25 March 2002
Dear Readers: Sincerely,
Dr. Warren hopes to help all who ask his advice and to enlighten all who read Ask Dr. Warren. For your own well being please keep in mind that
advice you read here may not apply exactly to your own situation, and that if you are sick, no information on the web can take the place of a hands on examination by your physican who knows you and cares about you.
Dr. Warren
Thanks for your help.
Best regards,
Merry
Dear Merry: If prune juice keeps your baby regular, just keep giving him the prune juice. It's natural, safe, and effective. If his stool gets too soft, decrease the amount of prune juice you give him rather than stopping it. Daily prune juice is preferable to using suppositories or medication.
Sincerely,
Dr. Warren
The thing is is that it doesn't seem to bother her at all, she doesn't get embarassed and if you let her she'll go on playing like nothings happened. Odd or not?
Thank you for your input
-H
Dear H: It is certainly possible that the new baby has something to do with your 7 year old neighbor's incontinence. Children often regress or experience some emotional symptoms when a new sibling is born. The apparent lack of caring about wetting is actually a common ego defense mechanism that children use known as denial. If the accidents were occasional and unexpected, the child would probably be upset by them, but she has learned to cope with the accidents by acting as if nothing happened.
Some children also may start having accidents because they become so involved in what they are doing that they ignore the urge to use the bathroom until they can no longer hold it and then can't get there on time. If that becomes habitual, some kids will then just go about their business, ignoring the fact that they're wet. If the little girl is spending more time away from her house since her sibling was born that may be what is happening, but if the problem began just after the new baby's arrival, it is more likely due to regression.
Sometimes medical problems like diabetes or urinary tract infections can be the cause of incontinence. You should talk to the girl's mother just to be sure she is aware of the problem. You can present it in a friendly, non-judgmental way by asking if she'd like to leave some spare clothes for her daughter at your house in case of an accident. The only other thing I could suggest you might do is to ask the little girl to use the bathroom before sitting down to play in your house. You are entitled to protect your furniture, and having her go before she gets involved in playing may prevent an accident.
Sincerely,
Dr. Warren
Thanks for your time
-Brandi
Dear Brandi: Urine infection can neither be ruled in or out by a urinalysis. If there is any reasons to suspect a urine infection, a culture must be done. Since you still have symptoms, you should have a repeat culture and any organisms grown should be tested for sensitivity to the antibiotic you are on. The choice of antibiotic should be directed by the sensitivities.
If the organism causing your original infection was found to be sensitive to cipro, your symptoms may due to vaginitis which could be a complication of antibiotic therapy. The redness and tenderness around your vagina suggests that possibility. Vaginitis can be treated with sitz baths - soaking in warm water (no soap) - 4 times daily, and applying a bland ointment like Vaseline or A&D.
The most important thing regarding your situation is follow up of the urine infection. You need a repeat culture.
Sincerely,
Dr. Warren
Thank you for any information you could help us with
-DG
Dear DG: Your description of the events sounds like a seizure. During the period after the seizure a person may be unresponsive, limp, or sleepy for a few minutes or longer. There are many reasons a person, including a child, may have a seizure. These include metabolic abnormalities as seen with dehydration and low levels of sugar, sodium, magnesium, or calcium in the blood associated with a variety of conditions. Congenital abnormalities of the brain and scar tissue from old injuries may provoke seizures. Acute infections like meningitis may cause seizures. Young children may have seizures from fever. Seizures may occur as part of other neurological conditions and may be hereditary. In spite of all these possibilities, most seizures are idiopathic, meaning cause unknown.
Sincerely,
Dr. Warren
-Cynthia
Dear Cynthia: The behavior you describe is way outside the range of usual childhood behavior problems. Does your daughter behave well at home? If so, there may be a problem at the school which needs to be investigated. Has she ever had experience playing with other children before she entered pre-K? If so, how did she get along with them? If your daughter's behavior has always been so extreme, she should be evaluated by a psychiatrist. If no psychiatric problems are found, you should then consult a psychologist or other counselor for behavioral management therapy.
For additional information on behavior management you should read the following three articles I have written about child behavior:
Sincerely,
Dr. Warren
-G
Dear G: Your son's sugar habit is unusual, but it will not do him any harm as long as he doesn't have diabetes. Of course, if he goes to sleep with sugar coating his teeth, he could get cavities. If your son hasn't had a recent , complete physical, he should have one to be sure that there isn't any physical or emotional reason for this unusual habit. In the meanwhile, since your son has demonstrated that his craving prevents him from being trusted or honest, store your sugar out of his reach, if necessary, in a locked cabinet.
Sincerely,
Dr. Warren
-A Very Concerned Grandmother
Dear Concerned Grandmother: Whoa!!! Your cart is way before your horse. It's not time to start looking for a second opinion before you know what the first opinion is. Your granddaughter needs a complete evaluation by a pediatric neurologist in order to make a diagnosis and recommend therapy. Children who suffer brain damage or other neurological injuries do not have to be retarded and no physician is interested in labeling them as such.
Most states have early intervention programs which provide physical therapy, speech therapy, occupational therapy, and educational programs for children with special needs. Early intervention provides the best opportunity for these kids to reach their potential and be ready for school with their peers. The aim of evaluation should be to find out what programs your granddaughter will need. Most state funded programs do require a diagnosis and medical certification in order to provide services, but this diagnosis is not intended to be a label . Whether or not your granddaughter's diagnosis will serve as a guide to help her and get necessary services or will label and stigmatize her will depend in large part on how her family responds to her diagnosis. If you treat her like a normal child and make reasonable demands on her based on your knowledge of her disabilities rather than letting her diagnosis become an excuse for doing less than her best, and if you act as an advocate for her in procuring services both in and out of school, she won't be held back by a label.
Sincerely,
Dr. Warren
He said his eyes still have to retract, some children it takes longer then others, my son is eight years old, he said if by chance it does'nt happen they can perform a surgery later on.I asked why or how this happens and he could not really give me a detailed answer,I've looked on the internet and could not find anything, could you please help me?
P.S - Does this effect him in any other way? And he said he does'nt have a wandering eye, the flat space makes it look as though his eye wanders sometimes.
-C
Dear C: The condition in which the eyes appear crossed (but really aren't) because of a broad flat bridge of the nose is called pseudostrabismus. It is a variation of normal. It does not have any effect on vision and does not require treatment. Pseudostrabismus is more common in infants because of the shape of their faces, including the flat bridge of the nose. The nose often elongates considerably in adolescence so that the appearance of pseudostrabismus is much less common in adults. But facial appearance is hereditary, and some adults do have that appearance. I can't see any reason a person would do surgery for pseudostrabismus since it doesn't cause any problem. Any such surgery would be purely cosmetic, but even that is generally not necessary since the broad nasal bridge usually has a pleasing appearance.
Sincerely,
Dr. Warren
If your questions haven't been answered here, perhaps you would like
to
question?!?
