Question: What do these 11th-grade patients have in common?
A girl misses school a few days of each month for severe abdominal pain and has not been doing well in school. Diagnosis: dysmenorrhea.
A boy has had prolonged grief and sadness since his brother was killed in a drive-by shooting three years earlier; he frequently misses school for various reasons and his grades have been declining. Diagnosis: depression.
Another boy has been very thirsty, has recently gained a lot of weight, has been bullied in school, and needs to repeat a grade because he flunked most of his classes. He has glucose (sugar) in his urine. Diagnosis: type 2 diabetes.
Another boy has short stature and delayed pubertal development; he also has been bullied and refuses to go to school. Diagnosis: Crohn's disease.
Answer: This is their first medical checkup in several years. These teens all have medical issues, and they are not reaching their academic potential. Thanks to Pennsylvania requirements for an 11th-grade physical examination, they are finally seen by their primary-care providers (PCPs).
Good grades and good health often go hand in hand. Not only that, they are predictive of good health as adults. How can we help our teenagers achieve good health and reach their academic potential? By making sure they get yearly checkups at their "medical home" to screen for chronic medical illnesses, mental-health problems, and health-risk behaviors. A medical home is a place where everybody knows their names and has their medical records. Their PCPs should spend some one-on-one time with them, too. This is such an important point that I wrote a blog about it here.
Chronic medical illnesses such as diabetes and hypertension (high blood pressure) can surface during the teen years. Hypertension, which can occur both in normal-weight and overweight children, is an example of a "silent killer" — when a person has no symptoms, yet may be developing early signs of heart and kidney disease. About 3.5 percent of all children and teens in the United States have hypertension, according to new guidelines published by the American Academy of Pediatrics,
Health-risk behaviors and poor academic performance go hand-in-hand, too. According to the Centers for Disease Control and Prevention, these behaviors include:
Sexual activity: About half of teens with mostly D's and F's were sexually active — as compared with 23 percent of teens with mostly A's. Good students also were more likely to have used a condom and less likely to have drunk alcohol or used drugs before their last sexual intercourse.
Violence: About half of teens with mostly D's and F's were involved in a physical fight during the prior year — compared with 15 percent of teens with mostly A's.
Substance abuse: Two-thirds of teens with mostly D's and F's had used marijuana — compared with 24 percent of teens with mostly A's. Similarly, about half of teens with D's and F's drank alcohol — compared with 24 percent of A-students. Low performers were more likely than high performers to report binge drinking (34 percent vs. 11 percent). I wrote a blog about binge-drinking, too.
Homes, sweet homes. Your teenagers need two homes: their homes with you, which should be safe and full of love, and their medical homes, which should help keep them safe and healthy. Both homes go hand-in-hand to help teenagers. Call your PCP for your teenager's annual checkup — and, please, don't wait until 11th grade.