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BY MARETHA BOTES SOMETIMES teenagers seek attention in the strangest ways. It could just be growing pains, but when your teen consistently complains of aches and pains, don't be too quick to fob them off. There could be more to it than you think. Her daughter, Cara, started complaining .7 of a nagging pain in her shoulder when she was 15, Riette Rust of Stellenbosch in the Western Cape recalls. She took her to their family doctor who noticed that Cara's shoulder blades were unaligned, and sent her for X-rays. Cara's spine was crooked, which was what was causing the pain. She had scoliosis. It was a congenital condition, the family was told, meaning she had been born with it. "I got the fright of my life when I saw the X-rays," Riette says. "Her spine was in an S-curve. I thought she was disabled and would need surgery, that she'd need to wear a brace for the rest of her life and would never be able to act or play hockey again. But Cara wasn't that upset. Although it was totally unexpected, she took the news relatively well. "Her scoliosis wasn't noticeable to the naked eye, unless you looked really closely at her shoulder blades. There's no treatment, although a back brace can improve the condition in some cases or stop it from deteriorating. But it turned out that she didn't need surgery or a brace as it wasn't serious enough." Cara (now 22) does exercises recommended by a physiotherapist to strengthen the muscles supporting the spine. She's also aware of her posture and never sits in a way that puts extra pressure on her spine. Cara has come to terms with the fact she has to sleep on her stomach for the rest of her life. But apart from that, she's fine. She can play sport and holds a drama degree. When she's stressed the pain in her shoulder increases, and when it becomes too much she goes to a salon for carboxy therapy - fine needles that deliver CO2 to her muscles to relieve the pain. Every now and then she takes muscle relaxants. "She'll need X-rays in future to see if her scoliosis has deteriorated7Riette says. Pierrene Wessels (18) of Pretoria had her life turned upside down two years ago after a sinus infection led to Guillain-Barre syndrome, a disorder affecting the nervous system that can lead to paralysis. At first she was dizzy and nauseous, and the family doctor put it down to an ear infection. But when she started experiencing pins and needles in her hands and feet she was hospitalised immediately. She spent two weeks in hospital having an MRI scan, blood tests, lumbar punctures and scan after scan to eliminate several potential diseases. Guillain-Barre was eventually diagnosed and Pierrene spent a week receiving intravenous treatment to boost her immune system. Her mom, Nicolene, says her daughter was fortunate in that neither her heart nor her respiratory system was affected, but her motor functions were badly damaged. "She could still move when she was admitted to hospital but by the time she was discharged two weeks later she was like a sack of potatoes. She couldn't walk, her arms were terribly weak and her hands were curled up towards her wrists." Pierrene had to be turned, carried, fed and pushed around for six months. She couldn't brush her teeth, scratch an itch or comb her hair. She had a special wheelchair that enabled her to sit up and which supported her body. "We had a part-time carer and a full-time domestic worker until the end of last year;' Nicolene says. "1 took over in the afternoon. Our house had to be adapted - we had a lift installed and converted one bathroom into a 'wet room; with a big open shower. We had to sell our cars and buy new ones that could accommodate the wheelchair." Pierrene is still receiving regular physiotherapy and her condition has started to improve slowly. She's able to move her upper body, arms and hands, and she can write again, although with difficulty. Her speech is still affected. It will be possible to assess permanent damage only in five years'time, Nicolene says. "Pierrene was in Grade 11 when this happened and she hasn't been able to return to school. In 2013 we enrolled her with (online home school system) Brainline and she'll write matric over two years. "She wrote three subjects last year and will be writing four this year. Pierrene is 18 and the toughest part for her has been the loss of regular social contact with other young people. She's struggling with light depression but tries to make the best of a very difficult situation." WHAT TO DO? Dr Elna Gibson, a paediatrician of Sasolburg in the Free State with more than 20 years'experience, always pays attention when a child is brought to her complaining of chronic fatigue, headaches, body pain or stomach aches. "My professor always said if a mother tells you there's a problem and you can't find it, go back and look again. If a child isn't well, there's always a reason behind it, whether it's physical or psychological. A doctor should examine them from top to toe." WHAT COULD BE WRONG? Lupus Your child complains of painful joints and develops rough red patches on their face, elbows, arms, scalp and ears, which become worse after they've been in the sun. They're constantly tired, sometimes feverish and often short of breath."Lupus is an autoimmune disease and is more common in girls than boys," Dr Gibson explains. "The symptoms are similar to arthritis but lupus also affects the kidneys:'Take your child to a rheumatologist for a diagnosis. Lupus is a lifelong condition and treatment usually includes immunosuppressant drugs. Avoid sunlight, oestrogen and stress, as these can affect the condition. Scoliosis This condition, also known as curvature of the spine, is also more common in girls and often exacerbated by a growth spurt. "You often have to look closely to notice it, and because there are no longer school clinics - where nurses would specifically check girls for scoliosis - early diagnosis is often not made;' Dr Gibson says. Your daughter could look a little off centre, with one shoulder blade or hip a little higher than the other. Get her to bend forward and check her spine - it should be straight without any deviation. There's no real treatment for the condition, although it can be improved with regular exercise. Some children might need to wear a brace for a while, and surgery is sometimes recommended in severe cases. Guillain-Barre syndrome This isn't strictly a teen illness, as people of any age can be affected. It can be lifethreatening if not immediately treated. The condition starts with a viral infection, and the body gets "confused"and starts attacking the nervous system with often devastating consequences. Symptoms begin with increasing lameness and a feeling of pins and needles. These days treatment can be very effective although people can be affected by the condition for the rest of their lives. "If your teenager suddenly complains of lameness or weakness after a viral infection, take them to the doctor immediately," Dr Gibson warns. Thyroid problems Common in girls from the age of 10. Dr Gibson says an overactive thyroid in teenagers is usually the result of an autoimmune disease where the body starts producing antibodies that attack the thyroid. Symptoms of an overactive thyroid include heart palpitations, weight loss, tremors, irregular menstruation, hot flushes and visible swelling at the base of the throat.Teens can also suffer from an underactive thyroid - symptoms include weight gain, fatigue and dry skin. Both conditions are relatively easy to manage. Bipolar disorder Your child's moods swing from one end of the spectrum to the other. One moment can they're optimistic, the next low and negative. Another warning sign could be a child who's busy with projects but rarely completes what they start. Their attention jumps from one subject to another and they can indulge in risky behaviour when on a "high': When they're down, they're depressed, feel hopeless and even suicidal. The South African Depression and Anxiety Group (Sadag) says it's important to get your child to a doctor when they're in an "up" phase so an objective bystander can assess whether this is normal teen behaviour or a symptom of bipolar disorder. Go to sadag.org for more information and to find out where to get help.