adolescent stories

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    MD97IBCLC2B2010MD97IBCLC2B2010
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    We were talking about parental consent on the dabate page- I started to think of lots of stories from residency and work- like a teenage girl who watered down her urine so we wouldn’t get a positive- she was admitted for vommiting everyday for a week straight- I asked the residents in the morning if they did a preg. test- yes, neg- I asked if they did blood- no- she said she never had sex- plus she was very traditional- dressed in complete (religious- won’t say which- garb) well- blood was pos- still didn’t want to tell parents- whats this kid thinking? didn’t want abortion either- so they’ll find out eventually- BTW heard a story of a girl dressed traditionally from another religion came with abdominal pain neither doc nor mom suspected anything so went for u/s- showed healthy fetus about 7 months! Sadly some of these girls were probably taken advantege of by someone they knew, and maybe don’t even really know what you mean by the word “sex” any way on to the stories…It gets very sticky- I had a teenager who came with her mom to the apt, she had told her mom that she had these painful “lesions” on her vaginal area, and her mom even saw them, I talked to her alone, and it turned out that yes she was sexually active, and no she didn’t want her mom to know! So, this looked like herpes- what do I do? Mom knows something is there and asks me what it is. Legally, I can’t tell her about daughters activities- I can however encourage daughter to tell her mom herself! So, I say that they are a viral infection, like a cold sore (not lying) and give Rx – what to do? daughter doesn’t have means to get Rx filled with out mom? This is problem with private pts- Planned Parenthood is only free for medicaid pts- I know- I called them! How about how parents get the explanation of benefits? anyway- back to story- mom is looking at me and asks something- can’t remember exactly wanting me to tell her what we discussed- I say whatever we discussed is confidential- mom starts crying! Now that I have my own practice I can set rules up front- this was the other guys pts- very ackward- other pts that I very appropriately asked with parent out of the room if they ever had any kind of sex- seemed fine with the Q. (hadn’t but you never know- Amy Grossman came from this town) later they must have told their mom who got very insulted that I would even think to ask such a Q. to their precious darling- told my boss, then he yelled at me!!!! BTW he had missed this Herpes case a fews days before b/c he HADN’T asked- she said burning on urination and he prescribed antibiotic for UTI even though the urine dip was neg! Once I had a very young girl in the ER for abd pain and incidently she had lesbian mothers- I always ask the big Q. with the parents out of the room- so kid wont be intim. to lie- she emphatically said NO I was very suspicious of a pelvic prob for whatever reason (this goes back to 1997)but believed her b/c she looked absolutely inocent and so I ran around for a long time searching for a virginal speculum- when I finally found one- and came back to the room- she was with her mothers crying- she started to feel nervous so she told them- after all that work I wouldn’t have needed the small after all ! (just kidding) Here’s a few more funny stories about adolescents- never ask “Are you sexually active?” They might think- no I just lie there- or that you mean promiscuous- they are very concrete- I once had a girl with fever- I asked if she ever had sex- no- later I asked if she was ever pregnant- no- then I asked if she ever had an abortion or misscarriage- YES! 2 wks ago she had an abortion! can you believe- what if I didn’t ask! first she lied- then she thought – she never was fully pregnant! I asked a boy once who was admitted for mono so bad he couldn’t swallow- the next morning I got yelled at in morning report- the attending said “How did you ask?” I said that I asked if he ever had sex? He said NO You must say “Has your penis ever touched a mouth anus or vagina!” I also had a boy in the ER once tell me that the first time he ever had sex with a women was when he was 9 this kid was a skinny 14 y/o is that possible? I had another girl in the ER who said she was lesbian and had multiple times PID from infection under partners nails!-

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