before going to work today, so I got my exercise. I also drank orange juice and later cranberry juice before going to bed. Now it's 2:00 am and I'm still awake. Apparently the neutralizing didn't work tonight.

Med struggle

noreply@blogger.com (Bob) — Tue, 30 Jun 2009 22:58:15 PDT

I am still working to get my medication right. In April I went up to 50 mg per day of Vyvanse. It did help me get through my graduate exam. Not long after that, I noticed it seemed to be too much. As 40mg had been too little, I struggled with it.

By May, I realized it was definitely too much. My biggest side effect when I get too much Vyvanse is something I started calling the Vyvanse hangover. I would get a splitting headache the following morning. I noticed that when I missed a day, the headache would not be there the following morning. It got to the point where I was missing more days. Not really on purpose, but I didn't mind if I missed because I knew I wouldn't have a headache the following morning and could start again.

At the beginning of June I spoke with my doctor and he agreed that I should go back down to 40 mg. The headaches have gotten better, but I did get another after about a week. Yesterday I took a 30 mg Vyvanse I had left over from a previous prescription. I did seem to have a little trouble focusing that day but not as much as if I missed a dose and I did not have a headache this morning.

I was told there was a protocol in taking ADD meds to skip one day a week but that protocol is not recommended. I now understand why it was used. For me the Vyvanse seems to build up to a point where the morning-after headaches begin and I have trouble sleeping. Taking a day off or at least lowering the dosage for a day seems to help that. I'll talk to my doctor about that on my next appointment.

Getting organized

noreply@blogger.com (Bob) — Wed, 29 Apr 2009 21:50:39 PDT

Organization is the bane of those with ADD. I know that the key to overcoming the problems of ADD is to get organized but the catch-22 is that it is because I have ADD that I have problems with organization. Medication has helped. It stimulates my brain so that I am able to focus on the work of organization. The next question is how to get organized?

The self-improvement industry has a number of competing systems to help get people organized. One of the most popular right now is David Allen's Getting Things Done (GTD). He uses a bottom up approach that involves collecting and a processing all information. Essentially, write everything down and makes lists of what you need to do.

This is different than older top down approaches like Stephen Covey's method (think Franklin-Covey planners) that begin with determining your values and goal and then setting priorities for the day that support those goals.

There are problems with each system. The GTD way can lead to improper prioritization. When you make lists of everything you want to do, everything has the same priority. The Covey way has its own weaknesses. For example, I may need to pay the electric bill, but that doesn't directly come from my goal of getting promoted at work.

Any system has to be personalized. There is no one-size-fits-all system for organization and I'm still trying to get a working system for myself. I'm using a Franklin-Covey planner and was able to convince my employer to send me to one of their seminars a couple of months ago. My work day doesn't really fit into their system that nicely though because my job duties don't have much that can be planned ahead. I supervise a contact center. My job function is to be available for whatever situations may come up that need to be elevated.

There are still goals to set and tasks to complete aside from my daily grind at work. I have been better at planning lately, although I still find myself changing between tasks too often. At least I've been able to come back to tasks I got interrupted doing and finsih them. That's been an definite improvement.

Passed it

noreply@blogger.com (Bob) — Thu, 23 Apr 2009 21:39:18 PDT

Today I passed my comprehensive exams and have completed all requirements for my Master's degree.

Next up, setting goals for a career change and getting some home improvements done.

Still living

noreply@blogger.com (Bob) — Sun, 12 Apr 2009 09:44:10 PDT

Not a whole lot has happened since my last post. I have increased the Vyvanse to 50mg/day. Still trying to figure out if that is the right dose or if I need to go back down. I'm not getting headaches on it, but I think I am being too serious.

This week is big for me. Last Friday I had the first part of a comprehensive exam for my graduate degree. I have the second part of the exam on Tuesday. Getting past that is my big priority right now and the Vyvanse is helping me focus on that. After I get past this, I think I my try going back down to 40 mg and see what happens.

In the meantime, I'm celebrating Easter today.

Daddy is ADD

noreply@blogger.com (Bob) — Sun, 22 Feb 2009 13:19:18 PST

I have two-year old daughter. She is already catching on to my idiosyncracies that come from ADD.

A few days ago I was taking her to run errands with me and got her buckled into her car seat. That's when I remembered I forgot my iPod which I always listen to in the car. It was not the first time I've had to go back inside to get something when trying to leave the house.

The next day I was ready for work and just about to leave. She was standing in front of me looking up with those big brown eys. I told her it was time for me to leave. She said, "iPod?"

"Yes, I have my iPod."

Then she said, "Keys?"

I reached into my pocket, "yes, I have my keys."

"Phone?"

I pulled it out of my other pocket, "yes, I have my phone."

That seemed to satisfy her. (Sigh)

Libraries and gum

noreply@blogger.com (Bob) — Wed, 31 Dec 2008 21:25:07 PST

Rob Hanly echoes Merlin Mann's advice I link to earlier this month. Rob refers to the Indiana Jones quote, “If you want to be an archaeologist, you’ve got to get out of the library” from the movie Indiana Jones and the Kingdom of the Crystal Skull. Yep, I need to get out of the library and start chewing gum.

This month has been all kinds of hectic. Birthdays (and their corresponding parties), Christmas preparations, and a 10-day vacation thrown in have all put other projects on hold. Not making excuses for not moving things along. In fact, I'm not even regretful about the lack of progress over the last three weeks. It has been a good month to enjoy family and holiday events. But all good things come to an end (even though they may be repeated later).

I wouldn't say there hasn't been any progress though. I have taken my medication faithfully - a change from having a difficult time even completing a 10-day course of anti-biotics. I haven't missed a single day of the Vyvanse. I'm also becoming more aware of when I'm struggling to focus and when I'm being productive.

Time to put some of that learning to use and work on a couple of goals like completing my last hurdle to finishing my Master's degree and finding a new job.

Well that was strange. Med update.

noreply@blogger.com (Bob) — Mon, 20 Jul 2009 19:34:50 PDT

I started Vyvanse this past Sunday at 20 mg. My doctor wanted me to step up gradually so I took 20 mg again on Monday, then went to 30 mg on Tuesday and Wednesday. Felt fine on Sunday, Monday, and Tuesday. Seemed to be better able to focus and felt more alert all three days.

Problem came Tuesday night. I could not fall asleep until 4:30 the next morning. Had to wake up at 7:15 to take care of my daughter. Best word I can find to describe Wednesday was anxious. Easily frustrated all day. Was also achy all day, which from experience I know was the lack of sleep.

Called the doctor and they said to step back down to 20 mg for a few days and then step back up to 30 mg. They want to see me if I keep having these problems.

I normally work until late at night so I left work early. And turned off the lights by 10:00 pm. Got a good 8 or 9 hours of sleep before my daughter woke up. Actually that was probably the most sleep I've had since she was born almost 2 years ago (parenthood does that).

I actually feel refreshed this morning but do have a headache in my right temple and the base of my skull on the right. I think that is a carry-over from clenching my jaw all day yesterday (from the anxious feelings I was having.) The headache eases when I focus on relaxing my jaw.

Went back to 20 mg this morning. It should be effective by now and I am feeling more alert than I normally would at this point. Before the Vyvanse it would be another hour before I could operate.

I did have a little insomnia the first night I took 20 mg, but I was able to fall asleep within an hour of when I normally do.

I hope the insomnia gets better after being on the meds for a little while.

Well that was easy

noreply@blogger.com (Bob) — Sat, 06 Dec 2008 23:11:34 PST

I had this fear in the back of my head that the doctor would say that I didn't really have ADD.

That wasn't a problem. He read over the assessments I completed from both him and the therapist I saw and it was pretty much a done deal. Really the appointment wasn't so much for diagnosis as it was discussing strategies on how to live with ADD and issues of medication. He did prescribe Vyvanse. I start it tomorrow.

Real advice

noreply@blogger.com (Bob) — Fri, 05 Dec 2008 21:17:52 PST

I need to start chewing gum.

Getting kinda scared

noreply@blogger.com (Bob) — Wed, 03 Dec 2008 22:30:00 PST

I have an appointment this Saturday with my pediatrician. Yes, that sounds strange but this pediatrician is an expert on ADD and does treat adults for that particular issue.

I spoke with him briefly earlier this week. He said there are two ways to treat ADD: without medication and with medication. But only one of those methods is effective - the medication method.

He also said that some doctors like to treat ADD with 15 year old medication (by which he meant Adderall or the even older Ritalin). He disagrees with that and prefers the newer Vyvanse which was just approved for adult use by the FDA in April of this year. Lucky me.

The thing is, all of these drugs are amphetamines. That is what is getting me anxious. Amphetamines are addictive. That worries me.

Well whaddya know

noreply@blogger.com (Bob) — Tue, 02 Dec 2008 20:10:28 PST

Not that this is official, but it isn't surprising.

I have an appointment with a doctor in four days. I'm guessing that he'll put me on medication.

Dead buffalo

noreply@blogger.com (Bob) — Wed, 26 Nov 2008 17:43:35 PST

Web celebrity Merlin Mann of the productivity web site 43folders.com and the world famous (and hilarious) You Look Nice Today podcast and is celebrating his 42nd birthday today.

This is relevant because in the post he wrote today, he reveals that he has adult ADD. The dead buffalo is how he describes the distraction that keeps him from completing the work he wants to do.

I have wondered if he had ADD. Merlin Mann has a number of web projects and podcasts that are infrequently updated or have faded away. Those projects seem to indicate the problems of short attention span that is typical of ADD.

In a perverse sort of way, it is comforting to see that Merlin struggles with the same issues. Thing is, he is at least able to get started on projects if not sustain them. I haven't been able to get to the starting phase. We'll see if I can't change that here shortly.

Strategies worksheet

noreply@blogger.com (Bob) — Sat, 22 Nov 2008 19:34:28 PST

What are my strengths?
Quick learner. Good with facts/figures. Good business communication.

What comes naturally to me?
Ability to understand technology.

I enjoy doing __________ (fill in the blank) most in my life.
At the moment - nothing. I can't focus on anything enough to do any activities.

What special skills or attributes do people notice about me?
Freakish knowledge of history and technology (computers, consumer electronics). Ability to de-escalate tense situations.

What kinds of positive feedback do I receive from others?
Compliments on job knowledge. Advise sought by peers on work problems.

What kinds of cues do I respond to? Visual? Auditory?
Extremely visual. Let me see it and I can generally remember it. Tell me a list of items and I will forget them.

How far back?

noreply@blogger.com (Bob) — Sat, 22 Nov 2008 17:48:14 PST

My therapist thinks my family has ADD. One sign is that I grew up in a very messy house. My mother avoids housework by reading romance novels all day. She seems to get overwhelmed with housekeeping. Seems to be a classic sign of the disorder.

In doing some reading, I found out that worrying is another symptom of ADD. That reminded me of my grandmother (my mother's mother). She was a hard-working woman all her life (but also had a dirty house). I'm told my grandmother was a worrier though I never noticed it.

To be fair, she did have some reasons. Living through the depression. Going through times where there was not enough food for a family of eight. I also think the death of your firstborn at age three may lend itself to creating some worry for the rest of your family. Still she struggled with this throughout her life. I'm told she also felt guilty about this worry. She was a devout Christian in the Evangelical Methodist tradition. Her faith taught her that she should not worry:

Matthew 6:26-27 (NASB)
"Look at the birds of the air, that they do not sow, nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not worth much more than they?
"And who of you by being worried can add a single hour to his life?

I think her worrying made her feel somewhat guilty. Yet in the rest of her life, she was a woman of iron will. I don't know that I have ever met a harder worker. For a woman who wasn't much over 5 feet tall, her strength could fill a room. Maybe that will of hers was her way of managing ADD symptoms.

She died a year and a half ago so I can't know for sure but I do see the ADD pattern in my family tree.

Coaching goals and abilities - part 6

noreply@blogger.com (Bob) — Tue, 25 Nov 2008 21:15:55 PST

6. Home Life

What quality time am I spending with my spouse?
Little. Normally only at night when we are both tired. Another reason I want to change jobs.

Is that time sufficient?
It has recently become clear that it is not.

What quality time am I spending with my child?
A lot. Every morning when she wakes up until I go to work in the early afternoon. However, that means I am not home to put her to bed at night. Also most of my days off are spent with her.

Is it enough?
Yes.

How important are my individual needs to my family?
At this point my family's needs are the priority.

How am I handling my share of family responsibilities?
OK. I am getting more done around the house and helping with my daughter.

How do I feel about the area where I live?
I really like the area where we live.

How does my home reflect who I am?
It is clean but needs some work - kind of like me.

Coaching goals and abilities - part 5

noreply@blogger.com (Bob) — Tue, 25 Nov 2008 21:15:25 PST

5. Financial Considerations

How often do I worry about money?
Not very often. I leave the finances up to my wife, an unfair burden I've placed on her.

Have I saved enough for emergencies?
No.

Do I have long-term investments?
Only in a 401k.

Do I have adequate health/home/life insurance?
Yes.

Am I living within my means?
I think so.

How do I generally regard the concept of debt?
Avoid it as much as possible.

What do I consider important enough to incur debt for?
Education or a house.

How manageable is my current debt?
Manageable and getting lower.

How financially secure do I feel?
Not secure. Living paycheck to paycheck.

Coaching goals and abilities - part 4

noreply@blogger.com (Bob) — Tue, 25 Nov 2008 21:14:38 PST

4. Spiritual Life and Sense of Well-being

How important to me is being part of a religious community like a church or synagogue?
Very important but I don't regularly attend church. Another area of guilt because I'm not doing what I want to do.

Is being spiritual, rather than religious, important to me?
No. It seems to me that this attitude is for people who want to be religious without really being religious.

How often do I pray or meditate?
Less than once a week. Another thing I think about doing but cannot actually get started doing it.

When do I feel most at peace?
Lying in bed at night with my wife or when sitting with my daughter for "quiet time" before putting her down for the night.

What makes me feel a sense of gratitude?
When I share happy (not necessarily "fun") times with my family.

What makes me feel fulfilled?
My wife and daughter or when I finish something that was challenging. But mostly my wife and daughter.

What stressors are present in my life?
Income. Job hours. Looking for a new job. Talking to new people.

Who are the people in my support network?
My wife. My in-laws. To a lesser extent my parents.

How often do I interact with those in my support network?
My wife, daily. Others, maybe monthly.

What do I do for myself only?
???

What do I value most in life?
My wife and daughter.

What do I do to honor those values?
They are where I spend most of my non-working hours.

Coaching goals and abilities - part 3

noreply@blogger.com (Bob) — Tue, 25 Nov 2008 21:13:42 PST

3. Social Life

How often do I see my friends?
Friends? I interact more online than with current associates.

Do my friends and acquaintances "lift me up," or do they drag me down?"
Lift me up. I tend to shy away from those who create negative influences.

How often do I have fun?
A few times a week. Normally with my daughter - taking her to gym class or the pool.

What do I enjoy beyond work?
Good question. Aside from taking my daughter out, I don't know. That's my problem. I get ideas of fun things to do but can't get started.

Coaching goals and abilities - part 2

noreply@blogger.com (Bob) — Tue, 25 Nov 2008 21:13:17 PST

2. Physical Health

How much sleep do I generally get?
Six hours a night.

When I wake up, do I feel rested?
No.

Do I eat three meals a day regularly?
Oh yes.

Do I limit calories, fat, sodium, and the like in my food?
No.

Is my weight under control?
No. I need to drop a good 40 lbs.

What medications do I regularly take?
Allopurinol and Zantac. Probably would not have to take Zantac if I lost the weight.

Do I exercise on a regular basis?
No.

Do I limit my alcohol consumption?
Yes. In fact I don't drink at all anymore.

Have I stopped smoking? (Or have I never started?)
Never started. Used smokeless tobacco but quit that years ago.

Am I happy with the state of my present health?
No. I am in the worst physical fitness of my life right now.

Coaching goals and abilities - part 1

noreply@blogger.com (Bob) — Tue, 25 Nov 2008 21:12:20 PST

The following is my responses to a worksheet from The Disorganized Mind by Nancy A. Ratey. The idea is that it will help me develop a snapshot of who I am and how I am living now. I hope to use this information to develop my goals and strategies to achieve them. Let's see:

1. Professional Life

Am i in the job or profession for which my education prepared me? (Am I doing what I was trained to do?)
Yes and no. My job is a fit for my undergraduate degree although perhaps under-utilized. Since I have taken this job I have completed the coursework for a graduate degree that is not a good fit for my current job.

If not, why?
I started the graduate degree with a career change in mind. I haven't yet been able to realize that career change.

What does it mean to me to have - or not - taken the path for which I prepared?
It is frustrating. I've had some job leads but nothing has come of them. Getting more frustrating by the day and I'm afraid it is starting to affect my work performance.

What do I do well in my job?
I am great with technology. I understand how it works and how it can be applied to improve efficiency.

Another strength is communications. I have been complimented for my ability to deal with irate people and de-escalate the situation.

What specific parts of my job do I actually enjoy?
The technological part. Building applications (but not the coding) to improve work flow.

What problems do I experience in my job?
Getting reports done. Overseeing employees. I hate that part.

Would I choose this job again if I were starting over?
No.

How much of my job do I have to "bring home?"
None, which is a benefit. I can really only do my job while at the office. When I'm home, I'm with my family.

What words best describe how I fell when I think about my job?
Frustrated, bored. I don't get to do enough of the part I like to do and too much of what I don't like. I hate my work hours (when they are, more than how many of them).