21 March 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
Thanks
-Mike
Dear Mike: Mononucleosis is a syndrome caused by infection with Epstein-Barr virus. The symptoms of infection with Epstein-Barr virus range from no symptoms at all to full blown mononucleosis with tonsillitis, fever, swollen glands, fatigue, enlargement of the spleen, rash, swelling over the eyes, jaundice, and dizziness. Mononucleosis is named for the affect it has on the blood, namely, it causes an elevation of the white blood cell count with a proliferation of atypical lymphocytes (mononuclear cells).
Mononucleosis is contagious during the acute phase with fever and tonsillitis which may last up to two weeks. Mononucleosis spread through infectious secretions such as saliva, and so requires close contact to spread. The recovery phase can last weeks to months with fatigue and dizziness as the main complaints. Patients are not contagious during the recovery phase.
Sincerely,
Dr. Warren
-Kathy
Dear Kathy: Some children tend to run higher fevers than others. Even though most parents find temperatures in the range of 104-106 frightening, this is not an abnormal range for fever and does not imply any abnormality of thermoregulation.
Most children who have seizures with fever will never have a second one, but some children do have multiples. Seizures with fever usually cease by 3 years of age for girls and 6 years of age for boys. If your son has been having less frequent seizures it could be a result of less frequent fevers as he gets older. If he has fevers without the seizures then you will know that his seizures with fever have ceased.
Sincerely,
Dr. Warren
-A
Dear A: A low hemoglobin means your child is anemic. This could be due to iron deficiency or it could be genetic if your family has a history of any kind of anemia. Anemia is not in itself serious unless it is severe or associated with a serious condition.
Sincerely,
Dr. Warren
Your advice is greatly appreciated!
-J
Dear J: Most newborns feed every 2½ to 3 hours. By 2 months old, that has stretched to every 3-4 hours with one longer sleep of maybe 5 to 6 hours; however, many two month olds continue to demand round the clock service. Because your babies are still small, they're not ready to feed more and go for longer intervals. As long as they're growing well, you should continue feeding them as you are.
There may be times it makes sense to wake a baby for a feeding, such as when you have to get out of the house, or if you're ready to go to bed and the baby is due for a feeding, but in general, it's best to feed babies on their own schedule. Since it is not really possible for you to feed both babies at the same time, it probably won't accomplish much for you to wake one baby just because the other is up.
Multiple births are a lot of work, even if they are not premies. Whenever possible, you should enlist the help of friends and family members so that you can get some rest. As the babies get bigger, they will begin to take larger feedings and go longer between feedings.
Sincerely,
Dr. Warren
Thank you so much.
-SS
Dear SS: When nursing babies are colicky, the first place to look is at mother's diet. Many moms are careful about eating spice, but continue to have other things in their diets which they don't realize bother the babies. The biggest offender is milk. Figuring out what is making a nursing baby colicky may require keeping careful track of when the crying occurs in relationship to what things mom has eaten.
If the baby is having formula regularly, changing the formula may make a difference, but as a general rule, mother's milk is the best tolerated, so I would not introduce a formula as a way to deal with colic. I usually discourage offering formula to nursing babies during the first few months because some mothers may have difficulty keeping their milk supply up if the baby takes formula in place of a nursing, and some babies may have difficulty switching between breast and bottle.
Unfortunately, the other general measures for dealing with colic are the same for all babies, nursing or formula fed - walking, rocking, singing, taking turns caring for the baby so everyone gets some rest.
Sincerely,
Dr. Warren
I have recurring aching in my lower left stomach area. I have spasms in that area as well. The pain follows down to my left testicle. I also have pain in my lower left back (around the PSIS). My urine appears cloudy when I have these pains, and I have runny stool when on days when there is a lot of pain. I have some minor lower back injuries and all symptoms seem to clear up if I go to a chiropractor. When I stop going, they come back.
Heard of any symptoms like this?
Thanks.
-TH
Dear TH: If the chiropractor is helping your pains, by all means keep going; however, if you wish some further diagnostic evaluation of your symptoms, you need to see a physician. Cloudy urine associated with pain could indicate a urinary problem which is not amenable to chiropractic treatment. Recurrent diarrhea could also be a medical problem, although it may be a stress reaction to the pain if it resolves when your pain resolves.
Sincerely,
Dr. Warren
-U
Dear U: I am unclear as to just what mixture you are concerned about inhaling, but tobacco doesn't produce any fumes if mixed with water and soap. I can't imagine what the purpose of such a mixture would be, or why your friend wants to keep it around, but if you're concerned, just ask your friend to keep it in a closed container.
Sincerely,
Dr. Warren
A friend told me that her daughter had some nasal problems when she was about 6 years old and the school nurse told her it was very common for that age. Is this true?
-Mrs. P
Dear Mrs. P: Although colds and allergies are common in childhood, sniffing is not part of a normal phase of childhood. Your son's constant sniffing, even in the absence of mucus, could be a sign of an irritated nasal membrane or it could be a tic (a nervous habit). If your son has allergies with a swollen nasal membrane, there are many effective treatment options. Tics are not as easy to treat, but are also amenable to treatment.
Sincerely,
Dr. Warren
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