ADD/ADHD in EMS providers

[RanchoEMT]

lol, I'm glad I'm not the only one who thinks of it this way. I've been known to say "My dopamine is out of whack" when I'm having an off day.

Diagnosed as an adult about 2 years ago. I got my medications sorted out pretty quickly and it made a world of difference. I still have some bad days, but overall I feel much, much better.

Which Drugs??? I'm thinking of getting checked out myself.

 

[medicRob]

Which Drugs??? I'm thinking of getting checked out myself.

Adderall, Vyvanse, Methylphenidate, Concerta, Focalin, Dexedrine, Straterra

However, it is important to note that in most situations, you aren't just going to walk in and magically get an ADD diagnosis. Mine took a year. I went to a doctor, told him I was having extremely hard times studying, inattention, etc. He told me there was nothing he could do til I saw a psych professional about it. The psych professional and I spoke in sessions for quite sometime before he realized that it wasn't stemming or rooted in anything else, that it was physiologic in nature. He then wrote up a recommendation-referral /w medical necessity to the physician who referred me to him, recommending the meds I am on. It took over a year of counseling sessions before they started my medication regimen.

Also, a lot of physicians are just as hesitant to prescribe Adderal (D-Amphetamine) because just as the name suggests, it is a very addictive stimulant when taken in doses above that which it is intended. Not to mention, if you have any cardiac history, ongoing medical conditions, etc.. he/she might also have issues.

 

[LucidResq]

Yeah, and like most drugs, there are side effects too, of course. I've been happy enough with Adderall to stay on it for 6 years but when I first started I lost weight at an unhealthy, rapid rate (around 5 lbs a week at one point). Still have dry mouth, palpitations occasionally and borderline-trichotillomania.

 

[46Young]

I suspect I might have it but am a little afraid to get diagnosed...
Reasons I think I have it include:
1) inability to maintain a social life for an extended period
2) often "tune out" when other people are talking
3) bad at following complex verbal directions
4) can't sit/stand still
5) get very distracted in large social groups and usually "shut down" socially in those situations
6) doing 100 things at once but never really 100% completing any of them
7) I can't read more than a few paragraphs without wearing ear plugs
8) I often have to re-read a paragraph I just read because I was thinking about something else while I read

2,3,4,6,7, and 8. My saving grace in school is my above average retention ability. I can usually get things on the first or second pass. Otherwise, it would be ugly.

 

[RanchoEMT]

Yeah, and like most drugs, there are side effects too, of course. I've been happy enough with Adderall to stay on it for 6 years but when I first started I lost weight at an unhealthy, rapid rate (around 5 lbs a week at one point). Still have dry mouth, palpitations occasionally and borderline-trichotillomania.

As in your balding? Or your pulling out your hair???? My father has an official 'hair island' on top of his head... Like Rob Corddry used to have. I'm not looking forward to my 40's.... If taking Adderall is gonna quicken that process i feel it be best avoided...

 

[RanchoEMT]

was having extremely hard times studying, inattention, etc.

It took over a year of counseling sessions before they started my medication regimen.

How do you feel now? I feel like my brain is just "uninterested in stress" and actually has a "Fuk-It" Mode, which turns off my ability for 'input' in stressful situations.
Example: I'll have a stressful task in front of me, like studying for a Final Exam and even a week out, I just can't seem to concentrate on it.

I think somewhere along the line my brain noticed I do best when not worrying/focusing too much on something... Bills, Girls, Sex, EMS, Death, Philosophy, etc...
-Brain Says: Whats the point of worrying? There is no benefit in these situations, and from then on a flip was switched off.... But the switch that controls the mini-stress' like waking up on time, paying bills, calling people on there birthday, studying for tests, etc. also seems to be turned off. Tho it is needed to function.

Ha! Your an NP now yes?? Let's do an OnLine Consultation, you can email me the prescription.

 

[usalsfyre]

I wonder how fast a pharmacist would call the DEA on that...

 

[LucidResq]

As in your balding? Or your pulling out your hair???? My father has an official 'hair island' on top of his head... Like Rob Corddry used to have. I'm not looking forward to my 40's.... If taking Adderall is gonna quicken that process i feel it be best avoided...

Not balding. I compulsively and unconsciously stroke my hair and occasionally pull pieces out, which I never did prior to taking Adderall. I'm fortunate to have avoided true trich, because many people with it pull their own hair out until they have bald patches or become entirely bald.

 

[abckidsmom]

Not balding. I compulsively and unconsciously stroke my hair and occasionally pull pieces out, which I never did prior to taking Adderall. I'm fortunate to have avoided true trich, because many people with it pull their own hair out until they have bald patches or become entirely bald.

A friend's daughter pulled out her eyelashes after she started an ADHD med. Talk about adding stress into a kid's life!

 

[RanchoEMT]

Anybody use Ritalin?
I've always wanted to o.d. and re-read the Critique of Pure Reason without bleeding from the ears...

 

[Chief Complaint]

Anybody use Ritalin?
I've always wanted to o.d. and re-read the Critique of Pure Reason without bleeding from the ears...

Lol. I used Ritalin as a kid and it worked wonders for me. Only needed it for a couple of years though.

When i started medic school, i was having a hard time concentrating so i went to my doctor. I told him that i wasnt interested in anything with amphetamines in it and he put me on a drug called Nuvigil (same as Provigil but with a longer half life...i think).

The stuff works very well, but i only take it occaisionally. Its also used to treat narcolepsy, and is given to Air Force pilots who have to fly extra long missions. Safe to say that it makes getting to sleep at night a bit difficult.

 

[medicRob]

I wonder how fast a pharmacist would call the DEA on that...

Let's not find out. ha ha. the ink hasnt even dried on my certificate of fitness yet.

 

[Aidey]

Ha! Your an NP now yes?? Let's do an OnLine Consultation, you can email me the prescription.

Some states require an MD to sign off on any Schedule II RX, so even if the DEA didn't have a problem with it you may still be SOL.

 

[Aidey]

I received my diagnosis fairly quickly, but my situation was a little different because the chance of the symptoms being something else had already been addressed.

My main med is Methylphenidate extended release, which is a generic version of Ritalin. My psychiatrist initially tried me on the regular release stuff and I was way to up and down. I could tell pretty much exactly when it was kicking in and wearing off. Working in the job we do taking a pill every 4.5 hours doesn't work very well. I've now been on the same meds for roughly a year and a half with no plan to change them.

 

[Deltachange]

ADHD, diagnosed eight years ago at eleven. Put on welbutrin but hated the side effects, got taken off, never did the adderal thing. Now I self medicate with caffeine when needed. Got through basic school just fine, hopefully the same can be said for medic school in a few years. But I get stuck on wikipedia loops, and know more useless facts than my high school's trivia team. It helps that EMS and the human body is so fascinating, I can hyperfocus on stuff that is relevant to my job/education.

 

[medicRob]

Some states require an MD to sign off on any Schedule II RX, so even if the DEA didn't have a problem with it you may still be SOL.

I am authorized in my particular medical center to prescribe as I see fit, schedule II included. However, we are of course required to take into consideration: Rational Drug Selection (For instance, not writing Percocet when Toradol can do the job), Pharmacoeconomics, and just a little bit of common sense.

However, I work in acute care in the trauma unit, so after-care prescriptions are usually written by our surgical stepdown docs and NPs. However, there are a few situations where I can follow up. When those situations present themselves, I always find it judicious to consult with my advanced practice and MD colleagues when necessary.

In summation, while I can in fact write scripts, doing so outside the Practitioner patient relationship is a big "No No" and could result in action by my employer, the state board, the DEA Diversion Control Office, and could result in formal charges being filed, ... so that's a big no, or as the above poster put it, "You're SOL".

 

[Aidey]

My guess is that it varies state to state. When I was working in a GP clinic if one of the NPs or PAs wrote for any Schedule II meds the MD working there had to sign the RX also.

 

[RanchoEMT]

... so that's a big no, or as the above poster put it, "You're SOL".

Expectations weren't very high to begin with... ^_^

 

[RanchoEMT]

Lol. I used Ritalin as a kid and it worked wonders for me. Only needed it for a couple of years though.

When i started medic school, i was having a hard time concentrating so i went to my doctor. I told him that i wasnt interested in anything with amphetamines in it and he put me on a drug called Nuvigil (same as Provigil but with a longer half life...i think).

The stuff works very well, but i only take it occaisionally. Its also used to treat narcolepsy, and is given to Air Force pilots who have to fly extra long missions. Safe to say that it makes getting to sleep at night a bit difficult.

So kinda like speed?? You say you take as needed?? "occaisionally" How does that work? Like you have a test or class your taking and you start popp'n?

 

[medicRob]

My guess is that it varies state to state. When I was working in a GP clinic if one of the NPs or PAs wrote for any Schedule II meds the MD working there had to sign the RX also.

Actually, it is not even state to state. It is physician to physician. I work under Critical Care Surgeons in a Trauma I, I am given a little bit more authority than you would see in a nurse practitioner in a lot of situations. It all comes down to:

A. What your state says you can do
B. What your facility says you can do
C. What your overseeing physician says you can do