Teenology 101

Transitioning from pediatric to adult health care: post 3

In this series on transition to adult medical care, we’ll discuss tips and strategies from parents, providers, and family advocates for those who are starting to navigate the complex process of transitioning out of pediatric care and into adult health care. Thank you to Dr Raina Voss and Joy Gehner for their help in organizing the series.

Transitioning to adult care: the story of one cancer patient and his family

In this guest blog post a family shares their story of working towards young adult self-management.

Patients who are cancer survivors, even if their cancer is cured, often need specialized medical care for the rest of their lives due to their past illness and the treatments they’ve undergone. The mother of a former Hem-Onc patient – 20 years old now – feels grateful to the Seattle Children’s Hospital Heart Center for helping launch their transition process. “They did a one-day conference, and half of it was about transition to adult care. We all went – me, my husband and my son. It was very useful, even if not everything applied to us because my son’s heart condition is not congenital.”

Due to the drugs he’d been exposed to during cancer treatment, this young man is at risk for a number of side effects that might only show up later in life, as well as for a recurrence of cancer. His long-term follow-up care as an adult needs to include awareness of this health history and specific monitoring for certain health conditions. This creates a steep learning curve for him – even more so, given that his treatment also created some difficulties with short-term memory. His mother sees careful note-taking as one skill he needs to develop, as he moves towards full independence in his healthcare management. Read full post »

Empowering your Adolescent who has ADHD

Guest Post by UW Nursing student Lauren Cohen Schorr

If you have an adolescent who has ADHD, you know that he/she reports having difficulty focusing, meeting deadlines, remembering things, consistently performing in school, and staying organized. As a result, at some point most adolescents who have ADHD have lived with feelings of discouragement and intense frustration.

Management of ADHD is not an easy task. I would know…

I was diagnosed with ADHD when I was 12 years old. As I started at a new school in an awkward phase of adolescent life, I thought “great, another thing that sets me apart from my fellow classmates”. I struggled in and out of the classroom to keep up and fit in with my peers. It took me several years to accept my diagnosis, but once I did, I decided to approach my ADHD as a challenge and opportunity rather than a roadblock. Read full post »

Managing anxiety at the start of school

Summer is in full swing, but Fall is just around the corner. As children and teens wrap up summer events and get ready for the start of school, anxiety might come up. For parents, it can be challenging to know how to support a teen who is feeling anxious about going back to school. Perhaps your teen struggled last year with missed days due to anxiety, or your teen is going to start high school and is feeling anxious because their friends are all going to different schools. No matter what the reason for feeling anxious, there are some things parents can do to help kids get ready for the return to school. Read full post »

Transitioning from pediatric to adult health care: post 2 Parent Perspective

In this series on transition to adult medical care, we’ll discuss tips and strategies from parents, providers, and family advocates for those who are starting to navigate the complex process of transitioning out of pediatric care and into adult health care. Thank you to Dr Raina Voss and Joy Gehner for their help in organizing the series.

Guest post by: Joy Gehner
Parent perspective on transitioning to adult care

When you have a child with special needs or complex medical issues, it takes a long time to learn about the care they need, and put together their team of doctors and other providers. After my daughter got her multiple diagnoses, between ages two and three, it was years before I felt like we had her full team of experts in place. It was really hard work, where I had so much to learn about what my daughter needed – and so did her care team.

We’ve been developing our relationships with these providers over the many years since then. We’re comfortable with each other. I trust them to know and understand my daughter and our family. When we talk about her care, we have a shared understanding of our experience, a shared history of knowing what works for us and what doesn’t. On an even more basic level, I’m familiar with the processes for making appointments, and how billing works. I know where to park and how to navigate the buildings to the clinics we need. I even have the phone numbers of her most frequent providers memorized, simply from having dialed them so often! Read full post »

Transitioning from pediatric to adult health care: post 1

Guest post by: Dr Raina Voss

Welcome to our new series of Teenology101 blog posts, which will focus on the transition to adult health care (and to adulthood in general). Transition is a super important topic when it comes to the health of teens – for teens who have chronic health conditions, their health status often worsens during this time, and we think that might have something to do with the rocky road of transitioning to adulthood. Despite that reality, discussions about transition often get skipped during medical visits, or put off to discuss at a future appointment.

We frequently hear from parents that there are things they wish they had known sooner to prepare themselves and their child for the transition to adult care. Our goal in this series of posts is to answer some of those questions, or at least get you thinking about how to find answers. Read full post »

Keeping teens busy over the summer

Guest author: Allison Hall

While summer is a time to de-stress from the school year and spend time with friends and family, excessive free time can also have its consequences; among them prolonged internet usage, television watching and boredom. To combat this lull, summer activities are an opportunity to enhance the personal, social, educational and professional facets of a teen’s life.

Summer opportunities are beneficial to maintaining progress in school, college applications as well as resumes. Beyond the practical applications, while most activities in school are planned and required, summer opens the doors to activities which are of interest to a teen. Whether volunteering, working a job or participating in a program, an organized activity allows for choice to explore an area of learning that school may not allow for. This independence and subsequent responsibility allows teens to gain real-world experience and the ability to apply knowledge learned in school to new settings. Further, the experience of searching for an activity, crafting an application, interviewing and meeting new people are all invaluable life skills.

Underlying the summer activities is an even more fundamental advantage: discovering a sense of identity, purpose or direction. As a student, the first question one is asked is: what are you studying? What are your future aspirations? While these questions are likely unanswerable as a teen, knowing what one is interested in (or not interested in) is enormously fulfilling and useful in future endeavors.

An example of such a program at Seattle Children’s Research Institute is called Summer Scholars, which is a part of the Social Media and Adolescent Health Research Team (SMAHRT). The week-long program is designed for high school students who are interested in pursuing careers in research in various fields. The program has a strong focus on diversity, by placing emphasis on reaching students for whom these opportunities may be difficult to come by, particularly those who live outside the city of Seattle.

During the program, each student is to develop a research question of interest to them which is related to social media and adolescent health. Throughout the week the students then collect data, analyze it, and ultimately produce a poster for which they give a presentation. In addition, Summer Scholars week is jam-packed with a plethora of fascinating undertakings. Among these, tours of Seattle Children’s Research Institute’s bench lab with a question and answer session, panels from STEM workers, a Seattle Children’s Hospital tour, guidance from researchers, mentoring from alumni of the program and much more.

The program has proved rewarding to students who find that the program helps them hone research skills, identify particular areas of interest, or simply opens their eyes to the breadth of careers available to them. More information can be found on SMAHRT’s website: http://smahrtresearch.com/

How does one find a Summer Activity?
1. Research opportunities to shadow or observe individuals who work in career fields of interest
2. Look into summer programs at universities or organizations that cater to a passion or interest
3. Become a summer counselor for youth or apply for other local jobs. Help your teen write a cover letter and resume or help guide them through the application process
4. Volunteer, join an existing service project or plan one of your own

Should your teen take a gap year

Guest post by University of Washington Nursing student Alicia Spiess

As high school graduations are being celebrated across the country, our guest author has some thoughts on whether or not it might be a good option to take a year off before pursuing further education. In this post, we hear about the ‘gap year.’

According to Forbes, the average yearly in-state tuition for a 4-year university is $30,000. Private and “elite” universities can cost double that. An average of 70% of America’s high school graduates attend college, and of those attendees, 1 out of every 3 drop out. One alternative that is common in other countries for high school graduates not ready for university is to take a year off. A “gap year,” consisting of constructive learning, is an option that is not often talked about in this country. When I began college in 2001, I did not know a gap year was an option, and as I was in my early 30’s, I ended up taking a sabbatical because of my own burnout and desire to experience other cultures. Looking back, I may not have done anything differently because I felt I was ready for university, but there are so many youth out there today who may not feel the same.

A gap year in the case of our youth can be defined as taking a “sabbatical” in-between the time one completes high school and starts university. This can push youth to discover who one is as a unique individual and what one wants to do in the next phase of their life. A year is a common amount of time taken off, and shorter time periods are possible, but not as common. A gap year does not mean your teen will sit on the couch all day playing video games or watching TV, but rather should be spent learning responsibilities and discovering new possibilities. The youth in both Europe and Australia have been participating in gap years for decades beginning in the 1970’s. Currently 12% of Europe’s youth take a gap year compared to 1.2% of those in American. We have to think, is a gap year such a bad idea? Instead of pressuring our youth to go straight into college, can we be open to other options to ensure the long-term success and decreased burnout of our youth which could follow them into adulthood.

What is to be gained from taking a gap year? This additional year may help our youth gain personal or professional experience through volunteer work in a field of interest, working to learn trade, learning a second language, or exploring their personal interests, all of which will be of great value for them throughout their lifetime. In a YouGov survey, in which 251 human resource employees participated, 46% said they would be more likely to employ a graduate who participated in a “constructive” gap year. Other studies have shown that students who have taken a gap year had a higher likelihood of completing their degree and with higher GPAs than those who did not. In fact, 9 out of 10 youth who took a gap year returned to college and completed their degree successfully.

Taking a gap year is not without its challenges. Taking a year off may become expensive. Some ways your teen can overcome this obstacle is to start planning early by saving money, fundraising, or by asking friends and family to donate. Some colleges or universities allow students to defer a year which ensures their spot the following year. It seems there are far more advantages than disadvantages in taking a gap year before college for those who may need it. A gap year can help youth to gain identity, as well as give them an advantage when it comes to scholarship applications and resumes. Several resources are listed below to help guide you and your teen in making a decision as to whether a gap year is right for them.

Tips and Resources for Readers:
Tips:
1. Encourage your teens to explore their interests without swaying them.
2. Help your teens to discover who they are through support and encouragement.
3. Take some pressure off your teens to attend college or university straight out of high school when they are not ready.
Resources:
1. “College Costs Could Total As Much As $334,000 In Four Years” article
2. “Why Are Gap Years More Common in Europe than the US”
3. Book: “Gap Year: How Delaying College Changes People in Ways the World Needs”
4. University Deferral Policies for Gap Years: http://www.americangap.org/fav-colleges.php
5. Gap year Programs: https://usagapyearfairs.org/programs/
6. Choosing a program abroad: https://www.gooverseas.com/7. LEAPNOW Transforming Education: http://www.leapnow.org/

Can too much caffeine hurt you?

In my clinical work, I’ve seen many changes over the years. One of them is the consumption of caffeinated beverages as a ‘normal’ and even expected part of high school life. Most of my patients (and their parents) come into clinic visits with a beverage in hand. This varies from a latte to energy drinks. With the health of my patients in mind, I often wonder if this is safe.

Caffeine has many side effects: increased alertness, increased ability to concentrate are the reasons most adults drink coffee or tea in the morning (I usually do)! But there are some negative effects as well: jitteriness, heart palpitations, diarrhea, insomnia, muscle tremors. It can also lead to an irregular heart rhythm (cardiac arrhythmia) and even death. With many beverages and foods (like chocolate) containing caffeine, how much is too much? Turns out this question isn’t so simple. Everyone metabolizes caffeine differently. For children, it’s recommended caffeine be avoided completely, but for everyone else, the exact amount is a bit harder to pin down.

It’s thought that up to 400mg per day for an adult could be safe (about 4 large cups of coffee), but if you rarely drink coffee, even that could be too much. The recent death of a teen from caffeine consumption is making me take a hard look at how I counsel my patients (and friends and family members) about the dangers of too much caffeine.

Here are some tips for teens on caffeine intake:

  1. Limit caffeine to just a treat. Instead of a cup of coffee to get your day started, work on sleep hygiene and a good bedtime routine. Turn off electronics (yes, this includes the cell phone) an hour before sleep and try to go to bed and get up around the same time each day. In general, teens need 8-10 hours of sleep.
  2. Don’t drink energy drinks. Energy drinks (including ‘energy water’) can contain up to 200mg of caffeine and a significant amount of sugar.
  3. Avoid sugary beverages. A cola now and then is ok, but avoid drinking sugary drinks (like soda). Even non-cola sodas can contain caffeine (including the fruity ones and root beer). Plus regular drinking of sugary beverages is associated with increased risk of heart disease and diabetes.
  4. Don’t use diet pills. Diet pills contain a number of things that medical providers recommend avoiding, but one of them is a high amount of caffeine. If you want to make healthy changes, instead talk to your medical provider and nutritionist for guidance on eating balanced meals and increasing your daily movement (exercise, walking, dancing, etc).

 

Teen Suicide Prevention

The Netflix show, ’13 Reasons Why’ has sparked national discussion about teen suicide. In this post from the Seattle Children’s Hospital On the Pulse blog, I provide tips to parents and teens on warning signs of suicidal intent and how to talk this with loved ones.

What You Should Know About Teen Suicide

 

Prescription Opioid use Among Teens

In healthcare, the increased use of prescription opioid medications (pain medicines like codeine) has lead to a number of concerns including increased accidental ingestion by toddlers and young children, increase in non-medical uses of opioid drugs, and an increase in the use of non-prescription opioids (such as heroin) by people who become dependent on prescription medications.

The increase in prescription pain medications began back in the 1990’s when concerns arose that we (US medical providers) were not adequately treating pain. Asking patients if they had any pain when they checked in for medical visits became the ‘5th vital sign’ in addition to checking height, weight, blood pressure, and heart rate. While asking about and addressing pain is very important, there was an unintended consequence of increased prescribing of pain medications. Read full post »