rocky mountain kids teens & tweens 2011

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Presbyterian/St. Luke’s Medical Center North Suburban Medical Center

Rose Medical CenterSky Ridge Medical Center

The Medical Center of AuroraSwedish Medical Center

RockyMountain kids

SpecialTeen & Tween

iSSue

WinteR 2011

When It’s More Than a buMp on The head page 4

aCL Injuries: an uneven playing Field page 8

protect Your Teen’s Well-being page 6

2 Winter 2011

Dear Parents,

I’m pleased to introduce this special issue of

Rocky Mountain Kids, specifically focused on the

health of your preteen and teen children.

Sometimes we need a reminder that as children

grow into adolescence, they are not simply “small

adults,” but have health and wellness concerns

unique to their age and stage of development. Even

as they grow into their teen years, our children are

still developing mentally, physically and emotionally.

Pediatricians, family medicine physicians and

doctors in the newer specialty of internal medicine/

pediatrics are all skilled in caring for kids in this age

range. Many of the doctors affiliated with Rocky

Mountain Hospital for Children have a special

commitment to care for children as they grow

into adolescence because they have followed their

patients’ growth and development since they

were born.

Let's always remember that our young people need

our love, guidance and support to develop into their

full potential, whatever it might be.

2 Winter 2011 Rocky Mountain kids

A Note from Dr. Washington

As kids get older, they may not feel comfortable visiting

their childhood doctor. Though some pediatricians have

special areas or office hours for teens, not all do. Waiting

rooms decorated with cartoon characters and filled with

crying kids may be uncomfortable for older children.

A family doctor may be a better fit for some kids and

teens. These doctors treat patients of all ages.

Like pediatricians, family doctors must complete three

years of training after medical school. They learn about

all areas of medicine and focus on preventing diseases.

Regular preventative care can be especially important for

teens, since many adult diseases begin in the teen years.

The right care can help detect and prevent these problems.

Family doctors are well-qualified to provide care for

children and teens. They can:

• Provide routine care, including screenings and shots

• Offer advice to reduce risky behaviors, such as alcohol,

tobacco and drug use

• Recommend eating and exercise habits

• Check for mood problems such as depression

Family doctors are also trained in well-woman care.

They can help address girls’ issues, such as heavy or

irregular periods. With help from a family doctor, young

women can learn to take responsibility for their health.

Selecting a doctor who is a good fit for your family is

important. You — and your teen — should feel comfortable

with a doctor. Regular health checkups can build a lifelong

partnership between your child and a family doctor.

Has Your Child Outgrown the Pediatrician?

OuR PHysiCian list at your fingertips You can download a list of Physician Resources at Rocky Mountain Hospital for Children at

www.RockyMountainHospitalForchildren.com.

Click on “Download a Pediatric Specialty Referral

List” at the right.

Reginald Washington, Md, FaaP, FaCC, FahaCHIEf MEDICaL OffICERROCky MOuntaIn HOSPItaL fOR CHILDREn

RockyMountainHospitalForChildren.com 3

Children often begin these sports at very

young ages. Before your kids hit the slopes,

make sure they have the right gear,

technique and knowledge of safety rules.

PREPaRE yOuR kIDS

Children should be outfitted with proper

cold-weather gear and prepared for rapid

changes in conditions. All equipment

should be age-appropriate and fitted and

adjusted properly. Practicing off the slopes

can help kids transition to lessons. Helmets

are a must, and parents can lead by

example by wearing helmets themselves.

EIgHt SafEty RuLES

1. Learn the sport. Qualified instructors can

teach children the proper skills to participate

safely and avoid injury.

2. Practice falling. Teach children to land on

their bottom, not their hands. Instructors

can demonstrate how to fall safely. Teach

them to avoid getting up until they have

come to a complete stop.

3. Do not ski or snowboard alone.

Children need to have adult supervision.

4. Be in control. The key to successful

skiing and snowboarding is control. To

exercise control, one must learn proper

skills, be aware of other skiers and

snowboarders and be able to adjust to

changing snow conditions.

5. know children’s limits. When on a

slope that is too difficult, teach children to

remove their equipment and sidestep

down the slope.

6. Wear sun protection. Altitude and glare

from snow make sun damage more likely.

7. Pay attention to fatigue and nutrition.

Skiing and snowboarding are hard work and

require rest and adequate nourishment.

8. know the code. The National Ski

Areas Association endorses a

responsibility code for skiers and

snowboarders. Familiarizing young

athletes with the code can help prevent

accidents and injury.

These seven safety rules

are prominently

displayed at ski

resorts:

• Always stay in

control and be

able to stop or

avoid other

people or objects.

• People ahead of you have the right-of-way.

It is your responsibility to avoid them.

• You must not stop where you obstruct a

trail or are not visible from above.

• Whenever starting downhill or merging

into a trail, look uphill and yield to others.

• Always use devices to help prevent

runaway equipment.

• Observe all posted signs and warnings.

Keep off closed trails and out of closed areas.

• Prior to using any lift, you must have the

knowledge and ability to load, ride and

unload safely.

Colorado is home to some of the nation’s most popular ski resorts, and our community has a growing number of young athletes who have a passion for skiing and snowboarding.

snOWbOaRding and

skiing saFely

oops...ouch!

noW What? Accidents and sports injuries happen, and teens may be especially prone. When you

need emergency medical care, you can count on our pediatric emergency services. Learn

more at www.RockyMountainHospitalForchildren.com and www.youthsportsmed.com.

“The developing brain is very different

from the adult brain.” —Karen McAvoy, PsyD

WHEN IT’S MORE THAN A BUMP ON THE HEAD

10337M_RMHCteen_.indd 5-6 12/28/10 2:00 PM

the Center for Concussion opened

this summer at the Rocky Mountain

Hospital for Children youth Sports

Institute as one of just a handful of

pediatric concussion centers nationwide.

The Center for Concussion grew out of

a pilot project last year between the

Rocky Mountain Hospital for Children

HealthONE Emergency Departments

and four Colorado school districts.

a teaM aPPRoaCh

REAP — which stands for Reduce,

Educate, Accommodate and Pace — is a

community-based model for concussion

management in young athletes.

When a child with a concussion is

seen at any Rocky Mountain Hospital for

Children Emergency Department, REAP is

set in motion. After leaving the emergency

room, families, schools and community

medical professionals are quickly

contacted by the REAP program, and

education and community collaboration

commence immediately.

The REAP program works on the

premise that concussion is best managed

by a multidisciplinary team that includes

the child, the family, various members of

the school team and the medical team.

The unique perspective from each of

these teams is essential to managing the

concussion after injury.

Even if a child hasn’t been seen at a

Rocky Mountain Hospital for Children

Emergency Department, he or she can still

be seen at the Center for Concussion, and

REAP can be put into effect.

Karen McAvoy, PsyD, director of the

Center for Concussion and author of the

REAP guidelines, volunteered hundreds of

hours this past summer teaching REAP to

coaches, parents, school districts and club

sports organizations.

The Colorado High School Activities

Association has shared REAP guidelines

changing the culture of

How concussions are Treated

with all high schools in the state as one

suggested model for concussion

management. Dr. McAvoy has also been

contacted by other state leaders to develop

similar programs for their district schools.

ReaP PRogRaM ReaPs ReWaRds

During the 2009–2010 school year, the

REAP program received more than 150

referrals for student athletes who were

evaluated for concussion in a Rocky

Mountain Hospital for Children Emergency

Department. The REAP program expects

to surpass that number this school year, as

more school districts receive training on

concussion management.

As doctors are developing a clearer

picture of how children and teens are

affected by concussion, newer guidelines

recommend that children should be

treated much more conservatively than

adults when it comes to this condition.

The developing brain is very different from


“The developing brain is very different

from the adult brain.” —Karen McAvoy, PsyD

WHEN IT’S MORE THAN A BUMP ON THE HEAD

10337M_RMHCteen_.indd 5-6 12/28/10 2:00 PM


Concussions affect the function of

the brain, not the structure. That’s

why routine tests like CT scans and

MRIs fail to show the effect of a

concussion. The ImPACT test was

developed at the University of

Pittsburgh Medical Center to provide

Join uS FoR a FRee SeMinaR!

The center for concussion offers educational

seminars for parents, students and athletic

coaches. call 720-979-0840 to get upcoming

dates and times.

a way to assess brain function.

The ImPACT baseline test takes

a “snapshot” of the brain under

healthy conditions. After a student-

athlete has been diagnosed with a

concussion, the baseline test is

used as a basis for comparison.

Follow-up ImPACT tests, when

compared with the baseline test,

help doctors monitor how well the

brain is recovering. The Center for

Concussion will offer baseline testing

to the community in 2011. The test

will be available to student-athletes

older than age 11. To learn more,

visit www.youthsportsmed.com.

the adult brain; it is much more likely to

show symptoms later and have longer-

term problems when injured, especially

if the child doesn’t have a chance to rest

and recover properly. Care for each child

needs to be individualized.

The Center for Concussion, through

its groundbreaking, community-based

management approach to concussion

in children, will continue to develop

recommendations for concussion

management in children.

ImPACT Baseline Test: A Better Look at BRain FuncTion

Being a teen and being a parent have never been more complicated.

Along with the usual risks and temptations, today’s families face

an uncertain economy and job market. And now there are even

more opportunities for distraction and mischief via social

networking sites, texting, YouTube and Twitter.

“Even though the challenges are different for this generation

of parents, the solutions to guiding young people through these

difficult years remain very much the same — staying close, continuing

to listen and seeking help when a problem arises,” says Michael Peck,

PhD, a psychologist in private practice in Los Angeles.

Answers to the following questions can help you recognize a

problem and get help for your teen if needed.

hoW Many aMeRiCan ChildRen have Mental

health PRobleMs?

In any given year, 10 percent of U.S. children and adolescents

suffer serious mental disorders that cause significant problems in

how they function at home and in school. Even so, only 20

percent of children with mental disorders are diagnosed and

treated appropriately. Untreated mental disorders can lead to

school failure, family conflicts, drug abuse and suicide.

What Causes teens’ Mental health PRobleMs?

Similar to adults, mental health problems in teens are caused by

biology and environment. Biological factors include imbalances in

brain chemistry and inherited risks for certain conditions, such as

depression. Environmental factors include substance abuse and

being the victim of rape, physical abuse or violence.

“Parents also need to know that no matter how well they

The teen years can be a battleground for many families. Staying close to your teen can help you win the war.protect Your Teen’s

raise their kids, teens will still make mistakes because their

judgment doesn’t develop until the mid-20s,” Dr. Peck says.

“The changes of puberty increase the risk for all mental

problems during adolescence.”

What WaRning signs should i be aWaRe oF?

A teen with a mental disorder may have these symptoms:

Chronic sadness or hopelessness

Persistent nightmares

Declining interest in and performance in school

Alcohol or drug use

Loss of interest in things he or she once enjoyed

An unbalanced relationship with food

What Can i do to helP My teenageR?

There’s no substitute for spending time with your teen. Keeping

the lines of communication open is one of the most important

things a parent can do. When kids hit 12, 13 or 14 — just when

they need help the most — many start to withdraw from their

moms and dads. “Knowing this can help parents to continually

make contact with their teens,” Dr. Peck explains.

What should i do iF theRe is a PRobleM?

If you suspect a problem, talk with your child. “Don’t ignore

warning signs in the hope that the problem will go away,” Dr. Peck

advises. “Act on them early by getting your child to a mental health

professional — his or her future depends on it.”

beingWell-


BuSy? GeT THe HealTH inFoRMaTion you need fast with our customizable parents pages. Tailor pages based on your child’s age and topics that are relevant to you. Visit www.RockyMountainHospitalForchildren.com and click on the green banner at the top of the page.

Avoid TobAccoDon’t start smoking, which can cause cancer, heart disease and lung disease. Chewing tobacco can lead to oral can-cer, gum disease and an increased risk for heart attack.

build Your bonesGood health habits can help you build

and maintain break-resistant bones. Get 1,300 mg of calcium a day and

do weight-bearing activities like basketball or jogging.

Ask for HelpEating disorders like anorexia and bulimia usually start in the teen years. If not treated, stomach, heart and other health problems may result. Reach out to an adult right away if you or a friend might have an eating disorder.

eAT Well And exerciseDoing so can help you maintain a healthy weight and avoid type 2 diabetes, which if left uncontrolled can raise your risk for early heart disease.

proTecT Your skinDon’t tan. UV light from tanning beds poses the same risks as the sun’s rays — skin cancer, eye damage and premature aging of the skin.

Got milk?Girls, you’re already stronger than you know.

By the time you turn 18, you’ll have 90 percent

of your adult bone mass. That means the

stronger your bones are as a teen, the

stronger they’ll be when you get older.

But experts say more than 85 percent of

girls ages 12 to 19 don’t get enough calcium, a

mineral that helps build bone. If you don’t

build enough bone now, you’re more

likely to suffer from osteoporosis

(weak bones) later in life. Very

weak bones can break easily

from mild stresses, like

coughing or bending over.

To build bones that stay

strong all your life, follow

these tips now:

• Instead of soda, drink

low-fat milk. Crave a sweet

drink? Have chocolate milk or

calcium-fortified orange juice.

• At snack time, reach for dairy

products like yogurt, cheese

cubes or pudding made from

low-fat milk.

• Dairy isn’t the only source of

calcium. Figs, almonds and broccoli

also contain bone-building vitamins

and minerals.

• Exercise makes your bones

stronger, too. Any activity that

involves jumping, walking or running

— like basketball, jumping rope or

dancing — is good for your bones.

Parents: share this Page with your kids!


teens: It’s Never Too Early To Be Healthy!


Playing sports and exercising helps kids

become healthier and more fit. But

young athletes may be subject to injuries

that can cause long-term damage. One

injury — the ACL tear — is on the rise,

especially among girls.

ACL injuries are damage to the anterior

cruciate ligament (ACL) in the knee. The

ACL is one of four ligaments that keep the

knee from wobbling or giving out when

you move. It’s often injured during sports

that involve starting, stopping, pivoting

and turning with speed, such as:

• Basketball

• Soccer

• Volleyball

• Football

• Field hockey

• Skiing

• Lacrosse

BIggER gaMBLE fOR gIRLS

Girls are four to six times more likely to

injure their ACLs than boys, according to

John Polousky, MD, orthopedic surgeon

with the Rocky Mountain Youth Sports

Medicine Institute at Rocky Mountain

Hospital for Children at Presbyterian/

St. Luke’s Medical Center.

“It’s almost reaching epidemic

proportions,” says Dr. Polousky. “We don’t

know exactly why it’s happening, but there

are a variety of factors including anatomy,

muscle strength, coordination and

hormonal differences.”

A child’s ACL tear is more difficult to

treat than an adult’s, Dr. Polousky says. This

is because surgeons must avoid injuring the

growth plates on children’s bones above

and below the knee.

If surgery is performed, the child will be

on crutches for about a week and will need

physical therapy. Children can

typically resume some activities

within one to two months.

knEE knOW-HOW

ACL injury prevention programs focus on

changing the way athletes train. Children

can practice stopping and starting while

Why are aCL injuries so prevalent in girls? a lot of research has looked into that same question. after puberty, female athletes tend to remain more upright with their knees less bent than their male counterparts, putting the aCL in a vulnerable position. to prevent injury, encourage young athletes to try the following activities for 15 minutes, several times a week:• Stop and start, keeping the knee straight over the foot.

• Stand on a block and jump, landing with the knee straight over the foot.

• Improve muscle balance with hamstring-strengthening exercises.

You Run Like a Girl!

aclan uneven pLaYInG FIeLd

injuRies:

keeping their knees straight over their

feet and practice pivoting inwards while

bringing their feet with them.

our pediatric orthopedic team is a leader in caring for children with a wide range of orthopedic conditions. Visit www.youthsportsmed.com

to meet our team.


no parent wants to see a child suffer

with acne. This common skin condition

affects nearly eight in 10 teens, and some

adults, too. For many parents, having a

child with acne brings back painful

reminders of their teen years, when they

suffered embarrassment and ridicule from

their peers. While acne may be an unfortu-

nate rite of passage for many teenagers,

your child doesn’t have to suffer.

“We’ve made many advances in skin

treatments in the past few years, and

there’s plenty that can be done to get rid of

acne,” says Lisa Swanson, MD, a pediatric

dermatologist with Rocky Mountain

Hospital for Children. “It doesn’t need to

be part of growing up anymore.”

aCnE IS tREataBLE

Whether your child has blackheads,

whiteheads or painful cysts, if he or she is

bothered by acne, a dermatologist can

help. Medicine has become more sophisti-

cated, and today’s acne treatments have

fewer side effects than in the past. “I think

the real message for parents and kids is

that acne doesn’t go away overnight, but

we can make it go away,” Dr. Swanson

says. “No one needs to suffer with acne.”

WHat kIDS Can DO

Good skin care can help some kids escape

major breakouts. Your child should wash

his or her skin every morning and night

with gentle soap and water.

If your children play sports that require

wearing a helmet, Dr. Swanson recom-

mends carrying facial cleansing wipes to

practice and games so

that they can wipe their

faces as soon as they

take their helmets off.

Tackling Teen AcneThat will prevent the dirt and sweat from

getting trapped against their pores.

MyTH: Acne is caused by poor hygiene.

FacT: Vigorous scrubbing can actually irritate

the skin and make acne worse. The best approach

is to gently wash your face twice a day with mild

soap and pat skin dry.

MyTH: Acne is caused by junk food such as

chocolate, soda, pizza, fries and other high-fat

foods.

FacT: Extensive scientific research has found

no link between food and acne.

MyTH: Sun exposure reduces acne.

FacT: Overexposure to sun can cause dry skin

and rashes. This is especially true for teens.

MyTH: Acne just needs to run its course.

FacT: The truth is, acne can be cleared up.

If acne products haven’t worked, consider

having your child see a dermatologist.

Get the facts on acne and its causes, treatments and myths at www.skincarephysicians.com.

Clearing Up Acne Myths

Meet our doctorLisa Swanson, MD, pediatric dermatologist. She was born in New Orleans, La., and raised in Scottsdale, Ariz. She attended college at the University of Colorado at Boulder, graduating with honors as an English major. After that, she obtained her medical degree from Tulane University School of Medicine in New Orleans. She performed her internship at Mayo Clinic in Scottsdale, and went on to complete her dermatology residency at Mayo Clinic in Rochester, Minn. She recently completed a fellowship in pediatric dermatology at Phoenix Children’s Hospital in Arizona.

parents are Key to Safe Teenage drivers

WHy SO DangEROuS?

Motor vehicle crashes are the number one

cause of death among 16- to 20-year-olds.

A lot of research points to sheer

inexperience as the main reason for this

frightening statistic, with failure to use

The American Academy of Pediatrics (AAP) recently updated its policy regarding teenage drivers. Citing numerous studies that show teenage drivers to be some of the most dangerous drivers on the road, the AAP stresses the important role parents play in keeping their teenagers safe behind the wheel.

safety belts, distractions and other

factors also playing a role.

PROtECtIng tEEnagE DRIvERS

To help protect teenage drivers — and

everyone else on the road — the AAP

encourages parents to:

• Serve as positive role models behind the

wheel. Parents with poor driving records

are more likely to have teenagers who are

involved in crashes. Always demonstrate

safe driving habits and buckle up.

• Be strict and enforce rules and

punishments. Risky driving behaviors,

traffic tickets and crashes are less

common among teenagers whose

parents control access to the vehicle

and set strict limits.

• Write and sign a parent-teenager

driving contract. A contract is a great

way to ensure everyone understands

expectations and rules.


Before your kids become teens, take them to the doctor for

preteen vaccines. tHe CenteRs FOR disease COntROl and PReventiOn ReCOMMends tHat kids ages 11 OR 12 get tHese sHOts:• MCV4, to protect against meningitis

• HPV for girls, to prevent types of human papillomavirus that

commonly cause cervical cancer

• Tdap, a booster against tetanus, diphtheria and whooping cough

• Yearly influenza shots

Even when they reach their teens, kids need to visit the doctor

once a year. During these visits, the doctor will make sure teens

stay up-to-date on their vaccines.

Make a PaCt With youR teen dRiveR. Download a Parent/Teen Driving Contract from the Colorado Department of Transportation at www.coloradodot.info/programs/colorado-teen-drivers/new-documents/parent-teen-driving-contract.pdf.

Big Kids Need vaccines, Too

How to Keep your Teens activeEven video game experts need fresh air. Not

every child is an athlete, but every child can

have fun moving without recreating drills

from gym class.

Aerobic exercise is perfect for independent

teens who like variety. Some possibilities

include power walking, running, in-line

skating, cycling, swimming, tennis,

basketball, dancing, kickboxing,

hockey, soccer, racquetball,

handball, ice-skating and

trampoline.

Plus, exercise can help

improve your teen’s mood

and concentration, and give

him or her loads of energy.

Studies show that support

from family and friends has

been consistently and

positively related to teenagers

keeping up with regular

physical activity. So shut off

that television and get them

moving!


could your Teen Have Bulimia?People with bulimia generally go on eating binges, then purge

with laxatives or vomiting. They may also exercise obsessively.

Other potential warning signs include:

• Reddened, calloused or scarred fingers from inducing vomiting

• Swollen cheeks or neck glands

• Teeth that look clear or are decayed from stomach acid

Irregular menstrual periods in girls

Use of diuretics or water pills

Strict dieting and a preoccupation with calorie counting

Intense fear of gaining weight

• Frequent use of the bathroom after meals

8,000,000 or more people in the united states

have an eating disorder. 90 percent are female.eating disorders usually

start in the teens but may begin as early as age 8.

source: national association of anorexia nervosaand associated disorders

Sound advice to prevent Hearing lossNoise-induced hearing loss was once considered a job-related hazard. But as more children and teens use personal music players, they are experiencing the same hearing problems as adults. Two factors con-tribute to hearing loss: sound level and length of exposure. Either or both may lead to irreversible damage in the inner ear, resulting in diminished hearing.

Pay attention to the volume of your children’s personal music players, as well as the amount of time they spend listening to music. If the music is painful to your ears, it’s likely harmful to theirs. Use a noise limiter to prevent excessive volume. A level of 80 to 85 decibels is considered safe.

Consult a doctor if your child has symptoms of hearing loss, including ringing in the ear (tinnitus), need for excessive TV volume and poor school performance. To learn about our rehabilitation and audiology programs, visit www.RockyMountainHospitalforChildren.com.

In the Know :HealtH bRieFs for PaRents

In the Know:

Rocky Mountain kids is published by rocky Mountain Hospital for children’s family of hospitals from Healthone.

the information is intended to educate the public about subjects pertinent to their heath, not as a substitute for consultation with a personal physician.

Beverly petry Editor

Rocky Mountain kids welcomes feedback from our readers. to offer feedback, please go to www.RockyMountainHospitalForChildren.com and click on “contact us.”

©2011 Rocky Mountain kids. all rights reserved.permission to reprint or quote excerpts granted by written request only.

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As a parent, you never want your child to have a medical emergency. But if the unthinkable does happen, you can rest assured that expert care is just around the corner.

Rocky Mountain Hospital for Children delivers high-quality pediatric emergency services at seven locations throughout the region. Each emergency department is

Presbyterian/st. luke’s Medical Center19th Avenue and High StreetDenver, CO 80218ER: 720-754-4115 open 24/7

the Medical Center of auroraPotomac and Mississippi Aurora, CO 80012ER: 303-695-2780

north suburban Medical CenterGrant and Thornton ParkwayThornton, CO 80229ER: 303-450-4519

Rose Medical Center9th and ClermontDenver, CO 80220ER: 303-320-2455

sky Ridge Medical CenterI-25 and LincolnLone Tree, CO 80124ER: 720-225-1900 open 24/7

swedish Medical CenterHampden and Logan (three blocks east of Broadway)Englewood, CO 80113ER: 303-788-6911

emergency Care just for kids, Close to Homestaffed with board certified pediatric emergency physicians — doctors who specialize in treating medical emergencies in infants, children, teens and young adults.

We know that kids are unpredictable, and not all emergencies happen during regular hours. That’s why the emergency departments at two RMHC locations — Presbyterian/St. Luke’s Medical Center

at 19th Avenue and High Street in Denver and Sky Ridge Medical Center at I-25 and Lincoln in Lone Tree — are open 24 hours a day, seven days a week, every day of the year. That means you and your child have direct and immediate access to experts in every pediatric subspecialty should an emergency arise.

for all your kids’ health care needs … RMHC is now part of all HealthONE hospitals providing you with the long-standing commitment to quality and safe care for children. Wherever the RMHC name is attached to the local hospital’s pediatric service, children and parents can count on the same level of clinical and service excellence you’ve come to know and deserve!

RMHC emergency locationsswedish sW eR Wadsworth and BowlesLittleton, CO 80123303-932-6911

✁

24/7 emergency care at two RMHc locations — presbyterian/St. luke's and Sky Ridge

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