Tag: Chronic Illness

Frequent Headaches and Migraine in Children

Children who get frequent headaches and migraine attacks have chronic illness. Such children and their parents face problem to adjust with school and their rules. Extra preparations and steps should be taken to cope with such illness. Pediatric specialist in migraine and headaches exist should be consulted for treatment and other precautionary & preventive measures. Also the triggers vary from child to child, which should be recognized accurately.

Firstly, it is the strict attendance rule in most of the schools that children with chronic illness find it difficult to deal with. To add to it, majority of the schools have zero tolerance policy regarding medications, even including over the counter medicines. Reports of students getting expelled for merely carrying Advil in school with them are common. Prior to making appointment with the doctor, it is recommended that parents read the policy of the school the child is attending. It is good to ask questions before hand, than feeling sorry later. Some of the schools asks for letter or medical record as a proof, incase the student didnt attend because of a health problem. Some schools consider sick leaves as regular leaves and in this case, the attendance gets affected greatly.

School nurses can be given the prescribed medicine so that they can give the medicine to the child at the required time. If this is the case, things such as medicine storage location and availability of substitute should be checked. Apart from not attending regularly, the child can sometimes be unable to take part in co-curricular activities especially physical education and outdoor recess. Other possible options should be discussed with the teacher. Usually a recommendation letter from the physician will do the needed. In all the cases, some kind of medical identification can be carried by the child at all times. If the child is attending an after school babysitter or program, directly after school, extra measures should be taken. The babysitter or program in charge should be told about the problem in advance. Their cooperation can be asked for timely administration of the medicine and for taking special care of the child. If the child himself is grown enough to understand the matter, the child should be educated about taking medications. They should also be made to understand that it is harmful to take medicines from any un-trustable source even if their fellow students do. Budge them to ask questions and clarify any of their fears of concerns.

Most of the children lack the ability to convey their problem properly. The situation is further aggravated because of different kinds of headaches. They can be related to chronic illness, tension, sinus or fever. Only diagnosis can bring out the correct problem. If the rate of headache becomes more frequent, like more than twice a month, doctors appointment should be taken instantly. Younger kids find it more difficult to explain the problem. If they become cranky, restless, irritating, tired, is having sleeping disorders and is not eating properly, a problem surely exists. Most of the children complain of headaches during exams because of increased stress. Seventy five percent of the children experience headaches because of tension. If so, stress management education, along with counseling, should be given to the kid.

Headaches can be an indication of other problems, too. So, thorough diagnosis is highly recommended. The childs previous medical history provides important clue. Prior to the doctors appointment, notes can be made after referring the medical history. Maintaining a log about the childs headache frequencies, pain location, time of occurrence, symptoms, etc. also helps. If not due to illness, headaches can also be a result of head injury. Sometimes, headache can be hereditary, like in the case of migraines.

Headaches can also be caused because of infections, vision problems, odd levels of blood pressure, neurological problems, muscle weakness, improper ear balance or serious problems such as tumor, blood clots, etc. If the doctor is not able to diagnose the problem, he/she can refer the child to a headache specialist or neurologist. Test such as CT scan or MRI are done if there is a serious problem. After the diagnosis, the doctor prescribes medication or will ask to take over the counter medicines. According to a study, children who face headaches and migraine take overdose of over the counter medicines for immediate pain reliving. In some of the cases, the parents are clueless about this situation. This practice is risky and mostly children above six years are involved in such cases.

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Obsessive Compulsive Disorder in Adolescents

Obsessive compulsive disorder or OCD starts from adolescence onwards. OCD is feeling of strong obsessions and compulsions which result in intense discomfort and affects daily functioning. Obsessions are thoughts which are persistent and recurrent. They even include unwanted images and impulses which lead to distress and anxiety. These feelings and thoughts are usually irrational or unrealistic. Compulsions are repetitive rituals or behavior such as checking something again & again, or mental acts such as counting. These obsessions & compulsions cause intense distress and anxiety and can interfere with the daily activities, relationships, social activities and academic functioning. The person with OCD thinks that he has no control over his actions. OCDs are relapsing and chronic illness.

The thoughts change as the adolescent grows. Younger children suffering from OCD often have thoughts of harm befalling on them and their family such as thief getting into the house through an unlocked door. This will make the children to recheck the door and windows again and again fearing that they might have left the door unlocked accidentally. Teenagers suffering from OCD fear that they might get fall sick due to germs, contaminated food and AIDS. The adolescent develops certain rituals, such as washing hands innumerable times, in order to get over the fear. These rituals help them to think that they have overcome the problem for the time being and give them temporary relief. If they do not perform these rituals, they become more and more anxious.

OCD is a sign of brain circuitrys unusual functioning and it involves the striatum part of the brain. The brain activity patterns of such people differ from normal people and people with other mental disorders. Researchers have concluded that OCD is usually a family problem and is a disorder of the brain. Streptococcal bacterial infection can create or worsen the condition of OCD. Adolescents with no family history of OCD can also develop it. Most of the adolescents feel embarrassed to talk about their OCDs. They think that people will label them as crazy and this will make them feel ashamed. This will make it difficult for the parents to talk to their children about their OCD, in order to solve them. Parents need to develop good communication skills for this purpose. Parents support is also very important to the adolescent. Cooperation is extremely important along with treatment, because if the problem is not treated the adolescent will grow into a disturbed adult.

Most of the adolescents with OCD can receive effective treatment. The treatment can include psychotherapy and intake of medications such as fluoxetine, clomipramine, fluvoxamine, paroxetine, sertraline and other serotonin reuptake inhibitors. When OCD is caused due to streptococcal infection, the adolescent can be administered with antibiotics to kill the bacterium which is causing it. Exposure and response prevention behavioral therapy is very useful in solving OCD. In this therapy, the adolescent is wontedly exposed to his/her fears which give him/her obsessive thought. After that he/she is trained to avoid these thoughts and the rituals which he/she carries out to tackle the anxiety.

An adolescent having OCD can also have depression, substance abuse, attention deficit hyperactivity disorder, eating disorders, and other types of anxiety disorders. When a person with OCD and other mental illness, is treated, OCD becomes more difficult to treat and even diagnose.

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High Blood Pressure in Adolescents

High blood pressure is a condition where the blood pressure is more than normal. It is also known as hypertension. Heart pumps out blood, so that oxygen can reach to different parts of the body via blood. The pressure with which heart pumps blood is known as blood pressure. The blood pressure comprises of two measures, the systolic pressure and diastolic pressure. Systolic pressure is the larger figure and represents the pressure within the artery of the heart, when contractions take place which pump blood to different parts of the body. Diastolic pressure is the pressure within the artery of the heart, when the blood is filling in the heart and it is at rest. Both the pressures are measured in millimeters of mercury or mmHg. High blood pressure is abnormal increase in systolic pressure or diastole pressure.

Blood pressure is measured by putting a blood pressure cuff on the arm and placing a stethoscope on the chest. There can be very little variation in blood pressure depending upon the time, emotional moods, age, gender, weight, height, physical activity, stress and other illness such as heart disease and kidney disease. Children and adolescents become anxious when they visit the doctor. This is also an important factor which affects the blood pressure and the readings taken get tampered because of it. That is the reason why many blood pressure readings are taken in order to determine whether the adolescent has high blood pressure or not. The nurse may even ask the adolescent to calm down while taken the readings. Time gap is given between each reading, so as to give time to the adolescent to calm down. Emotions can also affect the blood pressure reading.

An infant will have a normal blood pressure reading of 80/45, where as an adolescent will have a normal blood pressure reading of 110/70. Therefore, age, gender, and height are important factor when determining the normal blood pressure level. Adults will have a higher blood pressure than the infants and teenagers. Also, boys have a higher blood pressure when compared to girls and tall people have a higher blood pressure than short people. An adolescent is said to have high blood pressure when the blood pressure is more than the blood pressure of ninety percent people of his/her age, gender and height.

There are many risks associated with hypertension or high blood pressure. The risk of developing coronary heart disease increases proportionally. The arteries will develop greater resistance towards the blood flow, because of which the heart will pump blood harder. Stroke is also another risk. Adolescents who have had high blood pressure as a child, develop harmful effects on the blood vessels and heart till the time they turn twenty.

The causes of high blood pressure can be classified as primary and secondary. If the causes are definite, they are primary and if the cause is linked to some illness, it is secondary. Primary causes are high blood cholesterol levels, smoking, stagnant lifestyle and overweight. Secondary causes are obesity, immobility due to chronic illness, prescription drugs, intense pain due to burns or cancer and illegal drugs. High blood pressure can develop due to hereditary reasons.

Hypertension is diagnosed by blood test and urinalysis. The kidney function will also be checked, along with blood cholesterol levels. Family history check is another important factor. Adolescents eating habits, exercise levels, activities in school and home will also be studied thoroughly. High blood pressure is dealt with by weight reduction, healthy diet, and increase in physical activity. If hypertension is due to illness, the illness is treated first. These treatment measures will decrease the systolic blood pressure and diastolic blood pressure. It will also strengthen the heart and decrease the level of cholesterol in blood. This also helps to keep heart diseases at bay. The good thing is that only one percent of the adolescents, who have high blood pressure, need medication to bring back the blood pressure to normal.

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Depression in Adolescents

Depression in adolescents is a disorder which occurs due to persistent sadness, loss of interest, loss of self worth and discouragement. Depression is normally a temporary reaction towards situations of stress. Depression is a normal part of the maturation process of adolescents. It is even induced due to production of sex hormones. Adolescent females are depressed twice more than adolescent boys according to a study.

Adolescent behavior is normally marked with good and bad moods. The transition from a good mood to bad mood and vice-versa, can take minutes, hours and even days. That is the reason why true depression is very difficult to find out. Depression in adolescents can be caused due to bad school performance, break up with boyfriend or girlfriend, and failing relations with friends and family. These causes can lead to persistent depression. Other serious causes are chronic illness, obesity, child abuse, stressful lifestyle, poor social skills, unstable care giving and depression in family history.

Symptoms of depression in adolescents are eating disorders, weight change, irritable mood, excessive sleeping in daytime, excessive temper, criminal behavior, memory loss, fatigue, self preoccupation, sadness, difficulty in concentrating, worthlessness feelings, loss of interest, self hatred, obsession with death and thought & attempts of suicides. When these symptoms are being noticed for more than two weeks, it is important to get treatment for the adolescent. Depression not only affects interpersonal relationships, but school performance as well. Depressed adolescents are more prone to take onto drugs and alcohol as an attempt to overcome their depression. Such problems require intensive treatment.

The doctor will take blood test and perform physical examination to determine the cause of depression. The adolescent can also be tested for substance abuse such as smoking, heavy alcohol consumption, marijuana smoking, and usage of other drugs. After the physical examination, psychiatric evaluation is also done to understand the cause of sadness, loss of interest and irritability. Depression can also lead to the development of other psychiatric disorders such as schizophrenia, mania and anxiety. It is also important to determine whether the adolescent poses a risk for himself/herself and others. Family and school personnel can provide valuable information about the adolescent to the doctor.

Treatment for depression for adolescent is similar to the treatment of depression for adults. Along with the treatment, the adolescent are given antidepressant medication and psychotherapy. Antidepressant medications include tricyclics, Prozac, selective serotonin reuptake inhibitors or SSRI. Some of the medicines increase the risk, so it is a good idea that parents discuss the possible risks with the doctor. Only some of the antidepressant medications are meant for children and adolescents. Adolescents with severe depression need to be hospitalized as they are more prone to kill themselves.

Family and school support is necessary to tackle the depression of the adolescent. Parents can get their children admitted in emotional growth schools, boot camps or wilderness programs, to solve the behavioral problems. These programs consist of non medical staff and confrontational therapies. But care must be taken as some of the programs can in turn harm children who are depressed and sensitive. Adolescents, who get caught due to criminal offense, should be taken special care of by their parents. It is best that the child face the consequences and learn a lesson from it. Depressed adolescents respond well to treatment if they are treated comprehensively and early. More than half of the adults are known to have depression when they were in their teens.

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