12 June 2006

1. Cramps During Pregnancy
2. Dealing with Ear Pain
3. Multiple Pains and Symptoms
4. Head Lice
5. Extreme Sleep Problem
6. Chronic Cough
7. Antibiotics Effect on Teeth
8. Paralyzed
9. Disclaimer

• Read Questions & Answers in Another Column

Cramps During Pregnancy

Recently, my girlfriend got pregnant. Right now she is about seven weeks along and is having terrible cramps. They have gotten so bad that she can't walk and has even passed out once. We have went to the hospital and talked with them. They are not taking it seriously and are even rude at times. They gave my girlfriend a book on fiber and said that is probably what is wrong. So they really don't know and neither do we. Please, do you have any idea what is wrong? Thank you for your time.

-Ben

Dear Ben: It is possible that your girlfriend is having a problem with constipation which is why fiber was recommended. It is also possible that she is having a problem with the pregnancy. If your girlfriend wants to give herself and her baby the best chance, she should be getting prenatal care. Emergency rooms are not the best place for ongoing care and emergency room visits actually cost more than visits to a private doctor. You and your girlfriend should look into getting prenatal care at a local clinic. Most charge on a sliding scale based on income. You can also contact Planned Parenthood. They provide the full range of family planning services including prenatal care.

I cannot diagnose the cause of your girlfriends pain based on the information you have given me. The most worrisome cause of abdominal pain in early pregnancy would be a tubal pregnancy. If your girlfriend has severe pain associated with bleeding she should be examined by a doctor and have an ultrasound to check the pregnancy.

Sincerely,
Dr. Warren

Thank you for your time.

-SF

Dear SF: The swinging, rocking motion is soothing to babies and helps put them to sleep. It does not do anything specific for ear pain. If the baby is in pain from an ear infection, medication for pain such as ibuprofen (Motrin, Advil) might help. You could try a wind up infant swing to help with swinging the baby. The motion of a car ride might accomplish the same thing.

The pain of an ear infection is intense, but only lasts a few hours. If your baby is screaming night after night, you may be blaming his ear problems when he is really having separation anxiety.

Sincerely,
Dr. Warren

• Migraine headaches in front of forehead (past six years)
• Migraine headaches sometimes at the base of the neck (past six years)
• Legs hurt (ache) when she walks (for a while, but has gotten worse)
• Elbows and knees hurt a lot (past month)
• Arms feel "dead", heavy, numb at times (past month)
• Hands tingle, no pressure when trying to close them or hold something (past month)
• Hands shake (past month)

• She was on tegratol for a while, but when had a toxic reaction to it, the Dr. at Children's had to take her off immediately.
• Prozac
• Periactin
• May have been more, my sister is trying to remember

Thanks for your time!

-MC

Dear MC: Your niece should get excellent care at Boston Children's Hospital; however, depending on the type of evaluation your niece has had, it may be necessary for her to be referred to additional specialists for a fresh look at her problems from a different perspective. Has she had a thorough pediatric neurology evaluation including a recent MRI of the brain and EEG for evaluation of ongoing symptoms? Does she have true weakness on examination with the numbness she feels? If so, has she had an EMG or NCV studies? Has she been evaluated by an orthopedist for her musculoskeletal symptoms? Does she have joint swelling and tenderness which would require evaluation by a rheumatologist? If your niece has had recent onset of muscular and joint symptoms in the past month, it is a mistake to assume they are related to her migraines or to an injury dating back 6 years..

Finally, if the doctors caring for your niece have no answers, given her constellation of symptoms, you should consider chiropractic evaluation and treatment. While I cannot make a diagnosis without examining a patient and reviewing test results, one must at least consider that a spinal malalignment could cause headaches, limb pains, tingling, and weakness.

Sincerely,
Dr. Warren

Thanks.

-Helen

Dear Helen: If the treatment for head lice is successful, the patient should no longer be contagious the day after the treatment. The problem is knowing whether or not the treatment is successful. If the child continues to itch you should be suspicious that the lice are still there. Most treatments recommend repeat application in a week just in case any eggs hatch after treatment. Since it is hard to be sure all eggs are killed, it is best to remove as many nits as possible. It is a chore which is accomplished by carefully going through all the hair with a nit comb. Since the live nits are close to the scalp, this must be done by taking small portions of the hair and combing through starting right at the scalp.

Sincerely,
Dr. Warren

-Mr. & Mrs. H

Dear Mr. & Mrs. H: Is your daughter perfectly fine during the day? Is her physical and social development normal? If the answer to both questions is yes, then it's plain and simple that your daughter needs to learn to go to sleep and stay asleep in her own bed. Unfortunately, if she has already learned to scream "all night" to get her way, you're going to have several long nights ahead of you. She cannot learn to stay in her own bed without being kept in it. That doesn't mean you should ignore her, but it does mean that you should not feed her, take her into your bed, or take her out of her bed. Please read my article, Helping Your Child to Sleep Through the Night.

If the answer to either of the above questions is no, then further evaluation is necessary. The reason I asked about development is that children with neurological or developmental problems may have difficulty establishing normal sleep behavior. An examination that checks for such causes of sleep disturbance as ear infections may not address that issue unless the doctor reviews the child's development.

Sincerely,
Dr. Warren

-KP

Dear KP: Did the doctors find anything on examination, or did they just try the inhalers, steroids (Prelone), and antibiotics to see if they would help. You didn't tell me what other specialists you consulted. An ENT evaluation and allergy evaluation may shed some light on the cause of the cough. If your daughter has a normal chest x-ray and the pulmonologist finds that she has normal PFTs (pulmonary function tests) and a normal examination, then, considering that her cough disappears entirely when she is asleep, the likely diagnosis would be that her cough is a tic or nervous habit. If that should be the case, you might consult a pediatric neurologist about treatment for tic disorders.

Sincerely,
Dr. Warren

P.S. What is a candida diet, and what does candida have to do with coughing?

Dear Dr. Warren: In reply to your response, the first person we consulted was an ENT that specialized in allergies. He gave my daughter a diagnosis of candida which is an overgrowth of yeast in the body. The candida diet consists of taking the person off of all dairy, yeast and sugar products. You slowly introduce the products back into the persons diet. However, you are to completely change the way in which you eat, limiting these products. This doctor felt that this diet along with sublingual allergy drops would help her cough. So far, nothing has. Thank you for your response to my first letter. If you have any further response, I'd be glad to read it.

Thank you.

-KP

Dear KP: I am familiar with candida. It is the yeast that causes thrush and diaper rashes. It also causes vaginal yeast infections in adult women. It is treatable with antifungal medications. What I'd like to know is what evidence there was that allergy to yeast was causing your daughter's symptoms or even what evidence there was that she had an overgrowth of yeast anywhere in her body. I'd also like to know what evidence there is that limiting milk, sugar, and yeast (dietary yeast is not the same as candida) intake eliminates yeast infections.

To me, the candida diet sounds like a bit of hokus pokus, but then I guess my opinion doesn't really help you since you already found that it didn't help your daughter's cough. Based on your description including that your daughter's cough disappears during sleep, and based on the failure of all the treatment modalities which have been tried, I would pursue the possibility of the cough being a tic.

Sincerely,
Dr. Warren

-Robin

Dear Robin: Most antibiotics do not affect developing teeth. Tetracyclines and related antibiotics can stain the teeth and should be avoided in children younger than 8 years of age.

Sincerely,
Dr. Warren

Doctors were unable to diagnose the cause of the sickness and ever since that day she's been paralyzed, but before that she was trying to walk- at 10 months, she is a year now.

Presently, she is recuperating very slowly, sometimes she tries to talk (baby talk), but she appears quite weak and her legs wobbles anytime I try to stand her up. Although I keep praying to God to restore her back to her normal self, I would like to know what you think about this condition.

l have written my e-mail address below.

Hoping to hear from you soon.

Yours sincerely,
-LD

Dear LD: It sounds like your daughter has had a catastrophic neurological event such as a stroke. You haven't told me what kind of evaluation your daughter had which provided no clues to your doctors. She should see a pediatric neurologist and have an EEG and MRI of the brain. If those tests do not provide any information I'm not sure what else could be done to make a diagnosis.

Regardless of the results of a complete neurological evaluation she needs to start physical therapy, occupational therapy, and speech therapy to get her on the road to recovery.

Sincerely,
Dr. Warren

If your questions haven't been answered here, perhaps you would like to

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