Archive for the ‘teen health’ Category

Ask Shelby: Parenting Teens

September 16, 2013

Here is September’s installment of “Ask Shelby” from Chester County’s own Licensed Marriage and Family Therapist, Shelby Riley.

Dear Shelby,
My son is 15.  I just found “sexting” and sexual pictures exchanged between him and his girlfriend.  What should I do?                       

Signed, Freaking Out!

Dear Freaking Out,

I spoke with three families in one week about this same issue.  Teenagers have so many more options to explore their sexual selves in ways that can really come back to haunt them.  And they don’t have the cognitive development to really understand the long term consequences of texts and pictures that can be saved, forwarded to friends, and photographed in a screen shot and uploaded to all kinds of social media sites.  I had a 14 years old girl in my office who was humiliated by a topless “selfie” she took that ended up on Facebook. 

I would encourage you to get calm before you approach your son.  The last thing you want to do is shame him and create unhealthy ideas about himself and sex.  Although what he is doing seems shocking, it is really a natural result of normal adolescent sexual development and living in a world that is technology and online-focused.  I suggest you calmly let him know you have seen the texts and pictures and, before you share your thoughts, ask him how he feels about communicating with his girlfriend this way.  He may get upset that you saw these things, but if you can stay calm and don’t get hooked into a power struggle, you may get to have a real, vulnerable discussion about his sense of self, his relationships, and your hopes for him.  Kids need to know their parents can handle talking about sex and they need to hear what their parents’ values are about how to handle sexual issues. 

After he mumbles his responses at you and says, “I don’t know” a hand full of times, it is your turn to share your values.  Do you see sex as a natural part of growth and identity development, something to be explored freely?  Do you see sex as something sacred between two people in a long-term committed relationship?  Share your ideas about what healthy sexual expression looks like.  Share your concerns about his use of texting and sharing photos that can go public in an instant, either by mistake, excitedly oversharing in poor judgment, or in an act of anger during a break-up.  (I know, I know, your son and his girlfriend will never break up!)  Your son might not choose to adopt your value system, but most teens secretly would like to know what their parents think about these things, and your words will plant seeds for future decisions he will need to make.

When setting new limits around his use of the phone and internet, you have every right to limit his access to certain social media sites, phone privileges, and internet use.  If this is a first offense, I suggest allowing him some contact with friends and his phone, but let him know you will be supervising and monitoring him (get all passwords, and let him know the phone gets yanked if your password doesn’t work).  This isn’t “punishment” but a response to his actions—you have learned he needs a little help making good choices with the content he shares.

When it comes to his relationship with his girlfriend, try to avoid using terms like “condone” and “permission.”  Kids are aware that their words and bodies belong to them and they don’t need your permission to use them.  Kids hear words like “forbid” and “permission” and sometimes take them as a challenge to assert their free will and individuality from the family system.  I have found phrases like, “What my hope for you is,” and “What I want for you” to be very helpful.  They allow you to be clear about your values without making demands on your teen.  Try to include the idea that sex is a healthy part of life, that it can be a beautiful, fun, exciting part of a relationship.  Acknowledge that your teen will make his own decisions and let him know that you will always love him no matter what decisions he chooses around sex.  You can remind him about STDs, pregnancy, and the way sexual intimacy can fast-forward a relationship in ways he may not desire or be ready for.  I always like to include a piece about self-respect and making choices from a place of love for self, not from a place of fear or peer pressure.  You can set limits around the kind of time he can spend with his girlfriend, and you can have rules about not being in a room with the door closed while they are at your house.  

And lastly, remember that this won’t be one giant, heavy conversation.  He will mess up again. The most important thing you can do is create a feeling of safety and acceptance, as well as offer guidance and information without sounding scared, judgmental, or controlling.  (A tall order, I know—but you can do it!) One mom told me, “My daughter isn’t the same sweet, innocent girl I thought she was.”  My response—Yes, yes, she is.   Part of your work in all of this is remembering that despite the shocking words and photos you have seen, your son is still the sweet, lovable, wonderful kid he was before you saw those things on his phone.  He is fifteen—developmentally, his actions are on target—they are messy, they are scary, and he needs your intervention to help him make healthy choices for himself.

As always, if you feel like you need some help with this, or if you think your son would benefit from talking with someone outside the family, you can always schedule an appointment with a therapist to help you through this super-charged issue.  I wish you the best,

Shelby

Shelby Riley, LMFT is the owner of Shelby Riley, LMFT and Associates, LLC.  She is currently the President of the Pennsylvania Association of Marriage and Family Therapy (PAMFT).  Remember to check out Shelby’s website www.shelbyrileymft.com for useful information about therapy for individuals, couples, and families.

 

Anticipating Your Daughter’s First Gynecologist Appointment

May 21, 2013
This healthy post is provided by The Chester County Hospital and Health System. To learn more about women’s health, visit us online. >>

As a mom, you knew the day would come when you’d fight with yourself over the right time to have your daughter make her first gynecological visit. You realize your daughter is growing up — you want her to have the best care, but you know she may feel embarrassed or scared. Follow this guide to help determine when your daughter is ready, and then use these tips to prepare her for the upcoming appointment so that you are both comfortable with this unfamiliar territory.
Now? Next Year? Help!
It’s important to take cues from your daughter to decide when the time is right. If she is having extreme discomfort with periods, has a lot of questions, or is becoming sexually active, it is never too early to make an appointment.
If she seems to be fine with the changes her body is going through, Obstetrician and Gynecologist Melissa Delaney, DO, explains that 21 is the age that you should send your daughter to the gynecologist for her first pap smear. However, if your daughter is having problems with her period or is sexually active then she should be seen sooner than age 21.
Preparation & Explanation
Once you’ve decided on the right time, the next step is to prepare your daughter for her visit and to explain the importance of the appointment.
Education & Treatment
A gynecologist can provide information about any topic your daughter may be too nervous to ask you. She will have a confidential source for accurate information, and can learn about prevention and treatment of embarrassing problems. Most girls have their “private” questions answered by friends, but this provides her with another outlet to voice her concerns.
Mom’s Involvement
Talk with her beforehand about your involvement in the appointment. This will make the day of the appointment much smoother and less awkward. Depending on your daughter’s age and level of maturity, the two of you can decide what will work best.
  • Does she want you to take her to the appointment?
  • Does she want you to come back to the exam room with her?
  • Can messages be left on your house phone for all to hear?
Honesty
Be sure that your daughter is aware of the importance of her honesty. Her time with the gynecologist is completely confidential, and she should know that she can ask any questions she has. Assure her that there is nothing she hasn’t heard before, and she is there to help.
Outline the Appointment
Next, give your daughter an idea of how the appointment will play out. There are many different parts to a complete exam, but they do not take long.
Medical History
Have your daughter prepared to answer a few simple questions. She will most likely feel uncomfortable talking about these things for the first time, but knowing the answers to these questions ahead of time should help her through the appointment.
  • When was your last period?
  • Are you sexually active?
  • If so, are you using birth control? Are you with one or multiple partners?
  • Do you have any problems with your period such as pain or discharge?
  • Is there any chance you could be pregnant?
Physical
This is your run-of-the-mill physical. Height, weight and blood pressure will all be taken, and your daughter may also be asked to provide a urine sample. Explain that this portion of the exam acts as a baseline for future visits.
Breast Exam
“Breast cancer is rare in teens,” explains Dr. Delaney, “but the breast exam teaches your daughter how to do a self-exam. This helps her learn how her breasts feel so she will know if something is out of the ordinary in the future.” The gynecologist will most likely explain the importance of a breast self-exam and what to do if she ever feels a lump.
External Exam
Your daughter will be asked to undress and change into a gown and place a sheet on her lap. She will lie back so that the doctor can view the vulva (the external genitalia), and look for any problems such as swelling or sores. While this may be awkward, there is neither pain nor instruments to worry about at this point.
Internal Exam
Your daughter may not have an internal exam during her first visit. Dr. Delaney notes, “Your doctor will decide based off of medical history and conversation with your daughter what is appropriate.” If the gynecologist proceeds with the internal exam, she will use her hands and a tool called a speculum to feel and view the walls of the vagina and cervix. Assure your daughter that she will only feel pressure — she should not feel pain. Tell her to take slow, deep breaths and to relax her muscles if she becomes nervous.
Pap Smear
Gynecologists recommend a Pap smear beginning at age 21. During the internal exam, cells are taken from the cervix and are sent to the lab to check for changes and cervical cancer. She may recommend the human papillomavirus (HPV) vaccine to prevent certain types of cancer. This series of vaccines will be given at a later date.
STD Testing
This is an optional part of the exam. If your daughter is sexually active, she should be tested, and the gynecologist will determine what is best based on their conversation. If the test is recommended, some STDs can be tested for with blood or urine samples. Others can be tested by sample from a cotton swab like the Pap smear. The tests will be sent to the lab, and she will most likely talk with your daughter about the passing of STDs.
After the Appointment
Once the appointment is over, talk with your daughter about it. If she feels that the staff made her feel uncomfortable, you may want to look for a new office next time if she feels strongly about not going back. It is important that your daughter feels she is in a safe, trusting environment. Help your daughter make annual appointments from here on out to stay healthy.
To find a gynecologist, visit The Chester County Hospital’s Find a Doctor section. Here, you can enter your zip code and select “Obstetrics/Gynecology” from the specialty drop-down menu.
Information is adapted from Kids Health Nemours.

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Wednesday Wellness: Parents Beware of Trending Food Challenges

March 8, 2012

This healthy post was provided by The Chester County Hospital and Health System.


Food challenges, like the Cinnamon Challenge, the Flour Challenge, the Chili Challenge, the Gallon Challenge are others are all the rage on YouTube and other internet sites. Whether you’ve heard of them or not, they are gaining popularity among high school-aged and even the younger, junior high-aged crowd.

Though these food challenges seem innocent – creating laughter as the participants “fail” at completing them – there are risky consequences for which every parent should be aware. We’ll explore the Cinnamon Challenge here, but if you do a search on YouTube, you’ll quickly see what other double-dog dares the teens are trying and uploading.

Cinnamon Challenge

The Cinnamon Challenge dares someone to eat a teaspoon of ground cinnamon without a drink in less than a minute. Even though this might sound and appear to be easy, video-taped reactions of the act appear to be potent as participants cough, choke, gag, cry and even vomit trying to get the cinnamon down or out.

So why does cinnamon cause these severe reactions? Cinnamon contains cinnamaldehyde, an organic compound which gives it its signature “spicy” flavor. Cinnamaldehyde is also used as an organic fungicide and pesticide. The Environmental Protection Agency (EPA) cautions that this component, if ingested in large quantities, can cause acute dermal toxicity (poisonous effect of a substance on the body through the skin), acute oral toxicity, skin and eye irritation.

The type of cinnamon used can also factor into the effects it can have on those attempting the Cinnamon Challenge. Ceylon cinnamon, for the most part, is safer than its counterpart, Cassia cinnamon. Cassia contains substantial amounts of an ingredient (coumarin) that is known to prevent blood from clotting. It is powerful because it can also alter blood sugar levels in those with diabetes in addition to causing or worsening liver disease for those who are sensitive to that condition.

Parents are advised to be aware of these trending food challenges and keep cinnamon and other spices out of reach of curious children. Ingesting a significant quantity of cinnamon can cause severe burning in the mouth and throat which will require immediate medical attention. The burning may get to a point where it swells in the back of the throat, blocking access to air.

Often, the coughing is so severe that the person taking on the Cinnamon Challenge has difficulty catching their breath. Or they expel a cloud of fine cinnamon particles and inevitably inhale them into their lungs, which can cause severe chest pain. So, this is a serious threat to anyone who has asthma or chronic obstructive pulmonary disease (COPD).

A cinnamon allergy does exist (although it may not be diagnosed), and obviously this type of extreme challenge can cause a wide range of allergic reactions, including swelling, dermititis, skin inflammation or anaphylactic shock.

Bottomline: Food pranks can be dangerous and can pose a threat to anyone who participates. These challenges are not worth the few cheap laughs or web virality, and even though there have not been any reported deaths, it seems that its only a matter of time until a food challenge ultimately prevails against a risktaker who didn’t consider the serious health effects.