Question About Pediatricians Accuracy

Ok L., I am right with you! I would definitely go for a second opinion if for nothing else but piece of mind and I also agree that the Dr. is weird. How having her sleep with out any underwear on will help her "little girl" problem, is beyond me. How does he know she doesn't have a UTI or something more than just a "little girl" problem!?! I do not think you are over reacting, ticks are nothing to down play so I would take every precaution you can. Good luck.

Hi, I'm not a doctor, but on the topic of preventative antibiotics: overuse of antibiotics helps breed antibiotic resistant bacteria and super-infections which can set a person up for really nasty infections, chronic ear infections, and yeast overgrowth in the body which leads to a host of problems (like vaginal irritation).
You can test for Lyme's before you choose to administer antibiotics.
If your daughter is very uncomfortable, they can test to see if she has a yeast infection, bacterial vaginal infection, or urinary tract infection, a doctor will prescribe medication for each of these, but there are natural ways to cure them and to prevent a recurrence.
Good vaginal health practices to teach any daughter would be: wiping properly from front to back; keeping irritants away from the area like lotions, bubble bath, etc.; cotton undies; getting air in there by wearing loose fitting pants or skirts, and keeping the undies off at night- just wear loose PJ bottoms or a long enough nightgown. Nutritional helpers are fermented foods (think sauerkraut), yogurt, cranberry juice without added sugar. Avoid white flour and non-nutritive sugars especially high fructose corn syrup.
Hope this helps.

I wouldn't have been happy with those answers either. Ticks gross me out and I always think the worst of them and what you little one has could need more treatment than a night without undies. I'd schedule another appointment and specify that it be with her doctor and no one else. But hey maybe I'm overprotective too, who knows?

As far as the painful unrination she mentioned, you should definitely get that checked out for a possible urinary tract infection or bladder infection. My oldest complained of that in the winter and my pediatrician had her checked twice! It was not an infection, luckily, but I felt so much better knowing that we knew for sure. I don't think you are being unreasonable at all about that. As far as the tick goes, my understanding of ticks is that as long as they are removed and not burrowed into the skin, out of reach, or for weeks at a time, your daughter should be fine. It's good that they took pieces for testing just to be sure, though.

I do think that some pediatricians are more proactive about things these days, and that could be a difference between young vs. older doctors, but the bottom line is that if you are looking for a more active approach to your kids' care and they are not giving it, you have the right to demand it or find another doctor. These days, we unfortunately have to advocate for ourselves in the medical world. Also, my husband sometimes tries to brush off the kids' complaints or symptoms and say "they are fine, don't worry", so I understand that... women do tend to worry more but my opinion is that we have a huge maternal instinct that men don't have for a reason! Use it if it's talking to you! Good luck and don't panic - both issues can be resolved.

I work in a pediatric office and we do not treat kids without symptoms. The tic needs to be on 24-48 hours for it to transmit any disease and not all tics carry lyme - mostly deer tics which are the tiny/tiny ones. The idea of going without underwear is to get air to the area which yeast infections are common and are caused by dark/moist areas.

I can't really help with the tick problem except for saying not all ticks carry lymes disease. I think it's only the deer tick, but not 100% positive. As for the no undies at night, the idea behind it is to allow air to keep flowing around the area and not allow moisture to collect which can hold bacteria closer to the urethra (bladder opening) and increase the chance of infection.

I would get her tested for lyme. My daughter had been bitten by a tick, and we called the ped. he immediately got her tested, and she tested positive for lyme. She went on the antibiotics right away. This doctor should have ordered a test for you. Lyme disease is not something to be taken lightly. Hopefully, your regular doctor will be more efficient. An obvious sign of lyme is the bullseye mark around the area of where the tick bit. Be careful because that does not always show up. I wish you all the best.

When we found a tick in the back of my sons neck, we dug it out with tweezers and put the tick in a sandwich bag and froze it. I took my son and the tick to the pediatrician the next day and the Dr. told me not to worry since the ticks head was still attached to the tick. That upset me as well because I'm in the Army and have annual classes on outdoor "critters" and what precautions to take and what to do if someone is bitten by a spider, tick, snake, etc. The Army hands out a little credit card size type of plastic cards connected to a small key ring that have various information on precautions and "to-dos" if something happens, so I dug that keyring up and found a place in Connecticut that did Lyme disease testing. I don't recall that I actually mailed the tick, but I live in Mass, about 15 minutes from CT border so I may have just drove there. I do remember getting a letter mailed to me that said that there was nothing to worry about.

About your daughter's issue.... My boyfriends daughter had this same issue at age 3, and we thought is was because she didn't wipe good enough and had some bacterial infection or something. Since we only see her on the weekends, her mother usually takes her to Dr. visits, and they must have told her the same thing because she is 6 years old now and still goes to bed at night w/o undies. That is very disturbing to me as well, but I guess it worked. I've been trying to get her to wear undies at night when we have her on the weekends, but if I forget to check than she'll just go to bed without. Anyhow, she hasn't complained about it burning when she pees since than. The toilet paper thing refers to ONLY if you use colored or scented toilet paper because the of dyes and additives in those.

I know this isn't probably what you wanted to hear, trust me I questioned the Drs decisions on both when it happened to me, but they see little kids with these same issues all the time, that's why they're there. It's only the mothers who seem to over-react. My boyfriend still tells me, "that's why they're doctors".

R. M.

About Me: Single mother (sort of). I live with my son's father. I have a 5 yr old son and a 6 year old step-daughter. I work full time in the Amry National Guard.

Hi L., If he's an older doctor he certainly might not be up on all the latest things. It's very important to me which is why I travel 40 minutes to my doctor. He's young, athletic, has 4 children, his wife is a co-sleeping/extended nursing SAHM, he encourages my holistic approach, etc...

Things change too rapidly, and there are a lot of things that are issues now that weren't in the text books then...I'd get a second opinion.

My best friend has a baby 3 weeks older than mine (10 months) and her elderly doctor said, "Go ahead and start introducing cow's milk". My doctor said, "Absolutely NO cow's milk until she's a year." Old school vs. new school...would it hurt him? Probably not. Doesn't make it best.

I'm sure there are many doctors out there who are great and keep themselves well informed but "don't wear underwear at night" sounds like my grandmother "you have to let your girly parts breathe at night".

If you aren't comfortable NOW, you won't ever be. Follow your instincts on this one. There's nothing like finding a doctor you trust implicitly.

Hi L. - Just a quick note - some things may be outdated, and there MAY be something else going on... however no undies at night is perfectly natural! Why not? Allowing our vulva to be exposed to air is a good and healthy thing.

One question I might ask myself if I were you is why do you think you are reacting so strongly to this suggestion?

As far as the tick, one thing I do know is that they have to be imbedded for a certain period of time in order to pass any disease (different time periods for different diseases) and also, only certain ticks carry lyme and I think I remember reading recently that the ones common to our homes (i.e. not deer ticks), aren't the ones carrying....

So just do a bit of internet research - if it was at home, she should be fine.

And the way to remove a tick is NOT to light a match and blow it out, then touch the hot match to the tick. This shocks them into spitting any venom they do have into the body before they let go....

If you try to tug at the very, very head and it won't come,
put vaseline on the ticks back instead. They breath out their backs and this will suffocate them, but not shock them.

I think your doctor is 100% correct! Ticks are very common. I have pulled several of my girls this spring alone. Labs do not test ticks for Lyme and Doctors do not put a child on antibiotics just because a tick bit them. If your daughter shows signs of Lyme disease- then they will do a blood test. If it's positive she will be treated.
As for the painful urinating- he's right again. It's extremely common for little girls to have difficulty with this. They don't always wipe properly- that and a combination of bath soaps can irritate the urinary tract and cause discomfort. Having her sleep without panties is a good suggestion. Didn't your mother ever tell you to "air it out"? (Sorry if this is a bit vulgar) It just allows her to dry out a bit. Moisture can collect and make the issue worse.
Don't worry- I think your pediatrician is right on target! Just relax. Sometimes experience is just what we moms need to hear!
Good luck,
S.

There are so many things to be concerned about as a mom! Ticks certainly rank high on my list of worries, too. We, also, live in a high-infestation area and, with 2 dogs bringing the little buggers into the house, I try to be extra careful. Last year I found a tick on my hip that just didn't look right. I called the Dr. right away and was really annoyed when they wouldn't test me for Lyme immediately. So, I started digging around for info and, sure enough, they were right. The Lyme test is not reliable/accurate for at least 2 weeks after a bite. You can do it earlier, but you'll just have to do it again. That could be part of the reason for the casual response (that, and the fact that only deer ticks carry Lyme and not the more common dog tick). That being said, it's also very common to have a false negative, even after you wait the 2 wks. So I guess we all just have to be as cautious as possible to avoid 'em, and vigilant about symptoms once we find 'em. Good luck! Hope your concern is just normal, maternal caring and that your daughter is fine.

L., Please do not be afraid to push. And I would right now. I believe it takes 24 hours of a tick being attached to transmit the disease. Not all ticks "get big" (swell with blood inside to feed the eggs they will lay). I would treat with antibiotics for the reasons you stated, but I would see when she can be tested. Some diseases have an incubation period and you might need to wait before it will show up on a test. But better to know either way! I would think the antibiotics would cover a urinary tract infection - but you never know!
Never feel guilty about voicing concern for your child! I think you need to see a doctor that has a better bed side manner!!
Good Luck to you and family!

I think as far the tick bite - I would keep an eye out for the symptoms that appear when bitten by a deer tick (?). If she gets a red ring there, tired etc, then I would take her back to the doctor. But I am sure that doctor has seen many tick bites and probably is aware of symptoms as well.

For the painful urination.... is it something that happens everytime she pees? During or just after? Is she in obvious pain when she uses the bathroom? If so, then definately take her back to the regular doctor or visit someone new.

I am assuming that these issues are with your four year old and while at the doctors office - the doctor probably asked her some questions .. which is why he came to the conclusion that he did. Also 4 yr olds can exaggerate (not saying yours does), but if she doesnt like the toilet paper and its scratchy - her way of expressing it could be by saying "its painful". I would figure out what is exactly painful and when it hurts like that.

If you are not satisfied with his answer - then by all means I would defiantely bring her back, get a second opinion, etc! You know her best after all, and you are her only advocate (well, her dad too).

I also prefer not to give my daughter antibiotics with out being positive there is a reason, so I agree with doctors in that aspect.

I think they should have tested the tick though! To be on the safe side.

Good luck and I hope everything is ok.

Hi L.~

A good friend of mine has had lyme for years, so I understand your caution! If I were you I would just get in to see your regular doctor and talk to him/her about it. Also, it may or may not help, but you could read up on sypmtoms that preceed lyme disease. If you're daughter has had none of them, then you can worry less.

Good luck~
sbj

I have to add my agreement with the other Moms about the tick. Lyme Disease isn't something you want to mess with and most of the time you're ok but I have recently learned that up to 90% of deer ticks carry the disease so prevention is a must! If you saw no evidence of the bulls eye rash at the sight of her bite by the day of her dr appointment you are probably ok. The rash is pretty immediate after the bite. However, I would still keep an eye on it and take her to the dr right away if you see one developing. I would also call a local herbalist in your area and start her on a protocol for Lyme Disease along with the antibiotics if she needs them. Even though most everyone has the same basic symptoms for the disease not everyone has them in the same severity. I am not one to advocate antibiotics either but this is the one case where I think they do more good than harm. Just remember also to put her on a good pro-biotic to recolonize the good stuff that the antibiotics are going to take away.

As far as the uti question. I think the dr had good advice and was just being on the more cautious side before prescribing antibiotics unnecessarily. Both suggestions are great ones and could save you giving her unneeded medication. Lots of air circulation in that area of our bodies keep us from getting uti's and yeast infections. I can personally vouch for both suggestions. I never by toilet paper with perfume or dye and ALWAYS sleep without undies. Loose pj bottoms are usually fine since they cover and still leave room. Also look at the soaps you are using and bubble bath if you use that too. Make sure she's getting plenty of fresh clean filtered water to drink too. I also found that caffeinated drinks bothered me too (back in the days when I was drinking them!!).

Good luck. Your children are lucky to have such an advocate!!

Hi L.,

We've had three tick bites in the last year, so I've had some experience with it... Believe me, when it comes to Lyme disease, I'm a bit paranoid, but the more research I've done, the more I comfortable I feel. The important thing to note is that SEVERAL factors have to come into play for you to actually get the chronic version of Lyme Disease:

1) you have to be bitten by a DEER tick. Many ticks are actually dog ticks. Deer ticks are much smaller and usually have orange/brown wings (dog ticks are totally brown).

2) the tick needs to be infected with the Lyme bacteria. Many ticks aren't. Since you didn't save the tick, it's impossible to know. Of the three tick bites we've gotten, only once did the Dr. recommend testing the tick.

3) The tick needs to have been latched onto you for at LEAST 36 (and more likely 48) hours. This is the most comforting factor for me. We bathe our kids at least every other day, so the likelihood that a tick would be on them that long and go unnoticed is not high. Considering your daughter was bitten on her arm, I'm sure you noticed it pretty early.

Even if all three things DO happen, and you DO get an infection, so long as you catch it early, it's treatable with a high level of success. So if you remain concerned, keep on the lookout for signes - a rash (anywhere - not just around the bite), and joint pain are things I'd speak with your doctore about.

All that said, it's important to be diligent about checking your kids AND yourself on a regular basis.

Hope this helped,

M.

I am not sure about human transmission of lyme disease but I do know it takes 24 hours minimum attachment in canines for lyme to be transmitted. I have found ticks on myself before and have not gotten lyme disease. I have never had a tick checked. All ticks these days can transmit lyme disease not just deer ticks. If you are ever concerned, you can send a tick I think to the state lab or UCONN.

Hi L.,
Your news sounds pretty disturbing. You are not being paranoid!! I come from a region in Ny where limes disease runs rampid. I have had it and My mother has had it 3x's. There are all different types. The one thing you should know is the smaller the tick the more likely it is carrying the disease. If you don't have the tick to test it's o.k. It is a very simple blood test. Watch for signs if lethargy and joint pain. And write a letter to your peds that they need to update their knowledge or retire!!! Good luck. I don't want to scare you it can be very treatable. Pleas give us an update.
D.

al i can say is keep on the lookout for symptoms of the lyme disease. My now 5 yr old had it and we never found a tick or the bulls-eye looking rash.. Watch out for your daughter complaining of joint pain/leg pain and headaches. I wouldnt wait for the regular dr to call back I would march your daughter into that office. Dont wait for them, you are your kids best advociate! Good luck!

First may I say I hate the little disgusting insects. It has been a really bad spring for the gross little buggers. I found one attached to my daughters scalp when I was brushing her hair. She was a trooper. My husband and I have both found them crawling on us. I heard on the radio that 70% of deer ticks found in NH where carrying Lyme disease. I also do need to say that deer ticks are extremely small, the size of a fleck of pepper. Even infected deer ticks do need to be attached for a certain amount of time before they transmit the disease. I can't remember if it was 24 or 48 hrs. I had a tick attached in my bikini area last fall and a piece stayed in when I tried to take it out. I went to the doctor and they said that to leave it in and it will "sluff off". Trying to take it out would only hurt the tissue surrounding the bite and could cause infection. I hope the doctor meant that the tick was not engorged when he said it was not a "big" tick, because it "is" the small ones you need to carefull of. Quite honestly, it probably was not a deer tick and if it were it was not attached long enough to transmit the disease.

Hi L.! I have thoughts on both points and I hope they serve to calm your nerves a bit: My close friend is a pediatrician, and she and I live in a very tick-prone neighborhood (we have a family of deer who literally come up to the front of our house). I am obsessed about ticks and she tells me repeatedly that the tick would need to be on your child for between 48 - 72 hours for it, if infected, to transmit the disease to your daughter. If that tick was small, it truly wasn't on her long enough. Of course, if she develops any flu-like symptoms, bring her in, and they'll put her on antibiotics then. As for the second issue, perhaps that doctor thought your little girl might have a yeast infection (of course, he could've used that phrase instead of just saying "girl problems")...when I got one my doctor recommended the same thing...no undies so your body is exposed to some fresh air, since moisture contributes to the problem. All that being said, take a deep breath, relax, then be in touch with your doctor...sometimes you just have to go with your gut! :)

Hi L.,

Get your daughter checked for Lyme Disease!!!!!!!!!! I grew up in Old Lyme. Yes, the town namesake for this disease. That doesn't automatically make me an expert, but trust me when I tell you that we were made very aware as children what the signs were, what the ticks looked like, what to do--you name it. A deer tick, the kind that carries Lyme Disease, is a tiny tiny tick--not a big one! I have no idea about starting antibiotics just in case, but I would definitely get her tested. There are also a whole host of other things that ticks carry which she should probably also be tested for. My brother had the disease twice as a 5 year old, and then had a recurrence as an adult (but was expressed as something else called bells palsy--not sure of the spelling). Otherwise, he has been lucky with no other known side effects so many years later.

It certainly would have been helpful to get the tick tested, but clearly, that is a lesson learned for another day. As for it not being on her very long? All it takes is for the tick to imbed itself in the skin and the disease can pass--is that like the girl who got pregnant and said, but we only did it once and it was really quick? I am shocked to hear this about a pediatrician. If it makes any difference, when you think about it, half of the dr's out there practicing were in the lower half of their class in medical school. I'm NOT saying that this one was, but I think that you can see my point.

As for the painful peeing, that could be so many things. I remember growing up not to wear undies at night. Something about letting everything air out/breathe without any constrictions. Never knew whether it had any merit or not--our daughter sleeps in her undies. Could be something in the toilet paper irritating her--but have you changed the brand/type/anything recently? If not, I would doubt that as the culprit. I vaguely recall feeling something similar when I was little and my mom putting a little desitin on me. Will she let you check her out? It might be something as simple as "diaper" rash and maybe she's not wiping as well as she should be.

Try to check out her peeing habits--is she holding back because it is painful--that will only make it worse. Try getting her to take in more fluids to try to flush things through.

Hope this helps. But, if I were you, I'd get her checked for Lyme Disease--and pronto! You can never be too cautious with it.

Hi L.,
Do yourself a favor and get a second opinion. If it does nothing else it will at least set your mind at ease. Keep a close eye on the site, look for the classic bulls eye scar and call the doctor immediately if you see anything bullseye shaped. Last summer my barely 3 year old was bit by a tick, only we did not see it until it was a big scar, and already bullseye shaped. We had been traveling in the car to Canada and ended up taking him to a remote ER. The doctor there thought it was a skin rash and gave us penecilian. When we got home I took him to the pedi and he also did not think it was a tick bite, even though it looked similar to a classic lyme bite. It was only after I asked him to do a blood test that it was confirmed lyme disease! Even though two weeks had been wasted my son was put on a mega dose of antibiotics for 21 days. My pedi apoligized for not testing him sooner. According to a few reliable sources we were still able to catch it in time... the moral of my story, Mama's know best! Follow your instinct to investigate further. We all know not every tick carries lyme and not every bite results in Lyme. But when it comes to finding out if our kids have something that can change the rest of their lives. Good luck, good health to you and your girls.

Looks like you got alot of good advice. i just want to say as a first time mom myself if you are not satisfied with your pedi's advice just get a second opinion - you dont want any regrets.

hi!
I wouldnt worry to much about the underwear issue. Im assuming it was just to get some air around her crotch area. However, It should be standard to test the tick just to be on the safe side. Lyme disease is a major thing. Maybe call your reg. pediatrician and voice your concerns to him/her. Thats what they are there for...dont feel like you are being overprotective or too cautious. We're mommies, thats what we do!!!
Kepp us posted...
S.

It is not strange at all for the dr. to advise sleeping without undies; not old fashioned, either; it's actually progressive thinking
It can prevent more than one problem in girls/women, such as yeast infections, etc.
(Experienced mom of 3 now grown girls)

As far as the big ticks go (wood ticks as opposed to deer ticks), they're supposed to be harmless; by big, he may have meant that it hasn't filled up with blood yet or whatever it fills up with, so it probably hasn't had time to do any damage; it probably hadn't bitten her yet?? Not too much experience with ticks, though we've had a few on our clothes, etc.

As someone who has had Lyme and done extensive research on it, I think the doc that your DH saw is ridiculously behind the times. First of all, while I believe personally that any tick can carry Lyme, the party line is actually that it is the SMALL deer tick, not the LARGE wood tick that carries Lyme (the opposite of what your doc said).

Are you in an area where Lyme is endemic? There are protocols for treating tick bites with antibiotics now. Not everyone gets the rash. I would insist on antibiotics.

Also, what is the problem with testing her urine? It's a simple test!!!

Doctors are not gods, but mere humans. They may make mistakes even when trying to do the absolute best for your child. Your instinct as a mother is much more reliable in making a decision as to whether your daughter needs treatment.

I also do not use antibiotics unless I feel it is imperative. Believe me, with the possibility of Lyme infection, it IS imperative. Don't be afraid to insist on the kind of care that you need for your daughter!

We have taken about 10 ticks off my daughter in the past three years and (ready for this) as an infant (just cutting teeth) she actually found an inflated tick that had fallen off our dog and I discovered it in her mouth - stuck on her two little teeth - discovered b/c she was drooling blood (dog blood) from puncturing the sac!! Aughhh!! That resulted in calls to poison control, the vet and of course her pediatrician.
Needless to say, it's a bit of a problem b/c of where we live and having a dog (she brings them into our home). You're right to be concerned, but do your research and see if you recognize what the tick looked like.
The tick would need the opportunity to imbed itself under the skin, so there is some truth to the "not being on her too long" statement.
Also, watch for any signs of a rash. I and my husband have had Lyme disease. He got the classic bullseye rash and I got just a red blotchy one.
I got Lyme disease as a child - that was misdiagnosed by an old Dr. as an infected mole (You could actually see the tick under the skin, but he didn't look very carefully at it!) It led to facial paralysis that lasted several months and an embarrassing start at a new middle school. THe worst part - was my mother showed the dr. pictures that supported her belief that I had this "Lyme disease - we are hearing about" and he dismissed it.
So, don't freak out over it, but follow your gut. And if your daughter doesn't show any symptoms - then let it go. You're right not to want to give her preventative antibiotics. Save them for when they are really needed.

good luck.

L., you have every right to question a doctor's accuracy. They are human and make mistakes every day. Case in point my 7 year old nephew was taken to the emergency room just two weeks ago for a tick imbedded in the under side of his knee. The ER docs removed the tick, treated the site and sent him home. A week later his knee was swollen and sore. Another doc said that it was infection from the bite but my sister in-law insisted on a Lyme test. The test came up positive :(

Also your doctor's comment of "since it wasn't a big tick" makes NO sense. What is commonly known as a deer tick, which can carry Lyme can be the size of a small freckle! My son had one dig into his scalp last year. My husband and I both thought that it was a tiny splinter because only a little brown piece was sticking up. I pulled it out with sharp tweezers and almost gagged when I got it all out and realized it had legs and that it was a deer tick! I brought it and my son to his pediatrician who then called the university that was studying ticks in our area. They told him that over 90% of the deer ticks they tested carried Lyme. He started him on antibiotics right away.

Not to make your fears worse but ticks do not just carry Lyme. Reading about all the different ticks and what they can carry and how to prevent bites, treat bites, what to watch for at the site etc. would be helpful to you. Google ticks and you'll have an arm load of information. Being educated about ticks will be helpful when you speak to the doctors too!

As for that doctor, I say if your instincts tell you he's wrong about either the tick bite or the possible vaginal infection then go with what you believe and go to another doctor. If you're wrong, so what? If you're right you'll be saving your daughter a lot of misery and pain.

All the best,
S.

Just because he is a doctor does not mean he can not be wrong. please take her either back to him or to another dr. It is ok to question. I had a dr miss diagnose my daughter and said she had bad dandruff she had ring worms for a year in her head. And my new pd looked at her and in 2 sec new that it was ring worms.. So question them and I hope your daughter feels better!ps let my know if you need a new dr...*-*

He definatly should have at least tested the pieces,(did he say why he didnt test them?was there not enough of the tick pieces to send to the lab??)I guess just wait to see what your regular pedi says,but def let him/her know you arnt satisfied with his care!!Take care and hope your little one is alright!!

Just want to add my 2 cents as I have also really looked into this topic- we have a dog who is aways dragging ticks (deer ticks) into the house from the woods. It is not likely but is possible to contract Lyme and other tick borne diseases soon after the bite- but at least for Lyme, it is not as likely as when it has been embedded for over 24 hrs. Testing can be indirect and tedious, many people with Lyme disease spend a long time getting tests, and visiting doctors trying to get a diagnosis. That is because the tests are still not totally conclusive for infection. One of the best measures is to watch for early symptoms. Many people never get the textbook bull's eye rash, or any rash. But if you do notice your daughter developing any kind of rash in the next month, fever, or new aches and pains- it is time to discuss it with your doctor. This would be enough of a reason to begin antibiotic therapy. To describe Lyme disease in one word- it is "changeable," as in migrating aches and pains. The good news is that early treatment (soon after symptoms begin) is highly effective. Let us know what happens- I know that a lot of us are going to be having the same experience this summer- since tick exposures are getting more numerous out here.

I would defenitly go back and insist on some kind of screening for Lyme disease, but Lyme disease does leave a distinct mark around the tick bite. Here's a picture. http://images.google.com/imgres?imgurl=http://www.nlm.nih...
Also, depending on where you live, Lyme disease hasn't reached everywhere. Last year my husband got bitten by a tick (how he got, I have no clue!) so we went to the doctor. We'd gotten it all out (dowsed it oil, then used rubbing alchol), but were concerned about Lyme disease. So when we went to the doctor she said that the mark didn't look like Lyme disease and that as of last summer it hadn't gotten past Southern Maine, but she ran a blood test to be sure - came bakc negative. As far as burning when she pees, that could be a lot of things! Try cranberry juice for a little while and try changing the TP. When I was a kid my parents would get colored TP (lol which they don't even make anymore) but had to change it because my sister started to have issues with it.

Hi L.,
I'm not a medical professional but I go hiking outdoors etc. and I am concerned about Lyme disease.
Check out livingwithlyme.com a website that has info about lyme disease issues.
My feeling is that the dr *should have tested for Lyme
disease* since the tick penetrated and he had to remove the
pieces. I thought it was the small ticks that have the disease?. You should save the tick that penetrated the skin if possible and it can be tested for Lyme Disease.
I hope this helps--good luck L..
B.

Hi L.,

It is accurate that a lyme tick needs to be on for a while before the disease is transmitted. They also do not test the ticks anymore, so that wouldn't have helped anyway. She will likely be fine and if you keep a close eye on the tick bite and watch for a rash to develop, you will be on top of the disease so it is not debilitating. It is mostly problematic when the tick bite wasn't detected and therefore the symptoms were allowed to do their damage before someone did anything. In general, I think your daughter will be fine and that the dr. proceeded as any would.

All this being said,I am a big believer in maternal instinct. I don't care about anyone's credentials--if they don't deliver for my children, or if I just get the sense they are dismissive of my concerns, I will move on to someone else. You are not overreacting. I don't think mothers trust their gut enough! I don't have a response about her painful peeing, but I will suggest you go with the doctor you are most comfortable with and see what s/he says.

Furthermore, I am also a 40-hour-a-week working mom as well (with daughters the same ages as yours), and I think you should realize what a wonderful gift you are giving them by showing them that they can be successful in life by pursuing careers AND families.

Never apologize for being a wonderful mother!

Best of luck to you!
K.

L.,

The undies thing is normal advice. He probably thinks that maybe there is too much moisture down there. Also as a sufferer of bladder infections, the toilet paper could be bothering her. Don't use anything with color or scents.

I think the Dr. was right in prescribing the antibiotic as a preventative measure. Lime disease is VERY painful and you don't want her to even take a chance of experiencing that.

Having said that, your regular pediatrician should have called you the day you called him/her. If you haven't heard from your regular Dr. within 24 hours of your call, there's something wrong there. Call again.

Good luck.

P.S. I am a 50 year old stay at home mom and have experienced just about everything.

My cousin (an adult) had Lyme Disease recently and her test came out negative the first time. She did have a bullseye rash which I believe is the big telltale sign but her doctor wouldn't treat her until she had a positive test which she finally had a couple months later. I would look for the rash and in the future I have heard that if you save the tick they can test the tick directly. Good luck.

Not everyone develops the rash associated with Lyme disease. Around 25% of the cases there was absolutely no rash. If you feel uneasy call you Dr. and ask for the test. It might be hard on your daughter because they will have to draw blood but you need to do what you feel is the best for her.

I'm glad to hear that you called your regular doctor back. I believe it's always better to follow up or get a 2nd opinion if you're not satisfied with the answers you get from doctors. In my opinion, sleeping without undies does sound bizarre, especially without any context given from the doctor. If he had a specific reason for recommending such action, he should provide you insight as to why he thinks that would help. Some doctors tell people what to do but don't explain why. I feel that patients have to question doctors if they feel something needs more explanation. In my experience, most doctors will provide more insight. If they don't, then that's a clue to get another opinion. As for the tick bite, watch for signs of illness (fever, flu like symptoms, etc.). I believe Lyme disease is only caused by Deer Ticks, which are quite small in size. Many people report a bulls-eye looking rash around the bite area. Hopefully your daughter has not been bitten by such a tick and will be fine. Good luck!

Hi L.. I pulled a tick off my 2 year old's neck the other day and it was definitely a deer tick. My experience/understanding is that if it has been imbedded for less than 24 hours and a ring does not appear around the tick bite within a few days that there is no (little) chance of lymes developing. We did not take her to the doctor and have checked daily for the tell-tale ring but have seen no sign. It sounds like your doctor is on track and as long as you keep an eye on the bite spot for a ring there isn't too much to lose sleep over.
BTW--that same two year old girl occaisionally complains that her 'peepee' hurts when she goes to the bathroom. It is usually just a little irritated from not having wiped herself well enough and it gets better quickly. I do have her nap without undies on just to air it out :) Old fashioned, maybe, but she's healthy and happy!

Good luck.

Hi L. -

I think that you have a right to be concerned. Deer ticks that carry lyme disease are very tiny. My doctor has sent the tick out for analysis when I have been bitten. Most MD's will put you on preventative antibiotics such as doxycycline for 14 to 28 days to be on the safe side. Lyme disease is very serious and because of this most MD's won't mess around they will just give you the antibiotics. I would bring your daughter to another MD. In the meantime check the area for a bullseye type rash (which sometimes occurs with deer ticks but not all the time). Check to see if your daughter seems lethargic or has any muscle pain.

Yikes. I just hate to say it - but you need a new doctor! First, with regard to the ticks, it is absolutely true that if it is a baby tick - the size of this period . then it does not have any Lyme disease yet to pass on. They do not get Lyme disease until they have been on a host, such as a bird, mouse or deer, and then contracted it - and then they would grow bigger and get on the next host and pass on the disease. But was the tick REALLY this small "." ? Also, I have read that it needs to be on you for 24 hours to pass on Lyme disease. Of this, I have my doubts. My sister is a nurse. She had a tick on her leg - where she would have clearly seen it - and so knows it wasn't on for 24 hours. She got the telltale bulls-eye sign, and got tested and had Lyme disease. I think a test is definitely in order - but remember there are a lot of false negatives - so if she is having other symptoms, keep pushing. Keep in mind, not everyone gets the bulls-eye ring either.
With regard to it hurting when it pees - this doctor should be ashamed of himself for not testing for a urinary tract infection or vaginal strep. That is outrageous. Your daughter would not be making this up. I recall my daughter having problems a few years ago - and the doctor filling in looking at her urine and saying "It looks perfectly clear, I don't "see" anything." I insisted on a culture - the LONG culture which takes 48 hours - and sure enough she had a bad infection. They actually said to me "Wow, her count is pretty high considering that her urine looked so clear."
You should call today for a new doctor. If you need a recommendation in the Haverhill area, Dr. Rosenbloom at Pentucket Medical walks on water, as far as I'm concerned. Good luck!

How long was the tick on her? If it was less than 24 hours, I would not worry at all. It takes at least that long for the lyme spirochetes to go from the gut to the mouth of the tick. So even if you missed parts of the head for a couple of days, she will not get lyme (assuming that the tick was even infected). It is good to be vigilant and cautious, but if the risks are really low I would avoid the antibiotics at this point and make sure she is eating healthy and her immune system is working at optimum level.

Treat the peeing issue as totally separate right now. Try some cranberry juice (without sugar) if you suspect urinary infection, and cultured yogurt if you think it's yeast related. If the doc says no undies, he's probably betting on yeast. Back off on sugar and white flour for a few days.

Hi,

I would definitely follow up on the tick bite. I had a simple blood test, put on a three week antibiotic and experienced very few symptoms of Lyme Disease (which it turns out I did have!). ANd if it hurts when your daughter urinates it should be looked into. It could be a kidney infection, not just a UTI.

B

Hi
I am responding to the no undies at night. My daughter is very often red down there. She has had yeast infeections and such but more often it is because she doesn't wipe herself very well. She's 4... The no undies part is so her area will dry out at night. If she is like my daughter then the (not to be gross) unwiped excess goes on her underwear and just sits there being unsanitary all night, a good breeding ground for germs. At least with then no undies there is nothing for the germs to collect on and (agian not to be gross) warm and wet. No undies at night works... Hope this helps.
-A.

A second opinion never hurts.... trust your instincts.... There is no reason to panic about the tick now. I am sure that if you insist, they will put her on antibiotics. If she developes any symptoms, they will put her on them immediately, too. Also - if your daughter has a urinary tract infection, there will be nothing subtle about it... You will know. It is best for little girls to wear all cotton undies, to wipe themselves properly, not use bubble bath and yes, I have told my daughters that it
is fine not to wear underwear at night. Take care.

I have a friend whose son contracted lyme disease from a tick and it is true that the tick needs to be on her for 24 to 48 hours for there to be a problem. We were just talking about it yesterday.

Good Luck!

I had Lyme disease and it is not a good thing. I have found that patients need to be very proactive with this disease. It could be nothing but I would recommend you stay with it and see another doctor or pa just to be sure. Quick response is key with this disease.

I had this disease when I was in my 40's so I don't know the kid side of it. However it could not hurt to address this now. I was lucky to have typical symptoms (rash and pain at tick site). Others have neurological or heart problems which are much harder to link to the original tick bit.

BTW, if you are not happy with the second opinion get another. It took me four doctors to get an antibactic when I had a positive Lyme test and obvious symptoms.

Hi L.,
You are not over reacting, get another doctors opinion. Children can get UTI and she needs medication. Lyme disease is hard to detect even with bloodwork. It would be wise to have her checked out again to confirm and ease your mind.
Good luck.
L.

There are wood ticks and deer ticks. Wood ticks are bigger and do not normally carry Lyme. Deer ticks do but not all the time are they positive for the lyme.
My daughter had a tick in the back of her head last year. We pulled it out carefully with tweezers making sure we got the head. That tick was already feeding off of her blood. We called the doctor and he said to just apply antiseptic and watch for symptoms. A few weeks later she got a bulls eye on her back so we took her and she did the 3 week antibiotic preventative measures. She has been fine since. We caught it in time.

The other day at school she had a wood tick in her head and the school nurse took it out. She was positive it was not a deer tick and just cleaned the wound. I do not plan to take her to the doctor for that.
As fars as the burning while peeing. Sometimes children do not wipe well and over the course of a few weeks can develope a rash. I would apply some cream down there for a few days and see how she feels. I would elminate any bath products that could irriate her and do not use soap to wash her down there.
If it persist I would have her do a urine test to rule out a UTI.
Good luck

How big was the tick? If it was a large one like a dog tick, they don't carry Lyme disease. The vector in the NE is a deer tick, the size of a sesame seed when engorged with blood. Very easy to miss unless on an obvious part of the body. Antibiotic treatment for Lyme disease is 4-6 weeks of treatment. That is why you doctor did not just treat. He would have to have a high level of suspecion to commit your daughter to that course. It is too early to test her for Lyme disease, ( the body needs time to mount a reaction) and the test would only show she had been exposed and developed antibodies, not that she has the disease. So a doctor would want to see symptoms of the disease before treating for that extended period required (long term antibiotic treatment is not with out serious possible complications). A rash at the site of the bite that develops over time is seen in about 30% of cases and would be followed up with a workup. Also a flu like illness would trigger a work up in a known deer tick bite. So it sounds like your Doc is not far off the mark in how he handled the issue. He needed to give you more info on how he made his decision.

Always call your doc when you have questions and if he/she is not willing to discuss his/her reasons for doing or not doing something, then you need a new doctor that you feel more comfortable approaching.

As for the painful peeing, look at her bottom and see if she is red or irritated. Not wiping well, wiping from back to front in little girls can cause a diaper rash in the creases of the vulva that sting like crazy when they pee. Also bubble bath is a common cause of irritation in girls. His suggesting no undies at night has to do with letting the bottom dry out and not stay moist. Remember being told to leave the diaper off the baby for those very red raw diaper rashes? And you Gyn suggesting cotton panties instead of polyester, so your HOO HAH can breath? Same thing. If her symptoms are consistent or get worst with no external explanation, get a urine looked at by your doc. You can ask him to do that if you are still concerned.
Good luck,
J.

Ticks are disgusting critters, but the tick on your daughter would have to be in for more than 36 hours to be suspect. I have a friend that had Lymes disease with the bullseye rash, fever, body aches and all the other classic symptoms and NEVER tested positive for it; he was retested many times and the tests were still negative.
You might want to look into treating your yard with Tick Tubes, which kills the ticks in the nymph stage. The website for this is: http://www.ticktubes.com

Keep an e out for flu symptoms bc not everyone gets the classic bullseye rash.