May 04 2008

Medial Exams and Evaluations during Adolescence

Published by dodo at 2:12 am under Adolescent, Boys, Daddy, Education, Family, Gift, Girls, Mommy, Parenting, Teenager

During the next few years, your teenager will probably need medical input on a number of occasions. Screening exams for sports, camp, and general health assessment will need to be done. Injuries arising from sports or other vigorous activities may need attention. Problems related to menstruation may require medical evaluation and intervention. In addition, a variety of symptoms and emotional concerns may arise during these years.

Adolescent health-care guidelines recommend yearly visits to the doctor for assessment, screening, and guidance, even if there have been evaluations during the year for other medical problems. Quick exams for camp or sports, especially those done assembly-line style on large groups of adolescents, should not substitute for more comprehensive physicals by your regular health-care provider. If there are special health problems, more frequent exams may be necessary. Most doctors will talk with parent and teen together during the visit, but part of the time will be spent without the parent present. This is usually done in order to increase the likelihood that the doctor is receiving accurate information, with an assumption that many teenagers might feel uncomfortable answering sensitive questions in front of their parents. It is customary during this time alone for a physician to assure the young patient of the confidentiality of their conversation.’ It is therefore extremely important that you consider carefully who is going to provide health care for your adolescent.

KidsIn an ideal situation, you will be dealing with someone

  • who is medically competent;
  • whom your teenager trusts and can talk with comfortably;
  • who knows you and your family;
  • whom you trust, and who shares your basic values.

The last qualification is particularly significant because of the near certainty that your teenager will eventually be in a one-on-one situation with the physician. Your son or daughter may feel more comfortable discussing sensitive topics with a doctor than with you, even if you have an extremely close and honest relationship. You will want to be certain that the advice and counsel given behind closed doors, especially regarding sexual behavior, will not contradict or undermine principles you have been teaching at home. During these critical years, everyone needs to be on the same team.

Although adolescents usually have an interest in discussing a variety of topics with their doctors, they may feel embarrassed to broach certain subjects. The physician should have the interest (and time) to ask some probing questions and then offer sound input based on the response. (There is no guarantee, of course, that a teenager will tell “the whole truth and nothing but,” even when confidentiality is assured.) Along with questions about past history and any current symptoms, specific topics that are usually on the physician’s agenda (if not on the patient’s) include:

  • Growth and development. Younger adolescents are particularly concerned about whether they are normal, especially if pubertal changes are taking place earlier or later than in their peers.
  • Physical safety, including the use of seat belts, bicycle or motorcycle helmets, and appropriate sports equipment
  • Current dietary practices. Are they healthy, erratic, or extreme in any way
  • Vaccination history
  • Exercise and sleep. Is there enough of each?
  • Tobacco use
  • Alcohol and drug use
  • Sexual activity
  • Relationships at home and school
  • The emotional weather. Are there any signs of depression?
  • Sexual or other physical abuse. A physician who is attentive to an adolescent’s physical well-being and demeanor may be the first to detect signs of abuse. By law the physician is required to report any concerns about abuse to the appropriate local social-service or law-enforcement agency.
  • In addition to the usual elements of a medical exam (ears, throat, neck, chest, heart, abdomen), a few other areas are important:
  • Blood pressure. While not common in adolescents, hypertension (elevated blood pressure) must be evaluated further if it is detected.
  • The spine. Special attention is given to scoliosis, a sideways curvature of the spine. There are specific guidelines regarding the degree of curvature that help determine whether treatment is needed, and if so, what methods might be appropriate.
  • The groin area should be checked for hernias (primarily in boys).
  • The testes should be checked for appropriate development and for any masses. Testicular cancer is unique for its prevalence among young men, and teenagers should get in the habit of a brief monthly self-check for unusual growths in this area.
  • The breasts in both sexes.

When should a girl receive her first internal pelvic exam? Most medical authorities recommend that this be done

  • if there is a symptom or concern about disease: vaginal discharge, pelvic pain, or other symptoms in this area normally cannot be diagnosed by history alone;
  • if a girl has become sexually active;
  • if she is going to be married in the near future;
  • if she is in her late teens or early twenties, even when there are no specific concerns;
  • if she is going to start on birth control pills.

Possibly related posts: (automatically generated)
Medial Exams and Evaluations during Adolescence

Trackback URI | Comments RSS

Leave a Reply

LogoAlexa CounterFeedBurner Counter r();?>