Tattoos and Piercings

I grew up in an age when tattoos were the stuff of drunken sailors and Marx Brothers movies.  Now, of course, they are nearly everywhere–among the kids and, not infrequently, the parents. I admit, I still don’t get it, but on the other hand, who cares about the style opinions of a crotchedy old geezer like me? So I’d like to discuss some safety issues with tattoos and piercings.  A recent article in my journal Pediatric News reviewed an excellent  presentation by Dr. Cora Breuner of Seattle Children’s Hospital which I will summarize.

Tattoos have been around for >4,000 years, body piercings since at least 700 AD. As above, the style has really taken off in popularity.  38% of 18-29 year olds have them (72% of tattoos are on non-visible body areas) and 23% have body piercings.  Tattoo recipients have increased by 20% from 2012-16 alone, it’s now a $1.65 billion industry. Most people (86%) like their choice–it makes them feel happy, attractive, sexy, rebellious, unique–even athletic or spiritual.  Who am I to argue?

The main risk of tattoos is skin infection. Given the nature of tattoos, those infections can get quite deep and pretty unpleasant. However, by all accounts, the incidence is fortunately low. Michigan is one of the few states that maintains accurate records of tattoo infection and found only 18 in 2010.  Hepatitis C is some concern as well; this is a more serious problem but more difficult to track, due to the relatively high incidence of tattoo recipients who may engage in risky behaviors like IV drug use and unprotected and more aggressive sex practices. Obviously, sticking with licensed shops compared to illegal operations is better.  In NJ, shops must be licensed by the Health Dept. and artists must be OSHA certified in handling blood born pathogens. <18 year olds need parental permission for tattoos or piercings.

With piercings the risks are more varied.  Bleeding is uncommon with ears and noses but more so with tongue, uvula, nipples, and genitalia as these areas take longer to heal (3-9 mo compared to a few weeks for ears). Dental complaints can occur with piercings in the mouth–bleeding, chipped teeth, receding gums.  This is more common with “barbell” piercings (47% had some tooth chipping after 4 years–people tend to bite down on them).  Hepatitis C appears to be a greater risk with piercings compared to tattoos.

Historically, tattoos and piercings were problematic as young people grew and entered the employment pool, but my general feeling now is that that concern is passe. I don’t think anybody pays too much attention anymore. At any rate, if the involved body part is hidden, nobody notices anyway.

I think it is reasonable for parents to review these risks with teens who express interest in tattoos and piercings.  Of course insist on patronizing only reputable establishments; I think it’s fair for parents who object to require the kids to pay for it themselves.  But don’t force your choice on them–their lives, their bodies, their decisions, Mom and Dad.

Send along questions or comments, and thanks for following.

Stuttering

I have had several families asking about stuttering recently so it seems a good time to address the topic.  Stutter/stammering is usually merely a mild developmental issue most frequently between the ages of 2-5 years, more commonly among boys.  It may become more noticeable in situations where the child becomes nervous, anxious, excited, angry or generally with greater emotions.  On occasion it may be associated with other problematic movements like blinking, twitching, trembling, or other involuntary tic like behaviors.

There are several types of stutter/stammer utterances you may notice:

• Repeating the first sound in a word (“w-w-w-water”).  Note that repeating a sound in the middle of the word (“wat-t-t-er”) may be of greater concern.
• Prolonged first sound ((“ssssister”). Again, note that that phenomenon in the middle of the word(“sisssster”) can be more of an issue
• Use of interjected sounds (“um”)
• Long pauses
• Frozen speech(mouth open, unable to get sound out
• Appearing out of breath while speaking

Mostly there isn’t too much you have to do in this situation (I resist calling it a “problem”) as it will usually just dissipate on its own.  So generally watchful waiting and try not to worry.  Keep these general principles in mind:

• Keep things calm and relaxed.
• Speak slowly and clearly to your child. Pay attention.  Look at them when you speak to them and when they speak to you.
• Do not criticize or tease; don’t rush or interrupt them.
• Don’t emphasize their stutter; don’t avoid it, either.
• Encourage them to talk about topics of interest to them.
• It’s ok to ignore mild stuttered words.
• If stuttering, you can look at your child and discretely, slowly repeat the troubling word with them.
• Make teachers and ancillary caregivers aware of the stutter and of the above strategies.
• It can be beneficial to practice difficult, problematic words. Use of poems or songs with the “problem” words may help.

While most stuttering is purely self limited and developmental only, there is stuttering that is neurogenic ( due to brain problems) or psychogenic (emotional/psychological trauma or mental health) related. If there is a family history of speech problems, if the condition lasts > 6 months or is associated with other speech difficulties, if your child’s school performance or social interactions deteriorate due to the stutter we should look into it more thoroughly.  Note that there are many healthy, intelligent, accomplished adults who deal with stuttering every day (including, unfortunately, facing up to the occasional ignorant or boorish remark).   

There are several specialists we may contact–speech pathologists, audiologists(hearing specialists), neurologists. I urge everyone to disregard most pitches about medicines, herbals/supplements, or on line fad pitches for miracle cures.  As in most situations, they are mostly a load of bunk.

Please let me suggest one of my late favorite movies where stuttering is an important part of the plot: “The King’s Speech” (Colin Firth, Geoffrey Rush, Helena Bonham Carter) 4 stars, inspiring(the pic above from the movie).  Find it “On Demand” I bet you’ll love it!

Send along questions and comments, and thanks for following.