Life Inside My Brain-Part 2
Think particle accelerator meets Bugs Bunny
If the journey of 1000 miles begins with a single step, the journey to an ADHD diagnosis begins with a squirrel. A lot of squirrels.
It’s bad enough having the 24/7 ruckus in my head going. But getting a diagnosis for my suspected ADHD would prove to be a feat of endurance. Sort of like climbing Mt. Everest but without the risk of pulmonary edema.
My first step seemed logical. My family doc. And that’s when the fun began. The regulations around stimulant medications are legion. No family doc is going to grant a new prescription based on an assessment in their office. And those self-screening evaluations? They are helpful, but not enough for a real diagnosis.
“You’ll need to see a psychiatrist to get diagnosed.” Great. More doctor visits. Just what a breast cancer survivor can’t get enough of. (If you’re sensing the sarcastic font there, you would be right.)
But in a small way, I was happy to hear this because I take my health seriously. Scars aside, my physical health is good. Mental health, meh.
I’ve been in and out of therapy for much of my adult life. It’s been life-giving. But yet, the dance with depression and anxiety has continued. I have learned effective tools to cope with them through therapy and my inner work.
But it’s still there, simmering on the back burner. Maybe it’s time to get a thorough evaluation. I understand that many times symptoms can mimic other conditions. Through a mind/body filter, this means that sometimes that stomach ache might be grief. A literal pain in the neck may follow a visit with your annoying uncle.
In my mind, it’s not much of a stretch to consider than maybe anxiety and depression are really undiagnosed ADHD.
And now I find myself on a Zoom call with a shrink from Mayo. And this would be my first misstep in pursuing a diagnosis.
Mayo is excellent at what they do. ADHD stuff? Not so much. I learned this the hard way.
After filling the intake forms, she interviewed me, repeating many of the questions. And what she said near the end gobsmacked me.
She was playing with a Bipolar 2 diagnosis and wanted to prescribe a mood stabilizer. “We can still consider ADHD, but let’s try this first,” she said.
WHAT THE BLOODY HELL? I looked at the diagnostic criteria for Bipolar 2 and about fell out of my chair. I meet NONE of the criteria other than racing thoughts. My therapist laughed when I told her about the shrink said.
The side effects of the drug she was recommending were rife with side effects and required daily dosing.
NO THANK YOU.
It was then I realized I need to find a shrink who works regularly with ADHD clients.
So, I drive an hour through Phoenix traffic to meet with another one. When I made the appointment, the scheduler assured me this would be a “one stop shop” and I could get screened and come out with a script.
She could not have been more wrong.
This doc had the personality of a fence post. No handshake. No smile. And throughout the visit, I got the distinct impression he was sizing me up as a drug seeker.
His worse offense was referring to my breast cancer history as a “breast cancer scare.”
And he too just wanted to throw a prescription at the anxiety. He was completely tone deaf. I want to see if I have undiagnosed ADHD.
He told me I would need to go to an ADHD clinic for testing. He recommended a colleague related to his practice who could do that.
I was furious by the time I left.
Back to the Google Gods.
This time, I focused on finding a clinic that focuses solely on ADHD and made an appointment.
Right off the bat, I nearly disqualified myself from a diagnosis within the first minutes of visiting with the PA.
“You are the second person to have your forms filled out in advance in all the years I’ve been doing this work,” he said
Oh great. I was early for my appointment too. Being on time isn’t a strength with ADHD’ers.
I explained to him I believe my obsession with preparedness and organization developed as a young girl as a way to cope with the chaos in my head. (Not to mention the chaotic, cluttered home I grew up in.)
Phew. I dodged the bullet. He nodded. And then he started jiggling his leg.
“Do you have ADHD by any chance?” I asked.
Yes, he did.
Initial skepticism allayed; he reviewed my intake forms.
Yup. These things are certainly consistent with ADHD.
Omg. FINALLY. Someone is listening to me.
But then he dove into their policies. Because I’m over 50, they would run an EKG on me to make sure it was safe to take a stimulant. But it didn’t stop there. I would need a cardiologist to review the strip and report back to the clinic.
Are you fucking kidding me?
I was grateful he couldn’t read the thought bubble above my head.
And also, he could prescribe the meds for a year, but after age 60, no soup for you!
“Seriously? So, you’re telling me if you have a patient who is a truck driver and depends on his ADHD meds to keep him focused on traversing the roadways, he can no longer get meds?”
Clinic policy, he said.
“You’ll need to come back for the ObTest and then there will be a follow up appointment to review the results,” he said.
Are you fucking kidding me once again ran through my head. THREE appointment$?!
Wait! I thought I would get the QbTest today, I replied.
Oh, yes, that’s right, he responded. (ADHD much?)
His assistant was beckoned. After a quick EKG, which was normal, she led me to a room the size of a closet for the QbTest.
What is a QbTest? Here’s the definition from their website:
QbTest is a medical device that objectively measures cognitive performance and activity levels. QbTest combines a computer-administered Quantified Behavioural Task (QBT) with a high-resolution motion tracking system that uses an infrared camera to follow a reflective marker that is attached to a headband. The test objectively measures the three core signs of ADHD: hyperactivity, inattention, and impulsivity, to provide quantitative assessment of a patient’s activity level, ability to pay attention and inhibit impulses.
OMG. This looks like a torture chamber. Trying to sit for a 20-minute meditation is agonizing, but at least I had visual stimuli to help distract myself.
Blank walls. No window. And this computer screen. And did I mention already this was a size of a closet?
She strapped on the headband and explained the test.
There is going to be a series of circles and squares, both in either red or blue, that will flash on the screen.
My job was to pay attention and click whenever the image appeared twice in a row. Red circle, red square, no clicky. Red circle, red circle, clicky.
Easy sqeasy.
“See you in twenty minutes!” She closed the door and it was just me and this computer.
Focaaaaaaas, Theresa, Focaaaaaaaas.
The little shapes began parading across the screen.
Click, click. Oops. I think I clicked wrong.
Oh! Look at this little glowy button on the computer! Shiny!
Click. Don’t click. I bring my focus back to the screen.
My god, my lips are dry, where is my ChapStick? I fumble with my free hand to fish it out of my bag. I really need to address my ChapStick addiction. Nah, maybe another day.
Oh shit, I think I missed another one.
I take a swig of my water and survey the walls of the room.
My god, this is boring. And this damn chair is uncomfortable.
I shift around.
Oh, yeah, the test. I wonder if I could take a potty break? Oh, shut up, Theresa, and hang on to your bladder.
The shape parade continues. And I click and don’t click.
A mole on my arm catches my eye. Gee, does that look suspicious?
I scan diagnostic criteria for skin cancer and tell myself it’s fine.
Oh! The test!
After what felt like three hours, the assistant returned.
“My god, that was torture,” I told her.
She smiled. Upon my request, she gave me a copy of the report and we scheduled the next appointment. At least now I was just going to have two appointments instead of three.
In the parking lot, I tore into the three-page report she delivered.
And I had no frickin’ clue as to what I was looking at. There were a bunch of scribbles. And a box with very few squiggles.
It read, “99% were less active than you during the test.”
In the medicine world, “negative” means good and “positive” means not good. So, I was careful not to make a judgement beyond thinking I knew I was really, REEEEEALLLLY neurotypical… or I was bouncing off the walls ADHD.
Trying to Google interpreting the test was futile. I would have to wait to meet with the PA.
While I was down a rabbit hole, er, I mean Google search, I happened upon this and thought it bore a starting resemblance to my brain activity. It’s clear. I have a particle accelerator for a brain. Simulation of a lead-lead collision in the ALICE Detector. Swiped from the Cern Website.
Two weeks later, I return. The PA enters the room, holding the test results.
“Oh yeah, you’ve got ADHD,” he says. In spades, according to the test result.
I felt like breaking down and crying. I was seen and heard. He didn’t want to throw anti-anxiety drugs at me. He GETS it.
I ran the gauntlet for this moment. Should a do a victory lap with a banner that reads “I’ve got ADHD!”?
Now, just gimme the damn script and let me get my life on track for the first in 59 years.
He couldn’t give me the script, though without the cardiologist clearance, but we discussed the dosing for Adderral. Since I had already experimented, I knew what was working with me. A low dose, taken in the morning. If I need to be fully on board in the afternoon, I could take a second one.
And it was with this report that I returned to my GP.
“Yes, I will prescribe that for you,” she said.
Finally. It was TIME.
It was time for me to engage in my life in a way I never knew I could.
There is much work to do, I told myself.
And I head to the pharmacy.
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