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Daily Dose

The Dangers of Diagnosing Online

The hazards of using the Internet as your own medical textbook can be great.Here I am on the internet writing about the dangers of diagnosing yourself or your children via information on the web. The internet is a valuable resource, and I cannot remember what I used to do before I could “Google” something to get a quick answer. You don’t need a phone book anymore or zip code directory or even a map, as it is all available online.

But, when it comes to medicine there is still nothing as effective and reliable as seeing a doctor in person and having a physical exam. The hazards of using the Internet as your own medical textbook can be great. The Internet is a resource, and not a doctor. Just like Sir William Osler taught when he published The Principles and Practice of Medicine in 1892, the physician must examine the patient. The best doctors still take a complete history and do a good physical exam!! I often tell parents and patients to use the Internet as an adjunct once the diagnosis has been made. The Internet may be a great resource to provide further information about a specific problem or disease. But when searching online you want to make sure that you are using a resource that has good research and is reputable and reliable. Many postings on the web may be anecdotal rather than factual and there are no requirements on the web to post information. In other words, you don’t have to go to medical school and get a degree to “publish” on the Internet. I sometimes see a worried parent in my office, whose child may have awakened during the night with a “tummy ache”. Despite the fact that the child had already gone back to sleep, the parents stayed up searching the Internet for “abdominal pain”. Due to their Internet “research” the parents have convinced themselves that their child must have appendicitis, and by morning they are convinced that testing is warranted (of course they read every blog about “missed appendicitis”). The child may have had no other symptoms than that “tummy ache”, slept the rest of the night, and awakened feeling just fine, ate breakfast and are ready for their day. But, they appear in my office, many times 8 – 12 hours later and want to run for further tests and are planning for imminent surgery. All of this anxiety provoked by Internet research. Somehow, the most common symptoms have been overlooked during the parent’s panic. The child feels fine now, looks great and is ready to go back to playing! But the poor parents have scared themselves into wanting CAT scans and ultrasounds to “make sure” nothing is missed. A good review of the history and physical exam is often all that is needed in the case of the “mystery midnight tummy ache”. The only thing that came of that internet research is that the parent had 12 hours of a tummy ache worrying about obscure diagnoses rather than heading back to bed themselves. So, beware of using the Internet for research without knowing what you are researching. Always use reputable web sites and check out the credentials of those who are giving information. Beware of people or companies that provide information that are not in the mainstream and who do not provide valid scientific research to back their claims for a “cure”. When in doubt, ask your own doctor, I am sure they have an opinion about the pros and cons of online diagnosing. That’s your daily dose, we’ll chat again tomorrow. How much do you use the internet when it comes to a diagnosis? Let me know and leave your comment below.

Your Teen


It used to be that parents only had to worry about their child being bullied while on the playground. But now, with over 50 million children online, parents need to take steps to make sure their children are not being bullied while online.

“When a child is online, you can’t see how the victim is reacting, you can’t see how many people are against one person,” says Dr. Kristy Hagar, an assistant Professor of Psychiatry UT Southwestern Medical Center. She says some of the warning signs of cyberbullying include a child not wanting to go to school, behavioral changes and spending a lot of time online. “Girls tend to cyberbully more frequently than boys,” says Dr. Hagar. She also adds that pre-teens are more likely to tell their parents about it than older children. It is important for parents to talk with their children at an early age about internet safety and predators. Dr. Hagar also says parents should monitor their child’s online activities. “Set ground rules and time limits for computer use, this is the best way to insure safety.”

Daily Dose

Internet Gaming

1:15 to read

I know a lot of kids received electronics for Christmas so they may now play all sorts of games.  But, with the electronics comes the issue of how long may they play, what games are age appropriate and when is it “too much”? Do you ever feel as if your child vanishes for hours on end in their room and suddenly you realize that they have been “gaming” all day.  


I recently read an article on gaming addiction and I had not realized how problematic this issue has become.  It seems that an increasing number of of children and adolescents are becoming pre-occupied with internet gaming and they demonstrate compulsivity and exclude other interests, including family time, school and outside activities. 

This is a new type of addiction and is even included in latest version of the Diagnostic and Statistical Manual of Mental Disorders as “Internet Gaming Disorder”. Some of the criteria include:

*Pre-occupation or obsession with Internet gaming

*Withdrawal symptoms when not able to play, including irritability or sadness

*Loss of interest in other previously pleasurable activities

*Lying about internet gaming time

I did not realize that the problem with Internet gaming addiction is such a problem in South Korea. In 2006 it was reported that 50% of South Korea youth were dealing with addiction!! In the U.S. it has been estimated to affect somewhere between 2-7 % of the population. There have even been outpatient treatment programs that have recently opened in the U.S. to deal with this issue.

Interestingly, when gaming there is stimulation of areas of the brain that have been associated with addiction.  Some studies have been done looking at images of the brain while gaming and this addiction is similar in neuro-circuitry to substance related addictions.  Scary stuff.

So parents, be aware and educate your kids on responsible Internet use and gaming.Remind kids that addiction issues tend to run in families…you can’t change your genetics. Make sure you know the warning signs of addiction such as decreasing school performance, cravings to play or withdrawal symptoms when games are taken away.

The best treatment and intervention seems to be cognitive behavioral therapy (CBT) and specific therapy has recently been developed. However, this treatment is in early phases and interventions will continued to need to be studied. 


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