Thursday, April 28, 2011

Raising Resilient Kids in Seismic Times

Haitian Teens help build a clinic just three weeks after the earthquake, January 2010
Tonight I gave a lecture at the Mamaroneck High School to a committed group of district-wide parents who came to hear about the budget(not from me--not my forte!) and to listen to some simple guidelines from me about the importance of resilience for raising authentically successful kids.   Realizing that success in turbulent and uncertain times is not something that stops at high school or college, we can think about how to raise our children and teens in a way that fosters responsible adulthood.

My lecture is based on the Seven C's of Resilience,  a concept endorsed by the American Academy of Pediatrics and promulgated in the work of Doctor Ken Ginsburg, a pediatrician in Philadelphia. 

The Seven C's are:
Confidence: it’s not the 90’s message of self-esteem. It’s not about empty praise. How could you ever live up to being compared to Picasso in Kindergarten?

Competence: the real kind. the kind you feel when people notice what you are doing well, really well

Connection: Not about the internet or social media alone. But about the power of stories and generations of friends and family and the Venn diagram of circles of friends.

Character: Living a life of values. Having a strong yardstick of tradition, religion, law, standards, family values, and ethics

Contribution: knowing you matter in this world.  Understanding that service to others feels good. One day you might ask for it and then you will know that it actually feels good to help others.

Coping: Learning positive coping strategies for managing day to day and in crisis. This is about modeling what to do and not merely talking about what not to do.

Control: the concept of the "locus of control" and the different parenting styles: authoritarian, authoritative, permissive and disengaged.  Instilling a sense of “I can handle this” vs “What I think or do doesn’t matter”

Three books are recommended from this talk:
 
Ken Ginsburg, MD, A Parent's Guide to Building Resilience in Children and Teens: Giving Your Child Roots and Wings (American Academy of Pediatrics), 2006 and 2011

Richard Weissbourd, The Parents We Mean To Be, 2009

Michael Gurian, Nurture the Nature, 2007

Here is a list of qualities to consider when thinking about the meaning of real success as a person:
kindness, generosity, compassion, creativity; being innovative, full of ingenuity, unafraid, competent, trustworthy, global, and authentic. 
Feel free to comment and add more of your own. 
Thank you Mamaroneck PTA and SEPTA for this opportunity to reach parents. 

Wednesday, April 27, 2011

Herpes, whether you know it or not. That is the question.

Since April  is STD Awareness month, I thought it important to share a bit of new information about Herpes Simplex infection. Oy.


OK. It looks sort of pretty in this picture but not so much in this or this.

Recent research has shown that even symptom-free people without a known case of herpes to their name can be carrying and transmitting the virus.  So even a person who looks like this:
can actually be spreading herpes with kissing or oral sex.  This comes from a recent study published in the august journal JAMA.


"Most people, when they shed, do not have any symptoms," study co-author Dr. Christine Johnston, of the University of Washington-Seattle, said. "The people who are symptomatic are really the tip of the iceberg."  Aparently about one in six American adults have HSV-2, the most common type of Herpes virus which can affect oral and genital areas.

Johnston and colleagues evaluated herpes simplex virus type 2 shedding in a group of 498 HSV-2 seropositive people. About one in six never had symptoms of their infection. All participants obtained daily self-collected swabs of genital secretions for at least 30 days, regardless of whether they had herpes blisters or not.
Using condoms, taking antiviral drugs, and disclosing the infection to sex partners all have been shown to help cut the transmission rate in half, said Johnston.  This study is certain to be quoted all over the media and should raise concerns and awareness among young teens, their parents and health care providers and teachers.  In the absence of a vaccine or a more perfect solution, we need to be cautious and teach our kids about the risks and responsibilities of intimacy.  Oral sex might not transmit HIV or get you pregnant but WOW can it leave a lasting memento. 

Thursday, April 21, 2011

Wanna Be a Doctor? How Cool is This?

Recently, I was examining a teenage girl whom I suspected of having Mono. In order to determine whether she had swollen glands, an enlarged liver or a dangerously enlarged spleen, I checked her abdomen.  I started tapping on her abdomen by placing my index and middle fingers of my left hand on her upper tummy and then tapped the two fingers gently with my right index finger.   The sound to a physician is unmistakable.  There is the hollow sound of the underlying intestines (filled with gas and drum-like) and there is the dullness or hard sound of the underlying solid liver. 

"What the heck are you doing?" she asked.  So I explained to her about this ancient technique called "percussion" and how without an xray, MRI or a CT scan (terms she was familiar with), I could estimate the size of  her organs and whether they were normal. 

"That is SO COOL!"   she exclaimed.  I was thrilled that this simple method could intrigue my young patient so I asked the question I always do when someone shows the least bit of curiosity about medicine: "Did you ever think of being a doctor?"

I told her about Abraham Verghese of Cutting for Stone fame and his wonderful list of simple skills that every physician should have.  Called the Stanford 25 , it is a compilation of physical diagnosis maneuvers performed at the patient's bedside with little more than a stethoscope, the four senses (we don't do taste anymore!) and a trained mind.  I was happy to see that the examination of the liver is the fourth technique on the list.  I first discovered Verghese's mission when I was in Haiti with no technology other than what I brought in my backpack.

The deprivation of working in Haiti isn't necessary to appreciate the value of these fundamental skills.   I am reminded every day of how much I enjoy practicing the basics and trying to solve the body's mysteries.  Not to mention turning on a student every now and again to the field of medicine.

image from Google images

Saturday, April 16, 2011

From High Chairs to High School: 30 Teen Parenting Blogs



....including yours truly!

I was notified this week that my blog/website has been chosen by Amanda Harris to include in her exciting compilation  of online parenting advise givers.  Called From High Chairs to High School: 30 Teen Parenting Blogs  it features blogs by parents, professionals and teens themselves.  It also includes a site for "tweens", not an adorable pronunciation of "twins"-- rather the sometimes awkward age group of 7-12 year olds, especially girls. 

I salute Ms Harris for combing through the haystack that is the blogosphere and coming up with some diamonds.  I am honored to be a part of the list.  Here are a few others she features:

Connect with your teens through pop culture and technology where a recent post lists the top 25 entertainment personalities who Twitter and other important things to know about your child's culture. 

Support for Families with Troubled Teens: a good looking blog that  appears to support rather than diminish those kids who struggle more.

Denise Witmer's Teen Blog on About.com has long been one of my favorites.  It's always good to read the readers' comments here and the site does a good job of cataloguing related articles. 

From India comes an intriguing teen-written blog Rants of a Survivor written by teen, Shravan Vijayaprasad, who describes himself as a " random rambler with a mind full of crap and interesting crap at that too!" it gives us a small window into the life and times of an Indian adolescent.

So I am sending a shoutout to any of all my fellow bloggers who never might be sure if anyone is "listening" to our musings.   Somehow the message gets out there and into good hands.  Thanks, Amanda.

image from Google

Thursday, April 14, 2011

Is There Blood in Your Pot?

Every now and then I need to sit in the parking lot of my office and finish listening to a compelling story on NPR.  Today was one of those days.  I was listening to Viridiana Rios who according to her Harvard posting  "is a PhD candidate in Government and a doctoral fellow in Inequality and Criminal Justice at the Harvard Kennedy School. ...She studies drug trafficking, violence and corruption in Mexico. Currently, she works as an adviser for Mexico's National Security Council Spokesman, Mr. Alejandro Poire, one of the country's most important political figures currently designing Mexico's strategy to combat organized crime."

What drew me in was her passionate description of the interconnection between America's drug habit, including the occasional marijuana user, and the crime, victimization and murder of Mexico's innocent citizens, journalists, politicians, lawyers and fighters for social justice.  Caught between the drug-producing countries to its south and the largest consuming country in the world to the north, the Mexican drug lords are financed by our habits and by a continuous supply of weapons to support their nefarious activities. 

Rios does not condemn individuals for their personal drug habits. In fact, she seemed to imply today that California's liberalized marijuana laws might actually be a good thing for Mexico since the weed is grown in the US and does not involve illegal trade, transportation, weapons and gangs.  But, her plea to consider how each puff might be tainted by the blood, sweat and tears of her countrymen was arresting.  It's one more lesson in the globalization that insinuates itself into our lives at the expense of others.

image from charmingchitchat.wordpress.com

Monday, April 4, 2011

Tackling Weight Problems in our Students

image from experientia.com
It's Spring and this is the time of year when I am asked to see students for mandated periodic physicals and for sports clearance. This is also when I am stunned by the number of overweight children in our schools. Since I have only a few minutes with each student during these marathon sessions, I like to use the time well and will often talk with them about simple ways to make life style changes that can help them get a grip on their expanding torsos. Here are some of the bullets:

1. Always eat breakfast. No excuses. Eat it at home or in the car, bus or while walking to school. If you usually get breakfast at school, make sure to get it as soon as you arrive. Breakfast makes you a smarter, happier and leaner learner. Here is a recipe I love for "breakfast bread" from an earlier blogpost.

2. Eat protein three times a day. The protein portion should be about the size of your palm. Here are some examples:
  • two scrambled or hard boiled eggs
  • a hamburger patty
  • a thin chicken cutlet
  • Peanut butter on multi-grain bread
  • Sliced turkey meat
  • Other sources of protein including beans, cheese, milk, protein bars, tofu, nuts
3. Stop drinking soda even if it’s diet. Drink water instead. Low fat milk once a day is a great source of calcium, protein and fluids.

4. Eat three meals and two snacks a day. At least one meal should be sitting down with family members. Try to eat protein at snack time as well. And don’t forget the water!

5. Exercise for 20 minutes at least three times per week. Make modest, easy goals and you will feel the difference. All kinds of exercise count: walking the dog, walking to school, dancing in your room, raking leaves, riding a bike, even going to the gym if you must!