Tuesday, September 27, 2011

Lack of Sleep and Risk Taking in Teens

We already know that when we don't get enough rest, we may not be at our best.  One study, however has shown that teens who do not get enough sleep may be prone to take more risks.  Here is the link
http://thechart.blogs.cnn.com/2011/09/27/sleep-deprived-teens-take-more-risks/

The research also discusses that teens who do not get enough sleep may have higher rates of participating in risky behaviors "such as smoking, drinking alcohol, being sexually active, using marijuana, lower physical activity, and feeling sad or helpless."

What they  were able to identify is that when teens had less than 8 hours of sleep, the teens associated with 10 of 11 risk behaviors.  These risk behaviors included: "drinking sodas with sugar, time spent exercising per week, TV watching time and non-school related computer use, cigarette, alcohol, and marijuana use, being currently sexually active, feeling sad or hopeless, fighting, and whether they had considered suicide during the past year."

Should we be concerned about our teen patient population's sleep patterns?  My argument is that yes, as a health care provider we should recognize that our patients may be participating in risky behaviors.  In practicing risky behaviors, these individuals may be more likely to become injured.  Why, you may ask?  Well, this may be the soccer player who dives to make a goal, or a football player who lowers their head to make a 'crushing' tackle on an opponent.  Perhaps we should be asking our patients, when we take their medical history what their sleep patterns are like and how many hours of sleep they get each night.  Through our queries, we may discover they are not getting enough rest.  Further probing questions may be needed in order to identify the reason or reasons.

I am not suggesting that all student-athletes who take risks on the field are sleep deprived.  What I am suggesting is that perhaps, in light of the literature, we ask our patients what their sleeping habits are.  This may assist us in providing better, quality care that is individualized for them.

Saturday, September 3, 2011

Remember Your Uninsured Patients

This story highlights the assumption that once a prescription is written, an individual has the ability to fill it.  In this case, a patient had a tooth that became infected.  They had gone to the emergency room as they did not have insurance.  What follows is a sad story whereby the patient did not have the funds to fill the scripts that were written - one for pain killers and one antibiotic.  They were able to pay for one script and opted for the pain medication.  I am sure had they realized the fatal choice they had made, they would have chosen to fill the antibiotics.  To read the story here is the link:http://abcnews.go.com/Health/insurance-24-year-dies-toothache/story?id=14438171

As athletic trainers, we too, may fall into the trap of making assumptions regarding our patients and their ability to follow through with the treatment plan we prescribe.  Can you think back to a time when a patient may have been suffering from foot pain you know is related to the type of shoe they were wearing and told them to buy a new pair of shoes that would support their arches better?   Has a patient ever broken their glasses and you had assumed they could simply replace them by buying another pair?  Or  have you ever suggested your patient merely needed a pair of orthotics to take away their back pain?  Did you ever consider they may not be able to follow through with your treatment plan due to financial difficulties?

We need to be sure that we get to know our patients and have a better understanding and appreciation of who they are, how they value the medical community and their ability to follow through with the care and treatment plan we create.  Given the economic times that we are living in, it seems rather imperative that we do not make assumptions regarding our patients financial situation.  Rather, we may need to consider that when we make a treatment plan, we also bring up an appropriate conversation in a confidential setting in which we discuss with our patient their ability to follow through with what we would like them to do.  Perhaps theirs is a hardship case whereby they will not be able to complete all areas of the treatment plan.  In that case, working together both health care provider and patient can create an alternative plan that is 'do-able' to both.