Teens

All Articles in the Category ‘Teens’

The New Norovirus

Screen Shot 2013-02-12 at 10.27.08 AMNorovirus is a nasty one. It’s the leading cause of epidemics of vomiting/diarrhea and causes over 20 million cases of gastrointestinal disease (“stomach flu” with vomiting, diarrhea, abdominal pain, fever and achiness) in the US each year. Our experience with Norovirus historically is worse in years with “novel” or new strains of infection. Unfortunately there’s an new strain circulating around the globe. “Sydney 2012” was discovered in Australia last March and just last month the CDC officially announced it’s causing the majority of Norovirus infections. Over 1.2 million people in the United Kingdom have had it and the FDA reports this strain may potentially cause more hospitalizations. Time will tell if we have more Norovirus this year, too.

When new strains arrive, we tend to see a 50% increase in the number of cases of “stomach flu.” Norovirus is remarkably potent and contagious. It often isn’t killed by hand sanitizer (see #3 below). You touch the virus and touch your mouth and you could get it. We can get Norovirus multiple times in our lives because our immunity wanes after infection and new viral strains develop which cause unique disease. We get Norovirus from contaminated food, contaminated surfaces we touch, and from other people who vomit or have diarrhea and spread the virus. This is the cause of the stomach bug that you often associate with cruise ship outbreaks or daycare outbreaks when everyone starts vomiting one afternoon…

Around the holidays a stomach bug swept through our home. It did so for many of my patients, too. During the first week of January, I had a day in clinic where approximately 75% of the families I saw in clinic mentioned someone in their home had been vomiting over the past week. Unusual. I can’t tell you what virus it was (I didn’t test any child’s stool or vomit in the lab), but my bet is on Norovirus… Read full post »

Help Your Anxious Child: Blow Colors

This is a little trick I use to help coach anxious children whose minds just seems to “spin.” Patients have given me great feedback over the years that “blowing colors” really helps. Sometimes it’s for children and teens who can’t drift off to sleep, sometimes for those who are worriers, and sometimes for those who get anxious or overwhelmed at school. Blowing colors is a great exercise to return to regular belly breathing patterns, buy time and space for mindfulness, and improve control over feelings of overwhelm. See if it helps…

Greatest thing is–this is a good tool for a child or teen to regain control.  They can use the exercise anywhere, at any time. Lots of children and teens who get anxious feel ashamed of their anxiety and don’t want to reach out for help. Reassure them that no one will ever know they’re blowing colors or changing the hue of a room. Practice at home before bed, in school during moments of overwhelm, or even remind a child or teen they can blow colors while out with friends or at a sleepover.

About Violent Video Games

“We don’t benefit from ignorance. We don’t benefit from not knowing the science of this epidemic of violence.” Obama said. “Congress should fund research into the effects violent video games have on young minds.”

Only a month after the Newtown, CT tragedy I was pleased to hear the President’s plan today to decrease gun violence and his steadfast effort to improve the safety of our communities by decreasing violence, death, and suffering from firearms.  Delighted to hear that the government is looking to ensure that it’s safe to talk about firearm safety in the exam room (at a federal level) and also that he’s implored Congress to study the effects of video games on young minds. That being said, we do know a bit about the effects of video games on young minds. An American Academy of Pediatrics (AAP) 2009 Media Violence statement noted, “The strength of the correlation between media violence and aggressive behavior found on meta-analysis is greater than that of calcium intake and bone mass, lead ingestion and lower IQ, condom non-use and sexually acquired human immunodeficiency virus infection, or environmental tobacco smoke and lung cancer—associations clinicians accept and on which preventive medicine is based without question.”

To be clear, the $10 million that Obama is granting the CDC to investigate the effects of violent video games on our children is not a ton of money. And their tone, according to Stephan Dinan of The Washington Times places more responsibility in our hands — “But overall, the White House said that while limiting guns is the role of the government, controlling what Americans see in movies and games is best left to parents.”

As parents and pediatricians, community members and mentors, and American citizens, there are things we can do now to improve our children’s exposure to and absorption of violence.

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Thoughts On Children’s Massive Exposure to Violence

  • Data finds that witnessing violent acts in the media (in a game, TV, or video) can contribute to aggressive behavior, desensitization to violence, nightmares, and fear of being harmed. Research finds, “Consistent and significant associations between media exposure and increases in aggression and violence have been found in American and cross-cultural studies; in field experiments, laboratory experiments, cross-sectional studies, and longitudinal studies and with children, teens, and young adults. Read full post »

What To Say About Pot

Screen Shot 2013-01-10 at 5.48.25 PMThis is a guest post from Lara Okoloko, LICSW, a clinical social worker who lives in Seattle area with her husband and two young children. She is co-founder and clinical director of Center for Advanced Recovery Solutions (CARES). CARES provides respectful, solution focused counseling to the parents of addicted young people. More about their services can be found at www.caresnw.com

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Well, it’s been about a month since marijuana became legal in Washington State and we haven’t gone to pot yet, although the national news circuits may suggest so… But all joking aside, many are wondering what the impact will be for children in our state. Will marijuana use increase because it will be perceived as no big deal? Or will rates of use go down because the taboo factor will be erased?

As a therapist working with parents of teens and young adults, I know that parents already face an uphill battle convincing their sons and daughters that marijuana use poses risks to their health and well-being. My hunch is that legalizing marijuana will only increase the challenge.

Pot isn’t a rarity in high school. According to 2010 data from the Washington State Healthy Youth Survey, one in five 10th graders have smoked pot in the last month. By the end of high school, almost half of all students have at least tried it. This makes marijuana the second most used drug after alcohol. Surveys of drug use show a clear relationship between the perception of risk and the likelihood of drug use. The 2010 National Survey on Drug Use and Health found that only 1% of youth who saw great risk in smoking marijuana had used it within the last month, compared with 10% percent of youths who saw moderate, slight, or no risk. I don’t think it’s a stretch to say that legalizing marijuana will add to the perception that it is harmless, which will in turn increase the number of teens who use it.

One of the biggest mistakes parents to teens make is to believe that they no longer have influence on their kids

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People Are Dying From The Flu

Screen Shot 2013-01-08 at 12.45.43 PMInfluenza virus causes “the flu.” It’s a crummy cold that spreads easily causing high fever, body aches, runny nose, terrible cough, and rarely it can cause vomiting and diarrhea, too. The flu isn’t the “stomach flu.” It’s deadlier than that. It’s more dangerous for babies and young children, and for the elderly. It’s also particularly dangerous for those with asthma, diabetes, and people with neurologic or immune problems. This post is a bit of a plea: people are dying from the flu and there are ways we can potentially save others’ lives. Click through to read 5 myths about the flu and watch a 3-min interview I did for HLN television yesterday.

The bad news: We’re having a bad flu season. More people have the flu this year than at any time last year. This is early—flu usually peaks in Feb or March. The most dominate strain of flu that’s moving around the US is the strain called H3N2—it’s known to cause more serious disease. As of today, we have over 80% of our states reporting widespread circulating levels of flu. Here in Washington many people have been hospitalized from complications of the flu. Further, in Washington 6 people have died, one of them a child under the age of 12. A healthy 17 year-old died in Minnesota just this week. Flu is not just your “common cold,” it can be far worse. Eighteen children have already died this season. As of November, we didn’t even have 1/2 of our population with a flu shot. The goal to protect us all is 90%.

I’ve never had a family in clinic get influenza illness and then refuse the flu shot the following year.  They come in early and often for their shots. It’s that bad of an illness.

The good news: We have a vaccine for the virus that causes the flu. The flu shot and flumist nasal spray are effective and that H3N2 strain that we’re worried about, it’s in the flu shot and the nasal flu spray this year. It’s not too late to get a flu shot. You’ll be protected against the flu somewhere from 10 day to 14 days after getting it. Go out now and protect yourself and your family. By getting a shot you protect yourself, your children, and all those more vulnerable in our community unable to get the shot (those infants under 6 mo of age, those on chemo, or those with contraindications to the shot).

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You Need A Carbon Monoxide Alarm

There’s a new law today in Washington State requiring carbon monoxide (CO) alarms in apartments, condos, and single-family residences. You should have a CO detector on every level of your home (more tips below). I know you’ve heard that CO poisoning is not only dangerous but also potentially fatal. We also often hear horrific stories of accidental deaths from carbon monoxide after natural disasters. A recent study found disaster related deaths are particularly common (your power’s wiped out so you bring in a generator or grill for heating or cooking and get exposed to CO). Using a generator indoors is the most common cause of CO poisoning, followed by use of a grill. Unfortunately, over 400 people die in the US each year from CO poisoning—all of which could be avoided with proper education and detection in the home. The odd thing is that we often get to see CO toxicity play out on our favorite television shows (think Mad Men)~ the ever-again scene where someone clogs up the exhaust pipe of a car with a banana or handkerchief and dies (or attempts to) due to the toxic fumes.

One generator running inside a home, garage, or basement creates the equivalent carbon monoxide of 6 idling cars. Precisely why a generator needs to be 20 feet from inside spaces and away from open windows/doors. Carbon monoxide is found in combustion fumes–it can be produced by cars and trucks, small gasoline engines, stoves, lanterns, burning charcoal and wood, gas ranges, and heating systems. You likely know all this. But…

The thing to know: carbon monoxide in and of itself is more dangerous to babies and young children. Infants in utero, newborns, and young children process carbon monoxide differently, have more severe reactions, and may see effects faster than adults. If you and your young child were in a room that was filling with carbon monoxide, it’s your baby or child that would suffer the consequences first. They may not know how to tell you about their complaints and if they were sleeping you may not even know. Hence all of us needing a CO detector.

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The Science of Carbon Monoxide Poisoning:

The red blood cells in our blood circulate oxygen to all of our muscles and organs for survival. When carbon monoxide (CO) is in the air it can function as a disguised villain. When carbon monoxide is inhaled into the lungs via contaminated air, the red blood cell picks up the CO instead of just oxygen. Each carbon monoxide molecule that attaches to a red blood cell displaces a spot for oxygen. Therefore the circulating red blood cells go around the body without oxygen causing improper circulation. Organ failure and death can result after higher and higher level of our cells are bound to CO instead of oxygen.

The graphic is from the Centers For Disease Control (CDC)’s comprehensive review on CO poisoning.

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HPV Shot Doesn’t Trigger Teens To Have Sex

In 2006, I entered pediatric practice. It was the same year that the Advisory Commission on Immunization Practice (ACIP) recommended to start giving 11 year-old girls the Human Papilloma Virus (HPV) vaccine. Therefore, I’ve really never practiced pediatrics (outside of my training) without the ability to offer up immunization and protection against HPV virus; I’ve been discussing this for about 6 years. We now give HPV shots to both boys and girls because it’s so common–about 50% of all adults who are sexually active will get one form of HPV in their lifetime.

HPV virus can come into our body and do no harm. But it also can come into our bodies and cause vaginal, penis, anal and oral/throat warts. Other strains of HPV also cause changes in the cervix that can lead to cervical cancer and can rarely lead to penile cancer and/or tongue/throat cancer. Teens and adults can get HPV from oral, vaginal, or anal sex. Condoms don’t provide 100% protection from getting it.

GREAT NEWS: Being protected (by the HPV shot) doesn’t trigger risky sexual behaviors in teens.

Nice to have an immunization to protect against the potential development of such disfiguring, embarrassing, and uncomfortable lesions. And what a windfall to have a vaccine that prevents cancer. I often say to my patients, “If my grandmother only knew that I’d see the day where we could prevent cancer.” I mean it—if she only could have seen the day (she died in the late 1980’s).

The reality is though, parents to teenage girls have consistently been hesitant in getting the HPV vaccine in my office.  Over the 6 years hesitancy around getting HPV vaccine has lessened, but many of my patients’ parents have told me they don’t want their girls or boys to feel that getting the shots is a green light for sexual activity. And many have worried that having their girls immunized will make them more likely to engage in earlier sexual activity. Read full post »

Emergency Contraception For Teens

Stating that unintended pregnancy is a major public health problem, The American College of Obstetricians and Gynecologists (ACOG) recommended that birth control pills be available over the counter this month. And this past week the American Academy of Pediatrics (AAP) outlined use for emergency contraception use in teens girls while urging pediatricians to provide information and access to emergency contraception for sexually active teens.

All this may seem exceedingly “progressive” until you examine some of the realities. As many as 80% of pregnancies in teen girls in the United States are unintended. The birth rate for 15 to 19 year-olds is 34 out of 1000. Most pregnancies are a result of non-use of contraception or mishaps with protection (condoms breaking, pills being missed and/or forgotten or used inconsistently). We know teens don’t take their birth control as well as adults and lapses in pills or misuse can put them at risk. This is where emergency contraception can come in. I was taught how to prescribe emergency contraception to teens as a back up for contraception failure when I was in residency. I’ve been educating teens, discussing their options, and prescribing emergency contraception ever since.

What is “Emergency Contraception?”

Emergency contraception (EC) is the use of hormone pills after sexual assault, unprotected intercourse, or contraceptive failures.

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5 Things From Thing 1 And Thing 2

Truly, I’m distracted this Halloween. I think more than anything else, we should take the time (and money) today to donate to the Red Cross. Then put the costumes together. The destruction and suffering from hurricane-storm Sandy are at the forefront of our thoughts as families. For some communities, Halloween is postponed or delayed. It’s just a holiday, of course, but a big one for our children. It’s one holiday where children take center stage and create lasting memories. So I don’t want to de-value this, either — celebration is a really important part of our lives.

For those of us able to celebrate Halloween today, here’s some quick reminders. Fortunately, Halloween injuries are not all that common. A 2010 report found that there were more trips to the ER from sports injuries on Halloween than holiday ones. That being said, here are some tips I’ve read that are worth repeating.

  1. Sidewalks: On Halloween I worry most about injuries for children while walking around (getting hit by a car, tripping on a costume, or falling down), not razor blades in apples. Children are injured more as pedestrians on Halloween than from anything else the holiday inspires. When you set out with (or without) your children tonight, think about maximizing their safety on the sidewalk and on the street. Remind your kids never to believe that they are the right of way on the street. Yielding has great power and protection. Stay on sidewalks whenever you can.
  2. Be Seen: This is fairly self-evident but…..bring your cell phone, a light stick and/or a flashlight when trick-or-treating. Be seen and reachable when necessary. And remind teens about getting around while they are texting. Recent data finds teens are having more and more pedestrian injuries (up 25%), partly due to texting and walking. When distracted, they’re far more likely to get struck by a car. Read full post »

Why A Flu Shot Every Year?

We need a flu shot annually because influenza virus changes structure and shape as it moves around the globe each year. The strains that cause human disease are different from one year to the next, so we update and add to our protection annually by getting a shot or nasal flu spray. Children, especially those under age 5, are at higher risk for severe disease from influenza. In children and adults, influenza can cause a mild illness, but unfortunately, sometimes it can cause severe or even life-threatening complications. Children may have a more difficult time fighting off influenza partly because they don’t have years of exposure to other strains of flu and no real immunity built up. Therefore all children are considered a priority group for flu shots. Pregnant women, families with infants at home, and those with underlying medical problems like asthma, diabetes, or neurologic problems really need to get them, too.

It takes a well-orchestrated, worldwide effort to help predict which strains come to our country and which 3 strains are included in the annual flu shot or flu nasal spray here in The United States. The video explains more.

What You Need To Know About “Flu Season

How Experts Determine Flu Strains for Shots/Nasal Spray

Find A Flu Shot Clinic Near You

Every Year Is An Influenza Pandemic For Children (commentary)