Search for tag: "phobia"

Needle phobia. It's something that as a pediatrician I see every day, several times a day. At least two-thirds of children have a fear of needles. It's hard to tell who is worse with it though, little kids or teenagers.

Unfortunately, vaccines are still given as shots at this time, and kids get a lot of shots to help build their immune system. At the mere mention of being due for vaccines or blood work, some kids will just burst into tears.

So what can you as a parent do to help when your child is due for a vaccine or needs blood work done? I always will tell parents and kids at the well visit before they are due for vaccines that the next time they have a checkup, there are shots involved.

Mainly, I do this to avoid surprises. Often parents will say that they had no idea their child was due for shots. So when I tell the kids, they remember the next time and that actually seems to help them be better prepared. It's the surprise "you need a shot" announcement that catches kids off guard more and their anxiety goes through the roof.

Parents also feel better knowing that they can tell their child that, "We talked about this," and that they can prepare their child in advance, not spring it on them on the drive to the office or once they get here.

One thing we as pediatricians ask that you don't do is tell your kid that if they don't behave, they'll get a shot. I hear that all the time as a scare tactic and it really bothers me. I'm not going to give your child a shot if it's not needed.

If you tell your child in front of me that I will give your child a shot if they misbehave, I will tell your child that I don't give shots for behavior, but I do have time out spots in the clinic.

And for the teenagers, if they get out of hand, we do have security officers who can help with behavior outbursts. And yes, sometimes that has been needed when the teenagers become violent.

Kids often will ask me if the shots hurt. Well, they are shots. They're not fuzzy caterpillars. Same with the needles we use to draw blood. I tell kids that, "Yes, they hurt just a little, but it's over quickly," and, "We have to use the needles, but for a good reason," and it's to make sure that they are healthy.

I try to be upfront and honest with the kids. Even little kids understand when you tell them the truth in a calm manner and explain why we are doing what we are doing.

I had a vaccine one day and I saw a patient later who was afraid of getting a shot. I showed her my Band-Aid and she was so surprised. She was like, "But you're the doctor." And I said, "Yes, I am, and I sometimes have to get shots too." She then said if I was brave enough to get one, then so was she.

I also tell kids when they're old enough what vaccines they're getting and why they're getting them. I ask if they have any questions about the vaccines, and that seems to help them understand the importance of the vaccines.

Same with the blood work. I explain everything to them so that they know I'm not ordering labs just because I want to torture them. It's because I'm trying to figure out what is going on in their bodies and how to make them healthier.

I also have the advantage of telling kids and parents that my medical assistants are who I trust with my own family and who I trust to draw my blood and give me any immunizations. So they know that they're in good hands.

I let them know that I don't like getting needles poked in me either, so they know they're not alone and that I get it.

I talk directly to the kids so they know they're heard and we are doing what we can to make this as easy an experience as we can. And they know that they get a sticker when they're done for being so brave, no matter how old they are.

So while needle phobia is a real thing, there are ways as parents that you can help make immunizations and blood draws less scary, which goes a long way when the kids are here in the office.

Announcer: Need reliable health and wellness information? Don't listen to the guy in the cube next to you. Get it from a trusted source, straight from the doctor's mouth. Here's this week's Listener Question on The Scope.

Interviewer: My daughter's two and has been admitted to the hospital, and they can't get her temperature to stay down. It's only down long enough until the medicine wears off. It varies between 103 and 105, and I can't help but wonder if something more serious is going on. This listener question is going to be answered by Dr. Cindy Gellner. She is a pediatrician at the University of Utah. Dr. Gellner?

Dr. Gellner: So we get this question a lot. Fever phobia is a common phenomena among parents, because it's scary. It's scary to watch your child have a fever that's high, and your child is miserable. But parents need to remember that a fever turns on the body's immune system. Fevers are actually one of the body's protective mechanisms, and it means their child's immune system is doing its job.

Parents worry about how long a fever lasts, but fever normally will last up to five days with most viral illnesses, and most fevers between 100 and 104 are actually good for sick kids. They help the body fight infection. Fevers with infections don't cause brain damage. That's a question I get a lot. And only body temperatures over 108 cause brain damage. The body temperature for that only gets really high with extreme environmental temperatures, like if a child is locked in a closed car in hot weather. That's when we worry about the brain temperature.

It's also important for parents to remember that fevers that don't respond to medicine can be caused by either a virus or a bacteria. And when the fever medicine wears off, the fever is going to return, and it needs to be treated again until the body's immune system overpowers whatever is causing the illness. And whether the medicine works or not doesn't relate to the seriousness of the infection. If the fever is really, really high, the cause may or may not be serious. The more important thing is looking to see if your child is very sick because if they're very sick-appearing, then it's more likely to be serious.

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Interviewer: People with eating disorders experience severe disturbance in their eating patterns. It's important to remember that eating disorders are mental illnesses and the physical effects are the symptoms. That's coming up next on The Scope.

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Interviewer: Three percent of Americans suffer from binge eating disorder. We're talking with Dr. Jason Hunziker, a psychiatrist at the University of Utah. Dr. Hunziker, what mental conditions can cause an eating disorder?

Dr. Jason Hunziker: There are lots of mental illnesses that are associated with eating disruption or eating disorder for different reasons. An example would be somebody with schizophrenia gets very paranoid often, so they won't eat their food because they're afraid it's been poisoned. We have other people who are so anxious about allergies in food that they just won't eat, so they have a specific phobia about certain foods. Some recent studies have shown that people with bipolar disorder and/or depression also struggle with eating disorder of a different type in which they binge eat.

Interviewer: First of all, what is binge eating?

Dr. Jason Hunziker: Binge eating is when you're going along fine and you eat normal foods, then you have an episode in which you just can't get enough food. You binge on whatever's in front of you. Most often it's not stuff that's good for you.

Interviewer: Always.

Dr. Jason Hunziker: You eat lots of it. Then, you eat to the point that you almost feel like you're going to burst. That leads to some people then going in and purging and getting rid of the food that they just ate.

Interviewer: So, it's different than, say, on a Saturday night I'm in front of a movie and I'm eating everything that's in my kitchen. That's different. It's those people that do that but then feel guilty, and then they throw up afterwards. Is that correct?

Dr. Jason Hunziker: That's correct. Usually, with binge eating there is a number of times you need to participate in that event before it even gets classified as a binge eating disorder. That has to be several times a week or month. Then, you qualify for a binge eating disorder.

Interviewer: What exactly causes someone mentally to think okay, I need to throw up? Because when I eat too much and I'm full I just wait for the food to settle down.

Dr. Jason Hunziker: Not everybody does throw up when they have the binge eating. What they'll do, though, is they use that food as some way to help comfort them for whatever's going on in their life. Often, as I said, it is associated with depression. When people are sad and they're down they...

Interviewer: They eat.

Dr. Jason Hunziker: ...feel like eating. And, the same with bipolar disorder - when you're sad and you're down, you eat. That somehow gives them some comfort, while at the same time it induces shame, and guilt, and other aspects of well, now I'm gaining weight, and now I'm not thin. It's a vicious cycle for them.

Interviewer: We obviously know that we classify binge eating as an eating disorder which is a mental illness. What other physical health conditions can it cause?

Dr. Jason Hunziker: It depends on how long this goes. Clearly, binge eating is going to increase your weight. As your weight increases we know that affects all aspects of your body including your lungs, and your heart, and then the cardiovascular system and other physiologic effects that it can bring on. Type-2 diabetes in this country now is really expanding because of the obesity problem, and this would be another way to contribute to that problem.

Interviewer: That's interesting. There are all these sorts of more severe diseases that can come from just binge eating.

Dr. Jason Hunziker: That's correct.

Interviewer: Obviously, you know that's going to happen. You want to treat it. Is it something that you physically and emotionally are maybe aware of, or do you need somebody to tell you I think there's a problem you need to go see a specialist?

Dr. Jason Hunziker: I think that some people are aware and some aren't. I think if it's associated with your mood disorder that would be a time to get into your doctor and get on some medication for your depression, which often will help take care of those binge eating episodes. Sometimes the medication itself will help take care of that compulsion or drive to eat which some people just have. They just feel compelled to do it and they can't feel good unless they do it. Then, they feel bad after they do it. It's a really vicious cycle. The medicine often will help with that.
There are good therapies that can help with eating disorder as well. It's really important to understand the underlying cause, and if it's caused by another illness to make sure that you treat that illness so that you can then treat the binge eating.

Interviewer: Any final thoughts on binge eating?

Dr. Jason Hunziker: I think that the important thing to do is for the patients and/or their families to recognize that the binge eating is a disruption to them, and that they get into talk to their doctor as soon as possible about what could be done to help them...

Interviewer: Because it can be treated.

Dr. Jason Hunziker: ...because it can be treated.

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