Show Know Tha Warning Signs fix healthy meals combined with idealized images that tell us we will only be happy if we're a certain wriit and body type From there it’s a short bop to bulimia and anorexia nervosa These are growing even among boys” Both boys and girls face health-relate- d 01 Teen CHRONC COUGH could Signal medicine — within pediatrics and family medicine The field smoking or drug use DECUNNG SCHOOL PERFORMANCE OR A CHANGE M INTERESTS usually HEADACHES OR ABDOMNAL PAM teenage patients and do really well with them” says Dr Jonathan Trager an Kpflpmhrf soon to open a practice in Great Neck NY “You’ve got to start where you are —with the pediatrician or the familydoctoc As your child gets older ask if your doctor sees preteens and teens Abo look around: Is MIC OOCwTI OflliCv CCaTM JUm TOT DBDtCo and small children or for all ages? Iklk with the doctor about issues your teens will soon face Ask about the doctor’s approach to sexual issues Does he or she deal with irregular periods in giris or hormonal changes in boys?" DcTiager endorses incorporating gynecologic care into teen pediatric care because as he puts it “the doctor who knows your daughter best is ideally suit- i you your kids are eating? Many toaiw don’t make healthy food choteaa and sating dioordoro can bo a aorioua PnMm smoitf teenatfi girls and SET A GOOD EXAMPLE' iI "ten need good ck aMcafrana doctor who docs noiapproacn them with an sitborturtan stance” tan on is a big roe For example a teen girl may have a simple urinary-trainfection But if she’s ct been sexually active she may think she has an STD and won’t say anything If you've built up trust with her she'll call you come in and get and teens to trust you is the facts” the key says Dr CaroConsultations bensen tween teens and their lyn Lopez a family I specialist doctors generally are physician at a public I in has who treated hospital Chicago protected by confidentiality laws Many mhJ i teens from all economic strata Tbros state have such laws although specifics which includes gynecological care What matters is the relationship and trust that hat been huilt between thg need good advice from a doctor who understands and doesn’t approach them with n authoritarian tlnnrg " ghg myy vary from state to state Primarily laws iLaoM-Moe- y To help parents approach teens you teen about issues of concern ed to provide comprehensive care MMMMMAZM: Your GET A DOCTOR BOTH YOU AND YOUR TEEN UKE AND TRUST ' Then you’ll feel comfortable asking the doctor to talk wi th reason we’ve stuck with the same doctor for seven years is because she Mbftikiy Getting both parents tions with their teens even about difficult subjects such as drunk driving or steroids “Parents should have as much dialogue as they can with their kids” says Dr Trager “But parrots need to know when to back off too1 and to make sure kids know their love is unconditional” some aay in your teen’s nutrition and can provide healthy choice The laid-ba- good communica- PLAN REGULARLY SCHEDULED MEALS That way you’ll have doctor and your child” Meghan Cavanaugh your chart” she says “She’s and I know she would keep a confidence if I had something serious to talk about Plus my mom trusts her advice” “Warning Signs” at left) And parents must develop own eating habits and smoking drinking and drug use sends a message to your teen RmPIUNIglyi BOym knows exactly who you are without looking id - arise do more listening than talking Then ask questions to help your teen evaluate the choices he or tiw is making ' agrees TIn parntt1 rotes Good teen health starts wife parents observing their children far physical or behavioral changes (see box AVOD POWER STRUGGLES Whan oonfUetS could be a gynecological problem or it could be nutritional challenge for parents is with whom both they a doctor finding their feel comfortable and teens "Many pediatricians like treating child's life is in danger the child is a danger to himself or others or when a child is being abused physically or sexually health iaauea with your child Liston to Ms or her concerns Find out where ho or she Is getting health information Tips from friends or online advice— shout everything from steroids to doting—may bn wrong could buflcate depression an eating disorder or body image issue or substance abuse nationwide Given the shortage most teens get care instead from pediatricians family doctors internists and other when a physician determines that a DEVELOP GOOD OOMMUNCATIONSDiMuao A CHANGE M EATNG AND SLEEP HABITS WEIGHT LOSS OR GAM specialists health and substance-abus- e issues There are limits to confidentiality however Information is not protected What Parents Can Do means a teen is headed for trouble is growingbut there still are fewer than e their separation from their parents” It’s aboimportant because “most kens do not have a sense of what’s normal and what’s not” says Dr Mary R Frank a family physician in Rohnert Park Calif They can easily think a minor problem could signal risky behaviors or be a sign of depression or anxiety In 1994 the medical profession tried to remedy the problem of poor teen health care by offering board certification for a new subspecialty— adolescent adolescent-medicin- health-car- e decisions need make to they especially since they’re in the process of establishing BENG WITHDRAWN OR ISOLATED : Teens want some control over the your child i always tired something is wrong This could Inrficate mononucleosis ' alcohol or drug use or depression Doctirt for tMis 400 That doesn’t work FATIGUE If problems their parents never had to deal with son sufferMy own stomach discovered ing pains he had die beginnings of an ulcer when he went to the doctor r:2cd Prchlsos cover sexual matters and abortion Iwt they also caw pMtiin tr mental 0 Dr Lopez gives this advice: “Avoid the power struggles— no one wins those of a listener than a talker" Ctiaslni a lactar If you need to find a new doctor get Be more recommendations from other parents or from one of the professional associations that deal with adolescent medicine Interview a couple of doctors making a choice and let your teen meet them too The best teen health care is a collaboration among the teenager die parrots arid die doctor" D says Dr Trager be-fo-re i Fw hat flndtatf a doctor for ymr teenager a let of the top® taen " health leauei taan health reaoiroea viait watfafadkaMi |