Feature: When Kids’ Pain Won’t Go Away
Novel therapies treat kids with chronic headaches, abdominal pain
When unrelenting pain stops kids in their tracks and can’t be resolved with traditional treatment such as medication, minimizing the ache is one goal, says Gerard Banez, PhD. Helping children and adolescents get their lives back is the other, more important, one.
Dr. Banez, Director of the Pediatric Pain Rehabilitation Program at Cleveland Clinic Children’s Hospital, helps kids with chronic pain ranging from complex pain syndromes to chronic headache or abdominal pain.
“For the majority of kids, when they first come here, pain is boss. It has dictated so much of their lives,” Dr. Banez says. “They’re not going to school and not able to hang out with their friends, play sports or do extracurricular activities. We’re helping them take ownership or control — not allowing the pain to take over.”
Harnessing brain power to heal
The best ways to tackle chronic pain often involve bypassing physical sensations in favor of mental control. Both Dr. Banez and M. Barry Jones, MD, an anesthesiologist and pediatric pain management specialist at Cleveland Clinic Children’s Hospital, use novel psychological therapies to help kids return to everyday life — even if all of the pain isn’t gone. “I tell the kids that pain is pain, but suffering is optional,” Dr. Banez says.
Dr. Jones administers hypnotherapy to some of his young patients to teach them how to modify their physical responses to pain. By guiding them in this super-relaxed state — often using imagery or other techniques to help them “space out” — he teaches them to “be calm in the face of pain.”
Taking the emotion out of pain
Another benefit is that the subconscious mind is less resistant to dubious suggestions during the trance-like period, Dr. Jones says. For example, his patients may more easily accept the idea that their pain will abate simply because he introduces the concept during hypnosis.
“Hypnosis also helps us decrease our emotional response to pain, because suffering is almost always caused by an emotional response to pain,” adds Dr. Jones. “It helps us activate our own natural abilities to suppress pain signals.”
Tackling pain from different angles
Drs. Banez and Jones say their methods sometimes overlap and usually complement one another. In addition to physical and occupational therapy, the Pediatric Pain Rehabilitation Program incorporates psychological and behavioral counseling, mind-body skills training, acupressure and aromatherapy — all of which have been proven helpful, Dr. Banez says.
“The program helps convey that the best way to approach chronic pain is to maintain normal activity despite the pain,” Dr. Banez says. “For some kids, pain may not be a symptom we can totally eliminate, but we may have the ability to have a significant impact. As they become more active, the pain becomes less and less of a problem in their lives.”
Tip: When It Comes to Cereal, Keep It Simple
When your kids beg for colorful, sugary cereals, check the ingredients panel. If sugar is listed as one of the first five ingredients or there are more than 4 grams of sugar per serving, those are red flags. Buy cereals that are closest to their natural state (think rolled oats, shredded wheat and wheat germ), then top with milk and fresh fruit.
Parents Be Well – September 2011 Issue
Feature: Weight Loss – A Happy Accident on the Road to Fitness
An estimated two-thirds of Americans are overweight or obese. But for true health, we need to consider more than just the number on the scale. We need to consider fitness.
Fitness means different things to different people, says Cleveland Clinic exercise physiologist Heather Nettle, MA. Some define it as being able to function physically. Others define it as being athletic and strong.
To Ms. Nettle, the nature of fitness changes as we age. Strength and endurance, among the most important aspects of fitness, naturally diminish over time, and flexibility and balance — aspects of fitness that we may take for granted — become increasingly important.
More than the battle of the bulge
It’s easy to put on pounds as we age and our metabolism slows down. But “weight isn’t an end-all, be-all when it comes to fitness,” says Ms. Nettle. “If you have a little extra weight but are taking steps toward being more physically fit, you’re doing the right thing. Weight loss is just a happy accident in the process of achieving a healthy lifestyle.”
When it comes to fitness, it’s important to be realistic about the effects of aging on mobility and exercise — but that shouldn’t stop your exercise efforts completely. Make regular physical activity a routine. “Everyone should be doing some form of cardio and strength training,” she says. “Walking is a great place to start.”
With regard to weight loss, a strict or unreasonable diet just isn’t part of a healthy equation. To be physically active, your body needs plenty of fuel. “Food is an ergogenic aid for exercise performance — it helps aid performance just like when you put gas in a car to make the car work,” explains Ms. Nettle. “You need the right nutrition to perform physically.”
Comparing your progress in losing weight and becoming fit with anyone else’s is an easy trap to fall into. For example, Ms. Nettle often sees husbands and wives vying with one another to make progress — but comparisons are unreasonable. “It is sensible to make general comparisons with others who are the same age and gender,” she says, “However, genetic factors cause variance.”
That’s why you can’t always tell if someone is healthy or fit by their physical appearance. People who are “skinny-fat” are naturally thin but not very active. People who are “husky-fit” carry extra weight but lead a healthy lifestyle.
Realizing what fitness can do
Sedentary behavior — not weight alone— is the real measure of disease risk, says Ms. Nettle. So the best way to lower your risk of disease is to get moving. The benefits of physical activity are seemingly endless:
- Reduced risk of diabetes
- Lower risk of heart disease
- Reduced risks of prostate, breast and colon cancers
- Greater mobility
- Greater sense of health and well-being
- Higher quality of life with aging
It’s never too late to work on and improve your physical fitness, says Ms. Nettle. Let weight loss be an afterthought. With a healthy lifestyle, including healthy diet and exercise, weight can go where it’s supposed to.
Parents Be Well – September 2011 Issue
Fact Sheets: Sports-Specific Overuse Injuries
From school sports like soccer and football to extracurriculars like dance and martial arts, overuse injuries are on the rise in children and adolescents. Learn what you can do to prevent injury in your child’s sport or activity.
Recipe: Grilled Chicken & Vegetable Pasta Toss
Get one last use out of your grill with this light, one-dish meal. Using whole wheat pasta and fresh vegetables makes it high in fiber, and substituting a low-fat for a full-fat dressing cuts both fat and calories. Be creative, and use any vegetables in season that you have on hand.
4 boneless, skinless chicken breast halves (3 ounces each, about 12 ounces total)
½ zucchini, cut in half lengthwise
½ medium red bell pepper, quartered
½ medium eggplant, quartered
2 Portobello mushroom caps, halved
1 cup (one 8-ounce bottle) low-fat Italian dressing
6 ounces uncooked whole wheat linguine
¼ cup freshly grated Parmesan cheese
- Place chicken and vegetables in a heavy-duty resealable plastic bag. Add ½ cup of the salad dressing. Turn to coat. Close bag; refrigerate at least one hour, turning chicken once.
- Heat grill, then spray grill rack with nonstick cooking spray. Drain chicken and vegetables, reserving marinade. Place chicken on gas grill over medium heat or on charcoal grill 4 to 6 inches from coals. Cook 15 to 20 minutes or until chicken is fork-tender and juices run clear, turning once and brushing frequently with reserved marinade.
- While chicken is cooking, place vegetables cut-side down next to the chicken on the grill. Cook 14 to 18 minutes or until tender, turning once and brushing frequently with reserved marinade. Discard any remaining marinade.
- Meanwhile, cook linguine according to package directions. Drain and toss with remaining ½ cup of salad dressing.
- Remove chicken and vegetables from grill. Thinly slice vegetables; toss with linguine mixture. Slice chicken breasts crosswise, and fan slices over pasta and vegetables. Sprinkle with cheese and serve immediately.
Makes 4 servings
Per serving: (One chicken breast plus 1 cup pasta and vegetables)
Fat: 12 g
Saturated fat: 2 g
Protein: 37 g
Carbohydrates: 44 g
Dietary fiber: 9 g
Sugar: 5 g
Cholesterol: 77 mg
Sodium: 490 mg
Potassium: 822 mg
Recipe from our Children’s Hospital Pediatric Nutrition Support Team
Parents Be Well – September 2011 Issue
Let's Move It! Free Mobile App
Let Cleveland Clinic and your mobile phone keep you motivated. More than just a pedometer, our free mobile app offers walking challenges, a calorie tracker and videos to encourage and inspire.