Tag Archives: teens

Sixteen and Out of Control (Pedcast)

It’s DocSmo time again, so if you have a tween or a teen in your house, this pedcast is for you. I am your host, Dr. Paul Smolen, both the Doc and the Smo in DocSmo.com. I started this blog for the benefit of parents and children 3 years ago, and I must say, I am having fun creating these pedcasts. Nothing is off the table here, and we talk about anything “I” am interested in. Topics are everything child here, anything from the crib to college, from the stroller to the sports car. Today, I am going to talk about something that a lot of families experience when their children are about 15-16 years old… destructive behavior. You remember being 16, preoccupied by social stuff, hormones raging with all those thoughts, and probably major league insecure, desperate to be accepted by your peers. Many of the families that I have known in my 32 years of pediatric practice have struggled with their children when they were this age.

I often have a front row seat to what goes on in families. Many of these parents and children I have cared for and have known since the day they came home from the hospital. That’s a very intimate view, wouldn’t you say? Well, here is what I have observed. Even the nicest families with the smartest, nicest children can have struggles when their children are mid teens.  Psychologists say that these years are dominated by a need for independence, a sense of autonomy, and a rejection of our parents’ authority. I would agree with this evaluation. These struggles often come out as drug and alcohol experimentation, poor school performance, self-destructive sexual experimentation, an intense rejection of parental authority, and lots of oppositional behavior. This is a very difficult time for everyone in the family, but here is what I have learned from my years of experience… families where there is stability around a spinning-out-of-control child usually end up with a happy ending. If the teen is loved, has a stable home setting, and does not have major mental illness or drug addiction, usually the child does just fine.

The teen may be 17, 18, or even 25 before things improve, but eventually, if there is stability around them, they will start to focus on positive life goals, assuming major substance abuse or mental illness hasn’t taken over. So, here is my advice to families in the thick of teen angst…be patient, concentrate on the positive, don’t dwell on failure, set reasonable expectations, create as much stability and routine in your family as you can, and trust that your teen will grow up and be someone you can be proud of…someday. If you need the help of a psychologist, get it; if your teen has serious drug or alcohol problems, don’t be afraid to get the help of a drug program, or if you, the parents have unresolved psychological problems like marital problems, substance abuse, or depression, get help yourself. Create that stability around your children… they need that in order to do all the other difficult tasks of growing up.

Thank you for spending a little time with me today.  I hope you found this pedcast informative and useful.  Portable, practical, pediatrics is always our goal.  Take a moment to write a comment or send this podcast to a friend or relative. It’s easy.  This is Doc Smo, asking you to create some positive family energy to help your child achieve life synergy.  Until next time.

The Tired Teen (Pedcast)

Doc Smo here, you know Dr. Paul Smolen, your pedcast host.  Today we are going to discuss a topic that is most relevant for parents with teens in the house.   You folks with younger children, you listen up as well:  your time is coming before you know it. We all know that teenagers tend to be moody but what should a parent do when their child has persistent fatigue and changes in mood. Well, that’s the topic we are going to take on today.   It’s not too uncommon for parents to bring their teenagers to the pediatrician with physical complaints of fatigue, irritability,  dizziness, and sleep problems.  More times than not, these physical complaints turn out to due to difficulties with mood, either excessive sadness, worry, or even anger.  As a pediatrician, I always have my radar up for physical symptoms that might indicate a serious disease process but most of the time fatigue is an emotional symptom.  So once we are sure that our tired teen does not have fatigue from a something like diabetes or thyroid disease, what’s next?  How can we help them feel better?  I thought it would be useful to take a few moments and share with you my practical suggestions that I have found can be very helpful to children and families in who find themselves in this situation… having physical symptoms from emotional fatigue and stress.     I think step one is to visit a pediatrician who has cared for your child and knows them well.  I think a large part of the healing process comes from a child feeling that those around them care and take their complaints seriously.  Reassuring them that they don’t have some dreaded disease by taking their complaints seriously is also an important aspect of the doctor visit.  I feel this is best done by someone who they already know and trust. Don’t underestimate the power of a health professional listening, touching, reassuring, and demonstrating understanding.   Next I suggest that all my tired teens work on a few things that have been shown to improve mood in anyone, child or adult:   -I make sure that they are getting enough physical exercise.  I think they should exercise a minimum of an hour a day.  Walking is fine, riding a bike, throwing a Frisby, whatever but they need to get out and do it!  Movement and enjoyment is the key! And I mean out, that’s outside where there are green trees and lots of light.  Light sets our clocks for sleep and can help your child get enough sleep and the light also improves their mood…for real. Actually researchers have found that physical exercise is as effective at improving mood as most anti-depressants and a whole lot cheaper and safer! -Next, we go over their sleep habits and possibly make improvements there. Experts think that children older than 12 years old need 8-9 hours of sleep nightly. Regular bedtimes, turning off electronics, quieter activities in the evening are an important part of a healthy sleep formula.  I encourage the child to establish a regular bedtime ROUTINE. Many parents tell me that evening, near bedtime, is a good time to talk about your child’s feeling.  Bedside conversations like these can be very powerful and I think you should try and initiate these talks.  Enforce no cell phones or other electronics in your teens room.   -Nutrition is also an important aspect of mood and energy.  I explain to the tired teen that certain fats found in fish and other foods can really be helpful.   Fish consumption or an omega 3 supplement is a must as is vitamin D supplementation  in case the child’s level should be low.  In this situation, I actually recommend a multivitamin, especially if the teen’s diet is poor.  It also goes without saying that reducing soda, caffeine, and processed food will help anyone feel better.   -Finally, I think that having friends, helping others, and being praised for even the smallest of achievements can all be very uplifting activities. I encourage families who have a tired teen to try all these things. Parents can facilitate their child’s friendships by making an extra effort to provide transportation and activities their teens might like as well as encourage their teen to help around the house, neighborhood, or community… and of course they can praise and recognize any helpfulness, success, or healthy attitude their teen exhibits.     And finally, I think a follow-up visit to assess how your teen is doing is really important at which time we determine if things are getting better or a mental health referral is indicated.  Let me reiterate that what we have talked about is for mildly depressed or anxious teens and not for children with severe disturbances in mood or behavior.  If these measures doesn’t improve things for your child or you think they may be having serious thoughts of harming themselves or others, please…. get some professional psychological help.  You’ll be glad you did.   For more portable, practical parenting information, take a few minutes and explore the literally hundreds of pedcasts and articles posted at my blog, www.docsmo.com.  Your comments and stories are always welcome and of course we love when you share these posts with friends and family.  This is Doc Smo, hoping you can find a simple step to increase your teen’s pep. Until next time.

Migraine, what a pain! (Pedcast)

Welcome to the pediatric blog I call DocSmo.com.  I am Dr. Paul Smolen, founder and curator of this blog dedicated to parents and children.  We go beyond the office and give parents a little more depth in their understanding of pediatric health topics.  From diapers to the degree, we talk about it here.  Thank you for joining me today. The only thing better than the kids in pediatrics, are their parents.  I love bringing information to help parents. Today we are going to talk about a topic that is very close to my life experience, since I am a sufferer, of migraines… an incredibly common pediatric disorder. Believe it or not, most parents don’t recognize this headache in their children when they first begin. Well, we don’t want that to happen to informed, sophisticated DocSmo listeners so here we go.   Lets start with what is migraine?  It is a syndrome meaning a constellation of symptoms that follow a typical pattern.  Usually, a migrainer as they are called will first start feeling weak and very tired, possibly preceded by vision changes called a “visual aura”.  If you have never had one of these think of this as what the world looks like if you were looking through the air coming off a very hot road in the summer… it scintillates, it dances and distorts everything. That’s what an aura typically looks like but they can vary from person to person.  Next usually comes a throbbing headache, often focused around the eye or neck which steadily increases in intensity, a crescendo so to speak for you music lovers.  Often this head pain is more intense on one side of the head. Many migrainers get associated symptoms such as sweating, nausea, light and noise sensitivity, and vomiting as part of the mix. These headaches can be brief or last for days.  In between these “spells”, the child is completely normal.  So remember, fatigue with or without an aura followed by a crescendo type headache, often more intense on one side of the head and not responsive to rest or common pain meds is probably a migraine if the child is perfectly normal in between these spells.  If rest and mild analgesics help, this was probably just “I’m tired” headache.   So what causes migraine?  No one really knows but usually close relatives will have similar headaches so there is certainly genetics to this.  They might not call it migraine but maybe “sick headaches”, “menstrual headaches” or “sinus attacks”, but if they follow this pattern, they are likely migraine.  Estrogen and testosterone have a lot to do with these headaches so for children who have this tendency, that means onset most often in middle school.  Migrainers usually have triggers, whether that be stress, noise, bad smells, dehydration, missing a meal, certain foods, or in my case, calculus class in college.  If you are a sufferer, you often think you have a brain tumor.  I did.  What actually happens in the brain is not definitely known but the large nerve in a child’s face called the trigeminal nerve seems to be involved and cause real physical swelling and inflammation around the brain. That’s why the earlier the treatment is started, the better it works.  Stop the swelling and inflammation and the headache subsides. That also explains why acetaminophen usually doesn’t work… it doesn’t reduce inflammation like aspirins.   If your child has been examined and diagnosed with migraine, here is a useful approach I have learned and used over the years. I think it is vital to HAVE A PLAN LAID OUT BEFOREHAND, before the headache comes.  Here is what I recommend if your child starts to get sick at school with a headache you think is migraine:   -Should a headache start at school, have your child go to the school office and ask to take a usual headache reliever that reduces inflammation like Ibuprofen or Naproxen.  Make sure you supply the school with whichever you want. -Have your child be allowed to be in a quite place for 30 minutes after taking their medicine.  Make sure your they rate their pain on a 1-10 scale before they lay down.… if the headache starts getting better…muscle tension and fatigue was likely the culprit.  Time to go back to class.   -If things don’t get better and they are rating their headache as the same or worse, time for stronger medicine.  I go right to what is called the triptans… these are specifically designed meds for migraine. You can also leave a few of these in the nurses station for use because time is of the essence… the sooner the better. Two that are approved by the FDA for children, Axert or almotriptan and Maxalt or rizatriptan.  Maxalt tablets are available in a generic tablet and are very cheap… this is what I start Maxalt.  If a child cannot swallow a tablet or has a lot of nausea with their headaches, I go for the Maxalt melting tabs  (ODT’s)( currently much more expensive).  If a child gets to this stage, time to call Mom or Dad and go home.   -Pay attention to what triggered the migraine and file that information away for future use.  I have found personally, that ibuprofen, naproxen, or Motrin migraine, taken at times when I think I might be migraine prone, can prevent migrainous headaches.  I think this is only for frequent migraine suffers which hopefully no one in your family will ever be.   So remember, that migraine is episodic, escalating, severe, often localized pain in the head and associated with other symptoms like nausea, vomiting, noise and light sensitivity.  Most often they are incapacitating. If you think your child suffers from these, provide your child’s school with a written plan, some ibuprofen or naproxen, and a few triptan tabs.  See if that strategy doesn’t can’t work for you.  I hope it does.   As always, thanks for making me one of your trusted healthcare sources of information.  I will always try and bring you relevant, practical information that you can use with your children.  Your comments are welcome at my blog, or on facebook or itunes.   www.docsmo.com https://www.docsmo.com/docsmo-videos/     This is Doc Smo, hoping every parent has an advanced degree, in how to keep their children pain free.  Until next time.

Indoor Tanning (Article)

One of the most popular trends among teens and young adults at the moment is indoor tanning, which unfortunately poses many hidden risks. Many teens, especially girls under the age of 18, feel that the golden glow of tanned skin enhances their appearance. As teenagers are particularly inclined to put great importance on their own body image, tanning has become increasingly targeted towards this age group. Now, up to 40% of adolescent girls use indoor tanning salons, especially as they have become increasingly accessible and affordable. The popularity is in part also because indoor tanning is much faster than sunning outside, due to UV exposure 10 to 15 times higher than normal, and the results are longer lasting. Unfortunately, few teens are aware of the damaging and permanent side effects of tanning.

A recent study published in a journal sponsored by the American Academy of Pediatrics points out the correlation between indoor tanning and the development of skin cancer in young people. Melanoma, a highly deadly form of skin cancer, has increased dramatically in the last twenty years, and non-melanoma forms of skin cancers are also increasing significantly, in part due to the growing prevalence of indoor tanning and intense outdoor tanning. Tanning leads to skin cancer through the damaging permanent effects of highly concentrated UV rays on the DNA of skin cells. While skin cancer is the most life-threatening side effect of tanning beds, extensive sunburn, skin aging, and eye damage can also be caused by indoor tanning…and those are just the negative effects we know about.

Finally, new research indicates that tanning addictions are becoming more widespread and are legitimate mental health issues.  Yet, in spite of all of these risks, teens continue to tan. So, as parents, how are we to curb indoor tanning usage? The government has begun to look at instituting laws to ban underage tanning, but ultimately, parents are responsible for their teens.  Before your teen tans, make sure they fully understand all the risks associated with tanning, and encourage them to “be comfortable in the skin they’re in.” No sun-kissed golden glow is worth the risk of developing a life threatening skin cancer. Parents have enormous influence over their children’s choices, and talking through the health risks with your children early on and frequently can have a great effect on their decision to tan. Parents have powers that they often don’t realize that they have…Use them!  Also, studies show that young girls who tan often have mothers or caregivers who also tan. Setting a positive example by limiting your own tanning will perhaps lessen the pressure on your teens to follow this unhealthy trend. Ultimately, simply engaging in a family conversation about tanning will spread awareness about the risks and help teens understand the consequences of their decision. More often than not, when you treat a teen like an adult, they will act like an adult.  Try it and see.

I would encourage all interested readers to take a look at this article. :  http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2404.full.pdf+html. Click and read.

Comments are welcome at www.docsmo.com. Maybe even share this article with some teens you know.  Until next time.

Smo Notes: http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2404.abstract

Article written by Keri Register and Dr. Paul Smolen