Teens get a chair of their own

Ex­perts hope the cre­ation of Aus­tralia’s first aca­demic chair in ado­les­cent health will spur in­ter­est in a ne­glected area of medicine. Health ed­i­tor Adam Cress­well re­ports

The Weekend Australian - Travel - - Health -

KYLIE Pol­glase knows only too well the ex­tra pres­sures ill­ness places on teenagers. Born with cys­tic fi­bro­sis, by the age of 13 she was des­per­ately ill and needed a dou­ble lung trans­plant to sur­vive. At a time when other young­sters were busy so­cial­is­ing, study­ing and find­ing out about them­selves, oth­ers and the world, Pol­glase was hid­ing in her room.

She felt iso­lated and was deeply de­pressed, re­luc­tant to speak to friends or fam­ily.

‘‘ I was al­ways in the dark and I didn’t like sun­light or any­thing like that any more,’’ she says. ‘‘ I just didn’t have any emo­tion, I was kind of like a zom­bie.’’

By the age of 13 she had watched five friends die from cys­tic fi­bro­sis, a fig­ure that climbed to nine over the next two years. Be­fore she got her own lung trans­plant in 2005, at the age of 18, she spent al­most a year in hospi­tal, much of the time dosed up on mor­phine to kill the pain of her lungs col­laps­ing.

But even when she was at home, life wasn’t great. ‘‘ Friends my age didn’t re­ally un­der­stand, and I felt like there was no point talk­ing to any­one about it be­cause no one was go­ing through what I was,’’ she says. ‘‘ I started to with­draw from peo­ple and lock my­self away in my room prac­ti­cally ev­ery day.’’

In fact, Pol­glase was one of the luck­ier ones. She was treated by one of the rel­a­tively few doc­tors who spe­cialise in ado­les­cent health, and a nurse on her ward was set­ting up a peer sup­port pro­gram for teenagers with chronic ill­nesses. It be­came Pol­glase’s life­line.

‘‘ It used to be the only thing I would get out of bed for,’’ she re­calls. ‘‘ In hospi­tal I was on mor­phine 24/7, and I would drag my I/V pole with me when I went to the group. We never spoke about what med­i­cal prob­lems we had, but if some­one said ‘ I had the worst blood test to­day’, ev­ery­one could re­late to it. At school if I said ‘ one of my friends just passed away’, ev­ery­one would freeze, be­cause they didn’t know how to re­act.’’

Af­ter her op­er­a­tion, Pol­glase re­turned to the group as a peer leader, and de­scribes her­self as ‘‘ pas­sion­ate’’ in the cause of im­prov­ing health ser­vices for ado­les­cents.

But if this makes it sound like a sim­ple ques­tion of help­ing teenagers feel less lonely while they are treated, and not talk­ing to them as though they are young chil­dren, think again.

The Univer­sity of Syd­ney has just an­nounced the cre­ation of the coun­try’s first fully aca­demic chair in ado­les­cent medicine, which its back­ers hope will at­tract more re­search tal­ent to this ne­glected area.

A fundrais­ing ap­peal to en­dow the chair in per­pe­tu­ity has al­ready raised $3 mil­lion to­wards the tar­get of $4.5 mil­lion. But rather than wait to raise the full amount, the po­si­tion will be ad­ver­tised and the search for can­di­dates will be­gin while the ap­peal con­tin­ues.

Al­though not the first chair in the sub­ject — the Cen­tre for Ado­les­cent Health in Melbourne is headed by a pro­fes­sor — the Syd­ney post is said to be the first that is fully aca­demic, and the suc­cess­ful ap­pli­cant will not share their time with a clin­i­cal role.

The sta­tis­tics do ap­pear to sug­gest the new post is needed. Up to 20 per cent of Aus­tralian ado­les­cents have some form of chronic dis­ease. Over 75 per cent of deaths in this age group are pre­ventable, and one-third of young peo­ple are ex­pe­ri­enc­ing per­sonal trou­bles such as de­pres­sion, re­la­tion­ship dif­fi­cul­ties and en­gag­ing in risky be­hav­iour.

Young peo­ple are also dis­pro­por­tion­ately at risk in the ar­eas of ac­ci­dents, drugs, al­co­hol, smok­ing, eat­ing disor­ders and sex­u­ally trans­mit­ted in­fec­tions.

Many are also over­weight or obese: up to 31 per cent of males and 23 per cent of fe­males aged 12 to 24 are car­ry­ing too much weight, and from 1985 to 1997 the pro­por­tion of young Aus­tralians who are above the healthy range for body-mass in­dex shot up — al­most dou­bling in the over­weight cat­e­gory, and more than tripling the rate of obe­sity.

Susan Towns, head of the de­part­ment of ado­les­cent medicine at The Chil­dren’s Hospi­tal at West­mead, says the new chair will pro­vide ‘‘ clin­i­cal lead­er­ship’’ that will help start the ball rolling on re­search, which will in turn cre­ate more ev­i­dence for the best ways to treat ado­les­cents.

‘‘ It’s very hard to find spe­cific ev­i­dence (for best treat­ments) re­lat­ing to ado­les­cence,’’ says Towns. ‘‘ It’s such a time of change, not only phys­i­cally, but emo­tion­ally, cog­ni­tively and psy­cho­log­i­cally, that im­pacts on their health­care needs in quite a pro­found way.’’

Man­ag­ing chronic ill­ness in the con­text of the de­vel­op­men­tal changes that oc­cur in ado­les­cence is com­pli­cated, she says, by the pres­sures teenagers feel un­der in the nat­u­ral process of grow­ing up. Ill­ness in­ter­feres with this process.

‘‘ Young peo­ple, as they are go­ing through

Pic­ture: Amos Aik­man

Youth fo­cus: Susan Towns, cen­tre, with arts co-or­di­na­tor Natalie An­der­son and pa­tient Sa­man­tha Hobourn (15), left, in the ac­tiv­ity cen­tre at West­mead Hospi­tal

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