Doctors Lounge - Pediatrics Answers
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Forum Name: Pediatric Topics
|Linny - Wed May 04, 2005 9:56 am|
Two years ago last November my daughter had a really bad virus which she was unable to fight off. It took almost 4 months on and off of Antibiotics before she was finally well. Since then she periodically complained of leg and joint pain, plus a reoccuring red and inflamed throat ( although it never got infected ) I was always told that there was nothing to worry about and that it was just growing pains. Well 2 years on and I am at my wits end with worry. These past six months she has been steadily getting worse with the pain especially in her thighs, although her knees and feet occasionally hurt too. Every bone in her body seems to crack and creak with it sometimes causing pain as well. I have to frequently write notes to the school excusing her from P.E. which seems to aggrivate her condition and has often come home from school limping and crying.
She has now been off school for almost a week as its too painful for her to walk there or manage the stairs as the kids jostle her and she loses her balance. She has had blood tests done at the doctors but they have all come back negative. I took her to the doctors again today as i cant keep her off school indefinately but neither can I force her when she is crying and in pain, I just don't know what to do. The doctor this time examined her legs throughily and has told me that my daughter has weakness and wasting of the muscles of both thighs and is going to refer her to a Pediatriction. This is something that I was told could not be faked. The doctor looked concerned and said there were a couple of illness that could cause this wastage of her legs but wouldnt tell me what she suspected. It might take months to get an appointment with a Pediatric doctor and in the meantime I don't know what to do for best. Does anyone know what this might be or have an ideas of how I may treat her? I would be grateful for any advice.
Thanks in advance
|Dr. Heba Ismail - Fri May 06, 2005 9:47 am|
From what you've described, I believe she could be suffering either some inflammation of the nerves, known as 'peripheral neuropathy', or some muscle disease, known as 'myopathy', both of which have several causes.
It would be difficult to tell what type she has exactly until a paediatrician, preferably a paediatric neurologist examines her.
Meanwhile, there are a few things that can be done, which may be helpful.
She will certainly need physical therapy, so we can start there.
Routine exercise within her capability is encouraged; muscle stretching is very beneficial.
Special shoes with good ankle support may be needed.
Obesity should be avoided because it makes walking more difficult.
Pain control is essential and simple analgesics could be given:
Ibuprofen (Motrin, Ibuprin)
The recommended dose for her age would be: 200-400 mg PO q4-6h while symptoms persist; not to exceed 3.2 g/d
Acetaminophen (Tylenol, panadol)
The recommended dose for her age would be: 325-650 mg PO q4h; not to exceed 5 doses in 24 h.
|Linny - Sat May 07, 2005 7:20 am|
Dear Dr. Heba Ismail,
Many thanks for your response to my posting. My daughter has been prescribed Ibuprofen which she takes along side Paracetamol which I believe is like panadol which she tollerates quite well, although so far after 2 weeks it is not helping the pain when she is walking. Luckily we do not have stairs in our home as stairs are horendous for her to attempt. She says she has to almost will her legs to move in order to get up them and the pain is so bad her legs actually sweat with the effort, although coming down seems to be a little easier.
I have been in touch with her school as many of her classes mean walking up and down large numbers of stairs and they have assured me that if she cannot manage them then she can do her lessons downstairs. P.E is another factor that causes extreme problems so she is being excused that until futher notice. Thank you for the tip about exercise as it didnt occur to me that gentle stretching might actually benifit her so I have been looking to buy a tape of gentle stretching exercises she can attempt to try.
In the past when I mentioned to my doctor about the pains in her legs, I also mentioned that there is a family history of Arthritis, Rheumatism, OsteoArthritis but he told me not to be rediculous that it doesnt run in families and was definatly growing pains.
With this new doctor who told me after doing manual diagnostics on her legs that her thigh muscles were weak and that she could feel wastage, I didnt tell her the family history as I didnt want the same thing to happen. Should I mention this when she eventually gets her appointment through with the Pediatritian?
Once again I thank you for your reply.
|Dr. Heba Ismail - Sun May 15, 2005 7:10 am|
It's always improtant to mention any positive family history of disease or condition.
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