puberty

Relating to Teens with Chronic Illness

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A hallmark of being a teenager is rebellion. Puberty turns a once nice kid, into a hormonal, rebellious nightmare. No one enjoys puberty – one morning you wake up and the body you have been living with your whole per-pubescent life is no longer yours; it’s hairy, it smells, it’s awkward, your skin is constantly breaking out and half of everything you once loved is now uncool (your doll collection, your old friends, your parents, wearing matching outfits with your siblings, etc). Now add to this mix of hormonal hell, a chronic illness. Teens by nature want to rebel; but how do you rebel from a body that has rebelled against you.

It’s hard to treat teens, especially teenagers that have been dealing with illness the majority of their lives. Along with waking up one morning and hating everything, when dealing with a chronic illness that body hatred is one thousand times magnified. I have worked with young people with chronic illness before, and the overwhelming response is

“I want to be normal. I’ve had x condition my whole life and I’m going to have it for the remainder of my life. It’s not fair and I don’t want it.”

Just like any other teen, teens with chronic illnesses don’t want to be told what to do. Personally, when I was a teenager and in the hospital, I would disregard the advice of any doctor who tried to parent me. Chronically ill teenagers want to be treated like adults. If you are a doctor working with an ill young adult, talk to the patient – don’t direct the conversation towards the parents. At the end of the day it is the patient taking the pills and maintaining their care. All younger patients want is respect. They know their bodies better than you think and they just want to establish control in a relatively control free time of their lives. Treat the teen patient with respect and you’ll have much better results.

Early Onset of Puberty

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A colleague recently informed me that her niece, Kayla, just got her first training bra – but Kayla is only six years old. A photograph of Kayla captured the smile of a chubby, young girl that towered over her peers. Though Kayla is at the same psychological level as her classmates, her body is maturing at a faster rate as she deals with the early onset of puberty.

Kayla is certainly not alone. More and more girls are beginning to show signs of puberty earlier than previously recorded. In 1997, Herman-Giddens performed a study that confirmed breast development began younger than what had been considered the norm. She found that girls began developing breasts at the age of 9, two years earlier than the previously accepted age of 11.

Developed Nations Have Earlier Ages for Puberty

Parents, doctors and researchers are now trying to determine why girls are showing signs of puberty at such a young age. In 1998, research published in The American Journal of Epidemiology by the World Health Organization showed that menarche varied globally, with women in developing countries starting their periods at a later age than women in industrialized nations.
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