All Articles tagged ‘adolescents’

What Is The Cinnamon Challenge?


I’ve been mentioning the cinnamon challenge in clinic with my teen patients after I learned about it earlier this month. Read this nice summary. The challenge is to swallow a teaspoon of cinnamon in less time than it takes me to explain what it is (60 seconds). Reality is, my patients tend to know about the challenge, but their parents don’t. I usually talk about it along with a whole list of other topics while their parents are out of the room (bullying-the choking game-sex-drugs-violence-texting & driving or other threats to their safety). Recently, a patient was able to explain the challenge to her mom with me in the room right after her mom returned and joined us. We discussed the reasons the cinnamon challenge can be life threatening and stupid.  Teens don’t want to get hurt, but they really do want to be strong, and ohhhh, competition is seductive. Teens (like most grown-ups) love to preserve that feeling of invincibility. Precisely why the challenge has caught on.

The cinnamon challenge has its own website and has gone viral with the help of social media. The topic has been viewed online more than 60 million times with some pages boasting over 10,000 “likes.”  The reason? The challenge itself is so visual and so inexpensive to replicate, teens are capturing videos of the challenge and putting them on YouTube, Facebook, Twitter and on their phones. Pretty funny, right?

This is the part where I sound like a doctor. The dangers from the cinnamon challenge are real; multiple children have been hospitalized. Some children have had serious complications including loss of consciousness, collapsing lungs, ICU care, and days on a ventilator. Cinnamon is easily aerosolized but not easily dissolved. Once it lodges into tissue, it can cause great havoc and remain there. Coughing while gasping and/or choking on cinnamon can cause it to be easily inhaled or aspirated or swallowed leading into tissues in our bodies. We worry most about it collecting in the lungs.

The challenge is real. The side effects even more so.


Sudden Cardiac Death: What Parents Can Do

As a parent and pediatrician, any mention of sudden cardiac death leaves me feeling uneasy. The stories of young athletes dying or falling on the field are agonizing. All of us here on earth would like to do something to prevent these deaths.

Researchers and cardiologists are working tirelessly to understand predictors for sudden cardiac death in children alongside techniques to improve screening and prevention for young athletes. Dr Nicolas Madsen talked with me about recent work here in Washington State. There’s a video at the end of this post from the interview. I’m lucky, I met Dr Madsen when he was a medical student and now he’s an old friend. He’s one of those bright lights: a compassionate physician and father of three who just gets it and wants to solve big problems. He’s about to finish his fellowship here in Seattle and while completing his training, he’s uncovered some holes in the system. He’s helped me understand how to screen children better. As a parent, there are some simple things you can do to improve the screening your child receives prior to athletic participation.

“Sudden Cardiac Death is a needle in a haystack, but a very sharp one.” Read full post »

5 Things I Say (In Clinic)

Five things I say in Clinic (in no particular order). After reading this, you’ll be all set for Family Feud when the category is Things Pediatricians Say.

Number One: I’m so sorry you’ve been waiting for me.

The reason is often varied. I’ve not been picking my nose or even doing something as productive as blogging. Usually I’m running behind because a patient or two arrived tardy for check-in or I’ve had to return a call to a doctor at the hospital or a family needed more time for an urgent health concern or a patient scheduled an appointment to talk about one thing (say a medication refill) and then wants to talk about three things like starting birth control or their struggle with obesity or a new challenge at school or a rash or because I needed to “double book” a sick infant who needs urgent care. The reasons are unpredictable, clearly, and I hate to make anyone wait, but I also hate to have families leave without comprehensive care. I work my tail off (as do my magical medical assistants) to stay on time, yet inevitably I am set up to fail. It’s an unusual doctor who never runs even a minute behind in a general pediatric practice. I sincerely hate to have people wait for me, as it’s a huge added stress for us all. Starting all visits with an apology makes for a terrible day. So next time you find yourself stuck in some waiting room with your toddler (+/- your 3 other children) and you’re going bananas, know that when your child needs the extra time or attention, they’ll get it, too. And if they never do—lucky you. Read full post »

Plan B Back Behind The Counter

I was disappointed to hear the news that Kathleen Sebelius blocked the FDA’s recommendation to make Plan B available to all girls, over-the-counter (OTC). Plan B is an oral tablet containing hormones (similar to what is in a birth control pill) that when taken within 1 to 3 days of unprotected sex, can prevent an unwanted pregnancy. It is used as a back-up birth control. Primarily, Plan B works to delay ovulation thus making it less likely that a girl could be pregnant. Effectiveness increases the earlier a girl takes the pill after unprotected sex, so we want sexually-active teens to have it on-hand, just in case.

When it comes to Plan B, timing is everything.

Girls 17 and up can get Plan B for about $50 without a prescription. They can walk into any drug store, head back to the pharmacy counter, show an ID and purchase the pill to prevent a pregnancy. Those 16 years-old and under cannot; they must see a health provider to get Plan B. Trouble is, not every girl can see the physician when they want. Many girls at risk for an unwanted pregnancy may not have access to a clinician immediately or within a day or so. Further, girls may be too embarrassed or concerned about judgment to talk with their parent. And that’s where I start to worry; an unintended pregnancy can have significant physical and emotional health consequences.

Let me be very clear: I’m all for girls seeing their pediatrician for health advice. Read full post »

California Bans Indoor Tanning

Atta girl, California. This week Governor Brown signed a law making it illegal for children under age 18 to use tanning beds. No doctor note, no parent note, or any other paperwork necessary. It’s a real ban and it’s the strictest law in our nation. While 30 some other states have laws limiting indoor tanning use by minors, no other state has banned the use of indoor tanning for minors entirely. Although many professional groups have urged for a tanning bed ban, it has taken some time to get this trend started. Only 49 states to go.

I see patients in clinic nearly every week who visit indoor tanning beds. Their parents go sometimes, too. And we know that’s a huge reason some teens start tanning. So why the rule and why the necessary seemingly rigid law? Watch the video above and put it on your Facebook account. Show it to your children or your nieces, nephews, or neighbors. Read my take:

Teens and Tanning:

A study back in 2002 surveyed kids from all 50 states to determine (risky) behaviors increasing the odds of skin cancer. The findings were fairly grim. Over 80% of teens reported having a sunburn in the prior year and over 1/3 of them had experienced 3 or more burns. We know one bad sunburn in childhood dramatically increases the likelihood of a skin cancer later in life. Further, one out of every 4 teen girls between 15 and 18 years of age reported indoor tanning bed use. And worse, as teens get older, they use indoor tanning more: the rate of indoor tanning doubles between age 12 and 17. The reality is, teens won’t prioritize skin health so you may have to help. Some suggest using the argument for preserving beauty (“Sun damage gives you wrinkles”) is more powerful than using the argument for preserving life (“Sun damage may give you a skin cancer that kills you”). Read full post »

One Family Meal, A World Of Difference

Good Reads (Data) On Family Meals:

Correlations Between Family Meals and Teen Well-Being

Adolescent Risk and Mealtime Routines

Don’t have 100 or so seconds? Here’s the Cliff Notes on what I said:

Family meals matter. Not because of the fruits and veggies but because of the communication that occurs. Any meal can be a family meal (breakfast on Tuesday or supper on Sunday). Don’t think only about dinner. Aim for 100% of your family at these precious events, but I say anything over 50% will make a difference in not only your child’s, but also your life.


Seattle Mama Doc 101: What is the Choking Game?



Seattle Mama Doc 101: Teen Texting when Driving

Social Media: Where We Are

Social media is a part of the majority of our lives. A recent poll found that nearly 80% of mothers (with children under 18) were using social media. And it turns out if you’re over the age of 11 or so and live in the United States, you may be more likely to be involved in social media than an organized sport. As adolescents work to define their identities, they are doing more and more of this “work” online. Adding to the long list of things to talk about in the 15-20 minute check up with your doctor, social media and the use of new media technology is moving closer to the top of the list. It’s obvious but not necessarily instinctive. On a typical day in clinic, I have to ask a patient to put down or turn off their phone to talk with me. Plenty of teenagers think it’s perfectly normal to text or surf while talking with their doctor about birth control or concussions or vitamins or driving. Some parents do, too.

This month, an AAP report was published urging pediatricians to be involved in discussions with families about where we find ourselves with social media. The lead author, Dr Gwenn O’Keefe, wisely explains that social media has moved past being a technology issue and started to become a health issue. I entirely agree; simple math tells us that when we’re spending hours every day existing on social networks, it will inevitably affect our health. As you know, I’m an evangelist of social media for social change. My take is not that social media is all bad for me or for children and families. But it’s not all good, either. Clearly when you capture over 500 million peoples’ attention (Facebook), you’re onto something relevant.  Social media really is social and can help plenty of teens connect with peers, improve their technical skills, and augment their communication skills. Yet, of course, like anything in life, when moderation goes out the window, so does the pure benefit. Here’s an outline of the report and rationale of why I believe you, as a parent, should get involved with social media and why it matters. Read full post »

Atta Boy, Coach Madden

I believe all media is instructive. I know we (adults and children) learn about health care when watching (reruns) of ER, Scrubs, or Grey’s Anatomy nearly as much as we do from the nightly news, Dr Oz, or our newspapers. And although entertainment may not feel instructive, I know it is. Media, from what’s online, to what’s on the television, to what’s on your phone, to what’s in your Xbox, informs and instructs. I don’t care how you cut it, I believe that every second of media produced has the potential to make change and educate. That’s why I’m so pleased to have heard some news. The husband pointed out that ESPN announced last week that Madden NFL 12, a hugely popular video game (5 million copies sold of the last edition alone), is about to have some new rules. And a new role.

It turns out, Coach Madden (a giant in football) is really putting money where his mouth is, working to educate and make change. EA Sports announced that their newest version of Madden NFL (12) will now incorporate new rules surrounding concussions and play. The game, coming out August 2011 (regardless of player lockout) will emulate the real game. When a player gets a concussion, they are not only out for the remainder of the game, the announcers will explain that the player was removed because of the seriousness of head injuries. The new video game will also block the ability for players/avatars to make helmet-to-helmet tackles, dangerous headfirst tackling, and hits to the heads of defenseless players.

I don’t play football and I don’t play video games, but I do know that: Read full post »