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Reply: Choosing a pediatrician -- what matters most?

Its wonderful that you found a doctor that fulfills all of your criteria. ...

Posted by Andrew Adesman, MD

4 Replies | Reply | Watch This DiscussionReport This| Share this:Choosing a pediatrician -- what matters most? Its wonderful that you found a doctor that fulfills all of your criteria. ...

Reply: Head Size in Babies

To my knowledge, there is no relationship between head size and breast vs....

Posted by Andrew Adesman, MD

5 Replies | Reply | Watch This DiscussionReport This| Share this:Head Size in Babies To my knowledge, there is no relationship between head size and breast vs....

Reply: 2 year old with bad reaction to bug bites...is thi...

Alhtough you sound confident that this most recent incident is just a bad bug...

Posted by Andrew Adesman, MD

1 Reply | Reply | Watch This DiscussionReport This| Share this:2 year old with bad reaction to bug bites...is this normal? Alhtough you sound confident that this most recent incident is just a bad bug...

Reply: 14 year old with "security blanket"

At the risk of piling on, I would not be concerned about your son "cliniging"...

Posted by Andrew Adesman, MD

16 Replies | Reply | Watch This DiscussionReport This| Share this:14 year old with "security blanket" At the risk of piling on, I would not be concerned about your son "cliniging"...

Reply: cousin marriage

There is a strong social taboo in this country against marriage between first...

Posted by Andrew Adesman, MD

11 Replies | Reply | Watch This DiscussionReport This| Share this:cousin marriage There is a strong social taboo in this country against marriage between first...

Reply: 4 month old sleeping on tummy

Although you may sleep better knowing your baby is sleeping on her back,...

Posted by Andrew Adesman, MD

2 Replies | Reply | Watch This DiscussionReport This| Share this:4 month old sleeping on tummy Although you may sleep better knowing your baby is sleeping on her back,...

Choosing a pediatrician -- what matters most?

What matters most in choosing a pediatrician? It would be wonderful if...

Posted by Andrew Adesman, MD

4 Replies | Reply | Watch This DiscussionReport This| Share this:Choosing a pediatrician -- what matters most? What matters most in choosing a pediatrician? It would be wonderful if...

Reply: Frequent Urges to Urniate - 5 Year Old

I am hoping that the doctor did a urinalysis in addition to a urine culture. The...

Posted by Andrew Adesman, MD

6 Replies | Reply | Watch This DiscussionReport This| Share this:Frequent Urges to Urniate - 5 Year Old I am hoping that the doctor did a urinalysis in addition to a urine culture. The...

Reply: Acceptable Pain Level In Kids

Although pain is inevitable with major surgical procedures, the goal in general...

Posted by Andrew Adesman, MD

Although pain is inevitable with major surgical procedures, the goal in general is to make children comfortable. In general within the medical field, there is a sentiment that the medical establishment has historically been too withholding (insensitive, unresponsive) when it comes to providing analgesia. In many hospitals, there are pain specialists (even pain management teams) whose sole job now is to make sure patients are as comfortable as reasonably possible.

The difficulty here is that you believe your daughter is unable (unwilling) to express significant pain in a conventional way and that you know her signals for when she is in considerable pain. It sounds like the physicians manging her post-op course were skeptical about your perception about her pain experience.

Unfortunately, one can never truly know another person's pain experience -- just what is expressed or exhibited in reaction to the pain. In pediatrics, it can be that much more difficult to recognize pain in children -- especially since anxiety may play a large role and the child is less capable of verbalizing or expressing pain.

My suggestion for the future would be to have a frank and explicit discussion with your healthcare providers about your child's pain reaction in advance of any procedure that likely involves pain. You should describe what happened post-operatively in this instance, and you should clarify with the doctor if he or she is willing to treat your daughter for pain based on what you perceive -- even if it is an atypical pain presentation. To avoid recurrences, you should make sure the doctor resonsible for your daughter's pain management is willing to respect your wishes as much as possible.

However, since children have different pain thresholds (just as adults differ in pain thresholds), you must keep in mind that it is equally possible that your daughter is experiencing less pain than you are presuming she has.

Hopefully, her verbal and non-verbal communication skills will evolve and mature so that she better communicate her own pain experience.View Thread

Posted byAndrew Adesman, MD

7 Replies | Reply | Watch This DiscussionReport This| Share this:Acceptable Pain Level In Kids Although pain is inevitable with major surgical procedures, the goal in general...

Reply: Parents Hate Parenting?

Very well-said; thank you. Whether it be "do unto others", "pay it forward",...

Posted by Andrew Adesman, MD

4 Replies | Reply | Watch This DiscussionReport This| Share this:Parents Hate Parenting? Very well-said; thank you. Whether it be "do unto others", "pay it forward",...

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