HEALTH

o

N

r.:

W Z ~ --,

,: « o tf) UJ :::l >-

THE JOCK DOC i

Knee-cartilage procedure not open to alII

LET'S TALK

Children must learn

to be assertive with bullies

Q: My 74-year-old grand­ niece came home upset after seeing a fight between two former friends in her middle school locker room. What really concerned me. besides the minor injuries one girl sus­ tained. was that none of the girls stepped in to stop the fighting. When the teacher was alerted, the proper steps were taken. Such behavior was unthinkable when I was her age. but today girls have become more aggressive. What should my niece do if she is confronted? What would you advise? A: Bullying among adoiescent girls is a growing concern and includes hurtful teasing, spreading rumors online, making threatening remarks and physical aggression. Research has shown that bullying increases in middle school and is used as a strategy to establish recogni­ tion and dominance. Characteristics of bullies include poor communication and social skills, low frustration tolerance, manipulative behav­ iors and blaming others rather than oneself. Bullies will use any and/or all of these behaviors to intimidate and control others. Hostility and aggression can actually be a facade to mask feelings of inferiority and low self-esteem. There are various reasons why children bully other children. Frequently, bullies have learned this behavior in their home or neighborhood. Once this identification develops, the behavior is mimicked. Other children can be targets of parental aggression; yet it is outside the home where they rid themselves of these bad feelings by attacking others, perpetuating the belief that might is right. And then there are those who endure immense suffering and humilia­ tions as children. Years later, they seek revenge upon those who are weaker. In order not to be a victim. girls (and boys) must stand up for themselves. While a bully would benefit from learning healthier ways of interacting and resolving problems, it often doesn't occur unless mandated by school or the court. Bullies need to know if the rules are not followed. they will face consequences. Even if your grandniece is uncomfortable being aggressive .. she needs to learn to be appropriately assertive. This requires using "I" statements (e.g., I refuse to have you speak to me like this). This statement is best if conveyed in a firm but nonjudgmental tone. To minimize further problems. it is best not to respond pro­ vocatively; otherwise she could be blamed if an emotional escalation or physical confrontation ensues. Despite your grandniece being asser­ tive. a bully might not comply. So, the next step requires talking to school authorities. Bullies need to be held accountable. Unless a student learns to sta~d up for herself, state her objec­ tions and refuse to be a victim, the problem will not end. Dr. Andrea Corn is a licensed psychologist in Lighthouse Point. Write to her at com psyd@bellsouth.netorc/o Desonta Holder, 1 Herald Plaza, Miami FL 33732.

o ...J « ll: w I W I >-

Q: I have been told I have an area of arthritis of the knee and that eventu­ ally I will need a knife replacement. I saw on the .news that doctors are regrowing cartilage lin the knee that can get rid of pain a~d dela~ the need

DR. HARLAN for knee replacement surgery. Is this
SElESNICK possible for me? I
Jockdoc69 A: Although recent advances have
@ani com allowed orthoped1' c surgeons to

regrow cartilage in patients' knees, unfortunately there are still significllft limitations for this procedure. The procedure knOW\l as Cartisol was pioneered by the Genzyme company ih Massachusetts. It's effective for relatively smalliodlized full-thick­ ness cartilage defects in a patient's knee.

Unfortunately, many patients with lrrthritic changes have more diffuse cartilage thinning land thus are not candidates for the procedure. The success rates for patients who have met the criteria f6r the procedure however is extremely high and very encouraging. I recommend you discuss this with your orthopedic sur-geon.

If you want a second opinion you !)lay want to con­ tact Genzyme directly (617-252-7811) for a list of ortho­ pedic surgepns who are familiar with the procedure in your area.

Q: I am a 14-year-old who broke my wrist while snow boarding last winter. The doctor toldlme I had afrac­ ture through the growth plate and pu~. me in a cast. He told my mother that the break would lIkely heal but my arm could grow crooked. How likely J this?

A: Fractures through the growth plate in young ath­ letes are very common. If the fracnhe is not out of place and the growth plates stay lined up, it is unlikely that a growth disturbance will occur"However it is

HERALD FILE TROUBLE: Many patients with arthritic changes in their knees have more diffuse cartilage

thinning.

important when treating these injuries for the surgeon

. to mention thi,s as a possibility so that proper follow-up care, not just until the fracture heals, but for many months afterwards, be arranged to make· certain that no growth abnormalities occur.

Dr. Harlan Selesnick is the Miami Heat physician.

Write to him at jockdoc69@aol.com or c/o Desonta

Holder, 1 Herald Plaza, Miami FL 33132. -

the Idvemaking department

Ithat this is·a problem if either the man or the woman considers that the time to orgasm is too quick.

Achieving orgasm is a bit like the setting of a thermostat for an air conditioner. For some men the trigger gets set off at a lower level of sexual excitement (faster) and for others the setting is higher translating into a longer lovemak­ ing session. The best estilUate is that the time from vaginal penetra­ tion to orgasm averages 4.5 minutes

in the United States.

Men are p~ewired a·t a setting that is unique to them. Many men have used topical medications but they work only marginally and there isn't much fun when one or

DOCTORG

Woe in

both partners are numb below the belt. Some physicians will pre­ scribe antidepressants known as SSRIs. We don't' utilize these treat­ ments for depression, but rather for the side effects of these medicines which is to delay the time to orgasm.

Also, if you spend the time and effort on making your partner re!;\ch satisfaction bQfore you do, then your timetable becomes much less important and you can focus on mutually positive feelings.

Dr. Marc Gittelman is a board certified urologist. Write to him at DrMarcGittelman@yahoo.com or c/o Desonta Holder, 1 Herald Plaza, Miami FL 33132.

Q: My wife is claiming that our lovemaking is over before she can even heat up. It has been a problem my

DR. MARC entire life and it's
GITIElMAN getting worse. I am
drmarcgittelman embarrassed to
@yahoo.com talk to her about it.

I h,,,,e tried "ll the "back of the magazine" solutions but none has worked. Is there any­ thing that can be done?

A: Premature ejaculation is the most common of all sexual prob­ lems in men and it occurs in nearly one-third of all men. The medical definition of PE takes into account