A delicate question....

I am looking for some feedback on this: Last week, Andrew came home from school and was complaining that his penis hurt....It was swollen 3 times its normal size and he couldn't go to the bathroom because it was so painful.....I called our pediatrician immediately and was transferred to the nurse. Without ever seeing my son, here was her advice...elevate it (I'm not kidding)and give him a lot to drink so that he would have to "go"...and if he couldn't, take him to the ER.....

Isn't that a bit weird? At the end of the day, we changed his undies (we had used a new fabric softener and I thought perhaps it could be allergic?)and I put ice on it....the swelling went down and he WAS fine....but shouldn't the pediatrician have seen him? I am kind of alarmed by the idea that something this "delicate" would be handled over the phone....

Hope I didn't embarass anyone...

Kris

Kris, I'll ask Tom about it and see what he thinks. How does Andrew feel now?
Sorry lab has been such a pain recently. Having experiments not go well is such a frustrating feeling. I did a whole cell dissociation procedure on Thurs and discovered after 2-3 hours of work that the cells had lysed or something and there was nothing there. ARGH! You just want to cry and scream and tear your hair. Of course, having your PI come by while you're in the middel of the breakdown doesn' t help. I think many of the male profs of a certain age/generation don’t know what do do with emotion. Their lives are under control, why can’t their grad students be the same way? My PI actually said to me (when we were having a little talk about me not being involved in lab enough – I had just been through a tough breakup with a boyfriend of 2 years, who of course wasn’t worth it but still…I just told my PI that I’d been having a rough time with my personal life) that he couldn’t understand why all his grad students had to go through rough times. He of course had no clue about being slightly supportive – was just put out. Anyway, it usually does get better after all-out despair hits. =) Do you have a place you can make your own for writing your thesis? To spread out all your papers and references and just have intense writing sessions? That helped me. You’re incredible to be able to do so much with kids too… just remember that whatever oblivious PI’s or fellow grad students do to make it harder for you! I’d love to know the details of your project if you ever get a chance…
Kaaren

[Phoebe]

Kris- I asked Ron what he would have done if he were Andrew's pediatrician. He said he definitely would have had Andrew come into the office that day to check for lesions or trauma. I agree with your question about wondering if your son should have been seen.

I am glad everything worked out and Andrew is ok.

Jennifer

Hi Kris - I asked Tom about this and he said definitely Andrew should have been seen - contact dermatitis doesn't affect the penis area so it would probably be infection of the penis or urethra. Depending on circumsision (sp?) and site of the swelling, he rattled off various '-itis's' and said it should have been seen just to rule them out. Glad it passed, but thought you might be interested for future reference? Hope it's never needed, though!
Kaaren

Thanks guys....that is how I felt too. Andrew is not circumcised and so we were concerned that it had to do with that. I think that we were lucky that it went away with ice.....but the very idea that I should give him lots of fluids to see if he could go and then take him to the ER if he couldn't....I am just imagining my little boy sitting for 6 hours in our ER waiting room (I'm not kidding, either...when Alex split his lip open we waited for 7 hours in the waiting room with his lip hanging open and him crying the whole time!!!...then the Dr. who saw him said it had been too long since he had done it to stitch it, but because it was gaping it needed to be done...)having to go to the bathroom and not be able to.....

Kris

I read your post regarding your son's problem and I wanted to share an experience with you.

About 6 weeks after my youngest son (Connor) was born, my parents came to town to visit. On the last night they were in town my wife and I went out to dinner with them. We had a friend of ours, who was a nurse, babysit for us. She called us at the restaurant and said that she had fallen down the stairs while holding the baby, but everything seemed fine. I asked her if she had done a thorough assessment, to which she replied that she had. She said he hadn't cried or anything. We said we would be home in a little bit and we finished our dinner and went home.

When we got home we checked on Connor. He was sleeping peacefully in his crib, and neither my wife nor I saw any indication that he was injured. However, when we woke up at 8 am the following morning we noticed that he was guarding his right leg-- hiking up against his body in a flexed position-- and when we tried to straighten it out he cried. It was Saturday, so I decided to take him to the Emergency Room of our local children's hospitl to get checked out.

We arrived at the ER around 9 am. They x-rayed his leg and, sure enough, it was broken. Then the real fun began. The doctor didn't seem to think that the break was consistent with someone falling down the stairs. We went through a barrage of interviews by various doctors, nurses, and social workers. Finally, a lady shows up from the Division of Family Services (DFS) and tells us that she has to determine whether they need to place my son in emergency custody. She says, "If you noticed his leg was hurt first thing this morning, why did you wait until 2 pm to bring him to the hospital?" Apparently, the doctor that suspected child abuse had told her that we hadn't brought him in until 2 pm. We explained that we had arrived at 9 am and, fortunately, they had a computerized system that documented the time of our arrival confirming our story.

The end of the story? No, just the beginning. They let us take our son home with us, but we were forced to deal with a 6 month investigation by DFS. Even though my parents both confirmed the story, the babysitter stated she fell down the stairs, my oldest son (10 at the time) witnessed her falling down the stairs, we had to jump through all kinds of hoops including family therapy to determine if any patterns of abuse were present. It sucked! To make matters worse, that investigation remains on file for 10 years even though they concluded that no abuse had occurred. Now my wife and I are paranoid that one of our children will get hurt and we will automatically be suspected of abuse.

The moral of the story: Be very careful when you take your children to the doctor for treatment, especially for things like broken bones (and swollen penises). Document everything. If at all possible, take your child to your pedatrician who knows you and your kids rather than an ER.

And physicians, yes you have an obligation to protect children. But think about the potential consequences of your actions before you make accusations.

Beware parents, it can happen to you!

Well, I have a similar horror story to share ! Last year when we moved to this warm climate, I made the mistake of accidentally leaving the children's lunchboxes at school Friday afternoon! Monday we brown-bagged it and I took their boxes home with me around noon. I got busy with the kids and never got around to washing them. I cleaned them out with windex on Tues. morning and then put their lunches in them....when I picked them up Tues after lunch, I was met by an angry director who shoved the lunchboxes in my face and showed me ...you guessed it...little wormies...They were the size of bread crumbs and they actually looked like bread crumbs until you noticed them moving. I was MORTIFIED. I started crying and when we left, I threw the lunchboxes away. It was truly devastating to me and the most awful part was that the teachers had made a big deal out of it in front of my children!
So what happened? You guessed it!. You could have knocked me over with a feather when the SW unexpectedly knocked on my door and came in. She stayed for a half an hour and told me that she didn't even understand why the complaint had been filed either....that it was a bizarre complaint. We were lucky to have the investigation stop on the spot...we received our letter within two weeks....but God knows about something being on file. That never occurred to me. I am just thoroughly disgusted with that whole process! It is already one year later, and I am paranoid any time my children have trouble at school that someone is going to point the finger.

Interestingly, about two weeks after the whole thing ended, I went to school early to pick the kids up, and they were sitting in the dirt putting sand and dirt into their lunchboxes with the teacher sitting right there. Everyone else had their lunchbox inside.....I thought that was really odd!

No matter what happens to your child, you have to be careful, you're right. This year, when our active 2 1/2 year split his lip open because he literally tripped over his feet while running and hit his mouth on a kitchen bench, we were treated like criminals in the ER and then the insurance company initially refused the charge because they said it was failure to supervise our son...who was running to my husband to share a plate of noodles.....

I know several people who have had accidents with their children who have been blamed.....I used to think that it was better to be safe than sorry.... until I was on the receiving end! Now, I think twice before taking my child to the doctor...and I don't think that that is a good thing.

Thanks for sharing your story.

Kris

Being falsely accused of child abuse is a horrible, horrible thing, especially when you are innocent and there are those that are out there that truly are abusing their children. I worked in a large PICU where we saw more than our fair share of child abuse.There was nothing that angered the entire staff more. Most of the time, the child was removed from their parent's custody, somtimes not. Sometimes they died after being returned to knowlingly abusive parents. Child Protective Services is a system that I don't always understand. I have seen first hand the awful things that an adult can do to a child and it is something that will never leave me. The fact that anyone has in them the ability to beat up, sexually abuse, emotionally abuse or neglect a child is something I will never understand.


That said, I am sorry for both of you that you underwent investigation for child abuse. That undoubtedly is a traumatic experience for all involved. On the other hand, I am thankful that we have a system that tries to care whether children are being abused. It sounds as though you both fell vicitm to a system that doesn't always get it right on either extreme, and that doesn't have the public support or federal funding to make it all better.

"But think about the potential consequences of your actions before you make accusations. " Think about the potential consequences of your actions if you suspect abuse & don't act on it. 6 months of family therapy is a far cry from a child dead from being thrown against a wall by an abusive parent or starved to death because they were a picky eater.

I sincerely hope I have not offended in these statements. That was absolutely not the intention. I am a die-hard child advocate and it is simply how I feel about the matter.

Wendy

Well, I have mixed feelings, Wendy. Perhaps because of my own personal background, I am very inclined to support protecting children even at the cost of pointing the finger at the innocent. I am all too familiar with the consequences of child abuse...but having the shoe on the other foot is certainly an eye-opening experience. You are right...Brian enduring 6 months of counseling/observation by DCFS and me enduring an interview with an SW do seem like a small price to pay...but honestly, I feel pretty victimized by the system...I can't speek for Brian though but he seemed to feel the same way.

I began doubting everything that I did as a parent....I put myself under an incredible pressure then to be "perfect" and of course couldn't live up to it, which left me feeling depressed and inadequate. There is nothing in the world more stressful, I think than raising children. I came into motherhood with a certain idea of how things would be, and was pretty surprised to find that I couldn't always do things the way that I wanted, and that I wasn't always in control of what happened to my kids.

When Thomas was watching the kids once, he spilled spaghetti sauce in the fridge. He got out our clorox gel bleach cleaner that we keep ON TOP of the fridge to avoid the kids getting into it. While he was scrubbing, Alex, then 1 1/2 picked up the bottle and DRANK some..it happened in a split second. We weren't sure of whether or not he had truly ingested it or whether he just had gotten some in his mouth. Thomas was, of course, devastated...and I took Alex to the ER to be sure that he was ok. I was interviewed by at least 6 doctors...and they took Alex upstairs to the PICU even though he appeared to be fine, so that they could "scope" him to be sure he had no esophogeal burns. I was terrified....and the nurses treated me as if I had bound and gagged my child and force-fed him this or had carelesslly left it about. I am sure that they stood around for days talking about that horrible, neglectful mother..and my husband was the guilty party...and even at that, it was simply an accident and we were very overly-cautious in bringing him to the ER...something "good" parents would do....

I really resent being treated as if I am a bad mom anytime a child has an accident.

Honestly, I feel like nowadays because of the child-abuse issues, that you can't seek medical assistance for your child if you are a non-guilty parent without looking guilty.

After the whole episode with the kid's school, the school director apologized to me and told me that two years ago a little girl had been killed by her mother and that they had been asked to step up all of their precautions......I could appreciate that...but I am still left with a feeling of hurt. I think that I would still be a strong advocate of reporting every little thing if I hadn't had this experience. I have an undergrad degree in psych and have always been a strong advocate of protecting children....I just sometimes wonder if we haven't gone too far the other way now though?

I hope I didn't offend you....this is a tough topic, actually and I would hate to have hurt your feelings.

Kris
Kris

Kris-
No feelings hurt here. There obviously is no easy answer to this type of problem, or it would've been solved long before now. We see things from 2 ends. I honestly doubt there is anything that could be said that would make me believe that it is better to let a child go back to a potentially abusive home in order to save the parents from the embarrasement and trauma of being investigated.

For the record, it surprises me that either of you were investigated for child abuse. Neither story sounds implausible. It is certainly not unheard of to fall down the stairs carrying a baby & for that baby to be injured in that fall. A broken bone is not out of the question in that situation, especially if the type of fracture is consistent with the story, which I would imagine it was in Brian's case. Credibility is further confirmed when everyone involved gives the same account of the incident, as they also did in Brian's case. As a nurse caring for that child, I probably wouldn't have given that incident a second thought.

As for your stories Kris, I can only imagine how many times I would've had to buy new lunch boxes for my children (especially if I had 3 to keep up with!) because I left food in them over the weekend. You suffered an overreaction based on thier past experiences. I'm sure there's an official psychological name for that, but I haven't a clue as to what it might be. I wish that I could tell you the number of children that I've taken care of that swallowed a handful of pills from someone's purse, or got into household cleaners while they were being used. It definitely isn't a far-fetched story.

I'm sorry you were treated so badly by the PICU nurses. That was uncalled for and unnecessary. I can tell you that I learned to be a far less judgemental person during my time in ICU because of cases like yours. To look at it from the outside, you wonder how something like a child getting into a cleaner could happen. To talk to the parents, to interact with an 18 month old, to see the situation for what it is, you figure out that it could happen to anyone and that it doesn't make you a bad parent.

I can also tell you that the nurses did not talk for days about what a bad mother you were- because you weren't a bad mother any more than Thomas was a bad father. At least that never happened in my experience. If you had thrown your child against a wall, then had not brought him into the ER until the next day when he had cried for 24 straight hours you would be a bad parent. If you had fed your child once a day by holding his mouth closed around a spoonful of food, then beaten him with a belt until he swallowed, you would be a bad parent. Not bringing your baby into the ER until the day after a fall because there were no sypmtoms of injury until that next day does not make you a bad parent. The fact that Brian and his wife brought their child into the ER when they did suspect something makes them good parents that love their child. Taking your child into the ER after possibly drinking household cleaner makes you a good parent. The fact the the cleaner was within his reach for a short period of time truly is something that could happen to anyone in the situation in which it occured and also does not make you or Thomas bad parents.

I'm sure that you can tell that some of the things I've seen have affected me deeply. They are part of the reason I am no longer working in a PICU. Maybe they make me react to far toward protecting children. I imagine that at least to some extent, I would feel differently if I were being accused. By no means is my intention to downplay your feelings of resentment toward the system that accused you. I hate that each of you were falsely accused. I feel like it is a failure of an imperfect system rather than a failure of your parenting abilities.

Wendy

Thanks, Wendy. I appreciate your kind words.

Kris

What is interesting is that you would think as the spouses and children of physicians that you would be treated much more quickly and better than that.

When my son burned himself on the oven this last February the paramedics showed up to our house. We decided to take him to the hospital ourselves. No one questioned it. And when we took him to the ER we were seen immediately (while everyone else who was already there before us was still waiting) and one of the attendings was called in to give him the VIP treatment. No one ever accused us of causing harm to him, nor made us wait, nor gave us poor treatment. Now you may argue that it was wrong of them to take us before other people that were already waiting, but I will argue that it was a 1.5 year old with a second degree burn and in a lot of pain (screaming). And if you are a doctors spouse or child in a situation like this you are crazy not to take advantage of it. Sorry to hear of all these horrible situations. I hope all has been resolved since.