Intro4u2u

Guillain-Barré (pronounced: ghee-yan bah-ray) syndrome is a rare medical condition that affects the nerves outside a person’s brain and spinal cord. Although the condition can be frightening because it often causes people to have some type of paralysis, Guillain-Barré syndrome is very rare: It only affects one or two people in every 100,000. Most of the people who do get Guillain-Barré syndrome recover and are able to return to their normal lives and activities.
What Is Guillain-Barré Syndrome?

Experts believe that Guillain-Barré syndrome (GBS) is an autoimmune disorder. Autoimmune disorders happen when the immune system, which usually protects a person by attacking any invading organisms that may harm the body, mistakes the body’s own cells for foreign material and begins to attack them. Guillain-Barré can affect people of any age, but it becomes more common with increasing age.

The nerves just outside the brain and spinal cord are called the peripheral nerves. They transmit signals to our muscles telling them to move. When GBS causes these nerves to be temporarily damaged, the signals are interrupted. As a result, a person with GBS may become unable to walk, talk, or even make basic movements like lifting an arm.

GBS is rare, but it can get serious: If the muscles in a person’s chest are affected, for example, it may interfere with the ability to breathe and require the person to use a respirator for a while. The good news is that the paralysis that goes with GBS is usually temporary.
What Causes It?

No one knows yet what causes GBS or why it affects some people and not others. GBS is called a syndrome because, like irritable bowel syndrome or other syndromes, doctors diagnose it based on a collection of symptoms.

Although no one knows what causes GBS, scientists do have some theories about the syndrome and why it surfaces in the body. For example, doctors report that about half of all GBS cases seem to occur after a viral or bacterial infection like a sore throat or diarrhea. Some experts believe the infection somehow changes the cells of the nervous system so that they don’t work properly. In about 5% or 10% of all cases of GBS, the person had minor surgery or another medical procedure before the GBS symptoms occurred.

There’s no reason to worry that a typical sore throat or a medical test is going to trigger an autoimmune response and lead to GBS, though. Colds, sore throats, and the occasional bout of diarrhea are fairly predictable parts of everyone’s lives; getting GBS, thankfully, is not.
What Are the Signs and Symptoms?

When GBS does strike, though, it can progress quickly, with the most severe symptoms taking place as soon as 2 weeks after the first signs appear. The first symptoms, such as weakness or tingling in the legs, can show up within a day. These sensations can then spread to the arms and upper body, and the person may feel increasingly tired. Sometimes, the person with GBS also begins to lose his or her reflexes (for example, the person may not have the knee jerk reaction that happens when a doctor tests reflexes).

In the most severe cases of Guillain-Barré syndrome, the symptoms continue to increase until certain muscles become completely paralyzed. At this stage, the paralysis can interfere with breathing and heart functions, so a person usually has to go to the hospital. It seems frightening, but even at this stage doctors expect most people to recover completely.
How Is Guillain-Barré Syndrome Diagnosed?

As with other medical conditions, doctors rely on a person’s medical history and a physical exam to diagnose GBS. If a doctor suspects GBS, he or she will ask some detailed questions, such as whether the symptoms appear on both sides of the body (which is typical with GBS), whether the symptoms happened quickly and got progressively worse, and whether a person has noticed any loss of muscle tone and reflexes. Doctors may also do some tests to confirm that a patient has GBS.
How Is It Treated?

Once someone is diagnosed with GBS, he or she is usually hospitalized so doctors and nurses can monitor the person’s body functions. Because the way GBS progresses can be unpredictable, most GBS patients are cared for in an intensive care unit (ICU). This allows doctors and nurses to keep an eye on vital signs, such as blood pressure or heart rate, and to step in and keep the person’s body functioning until the nervous system can take over again.

In the hospital, a person with GBS may also receive treatment to help speed recovery. One treatment for GBS is plasmapheresis (pronounced: plaz-muh-fuh-ree-sus), where blood is drawn from the body and then processed so that the red and white blood cells are separated from the plasma, the liquid portion of the blood. Then the red and white cells are returned to the body without the plasma. Scientists think that this process helps remove some of the harmful antibodies and seems to reduce the severity and length of GBS symptoms. Another treatment for GBS is immunoglobulin therapy. This involves using healthy antibodies (immunoglobulins) from blood donors to help block the harmful antibodies in the body of the person with GBS.

How long someone with GBS has to stay in the hospital depends on how serious the condition is. Some people’s hospital stays last only a few days; other people are hospitalized for several weeks.
Recovering From Guillain-Barré Syndrome

Even after a person returns home from the hospital, it may take a while before he or she feels as good as new. Some people with GBS may need to be in a wheelchair or use a walker until they regain their strength. Many will need physical therapy to get their bodies moving properly again. Recovering from GBS takes patience: About one third of the people who have it feel some weakness as long as 3 years after having the condition. But the good news is most people do eventually recover from even the most severe cases of GBS.

GBS can be debilitating both physically and mentally. Because it strikes so suddenly and without warning, it can be difficult to deal with and adjust to the recovery period. Doctors may recommend that a person see a counselor or therapist or join a support group as a way to talk through the many confusing feelings that can go with having the syndrome. People recovering from GBS usually have tons of questions, such as “Why me?” and “Will it come back?”

GBS can really impact a person’s lifestyle, and it may take a while before people are able to participate fully in their favorite sports or activities. This can feel particularly hard for teens who are usually very active.

For people who have gone through the ordeal of a slow recovery, it’s natural to worry that the GBS might come back. Only about 10% of the people who have GBS get it again, though. One reason people worry about the syndrome repeating itself is because people recovering from GBS often notice symptoms that are similar to those they reported when they first had GBS, such as tingling in the hands or feet. In most cases, though, these symptoms are not a sign that the GBS is recurring. They’re more likely associated with some lingering nerve trouble after the initial bout of GBS.

As with any medical condition, if you’ve had GBS and you notice some of the same symptoms coming back, talk to your doctor.

It may take a while before a person who has had GBS is ready to get back to sports and other physical activity, but there’s a lot that medical experts can do to help make the road to recovery smoother and faster.

Lots of teens think that arthritis is something only their grandparents get, but it’s actually a condition that affects people of all ages. Read on to find out about juvenile rheumatoid arthritis, a specific kind of arthritis that usually occurs in people under age 17.
What Is Juvenile Rheumatoid Arthritis?

The term rheumatoid (pronounced: roo-mah-toid) refers to diseases that affect the muscles, tendons, joints, bones, or nerves. Arthritis is an inflammation (which means that it’s characterized by heat, swelling, and pain) of the synovial (pronounced: suh-no-vee-ul) membrane (the lining of the joints, such as the knees or knuckles). When the synovium becomes inflamed, fluid is produced, and the joints can become stiff, swollen, painful, and warm to the touch.

About 285,000 kids and teens in the United States have some form of arthritis. Juvenile rheumatoid arthritis (JRA) is the most common kind of arthritis among kids and teens. It is usually diagnosed between the ages of 2 and 16.

Symptoms of JRA can come and go many times over the course of the condition. Although JRA mostly affects the joints and surrounding tissues, it can also affect other organs, like the eyes, liver, heart, and lungs. JRA sometimes causes only minor symptoms and problems, but in some cases it can cause serious joint damage or limit growth.

Kids and teens with JRA may have pain and stiffness that can change from day to day or from morning to afternoon. Flares are periods of time when the condition becomes more active and symptoms worsen.

JRA is a chronic condition, meaning it usually lasts for a relatively long period of time (at least 6 weeks or more) and can last for months and years. Sometimes the signs and symptoms just go away on their own, which is called remission. Remission may last for months, years, or for a person’s lifetime. In fact, many teens with JRA eventually enter full remission with little or no permanent joint damage.

There are three major types of JRA:

* Pauciarticular (pronounced: paw-see-are-tick-yoo-lur) JRA. The prefix pauci means “few,” and articular means “associated with a joint or joints.” This kind of JRA involves four or fewer joints and usually affects larger joints such as the knee. About half the kids and teens with JRA have the pauciarticular type. It generally begins in young children between infancy and age 5. Sometimes iridocyclitis (pronounced: ire-ih-doe-si-kleye-tis), an inflammation in front of the eye near the iris (the colored part of the eye) also occurs. For this reason, eye exams are important, even when the arthritis is not active.
* Polyarticular (pronounced: pa-lee-are-tick-yoo-lur) JRA. The prefix poly means “many.” Polyarticular JRA affects five or more joints, usually the small ones in the hand and fingers. It also can affect the knees, hips, ankles, feet, and neck. Polyarticular JRA may have symmetric involvement of joints, meaning it affects the same joint on each side of the body. Involved joints are usually swollen. Symptoms may include a low-grade fever, tiredness, poor appetite, and rheumatoid nodules (bumps) on the affected joints. This form of JRA can lead to long-term joint problems and frequently requires treatment with strong medications.
* Systemic (pronounced: sis-teh-mick) JRA. Systemic JRA can affect several parts of the body, including internal organs and joints. This is the least common form of JRA. The first signs of systemic JRA are usually high fevers, chills, and a rash. Arthritis may begin with the fevers or not until weeks or months later. Fever usually occurs late in the afternoon or evening and can go up to 103 degrees Fahrenheit (39.4 degrees Celsius) or higher and return to normal within a few hours. The person may feel very sick when his or her temperature is high but fine during the rest of the day. About half of the kids and teens with systemic JRA recover completely, whereas the other half experience joint symptoms, such as pain and stiffness, which may persist for many years. In some cases the effects of the disease, such as decreased movement, stiffness, and pain in the joints, may last into adulthood.

Why Do Teens Get Juvenile Rheumatoid Arthritis?

Although scientists don’t know the exact causes of JRA yet, much research is being done on JRA and other forms of arthritis. They do know that JRA involves abnormalities of the immune system, which defends our bodies against germs, such as bacteria and viruses. When the immune system isn’t working properly — as in a condition like JRA, for example — it has difficulty telling the difference between germs and the body’s own tissues. This confusion causes the immune system to mount an attack and release chemicals that actually damage the body’s own healthy tissues. This results in the type of inflammation that causes the symptoms of JRA.

It is also known that JRA is not contagious. You can’t catch it from someone else or pass it along to another person the way you might a cold or other infection.
What Do Doctors Do?

JRA can be difficult to diagnose. All forms of this type of arthritis involve inflammation, but they also cause a variety of symptoms and require different kinds of treatment. No single test can diagnose all the forms of JRA and other types of arthritis. The doctor will do a complete physical examination to detect joint swelling, eye problems, and rashes. He or she may do blood tests, X-rays, and, in some cases, may use a needle to take a sample of synovial (joint) fluid for examination. The doctor may need to follow the course and symptoms of a person with JRA for several months to determine the particular type the person has. The doctor will also take your medical history by asking you about any concerns and symptoms you have, your past health, your family’s health, any medications you’re taking, any allergies you may have, and other issues.

Certain infections, such as parvovirus infection and Lyme disease, have similar symptoms and may be mistaken for JRA. These possibilities must be ruled out before a diagnosis of JRA can be confirmed.
How Is Juvenile Rheumatoid Arthritis Treated?

When JRA is diagnosed early and treated appropriately, it can usually be managed effectively and damage to joints can be limited or prevented. Medical care is aimed at easing the symptoms of JRA and may include medications to reduce inflammation (like ibuprofen). Newer medications, such as methotrexate and etanercept, can keep the immune system in check and control the disease far better than was possible 10 or 15 years ago. Range-of-motion physical therapy (exercises that improve flexibility), and the use of heat can also help control symptoms. Surgery is very rarely needed to repair damaged joints.
Living With Juvenile Rheumatoid Arthritis

If you have JRA, some mornings it may be hard to get out of bed. Maybe you reach for your sock on the floor, and you can’t straighten your elbow or bend your knees. Or you touch your shoulder, and it feels tender, warm, and painful. Periods of inactivity, like sleeping for 8 hours, can be followed by stiffness.

It may be tempting to roll back into bed and sleep the day away. But this can make things worse. Even though you may feel lousy sometimes, you can help yourself feel better. Just as runners, bodybuilders, and other athletes do stretching exercises to warm up, you can use gentle massaging and stretching to help soothe the muscles and ligaments around your sore joints. Once you’re up and moving, the discomfort usually lessens. Exercise can help keep full motion in your joints and strengthen your muscles and bones. A physical therapist can help you plan an effective exercise program to do at home.

Proper nutrition can improve your overall health, and a registered dietitian can help you to understand the basics of a healthy diet. For example, you might feel sick and unable to eat as much when you experience a flare. A dietitian can assist you in selecting foods that have a higher nutritional value to compensate for a poor appetite.

A positive mental outlook is just as important as exercise and a healthy diet. If you feel depressed or angry sometimes, talk to someone who can support you. Tell your parents, your doctor, or a friend about how you feel. Some teens with JRA become more comfortable with the condition by asking questions and learning as much as possible. It may also help to do simple things that we often take for granted. For example, each day try to schedule something to do that you enjoy and that makes you happy.

Most teens with JRA do the same stuff as other teens — they go to regular schools, help around the house, hang out with their friends, and are active physically, academically, and socially. Remember, your doctor and other medical professionals are there to support you and can help you manage the condition so that it has the least possible impact on your life

Chantelle was having a rough morning. Her hands were so stiff that she could barely dial the combination on her locker. Then she couldn’t move her fingers well enough to play her clarinet. It seemed that ever since marching band practice had started in the early summer, her hands and feet felt sore in the mornings. She was also tired all the time, and no matter how much she rested, she still felt sleepy and achy all over.

Chantelle told her doctor about her achy hands and feet and how she felt tired all the time. The doctor sent her for blood tests. A few days later, the doctor called and told Chantelle’s dad that she might have lupus.
What Is Lupus?

Lupus (pronounced: loo-pus) is a disease that involves the immune system and affects about 1.5 million Americans; nearly 90% of those diagnosed with the disease are female. Normally, a person’s immune system works by producing immunity cells and antibodies, special substances that fight germs and infections. But when a person has lupus, his or her immune system goes into overdrive and can’t tell the difference between some of the body’s normal, healthy cells and germs that can cause infection. So the immune system responds by making autoantibodies that attack the body’s normal cells.

There are three types of lupus:

Systemic Lupus Erythematosus (pronounced: er-uh-thee-muh-toe-sus)
Also called SLE, this is the type of lupus that most people mean when they talk about the disease. It was given its name by a 19th century French doctor who thought that the facial rash of some people with lupus looked like the bite or scratch of a wolf (”lupus” is Latin for wolf and “erythematosus” is Latin for red).

SLE is the most serious form of lupus. Like Chantelle, about 15% of the people who have SLE first start to feel sick when they are teens. SLE can affect the skin, joints, and tendons. It may also affect organs like the brain, heart, lungs, and kidneys.
Discoid (pronounced: dis-koyd) Lupus

This type of lupus is a skin disease that causes a rash on the face, neck, scalp, and ears. It is a much more rare form of lupus than SLE, although about 10% of people with discoid lupus will develop a mild form of SLE. It doesn’t affect other body organs the way that SLE can. The rash of discoid lupus can cause scarring, though.
Drug-Induced Lupus

This type of lupus is caused by a reaction to certain kinds of medicines. For example, some types of antiseizure medicines and acne medicines can cause this kind of lupus in teens. Drug-induced lupus is similar to SLE in the ways it affects the body, but once a person stops taking the medicine, the symptoms usually go away.
What Causes Lupus?

No one really knows what causes lupus. Researchers think that some people may be more likely to get it due to things that are out of their control, like:

* gender. Many more women get lupus than men; there are 10 women to every one man with lupus.
* estrogen. This female hormone may be a factor in lupus - almost all women who get lupus are of childbearing age.
* race/ethnicity. Lupus occurs more often in African-American, Asian-American, Latin-American, and Native-American women than in non-Hispanic Caucasian women.
* family history/genetics. About 10% of people with lupus have a family member with lupus.
* major stress or infection. If people have the genetic tendency to get lupus, extreme stress or an infection may trigger the disease - but the blueprint for lupus has to already be there. One thing researchers know about lupus is that it is not contagious. You can’t catch any of the three types of lupus from another person. And although lupus involves the immune system, it is not the same as other diseases that involve the immune system, like AIDS.

What Are the Symptoms of Lupus and How Is It Diagnosed?

Lupus can be hard to diagnose because its symptoms can vary from one person to the next. The symptoms can also make lupus look like certain other diseases. For example, like Chantelle, people with lupus may feel weak and fatigued. They may have muscle aches, loss of appetite, swollen glands, and hair loss. Sometimes they have abdominal pain, nausea, diarrhea, and vomiting.

If a doctor thinks that a patient might have lupus, the doctor may perform certain blood tests. If lupus is suspected, the doctor will probably send the person to a rheumatologist (pronounced: roo-muh-tah-luh-jist). Rheumatologists are doctors who have special training in diagnosing and treating autoimmune diseases like lupus.

Because signs and symptoms of SLE can be so varied, there are 11 specific signs a rheumatologist will also look for:

* malar rash. A malar (pronounced: may-lur) rash appears across the nose and cheeks in the shape of a butterfly.
* discoid rash. This rash features round, red, scaly patches that can appear on the face, arms, scalp, or ears.
* photosensitivity. This means sensitivity to ultraviolet rays, like the ones that come from the sun or from fluorescent lights. Most people with SLE are photosensitive and find that the sun worsens their lupus.
* ulcers in the nose or mouth. These usually don’t hurt and many people with SLE don’t even know they are there.
* arthritis. This makes joints hurt, especially in hands and feet. Unlike the kind of arthritis that older people sometimes get, this arthritis doesn’t damage the bones. Most people with SLE have some degree of arthritis.
* serositis (pronounced: sir-o-syte-us). This is the collection of fluid near the linings covering the heart, lungs, or abdomen.
* kidney problems. These can be mild or severe. Most people with SLE will have kidney problems, but only about half of them will have permanent kidney damage.
* neurologic problems. This refers to problems with the brain and nervous system, like seizures.
* blood problems. SLE can cause a lower than normal number of red blood cells (anemia), white blood cells, or platelets.
* immune system problems. Blood tests may show that the immune system isn’t functioning properly.
* positive ANA test. This is a blood test that shows a certain type of antibody. About 95% of people with SLE have a positive ANA test.

If a person has four or more of these signs or symptoms, it is likely that he or she has SLE. Most patients don’t develop all 11 of them

If you’re like most teens you’re probably pretty active and aren’t always really careful, so you end up getting bruises and cuts. Sometimes a bad cut that gets infected can lead to even worse things, like a bone infection. The medical term for a bone infection is osteomyelitis.
What Is Osteomyelitis?

Osteomyelitis (pronounced: os-tee-oh-my-uh-lie-tus) is a bone infection often caused by a bacteria called Staphylococcus aureus (pronounced: sta-fuh-low-kah-kus are-ee-us). Depending on how the bone becomes infected and the age of the person, other types of bacteria can cause it, too. In kids and teens, osteomyelitis usually affects the long bones of the arms and legs.

Bacteria can infect bones in a number of ways. Bacteria can travel into the bone through the bloodstream from other infected areas in the body. This is called hematogenous (pronounced: heh-meh-tah-gen-us) (hema refers to the blood) osteomyelitis, and is the most common way that people get bone infections.

Another way is by direct infection, when bacteria enter the body’s tissues through a wound and travel to the bone (like after an injury or trauma). Open fractures - breaks in the bone with the skin also open - are the injuries that most often develop osteomyelitis.

A bone also can become infected when the blood supply to that area of the bone is disrupted. This can happen in older people with atherosclerosis (pronounced: ath-uh-row-skluh-row-sis), which is a narrowing of the blood vessels, or in association with diabetes. Most infections of this kind occur in the toes or feet.
What Are the Signs and Symptoms?

People with osteomyelitis often feel severe pain in the infected bone. They may have fever and chills, feel tired or nauseated, or have a general feeling of not being well. The skin above the infected bone may be sore, red, and swollen. It’s sometimes difficult to diagnose osteomyelitis in infants and young children because they don’t always show pain or specific symptoms in the area of the infection. Also, older people with diabetes or another problem with their blood vessels don’t always show signs of fever or pain. For teenagers, it’s frequently a preceding accident or trauma that leads to the infection.

If the osteomyelitis developed after an open wound, the injured area may begin to hurt again after initially seeming to get better.
What Do Doctors Do?

If you have symptoms such as fever and bone pain, you should see your doctor. It’s a good idea to go as soon as possible because osteomyelitis can quickly get worse and become much more difficult to get rid of.

The doctor probably will do a physical examination and ask questions about any recent injuries to the area where you have pain. It’s likely, too, that the doctor will perform blood tests to see whether your white blood cell count is elevated (a sign of infection) and to look for signs of possible inflammation or infection in the body. The doctor will take your medical history by asking about any concerns and symptoms you have, your past health, your family’s health, any medications you’re taking, any allergies you may have, and other issues.

Often, the doctor will take a bone X-ray, which may show whether an infection in the bone is present. However, X-rays are often negative if someone has had osteomyelitis for only a short while. If the doctor strongly suspects osteomyelitis, he or she may suggest a test called a bone scan that provides a more detailed look at the bone. An MRI (magnetic resonance imaging) can produce much more detailed images than X-rays because of its ability to separate different types of soft tissues. MRIs not only can diagnose osteomyelitis, but also can help establish how long the bone has been infected.

Treatment of osteomyelitis depends on the severity of the infection and whether it is acute (recent) or chronic (has been present for a longer period of time). The doctor may use a needle to remove a bacteria sample from the bone to help identify the bacteria responsible for the infection. This is called needle aspiration. The doctor will then be able to choose the correct antibiotic to treat that particular infection.

In some cases, osteomyelitis will become severe and a cavity or hole will develop in the bone. Pus - a large collection of bacteria and white blood cells - may have formed in this cavity. If this happens, the doctor may perform a surgical procedure to help drain the pus out of the bone so that the bone can heal properly.

Osteomyelitis can be difficult to treat. After being diagnosed with osteomyelitis, you may be admitted to the hospital for a short stay so that intravenous (IV) antibiotics can be given (directly into a vein) to fight the infection. Once the condition improves, you will be allowed to go home but you may continue to need IV or oral (taken by mouth) antibiotics at home for several more weeks.

Most teens recover completely from osteomyelitis.
Can I Prevent Myself From Getting Osteomyelitis?

The easiest way to prevent yourself from getting osteomyelitis is to practice good hygiene. If you get a cut or a wound - especially a deep wound - make sure you clean it thoroughly. Wash it with soap and water, holding it under running water for at least 5 minutes to flush it out.

To keep the wound clean afterward, you should cover it with sterile gauze or a clean cloth. You can apply an over-the-counter antibiotic cream, too, but the most important thing is to keep the injury clean. Be sure to see your doctor, especially if you have a wound that’s not healing or if you’re continuing to have pain

Michael started running track freshman year, gradually working up to longer and longer distances. Now a senior, he recently took up trail running and dreams of running the Marine Corps Marathon someday.

Michael’s love for his chosen sport made it really hard when he started having some shin pain during his sophomore year. His doctor told him to take a break from running for 6 weeks because he had developed a stress fracture. But after a few weeks of rest, Michael went back to running as if nothing had happened and he hasn’t had any problems since.
What Are Repetitive Stress Injuries?

Repetitive stress injuries (RSIs) are injuries that happen when too much stress is placed on a part of the body, resulting in inflammation (pain and swelling), muscle strain, or tissue damage. This stress generally occurs from repeating the same movements over and over again.

RSIs are common work-related injuries, often affecting people who spend a lot of time using computer keyboards.

While most common in adults, RSIs are becoming more prevalent in teens because they spend more time than ever using computers. Playing sports like tennis that involve repetitive motions can also lead to RSIs. You may hear sports-related RSIs referred to as overuse injuries. Teens who spend a lot of time playing musical instruments or video games are also at risk for RSIs.

In general, RSIs include more than 100 different kinds of injuries and illnesses resulting from repetitive wear and tear on the body. These injuries vary from person to person in type and severity.

In teens, overuse injuries most often occur at growth plates (areas at the ends of bones where bone cells multiply rapidly, making bones longer as someone grows). Areas most affected by RSIs are the elbows, shoulders, knees, and heels.
What Causes Repetitive Stress Injuries?

Most RSI conditions found in teens are linked to the stress of repetitive motions at the computer or in sports. When stress occurs repeatedly over time, the body’s joints don’t have the chance to recover, and the joints and surrounding tendons and muscles become irritated and inflamed.

Certain jobs that involve repetitive tasks — such as scanning items as a supermarket checker or carrying heavy trays as a waiter — can lead to RSIs. Sometimes, playing musical instruments can cause problems from overuse of certain hand or arm movements. Any repetitive movement can cause an injury — even text messaging!

Using improper equipment while playing sports is another important factor in RSIs. For example, running in athletic shoes that don’t provide enough support can lead to shin splits and foot and ankle problems. Improperly fitted tennis rackets can contribute to a condition called tennis elbow.

Teens may be susceptible to RSIs because of the significant physical growth that occurs in the teen years. The growth spurt (the rapid growth period during puberty) can create extra tightness and tension in muscles and tendons, making teens more prone to injury.

Nutritional factors also come into play in RSIs. Proper nutrition is essential for developing and maintaining strong muscles and bones — and to keep up the energy levels needed to play sports and perform other physical activities well.
What Happens When Teens Have Repetitive Stress Injuries?

Symptoms of RSIs include:

* tingling, numbness, or pain in the affected area
* stiffness or soreness in the neck or back
* feelings of weakness or fatigue in the hands or arms
* popping or clicking sensation

If you notice any of these warning signs of RSIs, make an appointment to see a doctor. Even if your symptoms seem to come and go, don’t ignore them or they may lead to more serious problems.

Without treatment, RSIs can become more severe and prevent you from doing simple everyday tasks and participating in sports, music, and other favorite activities.
What Kinds of Repetitive Stress Injuries Can Teens Get?

RSIs that can develop in teens include:

Bursitis. Inflammation of the bursa, which are fluid-filled sacs that act as cushions for the joints, is known as bursitis (pronounced: bur-sye-tis). Signs of bursitis include pain and swelling. It is associated with frequent overhead reaching, carrying overloaded backpacks, and overusing certain joints during sports, such as the knee or shoulder.

Carpal tunnel syndrome. In carpal tunnel syndrome, swelling occurs inside a narrow “tunnel” formed by bone and ligament in the wrist. This tunnel surrounds nerves that conduct sensory and motor impulses to and from the hand, causing pain, tingling, numbness, and weakness. Carpal tunnel syndrome is caused by excessive bending of the wrist during typing, playing video games (using joysticks), and other activities. It is rare in teens and is more common in adults, especially those in computer-related jobs.

Epicondylitis. This condition is characterized by pain and swelling at the point where the bones join at the elbow. Epicondylitis (pronounced: eh-pih-kon-dih-lye-tis) is nicknamed “tennis elbow” because it frequently occurs in tennis players.

Osgood-Schlatter disease. This is a common cause of knee pain in teens, especially teen athletes who are undergoing a growth spurt. Frequent use and physical stress (such as running long distances) can cause inflammation at the area where the tendon from the kneecap attaches to the shinbone.

Patellar femoral syndrome. This is a softening or breaking down of kneecap cartilage. Squatting, kneeling, and climbing stairs and hills can aggravate pain around the knee.

Shin splints. This term refers to pain along the shin or front of the lower leg. Shin splints are commonly found in runners and are usually harmless, although they can be quite painful. They can be difficult to tell apart from stress fractures.

Stress fractures. Stress fractures are tiny cracks in the bone’s surface caused by rhythmic, repetitive overloading. These injuries can occur when a bone comes under repeated stress from running, marching, walking, or jumping, or from stress on the body like when a person changes running surfaces or runs in worn-out sneakers.

Tendonitis. In tendonitis, tearing and inflammation occur in the tendons, rope-like bands of tissue that connect muscles to bones. Tendonitis is associated with repetitive overstretching of tendons from overuse of certain muscles.
Preventing Repetitive Stress Injuries
Preventing Computer-Related Injuries

To prevent injuries from computer use, make sure your computer equipment and furniture fit you properly and that you use correct typing and sitting positions. If your parents are shopping for new computer furniture, suggest that they buy pieces that can be adjusted for each family member.

Here are some tips:

* Make sure the top of your computer screen is aligned with your forehead.
* Sit up straight with your back touching the back of your seat. Chairs that provide extra support, especially lumbar (lower back) support are helpful. Avoid slouching over your keyboard or tensing your shoulders, which can place unnecessary stress on your neck, back, and spine.
* Let your legs rest comfortably with your feet flat on the floor or on a footrest. (To test whether your legs are in a good position, try placing a pencil on your knee — the pencil should roll toward your waist, not off of your knee.)
* Use a light touch when typing. Place the keyboard close to you so that you don’t have to reach for it.
* Fingers and wrists should remain level while typing. Try a wrist rest for extra support. Your wrists and forearms should be at a 90-degree angle to the upper part of your arms. Elbows should be placed close to the side of the body to prevent bending the wrists side to side.
* It’s easy to lose track of time when you’re surfing the Internet or immersed in a homework assignment. Be sure to take breaks (to stretch or walk around) about every 30 minutes — even if you don’t feel tired or feel any pain. (If you lose track of time, use a timer so you know when you’re due for a break.)
* Try an ergonomic (”ergonomic” means specially designed for comfort) keyboard that has a curved design, and use a trackball instead of a mouse.

Preventing Sports-Related Injuries

Begin any sports season with a full physical exam from your doctor so that any problems or concerns can be addressed before you begin workouts and competitions. More tips:

* Always warm up and cool down with appropriate stretching exercises before and after playing.
* Wear the proper clothing and equipment for your sport. For example, tennis players should be fitted for rackets that allow for a good grip on the handle. Wear appropriate safety gear for your sport, such as kneepads and wrist supports.
* Drink plenty of water before, during, and after your workouts. Listen to your body and rest when you feel tired.
* Vary your day-to-day activities. Alternate distance running with bicycling or swimming, for example.
* If you are experiencing symptoms such as pain, swelling, numbness, or stiffness while playing your sport, stop playing right away and see your doctor as soon as possible.

What Do Doctors Do?

The sooner an RSI is diagnosed, the sooner your body can heal, so be sure to see your doctor if you have symptoms.

The doctor will try to assess how the injury occurred and what motions cause pain. Your doctor may perform X-rays, blood tests, or other tests to make sure there are no other health problems. In addition to doing a physical examination, the doctor may ask you about any concerns and symptoms you have, your past health, your family’s health, any medications you’re taking, any allergies you may have, and other issues. This is called the medical history.

If you are diagnosed with an RSI, resting the affected area is the key to getting better. Your doctor may recommend that you take anti-inflammatory medication (such as ibuprofen) for a period of time. Ice packs are sometimes recommended to reduce pain and swelling.

After the swelling and pain have gone away, your doctor may suggest a rehabilitation program with a physical therapist to exercise your muscles and prevent loss of joint movement.
Taking Care of Yourself

Prevention is the best medicine when it comes to RSIs. Overall flexibility and strength can help to prevent RSIs, so exercise regularly and stay active (remembering warm-ups, cool-downs, and stretching, of course!).

To avoid overusing muscles and joints, be sensible about the amount of time you spend doing any repeated motions. If an activity is repetitive, take breaks and do something different every 30 minutes or so

Every person’s spine curves. A certain amount of curvature is necessary for people to balance, move, and walk properly. But three people out of 100 have a condition that causes the spine to curve too much in the wrong direction. This condition is called scoliosis (pronounced sko-lee-o-sus). The name comes from the Greek word “skoliosis,” which means curvature.
What Is Scoliosis?

Scoliosis is sort of a medical mystery - no one knows what causes the most common form of scoliosis, idiopathic scoliosis. (Idiopathic is a medical term that means it’s not known what caused the condition or disease.) The condition can be hereditary, so a person who has scoliosis may have family members who have it. Girls are much more prone to developing severe cases of spinal curvature than boys are: Teenage girls over the age of 9 are five times more likely to be diagnosed with the condition than boys of the same age.

Xray of curved spine

Many times, a person with scoliosis has been developing the condition since childhood. But because scoliosis can develop very gradually, in most cases it isn’t diagnosed until a person is between the ages of 10 and 14. In scoliosis, the spine becomes abnormally curved from side to side into an “S” shape. When the curve gets severe, it can be visible and cause discomfort. If the curve gets really severe, it can even affect a person’s breathing and heart function and can lead to damage in the joints of the spine and pain in adulthood.
How Is Scoliosis Diagnosed?

Some teens have visible signs of scoliosis. Sometimes a curvature of the spine is obvious or one shoulder blade is noticeably higher than the other one. Other times, though, it’s not so obvious. And because scoliosis doesn’t hurt or happen suddenly, it’s not always easy to diagnose.

Some schools in the United States test for scoliosis. But the most accurate diagnosis is done by a doctor. Doctors routinely check teens for scoliosis during regular physical exams.
What Do Doctors Do?

After examining you closely, the doctor will decide if further treatment is needed. If he or she determines the curve isn’t a problem, you may not need any treatment - just regular checkups to make sure the curve doesn’t become larger. If the doctor wants to get a clearer view of your spine, he or she may order X-rays. If the doctor’s exam or X-rays show a significant curvature, you’ll be referred to an orthopedist.

Orthopedists, also known as orthopedic surgeons, are doctors who have had specialty training in the way the skeletal system functions and what can go wrong. They are skilled in making decisions about how to treat conditions like scoliosis. The orthopedist will examine you and study X-rays of your spine.

You may hear the orthopedist mention the Cobb angle. The Cobb angle is a measure of the curvature of the spine in degrees, and the number of degrees helps the doctor decide what type of treatment is necessary. A scoliosis curve of 10 to 15 degrees usually means that nothing needs to be done, except for regular checkups until pubertal maturation and growth are complete (the curvature of the spine usually doesn’t get worse after that point). If the curve is 20 to 40 degrees, the orthopedist will generally suggest a back brace. A Cobb angle of 40 or 50 degrees or more may mean that surgery is necessary.
Treating Scoliosis

About one in five teenagers with scoliosis needs to wear a back brace, and luckily, these braces are becoming better and better all the time. Teenagers who had scoliosis about a hundred years ago didn’t have very comfortable options. In the beginning, patients were strapped to racks and their bodies were pulled every which way. Later, metal jackets were worn in an effort to straighten the curve, but these weighed about 30 pounds apiece. Eventually, simpler back braces were invented, but they still had to be worn almost all the time.

Today’s braces are better still: They do not always need to be worn full time. Braces are worn by about 20% of kids with scoliosis, and most kids only need to wear them for 18 to 20 hours a day. Many of them are constructed of lightweight materials. Several different types of braces are used, and the one that the orthopedist chooses depends on the teenager and the severity of the curvature. Some of the most frequently used braces include:

* TLSO. This stands for thoracic-lumbar-sacral-orthosis, and depending on where you live, it may be called the New York, Wilmington, Boston, or Miami brace. This is a low-profile brace, which means it comes up under the arms. This brace is very comfortable, but it’s not right for every person with scoliosis.
* Wilmington jacket. This brace was developed at the Alfred I. duPont Hospital for Children in Wilmington, Delaware. It’s constructed of lightweight plastic and can be worn under clothes, so it isn’t visible.
* Charleston brace. This is also a low-profile brace, and it bends the spine in an effort to straighten the curve as much as possible to prevent the curve from worsening. This brace puts the wearer’s body in an awkward position, though, so it can only be worn while sleeping.

Whichever brace is used, its function is the same: The brace acts as a holding device that keeps the spine from developing more of a curve. A brace won’t ever make the spine straight, but if it does its job well, the curve won’t increase more than 5 or 10 degrees.

Sometimes, even with a brace, surgery becomes necessary to correct the curvature of the spine. (About one or two out of every 10 teenagers with scoliosis must undergo surgery.) During the operation, the orthopedic surgeon removes tiny pieces of bone from the patient’s pelvis (hipbone) and puts them in between the vertebrae in the spine to provide stability and prevent further side-to-side curving of the spine. The surgeon also uses metal rods, hooks, and wire to keep the spine straight until the bits of bone join together with the vertebrae.

The surgery usually takes between 3 and 4 hours. The patient is usually home within 1 week, and after 3 or 4 months, he or she can take part in most regular activities. After 6 months, the person can return to almost all activities, and after 1 year, he or she can return to contact sports.

After about a year, the bone fusion will be complete. The rods placed in the back during surgery don’t limit movement much - it’s still possible to bend down and move all different ways. The rods are left in the patient’s back, but only because taking them out would involve another operation, which isn’t necessary.

With the right kind of treatment - whether it involves a brace or surgery - almost every teen with scoliosis can have an active, normal life!

Samantha was diagnosed with scoliosis, a condition that causes a person’s spine to curve too much, in sixth grade. Between sixth and ninth grades, she received treatment for her condition - sometimes at a hospital hundreds of miles away from her home. Samantha’s spine is now much straighter, and it will stay that way, thanks to a spinal fusion (an operation in which the vertebrae, the individual bones that make up a person’s spinal column, are joined together). In this personal story, Samantha shares her experience being treated for scoliosis.

I didn’t have to go to school for 2 months. While I was home, I napped a lot and took leisurely walks through the neighborhood. My grandma came to visit and my family waited on me. When I got back to school, my elevator privileges allowed me to skirt large, rowdy crowds in the hallways. I was the only person in my class who was excused from carrying a ton of books back and forth to school.

Now that things have returned to normal, there are times I wouldn’t mind going back to the leisurely life after my spinal fusion operation. But the road from diagnosis to treatment was also a mental and physical hardship much of the time. I guess you could say my experience was a “mixed bag.” It was often physically painful and emotionally taxing, but there were many rewarding moments as well.
The Learning Curve

I found out about the curve in my spine through a scoliosis screening that the school nurse conducted in sixth grade. My parents took me to see a doctor in Richmond, Virginia, and I was officially diagnosed with what was then a 25-degree curve (anything below 10 degrees is normal; 50 degrees requires corrective surgery).

Over the next 2 years, I wore two different kinds of back braces to keep my curve from getting worse. But despite the fact that I wore a brace every day, the curve in my spine continued to deteriorate. When my curve reached about 35 degrees, I continued my treatment at a hospital in Delaware. I visited the doctor every couple of months, and in the fall of my ninth grade year, my X-rays indicated that my curve wasn’t getting worse. At that point I assumed that I’d be like my mom, who also has scoliosis, but her curve is not severe enough to hinder her from accomplishing day-to-day tasks.

My parents and I were relieved, and we assumed that there wasn’t much more to worry about. Although my curve was significant, it didn’t pose any real threats to my health. The only way that it affected me was in my appearance. The S curve in my spine created a “hump” on the right side of my back. To someone who didn’t know about my scoliosis, I looked like I had terrible posture.

Over the next several months, though, my mom noticed that the hump in my back seemed to be getting worse. The next time I saw my doctor, the X-rays proved her right: My curve had gone from 35 to 52 degrees. My only option, according to the doctor, was to have a spinal fusion, because the curve had reached the point where it would begin to put pressure on my heart and lungs.

Is the thought of Lyme disease making you feel you’d be safer in the comfort of your room rather than the great outdoors? Before you head out for a summer-long supply of video games, here’s some information to help you estimate if you are at risk of getting Lyme disease.
Location

There were more than 23,700 reported U.S. cases of Lyme disease in 2002, making it the leading tick-borne (this means that it’s carried by ticks) disease in the United States. Experts think that the number of people who get Lyme disease may be even higher, though, because sometimes people don’t know that they have it.

Nearly all cases of Lyme disease (95%) in the United States happen in the northeastern, upper midwestern, and northwestern states. Some cases of Lyme disease have also been reported in the southeastern and southern midwestern states, although the CDC considers these low-risk areas. The following states are typically the hardest hit:

* Connecticut
* Delaware
* Maine
* Massachusetts
* Maryland
* Minnesota
* New Hampshire
* New Jersey
* New York
* Pennsylvania
* Rhode Island
* Wisconsin

Some cases have also been reported in parts of Canada as well as in northern and southern Europe and even in Asia.
Outdoor Activities and Pets

Besides living in one of these areas, other factors that might increase your Lyme disease risk include:

* spending a lot of time outdoors in tall grass, brush, shrubs, or wooded areas
* having pets that may carry ticks indoors
* participating in activities such as yardwork, hiking, camping, fishing, or hunting in tick-infested areas

Safety Tips

So you got a job as a landscaper this summer and you’re planning a big camping trip. Does that mean Lyme disease is in your future? No, but it does mean that you should take some precautions to protect yourself:

* Wear enclosed shoes or boots, long-sleeved shirts, and long pants.
* Tuck your pants into shoes or boots to prevent ticks from crawling up your legs.
* Use an insect repellant containing 10% to 30% DEET (N, N-diethyltoluamide).
* Wear light-colored clothing to help you see ticks easily.
* Keep long hair pulled back or placed in a cap for added protection.
* When outside, don’t sit on the ground.
* While outdoors, frequently check yourself for ticks.
* After each outing, check yourself and your pet for ticks. Wash all clothes after leaving tick-infested areas, and thoroughly shampoo your hair to eliminate any unseen ticks.

If you use insect repellents containing DEET (N,N-diethyltoluamide), follow the recommendations on the product’s label and don’t overapply it. (Using more product than you need won’t increase your protection.) Place DEET on shirt collars and sleeves and pants cuffs, and only use it directly on exposed areas of skin. Be sure to wash it off when you go back indoors. Don’t spray aerosol or pump products containing DEET directly onto your face; instead, spray it on your hands and rub it into your face.
Ticks and Tweezers

You should know how to remove a tick just in case one lands on you or a friend.

First, don’t panic. Your risk of developing Lyme disease after being bitten by a tick is low. It takes 24 to 48 hours for the tick to transmit the bacteria that causes lyme disease. To be safe, though, you’ll want to remove the tick as soon as possible.

If you find a tick:

Call your doctor. He or she may want you to save the tick after removal so that the tick can later be identified as the type that may carry Lyme disease. You can put the tick in a jar of alcohol to kill it.

Use tweezers to grasp the tick firmly at its head or mouth, next to your skin.

Pull firmly and steadily on the tick until it lets go of the skin. If part of the tick stays in your skin, don’t worry. It will eventually come out - although you should call your doctor if you notice any irritation in the area or symptoms of Lyme disease.

Swab the bite site with alcohol.

One note of caution: don’t use petroleum jelly or a lit match to kill a tick. These don’t get the tick off your skin quickly and may just cause the insect to burrow deeper into your skin

Bell’s palsy is a temporary weakness or paralysis of the muscles on one side of the face. These muscles are controlled by the facial nerve. Because there’s a facial nerve on each side of a person’s face, and Bell’s palsy usually affects just one nerve, people with Bell’s palsy will most likely notice stiffness or weakness on one side of the face.
What Causes Bell’s Palsy?

When the facial nerve is working properly, it carries a host of messages from the brain to the face. These messages may tell an eyelid to close, one side of the mouth to smile or frown, or salivary glands to make spit. Facial nerves also help our bodies make tears and taste favorite foods. But if the nerve swells and is compressed, as happens with Bell’s palsy, these messages don’t get sent correctly. The result is weakness or temporary paralysis of the muscles on one side of the face.

Bell’s palsy is most often connected with a viral infection such as herpes (the virus that causes cold sores), Epstein-Barr (the virus that causes mono), or influenza (the flu). It’s also associated with the infectious agent that causes Lyme disease. Of course, this doesn’t mean that everyone who has a viral infection or Lyme disease will develop Bell’s palsy - most people don’t. But in a few people, the immune system’s response to a viral infection leads to inflammation of the nerve. Because it’s swollen, the nerve gets compressed as it passes through a small hole at the base of the skull, which causes the symptoms of Bell’s palsy.

Bell’s palsy can affect people of all ages, but it is most common in adults. People with diabetes and pregnant women are more likely to develop Bell’s palsy.
What Are the Signs and Symptoms?

The symptoms of Bell’s palsy usually show up about 1 to 2 weeks after a viral infection. The symptoms tend to come on quickly - usually Bell’s palsy reaches its worst point within 48 hours. A few hours or days before Bell’s palsy develops fully, some people may have a headache or feel pain behind or in front of their ears. A person may notice one side of his or her face droops or feels stiff. Some people may only notice a slight weakness, whereas others may not be able to move that side of their face at all.

Other symptoms of Bell’s palsy include:

* difficulty closing one eye all the way
* dryness in one eye
* trouble tasting at the front of the tongue on the affected side
* changes in the amount of saliva or drooling
* hearing sounds that seem louder than usual in one ear

Bell’s palsy affects only the face, so if a person has weakness or symptoms in other parts of the body, the problem has another cause.
How Is It Diagnosed?

If you have any of the symptoms of Bell’s palsy, you should see a doctor as soon as possible.

The doctor will take a detailed medical history and perform a thorough exam to eliminate other possible causes of your symptoms. The doctor will want to know over what period of time your symptoms developed, if you had any preceding illness or trauma, and if you are noticing any other problems such as weakness or paralysis in other parts of your body.

Tell the doctor if you are having problems like double vision or trouble swallowing or if you recently injured your face or head. Because more serious conditions than Bell’s palsy, such as an injury, can cause facial paralysis, it’s important to report any other problems you may be noticing.

There isn’t a specific test for Bell’s palsy, although a doctor may test for Lyme disease, herpes virus (HSV), or other infection. Some infections, like Lyme, can be treated, but in most cases the virus that may have caused Bell’s palsy in the first place has usually passed.

If the doctor suspects some other cause for a person’s symptoms, he or she may use imaging tests, such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI), to look inside the body and check for other problems. Some doctors may recommend an electromyography (EMG), which tests how well the muscles respond to nerve signals.
How Is It Treated?

For the symptoms of Bell’s palsy to improve, the nerve needs to renew itself, and that can only happen with time. However, some doctors may prescribe medicine to reduce inflammation. If a person with Bell’s palsy is unable to close one eye completely, the doctor may prescribe eyedrops, an eye patch, and protective glasses to make a person feel more comfortable and to prevent damage to the cornea.

Although it can seem frightening at first, most people with Bell’s palsy recover fully within 1 to 3 months. A few people are left with some permanent facial weakness after recovering from Bell’s palsy, though.
Taking Care of Yourself

It’s important to eat well and get lots of sleep when you have Bell’s palsy. Good nutrition and rest will help your body as it heals itself.

One of the hardest things about having Bell’s palsy can be dealing with the emotions that go with it. To begin with, Bell’s palsy can be just plain scary. And because Bell’s palsy affects how your face looks for a while, you may feel self-conscious or embarrassed in public. Even your close friends may tease you in what they think is a good-natured way, but if it feels hurtful to you, tell them. Let people know why your face looks the way it does. Bell’s palsy isn’t contagious, so no one can catch it from you, and nothing you or anyone else did caused it to happen.

Dealing with a condition like Bell’s palsy often helps you find out who your friends really are. Rely on the people you know can offer you the best support - your closest friend, family, or a school counselor, for example. Within a couple of months, you should be back to your old self

Apparently, having cerebral palsy makes me different.

I’ve had cerebral palsy since birth and I’ll have it until I’m old and grey. There isn’t a day that I’m not reminded I have the condition. And there never will be a day I won’t have it. But in my mind’s eye, life is good: If anything, cerebral palsy has made me a stronger, more humble person. I can even say having cerebral palsy has contributed to my success.

Cerebral palsy — CP for short — is a condition caused by injury to the parts of the brain that control our ability to use our muscles and bodies. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. Often the injury happens before birth. Sometimes it happens when a baby is being delivered or soon after being born. CP can be mild, moderate, or severe.

I’m in college now. As a teen with CP it was easy for me to get overlooked, discouraged, or even patronized simply because I wasn’t considered “normal.” This became especially apparent when doctors began prescribing “special devices” to help me re-establish or maintain a “suitable range of motion.” These devices were to be worn while doing everyday activities, including school-time activities.

Because my CP mostly affects my legs and the way I walk, I had to wear knee-high, white-plastic, custom-made leg braces at all times during my first couple of years of high school.

Laced with Velcro, these braces locked my ankles and heel cords in a fixed position. Needless to say I hated those braces! They were painful, noisy — thanks to the Velcro and cheap plastic — and they seemed to broadcast that I was “crippled” (my skin crawls when I hear that word).

Fortunately, I have a very mild case of CP, and only my walk is affected. My hamstrings and heel cords are spastic (meaning they might twitch or spasm on their own and I can’t control them) or tight. This causes me to walk bent-kneed and on my toes.

For people with more severe cases of CP, all aspects of their physical abilities — and sometimes even mental abilities — can be limited. I was fortunate that my legs were only slightly affected, which allowed me to participate in gym, school sports, and marching band. I was even bold enough to take part in school productions and plays.
I’m Rubber and Bullies Are Glue

As mild as my case of CP may be, there were always the high school bullies who found pleasure in bringing me down. Sometimes it felt that the only reason they were in school that day was to be my rain cloud, following me around pointing out my mistakes and flaws.

My bullies were girls as well as guys. They weren’t physically threatening. They were the kind who hurt with words or by forcing an embarrassing situation, constantly looking over a shoulder for supporting chuckles from friends. However, my bullies normally found themselves laughing alone, because I’d already beaten them to the punchline. I was well liked, so the joke was on them. The reality was they had a lot of catching up to do.

A bully can’t compare to what you put yourself through mentally. Just entertaining the thought that you’re not the same as everyone else can work against anyone, even when you know you’re above the norm in so many ways. During school, I never wasted time worrying what other people thought of me. I mostly worked on staying positive and meeting my own standards and expectations.

But there were times when people really got to me — their harassing, hurtful words began to penetrate. A couple of times, I even caught myself thinking, “What if they’re right?” I found this the hardest place mentally to pull myself out of. But I told myself what I knew to be true: “You’re the one who’s right! It doesn’t matter what they think, you know you’re better than them simply because you don’t resort to acting like them. They are making you feel like an outcast so that their pitiful lives don’t look so worthless after all.”

As a teen, most of our time is spent in school. I found it doesn’t do any good to avoid the people who put me in these mental dark places. Instead, I worked on beating them to the punchline, turning the joke on them. This helped me develop a great life skill: the art of the witty comeback.
Dating for Dreamers

Having CP and dealing with bullies is a breeze compared with dealing with the anxiety of asking your first crush out on a date!

To me — and lots of guys! — high school girls seemed unpredictable and hard to figure out. The only thing I could do was be likeable, engaging, and responsive. The hardest obstacle to overcome was starting the first conversation. A lot of guys think they don’t have anything interesting to talk about. This is where having CP came in handy!

When I was in ninth grade, there was a girl I liked who happened to be in all my classes. Soon, I got noticed and curiosity got the best of her. She was forced to ask the question that was on her mind for some time, “What’s wrong with your legs?” These weren’t the most romantic words to start a relationship, but it got my “foot in the door.”

When most guys are struggling for the attention of the girls they like (by making fun of people like me!), I have the advantage because people are naturally curious, and all I have to do is smile. I was responsive to the girl I liked, so it made it easier for her to talk to me, even if the ice-breaking question was a bit embarrassing.

Don’t count yourself out when it comes to dating. People will like you for who you are — that’s it!
Spastic About Sports

The same theme of having a positive attitude and a willingness to try can be applied to cerebral palsy and sports. I played many sports while I was in high school, but I was best at golf. Go figure: the one sport that requires balance and precision — two weapons that aren’t readily available in my arsenal. But I really excelled at golf.

My doctor explained how I was able to participate — and achieve — as well as I did in sports, particularly golf: It’s possible for some people with CP to learn how to get our bodies to work in other ways. In my case, I figured out how to use different back, arm, and leg muscles to mimic the techniques of the golf swing, instinctively adapting to my body’s limitations.

I would have never known that my body was able to adapt like this if I didn’t have the courage to try to play. I knew that I might fail, but I also knew that there was a greater possibility I’d have fun. I wasn’t afraid what the other members of the team would think of me, because by this time my reputation and positive mindset preceded me. I say this because I want to stress the importance of staying positive about CP — or any physical condition — and not think of it as a limitation.

In my experience, people tend to admire you most for trying. They want to see you succeed, sometimes more than succeeding themselves. Four years of varsity golf was one of the highlights of my high school career and some of my best friends in school played golf.

I also participated in wrestling, working up to competing on the varsity level as well. Although I wasn’t the best, I kept with it and tried my hardest. My body adapted its own techniques, like in golf.

In my case, participating in as many physical activities as possible was the best way (other than physical therapy or occupational therapy) to combat CP. Exercise keeps the affected muscles loose and limber, which helps to counteract the appearance of cerebral palsy.
Marching to the Beat of a Different Drummer

“Life is not about fitting in; it’s about standing out.” I don’t know who originally said that, but it became my mantra when I joined the marching band. That’s right: Keith, the guy writing about walking funny, joined the marching band as a freshman in high school.

Why? I really enjoy playing instruments, and in my high school, if you wanted to be in any band, you had to join marching band. It was a requirement: If you didn’t join marching band, you couldn’t play at all.

That’s how I found myself standing in the middle of a football field, trying out for the only high school sport where judges strictly critique the way you walk — no pressure there!

Being a member of a nationally recognized marching band is one of my more significant high school accomplishments. Although I can’t say for sure how much harder it was for me than the rest of the band to keep step and pace while maintaining musical integrity, I can assure you that wrestling doesn’t even come close to being as physically demanding.

Imagine standing on the 50-yard line of a football field as proud and as tall as physically possible while holding a 5-pound instrument up to your face. The conductor is counting 1-2-3-4-1-2; you’re marching in time. Now put yourself in my position: Imagine doing this with a large rubber band wrapped around your knees — but still maintain your form, remember all your notes, project your sound high…left foot…right foot…backward, forward, sideways…LOUDER. You can’t make any mistakes, because the judges see everything. I bet you can see why I stuck with it for 9 out of 12 months for all 4 years of high school!

The message here is, don’t get discouraged by your physical limitations. There is no physical way that my marching technique was anywhere close to being technically sound, but I tried my hardest, and I never gave up. Over the 4 years, my marching band and I won numerous regional and state level championships; in this case it wasn’t so bad to “stand out.”

Whether I’m winning or losing, young or old, I will always have CP. That will make me different from everyone else, but it is up to me to decide how differently I present myself. For me, CP is not an excuse for bitterness or negative actions, but more of a reason to better myself or an excuse to try harder and be more successful.

Life can be funny, so why not beat it to the punchline?