Rx For Parenting Today

Protecting Your Children from Racial and Religious Intolerance

As I watch the news and read the newspapers, I am appalled at what is going on under the Trump administration. There are accounts about desecration of gravestones in Jewish cemeteries, immigrants being sent out of the country with no chance for legal help when they had committed only minor offenses and on and on.  With all the social media kids are exposed to, as well as the bullying in schools, what are we doing to our children? 

I was fortunate to grow up in a small college town where we knew our neighbors and many in the town. Now children are growing up being driven to far away schools and learning little about the history of our country or the community in which they live. How terrifying it must be to live in the U.S. without the necessary papers and fearing there will be a sudden knock on the door and then deportation. Are we living in Nazi Germany where this happened daily to people Hitler did not like?

I am so glad my grandchildren are adults and have a wide view of the world. Their father and I have tried our best to help them understand people of different religions and colors. I think that on-going communication with their children is what parents can do to help turn this terrible tide of hatred and intolerance. I have grave fears for the future of this country if the Trump and Ryan policies are allowed to continue. Health care for all will be lost, more and more people will be forced out of their homes because of financial problems and businesses and the racial intolerance and hatred will keep growing.

Depressed Teenagers and Suicide

With all the national and international chaos we are seeing now, it is an even more difficult time to be the parent  of a teenager. I am sure it is hard to keep up with the day's work, both in and out of the house, as well as to be sure your kids are O.K. Children do react to tension. If you are a teenage girl, the desire to be part of the in-group, make-up, clothes and boyfriends can be all consuming. The latest statistics are that suicide is the second leading cause of death in kids between 12 and 19 years of age. If parents get too busy to realize a teen is depressed, the results can be devastating. Girls who don't fit the current beauty standards  set by movie and TV stars, can begin to feel that life is not worth living. Girls who did well in school, but then begin to get poor grades, spent a lot of time in their rooms, don't eat or cry a lot should be a cause of concern. Girls generally try to commit suicide with drugs, while boys more often find a gun to use. Suicide hotlines have saved many lives, but if a teenage boy or girl begins to change contacting the child's doctor is the first step. If the doctor does not offer any help then a good psychologist or psychiatrist is needed.

School counselors in the past were often helpful, but now they mostly take care of the problems of absent student. Many, too, don't have the training to counsel a student who is depressed. If parents have good communication with their teens, asking about what is going on is important. However, if a teen is depressed, they generally don't want to talk about it or talk at all. It is important to remove guns from a teen's reach, as well as any drugs that could be fatal. As a parent,  you want to be sure that no bullying is going on, either at school or on social media. Suicides have been reported when bullying goes on and is not recognized. So spending lots of time with your teens, doing fun things together and stressing a child's special skills will pay off now and in the future.

Kids and Drugs-In and Out of School

I was talking to the mother of a teenager the other day who said her daughter just started a public high school. On her first day, the girl was offered marijuana by three different kids. The teen had previously been in a private high school, but left because of bullying which the school did nothing about. The girl told her parents that at the private school she wasn't offered marijuana, but alcohol was the drug of choice. 

Now that marijuana is legal in many U.S. states, teaching your kids about how to handle it can be a problem. Parents who communicate well with their kids can start a discussion about drugs at the dinner table and ask the teens their plans to handle drugs.  I was lucky when my children were teens that I was the pediatrician for many of their friends and had a pretty good idea of what was going on with drugs in the schools. I would also ask both children about how I should handle a particular teen, not using a name. They always gave me good answers and were very helpful. I also had a teenage patient who I had to hospitalize for a drug problem and she wrote me a several page account of her exposure to different drugs. Her parents were not involved with her life and she committed suicide after she moved to another town. I still have the account she wrote for me.

One of the worse drug problems I had to deal with when I was in private practice was when kids would empty their parents' medicine cabinets, put the drugs in a paper bag, and pass the bag around to their friends. It was hard to know what they had taken and I lost a lot of sleep, but fortunately not a teenager. My best advice for parents is to turn off the TV and your cell phones and talk with your kids around the dinner table. Once the teens are off to college, new opportunities for drugs will be open to them, so it is never to early to start talking about the subject.

 

 

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Feeding a Child with ADHD

Occasionally, I take a teenager to school when the parents have to leave very early for their jobs. I am always amazed at what the girl does and does not eat. Even though her mother puts out food for her, the teen usually just drinks some orange juice and then is off to school. Occasionally, I have seen her eat a little cold cereal which probably has lots of sugar in it. Studies have been done about  the best diet for children with ADHD, but there have not been good control studies with large numbers of kids. The Mediterranean diet with lots of fruit, vegetables and fish has been suggested, but once again the studies are not adequate to make a final judgment. Parents with children who are hyperactive have told me that if they restrict the amount of sugar, soft drinks etc that their children do  much better. The Feingold diet was in vogue for a while and parents swore by it. In general, restricting lots of sugar, fast foods, and offering fruits, vegetables and fish makes a lot of sense. However, when both parents are working long hours planning meals and doing the necessary shopping is difficult. I found that if I made a meal plan for the week or several days and did the shopping on weekends that we had ate better. Because I was often called out at night, I had to have a live-in housekeeper when I was divorced. I always hired women who would be good with the children, but cooking was generally not their favorite thing. However, we all survived and family meals were special. Breakfast was an important meal and we all ate it together. It still is important for all of us. So looking at what your children do and do not eat could make a difference. I often asked parents to send me a three day diet history of everything a child ate, if there were problems, and I saw some amazingly bad diets. Changing what the family ate often made a difference in how everyone felt and how they acted. It is worth a try to look at what your kids are eating. 

Diagnosing a Muscle Disorder with Just Genetic Tests is Totally Inadequate

I have had two parents contact me recently about the diagnosis of muscular dystrophy given their children when only genetic tests were done. Both of the physicians who made the diagnosis were geneticists, who apparently had not had neuromuscular training. When the doctors were asked about doing muscle biopsies they said "No". My guess is that they did not have the training to do these and also did not have a lab were the muscle tissue could be processed.

No diagnosis of a potentially fatal disorder or any other disorder should ever be made just in a genetics lab. A great deal can go wrong, including human error or lab equipment problems. Fortunately, one of the mothers agreed to take her child to Mayo Clinic, the only place I will send neuromuscular patients. I have not heard from the other parent, but am afraid they are not willing to challenge the doctor, even though it is not because of the expense involved in making the trip to Mayo Clinic.  Yes, we have many more genetic tests than we did in the past, but a complete physical examination, the blood test, CPK, and a muscle biopsy are still necessary before a specific diagnosis should ever be made when there is muscle weakness.What if a child or teenager has a treatable muscle disorder and only genetic tests are done? I have diagnosed many cases of myositis on the basis of the history, physical examination, and muscle biopsy. I do not understand why even major medical schools do not have doctors trained in neuromuscular disorders see patients with muscle weakness.Other countries are far ahead of the U.S. in diagnosing and treating patients with muscle weakness.