The Triad of ADHD and How to Manage It

October 1, 2012

Taming the Triad – a registered trademark

The triad of inattention, hyperactivity, and impulsivity are the hallmark characteristics of the spectrum of attention deficit disorders, now under the broad category of attention-deficit hyperactivity disorder (ADHD) formerly known as attention deficit disorder (ADD). ADHD is sub-classified as with or without hyperactivity because some persons with this disorder can actually be hypoactive or more withdrawn in their activity level.

ADHD begins in childhood and may last a lifetime. It can also have its onset in adulthood as a result of brain trauma, infection, drugs, and other insults to the brain.

Because ADHD can have a wide variety of presentations and can co-exist with other conditions such as autism, obsessive-compulsive disorder, etc., it can be difficult to diagnose. This does not mean, however, that the symptoms cannot be managed. While it is helpful for optimum treatment to know the underlying cause of inattention, hyperactivity, and impulsivity, these symptoms can still be managed, regardless of their cause. Some suggestions follow. Be sure to discuss your concerns with your primary care provider to get the best possible diagnosis and treatment for the best outcome.


  • Spend only small amounts of time, maybe 10 – 15 minutes at a time on a task and build up the amount of time slowly to train the brain to become more attentive. In toddlers and pre-school children, this might need to be only 2 minutes in the beginning!
  • Vigorous activity between tasks can help improve attention.
  • Some need to be active during the task at hand (standing, tapping, etc.) While this may not be productive motion, as long as it doesn’t cause distraction to others, it may help the person with ADHD to be more attentive to the task at hand.
  • If learning disorders are present, be sure to make appropriate accommodations. Low frustration tolerance from inability to perform adds to inattention. Conversely, giving a person with ADHD a task to perform that is below their ability level also causes inattention because the person is bored by the task and doesn’t have the appropriate stimulation or challenge to maintain attention.
  • Music, bright colors, and other sensory stimulation might improve attention span but some, especially those with autism might have an adverse response.


  • Provide plenty of time for adequate uninterrupted sleep, about  7 – 8 hours per night.
  • Get plenty of exercise.
  • Maintain a healthy diet and consider nutritional supplements.
  • Avoid concentrated sweets. Besides obesity, sugar has other negative health consequences and can increase hyperactivity and even cause lethargy as the blood sugar level bottoms out after the  sugar “high”.
  • Caffeine may or may not cause attention problems, but it should be avoided in children.
  • Treat any medical conditions that could be impacting hyperactivity such as allergies, sleep apnea, etc.


  • Maintain a routine for meals, bedtime, and scheduled activities. Be sure to also provide free time during the day. Over-scheduling is just as detrimental as not having a routine.
  • Try to minimize schedule changes that will disrupt the routine, especially in the beginning. As the child gets comfortable with a routine, impulsivity tends to improve.
  • Try to anticipate the needs of the child so that the child doesn’t get frustrated. Frustration commonly leads to impulsive behaviors.
  • Redirect an activity instead punishing the impulsive act whenever possible.
  • Maintain discipline. Enforce rules consistently to avoid confusion, frustration, and manipulative behavior.

These are just a few of the ways to help minimize the behaviors that are problematic. Over time and with maturity, the child develops coping skills and learns to anticipate situations that can cause behavior problems. These suggestions also work for adults with inattention, hyperactivity, and impulsivity, regardless of the cause.

Coaching is also a good way to help work on some of these behaviors. Feel free to contact me with any questions you might have.

Anatomy and Physiology of A Nutrition Label

August 6, 2012

The anatomy of a nutrition label is fairly obvious – serving size, calories per serving, nutritional components with percent of daily allotment for each, and ingredients. The physiology (or what the label can do for you) is a little more tricky depending on your nutritional needs. While not all-inclusive, this blog will discuss some examples of how to get the most useful information for your specific needs from a nutrition label.

So how does a nutrition label work for you? Besides listing the serving size, nutritional components in terms of percent of daily allowance, and ingredients, the label can be a guide to helping you plan your diet. Most nutrition labels are based on a 2,000 calorie per day diet. Some will also list other daily allowances. You will need to determine your calorie allowance and adjust the serving size to meet your needs. You may also need to take into account specific medical conditions and the nutritional needs for those conditions when considering your meal choices.

Nutrition Label

BBQ Chicken California Pizza

The above is the label for a California Pizza (BBQ Chicken) and has daily values based on a 2,000 calorie per day diet but also gives some information for a 2,500 calorie diet. Additional nutritional information can be calculated as a fraction or percent of the 2,000 calorie diet.

I will use the example of a 1,500 calorie diet to evaluate the nutritional value of this slice of pizza. Since 1,500 is three-fourths or 75% of 2,000, the nutritional components in this label for fat, saturated fat, carbohydrates, and dietary fiber need to be multiplied by 0.75 to get the correct values for a 1,500 calorie diet.

If your diet is based on 1,500 calories per day, your intake of fat should be less than 48.75 grams of fat. How was this number derived? Since 1,500/2,000 = 0.75, you need to multiply 0.75 by 65 grams to get the number of grams of fat for your diet. This amount is 48.75. Since one serving of this pizza is only 10 grams it is not a bad choice for a meal since it will be 20.5% of your fat allotment for the day (10/48.75 = 20.5). Be aware, though, that even though this serving only provides 20.5% of your fat calories, it is still a high fat food because 90 calories of the 310 calories (90/310) or 29% is fat! Additionally, the saturated fat from one slice would be a little on the high side. On a 1,500 calorie diet, your allotment of saturated fat would be 0.75 x 20 or 15 grams per day. This serving provides one-third of your daily allotment of saturated fat (5/15 = 1/3) which means you would need to be more careful about eating any other sources of fat with this meal! Saturated fat needs to be modified beyond this amount in someone with heart disease or other circulatory conditions, so for those persons this slice of pizza might not be a good meal choice.

You should note that this slice of pizza only has 1 gram of fiber which is extremely low if you want to meet your dietary guidelines. On a 1,500 calorie diet you need to eat 0.75 x 25 or 18.75 grams of fiber per day. This slice only provides 1/18.75 or 0.5% of you daily need! Fiber is an important nutrient for persons with constipation, irritable bowel syndrome, and other gastrointestinal conditions.

Sodium is an important nutritional parameter to monitor especially if you have high blood pressure. Many doctors recommend less than 2,400 milligrams of sodium per day, which is not calorie-dependent. This slice of pizza has 810 milligrams or 34% (810/2,400) of your daily allotment of sodium! This is a poor choice for a person with hypertension!

Additional things to notice on this food label include the vitamins A and C. These are in very low amounts not providing much nutritional benefit. The amount of calcium in this slice of pizza is not bad at 25% of the daily allowance! Please note that children and pregnant and breastfeeding women need to eat higher amounts of calcium than those listed on the label. Also, most individuals eating less than 2,000 calories per day will need vitamin supplementation.

Vitamins and minerals such as calcium are based on a minimum daily requirement independent of the number of calories consumed so these values can be used directly from the label without additional calculations when meal planning.

These are just some examples of how a nutrition label can assist you in making food choices that are in line with your nutritional needs based on your specific health and medical conditions.

There are many sources on the Internet that can help you calculate your dietary needs. Seek the advice of your primary care provider for your nutrition prescription and a registered dietician or nutritionist to help you make food choices that are in line with that prescription!

Feel free to leave comments or questions. I will answer some questions below or if they require a lengthy response, I will address them in a future blog.

To your health!

Does God Test/Tempt Us?

July 1, 2012


Jesus Carries His Cross

Picture obtained from

Does God test/tempt us? I believe the answer to this question is a resounding “yes”! Paraphrasing Jesus, he said to “take up your cross daily and follow me.” (Lk 9:23 NAB)

Let me start with the definitions of test and tempt that I am referring to in this blog. According to the Merriam-Webster Dictionary, the definition of test I am using for the purpose of this blog is “to put to test or proof” and for tempt is the obsolete definition, “to make trial of”.

I believe every trial that we experience is on some level a test from God, not that He causes us to have the trial, but that He uses it for our benefit. While we frequently experience negative consequences from trials, we can also learn from them and grow stronger because of these trials.

2 Consider it all joy, my brothers, when you encounter various trials,
3 for you know that the testing of your faith produces perseverance. (Jas 1:2-3 NAB)

6 In this you rejoice, although now for a little while you may have to suffer through various trials,
7 so that the genuineness of your faith, more precious than gold that is perishable even though tested by fire, may prove to be for praise, glory, and honor at the revelation of Jesus Christ. (1Pt 1:6-7 NAB)

Some trials that we experience are because of our own failings, short-comings, or sins but even these trials can bring us benefit. 

20 The law entered in so that transgression might increase but, where sin increased, grace overflowed all the more,
21 so that, as sin reigned in death, grace also might reign through justification for eternal life through Jesus Christ our Lord. (Rom 5:20-21 NAB)

Sometimes, I believe that God does test/tempt us for our sanctification.

25 Besides all this, let us give thanks to the Lord our God for putting us to the test as he did our ancestors.
26 Recall how he dealt with Abraham, and how he tested Isaac, and all that happened to Jacob in Syrian Mesopotamia while he was tending the flocks of Laban, his mother’s brother.
27 He has not tested us with fire, as he did them, to try their hearts, nor is he taking vengeance on us. But the Lord chastises those who are close to him in order to admonish them.” (Judith 8:25-27 NAB)

God can also test us by pruning to make us more fruitful. Read the book of Job in the Old Testament to read about Job’s trials and how he became more fruitful because he maintained his trust in God through the testing of his faith.

If God does not test us, why did Jesus add “Lead us not into temptation” or in another translation “Do not let us undergo the test” in The Lord’s Prayer?

These are just a few of the many examples cited in Scripture to show how our relationship with God requires testing. How else would we grow in knowledge and love of Him?

I am available to speak to your group on topics in Christian spirituality. You may contact me at to discuss the details of your needs.

Please feel free to comment on your own experiences of how God has tested you!

The Ladder of Success

June 13, 2012

What are the steps on the Ladder of Success? I will point out a few. I’m sure you can come up with more!

I believe the first step on the Ladder of Success is vision. You need to have a vision of what success means to you. How will success look, feel, taste, sound, and smell? Engage all your senses. How will success affect your life – spiritual, emotional, physical, financial, intellectual, relational, etc? You need to get a very detailed vision of this success so that you will know when you have arrived. The more detail you can include, the more you can determine the steps that are needed to get there. Some of these steps might be finances, network of influence, talents, etc. Are you starting to get the picture?

Once you have set your vision, the next step is to determine your assets. What are your talents, your financial investment, network of influence, motivations, etc. All of these assets are various steps on your ladder. You might need to climb them sequentially or you may need to go up and down the ladder a few steps at a time until you achieve a level of success that can get you up the next step of the ladder.

You also need to determine your liabilities. What things are you lacking that can cause you to have to lower a step on the ladder or keep you from advancing a step? Some of the steps on the ladder that are assets at one point in your life can be a liability at another point in your life depending on the circumstances. That’s why most people go up and down on the ladder many times before reaching the top. This is not a sign of failure or weakness. It is normal! Very few people are sufficiently gifted or have the assets to make a straight shot to the top! The main reason for knowing your liabilities is so that you can negotiate them and learn from them so that you can overcome them or turn them into assets.

How do you turn a liability into an asset? This commonly requires thinking outside the box, persistence, perseverance, confidence, faith, and stepping outside of your comfort zone. These are all traits that we have at some point in our lives. Learn to read the sign posts along the way on that ladder. Get help from a friend, family member, co-worker,  boss, mentor, or coach to help you see any roadblocks or deficiencies that are holding  you back from going that next step.

Feel free to share your success steps and how you overcame obstacles!

If you have suggestions for future blog posts, feel free to share those here or send me a message.

Until next time, to your success!

STRESS – Senseless Thoughts Repeated Endlessly Surrounding Self

May 1, 2012

STRESS – Senseless Thoughts Repeated Endlessly Surrounding Self

Senseless Thoughts Repeated Endlessly Surrounding Self

One definition of stress given in the Merriam-Webster Dictionary is “a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation”.

One definition that I propose is “Senseless Thoughts Repeated Endlessly Surrounding Self”. In this definition, I am only considering emotional factors that cause bodily or mental tension but I acknowledge that there are other factors and that these factors are interrelated.

Consider how often in your day you can relate your stress to your mental thoughts and the emotions that those thoughts elicit. Our thoughts have a profound effect on our physical and emotional well-being.

If your thoughts center around negative self-talk, the potential results will be a negative self-image and self-limiting beliefs that will not only increase poor performance but will also add to a sense of defeat and despair or depression.

Persons who feel that they have options are better able to confront challenges in logical and systematic terms. A perceived lack of options leads to feeling trapped which sets off the “fight or flight” response and a whole set of chemical and hormonal reactions in the body that add to or create stress and tension.

We can create our reality with our thoughts. By this, I am not affirming magical thinking. Our reality is based in our thoughts. If I see the glass half-empty I am in a paradigm that is different from seeing the glass half-full. Positive thoughts lead to positive beliefs, positive chemical and emotional reactions in our bodies, and positive actions which lead to positive outcomes.

When our thoughts are negative, it is good to examine why they are negative and determine how the outlook can be changed. There are, indeed, negative things going on all around us. It is how we perceive these challenges and respond to them that determines our levels of stress.

I must also point out that stress in and of itself is not a bad thing. The “fight or flight” response is important in dealing with a dangerous situation! But chronic stress has a toll on our emotional and physical well-being!

Thoughts that are senseless (not based on reality or fact) are not productive. They are harmful and cause undue stress. The stress is compounded when the senseless thoughts are about the self. Senseless thoughts such as negative self-talk and self-limiting beliefs must be eliminated and replaced with thoughts that are based in fact.

If, however, you are having negative thoughts that are based in fact, then solutions to turn the negative facts into positive facts needs to be addressed. Example: “I can’t  succeed because I’m not smart enough.” First, it is good to recognize the truth for what it is. Second, while it may be true that this person doesn’t have the skills in the present situation to succeed, the response should not be defeat or despair. The response should be, “How do I acquire the skills needed for success in this field or what field do my natural talents lend themselves to?” This takes a large amount of stress off the person, because instead of feeling helpless, the person feels empowered to make choices!

We can choose to see the glass as half-empty or half-full. We can choose our paradigm. It takes practice and persistence to choose positive thoughts. It takes self-knowledge, insight, and courage to step out of our comfort zone. Sometimes, it takes another person to help us see where are thoughts are “Senseless Thoughts Repeated Endlessly Surrounding Self”!

For help in discerning senseless thoughts and ways to overcome them, feel free to contact me!

To your success!

Restoring Balance

April 2, 2012

Restoring Balance

How does one restore balance? There are many approaches to this problem. Identifying what needs to be restored is a good starting point. Recall the four Rs of balance mentioned last month. See the  diagram below and refer to the March blog post for more information on the four Rs.

Let’s use rest as an example. Are you sleeping less than seven hours or more than eight hours per day? If you are there is probably an imbalance in yourself that needs to be adjusted. Recall that poor sleep quality or inadequate amounts of sleep can affect all areas of your health so it is vital to have this parameter of rest in balance.

How do you get the proper rest? What is causing an improper amount of time spent in sleep or poor quality of sleep? Simply lying in bed for seven hours will not restore balance. The amount of time in sleep as well as the quality of sleep are the parameters for rest balance.

Once factors that are impeding good sleep are uncovered, the work of restoring sound sleep begins because without this vital apart of the balance triangle, the remainder of the self cannot come into balance.

One method of discerning the factors that are interfering with appropriate rest are to categorize them as intrinsic or extrinsic factors.

Intrinsic factors are those from within such as health problems (sleep apnea, for example) that are interfering with quality sleep.

Extrinsic factors (such as medication side effects) are factors outside of the body that are contributing to the problem. Usually extrinsic factors are easier to resolve but not always.

When sorting through all the potential causes of poor sleep you may need assistance from others. For example, do you sleep poorly due to restless leg syndrome? A partner can help identify this potential problem and you can then address it with your healthcare provider. Additionally, speaking to your healthcare provider about health, medications, and possible other factors is also a good idea. You might need to speak to your employer about your work schedule if this is a factor. Shift work is known to be a contributor to poor sleep quality. A good reference on this can be found at

Sometimes it helps to have an impartial person such as a coach to assist with getting back on the road to balance. That is where I can help. As a family physician, I have invaluable insights into many factors that can present as problems and I can also provide resources such as medical articles for your information. Being impartial, I can make assessments that might not otherwise be obvious. As a coach, I am there to assist and empower you to take control of your life balance.

Feel free to contact me for more information about this blog post or any other questions that you might have.

The blog topic for May will be about STRESS – Senseless Thoughts Repeated Endlessly Surrounding Self.

The Four Rs of Balance

March 22, 2012

March 1, 2012

The Four Rs for Balance

Balance in life can be measured or segmented in many ways. My formula for balance involves the  four Rs. These are relationship, rest, recreation, and refreshment. See the diagram below for how these lend to balance. These are areas of the self that need our utmost attention. As these areas start to come into balance, other areas such as work, finances, etc. can be addressed, although commonly they are addressed simultaneously. This blog only addresses the self and balance.

I place relationship in the center of the triangle and make it the largest parameter because I think it is the most important. By relationship, I mean the primary relationship in our life which is God. We are all hard-wired for God and when that relationship is not on solid ground, all other relationships and areas of our life are out of balance. Everything we are and do flows from our relationship with God. Relationship with God is necessary for:
  • the fruits and gifts of the Holy Spirit which are vital to our character and development of virtue (I will not delve into this further because it would take a whole blog topic to cover how our relationship with God is vital to our survival.)

The next most important area for balance which is at the top of the triangle is rest. Without rest, things quickly fall apart. Recreation and refreshment have about equal weight in terms of balance. By recreation, I mean time spent recharging our batteries as well as time spent on exercise, so really two areas for the price of one R. With refreshment, I mean the food that sustains us, our nourishment. So these are the four Rs. Now I’ll delve into three Rs that make up the points of the triangle.

Rest is vital for many reasons. Rest of at least 7 hours per day of quality sleep is necessary for:

  • clarity of thought and mood stabilization
  • adequate energy levels
  • proper metabolism (Lack of quality sleep increases the risk of obesity and many other health problems.)

Recreation in the form of relaxation:

  • recharges our batteries
  • adds to the quality of life
  • reduces stress
  • increases satisfaction in other areas of our life

Recreation in the form of exercise improves many areas of our health:

  • improves brain function – alertness, concentration, and cognition
  • improves quality of sleep
  • stabilizes mood, reducing anxiety and depression
  • improves energy, stamina, flexibility, balance, strength, and coordination
  • improves circulation and heart health
  • strengthens lungs
  • improves digestion and bowel function
  • improves glucose metabolism
  • helps maintain a healthy weight
  • improves longevity

Refreshment in the form of nutrition is vital to health. Good nutrition:

  • maintain healthy weight
  • supplies energy
  • supports immune system
  • aids digestion and bowel function

Information on dietary guidelines can be found at

For a BMI calculator to determine your ideal body weight, please go to

Lack of balance with the four Rs can lead to problems with health, relationships, employment, etc. I will discuss how to regain balance in these four areas in my blog next month.

Please feel free to post your questions and comments below.


I will be writing a short blog post monthly beginning on March 1st. Please leave your suggestions below on topics that you would like to see covered on this blog.

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Please note: Information provided on this site is for educational purposes only and is not meant to treat any health conditions or to be a substitute for seeking care from your personal healthcare provider.

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