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 »
I recently met a teen who had just broken up with her boyfriend. They go to the same school and have the same circle of friends. For her, the break up was a tough choice, but she didn’t feel like they had a connection any longer. Instead of calling him or having the conversation to end the relationship face to face, she tweeted the break up. For me, this felt impersonal but for this teen, a tweet was just an alternative mode of communication that was convenient and effective.
In this day and age, we spend so little time actually communicating face to face. Our pace is fast: constantly on the go and instantly responding to the latest text, chat, or instant message. If we send a message and don’t receive an instant response there is concern that we’re not valued, that the person may be upset at us, or worry that something is wrong. What does this instant communication and ongoing use of social media mean for teens and their social development? The answer: we don’t really know. But we do have examples from the past. Read full post »
Consider this scenario: you walk by your teen’s bedroom and over ear them having a deep conversation with a friend. While you don’t want to eaves drop, you realize their friend is disclosing thoughts of suicide. Your heart starts pounding… your teen is attempting to give advice to a friend who is considering ending their own life. You are worried about the friend, but you are also concerned that this could lead to anxiety and sadness in your teen. What do you do?
I’ve been asked for advice in this situation over and over again. Sometimes it’s my patients who ask me for advice on what they should say to their friends, but often it is parents who want to know if it’s ok for their child to be someone’s confidant? They are worried that their teen isn’t equipped to handle the situation (neither emotionally or with reliable crisis information to give to the friend). Read full post »
Recently a colleague told me about an encounter that left me thinking, ‘as Pediatricians, we really need to do a better job of explaining confidentiality!’ They were seeing a teen for a follow up visit and had asked the medical assistant to put the patient in room without the parent. The parent became very upset that their 18 year old was seeing the provider alone and complained to the front desk staff in the clinic. From my perspective, as an provider who specializes in adolescent health, rooming an 18 y/o without their parent seemed like standard practice. But what was neglected was the explanation to the teen AND their parent about why this is done. As a parent myself, I can empathize with the frustration the parent likely felt. They came to the appointment with their teen, they’re likely going to receive the office bill and pay it, and the teen lives with them, so they are likely very involved in the youth’s life. So why is confidentiality and the opportunity for teens to visit with their health care providers important? Read full post »
February is Teen Dating Violence Awareness Month. Dating violence goes by a number of different terms: intimate partner violence (IPV) or dating violence. It’s described as ‘physical, sexual, or psychological harm’ by a current or former partner. For teens (and adults), it may be hard to know when actions in a relationship have crossed the line into IPV. If a partner is controlling but not violent is that ok? If a partner prefers you don’t hang out with friends unless they are around is that normal? Read full post »
If you’re the parent of a youth with a non-binary gender identity or a youth who identifies as transgender, you may be going through or have gone through a number of emotions. These may include love, fear, sadness, grief, pride, worry, and happiness. Parents may feel loss for the idea or image of the child they had that has been replaced with the child who is asking for transition or pride that your child has the courage to speak up for their needs. You may have concern about the future barriers your child may face or happiness that your child is comfortable trusting you. All of these emotions are expected and no parent is going to have the exact same experience as another, however, there are some described stages that parents of transgender youth may experience.
In this post, guest author Christine Sogn Mental Health Therapist will help us briefly go through these stages. Read full post »
This time of year most of my friends, patients, and colleagues are in full holiday mode: they’ve prepared for large family gatherings, are taking vacation from school, or working on setting their New Year’s resolutions. Most people are both stressed with the preparation but also in a good mood and excited to spend time with family and friends.
As I start the New Year and reflect on the memories made this holiday season, I’m also reminded that I have a lot to be thankful for. I’m in good health, a spouse who loves me, happy kids, solid housing, and if I need anything I have a great group of family and friends who I trust to help (this includes emotional and financial need). However, I’m routinely reminded of my privileges as I drive along the freeway and see the tents set up by the homeless, view media accounts of children being bombed in countries overseas, or take care of patients whose parents pull me aside to tell me they can’t afford to purchase any gifts, I know I can’t take my life for granted.
Recognizing my privilege, I ask myself, ‘How can I, as a parent, teach my children to not take things for granted and recognize humanity in others?’ This is a big question without simple answers, but I wanted to share a few tips my parents taught me while growing up.
- Volunteer. This exposes you to new people; teaches you skills such as showing up on time, work ethic, and humility; and can be extremely rewarding.
- Donate. Donate time, money, skills, etc. There is going to be someone who is in need of help and can benefit from your donation, no matter how big or small.
- Have empathy. Everyone has a story, but they may not share the details.
- Treat people with kindness. A smile for the person holding a sign on the street corner acknowledges their existence and shows that you see them even if you don’t give them anything else.
- People will always remember how you made them feel. The emotions that accompany actions have significant impact. You may not be remembered for what you said, but you will be remembered for how people felt when they were around you.
I hope you and your family have had a good start to 2017. Have a wonderful New Year!
This post continues our discussion on transgender youth.
What we know: transgender persons have higher incidence of depression, anxiety, suicide attempts, assault. The media has had story after story of transgender persons being treated horribly. Identifying as a different gender than what was assigned at birth is hard. Parents and family have to manage changed expectations and it can be difficult to ‘get it right’ (i.e. say your child’s preferred name, use their preferred pronoun, and accept that the baby you were raising as one gender is different than what was anticipated).
A research study was released in Pediatrics, the journal of the American Academy of Pediatrics in March 2016 that is very encouraging for parents of transgender youth. In the study, researcher recruited children who identified as opposite of their natal sex in daily life. They did not include gender fluid youth. Children used pronouns that matched their identified gender, presented as the identified gender in all contexts (such as school, home, in public), and were ages 3-12 years. These transgender children who were supported in their identity by their families did not have differences in depression when compared to controls (controls included siblings and a group of gender and age-matched peers). Read full post »
Our country just witnessed the democratic process of the United States this week as the 45th President Elect was voted into office. This election has divided the country over the past year as our 2 major political parties tried their hardest to convince the people that they could do a better job as Commander-in-Chief then their opponent. So now what? Regardless of how we voted, there are some common things we can teach our kids. Here are the points I’ve discussed with my own kids and my patients:
- If my side lost, that doesn’t mean all hope is lost. If my side won that doesn’t mean all my problems are solved. The amazing thing about living here is that even if I disagree with my neighbor, I’m free to do so. I have a right to disagree or agree. There are so many inequities in our country that still need work. These haven’t changed over this week and won’t change unless we the People use our democratic process as it was intended. So let’s get to work. Encourage your teens to write letters to their State representatives about issues important to them. Be involved in your community. Get to know your elected officials and if you have a strong stance on a topic, tell your legislature about it.
- Inclusion. Get to know people who are different from you and be open to hearing other people’s stories. We can learn from each other and recognize that we might have more in common than anticipated. Afterall, every parent I know wants the same thing for their kids: opportunities for financial stability, long healthy and happy lives.
- Humility. No one person is right all the time. Be open to ideas that differ from yours. You may find a compromise that benefits more people. This doesn’t mean you back down and ignore your values, instead be open to listening instead of jumping to assumptions about the people around you.
- The Golden Rule. Treat others the way you want to be treated. Hatred is intolerable. If you witness a hateful act against someone, remaining silent is passive acceptance.
- Voting matters. Half of the people eligible to vote did not. Our right to vote is a privilege. Many countries don’t offer the same opportunity for the citizens to have a say in how the government works. Every vote does matter. This election, it wasn’t just the Presidency that was on the ballot. There were local initiatives related to public transportation and education. We elected our governor and state representatives. Your vote is your voice. Use it! For women and under-represented minorities, the right to vote is fairly new. People fought long and hard to gain this equality.
- Acknowledge our differences in order to learn from each other. I’ve already addressed this above. But the only way to continue making improvements on the inequalities in our country (such as education discrepancies between rich and poor, lack of jobs for those without higher education, unequal pay between genders, the list goes on and on) is to acknowledge if we have a privilege, then work hard to decrease the inequality that lead to that privilege.
Last week the American Academy of Pediatrics (AAP) annual conference occurred. This meeting is a convergence of Pediatricians around our nation to cover topics that span the range of childhood development. In the past, the AAP had fairly rigid guidelines on the use of media for kids. It was recommended that children under the age of 2 avoid all screen time and those over age 2 limit to no more than 2 hours a day. This month, the AAP has revised the recommendations to reflect newer research and national trends. Read full post »