June 21, 2011
School physicals can be downright embarrassing for the modest patient. Years ago, one of my daughter’s friends came to the office for her high school physical. The young lady was mortified when her underpants were revealed during the exam. What made her exam memorable was that she swam in my pool every summer and her bathing suit amounted to 4 postage stamps held on by strings, far less than what was revealed during the exam!
The lesson I learned was that modest young ladies and men are comfortable in bathing suits and that bathing suits make a physical exam much simpler. This year, please have your children wear their bathing suits under their clothes when they see their docs for their yearly physicals. Young ladies should wear their favorite two piece suits as it facilitates examining the spine.
While we are on the subject of school physicals, they are not just formalities. School and college physicals are a chance to uncover hidden health risks, to review immunization recommendations, to discuss wellness care and safe sex, and to answer questions the young students may have. Parents should prepare for school physicals by studying their own family histories focusing on early cardiac events and genetic predispositions. Family history is essential in illuminating hidden risks.
One or both parents should be present at the onset of the physical. Young athletes, intent on playing sports, are not going to admit to the chest pain they have been experiencing during sports, nor to the problems they have with breathing during running. When asked, “Do you ever have chest pain?, their answer is a resounding, “No!” If mother is in the room, she will chime in, “But what about last week when you had to leave the field?” The student will then scold his mother with, “That was nothing! You don’t know what you are talking about!”
I need mom’s input to be at my best. Sometimes dads are in denial and will cover for their child in order to avoid having their star sidelined.
Once the history is complete, parents should leave the exam room. There are questions young students have that will not be asked in front of an overly protective parent. There are questions doctors need to ask that may not be answered honestly when a parent is in the room! If the child is concerned about being alone with the doctor, ask to have a nurse attend the exam.
Parents should be prepared to discuss immunizations. Gardisil is a new vaccine that protects against venereal warts in boys and girls and against cervical cancer in girls. Discussing sexually transmitted diseases is challenging for parents and students alike. No parent likes to admit that his/her teenager might be sexually active but we all know that teenagers are! Finding out that your child has had sex after they are diagnosed with HPV is the ultimate bummer. HPV should become a thing of the past. Vaccinate your children.
The authorities are advising that teenagers get a second chickenpox vaccine and meningitis vaccine. A diphtheria/pertussis/tetanus vaccine is required when going into high school. Vaccines are expensive and the county provides vaccines at a reduced rate in shot clinics across the suburbs.
Recently, there has been a lot of press surrounding sudden death in athletes. Many of these athletes have died from silent cardiac disorders. Silent heart disease is difficult to diagnose and requires testing, such as EKGs and Echocardiograms. If you have any family history of early cardiac deaths, please discuss the merits of these potentially lifesaving tests.
School physicals are investments in your child’s future. Do not take them lightly. If your child is utilizing the school system’s discounted exam program, go with your child. If you cannot attend the physical, provide a written family history and list of issues and have the examiner sign that it was received and discussed. The life you save may be your child’s.