March 26th, 2009 by Stacy Stryer, M.D. in News, Opinion
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The number of teens giving birth in the United States has increased for the second year in a row, after a decline for 14 consecutive years. According to a reported recently released by the Centers for Disease Control, the birth rate increased from 41.9 births per 1000 teens in 2006 to 42.5 births in 2007. Not only does becoming pregnant and giving birth as a teen increase the risk of serious medical problems for the newborn, including low birth weight and an increased risk of death, but it also makes it more likely that a mom will have many socioeconomic difficulties, including a greater chance she will end up on welfare, not receive a high school degree, and live below the poverty level (which translates to difficulties for newborns as they get older).
Obviously, teens who become pregnant did not use a condom during intercourse, or at least not correctly. Therefore, these teens are also at risk of developing sexually transmitted diseases, such as Chlamydia, gonorrhea, and AIDS. Unfortunately, some of these infections, such as HIV, can pass through the placenta, and infect the unborn fetus. Given the fact that the risk of developing HIV and AIDS in adults is increasing in some areas of the United States, it also makes it more likely that an infected female will become pregnant. A report recently published stated that the rate of HIV is greater than 3% in Washington DC, which is considered an epidemic.
Although researchers don’t know why the number of babies born to teens has increased for the second year in a row, they speculate that increases may be due to increased risk taking, more relaxed and changing attitudes, portraying sex as OK or even a positive experience on TV, increased risk taking by teens, changing attitudes, and having teen role models who become pregnant (Miley Cirus, Jamie Lynn Spears, Bristol Palin).
How are we going to improve these statistics? We must ensure that sex, STDs, teen pregnancy and contraception is not only taught at school but also discussed in our own home – over and over. Our teens must not only learn our values, but also how to keep themselves healthy. It is fine to teach abstinence at home, but parents should also teach about condoms as a way to protect their teens. Often, we are the last to know that they have become sexually active. (Regular communication and discussion with our teens may give us the privilege of finding out sooner!)
It is also important to teach our teens how to deal with a certain situation before it happens, such as what to do when someone of the opposite sex makes an advance. If your child hasn’t been taught what to do in situations such as a teen making a physical advance, friends trying to increase poor behavior via peer pressure, watching drinks carefully , and others, she will probably be more likely to freeze up when such a situation arises and allow it to get out of hand. My rule of them it to talk about these tough subjects about 2 years before your teens may be in such a situation. This gives them time to think about it and formulate a plan of how to say “no” or how to stay safe. We need to see a reversal of the teen birth rate – in order to do this, we need the community, schools and parents all to work toward a common goal of educating and protecting our teens.
March 19th, 2009 by Stacy Stryer, M.D. in Uncategorized
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It’s already March 19th and I don’t have any ideas for April Fool’s Day for my kids. I am desperate and need help. In previous years I have put gummy worms in their sandwiches, short-sheeted their beds, convinced them school was cancelled, given them mashed potatoes that looked like ice cream sundaes, and offered cookies with (fluoride-free, of course) toothpaste as the filling. Last year I tried to pretend I had broken my arm. While my adult friends believed me, my kids just rolled their eyes. So, as you can see, my ideas are not working anymore and I need something grand and convincing.
Humor has always been an important part of our family. When my children were younger, we used humor to convince them to do things they didn’t want to do. For instance, in order to get them to clean their rooms we would put shoes on our heads, walk to their rooms, and dump them in the closet. My older daughter’s favorite game was to dress up as Cinderella (in rags, of course) and have me shout orders at her — I was not allowed to say “please” because I was, obviously, the evil stepmother. It’s amazing how clean the playroom could become those days.
When my husband had a brain tumor, I used humor to temporarily destress an incredibly difficult time period. Those days it was not uncommon to see us eating jello through a straw, dessert before dinner, or ice cream without a spoon. One desperate day we all dressed up in our rain gear, with umbrellas, and took a shower together while singing, “I’m singing in the Rain.”
Last year my daughter had 2 friends spend the night before presenting a history project in a county contest. They had worked incredibly hard on this project while continuing their other demanding curriculum, and they were exhausted, nervous, and stressed. So I went to the store and bought shaving cream and whip cream. After dinner I sent them outside in old clothes and let them spray each other. They ran around for over an hour in the dark, laughing and playing. To this day they still talk about it.
Humor and laughter are an important part of our lives. They relieve tension, reduce stress, and provide us with a temporary distraction from unpleasant thoughts or lives. They allow people to forget about anxiety and pain, even if it’s momentary. Scientific studies that have even shown that humor improves overall health and, more specifically, the ability to fight off infections, decrease the risk of developing a heart attack, and improve blood sugar control . Psychologically, it has been related to decreased loneliness and depression, and improved self esteem and feelings of hopefulness . Laughter clubs and therapy have been developed and exist in and out of hospitals throughout the United States.
humor in our family (response to "smelly" fish)
So, now you understand why it is so important for me to find some new, more exciting April Fool’s Day gimmicks for my family – ones that will really make them laugh! I am willing to share my “Vanilla” Sundae recipe with you, which has been used by many extended family members and friends.
April Fool’s Day Ice Cream Sundaes
Ingredients:
1. Instant mashed potatoes
2. Chocolate sauce
3. Whip cream
4. Maraschino cherry
5. Vanilla ice cream
Make the mashed potatoes according to directions and let them cool. Use an ice cream scoop to put 2 scoops in a bowl. Top with chocolate sauce, whip cream and, of course, a cherry. Serve. Have real vanilla ice cream available to serve so the victim can actually enjoy dessert in the end.
March 12th, 2009 by Stacy Stryer, M.D. in Health Policy
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By Stacy Beller Stryer, M.D.
I vividly remember my firsts in medical school – my first patient with cystic fibrosis who was so air hungry that he couldn’t even speak, my first teen who was constantly admitted to the hospital with an infection due to a genetic disorder that would eventually kill him, and my first 3 year-old patient with sickle cell anemia who almost died because her spleen decided to sequester many of her red cells. They were my firsts, but they certainly won’t be my lasts.
On March 9th, however, President Obama took a major step toward helping these children and so many others just like them. It gives me hope that someday there will be a few lasts. On Monday, he signed an executive order which relaxed restrictions on embryonic stem cell research and allowed federal funding for such projects. This is big. It reverses an almost 8 year policy that severely restricted such funding and the ability to use embryonic stem cells.
Embryonic stem cell research will open up the doors for potential cures and treatments for diseases such as Parkinson’s and Alzheimer’s, and for traumatic injuries, such as those that involve the brain and spinal cord. But the potential benefit of stem cells isn’t just for adults. Discoveries from embryonic stem cell research could save many lives and significantly reduce the suffering of children with a whole variety of diseases. Many medical centers, such as the University of Cincinnati, are or will soon be greatly expanding their stem cell research programs because of this policy change.
Why are embryonic stem cells so important for research? These cells are truly amazing because they have the ability to turn into any other cell in the body, such as blood cells, nerve cells, islet cells (which make insulin in the pancreas), or even entire organs. Plus, these cells can continue to duplicate, or make more of themselves, which is wonderful for both research and eventual treatment. Think about a newborn, that starts out as a single cell which then continues to replicate and differentiate until it becomes a fetus. It is truly a miracle and is the reason embryonic stem cells are so important.
Researchers at the University of Cincinnati want, through new research, to successfully treat fatal and other serious genetic disorders. Other medical centers will use embryonic stem cells to search for treatments for illnesses such as cancer, cystic fibrosis, diabetes, muscular dystrophy, and traumatic injury. The list goes on and on. Results will not occur overnight. It will be a long, expensive time intensive process. Through this process, researchers hope to learn how cells differentiate into specific types of cells and how genes turn certain cells on and off. The ultimate goal is to successfully repair or even replace ineffective, damaged and abnormal cells.
Some people are against the use of embryonic stem cells in research and treatment because they believe that, even though it can save lives, it also ends a life. This is an issue everybody has to think about on a personal and individual level. Currently, federal guidelines require embryo stem cells to come from extra embryos that were made when a couple underwent in vitro fertilization but were not used and, if not used for research, would simply be thrown away.
March 5th, 2009 by Stacy Stryer, M.D. in News
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By Stacy Beller Stryer, M.D.
Between seeing the hoards of patients with multiple days of high fever and sore throat; taking care of my own daughter who was sick almost an entire week; and trying to allay the fears of countless parents who read about the deaths of two teens in our community due to influenza, I am exhausted. There is no doubt that the influenza virus has arrived and is wreaking havoc in our community. According to the Washington Post, our region has just begun to see an increase in the virus but has not yet reached its peak. Each year, the virus peaks at a different time, usually between December and March, although we only know after-the-fact when the peak incidence occurred.
According to the Centers for Disease Control, approximately 5% to 20% of the United States population develops the flu, over 200,000 are hospitalized, and about 36,000 people die. This includes children, particularly those with chronic illnesses such as asthma and heart disease.
There are many different strains of influenza virus and each year the strain changes. Researchers try to determine which type will be most prevalent for that particular year and, based on this information, develop a flu vaccine with the three most likely types of influenza A and B. Even if scientists aren’t 100% correct, antibodies which are made against one strain can provide protection against different strains if they are closely related. In addition, it is possible that a related strain, while not entirely preventing an illness, can still decrease its severity and prevent flu-related complications. For this reason, the CDC recommends that everybody get the flu vaccine each year.
So, how do you know if your child has the flu and not another virus? Often it is difficult to tell the difference. People use the word “flu” liberally and often, when someone says they have the flu, they actually don’t. You must actually be tested for it to know if you truly have the influenza virus. However, if you followed me in my office for one day, even four hours, you would get pretty good at picking out who probably has the flu. The specific symptoms can vary somewhat from year to year but they tend to be much more severe than other viruses. In general, they include several days of high fevers, headache, dry cough, sore throat, runny or stuffy nose, extreme tiredness and sore muscles. The cough is usually the last symptom to go away.
The flu is spread from respiratory droplets, meaning people who cough and sneeze can spread the virus to others nearby. People are usually infectious about one day before they get sick until about five days after they become sick, although the infectious period can vary.
What can you do for your child? First of all, you can try to prevent them from getting the flu in the first place by getting the flu vaccine in the fall (or even in January or February if the peak hasn’t occurred), and by teaching good hygiene and hand washing techniques. You can also remind your children to stay away from others who are sick and to keep their hands away from their own faces.
If your child does get the flu, antiviral medications are sometimes an option to help decrease the severity and length of the illness, and to prevent potential complications. In order to be effective, however, it must be given within the first 48 hours of symptoms or before symptoms even develop. Each year, the Centers for Disease Control tests the flu virus in different regions throughout the country to see if the particular strains are resistant to the antiviral medications available. This year they have found that the influenza A is highly resistant to Tamiflu, one of the more common antiviral medications prescribed. Data so far shows that most of the circulating viruses this year are the “A” type. Tamiflu helps children feel better, on average, about 1.5 days before someone who has not taken it.
As a physician, I must watch for evidence of bacterial infections that have developed along with influenza virus in my patients. More common bacterial co- infections include pneumonia, ear infections, and sinusitis. Dehydration and worsening of chronic medical problems, such as asthma, can also occur. In 2006-2007, the CDC documented an increased incidence of staphylococcus aureus infections and methicillin-resistant staphylococcus aureus (MRSA) in patients who were hospitalized for influenza or who eventually died. If your child has symptoms that continue to worsen or that don’t begin to resolve after several days, or if your child has shortness of breath, blue lips, cannot speak full sentences or other signs of breathing problems, you should see a doctor immediately.
February 25th, 2009 by Stacy Stryer, M.D. in Health Tips
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By Stacy Beller Stryer, M.D.
I read an interesting article in the New York Times last week, “Inside the Mind of the Boy Dating Your Daughter.” When I saw the title, I was instantly drawn to it because my older daughter is going to enter high school in the fall (yikes!) and has recently begun talking about boys. She currently attends a magnet school where most of her classmates are female. She just mentioned, for the first time, that there are no boys to like in her program, which makes for boring sleepover talks (but makes her mother exceedingly happy). Given that I think she’s the cat’s meow, I thought I could get a little “inside information” from reading the article before throwing her into the world of male testosterone and upperclassmen.
However, the article totally surprised me. Coming from a family of 3 girls and having 2 daughters, myself, I am much more comfortable figuring out what a girl might be thinking or feeling than a boy. I must admit that I believed the folklore that teen boys basically have sex on their brains. But, according to a study recently published in the Journal of Adolescence, this is not the case. Researchers had 105 10th grade teens complete a survey about sex, love and relationships. Reportedly, most boys said the main reason they would date someone was because they “really liked her.” The second most common reason they wanted to date someone was to get to know her better, and because they were physically attracted to her. Of note, 40% of the boys stated that they had already been sexually active and 14% wanted to have sex to lose their virginity. We must remember, however, that this was a relatively small sample size done in one school.
As a follow-up, the New York Times asked people to send in their comments about the article, and they discussed the results in the Week in Review. Many of the comments sent in were from adult men, who didn’t believe the teens answered honestly because, as these adults remembered, (?is their memory correct) they thought about sex, and only sex as teens.
An important and notable comment made by Dr. Andrew Smiler, the author of the study, is that parents are less likely to talk to their sons about relationships than their daughters. He stressed the need to talk to boys frequently about relationships, respect, trust and sex.
This gives me some hope that my daughter won’t be bombarded with a storm of testosterone the moment she enters high school. Actually, I am not too worried because I have been preparing her for the world of “boys” since she was much younger. For years we have talked about puberty, and as she has become older we have added relationships, values, possible uncomfortable situations, and waiting to have sex. I believe that this will carry her a long way. And, according to research, I am right, because telling a teenager to wait to have sex actually makes it more likely that they will.
As parents, we must remember to talk to both our daughters and our sons. Our discussions should start early. In elementary school, they should know what puberty is and how boys and girls develop. They should also learn about love and respect. As preteens, they should have talks regarding dating, relationships, and sex. If you wait too long, they will not hear you, or they will already have had to deal with a sexual situation and may not have known how to handle it. Amy Mirion and Charles Miron, authors of How to Talk With Teens About Love, Relationships, and S-E-X, also discuss how important it is to have small, ongoing dialogue rather than the one “big sex talk.” They suggest that, when parents talks with boys, they be direct and simple, and that they include topics such as love, respect, and values. They also stress the need for boys to actually be told to wait before having sex.
Just in case, maybe I’ll send some pepper spray to school with my daughter next year …
For more information on how to talk to your children about relationships, sex, and other risky behavior, check out the following websites:
4parents.gov
WebMD
Children Now
