‘teens’

All Articles tagged ‘teens’

Plan B Approved For All Girls 15 And Older

Posted on April 30, 2013 in: Teens7 Comments

Chosing Plan BThe FDA announced today that it is approving Plan B for all girls age 15 and up without a prescription.

This is good news for girls in the US of A. The easier the access to contraception, the less likely girls will have an unintended pregnancy.

As many as 80% of pregnancies in teen girls in the United States are unintended. 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). The birth rate for 15 to 19 year-olds is 34 out of 1000 and although only 13% of 15 year-olds say they have had sex, by the time children head out the door to adulthood, the majority (70%) say they have had sex.

Allowing the majority of teens access to Plan B seems a great step in the right direction in avoiding unintended pregnancies. I was thrilled to see the news tonight about the FDA shifting the age from 17 years down to 15 years. Some 10% of teens report being a victim of sexual assault, putting them at risk for unintended pregnancy.

The Academy of Pediatrics’ policy on emergency contraception has provided comprehensive insight on understanding, prescribing, and using emergency contraception.
Read full post »

About Violent Video Games

Posted on January 16, 2013 in: School Age, Teens7 Comments

“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 »

Going Back To School Monday

Posted on December 16, 2012 in: Parenting5 Comments

Sick day alleyAs Monday approaches and we ready our children for school, I would suspect most of us have a little bit of dread in our hearts. I do. There is unease as we return our children to school. This post covers information for supporting your children but also information on supporting yourself during these upcoming days, too.

The past few days have been bewildering. Making sense of the tragedy in Connecticut is a huge challenge, particularly as the details of the shooting simultaneously unfold along side the details of the beautiful lost children and teachers and protectors. There’s little to say more than this is tragic and head-shaking. There is just no sense to what unfolded here in America last Friday. And although there are stories of incredible heroism we are left mourning and aching.

In my 4 years using social media, no single topic has over-run my channels like this shooting. We are all aghast and terrified, sad and stunned. As President Obama said, “We’re heartbroken.” When I opened the Sunday New York Times this morning, I gulped and teared-up again—I simply couldn’t wrap my head around the number of 6 and 7 year-olds that we’ve lost. Especially as one sat next to me at the breakfast table.

The randomness of this event allows us all to relate to the details of the horror and loss with uncomfortable familiarity.

We can and will work towards a safer future for our children. Don’t ease up on yourself or those in your community for action–improved communication, access to mental health, examining gun control–as months unfold. The future comes quickly. Today and tomorrow are about the ongoing effort to bolster yourself and your child in feeling great about the days ahead, in and out of school at the mall, wherever you find yourselves.

Tips For Parents With Children Going Back To School

  • Your child’s school is safe. The fact remains that this random, horrific shooting is an anomaly. Your child’s school is a very safe place to be. Remind yourself, and your children if they ask, that this tragedy was an exception.
  • Get the information you need to feel safe this week. Send an email to the principal, your children’s teacher, and/or fellow parents–perhaps commit to participating in ensuring you have good safety measures in place at your school. Leaving a VM message, sending an email, and/or joining the community of families wanting to ensure safety as the days unfold will likely ease your fears. Get involved. Write a letter to The President (The White House/1600 Pennsylvania Ave NW/Washington, D.C. 20500) or your congressman. Action is an antidote to anxiety. Read full post »

HPV Shot Doesn’t Trigger Teens To Have Sex

Posted on December 11, 2012 in: Teens, Vaccines7 Comments

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 »

Aurora Shooting: What We Can Do

Posted on July 20, 2012 in: Parenting3 Comments

It’s almost a relief that it’s summer vacation. For the sake of our children, I mean. The buzz about the horrific, deadening, jaw-dropping news regarding the massacre in Colorado may be slightly less focused at the center of their lives–they’re not congregating in the hall or at recess. Well, maybe. That’s the difference between 1999 and 2012–back when Columbine happened we all watched as television detailed the horrific events of a school shooting and the radio reported on the lockdown and a mourning community—but our children and teens weren’t on Facebook or Twitter or Youtube then. The stories weren’t quite as accessible–they weren’t in our pockets. Now we’re texting and streaming one video after another.

All this bad news takes its toll on us. It endorses the curiosity we have about tragedy and violence and it can trickle into present repeatedly. At some point, part of how we help our children and teens cope is by facilitating digital breaks. Unplug the phone, log off Facebook, and help your children mourn offline, understand how it may affect their plans, and encourage them to reach out for face-to-face support networks.

I agree with the American Academy of Child and Adolescent Psychiatry:

 There are no ‘right’ or ‘wrong’ ways to talk with children about such traumatic events.

The 24-news cycle is amped-up, accessible, and ever-present. It fills us with information by the second & minute, not the hour. Our children and teens learn, hear, and spread responses with unparalleled rapidity. Never before did we consume media and news like we do today. Even daily hours of television viewing are increasing. We’ve also piled our digital time on top of it.  This tragedy seeps into our centers.

After a cafe shooting here in Seattle in June and ongoing mass shootings throughout our country, I think we’re profoundly scared. Our culture encourages and enjoys violence in movies and video games. Shootings are glorified and little babies and children bear witness to death (at early ages) via digital & traditional media and advertising. The NRA fights to keep guns accessible. Politicians have attempted (and failed) to censor conversations about gun safety in the pediatrician’s office. Even today, influential leadership avoids discussions about gun control. All this and then we chat, talk, tweet, stream, and absorb violence with a hunger. It’s just so horrifying that sometimes it’s hard not to watch. We follow along in bed, on the bus, in our cars (!), and during our face to face time with loved ones and family. This news is upsetting and torrential. Many of us are left feeling a bit helpless or vulnerable. So are our children.

Now is the time to be assertive with your children. Listen more than you talk. And maybe commit to turn off your phones as much as you can.

7 Tips To Support Your Children After The Aurora Shooting

  • Hearing about events like the massacre in Colorado makes us feel increasingly vulnerable. Read full post »

Idaho: Vaccine Safety, A Desert, And A Networked Community

Posted on May 2, 2012 in: Doctoring & Healthcare, Vaccines9 Comments

I’ve just returned from a week in Idaho where I had the privilege to do a series of talks for the Idaho Department of Health (DOH) about using social media to communicate about vaccines. The best part of the week was all of the education I received. I traveled around the state (see those photos!), witnessed the DOH at work, connected with Idaho physicians & politicians & advocates & volunteers, and talked with many Idahoans about changing the understanding of vaccine science. Three times I heard Dr Melinda Wharton from the CDC present on vaccine safety. And more, in a matter of 4 days we talked with a clinician, nurse, or medical assistant from every single office in the state that provides vaccines to children. I mean, that’s a wow–a sincerely networked community circa 2012.

If all states had the opportunity to convene like they do in Idaho we’d really improve understanding, communication, and opportunities in health care surrounding vaccine safety and decision-making.

After arriving home to my boys, I’m compelled to share 3 things I learned in Idaho:

ONE:

I think it’s essential that we talk about the risks associated with vaccines when we give them–each and every time. Dr Wharton discussed known risks to vaccines and the science to support those risks. She also talked about inferred risks that aren’t backed up with science (autism, for example).

Take fainting: we know teens faint after shots sometimes. Read full post »

If It Were My Child: No Football For Now

Posted on April 9, 2012 in: If It Were My Child, School Age, Teens23 Comments

This is a position post where I take a stand that represents no one other than myself as a mom and a pediatrician. The reason I clarify this, is that my position is a strong one. No one wants to go up against someone like the NFL, it seems. But let me say this very clearly: It if it were my child, I’d never let them play football. No way. For my boys, the risks are too large, the sentiments too cruel, and the gains simply not worth it. There are plenty of other sports teams out there to grow, exercise, form friendships, and excel. I never want my children to be a part of any institution that houses intent to harm another human being. Although direct harm may not be a tenet in pee wee football, we all know that young sports teams are built to emulate the pros. If the NFL is the inspiration, for now, count my boys out. This isn’t just about the risk of concussion…

On my way into clinic on Saturday morning, I heard the alleged tape of Gregg Williams directing players to seriously harm opposing teammates. In the tape Mr Williams, the previous defensive coordinator for the New Orleans Saints, employed his players to inflict harm on multiple players–for example, attempt to tear the ACL of Michael Crabtree and work to re-concuss another player, Kyle Williams. Let me point out, some data finds the harms of concussions (particularly in adolescents) may be longstanding, and the risk of a second concussion may rarely be deadly.

In the tape you hear Gregg Williams repeatedly say, “Kill the head, the body will die” followed by, “We want his head sideways.” The tape goes on to capture more directives for harming additional players. It’s nauseating and provoking–got my fingers shaking during my drive. And really more than anything else, it was wholeheartedly disappointing. Particularly for me as a pediatrician. When parents now ask me about football, instead of talking about concussions as a significant risk, I’ll also be talking about ethics, sportsmanship, and integrity.

The great thing is that as parents we have lots of choices. Read full post »

What Is The Cinnamon Challenge?

Posted on March 28, 2012 in: School Age, Teens4 Comments

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 in the above video (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.

Watch the 60-second video above. Check in with your school-age or teen child and explain the facts. Find out what they think about it and stop the allure of the cinnamon challenge now.

Sudden Cardiac Death: What Parents Can Do

Posted on March 23, 2012 in: School Age, Seattle Mama Doc 101, Teens23 Comments

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 »

Reading A Growth Chart: Mama Doc 101

Posted on February 20, 2012 in: Infant, School Age, Seattle Mama Doc 101, Toddler13 Comments

Parents, pediatricians, and nurses have been using growth charts since the late 1970′s to track growth in their infants and children. The charts were revised back in the year 2000 as the data for the first charts (from a small study in Ohio) that didn’t accurately reflect the cultural and ethnic diversity of our communities.

The hallmark of a well child check is the review of a child’s growth. Growth can be a reflection of a child’s overall health, nutrition, and/or tolerance of possible underlying medical conditions. So understanding what your doctor or nurse practitioner says about your child’s growth should be a priority.

Watch the video to learn more about interpreting growth charts.

If your doc doesn’t have a computer in the room, ask to see the chart (on paper) or on a computer in their office. It will not only inform you, I suspect it will delight you to see what your child has done since the last time they have been seen.

The human body really is a fine-tuned machine and growth is simply astounding if you really stop to think of it.

If you have a challenge understanding how your child is growing or how the growth chart is presented, demand clarification. It’s okay if you don’t understand the presentation of facts on these grids; have confidence to speak up and ask for the doctor or nurse practitioner to explain it.

Revisions to the growth charts in 2000

Understanding growth charts