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Pediatric Wellness Exam around PubertyI am trying to find a new pediatrician for my daughter (11y/f). We went to a local female pediatrician, who was nice, albeit a little rushed and pushy. We talked for a little while, and the pediatrician did ask if she had her period yet or not. She has not. Upon physical examination, with little notice (hey I'm going to do this, and then did it) the doctor pulled up my daughter's shirt and bra, and then pulled up her pants at the waistband to look at her vaginal area. My daughter was struggling to not let her do this and is now traumatized by the interaction and felt like she could have given a little more warning. I know that physicians are very busy and have many patients to see, but I feel like I've failed to protect my daughter from this. I would think a conversation asking if she is developing breast tissue or pubic hair would have been just as efficient without stressing my child. Or even saying what she is going to do before doing that kind of exam. Is this a normal practice on a wellness exam? My daughter will not be returning to this doctor.
gpt
It is normal practice to check these areas, yes. Sounds like the doctor could have explained the process a bit better. At this age, I generally talk to the patient about what I'm going to do and why, then ask for their assent before proceeding.
Pediatric Abilify weaning schedule?Hi Reddit Docs, My 8yo (9 in April) son has been on Abilify for about a year, up to 15mg. Long story short we dont feel that it is making a difference and in fact hes getting worse, more physical/aggressive, even violent at times. Especially since we added clonidine again. (In addition hes being treated by a physician who specializes in ADHD, not a psychiatrist. He was diagnosed by a psychologist with ADHD, depression, and motor coordination development disorder. I had to see this Dr because he was diagnosed during the height of the pandemic and no psychiatrist was available. Basically threw different combinations of Vyvanse, guanfacine, clonidine, and Adderrall at him, hes currently on Adzenys, Abilify and just came off clonidine. Finally got him some Lexapro a few months ago and his baseline mood has improved but the outbursts are worse. Ive been trying again to get a psychiatrist with no luck. I currently have an emergency intake visit scheduled in 4 days with a social worker who is supposedly going to get us a faster referral visit.) What is the recommended taper schedule to come off the Abilify? Wanting to make sure current provider is giving us accurate info. Thank you!
I am not sure what the guidelines for treating children are where you reside but to me this seems like a hodgepodge of medication. I would personally be very concerned to write out so many medications (some of which counteract each other).My first question would be what was the main problem with your son before he got medicated? Why did you seek help? Is there family history of psychiatric illness?The tapering really depends on the patient and the symptoms experienced. One could recommend to reduce 5mg every week (so 15mg, 10mg and finally 5mg before stopping). This can be further adjusted depending on any side effects. This can be also adjusted more finely if you have an oral solution instead of tablets.