Teens, depression and the news

As summer comes to a close and I start seeing all my teenagers for the school physicals, it gives me time to reflect on the past year- how my children are growing so fast, how my patients seem to have aged overnight, and how so much seems to have changed this year in the office.

One of the things that I have been working on this past year is trying to find a way to help our teenagers that seem to be “falling”. I am seeing more and more teenagers that are sad, depressed, anxious or just plain worried. Life is fast paced and they have so many expectations on them. As parents we try to understand all they are going through, but their world is not the world we grew up in. Everything is out there on a screen or in print for them to see. The world moves by quickly and they are expected to keep up.

Last summer it really hit me how many teens are suffering. We saw teenagers from schools in Whitefish Bay and Nicolet commit suicide. I had many patients that made gestures looking for help- and teens are good at hiding their feelings. Also, their signs of depression are not always what an adult might think of as depression. While some may seem sad, others are angry and irritable. Friends may change. Grades may start to fall in school. I think the message is just be alert for changes- any change.

As we have seen this week on the news with the death of Robin Williams, suicide happens.  We will miss the laughter he shared with the world.  This makes us think that even if one seems to “have it all”, depression is something that is non-discriminating.

Action is being taken around our community to try to address the face of teen depression. The local schools have started an organization- RedGen. Through their efforts national speakers are coming to speak to parents and others in the community about this national trend. Take a moment and check out their website -www.REDgen.org. Come to one of their functions- it is a start.

When my teen patients come see me, I am now asking them to fill out an adolescent health questionnaire that is designed to help me identify those at risk for depression a little sooner.The more we can learn as parents, the more we can try to help our children.

I’d like to share a few resources that may be helpful for you or someone who you know.

http://www.mhawisconsin.org/

http://www.mhawisconsin.org/factsheets.aspx

http://www.mhawisconsin.org/Data/Sites/1/media/fact-sheets/teendepression[1].pdf

http://www.comh.ca/publications/resources/dwd/DWD_PrintVersion.pdf

We can’t fix everything for them, but hopefully we can provide them with some tools, or take them to someone who can give them tools to help them.

It’s Summer Time- Have Fun

Wow- it’s hard to believe it is already July 2nd!  Not that you can tell by the weather, but we have had some really nice days to enjoy outside. As I enter the summer months I am full of camp and school physicals. One of my favorite questions to ask the kids and teenagers is, ” so what do you like to do for fun?” You wouldn’t believe how many have a difficult time answering the question. Yes, I want to know what activities they are involved in, but I also want to hear what they think is fun. My face lights up when they say that they like to play in the creek, go for a bike ride, or sit and read a book. Our lives and our children’s lives are so filled with scheduled activities, that it is refreshing to hear about the not scheduled activities.
Summer is a great time to get out there and explore. Even if your children need to go to camp because you work during the day there is time on the weekend to check out everything around us. Going on hikes or bike rides as a family is great bonding time (oh yeah, don’t forget the helmet). Living in Wisconsin we have so many festivals to attend and see the different tastes and sounds of our community.
Try not to over-schedule though. During the year there is so much going on, take time to see where the day will take you. Allow your children to explore the outside without having to rush off and say you need to get to the next thing. Try something you haven’t done before. There are many triathlons that include kids now- this is so great because it encourages physical activity.
One thing, don’t get caught in the “I’m so bored” and then all they do is turn on the TV or get on the IPad. Let them be bored. Sooner or later they will figure out what to do. They might pick up a book and read for a little. They might explore the outside and discover they like to garden or just watch the worms in the garden. They might learn how to cook on a rainy day.
Give them a chance to be bored and see what they can do!

Laundry room safety

We all spend a lot of time baby proofing our houses, but one easy place to forget is the laundry room, or in my house “that corner of the basement.” Here are a couple of tips in case that area of your home was overlooked.

  • Keep detergents and other cleaning products in their original packages.
  • Store detergents or cleaning products in a cabinet with safety locks or an area that is out of reach. (Remember your kids can climb, so it may be safer to lock everything up.)
  • Never let your children touch single use laundry packets (or dishwasher packets). They can dissolve quickly when in contact with saliva or wet hands.
  • Use child-proof locks on front-loading washers and dryers.
  • Keep irons and their cords out of reach.
  • Make sure any laundry chutes and doors are child-proof.

A lot of houses don’t have laundry chutes, but I had one growing up and I remember really wanting to slide down into our hamper. Luckily I was too big to fit at the time. Don’t forget if your child does get into cleaning products or anything else you should call poison control. They are nice people and a great resource. The phone number is 1-800-222-1222. Don’t be embarrassed to call, we have had to call at my house (for me).

Drink Up

Now that the summer is finally in full swing, I think it is important to make sure that our children are getting enough fluids with the warmer weather approaching. We all lose body water throughout the day via various routes such as tears, urine and sweating. Water also evaporates off of our skin and vaporizes when we breathe. Most of our body fluid and salts can be replaced with the water and salts in our regular diet. However, during prolonged exercise during warm weather, we can lose even more, setting us up for dehydration.

Here are some signs of dehydration:

  • dry or sticky mouth
  • few or no tears when crying
  • eyes that look sunken into the head
  • soft spot (Fontanelle) on top of baby’s head that looks sunken
  • lack of urine or wet diapers for 6 to 8 hours in an infant (less than 1-year-old)
  • lack of urine for 12 hours in an older child
  • dry, cool skin
  • lethargy or irritability
  • fatigue or dizziness in an older child

The best way to prevent dehydration is to make sure kids get plenty of fluids when they are physically active, especially in hot weather.   They should consume more fluids than they are losing. If your child participates in strenuous exercise, they need to begin drinking extra fluid even before the activity starts. They should also continue drinking at intervals (about every 20 minutes) during the activity and after it ends. Keep in mind, too, that sugary drinks and soda are not good at keeping you hydrated. Water is best. Limit low-calorie sports drinks to episodes of extreme exercising.

Thirst is NOT a good sign of early dehydration. By the time a child feels thirsty, he or she may already be dehydrated. In addition, thirst can be quenched even before the necessary body fluids have been replaced.

Below is a weight-based chart regarding how much fluid your child should consume on a daily basis. This does not take into consideration exercise or hot weather. Parents always are amazed at how much fluid we all should be consuming.

Weight in Pounds                                Fluids per day

  •  10 pounds             16 ounces (2 cups)
  • 20 pounds             30 ounces (3-3/4 cups)
  • 30 pounds             40 ounces (5 cups)
  • 40 pounds             48 ounces (6 cups)
  • 50 pounds             52 ounces (6 ½ cups)
  • 60 pounds             55 ounces (7 cups)
  • 80 pounds             60 ounces (7 ½ cups)
  • 100 pounds          70 ounces (8 ¼ cups)
  • 120 pounds          75 ounces (9 cups)
  • 140 pounds          80 ounces (10 cups)
  • 150 pounds          85 ounces (10 ¼ cups)

 

 

When to Call the Doctor – Part 1

I created a document for a Mom’s group that I spoke at 2 years ago.  I just found the original in my files.  Hope this helps!

When to Call the Doctor (Part 1)

Fevers:

Fevers commonly occur at the beginning of illnesses.  Viruses can cause fevers up to 5 days. Typically, the highest fevers are in the first 48 hours of illness.  There is no “emergency” fever level – though most physicians want you to call if it is above 105 F.

The goal in the treatment of fevers is to provide COMFORT- not to bring the temperature back to normal. 

Fevers that start further into the course of illness are more likely to be due to bacterial infections. Commonly, ear infections, pneumonias, sinus infections are the “second” infection after first having a viral infection (like a common cold, upper respiratory infection or a stomach bug).

High fevers themselves do not cause seizures.  It is the rapid change from normal temperature to high fever that causes febrile seizures.

Before you call the doctor, try:

Tylenol and ibuprofen (ok to alternate every 3 hours).  Encourage fluids.  Try a warm (not cool) bath to bring down the temperature, remembering that if the water is too cold, the child will shiver (and raise their temperature higher).

Give it time!

Call the doctor with concern of a fever when:

  1. You are unsure if you need to seek medical care because it does not follow the rules of a virus or because it is accompanied by other concerning symptoms.
  2. Your child is less than two months of age and has any temperature >/= 100.5° F.  (And yes, the only accurate temperature in a small child is a rectal temperature.)
  3. Fever along with a stiff neck (not a sore neck).
  4. Seizure.
  5. Fever greater than 105° F.

 Remember a fever is the body’s way of showing you it is fighting the infection.

Put the phone down! Turn off the TV! Not another video game!

How many times a day do you say these words or something similar to your kids. It seems like their lives have been overtaken by electronics. Studies vary and state that kids today spend anywhere from 7-10 hours a day on entertainment media; phones, TV, computer, and whatever else they may have.

As adults we see how easy it is to say, just one more second I just want to read this story. The kids are getting pulled in every direction because their life seems to revolve around electronics. It is how they receive information about the day. It is how they get their school work done. It is how they communicate. All of this electronic time is having an impact on our kids. We are seeing more kids with attention issues and sleep disorders.   More kids are becoming overweight due to lack of exercise. While electronics are not causing all of this, they are definitely contributing.

While we can’t stop the electronic age, we can slow it down. It is important to have “electronic free” time. I know it sounds impossible. I am as much at fault as other parents. I give in when my youngest looks at me, she has been running around all day and finished all her homework and says, “Just one TV show please.” I start making dinner and then it’s 2 shows later and 25 texts and 2 new posts on instagram. It would have been much better for me to have her help me make dinner. Or if she is so tired, just sitting in the kitchen and telling me about her day.

Recently, a friend, who also brings her kids to see me, told me that they were electronic free during the week. She thought it would be one of the hardest things for her family to do, but for the past 3-4 months her kids are not watching TV during the week. They are not playing on their I-Touch or I-Pad. Rather they have learned how to use their imagination again, they have gotten outside to run around, and they have re-engaged as a family.

I challenge each of you to find a way to decrease the electronic use in your family. Start small. Make sure the phones are off during the dinner hour or put away. Keep phones, TVs, and computers out of your child’s/teen’s bedroom. Set a maximum number of hours during the day they can be on electronics - of any type. (remember – older kids will have homework they need to do on the computer so you have to be reasonable with this.) This is a great time of year to try this challenge. It can be hard to do in our Wisconsin winters, but now there is no reason to not be outside running around and enjoying the outdoors.

Parents, set the example and put your phone time and enjoy your children and all that is around you.