Category: Health & Wellness

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Ketamine Infusion Therapy Shows Benefits

Ketamine is a powerful drug that has been around for 50 years. Much of that time it was used by veterinarians and even by medics as a surgical anesthesia on the battlefield. Today’s battlefield is a landscape comprised of everyday people suffering from a variety of chronic disorders ranging from depression, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD), to fibromyalgia, migraines, and complex regional pain syndrome (CRPS). A major weapon in the battle is ketamine infusion therapy.

Board-certified Anesthesiologist and Infusion Specialist Douglas Kornreich, M.D., is a native of South Florida, and founder of KetaMed Health & Wellness in the Village of Rye Brook, NY. “I believe that ketamine infusions help people lead a more stable, less pain-filled life,” he said. “I’ve practiced for 20 years, and for 10 years, ketamine has been used to provide my patients with pain relief.” The doctor reports that the majority of cases using ketamine have proven effective, especially in treating CRPS, a condition that even Oxycontin failed to remedy. Ketamine
CRPS causes pain throughout the limbs, and is extremely debilitating. Many of the most powerful opioid medications have not provided relief, but ketamine has shown significant promise; some patients are pain free up to six months. “Ketamine treatments block pain receptors that lessen nerve sensitivity, and that enables the body to heal itself,” Dr. Kornreich said. “CRPS has no cure, but there are ways to manage pain and nerve sensitivity efficiently.” CRPS can be treated with a variety of protocols. One method is admitting a patient into the ICU and administer high does of ketamine continuously for several days. Most patients reported no pain for up to six months. “Another protocol is a series of daily four-hour infusions for 10 days, and that is the protocol that I use,” Dr. Kornreich said.

The Benefits of Ketamine
About 10 to 15 percent of the population experiences a depression disorder each year, but ketamine is not a first line of medical treatment for depression. Rather, it’s the last line of defense. About 50 percent of patients report a positive improvement after the first medication, but those that experience no improvement are placed on a second drug. If there is no quantifiable improvement after two medication cycles, ketamine infusion therapy can be used on those “treatment resistant” patients. Treatment resistant depression patients require six infusions over a two-week period. According to Dr. Kornreich, 60 to 70 percent benefit from the therapy.

The Federal Drug Administration has given its stamp of approval on ketamine as surgical anesthesia. Yet, despite the benefits of the treatment, it has not been granted approval as a treatment of depression-although the World Health Organization calls it an “essential drug.” The FDA has now placed ketamine on a “fast track” protocol for potential future approval.

Ketamine infusions have also been proven to be an effective treatment for people with suicidal thoughts. “It is so effective that it has greatly curtailed, and in some cases cured, thoughts of suicide in people after just one 40- to 60-minute treatment,” Dr. Kornreich said. “PTSD patients receive up to two weeks of relief from a single 40- to 60-minute session.” The cost of the drug is a minimal, but a host of other fees for nurses, administration, rent, malpractice, infusion pumps, vital signs monitoring, intravenous supplies, legal fees, professional dues, and miscellaneous expenses, can skyrocket the cost to $800 per infusion.

The Infusion Process
A physician and a nurse assistant continually monitor the infusion procedure. Patients are placed in a recliner in a dedicated treatment room and ketamine is infused via an IV tube that runs from the pump into the patient’s arm. During the process, the pump can be programmed to infuse precise amounts of the medication-and dosages can be altered immediately. Having used ketamine for more than 10 years, Dr. Kornreich is an expert in the pharmacological and physiological responses that cause changes in blood pressure and heart rate. EKG pads are positioned and a blood pressure cuff is applied prior to the infusion.

The Challenges
When administered by trained clinicians, ketamine has many potential benefits. In the wrong hands is potentially lethal. The opioid crisis is a result of illegally manufactured drugs being diverted onto our streets, and ketamine (often referred to as “Special K”) is popular. Using it as a recreational drug leads to addiction, cognitive impairment, bladder disease, and potential death. However, the clinical use of ketamine has a long and safe record. When administered properly, the intake of ketamine into the bloodstream can be properly monitored and controlled at significantly lower levels than if it were taken as a recreational street drug.

“Infusions maintain a lower level of the drug in the blood for a longer period of time and that is a great benefit when treating depression and other chronic issues,” Dr. Kornreich said. “Through the use of ketamine we have learned much about OCD, and PTSD and what is going on in the brain “This only leads to better medications that will work as well or better than Ketamine, and will not require an infusion.”
For more information about this topic, visit Ketamineadvocacynetwork.org or ketamedhealth.com.

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Ask Dr. Renae: Should I keep this secret?

Dear Dr. Renae,

My best friend tried cutting herself after she had a big fight with her mother. I promised to keep it a secret as long as she promised never to do it again. I now regret my promise. I keep wondering how I will know that she stopped since she and her mother do not get along. I don’t think she has cut again, but how can I be sure? I spend a lot of time worrying about her but I don’t want to betray my friend by breaking my promise. What should I do?

Stressed 13-Year-Old Friend

 

Dear Stressed 13-Year-Old Friend,

Being a good friend sometimes means doing something your friend might not necessarily like, but you know will keep them healthy and safe in the long run. You must tell an adult about your friend’s situation. Even if she has not cut herself again, the fact that she tried it once implies that she may need help channeling her emotions in a healthy way. It also sounds as though she needs to work on her relationship with her mother. My suggestion is for you to speak with your parents about this if it is something you feel comfortable sharing with them. If not, talk to a teacher, guidance counselor, or another adult you trust. You can ask whomever you speak with to keep this anonymous. They might be able to get your friend the help she needs without revealing that you told her secret. However, if it does come out your friend may be angry with you. If she is, remember this – while she may be angry now, she will thank you in the long run for having kept her safe and healthy.

A Caring Teen

Dear Stressed 13-Year-Old Friend,

I think that if she promises never to do it again, you should both be OK. However, if it happens again I would be concerned with her safety. She was probably just experimenting coping mechanisms to make her feel better, although it does not justify her actions. You are a very good friend for knowing when to keep promises and knowing when to try to get help for your friend. As a good friend, it’s important to have a heart to heart talk with her and see if you both can come up with something else for her to do when she gets angry with her mom. She can FaceTime you so she can vent her anger, journal, color, take a walk, listen to music, or something else your friend may find soothing. Sending love to you.

Your 14-Year-Old Friend

Dear Stressed 13-Year-Old Friend,

I totally understand where you’re coming from. You don’t want to betray her trust and ruin your friendship with her, but cutting yourself is much bigger than any promise or friendship. It is incredibly dangerous. You should talk to your friend and try to get her to agree to get help. You’re in a difficult situation, but keeping quiet may only make the problem worse. Try to reason with her and comfort her. You can also try talking to your parents about it and see if they have any good ideas on what you can do. Your guidance counselor at school can also help. I hope it all turns out OK.

A 16-Year-Old Friend

Dear Stressed 13-Year-Old Friend,

Go to your friend and ask her seriously if she’s been cutting again. You need to let her know that if she is, you are there for her. She is going through a rough time in her life. Help her find alternatives to cutting such as using a stress ball, writing her feelings down on paper, or drawing to calm down. Ask her what is bothering her because she is probably hurting a lot inside and doesn’t have any other way to express it. It’s important to keep promises, but in a situation like this, you could help your friend’s problem by asking your school’s guidance counselor how to handle this. If your friend has a serious cutting problem and you feel like that would be the best option, let your friend know that you care about her too much and you want to get help for her.

A Caring Friend

Dear Stressed 13-Year-Old Friend,

At the time when you made the promise to your friend, it felt like the right thing to do. After experiencing the weight of that worry, you now realize that keeping this secret is not safe or healthy for you and your friend. It will take a lot of courage for you to explain in the sincerest and caring way that you will help her decide the safest way for her to get help. Even if your friend only cut herself once, it is critical for her to be assessed by a professional for risk of suicide, depression, or effects of previous trauma that you might not know about. Medical care for her cuts may also be needed. Without the proper treatment for the problems she is experiencing, your friend may be robbed of a lifetime of success and happiness. Your School Counselor, School Social Worker or School Family Therapist will be able to help her improve her relationship with her mother and find other trusting supportive adults. Being a good friend means looking out for your friend’s best interest, especially when she is not able to look out for herself. If you keep this secret, you will be letting her down and letting your self down as well.

Dr. Renae

 

 

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Safety Always Comes First

Safety first. It is vital, it is important, and it is necessary.

A recent issue of the Parklander featured a cover photo of a woman operating a power tool without any protective eyewear, leather gloves, or long-sleeved shirt. The intent was for artistic purposes only, and meant to catch the eye of its readers. Based on the number of responses received, the magazine certainly accomplished that goal.

The use of the image opened the door for additional dialogue and input from readers who correctly pointed out that the cover photo was not compatible with the content contained in the article. We appreciate the valid input, and welcome constructive comments and suggestions from our community of readers.

One member of the community was Jerry Lozinski, a semi-retired engineer who worked in factories that adhered to strict OSHA guidelines. “I worked in product development, and it was our job to make sure they met the highest standards,” he said. “Sometimes people feel the product is the problem, but if you put a heater in a bedroom next to drapes and it starts a fire, you can’t blame the product. The same holds true for tools used when working around the house. Be sure you have the right tools and be sure you know how to use them.” He said that the cover photo was an example of how not to protect yourself when using a power tool.

“When you do a job, be protected,” Lozinski said. “Wear leather gloves, safety glasses, proper clothing and shoes (and in some cases head covering and a mask). Use common sense and make sure you are knowledgeable enough to perform the project.”

Sheets of plywood, ladders, drills, and saws were the order of the day as preparations were made for Hurricane Irma. The basic tools: a circular saw, a hammer drill (and charger), a regular wood drill, Tapcon screws, proper drill bits for the masonry, hex-head screws, and ladders. Note that it is important when drilling into cement, as masonry bits can overheat and sometimes break— depending on the density of quartz contained in the gravel composition of the cement.

Lozinski used a small electric chain saw to cut the root and limbs of a tree that had fallen in his yard. “I wore a complete shirt and long pants, heavy leather gloves, and steel-towed boots,” he said. “It’s important to cut at a proper angle so limbs fall in the right direction. If you don’t have the equipment you need, call someone who does. Don’t be afraid to ask for help.”

Joe Albers, a principal engineer at South Florida Water Management District, said men could be victims of their own machismo. “A lot of guys think they are supposed to know all this stuff about repairs, but it is better to be safe than sorry,” he said. “Don’t be too humble to ask questions about the right tool and the proper safety gear.” Albers, who does the bulk of his home’s repairs, said wearing personal protective equipment is vital. “Without the proper safety precautions you can easily end up in the emergency room,” he said.

The cover photo showed particles of wood flying dangerously close to the woman’s face. Albers said that circular saws could have a dust catcher or a vacuum connection to reduce the amount of exposure. “A dust respirator is good too, because once the dust gets into your nostrils it becomes a respiratory irritant,” he said. The woman pictured wore a chocker necklace and a tank top. The necklace didn’t necessarily pose a safety issue, but rings and bracelets do. “I came from a farming background and we didn’t wear rings,” Albers said. “Most famers and ranchers don’t wear wedding rings because they can be caught on something.” According to Albers, the photo didn’t convey the appropriate message.

Key questions to ask before any home project should be: What does the job entail? Do I have the skills to do it? Do I have the proper equipment required? What are the hazards? Albers admits he does not get involved with anything electrical, but he does simple plumbing. “When it comes to copper piping and soldering, I’ll hire someone,” he said. “I know my limitations.”

He advises wearing leather gloves for a better grip and hand protection, and to use a ladder planted on solid ground to prevent tipping. Also, use both hands when using a chainsaw. “It is one of the most dangerous tools you can own, so be sure there is a stable surface, and keep both hands on it to protect against kickback,” Albers said. He also said that hearing is also a part of safety, so wearing earplugs to listen to music when working isn’t advisable.

In summary, wear protective clothing, proper footwear, and glasses, use the right tools and drill bits, know the risks, know your strengths and weaknesses, and don’t be afraid to ask for help.

 

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Dr. Renae: The truth about Homework

Dear Dr. Renae,

My parents continue to suspect me of not being truthful when I tell them that I do not have homework. Most of my teachers allow us to complete assignments during class time, which I usually do. I always do my best work and I get good grades. How did the amount of homework assigned ever become the measure of a good teacher?

6th grade student

Hello 6th grade student,

Parents can be frustrating to deal with. However, I’d recommend possibly showing them the completed homework and maybe going over one of the problems with them to show you understand the work. The amount of homework doesn’t equal the measure of a good teacher, but sometimes parents are worried and don’t understand where you’re coming from. In most cases, your parents want to help you and want what is best.

A concerned individual

Dear 6th grade student,

You are absolutely right in saying that the amount of homework should not determine the quality of a teacher. However, parents expect to see their children to have homework assignments. When your parents see you without work to do, they might think that it’s because you’re procrastinating. My suggestion would be to enact a “to-do list” system. Every day, when you come home from school, show your parents a list of everything you need to get done. Put anything on it, from a history project to cleaning your bedroom floor. That way, when you don’t have any school work to do, your parents will see that it’s genuinely the case because had you been given an assignment, it would be on your list.

A caring friend

Dear 6th grade student,

I feel that you should be honest with your parents and tell them everything you said in the letter. I would also ask your parents why they feel the way they do and if they are that concerned, to talk to your teacher. Since you do your homework, the teacher knows you are a responsible student and will make sure your parents understand that. Have you ever done anything that would lose your parents trust? If so, ask them how to regain it, and if not, it is silly for them not to believe you. Just keep working hard and your grades will help you go far.

Your friend, the 9th grader

Dear 6th grade student,

I know exactly where you are coming from. If you are getting good grades that’s great and you have nothing to worry about. Make sure you show your parents your grades, so they are aware that you have completed your assignments. If you have a school planner, I suggest writing down all the homework that you have to do in the planner. Once you finish your assignments whether it’s in school or at home, cross them out. Then, show your parents the planner daily and when they see all your assignments crossed out they will understand that they are done. If they still seem to have a problem after trying that, it would be time set up a conference with your parents and your teachers to work out the issue.

An understanding friend

Dear 6th grade student,

To begin, I understand that feeling. A lot of teachers do allow their students to complete assignments during class. Do your parents know you have good grades? Try sitting down with them and telling them you would not lie to them about assignments and tell them your grades are important to you. Tell them your grades are good and won’t allow them to slip. I would make them understand that you have time to complete it in class as you do, and maybe show them the assignments you completed.

A friend who understands

Dear 6th grade student,

Your parents may have had a more traditional education, which entailed many homework assignments daily as well as weekends and holidays. Teaching has evolved into more creative methods that help promote learning instead of repetition. Your parents may be considering their educational experience as a measure of a good teacher. Completed assignments and good grades might not be enough to convince your parents that you are learning. I suggest that you share with your parents what you have learned in school each day with a sentence or two for each subject. In addition, I advise you to assign yourself nightly homework which consists of reviewing your notes, organizing your notebooks, reading your textbook, studying for upcoming tests, working on assigned long-term projects, and researching information that spark your interest. Your parents might shift their focus from school homework to your learning and maturing. That will help build their trust in you.

Dr. Renae

 

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Seek Help Sooner

Suicide among young people continues to be a serious issue. According to the American Academy of Child and Adolescent Psychiatry, thousands of teenagers commit suicide each year. Suicide is the third leading cause of death for 15 to 25-year olds, and the sixth leading cause of death for 5 to 14-year olds.

“Teenagers, experience strong feelings of stress, confusion, self-doubt, pressure to succeed, financial uncertainty, and other feelings while growing up. For some teenagers, divorce, the formation of a new family with stepparents and stepsiblings, or moving to a new community can be very unsettling and can intensify self-doubt. For many teens, suicide may seem like a remedy or a solution to their problems and stress,” the AACAP states on its website, aacap.org.

Jackie Rosen is the executive director for the Florida Initiative for Suicide Prevention program. She said there are three main causes of depression:

  1. DNA. The tendency of brain disorders can be transferred by DNA.
  2. Chemistry or psychological changes in the brain. These changes can now be detected by a MRI.
  3. Trauma. The earlier trauma occurs in life, the more it affects the diseases of the brain functioning. It’s this combination that can lead to suicide.

Jackie feels the brain is like a cup of water. “If you add one extra drop to a full glass of water, the water spills over. The same goes for people who are suicidal. They feel helpless and hopeless, the only option is to die, to stop the pain, kill themselves. Trauma changes the way the brain functions. It changes the chemical functioning of the brain, and hence, the person cannot handle the trauma,” she said.

 

For most kids, the average brain disorder starts at about 14 years old. This is the same time many teenagers start to “lose themselves, or act out.” People pass their behavior off as just a part of growing up. For the young people who suffer from depression, they can get worse and commit suicide. In order to overcome depression, and ultimately to prevent much of the suicide cases, proper medical attention is needed and may include medication and therapy.

Jackie started the Hope Sunshine Club, which takes place in 28 middle and high schools in North Broward and South Palm Beach. This club is an after school optional curriculum, that meets once a week and is part of a school approved curriculum.

Within these clubs, they have developed Solutions Unlimited Now or SUN. The purpose of the group is to help each other solve problems. FISP SUN is a ten step, structured group program, which teaches problem solving, coping, and social skills to enhance protective factors and resiliency. It is designed to help members reduce self-destructive behaviors and enhance feelings of self-worth.

FISP SUN groups meet once a week for one and a half hours for ten weeks. Each participant receives a brochure with the explanation of the program, snacks at each meeting, and a completion certificate after the ten weeks. The groups are completely confidential with the only exception being if someone is at risk for self-destructive behavior or dangerously destructive behavior towards others.

Edwin Shneidma is a clinical psychologist and a leading authority on suicide. “One of the most harmful myths about suicide is the notion that people who really want to kill themselves don’t talk about it. Most people who commit suicide have told other people about their plans. Many have made previous suicidal gestures,” he said. Schneidman estimates that in at least 80 percent of completed suicides, the people provide verbal or behavioral clues that indicate clearly their lethal intentions.

That is why it is important to pay close attention to your children and their behavior. The sooner you detect somethingis wrong, the sooner you can get professional help. For more information and help, visit fisp.org.

 

Signs of Suicide

fisponline.org

Verbal

  • “I wish I was dead.” • “You don’t have to worry about me anymore.” • “How do you leave your body to science?” • “Why is there such unhappiness in life?” • “Everyone would be better without me here”

Feelings

  • Feeling like a burden to others. • Depression. • Sadness. • Loneliness. • Extreme boredom.

Behaviors

  • Previous suicide attempt. • Giving away prized possessions. • Arranging to donate organs. • Making a will. • Alcohol or other drug use. • Careless, risk-taking behavior. • Withdrawal from family and friends. • Running away from home or responsibilities. • Change in school or work performance. • Extreme irritability, guilt, crying, inability to concentrate. • Violent and rebellious behavior. • Collecting pills, razor blades, knives, ropes or firearms. • Sudden happiness after a long period of depression

Situations

  • Recent suicide or death of a loved one or someone close to person. • Being a victim of physical or sexual abuse or rape. • Troubled family life. • Social isolation, lack of close friends. • Recent loss of job, friendships. • Failing or dropping out of school, losing job or divorce. • Not making a team, getting a promotion or membership in an organization. • Unwanted pregnancy or abortion, illness, or accident and losing ability to take care of self. • Being a “perfectionist.” Not living up to their standards or someone else’s expectations.
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A Convenient Epidemic: Childhood Obesity

What is a convenient epidemic? It is when you can find your vice on every street corner, see it on every TV channel, hear about in on every radio station, and it is displayed on every social media avenue. It is an epidemic that makes you see it and crave it everywhere you go, and is easily accessible and so hard to refuse…because you need it to live. So, what is the convenient epidemic that we speak of?

Childhood obesity. That’s right, childhood obesity.

This is a national epidemic that is plaguing the youth. Not only that, these obese children are turning into obese adults. Two percent of children are eating healthy according to the Department of Agriculture. That means 98 percent are eating unhealthy. Either way you say it, those numbers are outrageous and preventable.

Childhood obesity is a trigger to many community issues. Bullying, anxiety, depression, ADHD, early on-set puberty, diabetes, cardiovascular disease, student drop-out rates, crime rates, skin disease, healthcare costs, cancer, decreased life expectancy, and more.

How does childhood obesity and the unhealthy eating cycle actually start? Let’s think about that.

Remember when you were a child and visited the doctors’ office for your shots? What did the doctor give you? A lollipop? When you do well in school, did you get a pizza party in class? When you have a birthday, do you celebrate your day with cake? Do you bribe your children with cookies and ice cream or offer it for good behavior? Well, if you can relate to any of those things, you are “feeding” the problem. No pun intended.

Food associations are real, and can become extremely serious. From childhood, people associate good feeling with bad foods. Food as reward can be very dangerous. If bad foods are fueling good behaviors, you start searching for those feelings with every aspect of life. Since food is required to live, food becomes a pivotal part of your happiness and turns into a deadly habit.

A deadly habit may sound harsh, but some foods are proven to feed disease. The good news is, not all foods will kill you. You can eat to fight disease as well. Most foods that are sold in boxes and bags tend to be a sneaky source of unhealthy fats, sugar, sodium, and excess calories. Drinking milks and eating meats with hormones and antibiotics should be avoided. With that being said, fruits, veggies, beans, and lean meats should fill your plates. When it comes to the breads and rice, the darker the better. Brown rice, whole grain, or Ezekiel bread and quinoa are the healthier options. Planning to be healthy takes practice. Learning how to prepare your meals in advance will help you eat healthier. Making larger portions of healthier foods and store them, this will ensure healthy meals when you are on the go.

Furthermore, since nutrition is paramount to the health of our children, shouldn’t it be taught and encouraged in school? Children should learn how to read nutritional labels and understand what different foods do to your body.

According the CDC, nearly half of U.S. deaths are directly related to nutrition. It is our responsibility to make a conscious change in our communities and in our families. We must break the cycle. Grow fresh fruits and vegetables,  and make healthier choices. Join the fight against childhood obesity by educating yourself and your children on good nutrition.

Debra Tendrich is the founder of Eat Better Live Better, a non-profit organization that battles childhood obesity. Visit www.EBLB.org.

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Ask Dr. Renae: My guy friends girlfriend is jealous

Dear Dr. Renae,

I have always had boys as my good friends. I cannot handle the drama and am not into girly things like make up and fashion like most girls my age. I have had several experiences where my guy friends girlfriend becomes jealous of our close relationship. I understand because my relationships with my guy friends have a strong history and we share personal experiences. I have tried becoming friends with the new girlfriend and have tried backing off completely. Neither solution works and I usually wind up getting accused of scheming to steal their boyfriend. How can I handle this better? Can’t guys and girls be just good friends?

15-year-old Good Friend

Dear 15-year-old Good Friend,

I can totally relate. I have always found that guys are easier to be friends with and I’ve been called out by people for this. The best advice I can offer is that you ask your guy friends to take the lead on this one. If the initiation of friendship or backing off comes from you, your friends’ girlfriend will see that as a threat from the onset. But if your guy friends are the ones to tell their girlfriends about you and reassure them, the girls might be more receptive.

It’s a tricky situation, but I think that with open communication on all sides, it can be solved. I wish you luck.

A Caring Teen

Dear 15-year-old Good Friend,

I understand why you feel frustrated and in the middle of things. I believe that a guy who will stay with a jealous girlfriend should make it clear to her and not put all the pressure on you to explain. He chose to date her. If she can’t accept you, I think you should back off completely and stop trying. At the end of the day, you shouldn’t have to give up any friends because of a jealous girlfriend. I would talk to your close guy friend and ask him if he’s willing to have a talk with his girlfriend to clear things up. Good luck.

Your Friend

Dear 15-year-old Good Friend,

Next time there is a girl involved with your guy friend, have him speak to her personally and explain your friendship. He can help ease the transition before you meet or talk to the new girlfriend yourself. When you do meet her, try to make an effort with her so she understands that your relationship with your guy friend is platonic and you are strictly friends. Keep in mind that it isn’t your fault if she is insecure about her relationship. You are doing your best to not interfere. Your guy friend should back you up and help his girlfriend to feel comfortable with your friendship.

A Caring Friend

Dear 15-year-old Good Friend,

It is difficult to manage spending time with a boyfriend or girlfriend, good friends, and family while trying to juggle schoolwork, sports, clubs, and even a job. Most adults struggle with managing their time between job, family, friends, exercise, household management, and hobbies. The strength of your sincere friendship with history and trust is something that surpasses a new romantic relationship. It will take a long time for your guy friend’s new girlfriend to get to know him and you will always know more about his past. Your guy friend can assure his new girlfriend that although you are close, he does not share details about her or their relationship with you. Any girlfriend will be lucky to be with a guy who has you as a friend who cares about his relationships go smoothly.

Dr. Renae

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Ask Dr. Renae: Where’s my talent?

Dear Dr. Renae,

I do not have a special talent or skill. Everyone around me excels at something – sports, music, art, dance, acting, writing, academics, etc. I keep trying out different things that might interest me, but my parents become frustrated when I no longer want to continue. They feel like they are wasting time and money on lessons or equipment. Are some people just mediocre at everything?

All around average 14-year-old

Dear Not so average 14-year-old,

You shouldn’t beat yourself up about this. You’re only 14. You still have so much more life ahead of you and I can pretty much guarantee you’re going to find something that you’re amazing at. Most of the activities your peers may be excelling in are just hobbies. Odds are their careers will have nothing to do with what they’re doing right now. Stop putting so much pressure on yourself to find something. Let it come to you!

A 15-year-old friend

Dear All around exceptional 14-year-old,

Just because you haven’t discovered a particular interest yet, doesn’t mean you’re destined for mediocrity. Everyone is special and unique for some reason or another. You might be a great listener, or good with animals. Just because you haven’t found an aptness that manifests itself as a talent doesn’t mean you don’t have exceptional qualities. For now, I would recommend to stop trying things, since neither you or your parents seem happy. When something peaks your interest, then is the time to get involved. Remember – it’s not your hobbies or talents that define you, it’s your innermost personality traits, which cannot be quantified or qualified.

A caring teen

Dear All around average 14-year-old,

You are not mediocre at everything, you just haven’t worked at anything hard enough to really see if it is right for you. Everyone has an activity that is right for them and don’t worry if you haven’t found yours yet because you are not the only one. Don’t give up and keep trying to find the one that suits your interests. You also do not need to spend money to try activities. When school starts again, join a club or a school sport to try it out. When you find something you like, try to stick with it and continue to work at it. Hard work and dedication matter more than natural talent and you can only get better at something when you do it often.

A caring friend

Dear All around average 14-year-old,

I know exactly what you’re going through. I didn’t find a sport I liked until I was 16. Just like you, my parents felt they were wasting their time and money for me to find something I enjoyed. However, this doesn’t mean that you’re mediocre, it just means you haven’t found the right activity that you particularly excel at yet. This is completely okay. People develop their love for something at different times in life. If you end up like me, you’ll find your talent or skill when you least expect it.

A former try-it-all

Dear All around average 14-year-old,

I would definitely not say mediocre. Everybody is different with different talents and skills. I would suggest applying for a job to help pay for your pursuits. Maybe it’s not a talent or a sport, but something creative and productive you can do. Not everything is for everyone. If your parents are frustrated with you, tell them it was a learning experience for you – not a waste. It would be more of a waste to keep going on with something you don’t enjoy. You’re still young, and your life will work itself out.

A friend who’s been there

 

Dear All around average 14-year-old,

Everyone finds their passion sooner or later in life. Don’t let others who have passions frustrate you. I think it’s great that you are willing to try different things and branch out. Maybe you can volunteer for some of the activities you want to get involved in to see if you like it before making a financial commitment. Most important, don’t compare yourself to others, be happy with yourself and the accomplishments you have made.

Another 14-year-old who is passionate about lots of things

Dear All around average 14-year-old,

Excelling at a sport or hobby does not guarantee that you will enjoy it. Always competing with others or yourself can be stressful and detract from the unique pleasure of something that fulfills you. The competition mindset that drives you to strive for greater skill can also lead to unhealthy habits and injuries from overtraining. When you truly enjoy an activity, you will want to do it more often and that generally leads to improvement. I recommend that you change your goal of searching for a skill you excel at, to searching for activities and hobbies which you enjoy, regardless of your level of talent.

Dr. Renae

 

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Ask Dr. Renae: August 2017

Dear Dr. Renae,

My parents think I am too young to know that I am bisexual, believing that I have been influenced by my friends. I became aware of who I am when I was 12 and am quite comfortable with myself. Efforts to educate my parents about this have only frustrated me more. They do not take it seriously and feel like it is a phase I will outgrow. I know they love me but it is hard to relate to them when they do not accept who I am. How can I help them understand?

15, Bi and Proud

Hey Bi and Proud,

Oh boy, can I relate. I’m also 15 and I’m very sure I’m asexual, which means I don’t feel sexual attraction, and possibly aromantic, in which I don’t feel romantic attraction. When I bring these topics up to my parents, they usually get uncomfortable and try to tell me that I’ll want to have sex later in my life, that I’m too young to know, etc. I want you to know that while your parents may not believe you to truly be bi, it’s your own opinion that matters. Perhaps you should bring these concerns up to your parents and explain how they make you feel. Tell them the difficulty you’re having and how their misunderstanding is hurting you. At the end of the day, remember that you need to feel happy with who you are.

Asexual and proud

Dear 15, Bi and Proud,

I know how hard it is when the people who are supposed to be your number one go-to don’t understand who you are. You have to remember they grew up in different times than us. Our generation is more open and liberal about things such as the LGBT+ community, which they might not get. I would say  you should probably sit your parents down and have a serious discussion with them, explain how you feel and identify yourself. You have to emphasize that this is who you are, and not something you’ll outgrow. If anything, they’ll come around eventually.

17, once in your shoes

Dear 15, Bi and Proud,

As a teenager you go through a lot of changes and start to figure yourself out so it’s normal that your parents might need some time to adjust. This is probably big news for them. If you know bisexual friends whose parents are accepting, they can educate your parents a little more about becoming more accepting. Stand up for yourself. Make them aware that nothing can change the way you feel and keep on educating them about bisexuality. Eventually they will be able to understand your sexuality, but in the meantime stay true to yourself and don’t let anyone change who you are. What’s most important is that you have accepted yourself and you are happy with who you are.

A caring friend

Dear 15, Bi and Proud,

To begin, you know yourself and who you are. Since your parents don’t take you seriously, have you tried reaching out to another family member? Possibly an aunt, a cousin, trusted adult, or a grandparent? Explain to your parents that you understand people are easily influenced in this generation by the LGBT community. Also, help them understand that you are happy and it would mean the world to you if they would accept you. Tell them you want to include them in other areas of your life as you continue to grow in your journey. In the end, be open, proud, and true to who you are.

A trusted friend

Dear 15, Bi and Proud,

It is possible that your parents are hoping that your being bisexual is a phase, as they are uncomfortable with seeing you differently than they expected. There are several organizations which provide support to the LGBTQ community and their families. Both Sunserve (www.sunserve.org) and the YES Institute (wwww.yesinstitute.org) offer excellent parent resources. You might also find support at your school’s GSA (Gay Straight Alliance) club. Your pediatrician could be a voice your parents respect. Researchers have found a higher incidence of depression and suicide within the LGBTQ community, especially with teens who are rejected by their family. It will be very important for you to establish a lot of support in your life if your parents do not eventually offer you their unconditional acceptance. The Broward County School Board’s Family Counseling Program (754-321-1590) offers free, confidential services with licensed therapists with locations at almost every high school in the district. In the future, when you develop a serious attraction or establish a romantic relationship with someone of the same sex, it will be time to talk with your parents further. In the meantime, I recommend that you focus on other aspects of yourself when communicating with your parents. Do your best to keep lines of communication open. You have a lifetime ahead of you.

Dr. Renae

 

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Pediatric Occupational Therapy: Transitioning Children from Being Isolated to Being Included

“Nobody is superior, nobody is inferior, but nobody is equal either. People are simply unique. You are you, I am I.” Osho

Pediatric Occupational Therapists are life builders for children whose lives have been afflicted by disability, especially those with autism and cerebral palsy. OTs help these individuals to be free of their isolation, and help them to share their abilities with others. OTs do not attempt to make clients like everyone else. We embrace their strengths, and work on the areas that are weakened which affect their everyday functioning. If a child has difficulty controlling his or her self stimulating behaviors, we teach him or her how to satisfy that crave in supplementary ways so that it does not affect his or her functioning and those around them. We want him or her to share his or her uniqueness.

If a child with cerebral palsy demonstrates impairments with his or her motor control and coordination skills, which affect his or her activities of daily living including dressing, bathing, and social interaction skills, occupational therapist help remediate deficits and train clients and caregivers on compensatory techniques as needed to lead fulfilling lives.

Various children with autism may miss sensory information from the environment that provides signals about what is going on in their surroundings and may be referred to as having poor registration. The brain may not be getting what it needs to produce appropriate responses. Other children may be referred to as having “seeking behavior.” These individuals are characteristically active and continuously engaged in their environments. They add sensory input to every experience in daily life. They may seem impulsive and the consideration for safety when playing may be absent. Some children with autism may display hypersensitivity to sounds, sights, smells, tastes, and textures. These children may have sensitivity behavior. They have overreactive neural systems that make them aware of every stimulus that becomes available, and do not have the appropriate ability to adjust to these stimuli. Children may also present as having avoiding behavior, which represent those who may engage in disruptive behaviors, especially in situations where they know they are having difficulty. They avoid circumstances by either withdrawing or participating in emotional outbursts that enable them to get out of the situation. The child may appear stubborn and controlling and prefer routines without any sudden changes.

The child is creating a state to limit sensory input to those events that are known and therefore easy for the nervous system to interpret. There is not a cookie-cutter treatment plan for these exceptional children. OTs give the children and caregivers individualized recipes (treatment plans) called a sensory diet with ingredients (tools) to help the child regulate his or her sensory system for success at home, school, and in the community. Children with cerebral palsy characteristically demonstrate deficits with reflex, body movement, muscle tone, balance, posture, muscle coordination, and receiving and responding to information through the senses. These complications can considerably impair a child’s ability to successfully take part in daily living activities including, dressing, feeding, sitting, standing, socializing, and more. These limitations can lead to isolation.

Occupational therapists encompass the skills necessary to improve their posture, reduce muscle tone, and improve their range of motion. They will improve a child’s self-care skills, visual motor skills, handwriting skills, and the ability to navigate his environment. These skills are imperative to improve a child’s functional independence to replace isolation into inclusion. But treatment does not end in the therapy clinic. A comprehensive home exercise and activities program and family education are vital to this process. OTs are knowledgeable in many areas in pediatric care. The focus is on improving a child’s functional independence. Through individualized treatment strategies and taking a family centered approach, limitations can be altered into great expectations.

 

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Ask Dr. Renae: The moving blues

Dear Dr. Renae,

I developed a strong bond with my martial arts coaches after my dad died when I was very young. My mom and other relatives have given me an amazing life and I consider my coaches family. Now that my mom is getting ready to marry a great guy, they are talking about moving out-of-state in the future for a lower cost of living. For many years, I have looked forward to working with my coaches when I enter high school and can’t imagine them in my life not being in my life. They have been my rock, my security, and helped me through tough times. My mom says that I will adjust, but all I feel is a deep sense of loss at even the thought of moving. How can I look forward to high school when my future seems uncertain?

Crying my eyes out

Dear Crying My Eyes Out,

Moving is very difficult when you have to leave behind so many important people. However, when you move to this new place, you’ll meet new people and it could turn out to be a great experience. It’ll be hard leaving your coaches and everyone behind, but with today’s technology, it could be as if you never left. You could FaceTime, call, and text to keep in touch and keep up the strong family-like bond you have.

A friend

Dear Crying My Eyes Out,

I’m so sorry that you are not as excited as your mom and her boyfriend to move. I think that even though you feel a great loss, you can still keep in touch with the coaches thanks to technology. You’re very lucky to have had such great coaches Just because you’re moving, doesn’t mean you’re not able to still maintain a relationship with them. Even though you have hesitation about going to high school, things will be OK because you have a very good attitude and seem optimistic.

Fourteen-year-old who also does martial arts

Dear Crying My Eyes Out,

Thank you for sharing your story – it really touched my heart. If you have such a strong connection to your martial arts coaches, I’m sure that won’t change when you move. I am confident that you will be able to keep in touch with them and share your progress as time goes on. It seems you can’t do much to change the moving situation, but at the same time, you like the guy your mom is going to marry. That’s a huge plus. Maybe you can make an agreement with your mom that she’ll let you come back and visit during the summer. Your coaches might be even be able to give you an assistant job or internship. Stay focused on the positive, and I’m sure you’ll feel better.

A Caring Friend

Dear Crying My Eyes Out,

Change is always difficult, especially if you are surrounded by people who have given you support and comfort during the difficult times. However, change can be easier if you express your concern to those close to you. Talk to you mother and her fiancé about how your feel. You can also discuss the move and how you feel with your coaches. This could help put you at ease. Just because you might move in the future doesn’t mean your coaches have to be completely out of your life. Keep in touch and tell them how aid you are doing can help with the process of change and your thoughts of uncertainty.

Your friend

Dear Crying My Eyes Out,

It’s completely natural to worry about what this new place will be like. Try to think positively about the fact that from moving you will get a new landscape, new experiences, and new people to meet. Talk to your parents and maybe you could even have a say as to where you are moving to make sure you like the school. It’s easy to make new friends and relationships when you get involved in extracurricular activities and you never know, maybe there could be another martial arts place that you will like where you are moving. Remember that you are not alone and technology makes it so easy to keep in touch with people over long distances. It also sounds like you have a great future stepfather so this will give you a chance for your relationship with him to get stronger.

A Caring Friend

Dear Crying My Eyes Out,

It sounds like you have a very caring mother who has always found a way to give the best possible life for you, despite not having a father in your day-to-day life. Trust that your mom has continued to put your needs first by researching everything about the move before deciding what is best for you and the family. She sees a positive future for you in your new community, even better than what you envision in your current community. By maintaining close ties with your coaches and nurturing new relationships, you will increase your support as you enter high school. Having an impressive skill in martial arts will help you to meet friends who share your interest and gain admiration and respect from peers and adults in your new community. You might find it very rewarding to share your daily life experiences with your new stepdad as well. Your life will be different, however, it sounds like it could be even better.

Dr. Renae

 

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Ask Dr. Renae: Friendship is on the rocks

Dear Dr. Renae,

I feel very uncomfortable remaining friends with a long-term close friend of mine. She continues to be good friends with a group of people who betrayed me. I was blamed for things that were not my fault and was then ignored and abandoned. It was hurtful and I was devastated by this experience. My close friend has been there for me for three years and it is very difficult for me to make new friends. I find myself having trouble trusting her. How should I handle this?

Confused 17-year-old

Dear Confused,

It’s sad but true, you often see situations like this among petty and dramatic high school girls. I get that it’s hard to stay friends with someone who’s other friends betrayed and hurt you. You do have to understand that while it was wrong of them to treat you this way, they didn’t do any wrong to your friend so she has no reason to resent them. I think the best way to handle any high school drama is to talk to her. Talking out a situation is always the best option to avoid anyone’s feelings being further damaged. Tell her how you feel about her remaining close with those who hurt you. The only way she will understand and be able to change her behaviors will be making her aware of how you feel.

A True Friend

Dear Confused,

I understand where you are coming from. It’s hard to continue trusting people after others have betrayed you. You can’t expect her to stop being friends with them over something they did to you. It’s not fair to expect that of her since they never did anything to her. You can try to get your old friends back if you really want to be friends with them again. You would have to trust them and they would have to trust you. Since this friend is still friends with those who betrayed you, keep your eyes open and be careful with what you say and do. I do think you should continue to be friends with her though. She hasn’t fully picked your side or fully picked their side, so she may actually have a good point of view of the situation and see the good and the bad of both sides.

A Trusting Friend

Dear Confused,

If you’re feeling like you can’t trust your friend, then something needs to change. A friendship without trust is an unhealthy friendship. This doesn’t mean that you need to stop talking to your friend altogether, but you should definitely distance yourself, at least for the time being. Talk to your friend about the things she did that upset you and tell her that you think it’s time for a break. In the meantime, try putting yourself out there to make other friends. I know it is difficult, but it’ll be beneficial in the long run. Sit next to new people at the lunch table. Join a new after-school club. Do what you can to start mingling with a different crowd. Chances are, you’ll find your niche. If after a while you’re willing to give the relationship with your friend another shot, go ahead. But if you do, you’ll be in control of where the friendship is headed. You won’t let yourself be hurt again, and that’s what really counts. Best of luck!

A Caring Teen

Dear Confused,

I would talk to your friend and tell her how you feel. You could also talk to the group of girls and tell them how you feel, and ask if you can start over. I’m sure your friend will understand if she is a true friend. A true friend is someone who sticks by your side and doesn’t betray you. You might need to evaluate how close of a friend she is and how much she means to you. I think it is hard to let go of friends but you must value yourself and your worth. Try seeking new loyal friendships from activities, sports, or hobbies.

Been There Done That

Dear Confused,

Like you, I have a lot of trouble making new friends too. I recently found myself relying on one friend and need to branch out more. What I recommend is that you take a step out of your comfort zone (easier said than done, I know) and find someone else before you break it off with your other friend. I’m sorry for the misfortunes that have come your way and I hope you find new friends that won’t hurt you.

Someone Who Cares

Dear Confused,

Issues can’t ever get resolved if they aren’t aired. It is possible your friend is not at all aware of how you feel about her group of friends? Even if she is, make sure to talk to her, find a good time and place for just the two of you. Really let all your feelings out. If she doesn’t seem to change her ways and you still have trouble trusting her then it’s time to try to make some new friends. I would suggest joining a club, youth group, band, choir, or even take part in a team sport. Whatever you find interesting or you are good at would be ideal. Once you find something that you really like to do, there will always be people with common interests. Spending time with other people doing things you like is a great way to make friends. Even for a bit try to distance yourself from the negativity and have fun.

A Friend

Dear Confused,

It is normal to feel uncomfortable to interact with friends who are friendly with those who have wronged you, especially if it is a good friend. While you can’t control who people are friends with, you should take into consideration that she is a close, long-time friend of yours. If you are as close as you have stated, it might be good to tell her how you truly feel about the situation. Making your friend aware of how you feel is a good place to start. Talking it out and discussing the predicament you feel that you face may ease your worry. Thus, you won’t have to sacrifice your friendship.

Been Here Before 

Dear Confused 17-year-old,

Friendships often have similar complications in adulthood as well as between family members and in the workplace. Your parents might understand how you feel and are a valuable resource based on their own experiences. Being caught in the middle with conflicting loyalties is likely making your good friend feel uncomfortable as well. Do you find that spending time with her is difficult to enjoy as you are continually distracted by your memories of feeling abandoned by her current friends? If so, you can let your friend know that it is your problem to continue to work on. Do you find yourself suspicious of your friend’s loyalty to you, constantly worrying if she is judging you or sharing information about you with the others? If so, that is a relationship issue for the two of you to discuss. It is certainly tricky, but very possible for you to continue to enjoy your relationship with your valued friend. It will take much effort and intention, however, you can also learn to minimize your hurt memories by focusing on the positive aspects of your current life as well as your exciting future. If over time, these memories are still haunting you, a therapist can help you in putting this aspect of your life in perspective so it will not interfere with your future relationships. It will be well worth the effort!

Dr. Renae

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