Doctors Lounge - Pediatrics Answers
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Forum Name: Pediatric Topics
|spensaid0003 - Tue Apr 08, 2008 9:19 am|
Hi, I need some guidance, please... I am not sure what step to take next or if my son should just learn to live with his pain. He has 2 very different complaints - could they somehow be related?
He is 7 y/o. He recently had an endoscopy & was diagnosed w/reflux esophagitis, lactose intolerance, nervous stomach (all in February) & h.pylori (treated in December). He takes prevacid 15mg 2x/day (for 2 more months - at that time we will stop to see if he will be OK without it). He also takes lactaid with dairy. He sometimes takes Mylanta if the pain/nausea get bad but he claims that it does not help.
The pain/nausea has not gone away with these treatments. He complains daily. We taught him techniques to help if it is a nervous stomach (counting to 10, deep breathing) but I don't think it is this since he complains at random times and not at times when I think he should be nervous (before school, before tests...). Several biopsies were take & the doctor does not think it is anything bad (cancer).
Over the last 2 years or so he has complained of leg pain (mostly knee). Left leg only. The specialist couldn't find anything (we thought it was Osgood-Schlatter's... but now we are not so sure). He said the next step was an MRI (which we did not do since the pain subsided). He is now complaining of leg/hip pain (in his left leg) and he is almost in tears on a daily basis (last few days). We also thought it was growing pains, but I don't know since it is one leg only, happens throughout the day, meds & ice don't help it.
Could these somehow be related? I certainly don't want to let this go any further if I should be taking him for second opinions or following up with the Ortho Doc. He has had "shoddy nodes" for as long as I can remember (our Ped. mentions it at each visit but is not too worried about it). I, on the other hand, see the lumps in his neck & worry! Could this have anything to do with his other problems. He also has mild Asthma (he does not take any meds for this (at this time)). He is small for his age and lost about 3-4lbs... that is what prompted the Gastro visits & endoscopy. He has since gained most of the weight back. Bloodwork from last November came back normal (aside from h.pylori).
I am hoping you can ease my mind or tell me what direction I should head! Thanks for your time... It is most appreciated!
|Debbie Miller, RN - Wed Apr 09, 2008 1:44 pm|
You are certainly having challenges that would try your patience. I'm sure your little boy will be a very strong man one day, having endured these difficulties with such courage. I am glad that he has been seen by a specialist for the leg pain. This suggests there is not a serious underlying condition.
I doubt these two problems are related unless it is cramping due to calcium and potassium irregularities, perhaps caused by dietary restriction. Lab values were normal so it is probably not a significant lack. Consulting with a dietician to be sure he is getting all the necessary nutrients would be advised.
I would not rule out growing pains. These can occur asymmetrically, though most typically it affects both legs. Basically it is a severe cramp. Simple daily stretching exercises often help and you can try applying moist heat to the affected area as well. You can encourage him to try gently flexing his leg so the foot points up toward the knee if he gets the cramping. Massaging can help too.
Another possible cause might be arthritis, but I suspect your specialist has already ruled this out. If you don't get relief with the above measures, return to your doctor for further studies.
|spensaid0003 - Thu Apr 24, 2008 10:54 pm|
Thank you so much for answering me! I thought I would update on the leg & ask another question about his tummy troubles! My son has stopped for now complaining of leg pain (it is probably growing pains... just not the typical pains that most kids get).
Now it is all about the tummy pain & nausea. I thought we were nearing the end and resolving this... but it seems to be getting worse. He complains daily. I don't think it is nervous stomach mainly because it is not related to an event that would make him nervous. It is completely random and sometimes seems almost constant when he complains. For example, today was a very relaxed day after school & he complained for most of the afternoon on into bedtime (bedtime has never been a struggle or a stressful time).
Could the doctor have overlooked something? Are we missing some other cause? I feel that I should pursue this further but I am not sure where to begin (his Gastro Doc seems confident in his diagnosis - I don't know if I should get a second opinion or just accept the pain that he is in as the new "normal").
He drank 4.5 glasses of milk without a lactaid (well, actually he took the lactaid chewable over an hour before this happened at his grandparents house). Could that have lingering effects? The milk incident happened Tuesday evening (today is Thursday evening). Directions state to take another chewable if you anticipate eating dairy after 45 minutes.
I do so appreciate any help that you can give me!!! Thanks so much!!!
|Debbie Miller, RN - Sun Apr 27, 2008 1:01 pm|
I would consider an elimination diet since it could be some foods that he is reacting too. At least try eliminating milk - rather than taking the pill, try giving him Lactaid milk (lactose free, there are other brands too). This might work better for him. Often allergists prescribe an elimination diet where you start with a very minimal diet and gradually add foods. Often you can identify those that cause distress. If I were to get a second opinion, I might try an allergist. Rashes are easy to spot but some children react through the gastrointestinal system instead. Different people react differently.
In addition, try to use foods in their most natural state, fresh fruits, veggies, etc. and avoid additives. Many people are sensitive to preservatives and other substances (like dyes - especially yellow # 5, reds, and blues) added to convenience and packaged foods. Read the labels.
|spensaid0003 - Sun Apr 27, 2008 2:36 pm|
Good ideas :) Thank you! As an infant, he had a milk protein allergy (I could not eat anything with dairy while breastfeeding). He had allergy testing (when he was diagnosed w/asthma about 3 yrs ago) but I can't remember if we tested or tried to eliminate any foods. He saw a specialist for his asthma (which is very mild) - maybe I will set up an appointment with him & get some ideas. I think I will keep a food diary first (eliminating foods) to present to him along w/all his pain & any other symptoms! I so much appreciate your time!!! I will let you know what happens :)
|Debbie Miller, RN - Mon May 05, 2008 9:22 pm|
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