21
May

Coming Out To Your Doctor

Coming Out To Your Doctor - Difficult & Private

Coming out to your doctor may be difficult, especially for if you are a teen.  Often, a teenager comes out with a million thoughts running

Coming Out To Your Doctor

Coming Out To Your Doctor - Photo by Sharon McCutcheon

through their head.  Will my doctor accept me?  Will my doctor help me?  Does my doctor understand me?  Will my doctor tell my parents/keep my secret?  According to poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, 18% of all LGBTQ Americans refrain from seeing a physician for fear of discrimination

 

What If I'm Scared of Coming Out to My Doctor?

Coming out to you doctor may feel very scary and unsafe.  Consider asking your doctor if their office is a safe office where acceptance is commonplace.  Whenever the LGBTQ child is suffering, the most important thing I can say to them is, "You are safe.  You are safe here."  Because every child is special.  After all, one of the best gifts a pediatrician can give to any child, especially the LGBTQ child/teen is letting them know they are special and wonderful just as they are.  It is not my job to help the child/teen figure out their sexual orientation.  It is my job to make them feel comfortable enough so that I can help them with any health issues they may have to date. 

 

Come Out When You Are Ready

Coming out to your doctor can help you in many ways.  However, given the difficulty that this may involve, you may want to consider calling your/any doctor's office first to ask if they care for any LGBTQ patients.  Remember, you don't have to give your name out at the first call.  Ultimately, this may help you feel more comfortable and ready.  

 

How To Come Out To Your Doctor

There are many conversation starters you can use, such as "There's a conversation I need to have with you" or "How do you handle patient confidentiality?"  Consider telling the doctor in a matter-of-fact way.  Chances are, you are not the first LGBTQ patient they have ever had.  Follow up with a prepared list of questions that you have for your appointment.  There is a "Do Ask, Do Tell" brochure that may help answer questions about coming out to your doctor.  It is also important to know that there are laws that protect you and your doctor, so that your information is kept private.  Ask about confidentiality will make you feel safe as well.  In addition, you may consider bringing a friend, partner, or family member for support.

 

Doctors Can Offer Support in Many Ways

I've had teens come out to me as their doctor, some have been painful to witness.  Painful for me, because it incredibly hard to see someone suffer and be in such tremendous emotional turmoil and/or physical pain) for simply saying their sexual orientation and/or gender identity.  In the past, I reassured a transgender child in the midst of an immediate, intense, and severe panic attack by continually repeating, "You are safe.  It's okay.  You are safe here.  You don't have to talk about it, but if you do, I'm here for you."  I have had patients who became successful adults with great careers who thanked me for accepting them because I was the first person they came out to or that I cared for them and their issues with compassion and maybe even some tough love.  Most recently, I held and rocked a child that I cared for over 15 years until they stopped their uncontrollable shaking because they couldn't face themselves and their sexual orientation.   That child motivated me to write this blog.  I want to help other LGBTQ youths know that they don't have to suffer, that their doctor can help them.  Chances are your doctor cares and wants to help you in your journey to physical and mental health and peace.  

 

Do I Have to Tell My Doctor I'm LGBTQ?

It's best if you do tell your doctor.  Your doctor can't give you the best medical care if he/she doesn't know that you are a LBGTQ person.  A doctor needs to know a patient's sexual orientation, gender identity, and sexual activity history, to best help that patient and their medical and psychological needs. 

 

Medical Help & Disease Prevention Available

Sexual history will help me test for, diagnose and treat STDs.  Also, a pediatrician or internist will be able to teach you how to prevent HPV and offer the HPV vaccine to prevent this cancer and wart causing disease.  In addition, if you are HIV negative, but at high risk for developing HIV, then your doctor may start PrEP medicationWhat is PrEP?  Pre-Exposure Prophylaxis (PrEP) is Truvada, which is a daily pill that when taken helps prevent HIV in people who are high-risk by up to 92%.  Your doctor may start this medication, if you agree to take it every day and follow-up with appointments every three (3) months.  Consider bringing a List of Top Ten Issues LGBTQ People Can Discuss with Their Doctor with you to your appointment.  In addition, if you are a transgender youth or adult, your doctor, yes, even your pediatrician, can refer you to a specialist for hormonal treatment.

 

Psychological Help Available

A doctor will also be able to make some psychological recommendations, if needed.  LGBTQ teens are more likely to suffer from anxiety, depression, have increased risk of suicide, abuse, may need referral to a psychologist, a psychiatrist, and/or a support group, like the Gay Straight Alliance (GSA), and GSA Network.  GSA is a student-led or community based organization.  GSA is an important resource on social media on Twitter (@GLSEN)  and Facebook.  GSA Network is also a resource available on Twitter (@GSANetwork) and Facebook.  Local support groups area usual available for GSA and GSA Network on social media and in as clubs many schools.  Lastly, your doctor is a source of support, simply be accepting you and caring for you.

 

Doctors Willing to Learn LGBTQ Issues & Needs

Your doctor may be comfortable with caring for you as a LGBTQ patient.  However, we are not classically trained to care for LGBTQ patients, so there usually is a learning curve.  However, if your doctor says, "I don't know how to care for that issue, but let me do my research; I'll get back with you on that particular issue," then you have a great doctor indeed.  A doctor that's willing to learn, cares for you, and is honest is the best kind of doctor.

 

Additional Resources for LGBTQ Teens & Parents

• Coming Out: Information for Parents of LGBTQ Teens is a helpful resource from the American Academy of Pediatrics. 

 

• How To Support Your Child Who is Questioning Their Sexual Orientation by Everyday Feminism which includes definitions of many LGBTQ+ terms.

 

• Transgender Children & Youth: Understanding the Basics by the Human Rights Campaign.

 

• Teens & Gender from an NPR interview which includes many gender terms, such as gender questioning, gender queer, gender fluid, agender, etc.

 

• Sexual Attraction & Orientation by Kids Health.

 

• This blog also has information on Children & Affirmations and Daily Affirmations & Quotes that are helpful in general.

 

 

16
Apr

Test Anxiety Strategies

Are There Test Anxiety Strategies That Can Help?

test anxiety strategies, relaxation techniques, test anxiety, relaxation, guided meditation, affirmations

Test Anxiety Strategies - Photo by Tim Gouw

Yes!  There are many test anxiety strategies on how to deal with test anxiety.  First, I'm going to review the causes, the symptoms,  and who gets it before I discuss what test anxiety strategies to use for managing test anxiety.

 

What is Test Anxiety?

Test anxiety is a feeling someone gets before or during test taking.  It is a type of performance anxiety, that occurs when someone is typically concerned about getting a good outcome.  The result is physical and psychological symptoms that occur before or during tests.  Test anxiety can negatively affect learning and performance.  The good news is there are test anxiety strategies on how to deal with it.  

 

What Causes Test Anxiety?

It is caused by fear of failure, poor test preparation and/or problematic test taking history.  There is pressure to perform at your best level.  This can motivate the test taker.  However, it may also create fear of failure.  Good test preparation is important for a good test result.  It is also important to prevent test anxiety.  A calm test taker tends to know they've studied to the best of their ability.  They also tend to have studied over time, and not in just a few days or at the last-minute.  If the test taker has had a history of negative experiences with test or poor grades on test, this can also cause anxiety on future tests.

 

What Are Symptoms of Test Anxiety?

Symptoms are physical, emotional, and/or behavioral.  They range from mild or very intense. 

 

The physical symptoms may include: headache, nausea, vomiting, diarrhea, fast heart rate, fast breathing rate, feeling like you can't breathe.  If the anxiety is severe enough, a panic attack may occur.  When someone is having a  panic attack, it is generally very debilitating.  A panic attack can make a person feel paralyzed internally or externally, like they can't move, can't talk, & they may feel like they're having a heart attack.

 

The emotional symptoms may include crying, feeling fear, feeling sadness, and helpless.

 

The behavioral symptoms may include negative self talk, inability to think clearly, and inability to function.

 

Who Gets Test Taking Anxiety?

  • Worriers - If your child has a tendency to worry, he/she is more likely to suffer from test anxiety. Even if your child is prepared, your child's worrying could cause test taking anxiety.
  • Perfectionists - If your child aims for self perfection, then he/she is more likely to suffer from test anxiety.  Even if your child does wll in school, the very thought of getting questions wrong, or getting less than an A, leads the perfectionist to have test taking anxiety.
  • Unprepared People - If your child has not learned the subject matter, not practiced with classwork/homework, and/or studied the material, then he/she is more likely to suffer from test anxiety.

 

How To Manage or Prevent Test Anxiety ?

There are many ways to help your child manage, prevent, and/or minimize test anxiety.  

 

    Talk About It

  • Ask your child what's making your child feel nervous.
    • Talking about their feelings make children have less anxiety.  Stay calm too as this helps your child stay calm as well
  • Accept mistakes
    • This can be a part of you child's life lessons.  Teaching your child to handle things when the outcome is not what they expected will help them in life, not just in test taking.
  • Boost your child's confidence.
    • Tell them how wonderful they are.  Ask them to give themselves compliments.  What do they like about themselves? About their great brains?
  • Always offer support.
    • Remind your child that you are always there.  Sometimes, they don't want a solution.  Sometimes being a listener is all he/she needs.

 

    Review Studying Habits & Test Prep

  • Have your child practice on sample tests.
    • Having experience with what the test will feel like will prevent anxiety.
  • Focus on test preparation.
    • Establish a routine for studying and preparing for the upcoming test is very helpful.  Studying a little bit at a time, over a set time period.  It is usually better than craming it in the day before the test.  It also also for better retention of the facts.  
  • Learn your child's best study habits.
    • When does he/she study best?  Is it morning, afternoon, or night?  
    • Does he/she need breaks? 
    • Could hunger be slowing his/her learning/studying? Consider snack breaks in between studying.
    • Does he/she need to do something physical or move around in between studying.
  • Review test taking strategies.
    • Teach your child what to do if they are stuck on a test question.  If they can't answer one, then teach them to mark the question and move on.  They can get back to it later.  
  • Help your child feel their best the day of an exam 
  • Review all methods and test after the test is complete.
    • What were your child's strengths on the test?  Where are their weaknesses?  How could he/she have improved test prep?  What did he/she do that was just right?  What can he/she do again the next time?  Or do differently?  Ask them to evaluate this with you.

    Sleep & Screen Time

  • Find your child's best number of sleep hours.
    • Does your child need eight (8) hours a night?  Ten (10)?  Twelve (12)? Try to make sure they get their best sleep before tests.
  • Monitor your child's screen time.
    • If your child has too much screen time, especially at night, or the days or week before an important test can do more harm than good.

    Relaxation, Guided Meditation & Affirmations

  • Practice relaxation techniques.
    • Deep breathing 
    • Taking a bath
    • Listening to relaxing music
    • Create art.  Drawing and/or coloring is fun and relaxing.
    • Play a board game that's fun with the family the day before the exam.
    • Watch a funny movie with your child.  Sometimes, laughter is the best medicine.
  • Use Guided Meditation.
    • I recommend and use, I Am Peace, by Susan Verde.  This is a wonderful book.  It is geared for children.  I think it's a great book for any age.  The last page has a Guided Meditation.  I've read this out loud to my son while he is lying down with his eyes closed.  I must say that both he and I are relaxed at the end, every time.
    • The Balloon
    • Follow the Leader
  • Use Affirmations
26
Mar

Gun Violence in America

Gun Violence in America & March for Our Lives

America had a truly historical moment on Saturday, March 24, 2018.  The March For Our Lives was led by the student survivors of Marjory Stoneman Douglas High School, Parkland, FL.  There were 800,000 teens and adults who attended the March in Washington, DC.  Many more attended in cities across the U.S. to demand change in gun laws and talk about gun violence in America.

Gun Violence in America, March for Our Lives

Gun Violence in America

A March led by our minors is amazing.  Even more amazing is that they included all others affected by gun violence in America, including domestic gun violence victims, police gun violence victims, and more.  This was not just a march to stop school shootings and school violence.  They made a statement that "Enough is Enough". 

Articulate Teens

They were also incredibly articulate.  In an era when so many think children are just children, it was wonderful to see them show the world that our American children can stand up for themselves, provide valuable statistics to support their positions, and be able to address our Congressional leaders with words and action.  They are stating that when they are eligible to vote, that they will vote based on this sole cause.  Many don't believe they will follow through on their actions.  However, many don't realize that once your voice has been heard, you are a force to be reckoned with always.

 

Students Speak Up

Several students stood out.  Emma Gonzalez spoke and stood in silence for about 6.5 minutes to honor to victims of the Marjory Douglas High School shooting on February 14, 2018.  This was less than the duration of the school's shooting.  It was symbolic of the time that students and teachers died, were injured, and were hiding in fear.  The silence was deafening and powerful.  

Samantha Fuentes, another Parkland school shooting survivor with gun wounds on both legs and shrapnel on her face stood up for herself and her friend, Nicholas Dworet, who died and would've turned 18 years old on the day of the march.  Overcome with emotion, she vomited behind the podium and persevered with her speech and led the crowd in a Happy Birthday song to her beloved dead friend.  She was courageous and empowered.  David Hogg, another survivor stated, "The people in power are shaking."  The most popular chant at the march was "Vote Them Out." 

 

Young Children Speak Too

Dr. Martin Luther King Jr.'s granddaughter, 9-year-old, Yolanda Renee King, spoke as well, stating, she dreams of "a gun-free world, period." And 11 year old, Naomi Wadler, stood for the disproportionate number of black females killed by guns.  She said, "For far too long, these names ... have been just numbers. I'm here to say 'never again' for those girls, too." There are many more amazing children that made their voices heard.  Undoubtedly they are coping with tragedy in many ways.  This is their chance to cope and have an active role in shaping and owning their future.

 

Gun Law Changes the Students Want

The students have detailed explanations in their "Manifesto to Fix America's Gun Laws," as listed in their words, in their guest editorial in the Guardian.  These are the  nine (9) gun law changes they request, as written by the editorial staff students of the Marjory Stoneman Douglas newspaper, the Eagle Eye

  1. Ban on semi-automatic weapons that fire high-velocity rounds
  2. Ban accessories that simulate automatic weapons (e.g. bump stocks)
  3. Establish a database for gun sales and universal background checks
  4. Change privacy laws to allow mental healthcare providers to communicate with law enforcement
  5. Close the gun show loophole and loophole for second-hand gun sales
  6. Allow the CDC to make recommendations for gun reform
  7. Raise the firearm purchase age to 21
  8. Dedicate more funds to mental health research and professionals
  9. Increase funding for school security

 

Democracy at Work

This march shows how a democracy works.  It shows that everyone can use their voice.  It has empowered many of our youth for the future.  The future is in our children.  Wait and watch because gun violence is only the beginning for these children, these future lawmakers, these activists; their future has so much more ahead!

 

22
Jun

Faith Affirmation

My faith lifts burdens off my shoulders.  I trust in the Devine.  I will be still and receive His grace.

15
Jun

Fun Affirmation

I nurture the child in me.  I choose to have fun.  I play.  I live happily.

Fun Affirmation

Fun Affirmation:

I nurture the child in me.

I choose to have fun.

I play.

I live happily.

 

There is more information on Children & Affirmations on this website.

There are other Daily Affirmations available as well.

8
Jun

Be You Affirmation

Be bold.  Be beautiful.  Be the one and only you.

1
Jun

Unfolding | Unbroken Affirmation

Unfolding-Unbroken Affirmation:

You are more than your feeling of overwhelming brokenness.

Rise above the dispair.

For you are not borken.

You are forever unfolding.

Gradually, slowly, wonderfully, and magically,

you unfold every day into someone uniqu, new, and powerful.

 

There is more information on Children & Affirmations on this website.

There are other Daily Affirmations available as well.

30
May

Blue Whale Online Suicide Game

Blue Whale Online Suicide Game

Blue Whale Online Suicide Game

The Blue Whale game is a social media suicide game that has been linked to over 150 children suicides.  To date over 130 children suicides in Russia have been linked to the Blue Whale game.  The game has made its way to Europe.  It has been linked to suicides in Portugal, Spain, England, and Ireland as recent as April and May of 2017.  (http://people.com/human-interest/texas-parents-say-blue-whale-online-challenge-led-suicide-son/)

 

The Blue Whale Game is an online interactive challenge game that starts with an assignment of tasks for the player.  A series of tasks occur over a 50 day period to complete.  Some tasks may be as simple as watching a horror movie.  Gradually, the tasks are increasingly more severe involving self inflicted injuries.  As each task is completed, the player posts a picture of the task on Instagram.  Although this game has typically been played on Instagram, other social media platforms have been used as well. Some posts include pictures and videos of self inflicted wounds include a whale carving on an arm, balancing on a roof, or a pool of blood.  The player wins at the end of the game, when they complete the final task of suicide.  In some cases, this has involved posting "End" with a picture of a blue whale.

 

Instagram has begun to post a warning regarding the Blue Whale game when a search is done for the term "blue whale."

 

The game's creator, Phillip Budeikin, from Russia, is imprisoned.  He started the game in 2013.  He has stated that he was cleansing society of certain people that were biological waste.  Even though he is imprisoned, other "death groups" have continued with the Blue Whale game.  In addition, the creator receives love letters in prison. 

 

Please discuss the Blue Whale game, its dangers, and its links to suicide with your children and their friends, especially if you have my concerns regarding depression or suicide in your children or notice my change in their behavior.

4
Nov

Suicide Youth ADD/ADHD & Depression

Suicide in Youth with ADD/ADHD



Suicide Risk in Youth with ADD/ADHD

Suicide in Youth with ADD/ADHD

Of those children who committed suicide, 5 – 11 year olds were more likely to have Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD), as revealed in a recent study in Pediatrics revealed that.  Teenagers 12 – 14 year olds, were more likely to suffer from depression or dysthymia, and one third (1/3) of children had a mental illness.  In order to determine the cause of suicide of children 5 to 14 years old, the study reviewed data from the National Violent Death Reporting System from 2003 to 2012.

 
Of those children who committed suicide,young school aged children were more likely to have family or friend relationship problems.  In contrast, teenagers were more likely to have boyfriends or girlfriend relationship problems.  The study also revealed that there was a higher rate of suicides among black youth than young of other races.  In addition, 29% of young children and teenagers told someone about their intention to commit suicide before they attempted to do so. 
 

Suicide Warning Signs

 

Warning signs include, but are not limited to increased seclusion and alone time, increased time spent in their room alone, decreased time spent with friends, decreased time spent in school activities, poor grades or a drop in grades, poor communication, discussion of a desire to commit suicide, increased temper, increased frustration.

 
 

National Suicide Prevention Line

 
An excellent resource is The National Suicide Prevention Line.  There are many tools available on their website, suicidepreventionlifeline.org.  In addition, their Lifeline is 1-800-273-TALK (8255).  Online Chat is also available.  If Chat is unavailable, then please call the Lifeline, as help is available 24/7.  It is anonymous and confidential.  
 

Positivity during depression can be helpful, so that the child at risk does not feel so helpless and alone.  For older children, they can call the hotline.  They can text HOME to the Crisis Text Line at 741741.  Also, consider having a professional and/or you do affirmation work with your child.  Daily affirmations can be one of many tools that help.  Lastly, a professional psychologist and/or psychiatrist may be beneficial as well.

  

Summary

 

It is important to (1) know the warning signs for suicide among young children and teens, (2) be aware that ADD, ADHD and depression place these children at a higher suicide risk, and (3) know where to call for help.

 

15
Jan

I Am Everything Affirmation

I Am Everything Affirmation

I Am Everything Affirmation

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