From Fort Worth, Texas, USA:
I am trying to convince a woman that I know that her 10 year old son must go see a doctor. The mother is being investigated for child neglect, but the whole process takes time, and in the meantime, this child is like a ticking time bomb as far as his health. He went to the doctor about eight months ago, and the pediatrician told his mother that she is worried and wanted lab work done up on him. I asked the mother what kind of lab tests they needed. She said, "Oh, just like cholesterol and other tests", made it sound like no big deal, and never bothered to take him back.
He weighs 155 pounds at age 10 and most of his weight is in the chest and stomach area. He has sores on his legs that have been there since the beginning of the summer. They look like maybe they started out mosquito bites, but here it is several months later, and they are still there. He sleeps sitting straight up on a couch with his head tilted back. When I asked him why he sleeps that way and doesn't lie down, he told me he can't breath lying down. He is thirsty a lot and is constantly drinking water. He has a huge appetite and eats more than most grown men. He told me he sometimes feels like he is going to throw up and nauseated in school. He breathes like he has run a marathon, even when sitting still on the couch. I watched him while he slept, and he itches like crazy! He scratched a long time, especially in his groin area, but also just all over, including the legs where the sores are and his feet. He has a terrible body odor and even after I had him shower. Right after he got out of shower, he smelled a ton better, but about an hour later, his body was stinking again even though he had fresh clean clothes on! He falls asleep in class at school so his teacher is also very concerned, as many of us are.
His mother mom gets furious when I mention that he has signs of typeá2 diabetes. Although I do not have diabetes, nor does anyone in my family, I have been reading a little about it and this child has some signs, and his maternal grandfather has diabetes. His mother changed doctors now because the first doctor hinted at his potential health problem and wanted lab work done. I think his mother does not pursue this because diabetes means possible complications in her life, and she would not like to have to hassle with it.
Please help if you can -- I need more information on diabetes. Does bad body odor sometimes go along with it? This child is important to many of us, and we are afraid he is going to have a seizure or something like that.
Body odor is not a symptom of diabetes. If this child is being neglected, you are bound to contact the child protection authorities in your area. They will be able to assist with a medical evaluation if they agree that it is indeed necessary.
Additional comments from Dr. Philip Ledereich:With regard to his falling asleep and sleeping sitting up, he may have obstructive sleep apnea, which is associated with obesity (and in the pediatric population large tonsils and adenoids). You did not mention if he snored. It may be worth while to suggest he go for a sleep test. The fact that he can not lie down is suggestve of a restrictive lung disease of the obesity mass on his chest wall. Good luck with this poor child, and send us follow up of what happens.
[Editor's comment: If this child's mother needs to work, you also might offer to take him to the pediatrician. If work is not the issue, you could suggest going with the mother since it appears that she is in denial. You might also contact other relatives such as the child's father or grandparents for additional help. If all else fails, I concur with Dr. Brown in that you may need to relay your concerns to the proper authorities. Even though the mother is already under investigation, it may prompt them to take more immediate action if you describe your concerns in detail. In addition, if this child vomits or is nauseated while in your care, you might ask for permission to take to an emergency room for evaluation.
Last Updated: Tuesday April 06, 2010 15:09:30
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