29 May 2006
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.
-Jeff
Dear Jeff: If you really don't sweat, as in, not even a little bit (rather than you don't sweat much), that is not common. Sweating is part of how the body regulates temperature. Sweating removes heat from the body. It is controlled by the autonomic nervous system. The only situations in which a person would not sweat at all would be if he had no sweat glands, or if his autonomic nervous system did not function properly. The end result would be an inability to control body temperature. Anything that would make a person hot such as physical activity, high environmental temperature, or excessive clothing would make a person who can't sweat run a fever. Any illness that would cause a fever would likely cause a higher and more prolonged fever in a person who couldn't sweat.
You could only have no sweat glands if you were born that way. That is not common and is associated with round peg like teeth and sparse hair. These abnormalities would have been evident early in your childhood, and you would probably be aware of the associated difficulty controlling your body temperature.
Impairment of your autonomic nervous system would usually cause other symptoms, the most common being instability of your blood pressure possibly causing fainting spells. Other symptoms could include rapid or slow heart rate, diarrhea, and dysfunction of a variety of other organs. According to Bennett: Cecil Textbook of Medicine, 20th ed., Copyright © 1996 W. B. Saunders Company, "idiopathic anhydrosis [lack of sweating, cause unknown] may be segmental [localized to one part of the body] or generalized [no sweating from any part of the body]. This rare condition is sometimes associated with Adie's syndrome [an idiopathic condition involving degeneration of the ciliary ganglion which causes a large, poorly reactive pupil], but in other cases there are no other signs of autonomic impairment.... In most recorded patients, the deficits have been stable and did not go on to involve other autonomic functions."
So, essentially, if you have no other symptoms, your primary problem would be avoiding overheating. If this has never been a problem for you, you may actually be sweating enough to control your body temperature. You may just tolerate hot temperatures well enough and be in good enough physical shape to not sweat from the usual everyday exertion.
Sincerely,
Dr. Warren
Thank you
-Maria
Dear Maria: Sleepwalking is a fairly common occurrence in childhood and adolescence. Some 1 to 6 percent of children, more often boys, experience frequent episodes, with its onset typically between 6 and 12 years of age. Sleepwalking usually disappears after adolescence. There is some risk of injury during sleepwalking. The sleepwalker usually resists attempts of others to communicate with or arouse him, but may awaken spontaneously with mild confusion that lasts several minutes. Some sleepwalkers return to sleep, either in bed or in an unusual place, without waking up until morning. The sleepwalker generally does not recall the episode.
If you are concerned about the possibility of your son going outdoors during a sleepwalking episode, you could put an alarm on the door that would wake you up if the door were opened. That would not only reassure you that you could keep your son from going outside in his sleep, but would also protect you from burglars.
Sincerely,
Dr. Warren
-(unsigned)
Dear Mother of Twins: You can give the babies a decongestant cough medicine such as Robitussin Pediatric Drops. Keep in mind that decongestants can make babies cranky; however, if the twins are miserable from their cold, they may feel better with medication. In deciding whether or not to medicate, also keep in mind that cold medicines can relieve symptoms, but they don't cure colds and are not necessary for your babies to get better. Please read my article, Upper Respiratory Infections (URIs) for more information.
Sincerely,
Dr. Warren
-RH
Dear RH: It is highly unlikely that your son has had any kind of lymphoma or cancer for two years without the cancer growing and spreading to other areas. That having been said, if a lump persists ad the doctor cannot tell you with certainty what it is, the best way to eliminate the problem and answer your question is to have the lump removed and biopsied.
Your question does not make clear to me just where on your son's jaw his lump is. If it's in the midline under his jaw, we could be talking about a thyroglossal duct cyst which is getting intermittently inflamed. Thyroglossal duct cysts are not dangerous, but once diagnosed are generally removed. The fact that the lump swells and becomes tender could be consistent with an inflammatory lymph node which swells in response to upper respiratory infections. Whether or not to be concerned about lymph nodes depends on their location, size, and clinical course. For the most part cancers just get bigger and are not generally tender. There are normally a lot of lymph nodes in the neck. Inflammatory nodes are not dangerous.
Discussing the relationship of the lump to your son's thyroid would require that I have a greater understanding of where the lump is. Many thin children are simply growing according to their genetic endowment. If either you or the boy's father were thin as a child, it's not unreasonable to expect the same for him. The matter of whether or not your son is hyperthyroid is easily checked with a blood test. Hyperthyroidism causes other symptoms besides difficulty gaining weight including rapid heart rate, excessive sweating, and nervousness.
Sincerely,
Dr. Warren
Thank you for any information you may provide.
-Dean
Dear Dean: I suspect this is one of those situations in which the doctor has given a nonmedical explanation. When infants first start crawling, they may sometimes not use both legs equally. My twin brother reportedly dragged one leg when he started to crawl. If, based on the doctor's examination, he feels there is a musculoskeletal or neuromuscular problem, he should refer the baby to the appropriate specialist (orthopedist or neurologist).
Sincerely,
Dr. Warren
-R
Dear R: Try using small coated candies to practice pill swallowing with. Have your daughter drink the liquid with which she will swallow the pill from a soda bottle. The small opening of a soda bottle generally causes the tongue to curl in such a way as to facilitate the swallowing of a pill.
Sincerely,
Dr. Warren
-JJ
Dear JJ: Infants need 300-400 IU of vitamin D daily. If the baby is eating a commercial (not homemade) formula this should be met by the baby's formula. No additional supplement is necessary.
Sincerely,
Dr. Warren
Thanks.
-Kristi
Dear Kristi: Although I don't think the matter has been studied, my personal observation is that babies are rolling over later since we have started putting them all to sleep on their backs. Your daughter probably has no desire to be on her belly. You can help her get used to being on her belly by playing with her on the floor when she is awake.
Crawling and pulling to sit are generally accomplished around 10 months. Pulling to sit shouldn't be confused with being able to stay sitting when placed in the sitting position which is usually accomplished around 8 months.
Sincerely,
Dr. Warren
If your questions haven't been answered here, perhaps you would like
to
question?!?
