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Your Teen

What do Energy Drinks Actually Do to the Body?

2:00

There’s been a lot of discussion over whether caffeine-spiked “Energy Drinks” are really safe for consumption, particularly for kids and young adults.  Although many manufacturers add the advisory statement “not recommended for children, pregnant or nursing women and persons sensitive to caffeine” on their label, it often goes ignored.

The Substance Abuse and Mental Health Services Administration reports that as these drinks have become more popular, the incidences of caffeine related overdoses and deaths have increased.

In one heartbreaking example, 14-year-old Anais Fournier died from cardiac arrest due to caffeine toxicity after consuming two 24- ounce cans of Monster energy drink a day apart.

While the Food and Drug Administration (FDA) has been investigating whether there is causal link to the drinks and health problems, Mayo Clinic researcher Anna Svatikova and her colleagues wanted more information about exactly what happens in your body after you consume one of the drinks.

She and her team recruited 25 volunteers. All were young adults age 18 or older, nonsmokers, free of known disease, and not taking medications. They were asked to drink a 16-ounce can of a Rockstar energy drink and a placebo -- with the same taste, texture, color and nutritional contents but without the caffeine and other stimulants -- within five minutes on two separate days.

The energy drink had the following stimulants: 240 mg of caffeine, 2,000 mg of taurine and extracts of guarana seed, ginseng root and milk thistle. All typical ingredients associated with energy drinks.

Researchers took numerous measurements first before they drank and 30 minutes after. With the placebo, there was very little change. With the energy drink, however, many of the changes were marked:

•       Systolic blood pressure (the top number) - 6.2 percent increase

•       Diastolic blood pressure (the bottom number) - 6.8 percent increase

•       Average blood pressure - 6.4 percent increase

•       Heart rate - none

•       Caffeine in blood - increase from undetectable to 3.4 micrograms/mL

•       Norepinephrine level (the stress hormone, which can give you the shakes when you have too much caffeine) in blood - increase from 150 pg/mL to 250 pg/ML

Writing in JAMA, the researchers said that these changes may predispose those who drink a single drink to increased cardiovascular risk.

This may explain why a number of those who died after consuming energy drinks appeared to have had heart attacks.

They also exposed the volunteers to two-minute physical, mental, and cold stressors after consuming the energy drinks to see how that might affect blood pressure and other body functions.

The physical stressor involved asking participants to squeeze on a handgrip; the mental one to complete a series of mathematical tasks as fast as possible; and the cold one immersing their one hand into ice water. Interestingly, there was no further change.

Another thing that is typically overlooked when people choose one of these drinks is the serving size. A 16-ounce can is two servings. A 24-ounce can has three servings. Caffeine and sugar content is often listed per serving. But honestly, how many people drink a third or half a can at a time? Besides caffeine, other stimulants are often added to energy drinks such as Ginseng and Guarana. Most people have no idea what they are, what they do and if they negatively interact with medications.

The American Beverage Association defends the drinks and said in a statement  that "there is nothing unique about the caffeine in mainstream energy drinks, which is about half that of a similar sized cup of coffeehouse coffee" and that drinking coffee would have produced similar effects.

“The safety of energy drinks has been established by scientific research as well as regulatory agencies around the globe. Just this year the European Food Safety Authority (EFSA) confirmed the safety of energy drinks and their ingredients after an extensive review," the organization said.

It’s up to parents to decide whether these drinks are beneficial to their family or if they should re-think purchasing one for themselves or their child. A family discussion about the pros and cons of energy drinks with pre-teens and teenagers could give the kids the information they need to make a good choice.

Source: Ariana Eunjung Cha, http://jama.jamanetwork.com/article.aspx?articleID=2469194

Your Teen

Stop Yelling at Your Teenager!

2.30 to read

I’m going to go out on a limb and say that anyone who has a child has yelled at him or her at one time or another. As parents, we’ve all lost our patience when we believe our child is misbehaving. If ever there is a time when parents and kids are standing at the crossroad of “Listen to me” and “I don’t need to”, it’s during the teenage years.

Tempers often ignite with harsh words being said.  

While you may be trying to make an important point, aggressive yelling and screaming only pushes your child away and may be doing much more harm than good according to a new study.

An analysis involving nearly 1,000 two-parent families and their adolescent children suggests that such harsh verbal lashings not only don't cut back on misbehavior, they actually promote it.

The end result: an uptick in the kind of adolescent rage, stubbornness and irritation that escalates rather than stops or prevents disobedience and conflict.

"Most parents who yell at their adolescent children wouldn't dream of physically punishing their teens," noted study author Ming-Te Wang, an assistant professor with the department of psychology at the University of Pittsburgh School of Education. "Yet, their use of harsh verbal discipline -- defined as shouting, cursing or using insults -- is just as detrimental to the long-term well-being of adolescents," he said.

"Our findings offer insight into why some parents feel that no matter how loud they shout, their teenagers do not listen," Wang added. "Indeed, not only does harsh verbal discipline appear to be ineffective at addressing behavior problems in youth, it actually appears to increase such behaviors."

Wang and his co-author, Sarah Kenny of the University of Michigan, report their findings in the current issue of the journal Child Development.

The researchers were particularly interested in kids between 13 and 14 years old so they focused on 976 primarily middle-class families in Pennsylvania with young adolescent offspring, all of whom were already participating in a long-term study exploring family interaction and adolescent development. A little more than half the families were white, while 40 percent were black.

The teen participants were asked to disclose recent behavioral issues such as in-school disturbances, stealing, fighting, damaging property or lying to their parents.

Their parents were asked how often they used harsh verbal discipline such as yelling, screaming, swearing or cursing at their child. Most importantly, if they called their child names like “dumb” or “lazy.”

The teens were also asked to what degree they felt “warmth” in their relationship with their parents. Researchers inquired about the amount of parental love, emotional support, affection and care the kids felt like they received from their parents. Both teens and parental depression were tracked.

The study points out that the children who were on the receiving end of the harsh verbal attacks experienced an increase in anger and a drop in inhibitions. Those two reactions prompted an intensification of the very things that parents were hoping to stop – such as lying, cheating, stealing or fighting.

"Parents who wish to modify their teenage children's behavior would do better by communicating with them on an equal level," Wang said, "and explaining their rationale and worries to them. Parenting programs are in a good position to offer parents insight into how behaviors they may feel the need to resort to, such as shouting or yelling, are ineffective and or harmful, and to offer alternatives to such behaviors."

Parents get frustrated with their children and vice versa. None of us behave perfectly all the time. Raising your voice because you are frustrated is one thing, name calling and screaming is quite another.

Imagine if you were at work and your boss screamed at you, called you names and cursed at you because he or she didn’t like how you did something. That may have actually happened to you – remember how you felt, or think about how you would feel. Humiliated, angry and sad are the most common reactions people have.  

Children are trying to find their way in life; parents are their guides. The next time you feel you’re on the verge of screaming or saying hurtful things to your child - walk away. Give yourself time to cool down and find a better way to communicate.

People say kids are resilient and get over things quickly. Many are able to bounce back when bad things happen, but that saying is too often used to excuse bad behavior on a parent’s part. If you’ve crossed the line with your child, say you’re sorry and come up with better ways to handle your frustration and anger.

Words and tone matter and the best teaching method is by example. You can help your child learn what love, patience, tolerance, compassion and respect are by being an example of those very qualities.

Source: Alan Moses, http://consumer.healthday.com/kids-health-information-23/misc-kid-s-health-news-435/yelling-at-insulting-teens-can-backfire-on-parents-study-679863.html

Your Teen

Teenage Girls May Take Longer to Recover From Concussions

2:00

Teenage boys and girls can both suffer a concussion during sports activities; however, female athletes may take more than twice as long to fully recover, according to a new study.

Researchers examined data on 110 male and 102 female athletes, ranging in age from 11 to 18 years, who sustained their first concussion while participating in sports. 

To assess the duration of symptoms, the researchers examined patient records for young athletes treated for concussions at one medical practice in New Jersey from 2011 to 2013. The athletes were 15 years old on average.

Half of the girls reported still having symptoms at least 28 days after sustaining a concussion, while half of the boys no longer had symptoms after 11 days, the study found.

Boys were more likely to receive their injuries while participating in football, soccer, wrestling, lacrosse and ice hockey. Most of the girls’ injuries were from soccer, basketball, softball, field hockey or cheerleading.

Overall, 75 percent of the boys recovered from their concussions within three weeks, compared to just 42 percent of girls.

Researchers acknowledge that the study was a small group and focused on a single medical practice.

It’s also possible that some of the difference in recovery time for boys and girls was due to pre-existing medical conditions, notes one injury prevention director.

According to Dr. Mark Halstead, director of the Sports Concussion Clinic at St. Louis Children’s Hospital, females that who participate in similar sports as males have a higher rate of concussion.

“Boys and girls likely have different recovery courses, but we have to treat each concussion individually,” Halstead, who wasn’t involved in the study, said by email to Reuters Health. . “Adult coaches need to create an environment and culture for their players that stresses that a concussion is an important injury to not downplay and encourage the reporting of symptoms.”

Experts agree that the most important take-away from the study is that it is extremely important for adolescents who sustain a concussion to seek proper care and follow through with recommended treatment and rest following an injury.

A teenager, like an adult, may lose consciousness after getting a concussion, but the majority of people do not pass out after a head injury.

Watch for these symptoms if your teen has suffered a head injury:

·      Dizziness

·      A headache that lasts more than a few minutes

·      Trouble with vision, balance or coordination

·      Nausea or vomiting

·      Difficulty concentrating, thinking or making decisions

·      Trouble speaking, slurring or making sense

·      Confusion, sleepiness, emotional for no reason

·      Seizures

If your child experiences a head injury, make sure that a doctor examines him or her. If any of these symptoms persists, seek immediate medical attention. Concussions should always be taken seriously.

Story source: Lisa Rapaport; http://www.reuters.com/article/us-health-girls-concussion-sport/after-concussion-teen-girls-may-take-longer-to-heal-than-boys-idUSKBN1CH2SS

http://kidshealth.org/en/teens/concussions.html

 

 

Daily Dose

Tattoos

1:30 to read

Some of my adolescent patients (who are over 18 years) have come in for check ups and shown me their latest “fashion statement”, a tattoo or an occasional tongue piercing.  While years ago it was teenage girls with pierced belly buttons, that fad has declined (at least in my patient population), and societal acceptance of tattoos and other body piercings is more common. While I do see tattoos, tongue piercings and eyebrow piercings within my practice… it seems that I also notice them far more frequently on the parents of the new babies I am seeing.

 

While tattoos and body piercings may be a form of self-expression for a teen, it is also important to remember that there may be risks involved.  A recent article in Pediatrics reviewed risks and consequences of the ever growing “body modification” trend.

 

In several surveys somewhere between 20%-38% of youths 18-24 years old have a tattoo or body piercing (other than ear lobe) and the perception of the association between having a tattoo or body piercing and engaging in high risk behavior is changing.  

 

But, when a teen asks me about tattoos or body piercings I do remind them that there are risks involved, including infection. While most teens worry about a skin infection I also remind them of the risks of HIV, hepatitis B and C and even tetanus…so you want to make sure you have an up to date tetanus vaccine before thinking about a tattoo or piercing. You also want to make sure that there are good antiseptic processes and sanitary practices in place when choosing a tattoo parlor and always use a professional tattoo artist.  

 

I also tell them that tattoos should be viewed as being “permanent”, and I would consider where I had the tattoo placed, and would it be possible to cover it if necessary for employment opportunities?  In the not too distant past I remember our office requiring any employee with a visible tattoo to have it covered with long sleeves but while those days are over, at least in my  office, other employers may have rules about tattoos or body piercings. Because tattoos are supposed to be permanent I also remind teens that trying to remove an ill placed or “out of style” tattoo is difficult, expensive and may only be partially effective. 

 

If any piercing or tattoo begins to look infected or has skin changes the adolescent should definitely seek treatment with a physician. Better still….maybe use a henna “non-permanent tattoo” and limit piercings to the ear.

 

 

 

 

 

 

 

 

Your Teen

Is Technology Sabotaging Teen's Sleep?

2:30

For the first time in history, we have adolescents that have never known an age without cell phones, tablets and computers. These marvels of technology have been a part of their lives from birth and they spend an extraordinary amount of time engaged with them. 

All their texting, posting and web surfing is robbing teens of the much needed sleep they need to think and function clearly, according to a new study.

Experts say teenagers need at least nine hours of sleep a night to be engaged and productive during the day. Anything less can cause daytime sleepiness and interfere with school or daily activities.

How much sleep is today’s teen actually getting? Researchers analyzed a pair of long-term, national surveys of more than 360,000 eighth- through 12th-graders to find out.

One survey asked 8th-10th- and 12th-graders how often they got at least seven hours of sleep. The other asked high school students how long they slept on a typical school night.

In 2015, 4 out of 10 teens slept less than seven hours a night. That's up 58 percent since 1991 and 17 percent more than in 2009 when smartphone use started becoming more mainstream, the researchers said.

"Teens' sleep began to shorten just as the majority started using smartphones. It's a very suspicious pattern," said study leader Jean Twenge, a psychology professor at San Diego State University.

The more time students reported spending online, the less sleep they got, according to the recent study published in the journal Sleep Medicine.

Teens that were online more than five hours a day were 50 percent more likely to be sleep-deprived than classmates who limited their time online to about an hour.

Studies have shown that the light emitted by smartphones and tablets can interrupt the body’s natural sleep –wake cycle.  The bright light can make the brain think that it’s daylight and time to stop producing melatonin, a hormone that cues to the body to sleep. By disrupting melatonin production, smartphone light can disrupt your sleep cycle, almost like an artificially induced jet lag. That makes it harder to fall and stay asleep.

If smartphones, tablets and computers are one of the causes for teens’ sleep deprivation, experts agree that moderate use can help change that. Everyone -- young and old alike -- should limit use to two hours each day, the researchers advised in a San Diego State University news release.

It’s not only the light from smartphones that can disrupt your ability to fall asleep, but the content you’re reading. Social media has a way of pulling teens into a discourse or “following” marathon that can eat up those precious hours of rest.

The best solution for electronic sleep deprivation is to make sure your teen puts his or her phone away and shuts down the tablet or computer at least an hour before bedtime.

Story sources: Mary Elizabeth Dallas, https://teens.webmd.com/news/20171020/smartphones-screens-sabotaging-teens-sleep

Kevin Loria, Skye Gould, http://www.businessinsider.com/how-smartphone-light-affects-your-brain-and-body-2017-7

Daily Dose

Marijuana Use

1:30 to read

The legalization of marijuana in a majority of states for both medical or recreational use is making marijuana use more and more prevalent. It  has also made it incumbent for pediatricians to have conversations with teenage patients (and parents) about the harmful effects of marijuana use. 

 

We are now in the in the era of legalization of marijuana, and I find myself having more and more conversations with teenage patients who “think that weed is acceptable and safer than alcohol”.  That statement alone is worrisome. In fact, I “hear” that many teens are using marijuana on a daily basis, and do not realize or are in denial about any long term deleterious effects of daily marijuana use.

 

“Marijuana is not a benign drug, especially for teens. Their brains are still developing and marijuana can cause abnormal and unhealthy changes” according to a just published clinical report from the American Academy of Pediatrics (AAP).

 

Studies have shown that teens who use marijuana on a regular basis may develop serious mental health disorders including addiction and depression. (Some teens are wrongly trying to  self-medicate their own anxiety and depression with a depressant).  Marijuana may also decrease memory and concentration, as well as causing attentional and problem solving issues.  Going to school “high” is just not conducive to academic success.

 

There are also studies that have shown that addiction may be related to daily marijuana use.  17% of people who use marijuana in adolescence may become addicted and that number may increase to 50% for teen who smoke marijuana daily. Daily alcohol use and marijuana use are both harmful but do effect the brain in different ways.  

 

But even knowing those statistics, teen surveys done by the U.S. Dept. of Health and Human Services found that there is decreasing concern for the risk of using marijuana once or twice a week among 12-17 year olds.

 

Parental use of marijuana is equally concerning. Parents not only expose their child to second hand smoke, but seeing parents using marijuana recreationally makes a child more likely to use marijuana themselves. Just like alcohol, being “high” on marijuana makes it difficult to parent and to provide a healthy home environment for a child.

 

Lastly, in my own years of practicing pediatrics I have seen more than a handful of teens who have had serious drug problems….they will all tell you their drug use did not begin with cocaine or meth or even heroin…..they all say it was marijuana that started them down the terrible path of drug addiction.

 

While there is a place for marijuana use in medicine for those with certain chronic conditions or for the management of reducing the side effects chemotherapy, marijuana use is not harmless and will never be.

 

Talk to your teens about drug use and specifically marijuana use…legalization does not make it safe. It is a slippery slope for sure.

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. 

Your Teen

More Teens Getting Tattoos and Piercings

2:00

To many a parent’s chagrin, tattoos and piercings have skyrocketed in popularity among teenagers. While mom and dad may not want to have a serious discussion about the pros and cons of getting a tattoo or body part pierced with their adolescent, the American Academy of Pediatrics (AAP) says pediatricians should be taking to their patients about the health risks and providing safety guidelines.

The AAP released its first report this week regarding tattooing and piercing for adolescents and young adults. The report discusses health risk issues from tattoos and piercings as well providing guidelines to talk to about important safety measures.

"Let's face it, kids are getting tattoos or piercings now," said Dr. Jay Greenspan, chairman of pediatrics at Nemours/A.I. Dupont Hospital for Children. "We know it's mainstream and we want the medical community to be a part of it."

It's unclear how many American teenagers have tattoos and piercings. The report cited a Pew Research Center study that said about 38 percent of young people ages 18 to 29 have at least one tattoo.

In some states, it’s illegal for someone to tattoo or body pierce a minor without the parent’s written consent. But we’re talking about teens here, and where there is a will; there is often a way found around any constraints.  That’s why Greenspan believes that an honest discussion is necessary.

Ten years ago, there was an association between tattoos and alcohol, drug use, violence, sexual activity, eating disorders and even suicide. But that's not the case anymore, the report said.

Today’s teens are more likely to associate tattoos and body piercings with celebrities and sports figures than with the seedier side of life.

Seventy-two percent of teens that have tattoos have them in places that can be covered, the report said. High-ear cartilage is one of the most common visible piercings, followed by navel, tongue and nipple and genital. 

While the rate of tattoo complications is unclear, the AAP believes it's likely low. Common tattoo complications can be inflammation, infections and neoplasms. Preexisting conditions like psoriasis, systemic lupus and sarcoidosis can lead to reactions.

Data on body piercing complications is also minimal. What is known is that teenagers who have a higher risk of infection, particularly those who are diabetic or taking blood thinning medication, may have a greater risk of complications when getting a piercing. 

For piercings, stainless steel posts and studs are recommended to avoid skin reactions. Cheaper products typically have lower quality materials that can lead to a reaction.

So, what do you do if your teen wants a tattoo on their arm or stud placed in their eyebrow? Once you’ve talked it through and if you decide that you’re ok with it, make sure to find a reputable parlor (there are many) and consult with your doctor beforehand to learn how to care for and what to expect during the healing process. Tattoos and body piercings may have become a trend that won’t go away, but they still involve needles and require that certain precautions be taken.

Story source: Meredith Newman, https://www.usatoday.com/story/news/nation-now/2017/09/20/young-people-tattoos-and-piercings-report/686360001/

 

Daily Dose

Teens And Sexually Transmitted Infections

An alarming study in Pediatrics reveals a rise in STD among sexually active teens. Recently, I was reviewing an alarming study in an issue of Pediatrics. Although I use the word alarming, unfortunately it is better stated as “sobering reality” as the statistics only corroborate what I have seen in my own pediatric practice where I take care of many adolescents.

Despite our parental and societal “admonitions” not to have sex before marriage, teenagers are engaging in sexual activity, and they are also developing sexually transmitted infections. The statistics continue to show that somewhere between 60 to 70 percent of high school seniors have had “sex”, and by 12th grade, more girls than boys admit to having had intercourse. More than 15 percent have had multiple partners. In this study, which was done by the Centers for Disease Control and Prevention (CDC), 838 girls ages 14 to 19, who were participating in the National Health and Nutrition Examination Survey 2003 – 2004, provided specimens that were tested for gonorrhea, Chlamydia, trichomonas, herpes, and HPV (human papilloma virus). The prevalence of any of the five sexually transmitted infections (STI) was 24.1 percent. When results were broken down further those teens who reported only one lifetime sexual partner had 19.2 percent prevalence of any STI and for those teens who had more than three sexual partners the prevalence increased to 53.3 percent for an STI. Once again, as in previous studies the most common STI was HPV (types 6 and 11), followed by Chlamydia. HPV infections accounted for nearly three- quarters of the overall STI prevalence. Both of these infections may be silent, in other words, young girls may not have outward evidence of these infections but HPV may lead to cervical cancer and Chlamydia may cause problems with infertility. Unfortunately, I don’t think many teens are thinking about long-term consequences when they engage in pre-marital sexual behaviors. Teens are impulsive, live in the moment and typically feel that “these things happen to other people.” Even when talking about these issues with my own teenage sons I often hear “Mom, we get it we are smart!!” Smart kids get STI’s too. We need to continue discussing sexuality with our children, even at young ages. The more knowledge the better and while still supporting abstinence, they need to learn how to protect themselves if they do have sex. Abstinence only education has not been successful as we see our teen pregnancy rates rising and now the rate of sexually transmitted infections are even more prevalent and occur quickly after a girl’s sexual “debut”. All girls (and now boys) ages 11 – 26 should receive HPV vaccinations and sexually active adolescent females need to be screened yearly for Chlamydia. We need to ensure that all of our adolescents have access to sex education and sexual health care.  Keep up the dialogue. That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue!

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