It’s Not Too Early to Book Those Physicals!

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It’s never too early to start thinking about vaccines and physicals for the new school year, or for summer camp!

Please remember to call and book your appointments early to get the most convenient time for your busy schedules. Also please remember, our staff makes it a priority to complete your requests for forms as quickly as possible. We do advise all of our patients that we request a minimum of 3-7 business days to complete those forms.

If your child is planning on playing any summer/fall sports, attending any camps, and for those who are entering college, please plan accordingly so that we can get your form completed and returned to you before your deadlines.

In the event, that we are asked to expedite a form (i.e. 24-hour turn around), please be aware that there will be a $10 fee charged. Please help us to provide you with the best service possible by getting your forms to us in a timely manner.

Call us now! 203 239-4627

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Teens: Creating Your Personal Stress-Management Plan

Here is a 10-point plan to help you manage stress. All of these ideas can lower stress without doing any harm. None are quick fixes, but they will lead you toward a healthy and successful life. The plan is divided into 4 parts.

  • Tackling the problem
  • Taking care of my body
  • Dealing with emotions
  • Making the world better

When you read over the plan, you’ll notice that you can come up with a bunch of ideas for each point. PLEASE don’t think you should try them all.

This plan is supposed to help you reduce stress, not give you more. Try out some ideas, then stick to one or two for each point.

You might notice that this plan is almost like building a college or work résumé. This is the sane way to build a résumé; you are doing it to manage your life and remain happy and prepared for success, not to cram in activities to impress someone else. It will ensure you’re healthy and balanced, and that’s very attractive to colleges and employers.

Part 1: Tackling the Problem

Point 1: Identify and Then Address the Problem.
First decide if a problem is a real tiger or just feels like one. If it can’t hurt you, chances are that it can be better handled with clear thinking. This means turning off those thoughts that make you interpret the situation as a disaster.

  • A lot of people cope by ignoring problems. This doesn’t make them go away; usually they just get worse.
  • People who cope by trying to fix problems tend to be emotionally healthier.
  • When it comes to studying or chores, it is best to get the work done first. Because work or studying produces stress, many people put it off and choose to do fun things first. The problem with that is they’re not really having fun because they’re worrying about the work they’re ignoring. And of course, the longer they put it off, the more they worry. The cycle is endless.
  • Fights with parents and friends don’t go away unless you deal with what upset you in the first place, or unless everyone apologizes and decides to forgive each other.

Three ideas can help you manage a lot of work.

  • Break the work into small pieces. Then do one small piece at a time, rather than look at the whole huge mess. As you finish each piece, the work becomes less overwhelming.
  • Make lists of what you need to do. This will help you sleep because your head won’t spin with worry about whether you can do everything. At the end of the day, you’ll have less to worry about as you check off the things you have finished. You will look at the same huge amount of work and realize you can handle it.
  • Timelines can help with big projects.

Point 2: Avoid Stress When Possible.
Sometimes we know exactly when we are headed for trouble. Avoiding trouble from a distance is easier than dealing with it up close. You know the people who might be a bad influence on you, the places where you’re likely to get in trouble, and the things that upset you. Choose not to be around those people, places, and things that mess you up.

Point 3: Let Some Things Go.
It’s important to try to fix problems, but sometimes there is nothing you can do to change a problem. For example, you can’t change the weather, so don’t waste your energy worrying about it. You can’t change the fact that teachers give tests, so just study instead of complaining about how unfair they are. You can’t change the fact that your parents need to know where you go, so prove that you’re responsible and deserve more freedoms. People who waste their energy worrying about things they can’t change don’t have enough energy left over to fix the things they can. Also learn when not to take things personally. You feel badly for no reason when you take something personally that really has little to do with you.

Part 2: Taking Care of My Body

Point 4: The Power of Exercise.
Exercise is the most important part of a plan to manage stress. When you are stressed, your body is saying, “Run!” So do it. Exercise every day to control stress and build a strong, healthy body. You may think you don’t have time to exercise when you are most stressed, but that is exactly when you need it the most. If you are stressed about an assignment but too nervous to sit down and study—exercise! You will be able to think better after you have used up those stress hormones. Some people exercise before school so they can focus and learn better.

Point 5: Active Relaxation.
You can flip the switch from being stressed to relaxed if you know how to fool your body. Because your body can only use the relaxed or emergency nervous system at any one time, you can turn on the relaxed system. You do this by doing the opposite of what your body does when it is stressed. Here are 2 ideas.

  1. Breathe deeply and slowly. Try the 4–8 breathing technique. Lie on your back and place your hands on your belly with your fingers loose. Deep breaths first fill the belly, then the chest, then the mouth; the breath expands the belly and your hands pull gently apart. Take a full breath while counting to 4. Then hold that breath for about twice as long, or an 8 count. Slowly let it out to the count of 8, or even longer if you can. This will relax your body after a few breaths, but just as importantly, it requires your full concentration. Your mind is too focused on breathing to focus on worries. Do this 10 times and you will feel much more relaxed. Yoga, martial arts, and meditation also teach great breathing skills. When you get good at this, you can even do this in a chair during a test and nobody will know.
  2. Put your body in a relaxed position.
    • Your body knows when you’re nervous. If you sit down to take a test and your legs are shaking, you are saying, “I want to run!” Remember, you can’t concentrate and run at the same time, so you are making it harder to take the test. Instead, take those deep breaths, lean back, and tell your body there is no emergency.
    • When you’re angry, the natural thing to do is stand up and face someone shoulder-to-shoulder and chest-to-chest. You do this without even thinking, but this subconsciously tells the other person that you’re angry and ready to fight. It also may prevent you from thinking clearly. Do the opposite of what you would do if you were really going to fight—sit down, take deep slow breaths, and tell your body there is no danger. Then use your brain to get out of the situation.

Point 6: Eat Well.
Everyone knows good nutrition makes you healthier. Only some people realize that it also keeps you alert through the day and your mood steady. People who eat mostly junk food have highs and lows in their energy level, which harms their ability to reduce stress. Instead of eating greasy or sugary foods, eat more fruits, vegetables, and whole grains—they keep you focused for a longer time.

Point 7: Sleep Well.
Most kids don’t get the sleep they need to grow and think clearly. Tired people can’t learn as well and can be impatient and irritable. Here are some ideas to improve your sleep.

  • Go to about the same time every night.
  • Exercise 4 to 6 hours before bedtime. Your body falls asleep most easily when it has cooled down. If you exercise right before bed, you will be overheated and won’t sleep well. A hot shower 1 hour before bedtime also helps your body relax to fall asleep.
  • Use your bed only to sleep. Don’t solve your problems in bed. When you think about all the things that bother you, you have trouble falling asleep and wake up in the middle of the night to worry more. Instead, have another spot to think, like a worry chair. Give yourself plenty of time to think things through, make a list if you need to, and then set it aside! Go to bed to sleep.
  • Don’t do homework, watch television, read, or use the phone while in bed.

Part 3: Dealing With Emotions

Point 8: Take Instant Vacations.
Sometimes the best way to de-stress is to take your mind away to a more relaxing place.

  • Visualize. Have a favorite place where you can imagine yourself relaxing. The place should be beautiful and calm. When you’re stressed, sit down, lean back, take deep breaths, close your eyes, and imagine yourself in your calm place.
  • Take time out for yourself. Everyone deserves time for themselves—a bath or something that allows time to think and de-stress. Try a warm bath with your ears just underwater. Listen to yourself take deep, slow breaths. Take your pulse and count as your heart rate goes down.
  • Enjoy hobbies or creative art as an instant vacation.
  • Look at the beauty around you and get pleasure from the small things you may have stopped noticing.
  • Take mini-vacations. Sometimes we forget that the park around the corner is a great place to hang out. A walk outside can be a mini-vacation if you choose to forget your worries.
  • Reading a good book is an escape from reality. You have to imagine the sights, sounds, and smells—you are somewhere else for a while.

Point 9: Release Emotional Tension.
Sometimes feelings become so overwhelming that we cram them all away in an imaginary box and think we’ll deal with them later. But later, there’s so much stuff in the box that there is too much to deal with. This can make your head feel as if it is spinning. Sometimes you get angry or frustrated without even knowing why. You just know there is too much stuff going on in your head. It’s good to pick just one problem to work on and forget the rest for the moment. When we decide to deal with only one problem at a time, it’s much less scary to open the box.

Here are some ideas to release your thoughts or worries one at a time.

  • Creativity. People who have a way to express themselves don’t need to hold it inside. Creative outlets like art, music, poetry, singing, dance, and rap are powerful ways to let your feelings out.
  • Talking. Every young person deserves a responsible adult to talk to and some friends to trust. Hopefully, you can talk to your parents. If you do not want to tell your parents everything, make sure to find an adult who’ll listen and whom you can ask for advice.
  • Journaling. Write it out!
  • Prayer. Many young people find prayer or meditation helpful.
  • Laughing or crying. Give yourself permission to feel your emotions fully.

Part 4: Making the World Better

Point 10: Contribute to the World.
Young people who work to make the world better have a sense of purpose, feel good about themselves, and handle their own problems better. It’s important to understand that you really can make a difference in other people’s lives. The role of teenagers is to recognize the mistakes adults have made and build a better world.

My Personal Stress Plan

Now that you have read about the kind of things a person can do to reduce stress, you may be ready to create a plan for yourself. Click Here to download My Personal Stress Plan (PDF)


Editor’s Note: This article is written specifically for young people from 12 to 18 years of age. Your teen will get the most out of this article if he or she also reads For Teens: A Personal Guide for Managing Stress and downloads My Personal Stress Plan.

SOURCE: Building Resilience in Children and Teens: Giving Kids Roots and Wings, 3rd Edition (Copyright © 2015 Kenneth R. Ginsburg, MD, MS Ed, FAAP, and Martha M. Jablow). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Obesity: What Activity Should Your Child Choose?

There are a lot of avenues for your overweight child to pursue in the quest to become more active. From Little League baseball to ballet lessons, shooting a basketball to bicycling, he has many options to choose from. And that’s the key — your child, not you, should be the person making the choice. If he’s going to stay active long term, he needs to select something that he likes and will keep doing.

That’s why it’s important for parents not to micromanage their children’s physical activities. Some children enjoy organized activity, while others prefer outdoor free play for which they’re left to their own devices on how they’ll be active. Free play can be a powerful form of exercise, contributing to the development of motor skills and serving as a great outlet for your youngster’s energy. As a society, we’re overlooking the value of this kind of active play, even though the AAP recommends only free play, rather than team sports, up to the age of 6 years. Whether you live in a city or rural area, find a park, playground, or other outdoor area where your young child can do his own thing.

Yes, you can make sure that some balls and other play equipment are available whenever your child goes outside, but let him decide exactly what he wants to do. Parents often find it helpful to give their children 3 or 4 activity options from which to choose, or they might ask their youngsters what choices they’d like available. Pose a question like this to your child: “If you weren’t watching TV, what could you be doing instead?” Don’t be surprised if you initially get a blank stare from him, so give him some concrete alternatives: “Could you jump rope? Or play tennis? Or go in-line skating? Or go for a brisk walk?”

You might instead say, “Here are 3 activities you could do this afternoon. You could swim, go bowling with your brother, or go for a walk. Which one would you like to do?”

On the other hand, if you insist that your child participate in an activity that he finds boring or grueling—“Jimmy, it’s time to walk on the treadmill!”—he’ll probably lose interest quickly and end up in front of the TV. If you provide him the opportunity to participate in an activity that he enjoys, he’s likely to keep doing it.

Now, what about organized sports like soccer teams and Little League? They’re fine for children aged 6 years and older who want to join in, but it’s important to have realistic expectations. Your aim should be for your child to be physically active and enjoy the experience, not necessarily excel as the best player on the team. You shouldn’t be trying to create an elite athlete, and if he chooses to move from one sport to another rather than concentrating only on one, that’s fine. For example, if he shows an interest in a basketball league, great—but if he also wants to learn how to ski when winter comes around, all the better. Let him explore different activities.

He’ll develop a wide variety of physical skills and more importantly, he’ll keep moving. Here are some other guidelines to keep in mind when selecting activities with your child.

  • Anything that involves movement qualifies as physical activity.
  • It doesn’t have to push your child to the point of collapse to
    contribute to his efforts at weight management.
  • When you present your child with alternatives or options for activities, create the boundaries of acceptable choices.
  • Perhaps joining the hockey team is too expensive for your family budget—not only the sign-up fee, but the cost of the skates and other equipment. There are plenty of other choices that should be within your family’s financial means.
  • While many youngsters love being active with other kids, some overweight children feel self-conscious or embarrassed about participating in group sports. They may be more inclined to choose an activity that they can do on their own. Another approach is to plan physical activities for your youngster together with a special friend or sibling with whom he feels comfortable.
  • Above all, the activity must be fun, and your child should be successful at it.

What’s Right for Your Child?

There’s no scarcity of activities that you can make available to your child, and all kids can find some form of exercise that they enjoy, even if they tell you that they’d much rather sit and snack on the couch. You’ll find many of these options mentioned in several places. You can also use your imagination to add to the list of appropriate choices for your own child, perhaps including hiking, gardening, snorkeling, gymnastics, stair climbing, or playing with a hula hoop. You can get him a dog if he agrees to walk his new pet twice a day. You could also buy him a basketball and put up a hoop in your driveway.

Remember, even household chores—from raking leaves to vacuuming the house to washing the car—qualify as physical activity as long as they keep your child moving.

Don’t overlook youth activities sponsored by your community’s parks and recreation department, which might include volleyball, badminton, or table tennis. Encourage your youngster to stay active by giving him gifts like riding lessons. At his birthday parties, incorporate some physical activity, perhaps by taking his friends and him to play miniature golf or planning a trip to the batting cages to swing at baseballs.

Also, keep in mind that there are lifetime sports that he can develop a love for and continue doing throughout his lifetime. If you can get your child interested in an activity like this when he’s young, exercise and fitness are more likely to become a habit that lasts for many decades. In fact, the American Academy of Pediatrics recommends that physical education programs in schools emphasize lifetime sports (as well as activities that are not just for the best athletes). These lifetime sports include

  • Swimming
  • Racquetball
  • Skating—In-line and ice
  • Golf
  • Bowling
  • Bicycling
  • Tennis
  • Skiing
  • Jogging
  • Walking
  • Martial arts

No matter what activity your child chooses, whether it burns lots of body fat or just a little, it is better than just sitting. That’s the message to communicate to a child who wants to lose weight.


Source: A Parent’s Guide to Childhood Obesity: A Road Map to Health (Copyright © 2006 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Daily Physical Activity Recommendations

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Physical activity in children and adolescents improves strength and endurance, builds healthy bones and lean muscles, develops motor skills and coordination, reduces fat, and promotes emotional well-being (reduces feelings of depression and anxiety). Activities should be appropriate for their age and fun, as well as offer variety.

The daily recommendation for physical activity for children 6 years and older is at least 60 minutes per day. Active play is the best exercise for younger children.

The types of physical activity should be moderate to vigorous. Vigorous activity is activity that makes you breathe hard and sweat. During vigorous activity, it would be difficult to have a talk with someone. Some activities, such as bicycling, can be of moderate or vigorous intensity, depending upon level of effort.

The 60 minutes does not need to be done all at once. Physical activity can be broken down into shorter blocks of time. For example, 20 minutes walking to and from school, 10 minutes jumping rope, and 30 minutes at the playground all add up to 60 minutes of physical activity. If your child is not active, start from where you are and build from there.Here is a list of sports and activities for children and teens (and parents, too!).

AEROBIC EXERCISE
Use body’s large muscle groups
Strengthen the heart and lungs

Examples of moderate-intensity aerobic exercises include:

  • Brisk walking
  • Bicycle riding
  • Dancing
  • Hiking
  • Rollerblading
  • Skateboarding
  • Martial arts such as karate or tae kwon do (can be vigorous too)

Examples of vigorous-intensity aerobic activities include:

  • Basketball
  • Bicycle riding
  • Games such as tag
  • Ice or field hockey
  • Jumping rope
  • Martial arts
  • Running
  • Soccer
  • Swimming
  • Tennis

MUSCLE-STRENGTHENING (OR RESISTANCE) ACTIVITIES
Work major muscle groups of the body (legs, hips, back, abdomen, chest, shoulder, arms)

  • Games such as tug-of-war
  • Push-ups or modified push-ups (with knees on the floor)
  • Resistance exercises using body weight or resistance bands
  • Rope or tree climbing
  • Sit-ups (curl-ups or crunches)
  • Swinging on playground equipment/bars

BONE-STRENGTHENING (WEIGHT-BEARING EXERCISES
Tone and build muscles and bone mass
Can be aerobic exercises and muscle-strengthening activities

Examples of bone-strengthening activities include:

  • Basketball
  • Hopping, skipping, jumping
  • Gymnastics
  • Jumping rope
  • Running
  • Tennis
  • Volleyball
  • Push-ups
  • Resistance exercises using body weight or resistance bands

About Strength Training
Strength training (or resistance training) uses a resistance to increase an individual’s ability to exert force. It involves the use of weight machines, free weights, bands or tubing, or the individual’s own body weight. This is not the same as Olympic lifting, power lifting, or body building, which are not recommended for children. Check with your child’s doctor before starting any strength training exercises.


Source: Energy In Energy Out: Finding the Right Balance for Your Children (Copyright © 2014 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Just Breathe: The Importance of Meditation Breaks for Kids

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Our kids’ brains are tired, and children of all ages really need opportunities where they can take time out each day “unplugged” to relax and focus. Meditation offers this break and helps kids function more effectively and clearly.

Children today also have reportedly high stress levels. To help them take a break, the American Academy of Pediatrics (AAP) encourages parents to share meditation with their children—and teachers to incorporate mindfulness training into their lesson plans.

The simple act of teaching children how to stop, focus, and just breathe could be one of the greatest gifts you give them.

Meditation Options for Children
Meditative practices have been used since ancient times to improve health and well-being. But, just as an athlete may do different exercises, people who practice meditation often use different types.

The most common types of meditation practice are concentration, mindfulness, movement based, cultivating positive emotions, and emptying.

Many meditation practices use breathing techniques to promote a state of calm. Mindfulness meditation on breath, perhaps the most well-known type, involves sitting quietly, resting or closing your eyes and bringing your attention to your breath. When your attention drifts away, which it is likely to do, simply usher your attention back to your breath without judgment. You don’t need years of meditative practice to benefit from this technique, nor do your children.

There’s no doubt, however, that sitting still for any length of time can be difficult for some kids. For this reason, a movement-based meditation, such as yoga, may serve as a good introduction.

Research on the Benefits of Meditation in Children
Meditation is used to rest the mind, body and spirit. This, in turn, has many mental, physical, and spiritual benefits. Mindfulness meditation, specifically, is gaining a foothold in disease prevention and treatment.

A number of studies in school settings also show improved attention and behavior. Some research has shown benefits for attention deficit hyperactivity disorder (ADHD), anxiety, depression, school performance, sleep, behavior problems, and eating disorders. For example, a trial of 300 low-income, minority urban middle-schoolers using school-based mindfulness instruction led to improved psychological functioning and lower levels of post-traumatic stress disorder (PTSD) symptoms.

There are also physical benefits as it calms the nervous system and decreases stress hormones. Studies have shown benefits for gastrointestinal symptoms, obesity, headaches, high blood pressure, pain sensitivity, and immune function. For example, a trial looking at the effect of mindful breathing meditation at a summer camp of 166 teens at risk for cardiovascular disease found that breathing awareness produced a reduction in blood pressure and heart rate.

Meditation Tips
Meditation does not have a set of rules, but there are some tips that can help.

  • The length of time and frequency of meditating can vary for different people and different practices. But, pediatricians typically recommend the following time frames: Preschool children: A few minutes per day; Gradeschool children: 3-10 minutes twice a day; Teens and adults: 5-45 minutes per day or more based on preference.
  • Try incorporating deep breathing into your children’s daily bedtime routine—it can help them wind down for the night and make meditation easier to do when other situations arise.
  • Remind gradeschoolers and teens to take a few deep breaths before answering a difficult question at school, taking a test, or before an athletic performance.
  • As young children learn to manage strong emotions, deep breathing can be part of the process—especially before and after time outs.
  • While meditation can be done on your own, it can also be done with the help of a trained professional. Some counselors and individuals with training in meditation can help others learn and practice meditation.
  • Meditation is not currently covered by most insurance plans unless given by a licensed counselor. It is always best to check with your individual plan. Flexible medical spending programs may count meditation training as a medical expense.
  • There are multiple ways to learn different practices of meditation. There are books, audio recordings, videos, online training, websites, and even smartphone apps to help children meditate. Choose and practice the one that works the best for you and your child, and enjoy a calmer body, mind and spirit.

Talk to Your Pediatrician
Since meditation practices are generally safe and have many possible benefits, they can be used without much risk. As with any lifestyle change, however, it is best to discuss it with your child’s pediatrician before adding meditative practices to your child’s wellness routine.
Additional Information & Resources:


Last Updated 8/25/2016. Source: Section on Integrative Medicine (Copyright © 2016 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.