August 2014

Ask the Doctor - Children's Health Issues

Ask the Doctor - Children's Health Issues


Question - Fever Vomiting in Five Year old

Dear Dr. Lawrence:

I am wondering if I should be pushing the subject of a complete physical examination of my five year old daughter. She started kindergarten this year, and has spent the majority of the school year thus far sick at home either vomiting, fevered, or both. She has made no comments of sore tonsils, appendix, or ears, and these episodes have occurred every other week since the beginning of October. She has lost weight, and is not as lively as she used to be. She has dark circles under her eyes, but the pediatrician doesn't seem to be concerned. I know my little girl, and I have noticed a dramatic change for the worse in her. 
            
I don't know what to do.
 C.M.

Answer

Hello C.M.

If you are concerned make this known to the pediatrician, ask him or her to reevaluate your child given the total picture rather then simply treating her when she is acutely ill. 
            
I have always trusted my patients and the mother's of children, if they think something is wrong....I take this seriously. This does not always mean that there is something wrong, but it has always deserved my attention.
            If you do not get satisfaction from this pediatrician, than find another one, one who is good. If you do not know another good pediatrician, then call the pediatrics ward at the nearest large hospital, or go over to them and ask the nurses who is the very best doctor...You can also call your local medical society for a referral or if you have friends with children ask them who they trust.
            Do not stop until you are sure that you have the answers you need to satisfy you. You are the only protector your child has and if you feel something is wrong, and if you normally trust your instincts, than act on that and push it until you are satisfied. You would hate yourself in the end if you were right and something was wrong and you did not act.

I hope this helps.
Allen Lawrence, M.D.



Question - Lump on Child's Shoulder

Dear Dr. Lawrence:

What are blood vessels that are producing raised bumps on my child's shoulders. I think it is called Pyogenicgranuloma.

Thank you!
C.C.


Answer

Hello C.C.:

Pyogenicgranulomas are localized inflammatory lesions involving the skin. They are essentially over growths of blood vessels - hemangiomas that commonly develops at the site of some injury or trauma. They have a dome shaped bright red papule that often bleeds on touch. They are much more of a nuisance than a real serious medical problem. They are harmless and may resolve on their own or often are injured and break or fall of. It they do not resolve on their own and they are large enough to create a problem of any type they can be surgical removal by your child's doctor.
            
At the following sit you can see exactly what they look like: http://www.nevdgp.org.au/video/skin/pg_ss.html

I hope this helps.

Allen Lawrence, M.D.



Question - Sixteen month Old Problems Having Bowel Movement

Dear Dr. Lawrence:

My granddaughter is small for her age (16 months) but she has good eating habits. her problem is that her stool is so large and hard she cries and often vomits before she can go to the bathroom. This is almost every time. Her mother found that a warm bath helps and she can go in the tub, but we are very concerned that stools an inch and a half in diameter are hurting her intestines. Should her doctor be looking for something here?

Thank you,

M.R.

Answer

Hello M.R.

Has your daughter talked with the baby's pediatrician? She should make sure that the Pediatrician checks you granddaughter out. If everything is okay she should ask about a very mild stool softener. I might tell my patient to use a very small amount of Milk of Magnesia, a 1/4 tsp in the babies formula. Usually constipation or hard stools are caused by three main factors in babies (assuming there is nothing physical going on, too little water or liquids in their diet, too little fiber in their diet or stress.
         If your granddaughter is being breast feed, then her mother should drink more water and reduce any stress in her life so that her stress is neither transmitted to the baby through her increased body tension or through the stress chemicals that are being produced in her body that will likely end up in her breast milk. Mom could also increase the amount of water she is giving the baby either by bottle or using a sippy cup. She could also increase or add cereal and puddings to the baby diet, possibly between feedings.
         If she if now bottle feed or eating solid foods, more vegetables will also help. Mother should begin to increase the amount of vegetables in the baby=s diet, slowly but steadily. Less meat, more fruit and cereal will also help. Once again increase the amount of fluids she is giving the baby and reduce any stress in the family.

Hope this helps.

Allen Lawrence, M.D.