posted
I am concerned about my three-year-old daughter. I am wondering if I should take her into the doctor, if it's no big deal, or if the doctors wouldn't be able to help anyway.
First of all, she's always been small. Not abnormally so, but small. She started out life with a bit of acid reflux. If ever she ate too much, she vomited pretty severely. She doesn't do that much anymore, but she has always eaten only small amounts at a time, "like a bird" as the saying goes.
Also, she is always cold. Here in the midst of summer even. When the house is "comfortable" for the rest of us, she complains of being cold.
She also is tired a lot. She has always been one to toddle up to her bed and go to sleep when she is feeling tired. I do not know exactly how many hours she sleeps or anything, but she needs to need sleep more than I would expect.
She also has low endurance for physical activity. If we are walking for a decent distance, like a light hike, she gets tuckered pretty quick wanting to be carried.
She is also fairly pale and has dark circles under her eyes. (Though considering her parentage, that could just be genetics.)
Could she be anemic? Is she just normal? Is there anything doctors could do for her anyway?
posted
I'd get it checked out. I'm not a doctor, but a guy at my high school had similar problems (well not the cirlces under his eyes...but the other stuff) and it turned out it was a heart problem, and he needed surgery.
Posts: 1901 | Registered: May 2004
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I guess I am scared that she could have something potentially serious.
Do you know how the heart problem was discovered? She has had her normal check-ups where they listen to her heart, and as far as I know it *sounded* ok.
From what I can tell, she has had these symptoms since day 1.
Posts: 7050 | Registered: Feb 2004
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posted
I'm not a doctor or anything, but it does sound like she might be anemic. If not then probably something blood/heart related.
I kinda have the same symptoms, though not so severe (and without the vomiting), and I'm border-line anemic.
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posted
Eruve, I know very little about anemia. All I know is that somehow the person doesn't have enough blood cells or iron. It seems there are different kinds of anemia. Is there anything doctors can do for such a condition?
Edit: I had not considered the thyroid.
I appreciate all the advice I can get here. I get frustrated with doctors because it seems like the only disorders they care about are serious, life-threatening ones. I worry that they would "poo-pooh" this because it is not severe.
I figure if I know ahead of time some things it can be and if they are treatable, I can prod the doctor in the right direction, ya know?
I think that the problem with anemia is that the red blood cells are needed to carry the oxygen (via hemoglobin) and low iron hinders the process, so symptoms of anemia basically match loss of oxygen.
posted
I wouldn't get too concerned over any comments posted by those without a medical doctorate but I don't think it is out of bounds to schedule an appointment with your pediatrician and discuss your concerns and your daughters behaviour.
posted
I have made up my mind to take her in to see the doctor, but it want to gather information first. I find I prefer dealing with doctors when I know more about what is going on.
I have actually suspected anemia for some time now. I don't know much about it, but it appears there are different "kinds" of anemia.
posted
Bev--good. One thing I've noticed in my few years of working with kids is that never, ever dismiss a parent's instinct about something being off with their kid.
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posted
Yeah, too often I have trusted my doctors. I have not been impressed with the results. ::insert half-smile smilie here::
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posted
See, trusting your doctors isn't exclusive of making them listen to and act on your concerns as a parent. At least they shouldn't be--all the good docs I know DO consider a parent's gut instinct to be something to be truly listened to.
Posts: 14745 | Registered: Dec 1999
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posted
At the same time, you don't want your doctor to only look into the symptoms you can describe. With most illnesses, there are relevant indicators you may not know are important to mention.
I had a doctor ask me something totally innocuous that put him on the track for fixing a stomach problem that had gone undiagnosed for 2 years with another doctor. I had told these other doctors about what I considered symptoms. I didn't know that being more comfortable sleeping on one side was important.
All the good doctors I've had talk to their patients before trying to diagnose.
posted
I can give a brief overview of anemia from memory (and maybe i'll poke around to make sure it's thorough enough for casual knowledge):
Sometimes anemia is genetic (think sickle cell anemia, for example)... this is usually caused by a bad kind of hemoglobin that can't carry oxygen as well.
Sometimes anemia is because of a nutrient deficiency (like iron), which loses an important part of the hemoglobin complex.
Sometimes anemia is caused by a nutrient deficiency (like folate), which causes fewer red blood cells.
Sometimes anemia is caused by red blood cell destruction, or decreased construction.
And sometimes anemia is due to loss of blood (leaking slowly through the GI system, for example).
I'm probably forgetting some. But there are an awful lot of causes of anemia out there. Anemia's just a symptom of an underlying problem.
Posts: 1892 | Registered: Mar 2002
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posted
*thanks God again for her kids' pediatricians*
bev, if you are consistently feeling that your concerns are being dismissed by your doctor(s), I would look into finding another doctor (assuming this is possible, insurance-wise). The only doctor I ever had who did that to me is a FORMER doctor. You can do a workup, and tell me you haven't found anything; or look my sick kid over and tell me it's just a virus and there's not much that you can do -- that's fine. But don't dismiss my concerns out of hand.
There ARE different types of anemia. Some are genetic (know any relatives who are/were anemic?); some are dietary insufficiencies.
quote: Symptoms of anemia often go unrecognized. The first signs of its development may be a loss of appetite, constipation, headaches, noises in the ears, irritability, and/or difficulty concentrating or with memory. Established anemia produces such symptoms as weakness, fatigue, coldness of the extremities, depression, dizziness, overall pallor (pale complexion), pale and brittle nails (lack of iron), pale lips and eyelids, pallor in the palms of the hands, soreness in the mouth, restless leg syndrome, and a cessation of menstruation and/or a loss of libido. Pallor results when blood flow is diverted away from the skin, or other areas, in order to meet the more critical needs of the body, as the brain and heart.
quote: Hypothyroidism progresses very slowly and insidiously, making the diagnosis difficult for physicians. In the more advanced and long-standing cases the child may have other general symptoms of hypothyroidism, such as easy fatiguability, mild weight gain in association with a reduction in appetite, constipation, an intolerance of cold weather, dry skin, and either delayed (usual) or early (rare) onset of sexual development at adolescence.
posted
I had very similar symptoms to those my whole childhood, but usually they were seasonal, usually from september to may, or pretty much the school year. I would feel worst if I didn't get enough sleep because I had been somewhere or working on homework. When i went to a camp in fifth grade (bradford woods for Bton hatrackers)I got much worse because I didn't eat well at all, and could barely sleep since I had never been away from home for that long. That lasted till december of that year, sleeping in my mom's lap in a recliner, about three months. The summer between sixth and seventh grade I had my tonsills and Adnoids out because of chronic Sinus infections. That made the tired stuff better for a few years, but I got strep twice and have now had mono, so I have had very similar symptoms my whole life. I hope the doctor can do some tests to check for these things.
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posted
The first thing I thought from your description was Thyroid. And it's not just because I always agree with Dagonee (I don't, actually but I tend to stay out of those threads).
I hope you know to not give iron supplements to children. It's apparently a relatively serious cause of poisoning- kids taking vitamins designed for grown women.
Hope you can get it figured out.
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posted
Rivka, unfortunately it isn't so much a strong sense I have gotten from one doctor, but I have just found that doctors in general (at least around here) seem to not be too concerned with ailments that are not serious in nature or easy to understand.
I actually was impressed these last couple times I took my kids to the pediatrician. They asked more questions, checked up on more things than I had remembered in the past. I don't know if it is new policy or what, but I think it is a move in a good direction.
Posts: 7050 | Registered: Feb 2004
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posted
See if you can find someone just out of school. We had one of those for a while. There is also an M.D. with alternative training down near you, Dr. Remington.
It is unfortunately true that peds in Utah, and Utah county in particular, have a commodity mentality. There are just so dang many kids, and if you seem proactive they worry you are going to turn homeschool/no vax on them. The unmedicated birth rate at hospitals here is like 10%, 1/3 of nationwide I think.
Also doctors here are used to women being more submissive to authority because culturally--well, you know.
P.S. We Utah Mormons idolize the 50's, and the standard of care in medicine seems to go along with that.
posted
Yay for moving in the right direction. *thumbs-up*
Maybe it's because most of the doctors I've gone to (with the exception of the one mentioned above, who was picked because she was 1) on my insurance carrier's list and 2) nearby; and I was REALLY sick) have come highly recommended by other patients. But I have no tolerance for doctors who are dismissive. (Which is interesting, because I've tolerated it from people in a number of other fields.)
Posts: 32919 | Registered: Mar 2003
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quote:I am concerned about my three-year-old daughter.
That right there is more than enough reason for an appointment.
If a pediatrician doesn't respect a mother's instincts, then I'd say it's time to find another ped.
When we were trying to determine if Daniel needed physical therapy, my doctor turned to me and said "What do you think Mom? You're the one who sees him day in and day out - if you think there's cause for concern we'll send him."
I did. We sent him. And that led to us finding out about the genetic tissue disorder he has.
Always trust your instincts, I'm glad you're getting the appointment. let us know, kay?
Posts: 14428 | Registered: Aug 2001
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posted
Wow, Belle, your pediatrician sounds awesome! I don't think I've ever heard one talk like that.
*swoons*
Pooka, I will keep in mind what you said about fresh out of med school. Unfortunately, I have not figured out a good way of doing that.
I actually kinda liked the pediatrician I had before we moved. After moving I switched to the closer office. The *only* person there taking new clients was the physician's assistant. She's actually pretty cool.
A lot of my bad impressions came from the times I had to come in quick for an emergency and had to just see "whomever". Also, a lot of the bad experiences were with my *own* doctors, and a specialist my son is seeing right now.
*grumble grumble*
It is true that there are a *lot* of children here and I think it does add to the attitude. As I said above, a lot of these people are nice, and I did sorta like them, but nice people can still rub you the wrong way, ya know? The attitude that Belle described in her doctor.... I'd like to see more of that.
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quote: Do you know how the heart problem was discovered?
He was a basketball player, they randomly found the problem durring a physical. It was odd since he had to have a physical every year but they did not catch it till his senior year. Just random good luck that they caught it.
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posted
The "fresh out of med school" should be easy for you to find out. Find Utah's medical board website, and see how long the doctor has been licensed (I know that, at least in Arizona, it says how long they've been practicing, where they got their education, etc.).
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posted
Wow, rivka. I have even more of those symptoms. Come to think of it, I don't think I've had my blood tested in several years. *is a little worried*
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posted
I would be sure to write down all the symptoms you see, and take the list in. Ask family memebrs on yours and porter's side if anyonme has had these symptoms. And don't let the doc dismiss you.
Posts: 2711 | Registered: Mar 2004
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posted
Ludosti, unfortunately, I haven't been able to find a website like that. Any tips on how to find it?
Romanylass, I am not aware of any anemia on either side of the family, but it wouldn't hurt to ask. Writing down the symptoms is a good idea. I will try to be thourough, remembering how being thourough helped Dagonee.
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posted
Eruve, anemia is pretty common in teen-aged females. And "I don't think I've had my blood tested in several years" implies that you haven't had a physical in several years. Go get one (insurance permitting)! You're most likely perfectly healthy, but you should get regular physicals, just to be on the safe side.
And to have one less thing to worry about. Posts: 32919 | Registered: Mar 2003
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posted
It looks like this is the website for Utah's licensing board. Try "verifying" the license of one of the doctors you're considering and if you click on "Detail", it'll tell you when their license was first issued (I'm not sure if this refers to when they were first licensed in Utah or when they were first licensed period). It's unfortunate that Utah's website isn't as helpful as Arizona's (here's what I see when I look up my doctor). A more time consuming option is to just call the doctor's office and ask how long they've been practicing medicine. They should be able to tell you that.
It's really okay to the parent with the huge red letter "P" emblazoned on the chart.
Parent's are to advocate for their children. And in today's society, that is sorely needed.
As has been said, trust your instincts, chart your observations, and don't be afraid to seek out a new doctor that will listen to parents and treat the medical relationship as a partnership.
On top of which - in the end - YOU pay the bill.
And the customer is always right. Even when they're wrong. (Basic retail 101)
Posts: 5609 | Registered: Jan 2003
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posted
If you think something is wrong with your daughter, do not leave your next visit with her doc until he finds something wrong OR you have a second opinion scheduled (preferably with a doc in a different practice). On second thought, schedule a second opinion anyway.
My wife's "gut instinct" saved my son's life when he was 6 months old.
My wife insisted we take him to the after-hours clinic when he became unusually fussy one evening. I personally would have shrugged it off as an upset stomach or earache but my wife was convinced it was something more. The doctor could find no sign of ear infection, my son had no fever or any other visible signs of illness but my wife demanded that they keep looking. Finally they took an x-ray of his chest and discovered he had a diaphragmatic hernia and several feet of gut in his chest cavity. This led to a prompt ambulance trip to the local children's hospital and emergency surgery at 2 a.m.
Don't let the doctor shrug off your concerns, step up and demand that they explore all reasonable possibilities. TIP: if they haven't drawn any blood, they aren't even trying. Good luck!
Posts: 692 | Registered: Feb 2000
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Whoa! So glad she followed her instincts! Too often I have been known to second-guess my instincts or ignore them. Bad habit of mine. Posts: 7050 | Registered: Feb 2004
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posted
I know nothing about kids. Every time you take her to the doctor, though, he should be doing a growth chart and plotting out her progress. Kids are supposed to maintain a certain rate of growth. If she is maintaining her percentile, he probably hasn't been too worried. If she's been dropping her percentile, then he should have talked to you about it. If he's not plotting out the growth chart you need a new doctor, I'd guess. And if you have this many questions, you might as well just take her in and have a discussion. Look at her growth chart too, while there. If you are unhappy with his answers, and a dialogue doesn't help, then it is probably time to switch doctors.
Posts: 1990 | Registered: Feb 2001
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posted
bev, I have been sending you best wishes and prayers, but I didn't want to fill this important thread with useless chatter.
However, much of the advice given corresponds to my on philosophy on health care.
Please remember:
Your doctor is not ultimately responsible for you or your children's healthcare.
The nurse is not ultimately responsible for you or your children's healthcare.
The HMO, PPO, or Insurance company is not ultimately responsible for you or your childrens healthcare.
The government is not ultimately responsible for you or your children's healthcare.
Only you have that responsibility.
If the government or the insurance company, the nurse or the doctor try to tell you differently, tell them to shove it.
ps, a thread we had last month will get me to add your pharmacist to this list of those not ultimately responsible.
ppss, and we might as well add, your spouce and family to that list, though your spouce is also responsible for your children's health, they are not ultimately responsible for yours.
Posts: 11895 | Registered: Apr 2002
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After reading your post I initially had three potential areas to investigate, and they have all been touched on by fellow Jatraqueros.
1. Anemia - Up to 50% of female children are anemic in the sense that they have low iron levels. Many attribute this to a lack of protein intake, but other reasons can abound. A simple blood test can confirm this, and it is very treatable.
2. Hypothyroidism - This is what came to my mind first and foremost. If her condition is endocrinological, this is very treatable as well.
3. Other endocrinological disorders - This area is the one that may keep a parent up at night wondering...Most of these disorders revolve around insufficient Human Growth Hormone levels, but can now be treated very effectively.
I would encourage you to use word-of-mouth or other means to find a pediatrician you can trust and believe in, and get to the bottom of this.
Another area to watch for is excessive thirst or water intake, excessive appetite, or excessive urination. These could be signs of juvenile diabetes or diabetes insipidus. From your description of her symptoms, this sounds unlikely, however.
The important thing to consider is that some bloodwork will most likely shed some light on if your child will require any additional treatment. For all you know, she may not require any treatment, but I would strongly advise you to have her checked out anyway.
And remember, if you have trouble finding a pediatrician, ask your local pharmacist who they recommend. (we can help)! Posts: 1870 | Registered: Mar 2003
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posted
I have a regular multivit for her, but I am not that good at remembering to give her or Sanford their vitamins. I need to repent!
Posts: 7050 | Registered: Feb 2004
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posted
CT: I will see if they can give me a copy of her growth chart. She has always been thin, smallish, frail. Unusually loose joints in her hips since birth. She has perhaps gained a little weight, enough that her face is "chubby" now, but not much.
She went through a period around 6 months (I can't remember if it was 4-6 or 6-9) that she didn't grow. The doctor was really worried. She never ate much, but during that time I had started her on solid foods and her nursing had gone way down. It didn't help that she was *so* good about sleeping through the night, and when I would be all engorged and wake up in a puddle the next morning, she wouldn't eat it all. If I forced her, she would throw it all up! We always had to be careful about not getting her too full.
The doctor explained that even though she was getting lots of solids, she still needed lots of milk to get nutrition. I was shocked and felt so guilty, like I was starving my own child! I made sure to get her drinking breastmilk or formula and her growth picked up again.
She is a happy, fairly healthy child now. But she gets cold way too easily, always has, and she will often just go lay down and fall asleep--too often for my comfort. She loves to sleep and does not hesitate to go take a nap when she feels drowsy. She is pale, and has always had those dark shadows under her eyes. Her hair is thin and sparse too. This all combines to give her a slightly sickly look.
She still doesn't eat much, she grazes. I try to get her to eat, and she will often ask for food. I try to give her healthy options. She does not like to eat much meat. She will gobble up veggies though.
Trevor: I go through periods of being really good about it and then being really bad about it. I need to get back into that habit of doing it with breakfast.
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posted
When I am good at giving them to the kids, I am usually good with myself. But I have a hard time getting Porter to take them. By this time he is usually downstairs in his office working. And this is silly, but I hate to go all the way down there and I hate trying to call him up. And the guy *never* remembers to take them on his own! I really should be better about encouraging him too.
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