Teen hygiene

Solo health care
Your children are ready to take charge of their own health care when they're mature enough to ask questions of all health-care providers and to comprehend and deal in a responsible fashion with the information provided. In order to build a trusting relationship with your adolescent, the doctor will usually make a point to mention that their discussions will remain confidential.

In most Canadian provinces and territories, children as young as twelve can choose not to have their parents accompany them either when they go to their doctor or when they go into the doctor's examining room. They may also consent to a treatment if doctors believe them capable of understanding the implications of the treatment. In Quebec, the age is fourteen years and older, and parents have to be informed if the youth is admitted to hospital for more than twelve hours.

At the Children's & Women's Health Centre of British Columbia in Vancouver, health-care professionals say that children aged twelve and older are capable of deciding whether they want to pursue a recommended treatment. This policy grew out of the efforts of health professionals to deal with sexually transmitted diseases (STDs). If the matter is debatable, the case may go to the hospital's Ethics Committee.

Parents should have begun talking with their children at an early age about all aspects of bodily health so that nothing develops into a taboo subject between them. Single parents need to inform themselves about the health concerns of their opposite-sex child. Most kids want to talk to their parents about personal health issues that concern them; they just don't want to get a lecture. When it seems to you that your children are mature enough to handle a visit to the family doctor on their own, discuss with them whether they would like you to accompany them or to remain in the waiting room. Let them know that you respect their privacy, and that you'll understand if they want their discussion with the doctor to be private. You may still talk separately with the doctor about your own concerns after the examination.

Pap smears
A teenage girl by age eighteen or earlier if sexually active should include a Pap smear in her annual physical. This is a short and simple test to detect possible cancerous cells in the cervix. Because cells undergo a series of changes before they become cancerous, the analysis of the Pap smear will reveal any precancer cell changes. To ensure greater accuracy of test results, a woman should not douche, should not use birth control creams or feminine deodorants for 48 hours before the appointment, and should not have sexual intercourse for 24 hours before her physical.

Ensure your daughter understands how her doctor will obtain the sample of cervical cells for the test. She will insert the instrument called a speculum into her vagina to open it wide enough to touch the cervix with the tip of a cotton swab, transfer the sample to a glass slide, and send it to a laboratory to be analyzed for abnormalities.

Although Pap smears are not 100 per cent accurate, the procedure has greatly reduced the number of deaths from cervical cancer detected too late for treatment. When the Pap test results are positive, it means that abnormal cells are present 95 per cent of the time. If the results are positive, your doctor will want to discuss the implications of the cell changes and the necessary treatment. Abnormal cells on the cervix indicate not only cervical cancer but also infections such as herpes and human papilloma virus (Hpv).

Self-examinations
Some teens may want to establish a routine of monthly self-examinations for signs of problems. Although breast cancer is very rare among women under twenty, teenage girls who perform regular exams of their own breasts will become familiar with the exercise and the feel of a normal healthy breast. Your daughter should do this while sitting or standing, and use a circular, massaging motion with one hand over the breast and her other arm raised above her head. If she has any concerns, she should discuss them with her doctor.

Boys in their late teenage years might also learn to do a regular check for testicular cancer, which is very rare at this age. They should check each of their testicles individually for the presence of a lump, soreness, or tenderness, and discuss any concerns (abnormal lumps, discharge from the penis) with their doctor.

Excerpted from Understanding Your Teen: Ages 13 to 19 by Christine Langlois. Copyright 1999 by Telemedia Communications Inc. Excerpted, with permission by Ballantine Books. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.