? for the medical staff of the forum

[Penguinfan]

I am getting concerned about my daughter and have a couple questions, she is almost 5 and at age 2 she was diagnosed with arthritis in her right hand, she still never complains of pain or anything, but would say it got stiff now and then, she got an injection shortly after the diagnosis that seems to have worked wonders for her, she has been to her rhumetologist regularly and nothing further has been found, unfortunatly the rhumetologist that was treating her moved away and I am not happy with the doctor she was the last two visits as he did not do as thorough of a check as her previous doctor did and now she says her knees get tired, never says they hurt, but says they get tired, I don't see or feel any swelling, but this concerns me alot, also she is constantly sitting on front of the heat vents at home when the furnace kicks on, is this something that should concern me as well or am I over-reacting to her just being cold?

Certainly I am not looking for someone to diagnose her via a forum post, but more importantly I want to know what I should be asking the doctor, should I demand a more thorough exam, do I have the right to, can I request another doctor see her, what are some obvious signs that I should be looking for?
If you can answer any of these question my wife and I would greatly appreciate it as my daughters next appointment is coming up and we are gonna have to decide weather to keep it or try to get in touch with her past doctor and see if we can take her to her, a several hour trip, but obviously worth it if thats where she gets the best care.

Thanks
Penguinfan

 

[dr. freeze]

Unfortunately, on exam you can't do a whole lot to diagnose different kinds of arthritis....most likely in her age category it was an infection and thus the shot took care of it.....but with follow ups to a rheumatologist maybe not? i don't know...do you know the specific type of arthritis? it possibly coudl be gout as well but that is an unusual place for gout to occur...

as for the rest, you are probably over-reacting....in talking to pediatricians, this is the usual story -- parents are tougher to deal with than the kids...your concern for your daughter is normal and healthy and i myself will probably be even more neurotic parent, but she is probably just fine....

its been a cold winter anyway

 

[Penguinfan]

Thanks Dr. Freeze, unfortunatly my wife is usually the one who handles the doctor visits since I work so much and can't say what kind of arthritis was diagnosed. Yes, I over-react alot with her but we have been through a ton with her in her short 5 years starting right from day 1, certainly others have had it tougher so I won't trivialize that with my details, but I will be concerned and over-react until it's her turn to take care of me

Again, thanks.

 

[AR182]

dr. freeze,

isn't she too young to have gout ?

i always thought that gout is caused by diet.


penguinfan,

sorry to hear about your daughter having arthritis. i'm not in the medical field, & don't know if this is the same, but i have arthritis throughout my spine. i find that heat & massages relieve my arthritis. maybe try putting a heating pad on the area while she watches tv or gently rubbing the area for awhile. it may help.

 

[SixFive]

Re: ? for the medical staff of the forum

I want to know what I should be asking the doctor, should I demand a more thorough exam, do I have the right to, can I request another doctor see her, what are some obvious signs that I should be looking for?

I have learned through my kids that they sometimes hurt in their joints, and sometimes, it's very bad. This is often referred to generically as "growing pains", and sometimes requires a good steroid shot or anti-inflammatories. Your daughter will have these from time to time like every kid will, and it will be hard not to think the worst since she has already had problems (similar to a person who has had a heart attack becoming alarmed anytime they have an odd pain in their chest, back, arm, etc). I'm not sure what your daughter's diagnosis is since she is seeing a rheumatologist. I would think any related problems to her diagnosis would present with pain, swelling, erythema, and or loss of function, things that you would readily see. Change in behavior is also a good sign of a problem in children; for instance if your child comes home and lays on the couch, sleeps, doesn't watch tv, and doesn't eat a snack like on a normal day, she is probably sick with something whether related to this or just a virus.

Secondly, you have the right to do about whatever you want as far as seeing doctors. If you don't like this guy, and you think you have been "dismissed" or shown the hand, by all means, go somewhere else. Your own peace of mind is so important, and everybody should want to do the best for their children. Just because a physician tells you not to be concerned doesn't mean that is gospel. Physicians are generally wonderful people with a great drive to help others, but not all are like this, and all of them do make mistakes like we all do.

Best wishes to you and your daughter and her continued good health.