Kay, I'm so sorry - just a little (ha) extra stress you didn't really need right now, after the g'parent/in-law trip and the move and the new job. I have not BTDT, but from a medical POV, my first thought was about the dose of Strattera. If he's gained 50 lbs., could he need a higher dose? I work with a nurse who is ADHD and she describes being underdosed as feeling like a lamp that's not *quite* plugged in all the way - sort of staticky and out-of-sorts. Of course, you'll have to establish with a doc in your new place (where are you, btw?), and a Children's ER might well be the place to go - or at least the place to call to get a recommendation. From epocrates.com - here's the recommended dosing for a child (I don't know what he weighs) (I am, OF COURSE, not recommending that you change his dose yourself, but if you tell your new doc that he's gained about 25 kg, I would suspect they might want to readjust his meds, if that wasn't done at your last locale.) ("bid" = "twice a day") [>6 yo, <70 kg] Start: 0.5 mg/kg PO qam x3 days, then incr. to 1.2 mg/kg PO qam; Max: 1.4 mg/kg/day; Info: requires slower titration if pt is poor CYP2D6 metabolizer or on strong CYP2D6 inhibitor (see Drug Interactions); doses >0.5 mg/kg/day may be div bid; periodically reassess need for tx during maintenance [>6 yo, >70 kg] Start: 40 mg PO qam x3 days, then incr. to 80 mg PO qam, may incr. to 100 mg/day after 2-4wk if needed; Max: 100 mg/day; Info: requires slower titration if pt on strong CYP2D6 inhibitor (see Drug Interactions); doses >40 mg/day may be div bid; periodically reassess need for tx during maintenance Hope you can get in to see someone soon!

This reminded me of a scene I always enjoy from Dorothy Sayers / Peter Wimsey - illustrating punishment, forgiveness, AND restoration, after Bredon had taken peaches from a neighbor's tree: "[Harriet] looked up, to see chastiser and chastised emerging from the house, hand in hand. 'They seem to be quite good friends. Bredon was rather uplifted when he was promoted to a cane; he thinks it dignified and grown-up....Well, ruffian, how many did you get?' 'Three,' said Master Bredon confidentially. 'Awful hard ones. One for being naughty, an' one for being young ass enough to be caught, and one for making a 'fernal nuisance of myself on a hot day.' 'Oh, dear,' said Miss Quirk, appalled by the immorality of all this. 'And are you sorry for having taken poor Mr. Puffett's peaches, so that he can't get a prize at the Show?' Bredon looked at her in astonishment. 'We've done all that,' he said, with a touch of indignation. His father thought it well to intervene. 'It's a rule in this household,' he announced, 'that once we've been whacked, nothing more can be said. The topic is withdrawn from circulation.'" -Dorothy Sayers, Talboys (in Lord Peter) :001_smile:

That's true. I've seen teA parties WAY louder in the movies than I thought occurred in "real" life.

Ah, you are a better woman than I would have been! :)

I know this is about screaming, but my labor was 70 hours - the first half was spent crying quietly at home (or at the store, where I was trying to spend a gift card I had been given - I kept doubling over, sobbing, in the infants section!); once I went to the hospital (and received Versed), my dh tells me I laughed for 4 hours straight. I don't remember much of that, except when my hand fell into the pocket of a nurse who was fiddling with something at the bedside - and that was (apparently) the funniest thing that had ever happened to me - EVER. It's probably a good idea of what would happen if I were a drinker! I think some of the abdominal pain I felt was because I was laughing so incredibly hard! I've delivered a fair number of babies, and, as other posters have said, everyone's different. Some of it seems to be cultural, and some of it is that we're all just gloriously different! I did learn, for an Indian patient I had when I was a resident, to count in Hindi and to say, "Push," in Hindi (she didn't speak English). I was used to delivering some ladies who ... well, were loud enough to be in the movies ... who had very vocal coaches, so I thought that was how you were supposed to 'do it'. During the Indian patient's delivery, I was counting and encouraging her to push, and she started crying. I thought she must be in pain, but it turns out that she thought I was mad at her, because (in her mind) I was yelling at her. :( At any rate, a "willing suspension of disbelief" is, as always, needed to watch movies - maybe especially birth scenes!

Let x = original price. $350 = 3/5 x 350 /3/5 = 3/5 x/3/5 350(5)/3 = x x = 583 1/3 So now that you know x, you can figure the other questions. HTH.

We're reading The Planets, by Dava Sobel right now (as part of our study of the Solar System) and it's v. interesting - ds has studied the Solar System in the PH Science Explorer book, and Sobel's "take" is much more poetic. Seems like it will be a nice book, if not exactly a "living book."

powertyping.com (free!)

Ds just this year has enjoyed The Adventures of Tom Sawyer as well as Ender's Game. I remember reading and liking Edgar Allen Poe stories in 7th grade.

My ds is using CD Pre-Alg this year. It has been good, imo, because he is showing his work (mostly!), and understands the concepts. I have found, however, that he seems to do much better if I DO watch it with him and help him know how to pull the info from it. We pause the tape a lot once Dana Mosely has explained the concept, and I get ds to say what he thinks the next step will be, or what the answer will be (which he likes because it's more like a game to him!). THEN he does the problems in his notebook. I think there's something on the website that recommends doing every 4th problem (or so), so maybe doing all the odds is too much for your daughter? (I could be thinking of a different program though, so you might want to look at the website to verify this!) If ds misses too many from one section, I'll have him go back and do more from that section. HTH.

I searched on the Cook's Illustrated reviews for you: Highly Recommended or Winners (after their testing): Tongs: Oxo Good Grips 12 inch locking tongs Apple Corer: Oxo Good Grips Apple Corer Spatula: Rubbermaid 13 1/2 Professional High Heat Scraper OR Tovolo Silicone Spatula (about half the cost of the Rubbermaid one) Ladle: Rosle Ladle with Pouring Rim and Hook Handle (the Oxo Steel Ladle was ok (recommended with reservations), but too short, according to C.I.) Spoons: Exoglass Synthetic Spoon (although they still recommend having wooden spoons) Slotted Spoons: Oxo Good Grips Nylon Slotted Spoon Wooden Spoons: Mario Batali 13 inch wooden spoon OR H.A. Mack French Beechwood wooden spoon Pizza Wheel: Oxo Good Grips 4 inch pizza wheel Garlic Press: Kuhn Rikon Easy-Squeeze Garlic Press You'll have to look to see what's available on Amazon, but I hope this helps. Happy cooking (can you tell I LOVE my subscription to Cook's Illustrated?!)!

Here's a great site I use to figure out the order of series books: http://ww2.kdl.org/libcat/WhatsNextNEW.asp

Two that I'm familiar with that would probably do the trick: Analytic Grammar or Easy Grammar. You could search these boards for either of those titles and probably get a good idea about whether they wd work for your child.

Well, we use the DE on 3 computers (all I had to do was ask Ray at Lampstand, since we have a Mac, a PC and a laptop, all of which are used for school), and did not have to pay any extra for extra licenses or whatnot. If you buy the download DE, it's just not a problem, as far as I understand from the TOG forums. To the OP: your friend should definitely call Lampstand customer service - they have always bent over backwards to help me when I've had a question. (Talk to Juli!)

YMMV, but my 6th grade ds was too young; my 7th grade ds (same child!) gets it! Just a question of those neuronal connections developing, I guess.

Use it (finished season 1), love it, and best of all, ds GETS IT. (I won't say he LOVES it, but I will be sure to post when he loves anything about school :) !) What I really like (besides the content!) is that you end up with a reference book at the end - you can remove all the consumable pages, and just have a nicely-organized, take-it-to-college (which I think Erin did, right Erin?) booklet.

Well, my experience is pretty much limited to Medicare (since my practice is all geriatrics), but I learned recently that you actually DON'T have to see a patient to bill for it (again, I'm just talking about Medicare) - now, that would be bad medicine in almost every instance I can think of, but ... it underscores what Alice said about the way the system is wacky. (You have to document 2 of the following 3: history, exam, decision-making). Also, re pre-op visits - a lot of times, the hospital or surgicenter has requirements about the timing of exams, labs, etc. If you're required, for example, to have a chest xray within the 3 months prior to a procedure, and you had a CXR 91 days before the procedure (e.g., for some other reason), they will not accept the CXR, and so you have to be re-radiated and re-charged (or your insurance does). Or: I've seen patients on a Monday, who then found out from their surgeon that their (elective) surgery was scheduled (without consulting them) for the next week's Wednesday. Since the hospital required a physical "within 7 days," the Monday visit can't count, and they have to be seen again. I suppose that I could just SAY that I saw them on Wednesday, but I think that most people would be pretty uncomfortable knowing that their doctor lied on a form, right? I know I would! And what if something HAD changed between Monday and Wednesday? I can't say that something is an acceptable risk (which is what a pre-op eval is getting at) if I haven't actually determined that. It's a system that does not allow for insinuation of logic at all, most of the time.

I'm sure others will come up with a variety of things to fill up the bulk of a basket, but you sure won't go wrong with a bookstore giftcard - too bad they're not bulkier!

What about Spelling Power? http://www.castlemoyle.com/shopping/spelling/spellingpower.htm IIRC, it was designed to remediate spelling problems (I think the author originally developed it for her 6th grade dtr who read well, but spelled on a 2nd grade level), is used from age 8-->adult (all one book - gotta love THAT!), and reinforces the spelling with a variety of multi-sensory approaches (visual, tactile, etc.). We've used it for several years - we spend about 15 minutes 3x/wk - and I can see improvement in my very verbal, good-reader, "but you know what I meant so why should I bother to spell it correctly" child! I've never used the cards or the CD-ROM, or anything other than just the book itself.

Hi, Ellen, Subclinical hypothyroidism is usually just a way of saying that your TSH is higher than normal but your T4 isn't low --- it's usually a precursor to "overt" hypothyroidism (I think about 5-20% of people with it will progress to overt hypothyroidism every year). I agree that the term doesn't really make sense for the patient who DOES have "clinical" symptoms, but ... it's just what it's called! (Maybe the ladies here should come up with a new term for it!) You're absolutely right that some people's "range" is smaller than the "official laboratory range," and that can be harder to detect, to control, and to manage. I'm sorry that you had to wait for treatment. Here's a fairly old article (so the numbers for normals, etc., might be wrong) that details some of the issues. OP, even though it's an old article, the Figure (1; the algorithm) might be of some help to your doc in feeling more comfortable about treating you. http://www.aafp.org/afp/980215ap/adlin.html

My suggestion (if you like your current docs) would be to NOT change docs, but try the squeaky wheel approach: repeat your symptoms (and how distressing and disabling they are) to your doc and ask him if he would consider trying you on a low dose of Synthroid for a limited period of time (say, 3 months), and then following up your TSH (after 6 and 12 wks), and monitoring your symptoms. My guess (as a doc who appreciates reasonable, non-strident requests :001_smile:) would be that he might agree to this. My second guess is that you will feel better, and HE will be convinced and let you stay on the med! The reason that so many docs don't want to treat what would be classified as "subclinical hypothyroidism" is that the levothyroxine is not necessarily a benign medicine, and there is little-to-no evidence (honest-to-goodness well-designed controlled trials) that treating a TSH at your level would prevent some of the problems that crop up when people are hypothyroid. I would hope that your docs aren't behind-the-times, but rather trying to protect you from the adverse effects of treating. HTH.

Brehon, just be aware that the doctor might NOT be willing to keep the letter confidential, so make sure that nothing you say in it could come across as adversarial, but just a concerned-loving-granddaughter type letter, with specifics of what YOU'VE seen (so it won't seem to your g'father that folks are ganging up on him - paranoia can be a problem in dementia) that you're concerned about.

Well, I think I would do more than just ... agree with them. For example, your grandfather may not have ever had a MMSE, if the doc only hears, "All is well." But if the doc had a note (or some inkling from another family member) that all was NOT well, despite your g'parents' protestations to the contrary, I would hope that (at minimum) he would say something like, "Well, when my patients hit 75 [whatever], I recommend these blood tests, and also do this short test of memory. So, what's the date today?....." In other words, your note might trigger the doc's thinking about the problem. [i always remember new patient who was youngish (early 70s), and I almost didn't do a MMSE because it was late on a Friday evening, and she was so "with it" - well-dressed, well-spoken - confused, but not terribly confused, etc. I did the test, and was shocked that she scored a 4 (30 is perfect; less than about 26 would indicate a problem)! Your g'father may well know how to "act" in the doctor's office and the problems may not be apparent THERE at all.) Now, of course, a MMSE is not a diagnostic test, but if your grandfather scored even a little bit low, the doc would (hopefully) keep a closer eye on things, begin to think about adding a med for dementia, control lipids even more closely - something like that. It is really common for family members to compensate for the patient's cognitive losses (even without realizing they're doing it), and it's also (of course) frightening to think that "Dad might be losing it," so the problem is quite easy to ignore. You might want to point out to your dad that there are strategies to HELP your grandfather (not necessarily meds; polypharmacy is a big problem in the elderly, as other posters have said) and that your goal isn't to "put him in a home," or something like that. It's best to try to figure out WHY your family wouldn't want to know if something is wrong, and try to address THAT issue in a reassuring manner.

Lori D., thank you for posting this - it's a really helpful list of resources!