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Published June 24, 2013, 11:35 PM

Making the most of your teen’s sports physical

FARGO - Parents typically take their babies and toddlers for regular wellness checks every few months. But by the time kids hit their tween and teen years, they may only see the doctor when they’re sick.

By: Tracy Frank, INFORUM

FARGO - Parents typically take their babies and toddlers for regular wellness checks every few months.

But by the time kids hit their tween and teen years, they may only see the doctor when they’re sick.

The physicals required before kids can participate in sports can be a good opportunity to check overall wellness for in older child.

To make the most of your kids’ summer physical, Dr. Janet Tillisch, Essentia Health pediatrician and Dr. Chris Tiongson, Sanford Health pediatrician, recommend going for a complete physical rather than just a sports physical.

Sports physicals will often involve listening to a child’s heart and lungs and making sure they don’t have any sports injuries, Tillisch said.

Both doctors say that whether or not kids participate in sports, they should have regular checkups once a year.

“Teens have lots going on in their lives.” Tiongson said. “Physically their bodies are changing; emotionally, educational demands change. … It is easy to forget to pay attention to those changing needs.”

Tillisch recommends parents and teens make lists of questions or concerns ahead of time to bring to the appointment. She suggests thinking about issues like nutrition, sleep habits, illnesses that required missed school and social concerns like smoking, drinking and drugs.

“We try to make sure they’re eating healthy, three meals a day, and sleeping OK and that their urine and stools are normal,” Tillisch said. “And then I try to ask them what they’re doing for exercise.”

With childhood obesity on the rise, Tillisch said nutrition is very important.

If a child is overweight, they talk about the importance of being active and eating three meals a day, including five to nine fruits and vegetables a day.

The main concerns parents and teens ask about are school, sleep and weight, Tiongson said. Some worry that they’re not growing fast enough or that they’re putting on too much weight, he said.

“Sometimes kids are worrying about it when don’t need to worry about it,” he said.

Tiongons also recommends parents ask if their kids are missing any vaccines because the recommendations change over time.

Most kids will need vaccines at ages 11 or 12, and at age 16 kids need a meningitis booster shot.

Both doctors also recommend both girls and boys get the HPV (human papillomavirus) vaccine.

According to the Centers for Disease Control and Prevention, HPV vaccines are given as a series of three shots over six months to protect against HPV infection and associated health problems. Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection. Certain types of HPV can cause genital warts or cancer.

Cervarix and Gardasil vaccines protect against cervical cancers. Gardasil also protects against genital warts and cancers of the anus, vagina and vulva.

While the HPV vaccine is not required for school, Tiongson said most girls and about half the boys he talks to agree to receive it.

“The boys aren’t going to get cancer, but they’re obviously a big part of spreading the virus,” he said. “It’s one of those things where if they can take a shot for womankind, it’s a good thing to do.”

Once children reach age 15, Tillisch meets with the parent and patient together and then has the parent step out while she does the physical exam if the teen is comfortable.

At that point she will talk about sexual activity, birth control and sexually transmitted diseases. She will also ask about smoking, drinking and drugs at that time.

“Are they honest with me, who knows?” Tillisch said.

Tiongson also has parents step out of the room for a while.

“As they grow up, it is important to have some private time with the physician so they can talk about confidential things or embarrassing things,” he said.

In addition to risky behaviors, Tiongson said he also asks about issues like school, peer relationships, social media usage and driving habits.

When it comes to mental health issues, teenagers are sometimes moody, so Tiongson likes to ask the parents and teens if they have concerns.

“It is difficult because it’s hard to know where is the line between just being a teenager and when it starts to impact their life,” he said.

Questionnaires the kids fill out ahead of time can help pick up on which teens might have issues with anxiety or depression, he said.

Both doctors say to get the sports physicals early because spaces fill up quickly when it gets close to practice time.

The North Dakota High School Activities Association requires students who participate in sports affiliated with the association to have physicals on or after April 15 to cover the following school year, said Todd Olson, Fargo School District activities director.

The physicals will occasionally catch something that requires follow-up appointments but rarely prevent anyone from participating, Olson said.

The forms have gotten a lot more in-depth than they used to be, he said.

It used to be a small card. Now it’s a four-page evaluation form that includes questions about things like eating disorders, condom use, depression, and steroid use. The only page returned to the school office is the clearance form.

A similar form is required for participation in Minnesota State High School League athletics.

North Dakota requires sports physicals every year. In Minnesota, it’s every three years.

“It is a screening tool to make sure that there aren’t health concerns that will arise during participation,” he said. “The association also has a catastrophic health insurance policy that covers the participants in case of a catastrophic injury that only kicks in when something severe happens.”

Recommended vaccines for teens

Ages 11 - 12 years

• Tetanus, Diptheria, Pertussis (Tdap) Vaccine

• Human Papillomavirus (HPV) Vaccine (3 doses)

• Meningococcal Conjugate Vaccine (MCV4)

• Influenza (yearly)

• Pneumococcal Vaccine (for children with certain health conditions)

• Hepatitis A (HepA) Vaccine Series (for children with certain health conditions)

Ages 16

• Meningococcal Conjugate Vaccine (MCV4)

Source: Centers for Disease Control and Prevention


Readers can reach Forum reporter Tracy Frank at (701) 241-5526

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