Thursday, November 1, 2018

Dr. Nithya Sunder on talking to teens about sexual consent

Nithya Sunder, MD
Recently, the idea of consent has been in the news and can be very confusing for teens. It is also a topic that both parents and teens find difficult or uncomfortable to discuss. It is natural for teens to be curious about their bodies, sex, and sexuality so parents should be prepared to talk about sex to help their children make informed decisions. It is absolutely fine to discuss abstinence and encourage teens to wait to be sexually active until they are in a relationship with respect, commitment and love, but parents still need to be ready to answer teens' questions. The American Academy of Pediatrics (AAP) notes that teens are more responsible in their sexual behavior when their parents communicate openly with them. Not talking about sex with teens does not guarantee they will not be curious or will not experiment.  by the AAP has resources for parents on how to talk to them about dating and sex. 

Part of teaching respect includes teaching consent. Teens need to understand that they have the right to say no but they also need to respect any potential partner's right to say no at any step of sexual activity. The video below was circulated by the Thames Valley Police in the UK and helps discuss consent in a likely more comfortable way for teens and parents alike:           

Some teens feel forced by others to pressure their peers or partners to be sexually active in order to fit in. Discussing consent helps them be respectful of their potential partners but teaching them empathy helps too. It also helps to remind them that using alcohol and drugs can affect their ability to make clear choices. One way to encourage teens to develop empathy and compassion is to have them be responsible for others. Examples include babysitting, working as camp counselors, leading youth groups, and other forms of volunteering. Some resources for teaching empathy include books like "Raising Cain: Protecting the Emotional Life of Boys" by Dan Kindlon, Ph.D., and Michael Thompson, Ph.D. The book "Dear Bully" includes stories by young adult and children's authors about their memories of bullying but be forewarned that there are some violent and upsetting stories. Teaching teens how to trust their instincts and their values will also help them feel more comfortable making decisions without undue influence. has some recommendations on ways to build their self-esteem including being generous with praise, trying to provide constructive criticism, and asking for their opinions.

Remember that the providers at Pediatric Health Associates are also available resources for parents and teens for any questions and concerns.

a.  We are now on Instagram!   Just download the app and find us!
b . We have been experiencing high call volume as of late.  We know you have better things to do than to wait on hold.  Parents can now leave a message when calling for an appointment.  Our goal is to call you back within the hour. 
c.  We have upgraded our website to be mobile friendly.  Many parents have asked for the ability to pay your bill through your phone and the upgrade now allows this.   Of course all the usual information on the website can be viewed as well.
d.  Our North Aurora office is now open. The doctors who will be seeing patients at this office are:  Dr. Wall, Dr. Sunder, Dr. Shakir, Dr. Kanabar and Dr. Thomas along with nurse practitioners Kim Gubbins and Martha Strening.

Hours for our North Aurora office at 98 Miller Drive, Suite 101 have been updated to:

                                      Monday:        9 am – 8 pm
                                                     Tuesday:        CLOSED
                                                     Wednesday: 9 am - 12 pm
                                                     Thursday:     9 am - 5:00 pm
                                                     Friday:           9 am - 5:00 pm
                                                     2 Saturdays per month: 9 am - 12 pm

Friday, October 19, 2018



                Our North Aurora office is officially open!
                Mayor Dale Berman joined our ribbon
                cutting ceremony on Wed. October 17th. 
    PHA docs who will be seeing patients at the North Aurora office are:
   Drs. Wall, Shakir, Gronli, Thomas, Doman and Kanabar along with
   NP's Kim Gubbins  and Martha Strening. 

                    Preliminary office hours are:
                           Monday:        9 am – 8  pm
                           Tuesday:        9 am - 5 pm
                           Wednesday: 9 am - 12 pm
                           Thursday:     9 am - 4:30 pm
                           Friday:           8 am - 4:30 pm
                           2 Saturdays per month: 9 am - 12 pm

                                                      See you soon!

Friday, October 5, 2018

From the desk of Virginia Kash, MD    

                  ACNE 101 FOR PARENTS

 Having just come off the busy summer checkup season, after seeing scores of teens for their school and sports physicals, I have observed that there is one question that most teens have on their mind: “How do I get rid of my acne?”  And having 3 teenagers at home, I know first hand how acne can affect self-esteem during the teen years.  Studies show that patients with acne report higher levels of anxiety, depression, frustration, anger, and impairment in self-image.  Almost all teens get acne at some point during their teen years.  In fact, studies show that up to 85% of teenagers 15-17 years of age will be affected and that acne is the most common skin problem treated by MDs.  Interestingly, the incidence is equal in all races and often small pimples are common by 7 years of age. 

There are many myths about what causes acne: soda, chocolate, dairy and greasy food; however, these things do not directly cause acne. Also, you can reassure your teen that it is not their fault.  Acne is caused by 3 main factors that are beyond their control:
  • Hormones:  Hormones are a normal part of puberty and the teen years. One type of hormones called androgens stimulate the oil glands on the face, back, shoulders, and upper chest to produce more oil.  This can cause acne in some people.  Some girls get more pimples before or during their period.  This is caused by fluctuating hormone levels.
  • Heredity:  Acne can run in families.  If a parent had severe acne as a child, there may be a chance their child will get it as well.
  • Plugged oil ducts:  Small whiteheads and blackheads can form when the oil ducts in the skin get plugged with oil and skin cells.

     What teens should do & NOT do:
  • Don’t pop or pinch your zits!  This causes damage to the oil ducts and causes much more redness and swelling and can cause permanent scarring.
  • Do use a gentle face cleanser twice daily. It should be a mild, soap-free, and pH balanced cleanser.
  • Don’t scrub your face too hard.  This can irritate the skin and doesn’t prevent or get rid of the underlying causes of acne.
  • Do use a non-comedogenic moisturizer. This can increase the tolerability of topical medications that can be very drying.
  • Don’t use greasy makeup or oily hair products.  These can block the oil ducts and make acne worse.  Always look for oil-free, non-comedogenic makeup and skin products for the face.
  • Learn how to handle stress.  Often stress and anxiety can cause pimples.  Try to keep stress levels down by getting enough sleep and having time to relax.
  • Ask your doctor for suggestions of treatment options for your acne.
     Types of Treatment:
      While there is no cure for acne, it usually clears up as you get older.  In the meantime, there 
      are some products that teens can use to keep their acne in control:

      Benzoyl Peroxide (BP)
  • comes in a wash, lotion or gel
  • the most effective acne treatment you can buy without a prescription
  • it helps kill the bacteria in the skin, unplug oil ducts, and heal pimples
  • lots of different brands and strengths (2.5%-10%)
  • the gel tends to be more drying, so best to start with the wash or lotion
  • start slowly- only once a day with 5% wash or lotion.  After 1 week you can increase to        twice daily (morning and night) if skin is not too red and isn’t peeling
  • apply a thin layer to the entire area where pimples occur, avoiding the skin around the eyes
  • BP has a bleaching property and can cause bleach spots on colored towels and bedding. I  recommend switching to a white towel and white pillowcase while using BP
  • if there is no significant improvement after 4-6weeks, you can try a 10% lotion or gel once daily at first and then twice daily if it does not irritate the skin
    Stronger Treatments: (All of the following should
    be discussed with a doctor before starting)

  • if BP doesn’t get the acne under control, dermatologists recommend adding a retinoid, like Retin A (which is a prescription) or Differin (which is now over the counter)
  • it comes in a gel or a cream and works by unplugging oil ducts
  • it must be used exactly as directed
  • it is photosensitizing so best to stay out of the sun and always use sunscreen while outdoors
  • Retinoids can cause your skin to peel and turn red
  • these come in cream, lotion, solution and gel forms and are used for “inflammatory” acne, which are red, tender bumps or pustules.
  • antibiotic in pill form may be used if treatments on the skin don’t help.
  • brand names are Accutane, Amnesteem, Sotret and Clarivis 
  • this is an extremely strong medication taken as a pill.  It’s only for severe acne that has not responded to other treatments.
  • Isotretinoin is so powerful that it can cause birth defects and, therefore, cannot be taken right before or during pregnancy.
  • Patients who take this medication must be followed carefully by a doctor knowledgeable about its usage, such as a pediatric dermatologist.
      ·     BE PATIENT: It may take 3-6 weeks or longer before treatment shows improvement and can take
           up to 12 weeks for maximum improvement.
      ·     BE CONSISTENT:  Follow your recommended program every day.  Not using your program 
           regularly is the most common reason why treatments fail.
      ·     FOLLOW DIRECTIONS:  Not using products as directed can cause treatment failure or 
           bothersome side effects.
      ·     DON’T OVERDO IT:  Too much scrubbing makes skin worse.  Too much BP or topical retinoid 
           creams can make your face red, dry and scaly.

    References: “Acne—how to treat and control it”, 2010.
      “Pimple-popping 2.0: What’s new in acne care?”, Brandi M. Kenner-Bell, MD, FAAD, FAAP, 
       Northwestern University’s Feinberg School of Medicine, 2018.

Friday, September 28, 2018

Flu Vaccines now available. North Aurora office will open shortly!

According to the Center for Disease Control (CDC), 2017 was the worst flu season since 1976 claiming 80,000 lives of which 180 were children.   Many of the children who succumbed last year were healthy kids with no medical issues.  While that may not seem like a lot of kids and we tend to think “it will never happen to me”, the fact is that flu does not discriminate…not by age, not by gender, not by how healthy you are.   In fact, many of the children who succumbed were healthy and had no previous medical issue although the majority had not been vaccinated.

Flu shots are now available at all offices.    You can schedule just a flu shot visit with a nurse at the office.

In other news…..
PHA Website:
Shortly PHA will have an upgraded website allowing patients better access via cell phones.  In response to many of our families wanting to pay online via their phone, this upgrade will now give you that capability.   We will update the website and blog when the upgrade is online.

North Aurora Office Opening:
Our North Aurora office will officially open on Thursday, October 18th!   Located at 98 Miller Drive, Suite 101, the office is conveniently located off I-88 and the Orchard Road exit.   We will have an ADHD Center and Lactation Center on site.   Doctors who will be seeing patients at this office include Drs. Thomas, Gronli, Wall, Kanabar, Shakir and Doman along with Nurse Practitioners Martha Strening and Kim Gubbins. 

Appointment are now being accepted for North Aurora.   To schedule please call our appointment line at 630.717.2300.

She did it again!
Congratulations to Dr. Shelly Flais for her new book  "Caring for your school-age child" endorsed by the American Academy of Pediatrics (AAP).