What is adolescent medicine?
By Liana R. Clark, MD
Director, Teen Health Associates
What should parents do about health care for their teenagers? Sometimes teens feel awkward with pediatricians because they're no longer youngsters, but then they're not quite ready for adult doctors. Who can you look to, not only take care of their physical well-being, but also to make sure that their lives are on the right track?
The answer is an adolescent medicine specialist. We adolescent medicine physicians take care of the unique health care needs of the teenager, from age 12 to 21. We are physicians who have completed specialty training in pediatrics, family practice, or internal medicine and have undergone an additional two to three years of further training in adolescent medicine. We provide routine examinations, treatment of acne, sports physicals, menstrual and routine gynecologic care. Generally, we can address any issue your teens might have.
How is an adolescent visit different from a pediatrician's visit?
Adolescent physicians encourage our teens to actively participate in their health care. Typically teens are seen initially with their parents, but have private time for discussion of their personal, and social concerns with the assurance of confidentiality. Exams are also completed in private.
The first change our patients notice is that we want them, not their parents, to do most of the talking during the visit. This is to help them develop a relationship with their doctor directly, as well as helping assure that they begin to take responsibility for their health. Parents also have time to address any concerns they might have.
Next, we make sure to spend some time with the teen alone finding out how things are at school, with friends, and in their relationships. These issues can impact their overall health just as much as any medical one can. By providing this type of holistic care for our patients, we work to help teenagers navigate the often difficult road from childhood to adulthood
Questions Parents of Adolescents Commonly Ask:
1. When do I start talking to my child about sex?
There is no easy answer to this question. Usually as early as they ask questions about their bodies and how they work. Preteens usually have questions about the basic facts of reproduction and the changes of puberty, such as menstruation and wet dreams. Older teens are more curious about sexual feelings, relationships and their consequences. They may ask more about contraception and sexually transmitted diseases. The important things is to be prepared and comfortable with your answers. Don't be afraid to share your values. This will help counteract the negative messages put forth in the media. Teenagers also need reassurance that their thoughts and feelings are normal. Be patient with your child. Remember also, that in educating your younger child about respect for and control over his or her body, you create the framework for healthy and more specific sex education later.
2. I have a feeling my child may be experimenting with drugs, how would I know?
Children are trying drugs at younger and younger ages. Most parents worry about cocaine, crack, or heroin, but tobacco, alcohol and marijuana are the most frequently used substances. Teens are very influential in promoting drug use, usually to help them handle stress, to feel better or to relax. In the early stages of drug use there may be outward signs. But as the use increases, the changes in behavior often become more noticeable. There may be declining or erratic schoolwork, dropping out of extracurricular activities, different friends, changes in style of dress, mood swings and dishonesty. With intensification of use, the teenager becomes even more moody, ranging from euphoric highs to depressive, even suicidal lows. Behavioral changes include school failure, truancy, lost jobs, fighting, stealing, a shift away from their old friends and pathologic lying.
If drug use is suspected, parents should confront the teenager quickly and firmly when he or she is not high. They must make it clear that the drug use must stop and that the behavior, not the teenager, is unacceptable. The teenager will often respond with anger and denial. But parents are most effective when they are unwavering and calm in their position. If chronic abuse is suspected, a drug treatment program should be considered.
3. My child seems to be maturing at a different rate than his/her friends. When should I worry?
There is no "right" age for puberty to begin. For many children puberty occurs as young as 9 or as old as 17. The rate at which puberty occurs varies between families. A young girl, for example, from a family where the mother and her sisters had their periods around age 15, will likely develop slower than a girl from a family where the woman began having their periods at 10. Generally you should consult your doctor if your son has no development of his testes and penis by age 13 or no pubic hair by age 15; or if your daughter has no breast development or pubic hair by age 14, or no periods by age 16.
5. My adolescent doesn't want to listen to me anymore. Is this normal?
Adolescence is a time of self-discovery and self-centeredness. The teenager is trying to figure out who he or she is. This search for identity apart from their parents, can be frustrating and trying at times. You must realize that it is natural for adolescents to want to separate from their parents so that they can develop into their own person. They will want to voice their opinions and feelings, and should be encouraged to do so. What should be emphasized, however, is that you remain the authorities in the home. They may be allowed an increasing role in the family decision-making process, but at no time should you relinquish your status as parents. Working together during this difficult phase can help to ease the transition to adulthood.
6. How do I protect my teen from peer pressure?
As adolescents develop from children into adults, they begin to shift away from bonding to their families and bond instead with their friends. Their peers become the ones who influence what they wear, how they style their hair, what music they listen to and even how they speak. There is intense pressure to "fit in" with everyone else. This can often mean experimenting with drugs or sexual exploration because "everyone else is doing it." Parents have the difficult task of countering these strong messages. They can do this by listening to their teenager and their feelings. Share your feelings and values in a positive manner. Don't lecture or argue; work at having a good discussion. You are the only source for your adolescents to learn the values you want them to have. Encourage their individuality and ability to make good sound decisions. Finally, help them to develop the tools to resist peer pressure. Rehearse with them responses to common "pressure lines" like: "If you love me you'll have sex with me." It is hard for teens to resist pressure, especially if they have never practiced.
7. My teen is acting differently, how do I know if they are depressed?
Emotional changes are common during the turbulent adolescent years. Sometimes they are up and other times down. A teenager may have a depression following a traumatic event such as a break-up with a partner, or parental separation or divorce. This is considered a reactive depression. Dysthymia, on the other hand, is a frequent sense of unhappiness, sadness or irritability that comes and goes. Teenagers with dysthymia have trouble enjoying their usual activities, feel hopeless and have problems concentrating. They may overeat, or stop eating. Their sleep may be disturbed with difficultly falling asleep, staying asleep or sleeping for extremely long times. Major depression is more severe than dysthymia. Teenagers have loss of energy with fatigue, low self esteem and guilt and may have recurrent thoughts of death or suicide.
The causes of depression are many. Environment, biology and genetics all contribute to its development. There can be changes in neurotransmitters, the brain chemicals that control our mood. An imbalance in these may cause depression. If you suspect depression in your adolescent, discuss his or her feelings with her. Tell them about the changes you've noticed in them. Let them know that you are concerned about them and that you aren't angry. Then bring them to their physician for a medical evaluation. Let the doctor know your concerns. During private conversation with the teen, the doctor may be able to determine the degree of depression and can make an appropriate referral for a therapist.
8. How do I discipline my teenager? I want them to grow up, but I don't want to lose complete control.
As adolescents seek to separate themselves from their parents, they will frequently test the limits of your authority. Parent must not give up their authority, but must also allow the adolescent some room for growth and decision-making. Parents often begin to take the actions of the adolescent personally. "He broke curfew because he doesn't respect me." What parents must do is to understand the adolescent's need for some autonomy and freedom. Make it clear to your adolescent which household rules are absolute and which ones are flexible. When a rule is disobeyed, put aside your feelings of offense. Look at what the rules were intended to teach your adolescent. Beatings or punishments administered in anger tend to be very ineffective.
The teenager learns to solve conflict by violence or uncontrolled fury. First, regain control and calm down. Explain why you are disappointed in their actions. Then think of punishments that would help the teenager consider what they did wrong, such as grounding, extra chores or charity work. Be firm. By creating clear rules and fair punishments, adolescents will develop the respect you want for your authority as parents.
9. I want to talk to my teenager about birth control and sex, but I don't want to embarrass them or me. How do I get started?
First you should learn to be "askable." This means letting your adolescent know that they will not be judged, teased or punished for asking questions about sex. This lets them know that you respect their natural curiosity about sex.
You should also know the facts and respond in a straightforward manner. You have to feel comfortable with the subject manner. Get a book and review the information you wish to teach. You want to be up-to-date on the facts about reproduction, contraception and sexually transmitted diseases.
Learn to listen to your adolescent. You will be surprised at how much information you gain simply by being a good listener. Your adolescent's questions and comments often reflect their own thoughts, or an underlying concern they have trouble putting into words.
What is adolescent medicine?
Don't think that talking with your children about sex will make it more likely for them to "do it." Research has shown that teenagers who have information about sexuality are less likely to engage in early sexuality and these teens tend to be more responsible when they do become sexually active.
Use natural opportunities for discussions about sexuality and contraception. TV shows, sexually suggestive commercials or news stories provide a great way to begin a discussion. Also use your discussion to communicate your values. The best way to communicate your values is through your example. But don't try to force your teenager to adopt your point of view. When you give your opinion, not judgements, you are helping your teenager make his or her own decisions.
Great article – Impressive: We think you might be interested to know more about our company. Techno Data Group helps you get your hands on world’s best class customized B2B Contact List, which can make your sales and marketing campaigns cost effective. Achieve Your Marketing Goals and Grow Your Business.Adolescent Medicine Nurses Email List
ReplyDelete