14 January 2008
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
-V
Dear V: Ask Dr. Warren is a public service which I provide free of charge through my web site. Since I am also in practice, my telephone number is listed in the phone book, however, I do not list that information on my web site since that number is for my patients to contact me. If your teacher wishes to contact me he/she should contact me by e-mail through my web site. If there are special circumstances that require speaking to me, your teacher would have to explain these to me for consideration. If I feel these circumstances warrant more personal contact I will inform your teacher how this can be handled.
Sincerely,
Dr. Warren
-Mr. G
Dear Mr. G: Hair loss can occur for no apparent reason in a healthy person, but since there are a large number of possible causes of hair loss including medical causes, your daughter should be checked by her pediatrician. The most important correctable causes of hair loss include gland disorders (pituitary, thyroid, parathyroid), diabetes mellitus, and nutritional deficiencies. Local scalp conditions (infections, rashes, systemic diseases) and exposure to toxins may also cause hair loss.
Sincerely,
Dr. Warren
-Tom
Dear Tom: Pain relief for an injury can usually be accomplished with rest (which of course includes leaving adequate time for healing before reinjury), ibuprofen (Motrin, Advil), and application of ice. The question of whether or not you have rib fractures cannot be resolved without medical attention. If you are having a lot of pain or feel ill, you should see a doctor.
Sincerely,
Dr. Warren
Please advise and thanks.
-Celeste
Dear Celeste: Zyrtec is an antihistamine. It is used to treat allergies and hives. If allergies contribute to your daughter's asthma, it may provide some benefit; however, it is officially approved for use in children 2 years and older. You should consider whether or not you want to use this medication at a younger age than it is approved for. This does not mean it is dangerous for younger children. It only means that studies haven't been done which show it to be safe and effective in younger children. As far as protecting her against flu, I am not aware of any evidence that Zyrtec can protect against flu. You might want to be sure you fully understand why your daughter's doctor is giving her this medication so that you can make an informed decision.
Sincerely,
Dr. Warren
Sincerely,Dear Readers: Since this letter was written Zyrtec has been approved for infants as young as 6 months. The remainder of my advice is unchanged. It is used for treating allergies, not Flu.
Dr. Warren
-BC
Dear BC: Did your son have a febrile seizure (meaning he had a convulsion because he had a fever) and fall as a result, or did he fall and have a contact seizure which is a seizure resulting from a head injury. In either event, after a seizure a child will remain unconscious or semiconscious for a variable period of time. The child is not paralyzed, but he may be limp and not exhibit any voluntary movements until he recovers.
If your son had a seizure secondary to injuring his head and remained unconscious for 1½ hours afterward, he should have had a CT scan at the time to be sure he had no bleeding inside his head. Five days later, if this was not done at the time of the injury and your son seems completely fine, all I can say is that for any kind of seizure 1½ hours is a long period of unresponsiveness. You and your son's doctor will have to decide if he should consult a pediatric neurologist for further evaluation.
Sincerely,
Dr. Warren
Thank you for your time
-SB
Dear SB: With regard to the nutrient value of carrots, you are a bit confused. The statement that steamed carrots are the most nutritious refers to a comparison of cooking methods. Raw vegetables are by far the most nutritious. In addition, because of their greater taste and texture, they are often preferred by children. While it is true that all the fiber cannot be digested or absorbed, that fiber helps with regularity. This does not imply a problem with digestion of raw carrots. In fact cooked carrots have the same fiber. Raw carrots are good food for children. It is likely that your son's discomfort was related to his illness and not his consumption of carrots.
Sincerely,
Dr. Warren
Thank You
-BF
Dear BF: You haven't told me what kind of evaluation your son has had for his recurrent UTI. He should have a voiding cystourethrogram (VCU) to check for reflux from the bladder to the kidneys. He may also need urodynamic studies to be sure there are no voiding abnormalities. He should have follow up cultures to be sure the infection is cured. Lack of symptoms is not proof of cure. You should consult a pediatric urologist. In the meanwhile, make sure your son is not taking any bubble baths as these can contribute to UTIs.
Sincerely,
Dr. Warren
Thanks.
-Blythe
Dear Blythe: Vaginitis, inflammation of the vagina, will cause the vagina to be red and will cause burning on urination. It can be treated with sitz baths (sitting in plain warm water, no soap) 3 to 4 times daily and application of a bland ointment like A&D. Vaginitis may be caused by bubble baths, improper wiping (correct is front to back, no back and forth), nonabsorbent underwear (cotton or a cotton liner for the crotch is best), or no obvious cause.
Burning on urination could be a sign of a urine infection. If it is frequent or persists your daughter needs to be checked. If the rash is more than redness from irritation and does not clear up, it could be a yeast infection and should be checked.
Sincerely,
Dr. Warren
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