broader drug training for allied health professionals?

Where can parents find a child psychiatrist treating bipolar disorder in children and adolescents? That question is the most common question posed to the Child and Adolescent Bipolar Foundation http://www.bpkids.org

There are only 74,181 child psychiatrists for the U.S. population of 73,675,6002. So parents drive for hours or have long waits. There is legislation pending to make it easier for child psychiatrists (M.D. with training in drugs) to forgive their medical education costs.

There are a whole bunch of reasons why there are fewer psychiatrists today and likewise fewer child and adolescent psychiatrists. For sure there needs to be more allied health professionals with a solid understanding of drugs and their effects on children and adolescents. And there are ways to encourage other professionals to get appropriate education and training.

It makes sense to broaden drug knowledge for a wider number of health professionals working with children: clinical psychologists, school psychologists, clinical social workers, nurses etc. Why not give incentives to a wide variety of health professionals to get the necessary training?

In California, psychologists must complete 36 CEU’s every two years for re-license. Why not let psychologist write off as a tax credit all costs related to drug education. That likely would spur psychologists to get training in drugs.

Primary care MD’s report that about 20 percent (one in five) children under age 18 have a mental disorder with at least mild functional impairment.

Chronic Lyme disease mimics many diseases

Below is list of symptoms for Lyme disease. Note some mental symtoms:  poor concentration and memory loss, irritability and mood swings, depression, diziness and fatique.  Couple those with lots of symptoms arcross multiple systems.  This is a disease that mimics multiple disorders.  Basic Information about Lyme disease.  This info came from Turn the Corner at  www.turnthecorner.org 

  1. Lyme disease is prevalent across the United States. Ticks do not know geographic boundaries. A patient’s county of residence does not accurately reflect their total Lyme disease risk, since people travel, pets travel, and ticks travel. This creates a dynamic situation with many opportunities for exposure for each individual.
  2. Lyme disease is a clinical diagnosis. Spirochetal infection of multiple organ systems causes a wide range of symptoms. Familiarity with its varied presentations is key to recognizing disseminated Lyme disease. Case reports in the medical literature document its protean manifestations.
  3. Fewer than half of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15% in culture-proven Lyme borrelial infection.
  4. Fewer than half of patients with Lyme disease recall any rash. Although the bull’s eye presentation is considered classic, it is not the most common dermatologic manifestation of early-localized Lyme infection. Atypical forms of this rash are seen far more commonly. It is important to know that the Erythema Migrans rash is pathognomonic of Lyme disease and requires no further verification prior to starting 6 weeks of antibiotic therapy. Shorter treatment courses have resulted in upwards of a 40% relapse rate.
  5. There has never in the history of this illness been one study that proves even in the simplest way that 30 days of antibiotic treatment cures Lyme disease. However, there is a plethora of documentation in the US and European medical literature demonstrating histologically and in culture that short courses of antibiotic treatment fail to eradicate the Lyme spirochete.
  6. An uncomplicated case of chronic Lyme disease requires an average of 6-12 months of high-dose antibiotic therapy. The return of symptoms and evidence of the continued presence of Borrelia burgdorferi indicates the need for further treatment. The very real consequences of untreated chronic, persistent Lyme infection far outweigh the potential consequences of long-term antibiotic therapy.
  7. Many patients with Lyme disease require treatment for 1-4 years, or until the patient is symptom free. Relapses occur and maintenance antibiotics may be required. There are no tests available to assure us whether the organism is eradicated or the patient is cured.
  8. There are 5 subspecies of Borrelia burgdorferi, over 100 strains in the US, and 300 strains worldwide. This diversity is thought to contribute to Borrelia burgdorferi‘s antigenic variability and its various antibiotic resistances.
  9. Lyme disease is the latest great imitator and should be considered in the differential diagnosis of MS, ALS, seizure and other neurological conditions, as well as arthritis, CFS, gulf war syndrome, ADHD, hypochondriasis, fibromyalgia, somatization disorder and patients with various difficult-to-diagnose multi-system syndromes.
  10. Lyme is the number one tick-borne illness in the US. The CDC reports there are 24,000 new cases of Lyme disease in the US, but the CDC says that figure could be under reported by tenfold. ILADS believes newly diagnosed cases of Lyme may occur at a rate five times higher than the number of new AIDS cases. Chronic Lyme is reported in up to half of patients treated for Lyme.
  11. Symptomatic presentations of Lyme disease include:
    • Fatigue
    • Low grade fevers, “hot flashes” or chills
    • Night sweats
    • Sore throat
    • Swollen glands
    • Stiff neck
    • Migrating arthralgias, stiffness and frank arthritis
    • Myalgia
    • Chest pain and palpitations
    • Abdominal pain, nausea
    • Diarrhea
    • Sleep disturbance
    • Poor concentration and memory loss
    • Irritability and mood swings
    • Depression
    • Back pain
    • Blurred vision and eye pain
    • Jaw pain
    • Testicular/pelvic pain
    • Tinnitus
    • Vertigo
    • Cranial nerve disturbance (facial numbness, pain, tingling, palsy or optic neuritis)
    • Headaches
    • Lightheadedness
    • Dizziness
 

ticks carry Lyme Disease, common to Monterey Bay area

tickremoval2

Ticks disorders can lead to serious complications if left untreated.  If Lyme becomes a chronic condition it can lead to persistent muscle, bone, nerbe pain, fatique, and memory impairment.  Caught early, the typical treatment is 4 to 6 weeks of andibiotics. Be careful to check for ticks and see a physican for diagnosis and treatment.   What are the symptoms of Lyme disease?
The list of possible symptoms for Lyme disease is long, and symptoms can affect every part of the body. Symptoms usually appear within three to 30 days. The following are the most common symptoms of LD. However, each child may experience symptoms differently.One of the primary symptoms is often a rash that is pink in the center and a deeper red on the surrounding skin. The rash:
  • can appear several days after infection, or not at all.
  • can last a few hours or up to several weeks.
  • can be very small or very large (up to 12 inches across).
  • can mimic such skin problems as hives, eczema, sunburn, poison ivy, and flea bites.
  • can itch or feel hot, or may not be felt at all.
  • can disappear and return several weeks later.
Several days or weeks after a bite from an infected tick, flu-like symptoms can appear, including the following:
  • headache
  • stiff neck
  • aches and pains in muscles and joints
  • low-grade fever and chills
  • fatigue
  • poor appetite
  • sore throat
  • swollen glands
After several months, painful and swollen joints may occur.
Other possible symptoms may include the following:
  • neurological symptoms
  • heart problems
  • skin disorders
  • eye problems
  • hepatitis
  • severe fatigue
  • weakness
  • problems with coordination
Some people may develop post-Lyme disease syndrome (PLDS), a condition also known as chronic Lyme disease. Symptoms include persistent muscle, bone, and nerve pain, fatigue, and memory impairment.Symptoms of LD may resemble other conditions or medical problems. Always consult your child’s physician for a diagnosis.
How is Lyme disease diagnosed?
LD may be difficult to diagnose because the symptoms may resemble other conditions. The primary symptom is a rash, but it may not be present in up to 20 percent of cases. Diagnosis is usually based on symptoms and a history of a tick bite.Diagnosis of Lyme disease must be made by an experienced physician. Blood and laboratory tests are generally done to rule out other conditions.Research is underway to develop and improve methods for diagnosing LD.
Treatment for Lyme disease:
Your child’s physician will determine the best treatment plan based on your child’s individual situation. Lyme disease is usually treated with antibiotics for a period of four to six weeks.Treatment will be considered based on these and other factors:
  • If you are bitten by a tick that tests positive for spirochetes.
  • If you are bitten by a tick and have any of the symptoms.
  • If you are bitten by a tick and are pregnant.
  • If you are bitten by a tick and live in an area where the ticks are known to be infected.
Relapse and incomplete treatment responses occur. Complications of untreated early-stage disease include: 40 to 60 percent joint disease; 15 to 20 percent neurologic disease; 8 percent carditis; and 10 percent (or more) of persons are hospitalized, some with chronic debilitating conditions.