As promised in yesterday’s blog post, I’d like to introduce guest blogger Shawn Ladd, who is gracious enough to share his experiences at the Amen Clinics in Costa Mesa, CA. Thanks, Shawn!
I recently spent three days at the Amen Clinic in Costa Mesa, CA for further assessment and diagnosis of my ADD. I had a huge personal breakthrough when I was diagnosed with ADD (primarily inattentive) five years ago, but I’d noticed I was still struggling to initiate and follow through on projects, and was prone to bouts of depression.
Dr. Daniel Amen, known to millions of devoted PBS viewers for his specials during pledge weeks, is a prominent ADHD expert, psychiatrist, and best-selling author. What made him especially credible with me was his open and touching description of ADD in his own life and family, and his framework for distinguishing among seven distinct types of ADD. The Amen Clinics offer a multidisciplinary approach, but are unique in their use of SPECT scans (Single Photon Emission Computerized Tomography) that map blood flow into various parts of the brain responsible for particular cognitive and physical functions, and identify patterns that correlate with psychiatric and neurological conditions.
Some Amen Clinics also offer a quantitative electroencephalography (qEEG), a procedure that yields a similar map of the brain, but using electrical signals rather than blood flow. Curious to see if different methods led to different conclusions, I opted for both.
My evaluation would take place over three days. I completed an online patient history and questionnaires beforehand. This was a daunting amount of paperwork, but hey, it was online and I had a month to do it, including checking with family members about medical history or possible ADD-related events.
“On Day 1, I was a spaced-out klutz.”
For a valid assessment, I was asked to suspend taking Adderall (my ADHD stimulant medication) for four days before the SPECT scan. On Day 1, I was a spaced-out klutz. On Day 2, well, there was no Day 2 – I slept through it. By Day 3, I’d concluded that it would be anti-social, if not downright malicious, to drive 150 miles without being properly medicated. I took the train.
The appointments were spread over an afternoon, a full day, and a morning, so the clinic suggested a couple of hotels within walking distance. The clinic itself was in an office tower, with a neutrally decorated, spacious and comfortable waiting room with a big screen TV playing nature shows. I was greeted and waited for the first of two SPECT brain scans.
The first scan was taken immediately after a concentration task on a computer which included tasks such as: “Click as soon as you see the letter, unless the letter is an ‘X’”. Mike, the scan technologist, put an IV line into my arm, and left me to do the concentration task while he drew a vial of the dye that would bind to receptors in my brain to show blood flow. He dumped the dye into the IV line (I didn’t feel anything) and walked me to the ergonomic slab that I would happily sleep on for the rest of my life. I was slid into the scanner, which resembled nothing so much as three tin lunchboxes orbiting your head a couple of millimeters at a time for 20 minutes. That’s 20 minutes without moving your head, folks, or we start all over again, as Mike repeated once or twice. After the scan, I spent about an hour doing a couple of computer-based quizzes screening for any possible disorder (in addition to ADD). That was it for Day 1. That night, I peed a glorious sunset orange, expelling the SPECT dye.
Day 2 began with the qEEG. Dr. Christine Kraus, a neuropsychologist, put a “swim cap” with twenty-something contacts on my head and squirted a chilly conductive gel into each lead. A few minutes “eyes open,” staring at the wall, gaze fixed but relaxed, then a few minutes “eyes closed,” and we were done.
Later that morning, I spent two hours with Lisa, the medical historian. She’d gone over the forms I’d filled out online, my entire history, personal and family – with a fine-tooth comb, looking for gaps, inconsistencies, or missing information, and asked questions to clarify. Once you go through this process, you have a really vivid sense of how your life looks to someone who isn’t in your head. Finally, I completed a paper-based Beck Depression Inventory and a quality of life questionnaire.
After lunch, it was time for the second SPECT scan, this one without a concentration task beforehand. Instead, and much, much, worse, I was told to “Just lie back, don’t concentrate or meditate, don’t check your phone, don’t read anything. And stay awake.” After years of practice calming myself with meditation and breath work, and no Adderall in five days, I had to lie there for about 15 minutes with nothing to do. Frustrating. Then, dye injection and into the scanner for 20 minutes, just like the day before.
Read the conclusion of Day 2, Day 3’s adventures, and the final test results in Shawn Ladd’s Excellent Amen Clinics Adventure – Part II!