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DD (5yo) is in the 97th percentile for BMI...doc says she's in the obese category - Page 4

post #61 of 99
Quote:
Originally Posted by meemee View Post



StormBride would u really dump the ped? even after the OPs second post about the ped? would u not give the ped a second chance? just coz its weight? body images and wigged out ideas? 

 

I saw someone refer to the OP's second post about the ped, but even after re-reading the thread, I missed it. I'll read it again, and see if I can find it.

 

it seems the ped has supported the mama all this while. could we not give her the benefit of the doubt? could she have been whigged by a recent case and freaking out? i mean if it was growth spurt she should have already seen this trend shouldnt she in her well baby visits?

 

Why would she have seen the trend? IME, the usual well child checkups are once a year at this age. That's barely even a snapshot of the health of people who are changing at an incredibly fast rate. If the ped never saw her just before a growth spurt, she'd have no way of knowing what the child's pattern is. And, if she happened to see her last year (when her BMI was 70%) right after a growth spurt, and right before one this year, then she's pretty much comparing two different children, for all practical purposes.

 

dd does the same thing. goes rounder and then suddenly almost overnight shoots up. since i've noticed since 4 dd had done the same thing for the last 5 years. if the ped has been seeing her she should see this pattern shouldnt she? of course provided she saw her at the same time. i mean it just blows my mind that a ped of all persons did not factor in growth spurt. 

 

It doesn't blow my mind at all. But, as I said, I have trouble taking anyone very seriously when they put this kind of import on BMI. BMI doesn't allow for musculature (my oldest once put on 35 pounds in six months - it was all height and muscle, and he was slimmer, except at the shoulders, at the end of it than at the start), growth spurts or anything else. It's a very simple calculation and it's one absolute number. And, growth spurts aren't all at regular intervals. Actually, I don't think any of my kids have had regular growth spurts. (DD1 was wearing clothes in sizes 3, 4, 5 & 6 until a year ago, and her "true" size was probably about 4.5. She started wearing them at about 3 or 3.5...and very abruptly outgrew almost her entire old wardrobe a few months ago, at age 8.)

 

i understand where you are coming from - where everyone is coming from but dump the ped over this? just coz its a body issue - i dont think so. 

 

I guess I don't see dumping the ped as that big a deal. I'm not a big fan of the medical community and I find the level of testing, and prevalence of specialists in the US system really...odd. I don't have a ped, and don't want one. (I'm not even sure I'm going back to the one I saw about assessing ds2, because - as usual - she didn't listen to me at all.) My views aren't "just because" it's a body issue. They're also because I don't like the approach and attitude about it.

 

if the world thinks OPs dd is fat they are going to let her know pretty soon. dd is tall and broad and stocky. and in the same category as OPs dd. however dd looks it. she has a tummy, she is 4'9" and a 100 pounds. and guess what? she is the same as her father and uncle when they were that age plus she has a mother who has 'heavy bones' (how i have always 'looked' and what my weight said has always been different). the world has been calling her fat since she was 5 years old. including her own father. i've had to counter that a lot to make sure dd doesnt get a complex. i guess so far she hasnt since she chose a bikini for a swim suit. 

 

I have a medium-to-large build, and tend to bulk up with muscle. Even when I'm fit, I'm way outside the old "ideal weight" charts, and my BMI when I'm at my best would probably still fit just into the overweight category (between a large-ish ribcage, abdominal musculature, and a slight fat pad). I know a woman who was assessed, visually, as being overweight - by nurses and doctors - when she was actually underweight, simply because her bone structure is so heavy that she looks big, no matter what. I know what you're talking about - being a big kid is going to get you labelled "fat", whether you are or not. But, imo, there's a big difference between the other kids calling you fat (which is very hurtful - don't misunderstand me about that) and medical professional labeling you as having a medical condition, just because your body doesn't fit the effing BMI.

 

i would give the ped one more chance instead of dropping her like the plague. plus i am curious what else she asked and discussed. 

 

did she bring up growth spurt, family genes...? 

 

looking at OPs dd there is no way i would call her fat.

 

Obviously, the choice of keeping the ped or not is up to the OP. I don't see a doctor regularly, eihter for me or for my kids. I don't think doctors are the right people to see about my health. I see them when there's something wrong, not when things are okay. OP obviously values her doctor's input more than I do, so I wouldn't expect her to handle the situation the same way I would.

 

And, I agree about her dd. That child is not fat.



 

post #62 of 99
Quote:
Originally Posted by serenbat View Post

What exactly is this BIG harm in having a blood work done?  yes there is a problem or no there isn't

 

or just keep waiting and find out later you really have a problem and live with knowing that you did nothing when it was presented to you-I would not want to live with that

 

 

And where is it that after the results are back the ped won't want to meet with the child? I read what the OP wrote and I did not get that the dr was not going to follow up.

 

Most doctors DO NOT set follow up apts until the results are back-why is this somehow different?


What does a follow-up after blood work have to do with what we're talking about? They're two completely different things.

 

We have different priorities. I'm not going to tell my dd that her body is so screwed up that she needs medical diagnostics run on her, just because a "tool" as useless as the BMI has produced a big number. (And, I'm stlil wondering why the ped got the 97th percentile, when posters in this thread have used the same height and weight to get 94th and 95th

 

And, quite honestly, after seeing some of the idiotic things some of my friends and family members have been told by nutritionists, I don't think I'd be in a big hurry to go that route, either...not without a really, really major indicator that something was wrong. One high BMI, in a child who's at an age where her body is changing regularly, isn't a really, really major indicator.

 

With respect to your comments about finding out it was a big problem, and/or the ped being attacked...not an issue. Unless the ped was suspecting something imminently life threatening, I'm not going to beat myself up over waiting three months to avoid putting my child through the ringer. ("Here, honey - this nice lady is just going to stick a needle in your arm and take some blood, because we have to make sure there isn't a medical reason why you're so fat" is not trivial, imo.)

 

post #63 of 99
Quote:
Originally Posted by choli View Post




Well, I would prefer a minute long trama over a blood draw than to ignore a potential problem for "a few months".

 


"Minute long trauma"? Seriously? I've seen kids crying an hour after blood work, because the pain was worse than they were expecting, and they completely freaked out. Maybe OP's dd wouldn't be like that. Maybe she would.

 

post #64 of 99
Quote:
Originally Posted by mamazee View Post

Peds are crazy about this issue lately. My 2-year-old dd looks average to thin, but because she's 85th percentile for weight, her ped told me she's overweight. Nevermind she's 95th-100th for height! They don't even use logic when looking at these numbers anymore. I see the photo, she doesn't look thin but she certainly doesn't look at all obese either. I wouldn't worry about it.



This actually bothers me MUCH more than the OP.  The OP's pedatrician at least makes *logical* sense--- this is complete nonsense.  I'm not doubting you, I'm just doubting I could ever trust a medical doctor with such a poor understanding of simple mathematics.

 

post #65 of 99

BMI is problematic, especially for children.

 

All my sons are very lean.  Very.  So scrawny that when I posted photos of them swimming, I felt like I needed a disclaimer "Yes, I AM feeding these children!"  You can count every rib front and back, and all their vertabrae.

 

So they aren't fat.  Not even close.  And yet my middle child has a "borderline high" BMI.  Why?  Maybe because he is very compactly build?  Could it be that he is well-muscled for a kid of his build?  It's certainly not an excess of fat, lol.

 

She's a beautiful little girl.  She looks tall and well-fed.  It is normal for little kids to have some roundness and "extra padding".  My youngest still does, and he's just as lean as the others.  But around the face, and on his arms, he's still nice and squishy. :D  And that's not bad.  If she is active and you are feeding her healthy and nourishing foods, I don't think you have anything to worry about at all.

post #66 of 99
Quote:
Originally Posted by serenbat View Post

 

 

 

 

totally agree---ignoring a simple draw - what happens if (AND THIS IS NOT SAYING IT IS THE CASE HERE!) that there is a problem- such as diabetes or thyroid or something else and the child needs to start having regular blood draws? I don't know the family history here- the dr may suspect something - why not error on the side of caution?

 

another thing they also needs to be considered (if the OP has insurance-even state plans) insurance plans simply will not cover waiting a few months and doing another "well visit" - one per year unless there is a problem- the Dr is being proactive and addressing a increase and requesting blood work to see if another visit is warranted  

 

what happens if there is no hight increase and the child continues to gain weight- is it only at that time it is an issue?


I'm still trying to figure out why you (or the ped) would have any suspicion of diabetes or thyroid issues? I really think that if there were a family history of such problems, OP would have mentioned that in her OP, since she was looking for advice and opinions about her dd's weight and health.

 

re: the insurance aspect. If the OP's ped is concerned about her dd's weight, and wants her to come back for monitoring, why would that be considered a second "well visit"?? I know your system is completely screwed up, but I had no idea that monitoring a potential medical condition (and I do not believe there is one here, but the ped does) was the same thing as a "well visit". And, your politicians still have the nerve to talk about you having "health" care??? Really? It boggles my mind that they'll pay for blood work (and referral?), but not a follow-up visit.

 

As to your last question, I'm not even sure how to answer that. Yes - it's only at that time that it's an issue. As it stands, unless the OP left a lot of info (family history of diabetes, thyroid, etc.) out of her post, there is no evidence of an issue, except a completely meaningless number.

 

Another poster also mentioned being labeled "fat", because she was a larger child. That's part of what happened to me, and I've seen it happen to a couple of other people I knew when I was a child. "Fat" can be a self-fulfilling prophecy, and we need to be a lot more cautious about how we throw around sentiments about children's weight. Convince a child that she's fat, and it's not that unlikely that she will be...especially if she was already doing almost everything "right".

post #67 of 99
Quote:
Originally Posted by TiredX2 View Post





This actually bothers me MUCH more than the OP.  The OP's pedatrician at least makes *logical* sense--- this is complete nonsense.  I'm not doubting you, I'm just doubting I could ever trust a medical doctor with such a poor understanding of simple mathematics.

 


We are in the process of transferring our kids' medical records to a different pediatric office. I was so frustrated by this doctor.
post #68 of 99


 

Quote:
Originally Posted by choli View Post




Well, I would prefer a minute long trama over a blood draw than to ignore a potential problem for "a few months".

 


It wouldn't be a minute long trauma for many 5 year olds, mine included.  And yes, I'd wait a few months over this.  A child who's weight increased faster than their height is not a problem.  It's very very normal.  I don't see anything in the op, except the weight %, that is causing all this worry. 

 

For the pp who mentioned the kid who ended up with a tumor, that's not even remotely close to this case.  I'd give serious thought to a ct scan before I agreed to it, it isn't something to be taken lightly.  That argument's just not valid.  Anything could be wrong with anyone regardless of how they feel and grow, so should just start giving kid ct scans, mri's and blood tests randomly, just in case?

 

post #69 of 99
Quote:
Originally Posted by mamazee View Post

We are in the process of transferring our kids' medical records to a different pediatric office. I was so frustrated by this doctor.



That's great!  I can't even imagine trying to not explode if faced with that.  Good luck with your new office :)

 

post #70 of 99

 

 

Quote:
Ped wants blood tests run to check thyroid, etc. and then wants to refer us to a nutritionist. 

 

 

Quote:
I'm still trying to figure out why you (or the ped) would have any suspicion of diabetes or thyroid issues?

ahhhh many be the OP didn't disclose everything here 

 

 

 

apparently you are unaware that you do not need to have a family history of thyroid conditions or be diabetic to have a problem

 

 

 

 

I know of  two children who have no family history and both children have problems that were found via a blood draw and both were not "obese" but it was found after a well visit exactly as the OP's visit seems to have gone.

 

 

 

a "follow up visit" is not a "well visit" totally different 

 

if the OP does not do the blood work and does not have a "follow up" following the results and only request a "well visit" later within the same year-MOST insurance companies will not cover it

 

"well visits" are not "sick visits"


Edited by serenbat - 9/28/11 at 11:22am
post #71 of 99

OP, how you doing today? 

 

You have had, up to now, a good relationship with your ped?  You've trusted her?  Has there been another instance where she's given bad advice?

 

Rather than dropping her I think you should go back to her and ask her to explain more.  Tell her that the last visit really left you shaken and upset, and that you disagree with her conclusion that your dd is overweight.  Tell her the things you told us.  Ask her how much stock does she put into the bmi calculator and why. It's completely fair to challenge her to convince you. 

 

And it doesn't have to be a big confrontation, it can be a friendly visit.  But instead of stewing about it here, go back and ask her to explain herself more.

 

Think of her as a resource and take advantage of that. 

post #72 of 99

It looks like her weight and height are in the same percentiles so I don't think there is anything to worry about.  A child in the 97th for height should also be around that percentile for weight (this is how my dd's pediatrician explained it when I had concerns about my dd being in the 70th percentile for weight when she was in the 75th for height).  If she was a lot lower in her height percentile than she is now then it would be a problem, but IME the pediatrician has always looked at the whole picture not just one part of it. 

post #73 of 99

 

Quote:
("Here, honey - this nice lady is just going to stick a needle in your arm and take some blood, because we have to make sure there isn't a medical reason why you're so fat" is not trivial, imo.)

 

 

Holy cow, Storm Bride. Is that the way you talk to your kids?  I doubt it.  Way to hyperbolize.

post #74 of 99
Quote:
Originally Posted by serenbat View Post

 

 

ahhhh many be the OP didn't disclose everything here 

 


apparently you are unaware that you do not need to have a family history of thyroid conditions or be diabetic to have a problem

 

I'm aware that you don't need a family history. I'm trying to figure out why the ped believes this is something to address...no family history and no symptoms, so...??? I saw the part about the ped wanting to check her thyroid. I don't get why.

 

 

I know of know of two children who have no family history and both children have problems that were found via a blood draw and both were not "obese" but it was found after a well visit exactly as the OP's visit seems to have gone.

 

That's kind of mind-boggling to me, I must admit. I don't know any children with diabetes or thyroid conditions, and I didn't know they were that common. (Oh - I lie. I do know two teens who were diagnosed with thyroid problems when they were young, but they had symptoms - neither one was growing.)

 

 

a "follow up visit" is not a "well visit" totally different 

 

if the OP does not do the blood work and have a "follow up" following the results and only request a "well visit" later within the same year-MOST insurance companies will not cover it

 

"well visits" are not "sick visits"

 

Okay. I had no idea your system was that completely screwed up. I guess if the OP can't afford another visit in the next few months, and doesn't want to wait a year, she's going to have to have the blood work done. That sucks. I still don't get why the ped can't simply tell the insurance company that the child's increase in BMI was above average, and she wants to monitor her weight. It's not like the insurance companies haven't heard about BMIs...everybody else has. But, I'll take your word for it. Nothing I hear about US "health" insurance can surprise me at this point.



 

post #75 of 99
Quote:
Originally Posted by journeymom View Post

 

 

 

Holy cow, Storm Bride. Is that the way you talk to your kids?  I doubt it.  Way to hyperbolize.



No - the point is that it doesn't matter what you say to your kid, because that's what's happening. The doctor says her dd is too fat, and she needs to determine if there's a medical reason. There is no way to honestly answer a child's questions about why they're getting blood work that isn't going to come down to "you're so fat that the doctor thinks you're sick" whether you ever actually use those words or not.

 

Personally, I see the odds of this whole thing triggering issues in the OP's dd as a lot higher than the odds that there's actually a problem. The OP has to make her own decision, obviously. I wouldn't get the blood work or see the nutritionist...and I probably wouldn't go back until the next well child visit (if I did them) unless I noticed her weight going up).

post #76 of 99
Quote:
Originally Posted by journeymom View Post

OP, how you doing today? 

 

You have had, up to now, a good relationship with your ped?  You've trusted her?  Has there been another instance where she's given bad advice?

 

Rather than dropping her I think you should go back to her and ask her to explain more.  Tell her that the last visit really left you shaken and upset, and that you disagree with her conclusion that your dd is overweight.  Tell her the things you told us.  Ask her how much stock does she put into the bmi calculator and why. It's completely fair to challenge her to convince you. 

 

And it doesn't have to be a big confrontation, it can be a friendly visit.  But instead of stewing about it here, go back and ask her to explain herself more.

 

Think of her as a resource and take advantage of that. 


I agree that it would be a good idea to ask for a better explanation than to just drop her, since the doctor may have a genuine concern. I believe that weight should NOT be mentioned by the doctor in front of the child. That is something to discuss with just the parent, especially when the child is obviously not ridiculously overweight. Maybe you can ask for a consult without your daughter present. That would allow you to discuss the concerns in depth without the worry of causing issues with your daughter being worried that she's "fat." As far as other conditions, it is always a possibility. I'd probably opt for a follow-up before blood tests. Diabetes at that age would generally cause weight loss and other symptoms like increased urination. I don't think that is the issue. With the thyroid, you'd also see other symptoms such as fatigue. Unless there is a family history, that likely is not the issue.
post #77 of 99
Quote:
Originally Posted by Storm Bride View Post

Personally, I see the odds of this whole thing triggering issues in the OP's dd as a lot higher than the odds that there's actually a problem.


Yes, exactly.

 

Did the doctor talk about this in front of your daughter? I'd be really upset about that and yes I would move on.

 

I think it is alarmist and bizarre to suspect a thyroid problem in a child who looks like the child pictured and who clearly by her mother's reports is active and feels healthy. For what it is worth, I can think of more think of more than a handful of kids who had similar builds at that age and came from families with healthy eating habits. None of them would be considered overweight as teenagers.

post #78 of 99
Thread Starter 
Quote:
Originally Posted by journeymom View Post

OP, how you doing today? 

 

You have had, up to now, a good relationship with your ped?  You've trusted her?  Has there been another instance where she's given bad advice?

 

Rather than dropping her I think you should go back to her and ask her to explain more.  Tell her that the last visit really left you shaken and upset, and that you disagree with her conclusion that your dd is overweight.  Tell her the things you told us.  Ask her how much stock does she put into the bmi calculator and why. It's completely fair to challenge her to convince you. 

 

And it doesn't have to be a big confrontation, it can be a friendly visit.  But instead of stewing about it here, go back and ask her to explain herself more.

 

Think of her as a resource and take advantage of that. 




OP here. Thanks for so many thoughtful and helpful responses.

DH and I are feeling much better after taking the afternoon and evening to read this thread and talk over the whole situation. First off, this was NOT discussed in front of DD either at the ped's office or at home. The kids were playing in a separate room at the doctor's office so that the ped and I could talk. DH and I have agreed this will not be talked about with anyone else including friends, family, nanny, etc. We are taking no chances that somehow it gets back to DD that she "fat". It's hard enough to be a girl, growing up in a society that expects women to look a certain way and we are certainly doing everything we can to prevent our girls from having body image issues. He was actually even annoyed with me that I posted about it here...I assured him of the anonymity of this particular board but it still made him feel uncomfortable that I'm even putting it out there. He is really worried that DD will find out and be really hurt and traumatized by the "diagnosis".

I think I'm going to take the above poster's advice and call the ped back. I'd like to present her with some of the information and experiences posted on this thread and let her convince me the blood tests are necessary. As I said before, I have a great deal of respect for her (she is holistic and has always been not only supportive but encouraging of our choices). This is the first time I have felt like she is over-reacting.

A few people have asked about us, as a family. DH and I are both very average. I'm 5'5'' and weight about 150. DH is 6'1'' and weighs about 185. Our oldest DD is 7yo and she is tall and skinny. She has a totally different body type than DD though...long legs and built like a stick. It's actually how I looked as a child, until I hit about 25yo. We have no history of thyroid issues, diabetes, metabolic disorders, etc.

I also really paid attention to her eating/exercise yesterday (and this is a normal day for us). She had a sandwich on whole grain bread (1/2, not a whole), hummus and veggies and some homemade minestrone soup for lunch, with cantaloupe after. Normal kid sized portions. She played outside, riding her bike and scooter for 1/2 hour before lunch and 1/2 hour after lunch. During the day, she had snack - these new vegan muffins we sell at the health food store we own. She ate 1/2. It is raw, whole grain and made fresh. Before dinner, we went on a 3 mile run. While, I ran and the kids rode their scooters. But 3 miles is a lot for a 5 year old and she rode a block ahead of me the whole time! We came home from the run/ride and she played with the neighbors on our play set for 1/2 hr. At dinner, I made Mongolian Beef and added carrots, zucchini, broccoli and served it over udon noodles. She had a kid-sized helping and then wanted seconds. DH and I decided to let her have seconds...it's a totally healthy dish. She had a banana for dessert.

The more I'm reading on this thread, the more I think she's getting ready for a growth spurt. She is always hungry and hasn't grown much height-wise in the last 6 months or so. Not sure what I'm going to do about the blood tests. I'd like to speak with her ped again first and then maybe wait 6-8 weeks and see if the growth spurt does materialize.

I appreciate the help here...I knew it would help put things in perspective for me.
post #79 of 99

OP, it sounds like you're handling this all very well and doing what you feel is right.  I honestly see no problems at all, but I think talking to your ped about it some more is a really good idea.

 

 

post #80 of 99
Quote:
Originally Posted by Storm Bride View Post

Personally, I see the odds of this whole thing triggering issues in the OP's dd as a lot higher than the odds that there's actually a problem. The OP has to make her own decision, obviously. I wouldn't get the blood work or see the nutritionist...and I probably wouldn't go back until the next well child visit (if I did them) unless I noticed her weight going up).

 

I agree with this. One of my DDs has some special needs and is a little overweight. The two are related. She has low muscle tone, sensory issues that relate to food, anxiety issues that effect her eating patterns, etc.

 

Because we have moved several times for my DH's job, it is something I discuss with a new doctor's office before taking her in because I believe giving her messages over and over that her body is wrong is only going to make things worse. We focus on healthy eating and being active in ways that feel good. My chubby DD does not need a doctor who cannot understand and appreciate that. It seems pretty basic to me.
 

Every single girl growing up in American right now, regardless of her body build, will get messages over and over and over again that she is fat and that her body is wrong. Her mom and her doctor should be the voices of sanity.

 

 

 


Edited by Linda on the move - 9/28/11 at 2:20pm
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