Teenology 101

Transitioning from pediatric to adult health care: post 4

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.

A young man with chronic lung disease

In this guest post, a parent shares their experiences both frustrating and enlightening, about being the parent of a youth with the chronic illness, asthma. Though this illness is well known, it is still complicated.

My son is now 20. He’s been followed by medical specialists since he was three weeks old, for asthma and also for treatment of the numerous bone fractures that he was susceptible to because of his medications.

People – even doctors – often think of asthma as something you’ll outgrow. But asthma is a tricky disease. In my son’s case, it didn’t seem to follow a clear path and we dealt with lots of misunderstandings and heartaches over the years, trying to figure out causes and treatments. On occasion, when he was extremely ill, we were referred for additional testing – but all that was ever identified was severe asthma. Read full post »

Loneliness among teens

Loneliness. Is this the future of a generation?

In the past 5 years, I’ve noticed a trend in my conversations with teens and amongst friends, family, and acquaintances. As I raise my children and they ask for more time on the tablet or request to send texts to family, I worry about the trend taking hold of my kids. The trend is feeling alone.

I attended a speaking event by researcher Dr. Niobe Way a few years ago and left with tears in my eyes. She described the transition of boys from connecting, emotion expressing, playful little beings to young men who have ‘buddies’ but no confidants; are comfortable showing anger or pride, but not fear or sadness. Our culture may have shifted the definition of ‘masculine’ to be one that encompasses independence at the cost of connection. An article I read recently described this shift. In it, the author describes higher rates of unemployment, divorce, suicide, and violence among adult males. The key points in the article lead me to consider the increased number of mass shootings in the US. Men have carried all these out. I cannot assume that loneliness, shifts in cultural norms, or changes in how emotions are expressed cause people to kill. I do not know the motivations of the murderers and in no way am I excusing the horrific atrocities they carried out; but I have to hope that we can prevent a massacre from happening again. While many factors need to be considered and intervened upon, changing how we treat each other is a step in tackling the loneliness and despair a person may feel if they are so desperate they want to kill.

Loneliness and social isolation are also becoming routine in my conversations with patients (regardless of gender). We are more “connected” than ever before; nearly every US household has access to the internet or owns a smartphone. Teens spend hours on social media and text hundreds of times per day with friends. Social media brings many benefits: access to online education, remaining in touch with friends and family who are not local, and allowing an outlet to express emotion in an anonymous way. Yet, suicide is the 2nd leading cause of death among teens (second to motor vehicles). Is there a correlation between depression and online use? Read full post »

Eating disorders

I recently viewed the Netflix film, “To the Bone,” a story of one individual’s journey in recovery from anorexia nervosa. The emotions in the movie were true to the experiences of my patients and families as they manage the journey of getting better. The post is available on the Seattle Children’s blog: On the Pulse. Here’s a preview…

As an adolescent medicine specialist, I help teens manage a wide range of eating habits, many of which can negatively impact their overall health and development. For example, I often hear teens say they’re skipping breakfast or trying to diet. Some have very rigid rules around food that alarmingly result in their bodies showing signs of starvation. Although these symptoms can rarely point to a severe eating disorder like anorexia and bulimia nervosa, when these disorders do take hold they can be life altering.

To read more, view the full post here. 

 

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/