From Breast Lumps to Depression: Talking to Teens about Sensitive Health Concerns
When Jan Goldberg's 15-year-old daughter told her she'd found a lump in her breast, Goldberg was pretty calm – until her daughter, Kristin, said she'd found it three months previously. "That just put me over the edge," says Goldberg, of Parsippany, N.J. "All her life I've tried to be sure she knew she could talk to me about anything, and here she worried herself sick for three months, looking on the Internet for information – which of course was all about breast cancer – and thinking she was going to die, but keeping it to herself. I couldn't believe that she waited so long. What if this had been something really serious?"
In Kristin's case it wasn't serious, just fibrocystic breasts, which are fairly common. But the reasons she didn't come to her mom right away were more complex. It was a combination of embarrassment, worry that she was overreacting and her fear that she may be giving her mom devastating news. "I just thought it was cancer and didn't want to be the one to tell her that I was dying," she says. "I finally told her because I didn't know what else to do; I couldn't just keep reading about it forever and wondering. Of course, now I know, but I was just confused."
Figuring Out What's Really Serious
Breast lumps in teens are almost never something to be concerned about, says Dr. Andrea Marks, a specialist in adolescent medicine and author of Healthy Teens, Body and Soul: A Parent's Complete Guide (Diane Pub Co., 2004). However, while it may be hard for a teen to approach a parent about an embarrassing problem, it's absolutely necessary to rule out anything serious.
"I realize that these are sensitive issues to discuss, and the girl who doesn't tell her parents about a lump in the breast will probably be fine, but the boy who doesn't tell his parents about a lump in his testicle may not be," Dr. Marks says.
Common Problems Teens May Be Embaressed to Ask About
Dr. Marks offers the following guidelines to some touchy health topics – both so teens will understand their seriousness, and perhaps to give parents some concrete examples of things they might want to ask their teens targeted questions about:
- Lumps: Again, while lumps in the breast are almost never serious for teens, a lump in the testicle is considered a medical emergency – with or without pain. Any pain or swelling of the testicles or scrotum should be brought to your parent's attention and reported to your health care provider immediately.
- Discharge: Probably normal if it's from the nipple or penis, but should be mentioned to the child's health care provider. Discharge from the vagina is normal for the two years preceding menstruation.
- Burning or Itching: If vaginal discharge is accompanied by itching or burning, it could be a yeast infection and needs to be treated. Treatment is over the counter, but the diagnosis needs to be made by a medical professional to rule out other problems.
- UTIs: Short for urinary tract infection, UTIs are often accompanied by an urgent need to urinate, frequent urination and pain or blood upon urination. This needs to be treated with an antibiotic. According to Dr. Marks, who is also spokesperson for the AZO line of urinary health products (http://www.utifacts.com/), UTIs can be avoided and the symptoms eased with AZO, but it's also imperative that the underlying infection be treated. UTIs can be contracted at any age, and are much more common in girls than boys because of their anatomy.
- Bowel Issues: Pain or blood in the stool is relatively common in children, but does tend to ease up as kids move toward adolescence. This is not typically a serious issue and can be caused by constipation or diet. However, if it persists and is accompanied by other abdominal symptoms, it could be a sign of something more serious, such as inflammatory bowel disease. Even simple constipation should be discussed with the child's doctor to find ways to ease it.
- Acne: This may not seem like a problem on the scale of some of the others discussed here, but Dr. Marks says that acne is usually of great concern to preteens and teens and is often something they don't feel comfortable discussing with their parents, for various reasons. In fact, skin problems are not trivial because they can seriously impact a child's self-confidence, and parents should take them seriously.
- Moods: Dr. Marks did a study some years ago asking teens which health problems they'd be willing to share with their parents. As expected, a large number were not willing to discuss alcohol use, cigarettes or sex, but surprisingly, a large number said they didn't feel they could talk to their parents about their moods. In other words, if they were feeling down or confused or depressed, their parents would be the last to know.
Warn Teens About Going Online for Information
The Internet doesn't help, Dr. Spigarelli says, because teens get information that, while it may be correct in general, is not aimed at their specific age group. In addition, the plethora of reference materials may make the teen feel as if he or she should already know everything and keep them from talking to their parents out of a fear of seeming uninformed.
Of course, it may also be just a lack of the right words. "Think about if from the point of view of a 14-year-old boy," Dr. Spigarelli says. "It's hard enough to approach the female parent, who is probably the one who handles that type of issue in the family. Not only is it embarrassing, but how do you tell them? We may be comfortable using the word testicle, but that certainly isn't a word they're comfortable with. And yet the word they're comfortable with is one they may not want to use around their mom."
Keep Communication Flowing
Dr. Spigarelli suggests that parents just do their best to keep the lines of communication open, even if the child chooses not to use them. Also, try not to completely shield kids from bad news – whether health or finance or job related – so they see that dealing with bad news as a family is normal and healthy. Finally, be sure your child has a good relationship with her pediatrician or family doctor, has time alone with the doctor during checkups and access to him or her privately outside of regular visits. It may be hard for a parent to let go of that control, but it's better than having a child possibly suffer in silence because she doesn't want to go to a parent and has no one else.
And, to the kids, Dr. Marks has these last words: "Believe me. Your parents love it when you talk to them. Nothing thrills them more than having you come to them, whether it's for something serious or trivial. This is what parents work your entire lives to accomplish, and they would never put you down, get mad or brush you off. Go to your parents. It'll be easier than you think."