European Stars And Stripes (Newspaper) - March 22, 1988, Darmstadt, Hesse Heading off teen age health problems by Jane e. Broom new York times Merican Medicine is increasingly worried Aboul the health of the nation s 30 million town agers. The Only age group Hal has not experienced any improvement in health status in the last three decades. Hoping to head Olf any Deler Kotalion of adolescent health and even More serious problems in adulthood experts Are urging physicians to go beyond usual medical procedures to uncover treat and prevent the health related problems Hal primarily afflict teen agers. Sec mag a healthy teen agers rarely see a physician voluntarily Loi a routine checkup. But Many circumstances compel even the most reluctant adolescent la visit the doctor including such things As required physicals Lor Camp school athletics or employment needed immunizations accidental injuries of nagging health problems like acne stomach or Oil pains or headaches. Too often however the resulting examination Falls Short of uncovering the teen Ager s pressing health problems and misses a Golden Opportunity 1o immunize the youth against health risks. To Correct these shortcomings and to draw attention to the serious but alien hidden health problems of teen agers two experts have developed a guide to a thorough checkup Loi adolescents. The experts. T Andrea Marks do Columbia University s College of physicians and surgeons and or. Martin Fisher of North Shore University Hospital in Manhasset ny., Nole Hal while in 1381 the american Academy of paediatrics recommended adolescent health checkups every two years an annual exam would be optimal for discovering abnormalities in psychos dial development and participation in risky behaviour. Their guide published last Vily As a special supplement to the Academy s journal paediatrics emphasizes attention to such health risk Behaviours As sexual activity and the use it drugs and alcohol which currently account for the overwhelming majority of illnesses among teen agers. Another major locus of the exam should be detection and correction of risk factors thai can set the stage Tor Laler disease such As elevated blood pressure and cholesterol. They also urge instruction on preventive health measures Here is what these experts say a proper adolescent health exam should include a3 Many As one in live teen agers is inadequately protected against childhood diseases for which vaccines Are available parents can Holp by keeping or obtaining Complete records of All immunisations. Those of concern Are measles. Ii the Meastas vaccine was administered before the age of 12 or 15 months it should be repealed mumps. The condition is a particular risk to boys who can become sterile it infected Atter puberty . The disease is especially dangerous for guts who could transmit the infection to an unborn child. No vaccine should be Given to a Gill who might be pregnant and pregnancy should be avoided for three months alter immunization polio if those under 18 Ore not certain of Complete immunization the three dose Oral vaccine should be taken. Boosters Are needed Only when travelling to a polio Ridden area tetanus and diphtheria. The Throe dose primary series should be Given to All not definitely immunized. Adequately immunized adolescents should get Booster Nihols once every 10 years. In addition skin tests Tor tuberculosis Are recommended is one or two year intervals for Al adolescents growth and development can be compromised by bad eating habits. Nutrients often in Short Supply include Calcium Iron Zinc and vitamins a 86, c and Folarin. of nag a Tel Itom tee a doctor voluntarily for a checkup. Stipo Ortyl Emmet Tut in. In addition Many teen agers especially those who eat a lot of prepared snacks and Las foods consume Lar too much saturated lat Salt and cholesterol which Are particularly hazardous Lor those with a family a Malory of High blood pressure or heart disease. Ideally since food recall is notoriously poor the youngster should keep a food diary Tor a week before seeing a doctor the youngster s height and weight should be measured and compared to Standard growth charts adolescents who Are More than 20 percent above or 10 percent below Ideal body weight should be further evaluated. Adolescents who have been losing weight should be assessed to determine if the cause is dieting anorexia no Rosa depression or illness adolescence is the Ideal time to Start heading Olf a potential heart problem which is especially important 1or those with Hearl disease in the family. Factors to assess include the blood cholesterol profile blood pressure cigarette smoking obesity diabetes emotional stress and Lack of exercise. Two thirds Olleen agers with mild hypo tension will have High blood pressure As adults they should be advised to keep their weight Down avoid Salt reduce stress and get regular exercise. Dietary intervention is recommended for Icen agers whose local cholesterol exceeds 180 to 200 milligrams or whose protective High density Lipoprotein cholesterol is below 40milligrams inquiries should be Mado about relationships Witti family members and Peers school adjustment work performance sexual identity Independence self esteem and the general Outlook on Lile. The doctor should also Check for signs of depression or developmental difficulties such As decreased appetite difficulty sleeping undue Aligue or such behaviour As substance abuse truancy recklessness promiscuity delinquency end incorrigible. These issues should to discussed separately with the adolescent and with a Parent. Contrary to common belief most Leen agr is do not express inner Luin Wil through antisocial Behaviours. Rather surveys of thousands of teen agers not under medical care revealed that drastic mood swings and risky behaviour arc not usual Lor Leen agers the surveys were conducted by or. Daniel offer a psychiatrist at the Michael Reese medical Center in Chicago he found Hal to percent of those questioned Cope Well with adolescence. They Are not extremely rebellious Moody or unpredictable and do not take untoward risks. The remaining �0 percent should be considered disturbed and need professional help but Only one third of those now gel such help and go percent of those see a Counselor Only once or twice. Offer said this is thu area taking the greatest toll on the health of teen agers but in is what doctors generally Are least equipped to handle. First teen age patients should be assured of unless the situation presents a serious health threat. Then in a non dug mental Way they should be questioned about their involvement with drugs alcohol cigarettes and sexual activity thay shout also be asked directly Abou suicidal thoughts and typical signs of depression. Any hint of suicidal potential should be followed by consultation with a therapist. Teen agers who have had or Are contemplating sexual Intercourse should to asked about the use of birth control Laid about the proper use of non prescription methods and cautioned about sexually transmitted diseases. Boys with a homosexual orientation should be instructed on How to avoid aids and hepatitis. All sexually Active teen agers should be tested Lor gonorrhoea now three times More common among 15-to 19-year-Olds than it was in 1960. Adolescents who use alcohol or drugs should be assessed As to the nature and extent of abuse and in it is More than just curious experimentation referred Tor intervention. Marks and Fisher say such an exam can usually be completed in 30 to 45 minutes with a follow up visit scheduled to deaf with any findings that require More thorough evaluation they suggest thai might be used As a Lime Saver and ice breaker exercise May Benefit asthmatics by William Stockton naw York times or generations people with asthma have been ire aled As invalids. They have been told to avoid exercise because in would induce attacks of their disease. A Etc locus Circle was set up the less they exercised the less exertion in look to bring on an attack of coughing constricted bronchial passages and difficulty breathing. Bui that traditional medical Wisdom is undergoing a dramatic reversal that is changing the lives of Many asthmatics. New research How thai the More asthmatics exercise. The More exercise they can tolerate and the loss a Mon Are their attacks. By steadily increasing the tolerance Lor exercise and using medication now available some asthmatics have discovered new lives As recreational athletes. My asthma got worse and worse until t began to get what i Call an asthmatic personality said Marilyn Miller 43, who owns a graphic arts company in new Page 16 the stars and stripes tuesday March 32,1988
