“You have to be sensitive about what kids understand and don’t understand about the big picture so they don’t carry home anxieties that aren’t based on fact,” he continues.

Dana Swain has noticed that her teenage daughter, Vanessa, has some financial concerns.

“She is like our little caretaker,” Dana says. “So her thing is, ‘do we have enough money for that?’ A week ago, she bent down, and I heard her crack her knee and say ‘ow.’ She didn’t hit it. It just popped.

“I’ve been asking her for the last few days, ‘how are you feeling,’ because I want to keep an eye on things, and she says, ‘I’m fine. I’m fine.’ And I ask her, ‘are you really fine or are you just saying that?’ Because she is the worrier of the group,” Dana says. “I know she worries about our finances.”

James McKoy, MD, a rheumatologist and pain specialist in Honolulu, says he sees these same stresses with patients of all ages that he treats. And he says he worries because this kind of anxiety actually makes arthritis worse, which can set up a vicious cycle.

“It actually increases pain. And when that happens, that would require more visits to a physician, requiring more time for a parent taking their child or themselves to the doctor. So the economy is having a major effect on anyone with any ailment,” he says.

Doctors stress that some states have programs to help cover the costs of treating children with chronic medical problems. Drug companies and foundations have patient assistance programs and some charities will help provide transportation to medical appointments.

Medical professionals also say they’re also doing their best to work through these problems with patients too. Doctors and hospitals are scheduling lab tests closer to home, offering more appointments earlier and later in the day and even offering gas cards to help cover transportation costs.

“We’ve had to change our business because of the economy,” Ryan says. “It’s heartbreaking. It's absolutely heartbreaking.”