Thursday, January 06, 2011
The diagnosis isn't always ADHD By Dr. Anthony Policastro

We often do not realize how many ways the body connects its systems to each other. When I evaluate a patient for ADHD, there are other medical problems that I need to make sure do not exist. For example, iron deficiency anemia causes behavior issues in children. When a child with iron deficiency is treated with iron, the behavior improves before the anemia does. Lead poisoning can cause behavior issues. Food allergies can mimic ADHD. Over the years, I have had many patients that have had their ADHD disappear when we removed things from their diet. Milk is the most common culprit. An underactive thyroid gland can cause ADHD type behavior.Sometimes staring spells that look like attention problems can be due to seizures. The thing all of these disorders have in common is that there are always more symptoms than just ADHD which is why the history is so important in children with ADHD. We do other tests when there are other symptoms present. One of the key problems in ADHD is a lack of dopamine, a chemical in the brain. We have known for a number of years that people with ADHD have low levels of dopamine. The cause is usually genetic; they inherited low levels of dopamine. However, there are other things that can cause low levels of dopamine in the body. When that happens, the result is someone with ADHD symptoms that are not due to ADHD itself. One of these conditions is sleep apnea. Individuals who have sleep apnea at night have low levelsof oxygen. We know that over long periods of time, low oxygen levels decrease the level of dopamine in the brain. Thus, childrenwith sleep apnea have low levels of dopamine in their brain causing them to act like they have ADHD. Once the sleep apnea is corrected, their levels of dopamine will rise. The increase is gradual so the symptoms will disappear gradually. A new study now links asthma with ADHD symptoms. For years we have known that some asthma medications may make children hyperactive. In addition, children with asthma have low levels of oxygen much of the time. As a result, these children develop low levels of dopamine causing symptoms that look like ADHD. In the past we thought that children with asthma were more likely to have ADHD. However, it now seems more likely those children just have ADHD symptoms without having ADHD. The treatment of these children needs to be focused on the asthma and not the ADHD symptoms. Once the asthma is controlled, the oxygen levels will rise resulting in higher levels of dopamine. In turn that will result in less ADHD symptoms. It is likely that similar to sleep apnea, the improvement will be a gradual one. It is not unusual for different diseases to have similar symptoms which can be confusing for the patient and the doctor. Sometimes we get more information about diseases over time which allows us to look at things differently than we did before. Both sleep apnea and asthma can cause low levels of oxygen. They both can look like ADHD. Thus, the approach needs to focus on the underlying problem and not on the symptoms that they cause.

First Aid classes available Nanticoke Memorial Hospital will offer community First Aid classes to anyone interested in learning first aid on Tuesday, Jan. 11, from 6:30 to 9:30 p.m. at the Nanticoke Training Center on Water Street in Seaford. Participants will learn basic first aid that will enable them to administer help during the first few moments until emergency responders arrive. Classes are open to participants ages 13 and up. The course covers cognitive learning, role-playing and skill practice. Cost is $30. Payment and registration is required by no later than five business days prior to the class. Late registrations (if seating is available) will be an additional $5 fee. To register contact the Training Center office at 629-6611, ext. 8919.Pre-registration is required.

Red Cross seeks volunteers The American Red Cross of the Delmarva Peninsula is seeking volunteers to help in local communities. A Volunteer Orientation is scheduled at the Seaford Library on Wednesday, Jan. 12, from 5:30 to 6:30 p.m. Volunteers make up more than 98% of the organization's work force, providing many of the Red Cross life-saving services that your local community depends on. On a day to day basis, the local Red Cross responds to emergencies such as local house fires and flooding situations. Residents can count on the Red Cross, and trained local Red Cross volunteers, to care for those families left temporarily homeless. Free Disaster Response training is provided by the Red Cross for volunteers so they are ready to assist as needed. Other opportunities are also available - from teaching lifesaving skills like CPR and First Aid to conducting presentations stressing the importance of being prepared for emergencies to helping at local Health and Community fairs. To register for this Volunteer Orientation, residents are encouraged to call the local Red Cross at 1-800-777-6620, option 7 or send an email to For more information about the Red Cross in your community, visit

NMH earns Seal of Approval In October 2009, Nanticoke Memorial Hospital earned the Gold Seal of Approval from The Joint Commission for Primary Stroke Centers. In November 2010, The Joint Commission re-evaluated Nanticoke Memorial Hospital and decided to continue to grant the hospital with a passed certification. Nanticoke is the first Certified Stroke Center in Delaware to have earned this distinction from The Joint Commission. The Joint Commission's Primary Stroke Center Certification is based on the recommendations for primary stroke centers published by the Brain Attack Coalition and the American Stroke Association's statements/guidelines for stroke care. The Joint Commission launched the program, the nation's first, in 2003.

Stroke Support Group Nanticoke Memorial Hospital's next Stroke Support Group meeting is Tuesday, Jan. 18, 1:30 p.m., at Nanticoke Memorial Hospital's Mears Rehabilitation Center, 300 Health Services Dr., Seaford. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. The two-hour support group meetings consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors meet in groups to discuss concerns, provide support and allow for networking. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.

NMH offers CPR classes Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn how to perform the basic skills of CPR on adults, children, and infants and how to help an adult, child or infant who is choking. This classroom-based, video and instructor-led CPR course offers families, friendsand community members the opportunity to learn CPR and need a course completion card. Classes are open to participants ages 12 and up. This program is specifically designed for those who prefer to learn in a group environment with feedback from an instructor. The target audience is those who have a duty to respond to a cardiac emergency because of job responsibilities or regulatory requirements. Cost is $30. Payment and registration is required by no later than five business days prior to the class. Late registrations (if seating is available) will be an additional $5 fee. To register and to obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919.Pre-registration is required.

Childbirth classes offered Nanticoke Memorial Hospital will be offering a childbirth class on Wednesday, Jan. 12 from 6:30 to 8:30 p.m., in the hospital. The class will meet each Wednesday for four weeks. The maternity education classes are designed to offer information, counseling, support and hands-on experience to help prepare for a new family member. They will cover pregnancy in general, information to prepare the expectant mother for labor and delivery, and will include a tour of Nanticoke Memorial Hospital's Mother Baby Care Unit. A refresher course is also available for those who have previously taken childbirth classes. The refresher class covers breathing techniques, signs, symptoms and stages of labor, birthing options and a tour of Nanticoke's Mother Baby Care Unit. The cost of the childbirth course is $50, and the cost for the refresher course is $25. Mothers are encouraged to bring their partner or support person for all courses. Registration in advance is required for either class. To register, or for more information, contact the Health Education Registration line of Nanticoke Memorial Hospital at 629-6611, ext. 2540.

Alzheimer's Support Group Nanticoke Memorial Hospital's next Alzheimer's Support Group meeting is being held on Tuesday, January 11th, 1:30 p.m. at LifeCare at Lofland Park's, first floor Resident Lounge, 715 East King Street, Seaford. This group provides support and information about Alzheimer's and dementia to families, caregivers and anyone who is affected by this disease. Refreshments will be provided. Pre-registration is not required for this FREE support group. For additional information, contact LifeCare at Lofland Park at 302-628-3000, extension 8302.

Hospice offers support group Delaware Hospice's Bereavement Counselor, Midge DiNatale, will lead an eight-week support group for adults on "Grieving the Loss of a Loved One," Jan. 19 through March 9, from 2 to 3:30 p.m., at the Easter Seals Conference Room, 22317 DuPont Highway, Rt. 113, Georgetown. Any adult who would like to give and receive support from others experiencing a loss are invited to attend. Many people find that sharing reduces the loneliness and heartaches of grief.Topics discussed are what to expect when grieving, mistaken ideas about grieving, managing and coping with grief, family interactions, spiritual issues, how to handle special days and holidays and ways to find a renewed sense of purpose. There is no fee for this service which is provided as a community outreach by Delaware Hospice. Registration is requested by calling Midge DiNatale, at 302-416-0581 or 302-856-7717, or by emailing,

Family Caregiver Training offered The Alzheimer's Association Delaware Valley Chapter sponsors The Family Caregiver Education Series several times a year in each of Delaware's three counties. LifeCare at Lofland Park in Seaford will host the training on Wednesday, Jan. 19, from 8:30 to 4:30 p.m. This program includes a medical overview, legal and financial issues, challenging symptoms, daily care issues and information on getting the help you need. This training for family caregivers is free and lunch will be provided by LifeCare. Pre-registration is required by Jan. 14. For more information or to register, call Jamie Magee, branch office coordinator, at 854-9788 or 1-800-272-3900.

Heart and Stroke Gala The 2011 Southern Delaware Heart and Stroke Gala, "An Evening in Oz," will be held on Saturday, March 19, 2011, at the Sheraton Dover Hotel. The annual event benefits the American Heart Association and the American Stroke Association. Volunteers are actively planning the gala. Volunteers work on committees, including sponsorship, publicity, auction, hospitality, multimedia, website, entertainment, casino, photography and decorating. To find out more about sponsorship or to volunteer, contact Karen Gritton, special events director at or 286-5705. You may also contact the American Heart Association and American Stroke Association's Delaware office toll free at 877-750-4276.

Cancer support group The Wellness Community-Delaware offers a general cancer support group for people affected by cancer and their loved ones at Nanticoke Memorial Hospital in Seaford. The ongoing monthly support group meets in the first floor resource library of the Cancer Care Center on the third Monday of each month. The next meeting takes place on Jan. 21, from 3:30 to 5 p.m. The Wellness Community, an affiliate of the Cancer Support Community, is dedicated to helping people affected by cancer enhance their health and well-being through participation in a professional program of emotional support and hope. All facilitators are trained mental health professionals with a master's degree or more. Call 645-9150 for information or to register for this program. All support groups offered at The Wellness Community are free of charge. This program is made possible by the support of the Nanticoke Memorial Hospital in Seaford. For more information, visit

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. The program is facilitated by Nanticoke Memorial Hospital Cancer Center professional staff - Terri A. Clifton, MS, NCC, Cancer Care coordinator; Mary Brown, RN, DSN, manager Cancer Care Center; and Wendy Polk, nutritionist - with assistance from Lois Wilkinson, DBCC special projects manager, who helps facilitate the program at Bayhealth. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Bereavement luncheons Delaware Hospice's "New Beginnings" bereavement luncheons are an informal way to meet and talk with others, who have had similar loss experiences. Lunch begins at noon and is followed by a brief program. The location rotates each week of the month according to the following schedule:
  • 1st Thursday: Grottos Pizza, Rt. 26, Bethany Beach;
  • 2nd Thursday: Georgia House, 300 Delaware Ave., Laurel;
  • 3rd Thursday: Millsboro Pizza Palace, Rt. 113-southbound lane, Millsboro;
  • 4th Thursday: Blue Ocean Grill (formerly Milton House), 200 Broadkill Rd., Milton;
  • 5th Thursday (when applicable): Texas Grill (formerly Ocean Point Grill), 26089 Long Neck Rd., Millsboro.
"New Beginnings" luncheons are open to the public. Registration is not required.There is no fee except the cost of your lunch. For more information, call Carol Dobson or Paul Ganster at 856-7717.