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Your Teen

Knee Surgeries Increasing for Female Teen Athletes

2:00

In 1972, Title IX of the Education Amendments Act was passed. The law requires educational institutions to maintain policies, practices and programs that do not discriminate against anyone on the basis of gender. 

Young women and girls were given the opportunity to equally participate in school sports programs and receive athletic scholarship money proportional to their participation.

It was a monumental advancement for young girls and women, but along with opportunity came injuries.

A growing number of teenage girls are joining their male counterparts on the operating table to repair torn knee ligaments, according to a new study.

Researchers focused on surgery for a common knee injury known as an anterior cruciate ligament (ACL) tear, which has long been linked to intense participation in sports like basketball and soccer which require constant pivoting as well as contact sports like football.

The study of private insurance data for 148 million U.S. residents found that overall, the average annual ACL surgery rate climbed 22 percent from 2002 to 2014, when it reached 75 procedures for every 100,000 people.

For teen girls, however, the average annual knee surgery rate rose by 59 percent during the study period to 269 procedures for every 100,000 people. 

“Although there are proven ACL injury prevention programs available, they are not being widely adopted, particularly among young women,” said lead study author Mackenzie Herzog of the University of North Carolina at Chapel Hill.

The study didn’t focus on why the injuries are happening, but Herzog noted a few reasons why he thinks the increase in injuries might be happening in youth sports.

“Two particular trends that concern us are increased trends toward year-round sports participation at a young age and the tendency to specialize in one sport early,” Herzog said.

For teen boys, the average annual knee surgery rate climbed 44 percent during the study period to end at 212 procedures for every 100,000 people, researchers report in JAMA Pediatrics. 

Surgery rates also rose faster for women than for men, although adult male athletes still had more procedures. By the end of the study, 87 men and 61 women out of every 100,000 people had ACL surgery each year.

In an email to Reuters, Dr. Devin Peterson, a researcher at McMaster University in Hamilton, Ontario, who wasn’t involved in the study, said cross-training programs that include exercises to improve strength, balance, coordination and muscle control could help prevent ACL tears.

Pediatric sports medicine expert R. Jay Lee, offers these tips and more from the Johns Hopkins Medicine website:

Get a preseason physical. A preseason or back-to-school physical is a great way to determine if your young athlete is fit to play. “Sports physicals help assess any areas of concern for athletes before they start an activity, and in turn keeps them from further injuring themselves during play if a condition is present and needs to be treated,” says Dr. Lee.

Encourage cross training and a variety of sports. “I see kids today who play on two baseball or lacrosse teams on the same day or throughout the week and year. But it’s important for athletes to change the sports or activities they are doing so they are not continuously putting stress on the same muscles and joints,” warns Dr. Lee. Parents should consider limiting the number of teams their athlete is on at any given time and changing up the routine regularly so that the same muscles are not continuously overused.

Warm up before the sports activity. Stretching is an important prevention technique that should become habit for all athletes before starting an activity or sport. Dr. Lee suggests a mix of both static and dynamic stretching during warmups to help loosen the muscles and prepare them for play. Toe touches and stretches, where you hold the position for a certain amount of time, are considered static, while jumping jacks and stretches, where the body continues to move during stretching, are considered dynamic.

Make sure the proper equipment is used. Protective equipment, like helmets, pads and shoes, are very important for injury prevention. Parents should talk with coaches before the season starts so that they have adequate time to properly outfit their child before practices begin.

Recognize injury and get help quickly.  “I’ve seen a number of young athletes who have serious injuries and didn’t do anything about them, and now the damage has progressed,” Dr. Lee warns. “We need to get these kids in to see a doctor earlier to keep this from happening.”

If parents notice that there is a change in their athlete’s technique, such as a limp when running, throwing differently or rubbing a leg during activity, they should pull the athlete out of play. If the problem persists, parents should seek an assessment for their child prior to returning to the activity.

Dr. Lee warns: “Athletes will alter the way they do things because of pain, but then they can end up with a more serious injury because of it.”

Story sources:  Lisa Rapaport, http://www.reuters.com/article/us-health-acl-surgeries-girls-idUSKBN1952SE

http://www.hopkinsmedicine.org/health/articles-and-answers/prevention/10-tips-for-preventing-sports-injuries-in-kids-and-teens

 

Daily Dose

Stress Fractures & Vitamin D

1.10 to read

I take care of a lot of adolescent girls and many of them are involved in very competitive sports.  As participation in organized sports and single sports year round has increased so too have overuse injuries. 

 One of the most common overuse injuries is a stress fracture which occurs when “stresses on the bone exceed the bone’s capacity to withstand and heal from those forces”.  Stress fractures have been reported to occur in 3.9% of adolescent girls, and 90% of those stress fractures occurred in girls who participated in at least 1 hour/day of high impact activity. 

During my adolescent visits, I have routinely emphasized the importance of healthy diets as well as the need for calcium and calcium rich dairy products.  Knowing that adolescence is the most critical period for bone mineral deposition, and therefore has been considered an important window to hopefully prevent osteoporosis later in life. 

In a recent study out of Harvard over 6700 girls ages 9 - 15 were followed for 7 years to identify whether calcium, vitamin D, and/or dairy intake was associated with stress fracture. 

Surprisingly, there was no evidence that calcium and dairy intakes were protective against developing a stress fracture.  But, higher vitamin D intake among girls who participated in at least 1hour/day of high impact activity, was predictive of a lower risk of developing a stress fracture. 

So, while a balanced diet including dairy products is important for over all health, vitamin D seems to be protective and lowers the risk of a stress fracture. The study did not look at vitamin D intake above 600 IU/day (which is the current recommended dietary allowance). Further research will be needed to see if even higher amounts of Vitamin D prove to be even more protective. 

In the meantime, make sure that your adolescent is getting their recommended daily dose of Vitamin D and keep watching for further studies to determine the mechanism through which Vitamin D may alter stress fracture risk.

Daily Dose

Say No to Tanning Beds!

1.30 to read

I have previously discussed the importance of sunscreen but it is equally important to discuss the risk of artificial tanning and the use of tanning beds. I have emphasized that it is never too young to start using sunscreen, but for some reason teens think that tanning beds are a safe way to tan rather than going outside in the sun.

Not so.....tanning beds are using UVA radiation which can cause mutations in your DNA which can then lead to skin cancers. Dermatologists are seeing an increase in young women (who are more likely to use tanning booths) in their mid to late 20’s with  the deadliest form of skin cancer, malignant melanoma. Many of these women admit to frequent tanning during their teen age years.

Malignant melanoma is different than basal cell carcinoma and squamous cell carcinoma,  the other more common forms of skin cancer. Malignant melanoma may spread rapidly to internal organs and lymph nodes, and if not detected at an early stage,  may be fatal within months to years.

Young girls need to understand the risks of using a tanning bed and should be encourage to use a spray tan or a tan towel to achieve the “glow” that they are wanting. They need to understand the risks that are proven to be associated with tanning bed use. Many teens and young adults are using tanning beds that are provided at their dorms or apartments as well.

If there is a family history of melanoma or unusual moles then the risk may be greater to develop an atypical mole. Those young adults who have tanned need to be followed by a dermatologist who can examine their body head to toe and “map” their moles and identify any unusual moles. At the same time they may be educated as to how to follow their own moles and changes they should be aware of.  Do you know that melanomas may arise anywhere on the body, not only the sun exposed area!

Recent articles have shown that tanning beds may be associated with an increase in non melanoma skin cancers as well. While these lesions may take longer to develop, teens and young adults need to be aware of this risk as well.

The state of California has become quite progressive in advocating for the safety of children and their skin.  California recently passed a law that children under the age of 18 may no longer use tanning beds. Other states are looking at similar legislation. Makes sense to me!

So....... no suntanning and no tanning beds. Rub, wipe or spray on your tan or enjoy beautiful fair skin. Not only is it safer, you don’t have to worry about wrinkles later in life (trust me on this issue!)

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

Daily Dose

HPV Vaccine & Teens

1.15 to read

Summertime in the pediatrician's office means lots of check ups, and often this includes those tweens/teens/and college students who were “too busy” to schedule their doctor’s appointments during the school year.  The next three months will be busy indeed.

With HPV back in the news after Michael Douglas revealed that his throat cancer was due to HPV, what better time to remind parents and young adults of the need for the HPV vaccine.  The HPV vaccine has been available in the U.S. for over seven years, but statistics from the CDC continue to show that the HPV vaccine is still not being given at the same rate as other recommended vaccines. In other words, we doctors need to ensure that every person between the ages of 11-26 who we see is offered the vaccine, this also means we need to educate.

HPV causes CANCER!   This is truly the first anti-cancer vaccine, and I am hopeful that I will see more vaccines to prevent cancer while I continue to practice. I am sure that there will be more anti-cancer vaccines in our children’s lifetime.  This is exciting news as research continues on ways to combat cancer.

But.....for some reason (that is difficult for me to understand both as a parent and a physician), some parents are refusing to have their children vaccinated despite ongoing evidence that HPV is widely prevalent and causes numerous cancers.  The fact that this virus is transmitted sexually seems to be the root cause of parental concern.  Do parents not assume that their own children will become parents one day as well?  Don’t they want to be grandparents one day?  Well, that means having sex with a partner.  At some point in time, our children do become “sexually active” and shouldn’t they all be protected as much as possible?

Giving adolescents the HPV vaccine does not promote sexual activity. In fact, I think that by having a discussion about sexually transmitted diseases in an open and frank manner adolescents are more aware of the risks associated with pre-marital sex and multiple partners.

My adult sons gave me a huge compliment the other day when HPV was back in the news - they said “Mom, remember when you gave us that vaccine “off label”?  We thought you were crazy but you were really smart!” I will take any praise I can get....I just smiled. 

Daily Dose

Teens, Sun and Acne

Teens using acne medication need to take extra care of their skin during the sunny months.With the sun beating down on many us, this seems like the beginning of  a long, hot summer. I am already seeing kids with sunburned shoulders and noses, and this brings to mind all of my teenage patients who are using products, both OTC and prescription, for treatment of their acne.

Although I discuss sun protection with teens throughout the year, summer is an especially important time to re-iterate the risk of sunburn and sun damage, especially for those who are using acne products. While I was growing up (many moons ago), we all thought that baking our faces in the sun helped with pimples and acne. In fact, you may see some improvement in a teens “pimply” skin after they have been in the sun, but at what cost? According to the American Academy of Dermatology, 80% of lifetime sun exposure occurs before the age of 18.  Blistering sunburns before the age of twelve (think about those peeling noses) and freckles before age 12 are both signs that too much sun exposure has happened. Many teens use over the counter products containing glycolics, lactic acids and salicylic acid products.  These products promote exfoliation (peeling) of the skin which results in more sun sensitivity. Teens are also often prescribed a group of drugs called retinoids that are applied topically to control acne.  The most common names are Retin-A, Differin (a retinoid analog), Tretinoin (generic), Renova, Tazorac, and combination products like Ziana, and Epiduo. These products cause exfoliation of the top layer of the skin which initially causes increased sun sensitivity, but after about the first 30 days of using these products you actually get thickening of the skin and therefore will have minimal to no increase in sun sensitivity as long as you are not getting red, dry or irritated from these products. I typically do not begin a teen on a retinoid product during the summer months if they are planning significant sun exposure. Procedures such as micro-dermabrasion and peels will also cause increased sensitivity early on. Due to the above statements it  is important that teens using topical ( as well as oral) acne products apply a daily facial sunscreen.   Products such as Oil of Olay Complete 15 or Complete Defense 30, or Neutrogena Dry Touch #30 are both inexpensive and well tolerated. When buying a facial sunscreen you want to make sure that the product says “non-comedogenic, non-greasy, non-irritating and broad-spectrum (UVA/UVB) coverage. For sun exposure at the pool/beach/sporting activities etc. I would use a higher sunscreen product like Neutrogena Dry Touch 55. You want to apply these to the face 30 minutes prior to sun exposure.  Make sure that you are using more than enough sunscreen on the face, squirt out enough that it looks like you have too much and just keep rubbing it on until it disappears. We are all guilty of applying too little sunscreen when using these products. Rule of thumb is a shot glass full of sunscreen can cover the whole body, but also needs to be reapplied every 2 hours. Lastly, hats and sun protective clothing definitely have a place in preventing sun damage to teens faces. These are especially useful for teens who may be lifeguarding, working on outdoor projects, or spending long hours with continuous sun exposure. Do not allow your teens to tan in a tanning booth either as this is even WORSE than tanning outdoors. If you do get a facial sunburn try mixing 1 part vinegar to 4-6 parts water to make a solution. Chill the solution and use a well soaked washcloth to apply to affected areas. Ibuprofen is also more effective for pain relief and inflammation than acetaminophen. Frequent moisturization as well as the use of a OTC topical steroid cream may also ease the symptoms, but the skin damage has already been done. With good sun protection, and a little planning a head, most teens can continue to use their acne treatment products. That's your daily dose for today.  We'll chat again tomorrow. Send your question or comment to Dr. Sue now!

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Your Child

Worrisome Increase in Kidney Stones in Teens & Children

1:45

Typically, kidney stones occur in men over the age of 25, but new research shows that the annual incidence of kidney stones among children and teens has risen by 16 percent from 1997 to 2012.

Researchers analyzed data from South Carolina from 1997 to 2012 and were surprised to see that the largest increase was with teens (4.7 percent a year), females (3.7 percent a year) and blacks (nearly 3 percent a year).

During the study period, the risk of kidney stones doubled among children, and there was a 45 percent increase in the lifetime risk for women.

Teen girls had the highest rate of increase in kidney stones, and they were more common among females aged 10 to 24 than among males in the same age group. After age 25, kidney stones were more common in men, the study authors said.

"The emergence of kidney stones in children is particularly worrisome, because there is limited evidence on how to best treat children for this condition," said study leader Dr. Gregory Tasian, a pediatric urologist and epidemiologist at The Children's Hospital of Philadelphia.

"The fact that stones were once rare and are now increasingly common could contribute to the inappropriate use of diagnostic tests such as CT scans for children with kidney stones, since health care providers historically have not been accustomed to evaluating and treating children with kidney stones," he explained in a hospital news release.

"These trends of increased frequency of kidney stones among adolescents, particularly females, are also concerning when you consider that kidney stones are associated with a higher risk of chronic kidney disease, cardiovascular and bone disease, particularly among young women," Tasian added.

What causes kidney stones? According to the Mayo clinic, kidney stones do not have a single cause, although several factors can increase one’s risk.

Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate and uric acid — than the fluid in your urine can dilute. At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for kidney stones to form.

Some of the risk factors include a family or personal history of kidney stones, dehydration, diets high in protein, sodium and sugar, obesity and other several other medical conditions.

Symptoms can include:

•       Severe pain in the side and back, below the ribs

•       Pain that spreads to the lower abdomen and groin

•       Pain that comes in waves and fluctuates in intensity

•       Pain on urination

•       Pink, red or brown urine

•       Cloudy or foul-smelling urine

•       Nausea and vomiting

•       Persistent need to urinate

•       Urinating more often than usual

•       Fever and chills if an infection is present

•       Urinating small amounts of urine

If your child or teen exhibits severe back or side pain, pain and nausea and vomiting, pain with fever and chills, blood in the urine or has difficulty passing urine, he or she should be seen immediately by a physician.

There may be a number of reasons for the rise in kidney stone rates, including not drinking enough water and poor eating habits, such as increased salt and decreased calcium intake, the researcher said.

The findings were published online in the Clinical Journal of the American Society of Nephrology.

Source: Robert Preidt, http://teens.webmd.com/news/20160115/rise-in-kidney-stones-in-teens-a-cause-for-concern-study

 

 

Your Teen

Parenting Tweens & Teens

2.15 to read

As a mother or father, who hasn’t wished that their child came with a “How To Be The Perfect Parent” handbook? It would be nice if for every stage of emotional and physical growth there was a clear –one size fits all- plan that would take the stress and confusion out of developing good parenting skills. Alas though, there’s no such thing, but there are experts who can help guide you. 

With children come different personalities that respond uniquely to his or her situations. It’s part of the challenge of raising a mature, thoughtful and self-sufficient adult.

The tween and teen years can be some of the most challenging times for child and parent relationships.

What is a “tween?” The tween years are approximately 9-14. It is less an age category than a developmental stage when your son or daughter is no longer a child and not yet a teen. Today puberty is statistically happening at younger ages on the average and that could be confusing to parents who think that their kids will be childlike until they’re 12.

More focus is placed on tween behaviors now than just 2 or 3 generations ago. Society has changed dramatically during the last decade.  Media images that encourage “grown-up” looks and behaviors as well exposure to sexualized fashion, music, and even dolls has had an enormous impact on this generation of youngsters.  The tween years aren’t what they used to be.

Everything is in flux as your little one strives for more independence, and you try your best to help them avoid making mistakes that can last a lifetime. And then there is the “generational gap” that puts a strain on being able to even have a civil conversation. Fashion, music, drugs, alcohol, sex, movies, cars, celebrities, school and peers begin to play a larger role in their life than you can possibly imagine.

And then there are teenagers, the adolescent years between 13 and 19. 

There may not be a one size fits all easy-peasy guide to parenting available, but there are tips from experts that can help parents navigate the rough waters of the tween and teen years.

WebMD.com delves into 5 common mistakes parents make as their children hit the unpredictable tween and teen years. Let’s take a look at some recommendations.

Parenting Mistake # 1- Expecting the worse from your child.

Although the tween and teen years can be difficult, expecting the worse from your child can lead to self-fulfilling behaviors. 

Teenagers get a bad rap, says Richard Lerner, PhD, director of the Institute for Applied Research in Youth Development at Tufts University. Many parents approach raising teenagers as an ordeal, believing they can only watch helplessly as their lovable children transform into unpredictable monsters. Expecting the worst sets parents and teens up for several unhappy, unsatisfying years together.

“The message we give teenagers is that they’re only ‘good’ if they’re not doing ‘bad’ things, such as doing drugs, hanging around with the wrong crowd, or having sex,” Lerner tells WebMD. Raising teenagers with negative expectations can actually promote the behavior you fear most. According to a recent study conducted at Wake Forest University, teens whose parents expected them to get involved in risky behaviors reported higher levels of these behaviors one year later.

Lerner urges parents to focus on their teenagers’ interests and hobbies, even if you don’t understand them. You could open a new path of communication, reconnect with the child you love, and learn something new.

Parenting Mistake # 2 – Reading too many parenting books.

What was I just saying about wanting a book to provide all the parenting answers? It appears that is not only impossible, but it’s not even a good idea.

Rather than trusting their instincts, many parents turn to outside experts for advice on how to raise teens. “Parents can tie themselves into knots trying to follow the advice they read in books,” says Robert Evans, EdD, executive director of the Human Relations Service, Wellesley, Mass., and author of Family Matters: How Schools Can Cope with the Crisis in Child Rearing.

“Books become a problem when parents use them to replace their own innate skills,” Evans tells WebMD. “If the recommendations and their personal style don’t fit, parents wind up more anxious and less confident with their own children.”

Use books (and articles like this) to get perspective on confusing behavior and then put them down. Spend the extra time talking with your spouse and children, getting clear about what matters most to you and your family.

Parenting Mistake #3 - Sweat the Small Stuff 

Too often, we all sweat the small stuff, and sometimes ignore the big stuff. It’s certainly much easier to focus in on a behavior that we don’t like instead of trying to deal with a behavior that is frightening or dangerous.

Maybe you don’t like your daughter’s haircut or choice of clothes. Or perhaps she didn’t get the part in the play you know she deserves. Before you intervene, look at the big picture. If a certain mode of self-expression or set of events does not put your child at risk, give her the leeway to make age-appropriate decisions and live with the results.

“A lot of parents don’t want growing up to involve any pain, disappointment, or failure,” Evans says. But protecting your child from the realities of life robs her of the opportunity to take chances and learn from her mistakes while she’s still under your roof. Step back and let your child know you’re there when she needs you.

Parenting Mistake # 4 - Ignore the Big Stuff 

The big stuff is where things get dicey.

If you suspect your child is using alcohol or drugs, do not look the other way. Parents should address suspected drug or alcohol use right away, before it escalates into a bigger problem, says Amelia M. Arria, PhD, director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health.

“The years when kids are between 13 and 18 years old are an essential time for parents to stay involved,” Arria tells WebMD. Parents might consider teen drinking a rite of passage because they drank when they were that age. “But the stakes are higher now,” she says.

More drugs are available today, illegal drugs and legal medications. For example, cough remedies with DXM (dextromethorphan) have become a new drug of choice for some teens. DXM is easy to get and teens and parents alike underrate its potential dangers. Studies show that between 7% and 10% of U.S. teens have reported abusing cough medicine to get high. Although safe when used as directed, DXM can cause hallucinations and disassociations similar to PCP or ketamine (Special K) when used in excessive amounts, as well as rapid heartbeat, unconsciousness, stomach pain, and vomiting.

Watch for unexplained changes in your teen’s behavior, appearance, academic performance, and friends. If you find empty cough medicine packaging in your child’s trash or backpack, if bottles of medicine go missing from your cabinet, or if you find unfamiliar pills, pipes, rolling papers, or matches, your child could be abusing drugs. Take these signs seriously and get involved. Safeguard all the medicines you have: Know which products are in your home and how much medication is in each package or bottle.

Drugs are not the only “Big stuff” to keep an eye on; too much time on the computer or texting, sexual activities and interests, distracted driving habits are just a few other categories that require more attention from parents.

Tweens and teens make mistakes and get themselves in over their head with drugs and alcohol, sexual behaviors, poor school grades and more. These risk behaviors can become real problems in your teen's life and be hurdles in the way of their success. While it's important for a parent of a teenager to allow privacy, we also have to be monitoring what our teens are into so we can help guide them away from risk taking behaviors. Your teen needs to have limits in your home. When you allow your teen to do anything they want, they will begin to take control and you are no longer the parent.

Parenting Mistake #5 - Rule With an Iron Fist, or Kid Gloves

Some parents, sensing a loss of control over their teens’ behavior, crack down every time their child steps out of line. Every day brings a new punishment. The home becomes a war zone. By contrast, other parents avoid all conflict for fear their teens will push them away. They put being a cool parent ahead of setting limits and enforcing rules. For these parents, discipline is a dirty word.

This style of parenting focuses on obedience above all else. Although the house may run like a tight ship, teens raised in rigid environments don’t have the opportunity to develop problem-solving or leadership skills.

Yet too little discipline does a disservice to teens as well. Teenagers need clear structure and rules to live by as they start to explore the world outside. It is up to parents to establish their household’s core values and communicate these to their children through words and consistent actions. Lerner calls this being an authoritative parent, an approach that “helps children develop the skills they need to govern themselves in appropriate ways.”

 

One key thing to remember about the tween and teen years is .. it’s not personal. It may feel very personal when your child yells that they hate you, can’t stand you, or never wants to see you again, but in most cases, it’s an angry outburst driven by not getting their way.  Remember your teen years?  We’ve all said things we regret later, learning to communicate effectively with your teen or tween smoothes a lot of bumpy roads.

Keep in mind that your influence runs deeper than you think. Most teens say they want to spend more time with their parents. And teens choose friends that have their parents’ core values. Keep making time for your child throughout the tween and teen years. Even when it doesn’t show, you provide the solid ground they know they can always come home to.

 

Daily Dose

HPV & Sexually Active Teens

1.30 to read

Another article on HPV has appeared in this month’s journal Pediatrics.  This one is really interesting as it relates to adolescent behaviors, not just to vaccine efficacy. 

When the HPV vaccine was first released (over 7 years ago) there were many parents who were skeptical about giving a vaccine, which provided protection against a sexually transmitted infection, to children between the ages of 11 and 12 years. Remember, it does not protect against any other sexually transmitted infection or pregnancy, just HPV. 

In my own practice I had many parents who would comment, “ I will give my daughter (we now give the vaccine to boys as well) the vaccine when she is older, as I don’t want her to think that she can have sex, just because she had the vaccine”.  I have often heard this same comment made by parents when I suggest that birth control pills might help their daughter’s adolescent acne. I have not only raised my own three sons, but many an adolescent in my practice and I have yet to believe that a vaccine or a medication are the reason a teen decides to have pre-marital sex. In fact, I think that most teens don’t THINK enough before having sex!! They often think after the fact, when they feel scared or remorseful, and then want to make sure that they were protected, but it is already too late. (remember: the immature, impulsive teen brain!) 

So, this study conducted by Kaiser Permanete/Emory University, followed more than 1,300 pre-teen girls who received the HPV vaccine over a three year period.  In fact according to Dr. Robert Bednarczyk, the lead author, “there was no increase in pregnancies, sexually transmitted infections or birth control counseling, all of which suggest the HPV vaccine does not have an impact on increased sexual activity”.  

 While the HPV vaccine protects both boys and girls from four serotypes of HPV that cause both pre cancerous and cancerous lesions as well as genital warts, getting vaccinated does not modify adolescent girls (and one would assume boys as well) sexual behavior. What is does do is to provide protection before the adolescent is ever exposed to the virus, so that once they enter their sexually active years they have antibody to protect them. 

Unfortunately, not even 50% of adolescents have received even one dose of the HPV vaccine, and only 35 % (girls rates higher than boys) have completed the 3 dose series.  

Hopefully this study will allay some parental misconceptions about the HPV vaccine and we will see immunization rates continue to rise.

Daily Dose

Uber & Teens

1:30 to read

Do you have Uber cars in your area?  I first found out about Uber (and I am only using them as an example) when my son lived in NYC and often used the car service. Later on I heard about college kids using Uber as well.  In that case, many college kids did not have cars and/or they were being “responsible” after being at a party.

But recently, in conversations with my adolescent patients, I have heard that high school kids are using Uber to come home after a party, or other social activities. In otherwords, their parents are not picking them up from the dance, concert, or party but are letting their children (often young girls) call Uber.  Where are their parents and what are they thinking?

I realize that once your child heads off to college you hope and pray that they are making good choices and are being safe. You don’t really plan on picking them up after an event or talk to them that same night about what they have been doing and with whom.  But when we had high school age children, my expectations were that we, the parents, were responsible for taking our teens to the party and to pick them up. Once they were driving the “rules” changed a bit in that they were then often driving themselves to an event and then would drive home and we would be up waiting for them to get home.  They always knew that we would be there when they got home and also that if there were any “issues” we were also available to pick them up. We talked a lot about underage drinking as well as driving and responsibility.  Never did I think they would call a cab or car service, nor was that idea ever broached, they were to call their parents.

So now that these “app” car services are available around the clock, are parents abrogating their responsibilities for parenting teens?  By allowing their teens to call a car service for their ride home, are parents seemingly not interested in where their child has been or who they have been with or what they have been doing before they get home?  You certainly can drop your child at a concert or party and tell them to text Uber to get a ride home, but does this parental non-participation quietly help to condone inappropriate, risky, teen behavior?

Although picking your child up at the end of the evening or checking on them when they pull in the driveway will never ensure that your teen does not get into trouble, I think it does help them think a bit more about having to interact with their parents at curfew time. This “worry” might help lead them to make a better decision about drugs, alcohol or whom they are hanging out with. Putting teens into the “hands” (cars) of strangers as their ride home just seems wrong. Parents be aware. 

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