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Daily Dose

Teen Dating Violence

1:30 to read

February is Teen Dating Violence Awareness month… but this is a subject that we should be discussing year round. Relationship violence is much too frequent and the latest statistics show that more than 1 in 3 women and 1 in 4 men will be in a violent relationship in their lifetime.  Most of those will experience relationship violence between the ages of 18 - 24 years….but many of those affected said that had never been told what relationship violence looked like. 

The key to ending relationship violence is to educate teens as to the signs of an unhealthy relationship.  This means that parents need to be discussing what a healthy relationship is and what it is not, so that their child will know the difference.  

There are often many clues and warning signs that YOU are in an unhealthy relationship.  These may include having a partner who is too smothering and jealous. They may get upset if you spend time with your family or friends, and are jealous of any time spent away from them…for whatever reason.  Their jealousy may escalate where they even begin asking you to check in with them excessively via texts or phone….to make sure they “know where you are”, always. 

At the same time another sign of being too “controlling” is having your partner ask for your passwords to social media accounts.  This will enable them to go on to your sites,  even without your permission.  Not only may they use this as a way to read your texts, but they may even  change your Facebook page when they want to….more control.

Sex may be another area for concern…. They may ask you to do something that you are uncomfortable with.  They may also “force” you to have sex when they want, rather than when mutually decided.  They may even threaten to break up with you if you don’t submit.

Relationship violence may also include verbal abuse…where your partner speaks badly of you to other friends or even puts you “down” in public.  They may belittle you and shame you and embarrass you in front of your friends.  This is never appropriate. 

Teens will tell me that their partner would often say, “if you loved me….you would….”, but that is not what  real love looks or sounds like.  That statement should actually be a warning sign of a possibly unhealthy relationship that is far too controlling.  I would tell that teen to “run Toto run”…even if it seems terribly hard.  Get out of the relationship before the relationship becomes even more unhealthy and even scary.  Let your teen know that you are there to listen and help if asked.

Keep the conversation going and let them know that there is a difference between a healthy and unhealthy relationships. Remind them that they want to look for respect in a relationship.  Power and control are not love. 

Daily Dose

Pokemon GO

1:30 to read

My office is suddenly a bit more “interesting” after a 13 year old boy who was bored while waiting in an exam room took out his phone and started playing Pokemon Go!!  Who knew that there was a Pokemon in my office…or was there?  

If you have children between the ages of 8 -15 I bet someone in your house is playing Pokemon Go - and it is not just kids, many adults are also engrossed in the new game as well. I can remember my sons playing with Pokemon cards years ago, and I don’t think I understood the game then, but it was certainly entertaining for them and they spent hours trading cards with their friends…wonder where those cards went…maybe they are a valuable antique now?

At any rate, as I am trying to understand the game I am also seeing a lot of news coverage about the Pokemon Go rage that is sweeping the country.  There have been several interesting news stories about accidents that have happened while people are so busy looking for the Pokemon on their phones and not paying attention to their surroundings…they have fallen into water, run into walls and almost been hit by cars, fortunately no one has been seriously injured.

One mother of 2 boys who are engrossed in the game told me that her boys sit in the backseat of the car “screaming at her to slow down”!  She said she was not going fast and could not figure out what all of the commotion was about until they continued to ask her to slow down to a crawl….in order that they might see if they were passing any Pokespots??  Unfortunately, she informed them that she needed to go with the flow of traffic and they were out of luck for the moment. Who knew your “tweenage” children would ask you to drive slowly!

As I have been reading a bit more about Pokemon Go I am learning about “augmented reality” and how “an artificial digital world can be mapped onto the real physical world”. It seems that this is not new technology, but with the advent of Pokemon Go being available for free on every cell phone around the country,  it will not be long before we see this phenomena in other aspects of our lives. 

The game and the technology displays a Pokemon floating on your phone’s screen and it appears as if it is in the real world in front of you. (brings back the ad, “is this real or is this memorex?”).  I must say, I really don’t understand it and it is a bit scary how the digital and physical world seem to overlap.

In the meantime, I have found a new game to discuss with my patients, and my office has a new mascot….I just don’t understand how he got into the exam room and if he is watching me all of the time?  

Daily Dose

Off The Grid

1:30 to read

As the summer is coming to a close and school is starting in the next few weeks, I am doing a lot of check ups, especially the tweens and teens who are getting ready for school sports.  I have been asking all of them about their summers…camp, vacations, volunteer work, travel….and interestingly many of them commented about being without their electronics for one reason or another. (In several cases their parents were insistent that the family “go off the grid” for their vacation, while some went to camp where they were not allowed to have electronics, while a few others were in such remote places the internet was just not available.)

So, what did they have to say about putting up their cell phones and laptops….surprisingly, many of them ended up liking it!!  Now they did say that the whole “idea” of no electronics put them in a total tailspin… but, after a few days of not reaching for the ubiquitous cell phone every 30 seconds to check for texts, and not feeling as if they had to take a “selfie” of every moment to share with their friends, the whole experiment (whether forced or not) ending up being quite freeing!!

Lots of the teens began to talk to their friends or family, that is in language and conversation using spoken words…no typing, and how personal it seemed. The entire family at times was engaged in conversation about many topics where everyone was talking together and not isolated by the screen and individual texts.  Lots of my patients said that they enjoyed the scenery without feeling as if they had to document each minute with their camera phone…but rather just take in their surroundings through their own lens….making it seem even more memorable.

Many of the teens also worked on their summer reading with less stress, as they read throughout the summer and actually “enjoyed” reading…and did not find themselves trying to read 500-600 pages in the 2 nights before school started. Some even remarked that they had missed reading books and having the quiet time.

All in all they did say that as difficult as it is to “disconnect” it is probably a good thing once in awhile. They were not giving up their cell phones (CRAZY IDEA), but they did realize that they may spend and excessive amount of time trying to stay connected, when they are really not connected at all.

So….let’s all try to commit to cutting back on electronics for the school year and going back to some basics…conversation, family meals, reading at bedtime (not on electronics ) and no screens in the bedroom….agreed?

 

 

 

Daily Dose

Back to School

1:30 to read

Schools around the country have opened their doors and some will be starting soon. This is the first week of school for most students in my area and parents have been busy in the last few days attending “back to school” and “meet the teacher” nights in preparation for a new school yea

So…every school has different rules, expectations and strategies for helping their students evolve into their “best” selves and as you get older the “rules” often change in hopes of making students more independent and responsible. I other words, getting ready for the “real world ‘ one day.

Catholic High School for Boys in Little Rock, Arkansas has recently been highlighted in the news and on social media for the sign that is posted on the entrance to the school. It reads “If you are dropping off your son’s forgotten lunch, books, homework, equipment etc, please TURN AROUND and exit the building”  Your son will learn to problem solve in your absence.”  The school posted the same message on their Facebook page as well.

According to the principal of the school, this has been a Catholic High rule for quite some time…it was also a rule at the high school my boys attended.  While some feel that this is unjust and that the students should be allowed to “phone home” if they have forgotten something, the school’s explanation is really fairly simple…allowing your child to have some “soft failures” and to learn both problem solving skills and responsibility will ultimately mold them into functioning members of society as they reach adulthood.  Sounds reasonable to me.

I know that as my boys went from elementary school, on to middle school and then high school their father and I had greater expectations that they needed to be responsible for getting their “stuff” to school.  We started off the school year with a game of sorts where you were given 3 “hall passes” for the year. I guess this started from something at school where they were given a hall pass to go to the bathroom or the office, and some teachers would hand out homework passes that allowed you to “skip” an assignment. So, each child ( this probably started in about 3rd or 4th grade) had 3 passes/year  where they could call and have us “rescue” them if they forgot something. Once you used up your “hall passes” you had to suffer the consequences of no lunch or turning in an assignment late.  Interestingly, each child was a bit different….one would use them up pretty quickly, another would “hoard” them for late in the year.  One wanted to know if they could be accrued? 

By the time they reached high school it was not a SHOCK when they were told the school rule that they could not call their parents.  It seems they figured out how to borrow money for lunch, or share with a friend, how to borrow a tie or jacket for an assembly and that turning in assignments a day late usually meant 10 points off. Not only did it help them become more organized and responsible, it also made me a working Mom “feel less guilt” that I really was not available to rescue them sometimes, even if I wanted to.  Do you think you would appreciate waiting in your pediatrician’s office (any longer than you may already) while they tried to run a homework assignment to school??  

You might try starting off the school year with a few hall passes and see if it works for your family!  

Daily Dose

Healthy Habits

1.15 to read

We are 2 months into the new year and it's a great time to get rid of bad habits and that goes for all of us. It is especially a good time to work on developing healthy habits at home for children of all ages. 

What better time to start making sure that your children are getting enough sleep.  Winter months are great for setting bedtimes, as it gets darker earlier and somehow it seems easier to get little ones to bed when it is dark.  Recently, a parent emailed me that their 2 year old was now staying up until 10:00 p.m. because “he didn’t want to go to bed”. This little boy wanted to stay up and play on his parent’s table” rather than going to bed, and he was driving them crazy as they got less and less sleep themselves.  The dad asked, “what should we do?  Do we put him to bed earlier, even if he doesn’t want to?”   

The answer is yes!  They need to have a consistent bedtime for their 2 year old son, with a good bedtime routine.  For me as a parent, that meant bath time, story time, hugs kisses, and lights out!  Even as the kids got older I tried to enforce a teenage bedtime of no later than 11:00 p.m. on school nights. Teens need sleep too, and every night is not  pre-finals night so make sure your teen is going to bed and no electronics in their room either. 

Many people start diets at this time of year, but I would rather talk about changing eating habits.  Do you already have family dinners?  Are your children getting a healthy breakfast before they head off to school?  Do you pack your child’s lunch at least 2-3 days a week?  We can all improve our eating habits, and by changing even one thing (no more soft drinks in the house or serving a green vegetable at dinner), will impact nutrition and health. Little changes but a good start. 

So, here’s to a healthier 2014 and to starting off with good habits and maybe trying to change a bad habit.  I often race off to work, so I’m going to  try to eat breakfast regularly. I may have to get up 10 minutes earlier, but it is do-able. I’ll let you know how it goes.  

Daily Dose

Your Child's Well Check

2.00 to read

From the moment your baby is born until you send them off to college, your child will be seeing his/her pediatrician for “well child check-ups”. These are regularly scheduled visits which occur quite frequently when you have a baby or toddler and become a yearly visit once your child is over the age of 3. The well child visit is an extremely important part of a pediatrician’s job, and is also your child’s medical home.

In fact, one of the most rewarding aspects of being a pediatrician is having the privilege to observe a child from birth through their teens, in a sense, “helping to raise them”. Therein lays the reason for check-ups.

When you see your pediatrician for a check-up, I’m sure you get your child’s weight, height, BMI, (and blood pressure once they are older), as well as their growth percentiles.

The doctor also does a physical exam on your child, which is hopefully all normal. But there is a lot more than that to your visit. This is the time for your doctor to discuss your child’s milestones; whether that is sitting up for the first time, first words or how they are performing in first grade.  These conversations continue for all of your child’s school years as well.

It is also the time to discuss multiple other topics which should include sleep habits, nutrition and safety which is pertinent to all age groups. As your child gets older the conversation should include discussions about school performance, bullying, studying, screen time, family meals, exercise, and the child’s interests.

For the teen patient I think it is important to discuss sexuality, peer pressures, driving, and the adolescent’s long term goals.  The list goes on and on, but certain topics should certainly be yearly discussions which are then tailored to the age of the child.

 As a child gets older it is important to have some time where the doctor may be alone with the adolescent who may want some “private time” with the doctor. It is equally important that the exam includes time spent with the both the parent and the adolescent to wrap up the check up and answer any questions that a parent may have had that their adolescent did not.

For my patients 18 and older, I find that many times their parents do not come for their check-ups as the relationship has now become a bit more about a young adult with their doctor. Everyone is different and there is not a “right” way to handle the adolescent, but it is more important to have an open rapport and conversation between patient and doctor.

Lastly, every check-up should have time for questions. It is helpful if parents have a list of questions ready for the doctor.  Young parents often have simple questions as they are new parents. So, they often start off with “I think this is a stupid question…” but, there is not a “dumb” question as they have never been parents before.  For parents with older children the questions are often more lengthy and may even require another visit or phone call to follow-up or complete the conversation.  In either case, the check-up is the place for questions.

I really enjoy my patient’s check-ups and continue to realize the importance of the well child exam and the doctor-patient relationship. Don’t miss them.

That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Playtime with Your Kids

1.15 to read

I have frequently prescribed play therapy for children but recently I have prescribed it for several parents.  This prescription has been written on several different occasions. 

I have more than a handful of new parents (and even some seasoned parents) who are going to classes to learn how to play with their infants.  Yes, there is a course (at least in my area) that actually goes through how to sit on the floor and play pat a cake, or play with blocks. It teaches parents how to get close to their baby’s face when talking to them, or how to play where is your nose or where are your eyes!  They even have a curriculum and workbook.  It is play therapy for a new parent who feels as if they need some guidance on how to interact and play with their baby. 

But more recently I wrote a play therapy prescription for a parent after her daughter suggested it. I had actually sent the young girl for some play therapy due to some anxiety she had been having. She really enjoyed getting down on the floor and playing dolls and games with the therapist. At the end of one of the sessions she told the therapist that she “wished that her mom knew how to play dolls with her”. She said that her mom worked a lot and when she was home she was on her computer or cell phone. She just wanted her mother to spend some time with her playing!  It sounds easy enough, but not for everyone. The good news is that the mother was quite receptive and once she and her daughter had spent some time in play therapy everyone was happy and the little girl’s anxiety seemed to go away. 

Playing with your children is one of the joys of parenting, but some parents need to be reminded or even “re-taught” how to play. Playing does not need to be fancy or scripted, but just some one-on-one play time with your child. All children need play time, so make the time to play together. 

So, as a pediatrician not all of my prescriptions are for the children, sometime it is “us” parents who need the prescription.

Daily Dose

Toddler Behavior

1.30 to read

Do you have a toddler? If so you are in the throes of some difficult, albeit sometimes funny, yet inappropriate behavior. It happens to every parent...suddenly their precious child turns into Dr. Jekyll and Mr. Hyde.  Somewhere around 15-18 months, you will most likely see this change in behavior. Although most books refer to the “terrible twos” I really think it is the “me no wanna” 18-30 month old. 

“Me no wanna” is the phrase we often used around our house, and it was coined when the boys were toddlers. It just seemed like the best line when our sweet toddler would rather have a tantrum than do the simple task that we wanted him to do. Example: please put your toy back in the box. “Me no wanna”, I would prefer to fall to the floor and scream.   

How is it that your typically sweet 20 month old child can be in middle of playing nicely and then suddenly seems possessed as they fling themselves to the floor kicking and screaming?  What is the matter?  Are they having a seizure? Or is it that “something” just didn’t seem right to them and they are angry and frustrated???  How can they change behavior so quickly.?   (hint, foreshadowing for those teen years). 

You never know with a toddler what kind of answer you will get when you say something as easy as “let’s get on your shoes to go outside”. Sometimes they happily run get the shoes, bring them to you, sit down and the shoes go on licitly split.  The next time they get the shoes, throw them across the room, lay on the floor and look at you like “me no wanna”. 

Trust me, you are not a “bad” parent, you are just living through some really challenging parenting. It is exhausting at times, but while this age is typically difficult it is some of your most important parenting. This is really the beginning of behavior modification.  Your brilliant toddler is testing you, this may be the first time you the parents understand why everyone talks about boundaries and consequences. 

Some children also express their “me no wanna” by acting out with hitting, biting and kicking. Again, very inappropriate behavior. Your job is to change that behavior by using time out, or taking away a toy or even putting the child to bed early.. There are so many ways to start letting your toddler know that there are consequences for misbehaving, and that tantrums don’t work. 

I am in throes of “me no wanna” again, only this time it is with a puppy! Seems very similar to me.

Daily Dose

Breaking Bad Habits

1:15 to read

Do any of your children bite their nails or suck their thumbs? If so, are you always saying, “take your fingers out of your mouth, they are dirty”, or “if you keep biting your nails you will get sick due to all of those germs on your fingers”!  I was guilty of saying those very things to my own children, and I also remember being a nail biter and my mother saying the same thing to me.

Well, who would have thought that a study just released today in the journal Pediatrics might make us parents eat our own words (it wouldn’t be the first time).  The study, “Thumb-Sucking, Nail-Biting and Atopic Sensitization, Asthma and Hay Fever” suggests that “childhood exposure to microbial organisms reduces the risk of developing allergies”.  Who knew that there might be something so positive coming from a “bad habit”.  

This study was done in New Zealand and followed over 1,000 children born between 1972-1973 (dark ages) whose parents reported that they either bit their nails or sucked their thumbs at 5,7,9 and 11 years old. The participants were then checked at ages 13 and again at 32 years old to look for an allergic reaction ( by skin prick testing) against at least one common allergen.  And guess what…at 13 years of age the prevalence of an allergic reaction was lower among those children who HAD sucked their thumbs or bitten their nails.  Incredibly the the findings persisted almost 20 years later!  This study even looked at cofounding factors including sex, parental history of allergies, pet ownership, breast feeding and parental smoking… none of which played a role. 

So, while not advocating for children to suck their thumbs or bite their nails (which unfortunately I did until high school when I decided to have nails to polish) there may be a silver lining….a protective effect against allergies that persists into adulthood. 

Lemonade out of lemons!!!

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