• Confidential visit between medical provider and teen
• Includes discussion of growth, diet, exercise, sleep, home life, school life, social life, mental health, risk taking behaviors, sexual health.
• Does not allow time to discuss/manage ongoing health issues, such as asthma, headaches or other chronic conditions.
• Includes a physical exam
• Males will undergo an exam for hernias
• Females, if sexually active, may require a pap and pelvic exam
• Parents have the opportunity to let the medical provider know any concerns they have about their teen
• Immunization update
• Forms to complete:
• Guidelines for Adolescent Prevention Survey (GAPS) from the American Medical Association
• Parent Questionnaire
• Teen Questionnaire
• The teen survey is meant to be reviewed between the teen and medical provider only. This is intended to promote open and honest communication and help the teen establish autonomy in his or her health management.

• Required for athletes competing at the high school level.
• Every 3 years in Minnesota
• Every 2 years in Wisconsin
• Includes the components of a Well Teen Check as well as an in-depth review of the athlete's sports history.
• Includes a complete physical exam, including thorough musculoskeletal exam.
• Immunization update.
• Forms to complete:
• Minnesota High School Athlete Survey
• Wisconsin High School Athlete Survey

Guns and Firearms
On the average day, one Minnesotan dies from a firearm injury, and another has a nonfatal firearm injury.
About 74% of the fatal firearm injuries are suicides rather than assaults or unintentional injuries.
 
Seat Belts
In 2002, more than 5,000 of 16-19-year-old teens died of injuries caused by motor vehicle crashes, 62% were not wearing seat belts. In 2007, 63% of 9th graders and 69% of 12th graders in Washington County always wore their seat belt (Minnesota Student Health Survey, 2007 data).

Seat belts are the most effective safety devices in vehicles.

In potentially fatal head-on crashes, seat belts increase your chance of survival by 45% in a car and 60% in a pick-up truck.
Without wearing a seat belt, a 35 mph crash is the equivalent of falling from a third story window.
 
Fire Safety

• Escape Plan
• Don't panic
• Get out fast - don't take anything with you
• Have 2 escape plans
• Feel doors before opening
• Have a place to meet outside, then call 9-1-1
• Don't go back in for anything
• Crawl to safety if too smoky or hot to walk out
• Smoke and Carbon Monoxide Detectors
• Check monthly to make sure in working order
• Change batteries yearly
• Fire Extinguishers
• Four types - Dry Chemical, Halon, Water and Carbon Dioxide
• How to use a fire extinguisher: PASS
• Pull pin
• Aim at base
• Squeeze handle and stand 8 feet away
• Sweep back and forth
• More information
• Fire Hazards
• Frayed electrical cords, or cords under carpet/furniture
• Materials draped over lamps
• Overloading electrical outlets
• Unattended candle

Fireworks

• Fast Facts
• Who: Under 14 years old, about 45% of injuries
• What: Fire crackers, sparklers and rockets
• When: Within a month surrounding 4th of July (60% of injuries)
• Where: Hands, eyes, face, head and ears

Electrical Safety

• Recalls
• Electrical Hazards
• Frayed cords - throw them out
• Wet floors around electrical usage
• Appliances next to showers, baths and swimming pools
• Don't touch outlets or switches with wet hands
• Dry Christmas trees - water often
• Unplug Christmas lights before going to bed - they could short out

Tornado Safety

• What to Do
• Don't panic
• Basement - get there quick
• No basement
• Go to small centered room on lowest level
• Get down on floor and cover head with your hands
• Cover up with bedding, if posible, to shelter from debris
• Mobile home
• Get out and go to nearest tornado shelter
• Get away from windows and exterior walls, if you stay
• Cover up with bedding, if possible, to shelter from debris
• At school
• Stick to the drill
• Stay away from windows and exterior walls
• Get on the floor and cover your head with your hands
• In a vehicle
• Very dangerous place to be
• If it is far away, and traffic is light, drive away from it
• Park and get to safety
• Avoid under bridges, low protections from debris, traffic hazard
• What to Have
• Radio with batteries
• First aid kit
• Canned food
• Water

Driving

• Minnesota Laws for Newly Licensed Teen Drivers (PDF)

• People between ages 12-17 are two to three times as likely as adults to be victims of violent crimes compared to adults.
• In 2002, more than 877,700 young people ages 10-24 were injured from violent acts. Approximately 1 in 13 required hospitalization.

According to the Report of the Surgeon General more than 14 million children and adolescents in the United States, or 1 in 5, have a mental health disorder. Mental and behavioral disorders and serious emotional disturbances (SED) in children and adolescents can lead to school failure, alcohol or illicit drug use, violence, or suicide (Healthy People 2010). It is anticipated that approximately 70 percent of children and adolescents that are in need of treatment do not receive mental health services.

The following are the Healthy People 2010 objectives related to mental health issues:

• Reduce the proportion of children and adolescents with disabilities who are reported to be sad, unhappy or depressed.
• Reduce the suicide rate.
• Reduce the rate of suicide attempts by adolescents.
• Increase the proportion of children with mental health problems who receive treatment.

Mental Health links:

• National Institute of Mental Health
• American Academy of Pediatrics
• When to Seek Help
• KidsHealth

Teen Suicide

• According to 2007 data from the Minnesota Student Health Survey, 14% of Washington County 9th graders and 13% of Washington County 12th graders had suicidal thoughts in the last year. And 4% of Washington County 9th graders (5% female, 3% male) and 2% of Washington County 12th graders (2% female, 3% male) attempted suicide.
• In the past 25 years, the rate of suicide for those between ages 15-24 has tripled. 

Depression

• 1 in 8 adolescents may suffer from depression.
• Of all these teens, 30% receive some sort of intervention or treatment.
• If you have concerns about depression for yourself or someone you know, please contact one of the following resources:
• Wellness Center at Stillwater Area High School 651-351-8098
• FamilyMeans 651-439-4840
• HSI Crisis Line 651-777-1777
• Stillwater Medical Group 651-439-1234

According to 2007 data from the Minnesota Student Health Survey, 20% of Washington County 9th graders and 16% of Washington County 12th graders get 5 or more servings of fruits and vegetables.

The new Food Pyramid Guidelines suggest a range of servings for each major food group. Most individuals should consume at least the minimum number of servings for the major food groups. The more active you are, the more servings you will need to consume. If you are an athlete you will want to aim for the upper number, especially in the grain, fruit and milk groups. These groups provide the carbohydrate which is your number one energy source.

The following is a list of serving sizes:

• Bread, Cereal, Rice and Pasta
• 1 slice of bread
• 1/2 bagel or English muffin
• 1 oz. of cold cereal
• 1/2 cup cooked pasta, rice
• 1/2 cup cooked cereal
• 4-6 crackers
• Vegetables
• 1/2 cup cooked or chopped raw vegetables
• 1 cup raw leafy greens, such as spinach or lettuce
• 1/2 cup cooked dry beans
• 3/4 cup vegetable juice
• Fruits
• 1 medium orange, apple or banana
• 1/2 cup diced canned or cooked fruit
• 1/4 melon
• 1/2 grapefruit
• 1/4 cup dried fruit
• 3/4 cup of 100% fruit juice
• 1/2 cup small fruit, such as berries or grapes
• Milk, Yogurt and Cheese
• 1 cup milk
• 1 cup yogurt
• 1 1/2 oz. natural cheese
• 2 oz. processed cheese

How to Pick a Healthy Meal at School...
Hot Lunches:

• Think variety! Eat something from most of the food groups. Hot lunches are typically balanced. Example: protein (meat), vegetable, starch (noodles, rice, bread, fruit and milk).
• Limit fried foods - such as shrimp poppers, chicken tenders, chicken patties (fried), french fries - to 1, no more than 2, times a week.
• Limit corn dogs, hot dogs, hamburgers to 1, no more than 2, times a week.
• Choose sub sandwiches, pasta bar, salads, peanut butter and jelly sandwiches instead.
• Limit trips through the ala carte line. Eating foods such as chips, pop tarts, cookies, jumbo muffins, fruit drinks and candy is okay for an occasional treat - but not daily. These foods are typically higher in fat and calories, and low in nutrients.
• Try to plan ahead each week. Look at the school menu online and plan your selections in advance.
• If you are vegetarian, usually one main menu item is vegetarian. Ask the cafeteria staff for alternative selections if you are unable to find a vegetarian selection (example: peanut butter sandwich, yogurt, salad).
• If you have diabetes and want to know the carbohydrate content of the foods served at school, contact the school nurse or call Central Services Office for the school district, and the school dietitian will give you a copy of the carbohydrate content of the school menu.

Quick and Easy Breakfast Ideas:

• Carnation instant breakfast drink
• Peanut butter on toast or bagel
• Nutrigrain or granola bar with milk or juice
• Bowl of cereal with milk (aim to eat low sugar cereal)
• Yogurt and granola or cereal (portable yogurt works well too)
• Trail mix and juice box
• Peanut butter and crackers
• Cheese and crackers (food does not have to be breakfast food! Try string cheese and some crackers)
• Peanut butter or meat/cheese sandwich
• Graham crackers with peanut butter and a glass of milk
• Fresh fruit

Calcium
Average calcium intake for adolescents ages 12-19:

• Males - 1,081 mg
• Females - 793 mg

The Food and Nutrition Board recommends 1,300 mg per day.

• 1 cup (8 oz.) milk = 300 mg
• 1 container of yogurt = 400-450 mg
• 1 cup calcium fortified orange juice = 300 mg
• 1 oz. cheese = 70-115 mg
• 1/2 cup cooked broccoli = 89 mg
• 1/4 cup almonds = 94 mg

If an individual is lactose intolerant, lactaid free milk is available. Otherwise the individual may need to supplement their diet with calcium chews (1 chew = 500 mg calcium) or tablets (1 tablet = 500 or 600 mg).

Adolescents lay the groundwork to preventing osteoporosis between the ages of 15-25 years old. Maintaining adequate calcium intake during childhood and adolescence is necessary for the development of peak bone mass, which may be important in reducing the risk of fractures.

Water Intake

• Water is an essential nutrient for the body.
• The human body is made up of 60% water!
• Aim to drink at least 6-8 (8 oz.) glasses of water each day.
• Athletes
• Drink water prior to, during and after competition to prevent dehydration. Depending on your size and how much you sweat, you lose about a quart (4 cups) of water per hour.
• Water is the best fluid to drink for competitions up to 90 minutes in activity or 60 minutes of continuous activity. Sport drinks help hydrate the body when competing in events that go beyond 90 minutes. (Adapted from Eat to Compete Coaches Playbook.)

Vegetarian
If you are a vegetarian, please refer to the Vegetarian Food Guide Pyramid for appropriate portion sizes and foods. One serving equals:

• Bread, Cereal, Rice and Pasta
• 1 slice of bread
• 1/2 cup cooked pasta
• 1/2 cup cooked cereal
• 1/2 cup cooked rice
• Vegetables
• 1/2 cup cooked vegetables
• 1 cup raw vegetables
• 1/2 cup vegetable juice
• Fruits
• 1 piece of fruit
• 1 cup of 100% fruit juice
• 1 cup of canned or cooked fruit
• Milk, Yogurt and Cheese
• 1 cup milk
• 1 cup yogurt
• 1 1/2 oz. of cheese
• Tofu, Beans, Eggs and Meat Substitutes
• 4 oz. tofu
• 1/2 cup cooked dry beans
• 1 egg or 2 egg whites
• 1 cup soy
• 2 Tbls. peanut butter or nut butter
• 1/4 cup nuts
• 1 oz. meat analog or substitute

Eating Disorders

• 1 in 10 teenagers are estimated to struggle with anorexia or bulimia.
• 16.7% of males and 15.4% of females ages 12-19 are overweight.
• A national survey of 8th-10th-grade students found that 32% skipped meals, 22% fasted, 7% used diet pills, 5% induced vomiting after meals, and 3% used laxatives to lose weight.
• Experts estimate that 10 million females and 1 million males in the United States have an eating disorder. An estimated 5% of those with eating disorders die as a direct result of the eating disorder.

Eating Disorders links:

• The Emily Program (office in Stillwater)
• Methodist Hospital Eating Disorders Institue
• U of MN Children's Hospital STAR Center
• U of MN Children's Hospital Pediatric Weight Management Center

Alcohol Use

• 13% of 9th graders and 33% of 12th graders participated in binge drinking (5 or more drinks in a row) within the last two weeks. 38% of 9th graders and 67% of 12th graders had any alcohol within the past year. (Minnesota Student Health Survey, 2007 data specific to Washington County.)

Drinking & Driving

• In 2003, 25% of drivers ages 15-20 who died in motor vehicle crashes had a blood alcohol content of 0.08 g/dL or higher.
• In 2007, 27% of Washington County 12th graders admitted to driving after alcohol or drug use (Minnesota Student Health Survey Data).
• Alcohol use is involved in 25% to 50% of deaths associated with water recreation.

Drug Use

• 15% of 9th graders and 35% of 12th graders in Washington County have used marijuana one or more times in the past year. The state average for Minnesota is 15% of 9th graders and 30% of 12th graders. (Minnesota Student Health Survey, 2007 data)
• Prescription drugs/pain relievers are the third most abused substance by 9th and 12th graders in Washington County. (Minnesota Student Health Survey, 2007 data)

Tobacco Use

• 1 in 3 12th-graders in Washington County have used cigarettes in the past month.

Tdap is the tetanus vaccine. It helps prevent against tetanus (lock jaw) and now includes a booster for pertussis (whopping cough).

• During 2005, 1,571 (30.6/100,000 population) cases of pertussis were reported in Minnesota, representing a continuation of the increase first seen in 2004 when 1,368 cases were reported in Minnesota.
• Teens should receive this vaccine at age 12 and every 10 years afterward. 

Menactra is the preferred vaccine for meningitis and blood borne infections cuased by Neisseria meningitides, a type of bacteria.

• This vaccine is administered once after age 11.
• Infections caused by Neisseria occur in all ages, with a peak in kids younger than 2 years old and another peak at ages 18-19. College first-year students living in dorms have been considered at highest risk, but teens in high schools are also affected.
• 16 cases of Neisseria meningitidis invasive disease (0.3 per 100,000 population) were reported in 2005 in Minnesota.

Hepatitis B vaccine is a series of three shots. This is now given in the infant period, but some teens may have not received it yet.

• Hepatitis B is one form of a viral liver infection (hepatitis) which is transmitted by infected body fluids.
• It can lead to chronic, life-long liver disease, resulting in liver tumors and liver failure.
• In 2005, 42 cases of acute hepatitis B virus (HBV) infection (0.8 per 100,000) were reported in Minnesota.

Human Papillomavirus vaccine (Gardasil) is the first vacine ever available to fight cancer. This vaccine helps protect against infection by HPV, which is the most significant cause of cervical cancer. Explore these Health Resources for information on HPV and Gardasil.

• Gardasil is approved for females ages 9-26.
• It is administered in three doses.

Influenza vaccine is administered every fall and winter. The vaccine changes slightly each year to match the predicted form of influenza.

• Teens with asthma, immune system problems, or other chronic health issues should receive this vaccine yearly.