Health & Safety, Parenting Tips

Healthy Meal Prep Tips for Busy Parents

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By Elise Harlow, registered dietitian at CHOC Children’s

When life gets busy, making homemade meals can fall to the bottom of your to-do list. Drive-through or take-out dinners may sound more appealing and time-friendly! While there is nothing wrong with the occasional fast-food meal, by cooking meals at home you can reduce the amount of added fat and sodium, and have control over the types of ingredients going into your family’s food.

To increase the amount of homemade meals you have on hand during busy times, meal planning and meal prepping can be your best friend. This can also be a great way to involve your kids in the kitchen and increase their interest in healthy foods.

Meal planning: this means taking one day out of the week to sit a down with a planner and plan out your meals for the upcoming week. After your meals are planned out, make a grocery list for all the ingredients you will need for the week.

Helpful tip: use leftovers from dinner for lunch the next day. For example, a roasted chicken for dinner can become a chicken salad sandwich for lunch the next day

How to involve your children: Let your children help you in planning meals by letting them choose what is for dinner one night a week. Maybe one day they can choose a meal that they know they like, and one day they get to pick a new food that they would like to try. You can even bring your children along with you to the grocery store to help pick up the ingredients needed for the week. Children tend to be more likely to try new foods when they have some sort of say in what they are eating.

Meal prepping: this means that once a week you pre-cook whatever meals from your meal plan that allow for this. For example,  roasting a chicken on Sunday and using the chicken in dishes for the rest of the week, or making lasagna on Sunday for dinner during the week, or portioning out yogurt and fruit in single-serving containers for easy grab-and-go breakfasts each day of the week.

How to involve your children: assign your children age-appropriate tasks that they can do on their own. Again, this will increase their interest in the food and could make them more likely to try new foods. Some ideas include scrubbing vegetables, counting ingredients, measuring, or mixing ingredients together.

A crock pot or slow-cooker can be your best friend during busy times. The beauty of a crock pot is that you can throw the ingredients in the crock pot in the morning on your way out the door to work and arrive home to a warm, homemade meal for you and your family. Looking for ideas? Below is a recipe for steel cut oats, that could even be cooked overnight, which means waking up to warm cooked breakfast!

Slow Cooker Steel Cut Oatmeal

Recipe adapted from CookSmarts.com
Ingredients
2 cups steel cut oats
6 cups water

2 cups milk of any type
2 tablespoons butter
2 to 3 peeled apples
¼ cup honey
2 teaspoon salt
1 tablespoon cinnamon
Optional add ins: flax seed, chia seed, almonds, pecans, shredded coconut, hemp seeds, pepitas, etc.

Directions

  1. Spray the slow cooker with cooking oil or brush with cooking oil to prevent sticking.
  2. Put all ingredients into the slow cooker. Cook on low for 8 hours or high for 4 hours.
  3. Top with optional add-ins of your choice.

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Health & Safety

Meet Dr. Esther Yang

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CHOC Children’s wants its patients and families to get to know its specialists. Today, meet Dr. Esther Yang, a pediatric psychiatrist.

Dr. Esther Yang
Dr. Esther Yang, a pediatric psychiatrist at CHOC Children’s

Q: What is your education and training?

A: I attended UCLA for my undergraduate studies, Loma Linda University for medical school, and University of California, Irvine for both my psychiatric residency and child and adolescent psychiatry fellowship.

Q: How long have you been on staff at CHOC?

A: Two months.

Q: What are your special clinical interests?
A: I am interested in cultural psychiatry, the integration of mental health and spirituality, and implementing a holistic approach in treatment by working with therapists and other providers to integrate care. During fellowship training, I received a grant from the Substance Abuse and Mental Health Services Administration to work with minority communities in building awareness about mental health.

Q: What are your most common diagnoses?

A: Depression, anxiety and ADHD. It seems to be much harder today to be a teen than it was ten years ago with social media, bullying and increased responsibilities.

Q: What would you most like community/referring providers to know about you/your division at CHOC? 

A: In the psychiatry clinic at CHOC, virtually every patient that we see is also seen by a therapist in the same clinic, making it possible to integrate care, and all of our doctors are fellowship trained in child and adolescent psychiatry. There are many resources and more on the horizon with the opening of the inpatient unit and the intensive outpatient program.

Q: What excites you most about CHOC’s mental health initiative? 

A: It’s an exciting time at CHOC with the upcoming opening of the inpatient mental health unit, programs such as the intensive outpatient program and new clinics – all coming at a time when there continues to be a shortage in providers and services in psychiatric care. It inspires me to work at a place that is committed to the treatment of children and advancing mental health care.

 Q: What inspires you most about the care being delivered at CHOC? 

A: I love the concept of a hospital that is dedicated to the treatment of children and that every single person shares that dedication. I’ve had personal experiences with my children being patients at CHOC prior to working here and it was a very positive experience where we felt genuinely taken care of. I knew that if I ever had the opportunity to work here, it would be a privilege.

Q: Why did you decide to become a pediatric psychiatrist? 

A: I decided to become a pediatric psychiatrist my senior year in high school after hearing a psychiatrist talk about mental health and the great stigma that exists in minority communities during a lecture at our church. I’ve never regretted this decision and it’s been an incredible journey. I enjoy listening to everyone’s unique stories and working to break stigmas and barriers to access to care, which continue to exist.

 Q: If you weren’t a physician, what would you be and why?

A: Honestly, I would probably be a stay-at-home mom. I love spending time with my family, doing crafts with my kids and cooking. I also believe that the key to healthy kids starts in the home, and my skills as a psychiatrist are sometimes useful at home when it comes to training and discipline.

 Q: What are your hobbies and interests outside of psychiatry? 

A: I enjoy reading, baking, and crafting.

 Q: What was the funniest thing a patient told you?

A: I told my therapy patient that I would have to transfer his care to another doctor because I was going on maternity leave. He replied, “Oh, I thought you were fat or something.” I was nine months pregnant.

Download the Let's Talk Guide and start a conversation about mental health

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Health & Safety

Stomach Flu or Appendicitis? What Parents Should Know

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Parents often mistake appendicitis for a bad stomachache. It can be particularly difficult to diagnose in younger children, who can’t adequately describe their pain. CHOC Children’s pediatric surgeon Dr. Troy Reyna, who says appendicitis is the most common reason for abdominal surgery in children, provides helpful insight for parents in the following Q & A.

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What is the appendix? 

The appendix is a small extension of the intestine usually the size and length of one’s little finger. The appendix finds its home in the right lower corner of the abdomen. It is attached to the cecum, which is the beginning of the large intestine.

What is appendicitis?    

It is thought that appendicitis starts as a result of obstruction either by swelling of the inner lining (mucosa) or by hard stool (fecalith). Once the obstruction starts, the appendix swells, resulting in pain that may start centrally and later migrate to the lower right abdomen. Anyone with an appendix can get appendicitis. Approximately 80,000 children in the United States suffer from it each year.

How do I know my child’s pain is related to appendicitis?

The pain with appendicitis may be vague in the beginning and be confused with the stomach flu. Generally, though, the flu will subside after 24 hours of slight bowel rest. In appendicitis, the pain will increase in intensity and often cause a child to become immobile, as movement can aggravate the pain. The location of the pain is usually midway between the navel and the right hip bone. Pain that persists and is associated with other symptoms, such as vomiting, decreased appetite, decreased frequency of stools or changes in mental status, requires prompt attention by a medical professional.

What will be done for my child?             

If your child is seen in a doctor’s office and his exam is mild, you will likely be advised on fluid management and told to follow up in 24 hours if no improvement is noted. If your child is seen in a pediatric emergency facility, such as the Julia and George Argyros Emergency Department at CHOC Children’s Hospital, he will likely receive an IV (intravenous) to get needed fluids, and get blood drawn for a lab study. He may also receive an abdominal ultrasound. If a diagnosis of appendicitis is considered, then a pediatric surgeon will be called to assess your child and address any questions or concerns you may have.

What kind of operation is involved?     

The operation for appendicitis is usually done with laparoscopy. One to three small incisions are made in the belly button and off to the side. Small plastic tubes are placed through the incisions. A camera is placed into the abdomen to visualize the appendix or look for the cause of the pain. The appendix is usually then stapled or tied off and removed. The small incisions are closed. If the appendix was not ruptured, your child can drink and eat as soon as it is safe and go home within 24 hours of surgery. If the appendix is ruptured, your child will need extra antibiotics for several days to treat the peritonitis and prevent further infection.

What if it is not appendicitis?   

The appendix is carefully inspected during the surgery. In about 15 to 20 percent of the time, the appendix is normal and another cause is discovered that will require surgery. The cause may be an anomaly of the gastrointestinal tract. In girls, the problem could also be related to the fallopian tubes or ovaries. Whatever the cause, it will be treated. After surgery, the pediatric surgeon will brief you thoroughly on details and expectations.

What can I expect after surgery?              

After your child is discharged from the hospital, there will be a short recuperation at home – approximately two to three days. He will be restricted from physical education for two to three weeks. He’ll need to be seen, for follow up, by his surgeon about two weeks after leaving the hospital. Within six weeks, your child should be able to resume normal activity.

Dr. Troy Reyna is a pediatric surgeon with CHOC Children’s Specialists. He is board certified in general and pediatric surgery. He can be reached at 714-364-4050.

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    Stories

    CHOC Nurse Following in her Mother’s Footsteps

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    Spending her lunchtime with her young daughter Monica was something Maria Arreola always enjoyed when working her shift at CHOC Children’s Hospital. Proud of both, she looked forward to the times when Monica could join her at the hospital. And Monica enjoyed it, as well. Little did the two know then just how much of an impact those times together would have on their futures.

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    Maria Arreola joined CHOC in 1981 – a dream come true. Eager to get a foot in the door, she accepted a position with the environmental services department in hopes she’d eventually land a spot as a clinical assistant (CA). Six months later, she was working as a CA in oncology.

    She loved her job, and particularly enjoyed when her daughter Monica would visit her for lunch. Maria’s co-workers would frequently ask Monica what she wanted to be when she grew up. Her reply was always the same: “a nurse.”

    “I saw something very special in Monica, something that told me she would be a wonderful nurse,” says Maria.

    Though she didn’t tell her mom. Monica wasn’t always so sure. What she did know, however, is that CHOC was unique.

    “Even at a young age, I knew CHOC was different, and I thought it was so special because it was just for kids,” recalls Monica.

    The kids are what drew her mom to CHOC.

    “I love working with children and their families; it’s my passion. And being at CHOC means I get to care for patients, as well as provide support to their parents. It’s wonderful to be able to make such a difference,” explains Maria.

    That desire to make a difference lured Monica to follow in her mom’s footsteps. She joined CHOC in 2007 as a CA in the neurosurgical unit. At the time, Maria was working in that same unit.

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    Monica grew up visiting her mom, a registered nurse at CHOC Children’s Hospital, on lunch breaks. Inspired by her mom’s work ethic and compassion for patients, she grew up to be a registered nurse at CHOC.

    “Whenever we had the same shifts, I admired my mom’s work ethic and was inspired by her passion and her ability to connect with families,” says Monica.

    And like her mom, Monica enjoys practicing patient-and-family-centered care.

    “I love being an advocate for my patients, and a voice for those who perhaps can’t verbalize. As care providers, we need to partner with our patients and their families to really understand and meet their needs,” explains Monica.

    After a few years, and with encouragement from her mom, manager and co-workers, Monica decided to become a registered nurse. She continued to work part-time as a CA while completing her education. The support from everyone was amazing, says Monica.

    Most recently, she completed CHOC’s RN Residency Program.  And, to the delight of her mom and her co-workers, of whom many watched her grow up, she was hired as a registered nurse in the neurosurgical unit. Monica’s mom still works at CHOC, in the neurosurgery clinic. So, while one Arreola works with CHOC Children’s Neuroscience Institute patients on the inpatient side, the other gets to interact with them as outpatients.

    “I am so proud of my daughter, of the human being and of the nurse she became. I also still love working at CHOC,” says Maria, who recently celebrated her 25th year. “Having my daughter part of my CHOC family, as well, is amazing.”

    When Maria and Monica aren’t working, they enjoy spending time with their family, going on hikes and enjoying Maria’s cooking.

    Have you been inspired by a nurse at CHOC? Nominate them for the Daisy Award

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    Inspiring the Next Generation of Nurses

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    In honor of National Nurses Week, and as part of CHOC’s week-long celebration of our incredibly skilled and caring nursing staff, we asked several members of our nursing leadership team what advice they would offer to the next generation of nurses.

    nurses
    Melanie Patterson, vice president of patient care services and chief nursing officer

    Melanie Patterson, senior vice president and chief nursing officer

    Q: What advice do  you have for those pursuing their professional aspirations?

    A: Recognize your strengths and spend time building on them. Don’t waste time focusing on your flaws; instead, strut your strengths! Know who you are and be that person always. Don’t beat yourself up when something doesn’t go perfectly. Sometimes, what we consider our biggest “mistakes” can make the biggest wake. Realize you make a wake, whether rough waters or not, so make that wake count. Showing your humility in the face of adversity is many times the best gift you can give another person or group.

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    Nancy Kraus, service line director of critical care, director of clinical education

    Nancy Kraus, service line director of critical care, director of clinical education

    Q: What advice do you have for aspiring nurses?

    A: In any profession there are a variety of roles and responsibilities you can have throughout your career. Typically you choose “A” and think you might progress to “B” or “C.” Don’t rule out “D thru Z.” Sometimes you find what you are most passionate about by stepping outside your comfort zone. Take every opportunity that is offered to you large and small – all will become growth experiences that help you progress personally and professionally. As a young nurse just starting my career I never would have imagined I would have had the opportunity to be a bedside care provider, a college professor, a national public speaker at conferences, a global health volunteer, a peer leader with my physician partners, assist in research, lead an organization to a Magnet award of excellence, mentor others, be “the neighborhood nurse,” and now a director over critical care. All of these opportunities came because early on I decide to say “yes” when opportunities were offered to me to try something new, when someone asked for help, when I joined a group project or chose to be engaged and participate outside of my primary position.

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    Alisa McCormick, nurse manager, pediatric intensive care unit

    Alisa McCormick, nurse manager, pediatric intensive care unit

    Q: What is something you wish you would have known when you began your career?

    A: I wish I would have had the advice that a friend gave me recently. The advice was to always have someone behind me that I am helping to grow and develop, and someone ahead of me that is a mentor, helping me to grow and develop. Embracing such a simple concept of balance as a new nurse would have helped me focus and develop my career much sooner. I waited over 20 years to return to school mostly out of fear. Returning to school allowed me to gain the skill and confidence to step out of my comfort zone, become a manager, participate in evidenced-based projects, lead hospital-wide initiatives, mentor and develop my staff, and most importantly support the development of a unit-based mentor program for new nurses in the PICU.

    Susan See, nurse manager, neuroscience unit

    Q: What advice do you have for aspiring nurses?

    A: Everyone has their own unique story. It is up to you to determine what your story looks like. Whether you are early in your career or you have been in healthcare for years, there is no better time than right now to keep your passion alive and active by embracing opportunities and striving to reach new goals. Decide what is most important to you, make deliberate choices, and run full force to attain your goals. There is something magically satisfying about doing what you love. It makes you better at what you do, and best of all, you will shine that satisfaction. Thoreau said, “Never look back unless you are planning to go that way”. Be uniquely you and continue to create what you want your story to look like!

    Have you been inspired by a nurse at CHOC? Nominate them for the Daisy Award

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    Oncology Patient Grows Up to Become CHOC Oncology Nurse

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    When most adults think back to their earliest memory, they might remember a field trip in preschool or a vacation with family. But Caroline, a registered nurse in the Hyundai Cancer Institute at CHOC Children’s, remembers CHOC. She was diagnosed with cancer at age two, and spent the next two and a half years in and out of treatment.

    nurse
    Caroline was diagnosed with cancer at age two. Years later, after winning her battle, she returned to CHOC as a registered nurse.

    “I remember the playrooms, my nurses, the child life specialists, and the friends I made in the hospital,” she recalls. “Several families got really close because of our shared experiences and regularly got together for years after we all finished treatment.”

    Caroline now works alongside several of the nurses and physicians who helped her beat cancer as a young child.

    Karen DeAnda, a registered nurse at CHOC, was the first one to care for Caroline after her diagnosis, and started Caroline’s very first IV.

    “I do recall the day Caroline came in for the first time. She was tiny, and I was a brand new nurse,” DeAnda says. “Those initial first days when a patient is being diagnosed is very difficult on the entire family. I clearly remember the day she was diagnosed and helping her through that first evening in the hospital. It was a surreal experience to see her so many years later as a grown woman; it made my heart pound. She is truly an inspiration to our patients and families.”

    nurse
    Caroline was a young child when she was at CHOC fighting cancer. Today, she’s a registered nurse at CHOC standing alongside patients fighting their own cancer battles.

    Caroline’s parents were at her bedside as often as they could be, but when they weren’t able to be there, her nurses stepped in.

    “My nurses were the people who were always there with me when my parents couldn’t be. It was like a big family,” she says. “My mom was a huge worrier, and for her to trust my nurses was a big thing.”

    Although Caroline was very young when she was diagnosed with cancer, she has a unique connection to the patients she now cares for and their families.

    “Caroline’s compassion and firsthand experience is a gift to our patients and their families. Whether or not she even shares her story with her patients, the fact that she has walked that walk, regardless of her young age at the time, allows her to have immense empathy and understanding for what the entire family is experiencing,” DeAnda says.

    The impact that Caroline’s care team had on her as a patient directly influenced her career path.

    “I’ve always been interested in medicine,” she says. “There was never a question about what I wanted to do when I grew up; I always knew that I would become an oncology nurse at CHOC.”

    For a short time during her undergraduate studies, she momentarily lost sight of that goal, and was struggling in school. At the time, CHOC was in the midst of constructing the Bill Holmes Tower, and Caroline’s dad arranged for the two of them to have a behind-the-scenes tour. One of Caroline’s primary nurses during her cancer treatment, Melanie Patterson, now the vice president of patient care services and chief nursing officer at CHOC, showed them the new technology and amenities that would be coming to CHOC, and it reignited Caroline’s passion.

    She applied to nursing school the next day, and began volunteering in CHOC’s oncology unit, two things that made her former nurse very proud.

    “I remember Caroline’s beautiful hair the day she was diagnosed. This beautiful toddler girl— my heart melted for her immediately. She was very young when she was treated, but this prepared her for the emotional, mental and physical toll of oncology nursing” Patterson says. “We have many former patients working at CHOC, and it makes my heart and soul glow knowing that CHOC nurses have impacted kids growing into adults that way.”

    Once on the receiving end of the small acts of kindness from nurses — who once went out of their way to pick up Caroline’s favorite food when she was sick from treatment and wouldn’t eat—Caroline now understands the importance of going the extra mile for patients and families.

    “Remembering how a mom takes her coffee in the morning, or seeing a child who is cold and bringing them a heated blanket when they didn’t even know we had those, can sometimes be the thing that changes their outlook on the whole day, and such a welcome surprise for them,” Caroline says.

    Transitioning from patient to nurse did not happen without a few unexpected revelations.

    “When I became a nurse, I was surprised at how much this career is a labor of love. When I was a patient, I had no idea how much work nurses did behind the scenes when I wasn’t looking,” Caroline says. “I felt like the center of their whole world. I didn’t know they had a lot of centers of their world.”

    As much as Caroline enjoys caring for pediatric oncology patients the way she once was cared for, she loves even more when she gets to send them home.

    “What I love most about working at CHOC is seeing patients get healthy and sending them home, where they belong,” Caroline says. “I also love seeing so many people come together for one child’s health. Seeing that happen day after day is really powerful.”

    Have you been inspired by a nurse at CHOC? Nominate them for the Daisy Award

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    Health & Safety

    Cancer Patient to Caregiver

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    When Kim was seventeen, her life looked much like a typical teenager’s. She had a part-time job, enjoyed trips to the beach with friends, and was anxiously awaiting her senior year of high school.

    But when she found herself short of breath more often than her friends were, her mom brought her to a local emergency room , just in case. She was ultimately diagnosed with acute lymphoblastic leukemia.

    She would spend the next 26 months in and out of CHOC Children’s fighting cancer, but always with an end goal in mind: to return someday as a hematology/oncology nurse at the Hyundai Cancer Institute, which she did, ten years after her diagnosis.

    “Even back then I thought that when I was better, I was going to be a nurse at CHOC,” she says. “I don’t think I chose my career; I think it chose me. Ever since I got sick, there was never an option to do anything else, anywhere else.”

    Despite spending so much time in and out of the hospital while fighting cancer, Kim says she never felt like a patient, something she credits to her nurses.

    “I was very involved in my care because I was fascinated by medicine,” she says. “They had protocols to follow and did everything they needed to, but I never felt like a patient. I was always Kimberly.”

    Despite knowing the hospital setting from a patient’s perspective, there were a few surprises when she joined the care team.

    “At the time, I didn’t realize all the behind-the-scenes work of being a nurse,” Kim says. “No matter what stressful situation had occurred to them earlier that day or just before they came into my room, it didn’t matter. As soon as they would walk into my room, it was all about me, and they were leaving their stress at the door.”

    She now works alongside several physicians and nurses who cared for her when she was a patient.

    “A lot of times when I see them, despite the hustle and bustle of working in a hospital, they’ll take a moment to come up to me and hug me extra tight,” Kim says.

    One of her nurses, Dana Moran, lights up every time she sees Kim. The two bonded over TV shows, movies and anything else Kim had wanted to talk about when she was a patient.

    “At that age, it’s easy to become discouraged and shut down emotionally, but not Kim,” Dana says. “She was scared and she was sick, but she never lost her sense of humor. She remained strong and positive for the people around her who were worried about her.”

    Small acts of kindness from nurses like Dana have stuck with Kim for more than a decade.

    “My mom would tell me how the nurses brought her hot coffee every morning, and how much a small gesture like that meant so much to her. So, I try to tap into the little things like that, since I know they make such a big difference to patients and families,” she said.

    Kim’s pediatric oncologist, Dr. Lilibeth Torno, met Kim’s ambulance upon her initial transfer to CHOC, and they now work side by side.

    “I admitted Kim when she was first diagnosed. Her mom had a bouquet of flowers which she handed over to me,” Dr. Torno recalls. “As a former patient, she truly understands, more than anyone else, what it is like to have a life-threatening diagnosis. She experienced firsthand the difficult procedures and treatment her diagnosis entailed, and it has made her an effective advocate for her patients. It is a joy and privilege to walk this difficult journey with our patients. It truly makes my work meaningful to see them move on in life.”

    Kim’s time as a patient also affected her career on a very detailed level.

    “Whenever I do a task, no matter how small, I can remember when that was done to me, and I think it brings a softer touch to what I do,” she says. “My whole heart is in what I do. I treat my patients’ families like they were my own.”

    Celebrating important milestones for patients is an especially heartfelt part of her role as a nurse.

    “As much as we love seeing our patients here, there is nothing better than being able to send patients home,” Kim says. “I remember how happy I was to be sent home at the end of a hospital stay, and I love being able to help them celebrate by singing, “Happy Last Chemo to You.”

    Have you been inspired by a nurse at CHOC? Nominate them for the Daisy Award

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    A Heartfelt Thank You to All CHOC Nurses

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    nurse
    Melanie Patterson, vice president of patient care services and chief nursing officer

    By Melanie Patterson, vice president of patient care services and chief nursing officer

    Every day we are inspired by the compassionate care our nursing staff provides for patients and their families. But as we celebrate National Nurses Week, we take an extra moment to celebrate the extraordinary skill and empathy you bring to CHOC Children’s.

    All of our nurses are committed to every patient and family that walks onto the campus. CHOC is grateful for the way you partner with parents as valued members of a patient’s care team. Our nursing staff cares for the entire family, and we know we cannot be successful without a strong partnership with parents. You are often tasked with walking a difficult journey alongside your patients. Thank you for understanding that often small acts of kindness make a big difference with the families that entrust us with their child’s care.

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    Our organization’s commitment to nurture, advance and protect the health and well-being of children is brought to life by our world-class nursing staff. We recognize and appreciate the sacrifices you often make in order to provide the best care for kids in Orange County.

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    Throughout my 24 years at CHOC, I’ve been blessed to work alongside many of our outstanding nurses. Several of you first came to CHOC as an oncology patient,  and I had the privilege of being your bedside nurse. Seeing the brave way you battled cancer, and then seeing you grow up and return to CHOC as oncology nurses makes my heart and soul glow knowing that CHOC has impacted kids growing into adults that way.

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    Thank you all from the bottom of my heart for the miracles you perform every day. It’s my honor to work alongside each and every one of you.

    Have you been inspired by a nurse at CHOC? Nominate them for the Daisy Award

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    Stories

    Why I Love Being a CHOC Nurse

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    In celebration of Nurses Week, we asked a few members of our nursing staff to share what they love most about being a nurse at CHOC Children’s. Here’s what they told us:

    Cassandra Maxwell, clinical nurse, hematology/oncology unit

    Kendall Quick, clinical nurse, neuroscience unit

    Monique Pena, clinical nurse, pediatric intensive care unit

    Sheila Paris, nursing supervisor


    Dana Moran, charge nurse, outpatient infusion center

    Pernilla Fridolfsson, clinical nurse, PICC team

    Tayler Key, clinical nurse, medical unit

    Have you been inspired by a nurse at CHOC? Nominate them for the Daisy Award

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    Health & Safety

    Stimulants Abuse in Teens

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    By Sandy Merino and Jennifer Yen, clinical pharmacists at CHOC Children’s

    With final exams right around the corner, teens will be tempted to turn to stimulants as they hope to cram in some last-minute late-night studying. Kids seem to be under more pressure now than ever before. Get to know the dangers of stimulant abuse to help your kids make smart decisions and stay healthy while performing under pressure.

    These days, stimulants are only prescribed to treat a few health conditions, including attention deficit hyperactivity disorder (ADHD), narcolepsy, and rare cases of depression that have not responded to other treatments. Any time these drugs are taken in a way that is not intended, it is considered abuse.. This includes taking someone else’s prescription, taking the medication in ways other than prescribed, and taking the stimulant to get high. A basic understanding of stimulant abuse can help you as a parent protect your family and friends against it.

    The Science Behind Stimulants

    As the name suggests, prescription stimulants increase biochemical activity in the brain that can help boost alertness, attention and energy. The most common prescription stimulants are Adderall, Ritalin and Concerta. ADHD is one of the most commonly diagnosed conditions in children and adolescents. According to the Centers for Disease Control (CDC) and National Institutes of Health (NIH), approximately ten percent of children between ages 4 and 17 years are diagnosed with ADHD, and about 60 percent of them take medication. When they are taken as prescribed they are generally safe and effective. Doctors prescribe these medications starting at low doses and then gradually increase them, monitoring for effectiveness and side effects. The lowest effective dose is then continued, and the child is monitored on a regular basis. When taken as prescribed, many of these children will experience a reduction in ADHD symptoms and an improvement their academic performance, behavior, social relationships, and self-esteem.

    Unfortunately, stimulants can be abused, and often by friends and family. Did you know that almost ten percent of high school seniors admit to abusing ADHD medications in the past year, according to the National Institute on Drug Abuse? This number is as high as 35 percent among college students.

    Pressure to perform tempts teens to turn to stimulants

    Teens and young adults who abuse stimulants often do so for a better ability to concentrate, increased energy and more confidence. Academic pressures are the main trigger for teens and young adults to abuse stimulants, such as pulling all-nighters to study. What they might not realize, though, is that these drugs can be habit-forming when abused and can be dangerous when taken in high doses. Stimulants can speed up heart rate and blood pressure, and cause insomnia and anxiety. Although students expect stimulants to help their academic performance, studies have found that stimulants do not increase learning or thinking ability when taken by people who are not diagnosed with ADHD. Students who abuse prescription stimulants actually had lower GPAs in high school and college than those who didn’t abuse prescription stimulants, according to the NIH.  Although a late-night study session and some Adderall might seem like a good way to cram for exams, it actually doesn’t work, may hurt them in the short-term, and definitely won’t help them with their long-term goals.

    While some teens turn to caffeine pills or Adderall medication believing it will help them focus and cram for school exams, others turn to energy drinks. Many teens aren’t aware of exactly how much caffeine they’re consuming in each energy drink. Although experts consider 200-300 mg of caffeine a day to be a moderate amount for adults, teens should limit their consumption to much less, about 100 mg per day. Meanwhile, many caffeinated drinks easily contain 80-160 mg of caffeine in one serving. Some popular energy drinks contain up to 240 mg per can. Teens consume caffeine in more places than they realize: hot chocolate, iced tea and non-cola soda all contain caffeine. Too much of it can lead to anxiety, dizziness and headaches.

    Abusing stimulants to get high

    While some teens abuse stimulants for academic performance, others may use them to get high. When stimulant medications are taken suddenly and in ways not prescribed, they can rapidly increase dopamine activity in the brain, causing a sense of euphoria, which can increase the risk of addiction. This effect on the body and brain is similar to the effect of illicit drugs. Prescription stimulants are normally meant to be taken by mouth in a pill form, but other ways of abusing them include crushing the tablets to snort or inject them. This can cause additional problems because inactive ingredients in the tablets can block small blood vessels, leading to severe damage to the heart, brain and other organs, not to mention the risks associated with intravenous drug abuse, such as hepatitis and HIV/AIDS. Another form of prescription stimulants is a prescription patch, which contains an entire day’s worth of medication that is meant to release slowly over time through the skin. Some people abuse the patch by extracting the medication and consuming it all at once or by chewing on the patch. This is an extremely unsafe method of prescription drug abuse due to the more rapid method of exposure.

    Be aware of the most commonly abused stimulants and their side effects:

    Drug Street Name Medical Use Reason for abuse Adverse Effects
    Amphetamines (Eg: Adderall and Dexedrine)

    Methylphenidate (Eg: Ritalin and Concerta)

    		 Skippy

    The Smart Drug

    Vitamin R

    Bennies

    Black Beauties

    Roses

    Hearts

    Speed

    Uppers

    Lightening

    Amped

    Black/Blue Mollies

    		 ADHD

    Narcolepsy

    Depression

    		 Academic performance enhancement

    To stay alert

    Lose weight

    Get high

    		  Decreased sleep

    Decreased appetite

    Sense of anger

    Paranoia

    Increase in blood pressure

    Dangerously high body temperatures

    Irregular heartbeat

    Risk for seizures and stroke at high doses

    If you or your family has ADHD medication at home, be aware that it may be of interest to friends and family. Keep a close eye on your supply, especially if you have other teens and young adults in the house. Always keep medication out of reach of children. Keep open lines of communication with your kids about the pressures they experience and healthy perspectives on drug abuse. If you notice any red flags like a rapidly dwindling medication supply or sudden increases in cash flow, talk to them about it.

    If you notice some changes in your teen and suspect drug abuse, look out for red flags such as: insomnia, excessive weight loss, twitching, disinterest in their hobbies, memory problems, neglect of personal appearance, sudden disinterest in work, school, or family responsibilities, or change in spending habits (for example, money missing or sudden requests for money without a reasonable explanation). If you notice or suspect signs of a drug problem in your teen, take action right away. Consult their primary care physician or school guidance counselor.

    If you or someone you know is in a crisis and need to speak with someone immediately, call the National Suicide Prevention Lifeline: 1-800-273-TALK. This is a crisis helpline that can help with a variety of issues.

    If you need information on treatment and available resources, speak to your child’s primary care doctor, or visit the Substance Abuse Treatment Facility Locator, or the National Institute on Drug Abuse for Teens.

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