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Source: (consider it) Thread: Purgatory: ADHD and Ritalin
LeRoc

Famous Dutch pirate
# 3216

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I worked as an Activities Councillor for these children, and as a volunteer, so I would only discuss their medication if I really felt there was something wrong.

Maybe it is my issue, and I definitely don't know much about the pharmaceutical side of ADHD, but I have always felt that Ritalin is quite a strong chemical.

Like I said: it definitely helps to control the condition and to get forward for many children. But even if they are happy with it, I would always be in favour of continuing research, also towards medicines with less side effects.

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I know why God made the rhinoceros, it's because He couldn't see the rhinoceros, so He made the rhinoceros to be able to see it. (Clarice Lispector)

Posts: 9474 | From: Brazil / Africa | Registered: Aug 2002  |  IP: Logged
Telepath
Ship's Steamer Trunk
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I prefer Ritalin because it's been around for so long and is so heavily researched, not to mention that I don't get any side effects and, if I did, I could reasonably expect them to be easy enough to manage and/or to go away if I stopped taking it.

There are alternatives such as Strattera, a non-stimulant. I haven't tried it as it's too newfangled for me, but I don't suppose Strattera will be the last nonstimulant treatment they ever invent.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

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christianjimmy
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quote:
Originally posted by Telepath:

Anyway. Ritalin is a stimulant. Give it to a hyperkid and the kid calms down. Hey, wait a minute! Stimulants don't calm you down! That means it must be a paradoxical effect! Paradoxical effects are effects that are the opposite of the ones you'd expect, and they happen in children and the elderly. Therefore, it was assumed that Ritalin wouldn't work on teens and adults.

So, well, then I guess somebody must have given Ritalin to a hyperteen or hyperdult and found that it worked, so it must not be a paradoxical effect after all. Oh.


As far as I remember from my Psych. degree, the reason why Ritalin (as a stimulant) worked was that effectively it over-stimulated the brain, leading to reduced levels of activity across the board. So not a paradoxical effect, rather harnessing the stimulation to smother the associated behaviours deriving from ADHD or ADD. I was quite surprised when I learnt this, and at first questioned the ethical issues associated - however that was entirely in the abstract, and since then have come across a number of people with ADHD who have been helped enormously by using Ritalin to subdue their over-activity, and my wishy-washy theoretical problems strangely disapeared...

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[on discovering that 'Happy Birthday' was composed in 1924]
Alan Davies: What did people sing in 1923, for goodness' sake? They got the cake out and everyone just stood about in a slightly awkward silence?

Posts: 411 | From: That small insignificant country next to Wales... | Registered: Nov 2001  |  IP: Logged
mousethief

Ship's Thieving Rodent
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quote:
Originally posted by christianjimmy:
As far as I remember from my Psych. degree, the reason why Ritalin (as a stimulant) worked was that effectively it over-stimulated the brain, leading to reduced levels of activity across the board.

Except that this rarely happens with non-ADHD kids. Either the stimulant does nothing, or it sends them pinging off the walls. There's a reason stolen Ritalin prescriptions are sold on the street, and it's not because they calm people down.

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This is the last sig I'll ever write for you...

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Spong

Ship's coffee grinder
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quote:
Originally posted by Telepath:
And as for the sexism of it all - it couldn't be that girls and women are just being left undiagnosed in unknown numbers, could it?

Or it could be genetic. As I said earlier, there seems to be some connection with autistic spectrum disorders, and they are about five times more common in males than females.

ASD diagnosis is also increasing similarly spectacularly. There's a lot of disagreement about whether this is a genuine increase in numbers or just a reduction in previous underdiagnosis. However, the 'blame it on the parents' approach does echo the 'refrigerator parenting' that was supposed to be the cause of autism thirty years ago.

Spong

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Spong

The needs of our neighbours are the needs of the whole human family. Let's respond just as we do when our immediate family is in need or trouble. Rowan Williams

Posts: 2173 | From: South-East UK | Registered: Oct 2001  |  IP: Logged
christianjimmy
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# 1820

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quote:
Originally posted by Mousethief:
quote:
Originally posted by christianjimmy:
As far as I remember from my Psych. degree, the reason why Ritalin (as a stimulant) worked was that effectively it over-stimulated the brain, leading to reduced levels of activity across the board.

Except that this rarely happens with non-ADHD kids. Either the stimulant does nothing, or it sends them pinging off the walls. There's a reason stolen Ritalin prescriptions are sold on the street, and it's not because they calm people down.
Sorry, yes, should have said, (AFAIK) it over-stimulates the brains of ADHD kids because their brains are at an already elevated level of activity, so further stimulating it sends their already heightened level of activity into overdrive, and thus smothers the effects of hyper-activity. With non-ADHD kids (with lower base levels of brain activity) it just sends them wild.

And yes, there is quite a market for stolen Ritalin prescriptions in certain playgrounds around the US and UK...

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[on discovering that 'Happy Birthday' was composed in 1924]
Alan Davies: What did people sing in 1923, for goodness' sake? They got the cake out and everyone just stood about in a slightly awkward silence?

Posts: 411 | From: That small insignificant country next to Wales... | Registered: Nov 2001  |  IP: Logged
Karl: Liberal Backslider
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Which is strong evidence for the existence of ADHD - give Ritalin to someone who doesn't have it, and they become more hyper and uncontrollable.

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Might as well ask the bloody cat.

Posts: 17938 | From: Chesterfield | Registered: May 2001  |  IP: Logged
Telepath
Ship's Steamer Trunk
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originally posted by christianjimmy:

quote:
And yes, there is quite a market for stolen Ritalin prescriptions in certain playgrounds around the US and UK...
So I hear, and I can't imagine anything more pathetic. It reminds me of Adrian Mole getting his Airfix plane stuck to his nose when he decides to try his hand at glue-sniffing.

Originally posted by Karl:

quote:
Which is strong evidence for the existence of ADHD - give Ritalin to someone who doesn't have it, and they become more hyper and uncontrollable.
Or they might not. They might clean off the top of their desk, sharpen some pencils, and settle down for a nice evening doing their taxes. You just don't know.

That's why it's not recommended to try and diagnose it by giving the patient some Ritalin and seeing what happens.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

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Bishop of Stortford
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quote:
Originally posted by christianjimmy:
it over-stimulates the brains of ADHD kids because their brains are at an already elevated level of activity, so further stimulating it sends their already heightened level of activity into overdrive, and thus smothers the effects of hyper-activity. With non-ADHD kids (with lower base levels of brain activity) it just sends them wild.

[/QB]

Hmmm.. I've been reading up on this, and what I have read is that the brain of an ADHD child is not over-active. It's the body that's over-active because the part of the brain that regulates active behaviour is not working properly. Ritalin is supposed to work by stimulating the inactive brain, which allows the child to control themself. Is that correct, or not. Or is it all just a question of un-provable theories?
Posts: 176 | From: Bishop's Stortford, Hertfordshire, UK | Registered: Mar 2004  |  IP: Logged
Karl: Liberal Backslider
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quote:
Originally posted by Telepath:
originally posted by christianjimmy:

quote:
And yes, there is quite a market for stolen Ritalin prescriptions in certain playgrounds around the US and UK...
So I hear, and I can't imagine anything more pathetic. It reminds me of Adrian Mole getting his Airfix plane stuck to his nose when he decides to try his hand at glue-sniffing.

Originally posted by Karl:

quote:
Which is strong evidence for the existence of ADHD - give Ritalin to someone who doesn't have it, and they become more hyper and uncontrollable.
Or they might not. They might clean off the top of their desk, sharpen some pencils, and settle down for a nice evening doing their taxes. You just don't know.

That's why it's not recommended to try and diagnose it by giving the patient some Ritalin and seeing what happens.

I understand from Mrs Backslider that this is what happens when kids without ADHD are misdiagnosed and given Ritalin. It doesn't happen that often, but when it does, that's what happens.

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Might as well ask the bloody cat.

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Bartolomeo

Musical Engineer
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I am too old to have been diagnosed with ADHD although in retrospect it most certainly had to have been a major factor in my struggles in school. I remember trying to complete math tests and being the only one in class unable to complete them in the prescribed amount of time. The problems were easy enough, but I couldn't concentrate long enough to finish the test. It started in first grade and continued at least through early adulthood.

I am confident that with today's understanding I would have been diagnosed and treated, and that my life would have been the better for it.

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"Individual talent is too sporadic and unpredictable to be allowed any important part in the organization society" --Stuart Chase

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Josephine

Orthodox Belle
# 3899

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quote:
Originally posted by Bishop of Stortford:
I've been reading up on this, and what I have read is that the brain of an ADHD child is not over-active. It's the body that's over-active because the part of the brain that regulates active behaviour is not working properly. Ritalin is supposed to work by stimulating the inactive brain, which allows the child to control themself. Is that correct, or not. Or is it all just a question of un-provable theories?

No, you're absolutely right. This article explains that the evidence base strongly supports the idea that ADHD is largely the result of having smaller and hypo-functional lateral prefrontal cortices.

This article, which is a bit more "layman friendly," says:

quote:
ADHD sufferers had less activity in the right frontal lobe of their brains than those without the disorder.

The area of the brain that is less active in children with ADHD is part of an ‘Attention network’. This network is activated by people without the disorder in order to concentrate or control themselves. The particular brain region seen to be underactive in people with ADHD normally grows and becomes more active with age. However, in children with ADHD it does not seem to mature so quickly.

The so-called paradoxical effect is a result of the fact that the part of the brain that allows you to inhibit response -- allows you to choose not to pay attention to something, not to say the first words that popped into your head, not to move when your body wants to move -- is under-active. When you stimulate that area of the brain, it allows you to inhibit inappropriate behaviors and inappropriate responses to distracting stimuli.

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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!

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Lumpy da Moose
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To my own peril, I'm going to post without reading all the 3 pages of postings already; I will attempt to address some of what the OP was looking for.

In my experience, I suspect that a lot of parents are looking for ways of dealing with boisterous children without having to actually assert some discipline. This is NOT always the case, but I think there is a tendency to want to medicate rather than deal.

Those of us who are ADD/ADHD and/or have children with the affliction can definitely tell you that it is NOT an imaginary disorder. I have been through it as a child, back when methylphenidate was considered a bit of an experimental treatment for the affliction. I very clearly remember hearing the word "hyperkinetic" applied to me and/or my behavior. I also remember very clearly how easily I was distracted by such seemingly simple things as the patter of classmate's shuffling feet while in the classroom; it is a memory snippet that is quite clear even today. There were other such things as hearing the birds sing, or watching the rain. I remember distinctly my exasperated boredom at having to fill out a sheet with 100 squares each number 1-100, for probably the 4th or 5th time in the first grade. I had successfully completed the task the first time-- let's move on! Most of my school years (and a LOT of my adult years) were filled with boring repetetive tasks which I already mastered easily. I had a tough time sitting still (sometimes still do, but now I can get up from the desk without getting yelled at), and was out of my seat a lot. I had an exceptionally difficult time working on things that required an extended amount of concentration and that I was not interested in such as math. I could sit and read interesting books for hours and often my folks had to make me go out on play. I do NOT remember actually taking anything for this as a child, though my dad claims I did. I asked him if it worked, and he said, "Oh yeah." It must not have been for very long term, more than a few weeks at most or I would remember it.

I saw almost all the same behaviors in my son as he grew up. This was NOT from environment, as his mom and I divorced when he was 2 and he lived primarily with her. He would spend visitation time with me, but not the ins and outs of everyday life. When he was attending a small private Christian school and had smaller classes, the teacher there tapped his energy to help with other students or get put on special projects. When he began to attend public school where such activity appears to be frowned upon, he ran into disciplinary problems. We did the whole gamut of testing and finally tried him out on Ritalin. Seemed to work OK for him without too many side effects, though he would get a little whiney or weepy when he "crashed" at the end of the day.

Currently, my youngest stepson has the "H" part of it real bad. He does tend to get a bit zombie-like when medicated (which I didn't notice with my own son, btw). He really is a kid out of control and no amount of disciplining works with him. He just doesn't remember being told not to do something you pointed out to him 10 minutes ago. Yet he tests as above-normal in intelligence and has an extensive vocabulary for a 7 year old. As in my oldest (and me), things that interest him can hold his attention for hours-- a good dinosaur book, cetain movies, GameBoy, whatever. Sit him down to do his homework and you almost have to shackle him to the desk, and even then unless the place is silent as a tomb anything will distract. Medication does tend to help him here, but he takes enough that it takes away his appetite and he doesn't eat much. My stepdaughter who is 11 should be taking her Straterra (and refuses vehemently to do so-- everything makes her barf, so she says) and needs it because she too is very scatterbrained and could come in the house with her books, drop them on the floor, and then claim she has "no idea" where they are-- she dosn't remember bringing them home. She also has an extremely difficult time with doing homework. The middle stepson is just now 15 and getting more focused, but he has trouble from time to time. Mrs. Lumpy is the only non-ADD/ADHD one of the bunch and I'm sure we all drive her up the wall on occasion.

I can tell you for certain about the children under my care that not one of them has been misdiagnosed or given meds just to shut them up. I know my son gets his honestly from me. I don't know my other kids dad well enough to say for sure, but Mrs. Lumpy claims that he has those tendencies as well.

As for "medicating your kids will make them drug users," I think this is a load of dung. Matter of fact, I read in one of the many books I've been through on this subject that NON-medicated ADD/ADHD kids tend more toward drugs looking for some calming effect on their restlessness. I can say this certainly resonates with me, as I would suggest that was my experience. Meditation, btw, did not work very well for me. It wasn't until I was in college for the third time that someone turned me onto illicit amphetamines and I found I could actually snap off the distractions and really dive into my work, whether it be a mid-term exam in math-for-dumb-English-majors or when putting together my term paper for my lit. class. That right there speaks volumes.

I spent many years berating myself for not being able to just do "normal work" like other kids were easily able to do. I didn't and don't want my kids to face that same issue which will follow them all the rest of their lives.

I don't doubt there are a lot of people seeking to get their kids medicated so they don't have to take responsibility for them. However, there are some who really do need the help.

And that's all I have to say about that. [Biased]

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member, Our Ladye of the Bandwidthe and All Angels

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Telepath
Ship's Steamer Trunk
# 3534

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Originally posted by Lumpy da Moose:

quote:
In my experience, I suspect that a lot of parents are looking for ways of dealing with boisterous children without having to actually assert some discipline. This is NOT always the case, but I think there is a tendency to want to medicate rather than deal.
To be pedantic, the first choice of such parents was probably to do nothing, rather than deal. It takes effort to get to the medication, after all. Why crawl over a mile of broken glass if you can tolerate just sitting in the same spot?

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

Posts: 3509 | From: East Anglia | Registered: Nov 2002  |  IP: Logged
Horatio Harumph
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# 10855

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quote:
Originally posted by Telepath:


To be pedantic, the first choice of such parents was probably to do nothing, rather than deal. It takes effort to get to the medication, after all. Why crawl over a mile of broken glass if you can tolerate just sitting in the same spot? [/QB]

ouch ouch ouch ...

do you seriously think thats the case?

that is seriously harsh!

I have a whole range of things I want to type in the response to that commment AND the one that was in reply to, But I am gonna be sensible, go away and think on it before I post, because I am so wound up at the moment, that people make those sort of assumptions that I would probably break the rules if I were to post right now.

Lookin

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Chocolate is proof that God wants us to be happy.

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Telepath
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I think it's the case that if there exist parents who medicate but do nothing else to deal with the problem, there are probably also parents who don't even medicate to deal with the problem.

It isn't particularly easy to get diagnosis, to get treatment subsequent to diagnosis, and to maintain the treatment once you've got it, and I would not be surprised if some parents chose to deal with the problem by doing nothing at all. And why should they when they're only going to get a big pile of hassle, suspicion and societal condemnation for their trouble?

The only reason to bother in the first place is if the difficulties have escalated to the point where they're forced to. Some parents' lives may never be made so uncomfortable that it forces them to act. (This is not the same as making a conscious decision to pursue no treatment of any kind, BTW, which may or may not be a good decision in any particular case.)

I don't see why that's harsh, I just think it's realistic.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

Posts: 3509 | From: East Anglia | Registered: Nov 2002  |  IP: Logged
AFSkypilot
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# 10498

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I have to say that I disagree any attempts to use medication just "to control the kids."

The way I approach the problem is to try to use some simple disciplining techniques by teaching parents--and teachers--the belief behind most misbehaviors and suggesting ways to counter the misbehavior mostly by allowing the kids to experience the consequences of the behavior they chose.

Someone much earlier said ADHD is a rule out diagnosis. Not exactly. If a child is acting out many different things should be considered before arriving at the ADHD diagnosis: diet; environment; history of abuse; family history--most importantly history of alcohol/drug abuse in the family. A complete physical and psychsocial assessment should be done. If there is no other explanation for the acting out, try giving a mild stimulant, such as coffee to see what the reaction is.

Even if it is determined that a child does have ADHD and a medication is chosen, child and family therapy is still important to help the child learn to make more responsible decisions.

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AFSkypilot
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May I make a suggestion?

For those who might want to learn more about this disorder, go to: CHADD

Posts: 130 | From: Land of the Cougars | Registered: Oct 2005  |  IP: Logged
Telepath
Ship's Steamer Trunk
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AFSkyPilot, good points, though I would like to make the point that ADHD does not solely manifest itself in misbehaviour.

I know you are not doing this, AFSkyPilot, but a lot of discussion about ADHD is couched in terms of what the observer wants and expects, whatever that is.

When you take all this away, the person with ADHD is still there, still has ADHD, and might still need help in terms of what they want, not only in terms of how they affect others.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

Posts: 3509 | From: East Anglia | Registered: Nov 2002  |  IP: Logged
Beautiful Dreamer
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This is to the OP

I have heard of ADHD and I can say that it is very real. It is more than just not being able to sit down when told to, it is more like not being able to concentrate on anything even if you want to. Adults can have it too. I know, I am bipolar and we have a lot of symptoms in common. If someone has ADHD, they can benefit greatly from medication and therapy.

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More where that came from
Now go away, or I shall taunt you a second time!

Posts: 6027 | From: Outside Atlanta, GA | Registered: Jan 2006  |  IP: Logged
Josephine

Orthodox Belle
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AFSkypilot, why would you assume, if a child is having difficulties, that the parents need to be taught "simple disciplining techniques" and that the main things to consider are "diet; environment; history of abuse; family history--most importantly history of alcohol/drug abuse in the family"?

I ask because that's the sort of stuff we kept hearing, until we finally got Littlest One to an incredible neurologist who was able to identify the root causes of his behavioral difficulties. It wasn't that he was oppositional, or defiant, or making bad choices. He was refusing to do things that were, in fact, impossible for him to do, because of his complex neurological impairments. But no one at the school, and no one involved in mental or behavioral health, ever considered any possibilities other than lousy parenting and a kid who made bad choices.

Are mental health counselors taught to look for signs of sensory or motor impairments, or to consider the effects of disability on behavior?

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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!

Posts: 10273 | From: Pacific Northwest, USA | Registered: Jan 2003  |  IP: Logged
Telepath
Ship's Steamer Trunk
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Well, Josephine, we've got to be clean-living model citizens because the normal folk have outsourced their Puritan guilt onto us [Big Grin] We have to do all the weight training, and the Seven Habits, and the nourishing yet thrifty menu plans, and the one-and-only one elegant glass of red wine with our organic supper (for the good of our arteries), and the life coaching, and the soothing yoga, and the wholesome family board game night, so they don't have to.

As a reward, we get to write all the beautifully penned thank-you and condolence letters that normal people don't have time to write because they have to watch telly and drive cars, and grownup stuff like that [Killing me]

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

Posts: 3509 | From: East Anglia | Registered: Nov 2002  |  IP: Logged



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