Medicine Monday- Bruising, Thumb Sucking and Anemia in Children
Posted by Dr. Cason on Monday, August 11th, 2008
Hi Everyone!!
Welcome to my first Medicine Monday! This is where each week I post the answers to the questions I have received in the previous week. Some of the questions come from my readers and some from my clinic. Believe it or not I frequently have to admit that I need to do some research and get back to them!
Yes doctors look stuff up all the time and if they are not looking something up maybe they should!
Here we go:
Question #1:I have a healthy 16yo girl who bruises very easily. I mean if you touch her hard she bruises. She has been like this from the get go. She regularly has at least one or two and cannot remember how she got them. I was wondering if this means that she may be deficient in something? Any clues?
Answer:For most people bruising is a sign that there has been some damage to the underlying tissue. You run into a wall, you get a bruise. Reducing the injuries reduces the bruising. Easy peasy. BUT very rarely there can there be something wrong with the platelets or the body’s clotting factors. Why this is could be genetic or a side effects of a more serious illness. If you notice that your child bruises easily without any associated injury you should make an appointment with your doctor. There are some simple blood tests that can put your fears to rest.
Question #2: Is there any way to get a two and a half year old to stop sucking his thumbs? Harry is a hard core thumb sucker and is just healing from a very nasty blister that he gave himself. I was about ready to take him to the doctor from fear of infection when it started looking better and a lot less icky. This is not the first time that he has injured his thumbs and I naturally worry about it. Any tips? Should I wait it out since he is so dearly attached to sucking his thumbs?
Answer:Awww how sweet. I’m actually not a big believer of creating a lot of drama around the thumb. I have two thumb sucker children and I just let them be. Most dentists will say get rid of the thumb by age 4. And just how we do this I’m not sure. There are some bitter things you can put on the thumb but I haven’t tried this. I actually believe the thumb serves a necessary coping mechanism for some kids and I would say help him learn to cope using other methods as well such as a blanket or special toy.
Question #3.Is it better to treat iron deficiency before the child becomes anaemic or is ok to wait until the haemoglobin drops? Ivy’s MCV and other stores are low and dropping but she is not yet anaemic.
Answer:I would check Ivy’s iron levels and ferritin. You could then see if she might benefit from additional iron. But if she’s not anemic and her iron stores are normal don’t treat. Here is more info regarding iron deficiency anemia
That’s it for now. Next week we’ll talk a little about imaginary friends. It’s a question I recently received from a family I see in my clinic. What about you all? Have you had an imaginary friend? Or rather did you? What about your children? Anyone invisible hanging around lately?
Filed in Everything Medicine |
Sara Rosson 11 Aug 2008 at 1:01 am 1Hi Dr Cason-
I have a comment on the anemia question and taking iron drops. My son was anemic as a young baby and I was nervous about giving him the drops, so with the guideness of our pediatrician, I asked if I could try giving him high iron foods instead of the drops to boost his levels. She agreed to try it for 1 month and retest. We retest and after 1 month his levels were back up. My son was never a picky eater, so it was easy for us to “push” meats, legumes, and iron fortified yogart. We balance this with lots of citris fruits for the Vitamin C. She has told him that she now recommends this to some of her patients.
As for imaginery friends, yes, they have been around a lot lately. My son, now 3.5 years old, tells me, “My friends are here” and “We are having a sleepover.” They have slept over almost every day for the past few weeks! I even call their imaginery moms to see if they can come over to play or have them come pick up the kids if they are not behaving. (At the request of my son, of course!). I think it is great and I tell them they need to behave and play nice. I treat his imaginery friends like I would if his real friends are over. I don’t want him to think there is something wrong with having imaginery friends.
Sara Rosson 11 Aug 2008 at 1:04 am 2Oh, and my son still sucks his thumb too! That one is a hard one to take away. He really only does it when he is tired. My husband is eager to stop it, but not sure how and if I want to take on that battle right now.
Sometimes I wish he took a pacifier as a baby because at least that is something you can more easily take away and it stays away. A bit hard to get rid of the thumbs!
Kylaon 11 Aug 2008 at 2:05 am 3I had an imaginary friend as a child. Humpty Dumpty and his family (he had a sister, mother, and father) lived in my bathroom, although Hunpty would come out and play with me in the rest of the house, too. My mom made me a handmade Humpty Dumpty doll and I remember going into the bathroom and telling him I couldn’t play with him after that.
KayTar doesn’t suck her thumb, but she is still firmly on the bottle. Because it is the only thing keeping her from the g-button, we’ve decided it isn’t worth fighting quite yet.
Kylaon 11 Aug 2008 at 4:12 am 4This is totally unrelated, but I just found this blog and thought of you! http://www.mothersinmedicine.com/
Kylas last blog post..She steals the show, she does.
Awesome Momon 11 Aug 2008 at 4:25 am 5Thanks for the answer. I have been letting him be with the thumb and had not even planned on a forced weaning until that last really bad blister. I think I will wait and see for now and hope that there is not a repeat.
I had always wished that my imagination was strong enough to have an imaginary friend, but I never did.
Awesome Moms last blog post..Competition
Dr. Casonon 11 Aug 2008 at 5:23 am 6Sara- I just love you!! Thanks for such a detailed response. Yes increasing iron rich foods helps a lot. I’ve added a link up in my answers that can give people more info on anemia!
Kyla- Now that you put it that way I can see that my kids are playing with imaginary friends all the time! And I don’t mind. I’ve seen this blog once before but I need to go back again. Seriously too many good blogs out there. If you haven’t noticed I can barely keep up!
Awesome- Was he really stressed about something where he sucked extra hard?
Mutha Maeon 11 Aug 2008 at 9:26 am 7My daughter had an imaginary friend named Dubbie Dubbie and Dubbie. To this day we aren’t sure if Dubbie was one person or three. We also don’t know what Dubbie looked like. He or They hung around for about a month, then was never spoken of again. She was 2 at the time. Now she’s four and gives me a dirty look when I bring him/them up.
Mutha Maes last blog post..I have PMS and I’m not afraid to use it!
Kylaon 11 Aug 2008 at 10:47 am 8I had to come back again, because strangely enough, KayTar started playing with an imaginary friend just today! We were at my parent’s house for dinner and she was in the bathroom playing with “Kyla”. I said, “But I’m Kyla.” and she said, “No, this is Kyla. (pointing at no one) She lives in the bathroom, she’s my best friend!”
Kylas last blog post..She steals the show, she does.
Barbara Swaffordon 11 Aug 2008 at 5:01 pm 9Hi Dr. Cason,
Although I don’t have little ones at home anymore, I just wanted to let you know your Medicine Monday series is great. What a wonderful way to share what you know with your readers.
Keep up the great work!
Barbara Swaffords last blog post..Psssst! Your Blog Is Showing
tiffon 11 Aug 2008 at 5:13 pm 10Thanks, Dr Cason, All of Ivy’s stores are low, she is just not yet anaemic.
As for imaginary friends, My eldest created two imaginary friends for herself. Claire Bonnet and Lucy. They would only come to play when she was sick and or in hospital. Lucy came with her for each and every operation and test and Claire bonnet was always there afterwards to pick up the pieces. She was the only one to have the imaginary friends though. It was really interesting to watch. Especially as she was one of twins, so she always had company.
tiffs last blog post..Weekly Winners.
Dr. Casonon 11 Aug 2008 at 7:23 pm 11Mutha Mae- You sure Dubbie wasn’t a girl? I got that feeling when you said the name. I love that she now gives you a dirty look. 4 yrs old is funny!
Kyla- Does Kyla look like you?
When we moved from San Diego we lived in our house with no toys for weeks on end. The kids started to steal my shoelaces from my shoes and call them snakes and carry air around gently in their palms and call them their babies. Imagine that! Playing with air! So creative!!
Barbara- I’ve always wanted to incorporate pediatrics in my blog and I think this is a good way to get people involved too!
tiff- Okay now I’m really confused. What is her RBC, Hgb and HCT, and MCV? Do you remember? Claire Bonnet and Lucy sound like little story book characters! So sweet!Are they gone now?
Annieon 12 Aug 2008 at 3:02 am 12Hi Dr. Cason,
I really am enjoying your blog. I found it through your comments on Barbara Swafford’s blog.
I have a 14 year old who had an imaginary friend for quite a long time, a few years, as I recall. She called her imaginary friend Sam. I never knew whether Sam was a boy or a girl.
My 10 year old son had an imaginary friend when he was young also. I think his name was Henry or something but I don’t remember and wasn’t around very long.
Neither my 7 year old nor 3 year old have had any that I know of.
But I have theory - I think the older 2 had them because of some trauma that happened in their lives at the time. It was a coping mechanism for them. The younger 2 have never really had any trauma.
None of them ever sucked their thumbs, although my oldest daughter and youngest son both used pacifiers as babies.
~ Annie
Dr. Casonon 12 Aug 2008 at 5:32 am 13Annie- Hi It’s amazing what children will do to cope. Sad at times but amazing. Thanks for visiting I hope to see you around more!
tiffon 12 Aug 2008 at 9:33 am 14Yes, they’re gone now. They left when she was about six, which incidently was when the immunodeficiency got alot better. They did come back once, about three years ago, when she had suspected meningitis and was delirious. I agree with Annie, I think they were a coping mechanism for her. I’ll be interested to see if Ivy brings home any imaginary friends, because I think Imogen was about three when Claire Bonnet and Lucy came to stay.
As for the stores, I will ask the paed and get back to you. All I remember is that everything was low except, retics which were elevated and he classed it as iron deficiency without anaemia. I was just interested in whether you would treat with iron, without the anaemia. He is thinking the meds are playing a large role in this. She has had haemolytic anaemia in the last six months and iron deficient anaemia but as soon as we treated with liquid ferrous, she bounced back.
Tatianaon 15 Aug 2008 at 3:38 pm 15Hi Dr. Cason! I just found your site today and i love it already! I have a question and maybe you can answer it. My husband and i have been trying to concieve for over a year and have been extensively tested for various things. The only thing that has been abnormal has been my progesterone and estrogen ( both are low). I purchased progesterone cream, do you think this will do the trick? My husband is in the army and it is a fight to get anything done at our military treatment facility. They do not want to help us. Every last thing has been a struggle!