Friday, December 22, 2006

Specialized clinic for teens dealing with sexual abuse, trauma

Meehan, Mary. Lexington Herald-Leader, May 16, 2006, pg. D1.

Things did not start smoothly for Katherine Helms and Dr. Hatim Omar.

Katherine, sexually abused as a child and placed in foster care, didn't like men. Especially older men. The thought of some strange doctor in a small room, touching her, sent her into a defensive rage.

"I thought she was going to kill me the first time she came here," said Omar, who runs a University of Kentucky clinic dedicated to adolescents.

Katherine had been in dozens of foster homes -- after 26, she lost count. She was getting into trouble at school, acting wild.

But Omar has a way of asking questions -- even the tough and uncomfortable ones -- that is caring but not condescending. He told her to e-mail or call whenever she needed anything.

Now, more than 2 1/2 years since that first meeting, he's become one of the few constants in Katherine's life.

She's been in the same foster home for more than a year. She's making A's in school. She looks forward to monthly visits to the doctor and his team, which includes a social worker and a nutritionist. The clinic has helped her not only with colds and growing pains but also with healing her emotional wounds.

Katherine, 16, who sometimes tells her story to other kids to help spread the word, says the clinic "has helped me with a lot of things." She has learned to cope with stress and to find productive ways to deal with all her hurt and anger.

Today, she's the kind of girl she never dreamed she could be -- one with a future.

Seeing the need
Omar, one of only hundreds of doctors worldwide certified in adolescent medicine, started the clinic in 1998. He said Katherine is a good example of why a specialized clinic for teens is needed.

Adults might be concerned with high blood pressure, heart disease and diabetes. Teens need help in dealing with abuse, accidents, suicide, eating disorders, sexually transmitted diseases and pregnancy. Each year, the clinic sees about 3,500 patients. In addition to physical health, the focus is on recognizing risk-taking behavior or mental health issues early to avoid complications including teen pregnancy or suicide.

Omar is planning satellite branches in the state, perhaps in Pikeville or Somerset. The Kentucky legislature recently allocated $150,000 a year to support that effort.

Teens sometimes fall into a vacuum when it comes to health care, Omar said. Some pediatricians don't treat teens. Some doctors won't take foster children or difficult-to-treat cases. Some aren't trained to deal with teens, and others don't have the time or resources to determine the best course of care.

Omar's team takes all adolescents, regardless of their ability to pay or how challenging the case might be.

A unique approach
Recently, a woman told Omar her severely autistic son hadn't been to a doctor's office in years. Her son, who had a fear of going into office buildings, did manage to receive prescriptions from a psychiatrist because the doctor agreed to meet the family in the parking lot and talked to the boy through the car window.

When she was told Omar's team would try to arrange a home visit, she cried.

Other cases aren't as dramatic, but they're just as troublesome for parents, especially when a teen complains of not feeling well but a diagnosis remains elusive.

Sometimes. chronic problems have simple solutions, said Omar, who also uses the clinic as a teaching tool for University of Kentucky medical students.

Teens often complain of headaches, and many times the headaches are tied to dehydration, Omar said. If teens drink sodas loaded with salt all day and nothing else, they might seem to be getting plenty to drink, but their body isn't getting the hydration it needs. Another common malady, chronic stomachaches, can be tied to severe constipation because some teens refuse to use school restrooms, he said.

A variety of ills
Other health matters -- especially those involving sexual development and activity -- are difficult to talk about. For example, Omar said, most adolescent boys will temporarily develop enlarged breast tissue. It's all caused by the temporary imbalance in the teen's surging hormones and happens when the female hormone estrogen out-muscles the male hormone testosterone. Omar said few teen boys want to talk about their growing breasts. Some are so ashamed or disturbed they become suicidal, said Omar, who also leads a heralded anti-suicide group.

The clinic treats teens for emotional ills as well. Christian Farmer, 18, came in from Somerset after a car wreck 18 months ago. Tamara Miller, her mother, said her daughter slipped away in front of her.

"I watched a very healthy and active child who became somebody who would lay around and cry," Miller said. "I knew something needed to be done, but I didn't know what."

The car accident, in which Christian was thrown from the back seat to the front, didn't result in broken bones. Local doctors, she said, disregarded the family's repeated attempts to find an answer. She's a teen, they told Miller. Teens complain. She's fine.

In Omar, Christian said, she found a "doctor who actually listened to me."

Her pain was real, and the doctor prescribed anti-inflammatory drugs. He also determined that the accident and the aftermath had led to serious depression.

After just two weeks of treatment, Miller said, Christian has "a new light in her eye."

Making progress
For Katherine, the clinic has been a lifeline. During a recent visit, the brown-haired girl sat, staring into the distance, a vacant look in her kohl-rimmed eyes, talking to her social worker in a low, even voice.

There was a boy. She liked him. She was afraid he wouldn't, really, like her. If he knew all her story -- all the trouble, the sexual abuse, all the foster homes -- he would leave her. And in the end, he did.

Everybody leaves her.

The social worker, Marlene Huff, pointed out that the team is there for her and won't leave. Katherine, who has a dainty pair of purple earrings and a small hand-carved vessel of rose oil in her pocket that were gifts from Omar, considered this at best a possibility. But she kept talking, moving on to complain about how she's been bickering with her foster mother about being able to go out with her friends. She wants to get a job. Her foster parents want her to concentrate on school.

Normal problems, Huff kept saying over and over. You are dealing with things every teen deals with -- not how you are going to survive the night, not how to avoid the grown-ups around you.

That's progress.

Reach Mary Meehan at (859) 231-3261 or 1-800-950-6397, Ext. 3261, or

Find out more
For more information about Adolescent Medicine and the Young Parents Program, call (859) 323-5643.

The clinic, at the University of Kentucky, provides a wide range of physical and emotional treatments specifically for teenagers. Omar started the clinic in 1998. The clinic now sees 3,500 adolescent patients a year, helping teens deal with abuse, accidents, suicide, eating disorders, sexually transmitted diseases and pregnancy.


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