Breast exam for 11yo?? - Page 2 - Mothering Forums
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#31 of 51 Old 11-15-2007, 07:38 PM
 
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I think it's great that your outta there, so mazel tov on that. Truly. It might seem that this is a bad thing, but it is very clearly not as you are going in one direction and the ped is going entirely in another.

It's hard but there does come a time to part divergent paths and call it a day.

As for the labial adhesions, I don't believe that they would be detected in infancy, because I would not allow someone to spread my infant daughter's labia for any kind of routine exam.

We only knew about my daughter's because they tried to catheterize her in the hospital during a very uncoventional situation and the nurse, thankfully, said "oh, your daughter has labial adhesions. They will likely clear themselves up during purberty, but if not they can be treated with a topical hormone (estrogen, was it?) I'm not going to do anything else, we'll just leave her be, I don't want to tear them or hurt her. On to the next thing." Really, Thank G-d for that nurse.

As for tampons, a lot of women don't know about how unhealthy they are and also enough about their bodies to make an educated decision about it as a newly menstrauting woman. I personally would encourage my daughter to not use anything other than soft, cloth pads for some time, until her body was mature enough to give it time for adhesions or anything else for that matter to develop and be dealt with by the body in a normal healthy way. I would also recommend that she go to an GYN or midwife who can do exams and explain things to her and talk with her about issues she should be aware of.

Labial adhesions are common and normal and just another of nature's ways of keeping us healthy and safe.

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#32 of 51 Old 11-15-2007, 07:54 PM - Thread Starter
 
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Originally Posted by PiesandAbrosmama View Post

Yeah sounds like in the long run maybe better to find someone that at least RESPECTS your parenting style instead of being treated like a freak! Not easy, also feeling a rejection I would, but not worth it IMO for the long haul.
Blessings, Sarah
That's why this is so surprising- they ARE very respectful! I thought I had a real "keeper" with this ped's office because they were so respectful to me even though they disagreed with me!

Ruth, single mommy to Leah, 19, Hannah, 18, and Jack, 12
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#33 of 51 Old 11-15-2007, 08:20 PM
 
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Ruthla, I could be way off, but this is what I'm hearing (and NOT judging, hear me out):

The med. establishment taught these dr's. They teach that proactive health care includes one full body exam per year, and regular vaccinations. You have rejected vaccinations, and now are rejecting big parts of the physical exam. They are most likely feeling that you are not helping them to foster a relationship of trust w/your children, who are rapidly becoming adult-like in their physical selves. They are not able to make health care decisions for themselves, but they are becoming young women who will need to care for their changing bodies in ways different from their childhood bodies. To dr's that includes dealing with external genital exams, pelvic exams (which are recommended from the time a girl begins menses) and breast exams.

To this dr. (more likely, rather than the entire practice) it is disrespectful and you are contributing to your daughters' inability to properly care for themselves.

Now I asked you to hear me out because I have made the SAME choices w/my dd (9yo). She didn't want to show her private parts to her dr. and the dr. said she didn't have to, she used her fingers and felt the nodes in her groin and while she was there she kind of gently rubbed the pubis to make sure that it wasn't unduly sore. She did not check her breasts at 9, but my guess is that if she is developing them at 11 or 12 she will do that. I try to back off and let my dd guide the discussion/experience, but I do back her up. We have not vaxxed. It took us several ped/fp practices to find one that seems, like this one was for you, at least open to our choices. The dr. we use now is a DO - which is a type of MD that is somewhat more whole-body than your normal MD. She asks what dd is reading, what sports she is doing, whether she enjoys this or that etc. She is terrific! If they asked us to leave, I'd be devestated! So I can really relate to your issue!

My guess: there is probably a clinic in your area you can use and develop a relationship with. We have one here (we're just south of Albany), and we've gone a couple times, so they now have us on file. That's usually enough to be able to use them on an irregular basis. They can do physicals for school, and deal with prescribing for strep, etc. They are not specifically part of our plan, but they are very low cost, because they are a clinic, not a practice. Maybe there is something like that for you, at least temporarily.

Secondly, if there is a different dr. at the old practice that you did have some kind of rapport with, call and make an appt. to see them. Talk this out, if you can. If you can't, then I think you WILL have to start making phone calls! I'm so sorry. If there is no backtracking, then start thinking about the amazing new practice you will find that works for EVERYONE (you, dd's, hmo, etc.)! They are out there for you, just make it happen powerful mama!

I hope it resolves in the best possible way for you all!

Mama to B and O , wife to J and me to me! :
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#34 of 51 Old 11-15-2007, 09:46 PM
 
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As far as I am aware the "quick peek" at genetals is to look for Tanner staging......you can google that to see all the different stages. It isn't just hair or no hair, but the growth pattern courseness etc. Breast buds the same, but I don't think I would want a doc to touch them at 11 unless there is a problem. Delay in tanner stages is associated with hormonal imbalance, chromosomal abnormailties, enzyme deficiencies, etc plus there is probably something where they have to write it down to cover their behind.

I also think it is probably another chance for them to look at skin that is always covered with clothes for bruising, and signs of abuse, or other moles, lesions. And a way to initiate discussion of sexuality/puberty/questions/bladder issues.

My kids get the quick peek without touching every year, but I go to a female doc so I guess that may make me more comfortable with my daughters.

All that said, that is a really crappy reason to fire a patient! If he thinks it is so important why not fully explain the benefit of that exam? Terrible.
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#35 of 51 Old 11-15-2007, 11:04 PM
 
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Ruth, ask around, friends, moms you know who practice natural parenting, maybe at LLL etc; that way you can find someone more accepting of non-vaxing choices and defiantely someone who respects kids!!!
Hopefully something good will come from this!
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#36 of 51 Old 11-15-2007, 11:22 PM
 
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WOW and you not feeling well to boot.
I would have done the same thing w the exam situation, I will not allow my dd to be humilated like I was.
I was 12 and my mom allowed a male doc at a walk-in clinic to do an exam on me. I was well into a C cup by then and having my periods. I was mortified and I can't believe she did that. It was the last physical exam I had until I went for my first PAP at age 20.

You are an excellent mama for stopping that dirty doctor (I'd use another name, but I'm too nice). I seriously have problems w doc checking young girls out, there is NO medical reason in a standard physical to do so.
My grandmother's didn't go through such an exam as pre-teens, that would have been horrific in their day and it still is.

I'm sorry about the doc firing you, I was terminated from my OB 8wks before I was due for a 3rd c/s. I was not given the 30days notice. I was without care for a while and had a hb. Hind sight, of course, getting terminated altered my life forever in a positive manner.

Instead of posting over in vax, I'll say here I think a larger practice might be a better situation just b/c you are 1 in a million. All you really need a doc for is in the event your children to happen to get sick and possibly to CYB w Medicaid.

I had 1 child get sick on a weekend w our FP and the ER was the only option, the FP doc called us up the next morning to check on us. He never showed up at the hospital. So, I don't see the point of establishing relationships. I also grew up in the military care system during my teen years and young adult life, there is no choice, you get you who get at the clinic. So I suppose I never had the illusion that the doctor is my friend or that there is 1 particular doc who will look out for my care.

You would think they would be more respectful of you, I am assuming you wear your snood out regularly (maybe wrong other head covering). I have found modest dress commands respect from others, it is really enlightening. To me it is a symbol to the world that I follow a higher calling. I have not had our pedi harass me once it was made known our non-vaxing status is for religious reasons and due to my modest dress she would have no reason to think otherwise (in addition to me telling her now gone partner that if G-d wanted my child, no vaccine was going to stop that from happening -- that in response to a threat that if my dd did not have Prevnar she would die in 24 hours from exposure to the deadly strains of bacteria it protects against. It shut her up and I think her jaw dropped to the floor).

Again I'm so sorry you have this added stress.
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#37 of 51 Old 11-16-2007, 05:46 AM
 
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we were kicked out of our ped office for delaying vax (and i was not harassed but teased by one of the other drs for my religiosity) but we found a family practice dr who we LOV?ED . they are usually more open and chill. can you see one of those?
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#38 of 51 Old 11-16-2007, 01:38 PM
 
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I'm really creeped out by a male dr, wanting to examin any young girls' vaginal area. Just a gut creepy feeling. Probably just me and my own hangups with men and little girls, but had to just say it.
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#39 of 51 Old 11-16-2007, 03:00 PM
 
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Ruthla, I think you did what was right. I'd definitely complain to Medicaid and then, ask around for a more respectful ped.

I just can't see why a doctor couldn't give some literature to mom and daughter about what happens at puberty, what to watch for, etc. and then go over it with mom and daughter. I absolutely would not allow an exam either.
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#40 of 51 Old 11-16-2007, 05:03 PM
 
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If you only have an MD for emergencies and school physicals, I would probably take a random dr. for emergencies and get no more physicals. If you're in CA, I believe you can waive physical examinations. I know you can do it for kindergarten, here is the text:

Parents' Right to Waive Exam

A parent or guardian having control or charge of any child enrolled in the public schools may file annually with the principal of the school in which he is enrolled a statement in writing, signed by the parent or guardian, stating that he will not consent to a physical examination of his child. Thereupon the child shall be exempt from any physical examination, but whenever there is good reason to believe that the child is suffering from a recognized contagious or infectious disease, he shall be sent home and shall not be permitted to return until the school authorities are satisfied that any contagious or infectious disease does not exist. (CEC 49451)

I wasn't aware that physical exams were required annually for public school. If exams are needed for participation in sports or other activities, my crunchy school friends say they use chiropractors or NDs or DOs. The form I had a DC fill out for my dds participation in a wilderness camp asked for the signature of "health professional."

Of course I agree with pps that you're right to stand up for your daughter's privacy and sovereignty over her own body! And it DOES seem creepy and unnecessary to insist on such exams at that age. I would also complain to Medicaid and the HMO. Is there any way you can find out if breast exams and visual inspection of genitals is the "standard of care" for 11yo girls in your area?

I'm sorry you're going through this.
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#41 of 51 Old 11-16-2007, 06:44 PM
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Wow! Have things changed since I was a girl? I don't recall any genital or breast exam when I was 11 years old. In fact, I don't think I had any such exams until I went to a gynocologist for the first time and that was when I was in college!

I would have had the same reaction, Ruthla.
Same here. There is no reason for genital exams of pre-pubescent non-sexually active girls, notwithstanding prior conditions or another problem (such as needing to rule out gynecological problems as a source of abdominal pain, etc.)
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#42 of 51 Old 11-16-2007, 10:26 PM
 
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Am I the only one who thinks looking at the genitals is of consequence in a physical? It is standard of care, and on every physical check list. My doc groups 11-14 year olds as adolescents similar to this form http://www.chcpf.state.co.us/HCPF/EP...ev%2004doc.pdf

I think a physical is a chance to check out everything regardless of symptoms. I would expect my doc to listen to her heart even though she wasn't feel palpitations or having trouble breathing. I think maybe those of us who post on these boards are more tuned into our kids and that is why many feel it isn't warranted. To the doc, who knows the kid could be getting abused, or not developing, or developing too early, or whatever else. Her genitals are as much a part of her body as her lungs and eyes. I don't want just anyone looking, but I want my children to know the appropriate people to turn to, and that includes sexuality.

You could certainly complain about being fired and the way he fired you, but the doc wasn't out of line with the exam. I also think it is a crock and he used this as an excuse to fire you cause you won't vax.
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#43 of 51 Old 11-16-2007, 10:47 PM
 
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No, you aren't the only one who thinks of genitals as part of the human body, worthy of the same care that the rest of the body receives.

If you don't buy into medical care, that's your choice. But the point of a physical exam is to ensure that the body is growing and developing appropriately. There are many, many reasons to check for appropriate sexual development (all externally). IF you don't agree, that's fine, but please, don't disrespect the docs opinions just because they differ from yours . . . .

Perhaps your doc did you a favor by letting you know that s/he was going to have a difficult time remaining supportive of your choices, giving you the opportunity to look elsewhere for a more like-minded provider of healthcare. Hope you find someone soon.
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#44 of 51 Old 11-17-2007, 05:12 PM
 
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What about calling the office to speak with the office manager- tell her what went down- ask about their policy on young ladies and why the dr wanted to do an internal and if necessary- ask to meet with the dr and the mgr.

I think an internal is not of the norm here and unless your daughter is overly developed and menstruating and sexually active there should be no reason.
Ask them why. Or ask to see another doctor in the practice.
I would never never never allow anyone but a gyn to do an internal.

A young women of that age is so sensitive about her body that a good doctor would be aware of that and explain his intentions- discuss them with the patient and parent.

I've found that when I am confronted by the Drs. about vaccinations I say that my research is still out, that I am still investigating- I listen to what they have to say- nod, smile and politely say I'd like to wait. Getting angry and opinionated has a negative affect. I never ruffle anyones feathers and never get confrontational. I take all the scripts and all the pamphlets and trash them as soon as I leave the office.
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#45 of 51 Old 11-17-2007, 05:39 PM
 
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I am sorry you had to go through this....

A friend of mine went through something similar a bit ago and ended up staying with the practice but making sure she saw other doctors in the practice by scheduling visits in advance and (luckily hasn't had any emergencies come up where she gets luck of the draw...

She is currently leaving the practice and wrote a nice long letter to them, cc'd to the HMO (she has insurance through the state too) bc she called to get her 2 girls scheduled for their flu shots and the lady on the phone asked what her insurance was and she told her, "Please hold a minute" and when she came back, she was told that they were out of flu shots for "those" children and to call back in a bit when they *may* have more....Another friend of hers called later that day to schedule her dd and ds's flu shots and was able to get right in (they aren't on state funded insurance)......they had the flu shots there....

My friend was livid as there are only a handful of pediatricians who accept the insurance and wanted to know how the shots were different....Are there different flu shots for state insurance vs private insurance....????? Just alot of BS and being treated differently......so she's looking........

((hugs)) I hope they didn't fire you......
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#46 of 51 Old 11-17-2007, 09:53 PM - Thread Starter
 
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I have no problem with my daughter having a genital exam (it would have been only an external exam) but SHE had a problem with it, so I stood up for her. I don't want her to lose trust in me or to feel unsafe with doctors in general.

And is is REALLY necessary for a doctor to palpate the breasts of an 11.5yo?

Ruth, single mommy to Leah, 19, Hannah, 18, and Jack, 12
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#47 of 51 Old 11-17-2007, 10:02 PM
 
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I asked our doc about the genital exam and he said that he doesn't perform them on girls unless the girl and/or parents have "the wrong" answers to his questions (such as presence of pubic hair, for example) or feel something is wrong or want one. He gives shower head hanger cards about self testicle and breast exams though said he does check testicles on most boys because they usually say yes or the parents do...guess they see it as less invasive? no idea.

"Parents are simply trustees; they do not own the bodies of their children"-Norm Cohen  Martial arts instructor intactlact.gifhomebirth.jpgnak.gif and mom to 4: DD1 (1/05) DS (7/06) DD2 (5/08) DD3 (2/11)
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#48 of 51 Old 11-17-2007, 10:28 PM
 
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i'm sorry this happened to y'all ruthla. your dd is old enough to have an opinion of who she wants hanging around her genitalia and breasts IMO, and a dr should respect that of any girl close to adolescence (sp)

l, <>< wife to my sweetie, proud mama to 3 cubs, 2 who clw & 1 that i i ep for . baby was evicted early by induction due to severe pre-e/hellp syndrome
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#49 of 51 Old 11-17-2007, 10:54 PM
 
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I have no problem with my daughter having a genital exam (it would have been only an external exam) but SHE had a problem with it, so I stood up for her. I don't want her to lose trust in me or to feel unsafe with doctors in general.

And is is REALLY necessary for a doctor to palpate the breasts of an 11.5yo?

I misread the original complaint. I didn't realize the doctor wanted to palpate her chest. That I would have a problem with unless pathology was found at a glance. I would say no to touching an 11 yo, but a visual examination I would allow. And we could discuss anything further required based on the visual inspection.

Maybe you should look for a female doc for your daughter to see if there are any on what sounds like a pretty abbreviated list.
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#50 of 51 Old 11-17-2007, 11:13 PM
 
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Honestly, I would have a serious problem with a doctor wanting to examine the genitals of my pre-pubescent, non-sexually active child without a definitive reason- not just as part of an exam.
And if my child objected, there would be no way in hell that I would force her to have the exam.:

I think you did the right thing by protecting her.

Realistically, any doctor who is working with young girls should be sensitive to their modesty and feelings (which are usually very strong at this age), and should not be allowed to use an unwillingness to have their genitals examined as a reason to fire you as a patient.
I would report this doctor, to the office manager, to the insurance, and to the board that directs and oversees his practice.

Homeschooling mom of 2 rambunctious, loving, spectacular boys, wife to an incredible man who has been my best friend on this journey <3

 

 

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#51 of 51 Old 11-18-2007, 01:01 AM
 
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Honestly, I would have a serious problem with a doctor wanting to examine the genitals of my pre-pubescent, non-sexually active child without a definitive reason- not just as part of an exam.
And if my child objected, there would be no way in hell that I would force her to have the exam.:

I think you did the right thing by protecting her.

Realistically, any doctor who is working with young girls should be sensitive to their modesty and feelings (which are usually very strong at this age), and should not be allowed to use an unwillingness to have their genitals examined as a reason to fire you as a patient.
I would report this doctor, to the office manager, to the insurance, and to the board that directs and oversees his practice.

: I couldn't agree more. Neither of my girls had their genitals checked at this age. Their dr. just asked questions pertaining to their development and that was that.

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