10 January 2005
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
-R
Dear R: Why is your lawyer giving you medical advice? Is he preparing to take part in a lawsuit before an adverse event even happens? His involvement in this manner is unconscionable.
The best person to give you an unbiased opinion as to your child's risks with anesthesia is the pediatric neurologist who is managing his seizures. There is no such thing as risk free anesthesia, but anesthesia is reasonably safe today. The risk of anesthesia must be balanced against leaving your son's enlarged adenoids untreated. I doubt that your lawyer is qualified to advise on such matters. He should be hanging his head in shame for sticking his nose in in this manner.
You should discuss the anesthesia risks with your son's pediatric neurologist and discuss the risks of the surgery and the risks of not doing the surgery with the ENT.
Sincerely,
Dr. Warren
-Shirley
Dear Shirley: Enlargement of the heart is not a specific diagnosis, but a finding which can be seen with heart disease, especially congestive heart failure. It is possible for a child's status to change, so if your daughter's heart were borderline enlarged, it is possible at another time it could be normal and then again borderline enlarged, but since it is borderline, it is subject to interpretation. The x-ray technique is also crucial since an AP film (taken front to back) makes the heart look larger and cannot be reliably used to determine cardiac size.
The issue and whether or not there should be any health concerns regarding your daughter's heart would be best resolved by consulting a pediatric cardiologist.
Sincerely,
Dr. Warren
-D
Dear D: Shaving legs is not harmful and so can be started as early as a girl with heavy or dark leg hair is old enough to be concerned about its appearance. This is unlikely to be an issue before 8 or 9 years of age.
Sincerely,
Dr. Warren
-D
Dear D: Thirteen is old enough for a girl to shave her legs.
Sincerely,
Dr. Warren
a.. she has been breastfed for the first three monthsMy biggest concern is the blood in her stools. I am very worried and I am send you this info because we have taken her to three Pediatricians and they don't seem to think its a big deal. Please give me your opinion whenever it's possible. I thank from my heart.
b.. she has been on Similac this last fourth months
c.. she has had quite a lot of reflux since she was born
d.. she recently had a cough and was given Penxatril ( a Peniciline based antibiotic for a week and that got rid of the cough).
e.. she does not yet eat anything but her milk
f.. she has had in the past weeks off and on blood strings in her stool few.
g.. she has a small anal fissure but it seems only irritated, it does no seem to be bleeding
h.. she eats very well and takes plenty of water.
i.. she wakes up at night just about every hour or hour and a half, even though she is been fed very well
j.. when she wakes up at night she cries and it clearly seems to be a combination of reflux and colic pain in her abdomen.
k.. lately she has been crying for two hours straight and we know from her reactions that something is causing her some pain
l.. all her bottles are sterile and we use purified water which is also boiled to mix the milk powder
Sincerely,
-Gerardo
Dear Gerardo: It is possible that blood streaks on the stool can be coming from an anal fissure even if you don't see visible bleeding; however, blood in the stool could come from colitis of infectious origin or formula intolerance. Usually I would recommend switching to a hypoallergenic formula like Alimentum or Nutramigen for a colicky baby. This may work, but because of the blood in the stool I'd suggest seeing a gastroenterologist. The pediatricians who saw your baby may be right that it is not a big deal, but they haven't told you what the problem is, so it's hard to have faith in their assessment of the situation.
Sincerely,
Dr. Warren
I live in Massachusetts.
Thank you for your time and I look forward to your response.
-L
Dear L: I wish I could help all the desperate people who look to me for answers, but when a child has complex problems I'm not brilliant enough to come up with an answer from a brief e-mail description when doctors who have examined the child and run a full battery of tests have not. It is clear that your son has a neurological problem. His low muscle tone, poor head control, and behavioral issues are all part of that problem. It is not clear to me whether this is a congenital/genetic problem. Some neurological conditions with which children are born do not become evident until their nervous systems have started to mature. The problem could be related to a vaccine although a direct cause and effect relationship between DTP vaccine and encephalopathy remains controversial and unproven.
If your son's evaluation is not being directed by a pediatric neurologist, you should consult one. If you are near Boston Children's Hospital you should consider going there to see a pediatric neurologist.
In the meanwhile, your son's progress depends largely on the interventions of therapy. Many states provide early intervention for children with neurological or educational problems. For younger children these programs may be administered through the health department while school districts are often responsible for early intervention after 3 years of age. You want to be sure your son is getting all the services he needs to which he is entitled.
Sincerely,
Dr. Warren
We have located "Woodward's", manufactured and bottled in London, England which specifies Active Ingredients as : Terpenless Dill Seed Oil 2-3 mg. and Sodium Bicarbonate B.P. 52-5 Mg. Seems harmless to me and Giving her a half to one teaspoon during or after a feeding seems to be helping. Do you have any information on gripe water and whether or not its ok to use? One web site said that "gripe water" contains 90% alcohol? However I cannot confirm that in Woodward's Brand?
Thanks in advance for any information you might have!
-JF
Dear JF: I have no knowledge about gripe water. Since it's production and use are not regulated by the FDA, it wouldn't surprise me if there were multiple different formulations. Sodium bicarbonate is an antacid, similar to Children's Mylanta. I have no idea whether or not Terpenless Dill Seed Oil is safe or provides any benefits.
If your daughter's symptoms persist, you should consult with a pediatric gastroenterologist about her diagnosis and management.
Sincerely,
Dr. Warren
Please reply: Thanks!
-Peter
Dear Peter: Herpes causes blisters and open sores, not pimples with oily secretions in them. If you have not had sexual relations there is no reason to be concerned about a sexually transmitted disease. Pimples and boils can occur on any part of the body which has hair follicles and oil glands.
Sincerely,
Dr. Warren
-Ian
Dear Ian: The risks from asbestos come from inhaling it. If the siding you removed was solid and in good condition, then there would be no fibers to inhale. If there was deteriorating fiber, then there is some risk of inhaling it, but your risk was certainly decreased by being outdoors. Chronic inhalation can cause lung disease, but a one time exposure carries very little risk. If you do these kinds of things in the future, you can protect yourself by wearing a filter mask over your mouth and nose. It's pretty common practice for workmen in dusty environments to wear them now. I'm not talking about fancy equipment, just a simple paper mask which is probably available in your hardware store.
Sincerely,
Dr. Warren
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