Students and Stress
The recent mass shooting at the hands of a disgruntled teen gunman in Parkland High School that took away the lives of 17 students and teachers certainly was one of the worst preventable tragedies that befell our nation. This was followed by widespread student protests and considerable discussion in the media about gun control.
Do we ever wonder about the emotional toll these events take on the mental status of our school going children? After the disbelief and shock have died down, many of them feel confused, lost or dejected, not knowing what’s next and how to move forward. Anger, negative emotions, feelings of hopelessness – all tend to pop up in their minds and a whole generation of children will grow up with school phobia.
Today’s children have to face many other issues as well. Stress involved in the pursuit of academic excellence is already built in. Then there is the peer pressure that forces them to dabble in unhealthy behaviors like indulgence in alcohol, drugs and more. Bullying is another major issue that has a negative impact on the child’s well-being. According to the U.S. Department of Justice, “Bullying is widespread and perhaps the most under-reported safety problem on American school campuses.” It has no place in the society. Discrimination based on color, ethnicity, social status, etc., are also widespread in many campuses.
The other day, my 4-year-old grandson walked into his kindergarten class and proudly showed off his new shoes with blinking blue lights. A 5-year-old classmate looked at him and said dismissively, “Oh, that’s not cool!” Needless to say, he was crushed and had to be consoled by his mother. The children need to know that everyone they meet especially in their peer group may not always praise them or be friendly, some may even criticize or harass them, so they have to develop a certain degree of courage and fortitude to face these challenges in the right spirit and move on.
Negative emotions such as anger, fear or jealousy can stymie the kids and they may act out in public. If the adults – parents, counselors and teachers – do not understand their emotional conflicts and try to dismiss them as a default response, it will only lead to more pent up frustration and distress, causing distrust in the adults around them. How many times parents say to their kids, “Oh, don’t worry, it’s nothing, you will get over it?” Instead of ignoring their emotions, the adults should empathize with them, understand the basis of their stress and find possible solutions.
Mental health issues among children, adolescents and adults have been the subject of intense scrutiny in the wake of the Parkland tragedy. Looks like many who are committing these crimes are young people and the question as to the reason why they do it, lingers. Their violent past, drug habits and hatred towards others or society at large often go undetected. One answer may be “poor parenting.” Many children grow up with single parent who do not have much time or mentoring skills to attend to their emotional needs. Some of these children are orphans living with adoptive parents. In addition, kids are often desensitized to the violence taking place around them since they watch this often enough in the regular media or experience them through social media like Facebook, WhatsApp, etc.
One undeniable factor is that many children are growing up with anger issues, whether it’s related to bullying in the school or difficult relationship with a disciplinarian teacher or discrimination from other students. When children are acting out trying to vent their frustrations, it’s a mistake for parents, teachers or guidance counselors to disregard their emotions of anger, sadness and fear. Instead, the concerned adults should communicate with them, try to understand their conflicts and respond appropriately. Show them you care and you are with them and they would know they have a true friend in you. Once the parent or the teacher senses antisocial feelings in the child, the right steps should be taken promptly to rectify them, if necessary with the help of a psychologist.
It’s our duty to provide every child a good environment for his or her studies and personal growth and make schools a safer place. Let us also make sure that children who exhibit delinquent behaviors receive proper mental health management, so future tragedies like what happened in Parkland can be prevented.
SPORTS EYE SAFETY MONTH
April is Sports Eye Safety Month – a subspecialty given the number of eye injuries seen in sports from professional sports to our local backyards. Basketball, baseball, hockey pose the greatest risk followed by horse racing, polo and handball.
Sports-related eye injuries occur to the tune of about 100,000 events every year. One-third of these occur in children under the age of 16. Most importantly, 90 percent of these injuries could have been prevented. Any sport that involves a stick or racket, a ball or other projectile, or body contact presents a risk of serious eye injury.
Existing classification systems rank sports with their risk for eye injuries as follows:
High risk: basketball, baseball and hockey.
Moderate risk: horse racing, polo and handball.
Low risk: track and field, fishing and golf.
I have suggested a modification wherein the risk level is functionally modified using the ocular status as a qualifier.
Besides patients who have had structurally weakening surgeries, an emerging population of patients is those who have had Lasik. With millions of people all over the world undergoing Lasik, I have proposed a serious look into this category of "normal eyes." They are potentially prone to flap displacement during contact/projectile sports and can have visual consequences of the same. Thus, I would recommend that these individuals safeguard their "gift of sight" with added precautions and wear protection as a modified-risk category class (per my proposed classification system).
Physicians have an obligation to warn players of potential risk and recommend appropriate eye protection. Sports eye protection should be designed specifically for the activity or sport. Eye protection that bears the seal of sanctioned organizations should be mandated for high-risk sports.
The team physician should insist that players of sports with an eye hazard-wear certified protectors. Non-team physicians should include a sports history as part of the routine examination of all patients and recommend protective eyewear appropriate for the patient's activity.
The basic steps in choosing protective gear for an eye-safety program include:
• Knowing the athlete's vision and eye history.
• Using only eye protectors that have been certified to national performance standards.
• Having professionals assist the athlete in selecting and fitting protective eyewear.
• Additional recommendations: Proper fit in children is essential because some children have narrow facial features:
• Protectors with clear lenses (plano [nonprescription] or prescription) should have polycarbonate lenses, the strongest lens material available.
• For sports requiring a face mask or helmet, the helmet must fit properly and have a fastened chin strap for optimal protection.
• Contact lenses offer no protection. Therefore, athletes who wear contact lenses must also wear appropriate eye protection. Regular spectacle frames also are not adequately protective and can shatter on impact.
• Athletes must replace sports eye protectors that are damaged or yellowed with age because they may have become weakened.
• Functionally, one-eyed athletes and those who have had an eye injury or surgery can participate in almost all sports if they use appropriate eye protection. The exceptions are boxing, for which eye protection is not practical, and full-contact martial arts, for which protection is not allowed.
• Select games and toys appropriate for the child's age and responsibility level.
I have proposed a three-point protocol (2001) for delineating the incidence and controlling the outcome of sports-related eye injuries.
Prevention. This can be achieved in a three-step program of education; effective role modeling with adults setting a good example for children by always wearing protective eyewear while using power tools, rotary mowers, line lawn trimmers, or hammering on metal; and strict adherence to approved equipment.
Recognition. Early recognition and high index of suspicion is a must since the seriousness of sports-related injuries may not be immediately obvious. These injuries can be devastating in terms of their spectrum of damage with pain, loss of function and long-term disability.
Management. Finally, effective management by an ophthalmologist may involve corrective surgical intervention.
The vast majority of sports officials, administrators and physicians are genuinely concerned about making sports as safe as possible while still maintaining fun and appeal.
In Canada, ocular trauma decreased by 90 percent after certified full-face protectors attached to the headgear were made mandatory in organized amateur hockey.
Thus, sports-related eye injuries are in-deed preventable, and the incorporation of the above suggested protocols will lead to a harmonious outcome. After all, isn't that what sports is all about?
Gulani AC. LASIK complications course: management & avoidance. European Congress for Advanced eye Surgery, Sept 2014.
Vinger PF. The physician and sports medicine: A practical guide for sports eye protection 2000; 28:49-69.
American National Standards Institute. American national standard practice for occupational and educational eye and face protection. Des Plaines, Ill: American Society of Safety Engineers, 1998.
American Society for Testing and Materials. 1999 annual book of ASTM standards. General products, chemical specialties, and end use products. West Conshocken, Pa: American Society for Testing and Materials, 1999.
Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at firstname.lastname@example.org or visit www.gulanivision.com