Trip to the ER Because of Diaper Rash

medical-advice

During my pregnancy, when I began my research about circumcision, the number one thing that began to scare me about leaving my sons intact is the constant warning about bad medical advice when it comes to the intact (uncircumcised) baby. Website after website warned about early retraction, proper care, and ensuring that those standards are practiced when your son is being seen by physicians.

You have to know, I take information like this very seriously. And, when it comes to the health of my children, I’m not the kind of person you want to mess with. I have no issues telling a doctor their wrong. My hope however, is that I could learn so much about this issue that when faced with medical advice I knew was not correct, I could guide even a doctor to learning the correct information. Last night, I seriously failed at that entire idea.

It Started With Diaper Rashes

Almost two weeks ago I made a decision to switch the boys from using Luvs, which they have used almost their entire life, to Huggies. I did this because I discovered that if I purchased diapers at Costco, I would spend the same amount as I do on Luvs, but I’d get about 85 more diapers. When you have twins, that’s a very substantial difference. Every diaper available counts. Every diaper is needed.

I change my boys often. I don’t let them sit in wet or poopy diapers. Ever.

huggies-diapers

Within a couple of days of using Huggies, I was not happy with them. They leak CONSTANTLY. Sometimes, even with the first pee in the diaper. And when this happened, I’d change them.

A box of 200 diapers, which should last roughly two weeks, we blew right through. Because, if it wasn’t for the constant leak issue, the boys developed a rash. Along with the rash, they started pooping, a lot; as in 5 or 6 times per day. Not considering that all of this is due to the diaper, I pick up a fresh tube of A&D ointment, and begin to treat the rash.

The rash, quickly, got worse. At one point, it was so severe for Henry that it literally took his breath away for me to wipe him during a change. And immediately after he caught his breath, he would roll over and try to crawl away from me while crying. If this doesn’t indicate my child is in pain, nothing will. But, to add insult to injury, the rash began to puss and bleed with every change.

Joanne and I quickly went to all of our usual diaper rash remedies. A&D couldn’t get it this time. We tried breast milk, no go. We tried Vaseline, no go. I tried prescription power we received when we were discharged from the hospital after their birth. It didn’t work. And then, I went to my trusty Lotrimin. At this point, I knew it was a yeast rash and Lotrimin always does the trick for me with a yeast rash. Still, it didn’t work.

Yesterday, Oliver began scratching. He cannot keep his hands off his diaper, grabbing and pulling at it. And, he laid on the floor and grabbed at his inner thighs, where the rash had begun to spread. At around 7 PM, at another diaper change, puss oozed every where on Oliver as I attempted to wipe him clean. He was crying, puss was oozing, and then there was blood. I decided enough was enough.

I left Oliver without a diaper for awhile, and called the nurse advice line with our insurance. She recommended that we immediately take them to the ER. And not because this was an emergency but because she felt that they could give me something (beyond a prescription) that would be to ease their pain. I was down for anything at this point.

So, we went to the ER.

Our ER Visit

When I looked at our discharge papers, I was surprised to see that our check in time was 8:01 PM, and we were discharged at 8:22 PM. So, keep in mind that what I’m about to tell you took place within a 21 minute span.

yeast-diaper-rash

This is not my boys, but a good example of what a yeast or “candida” rash looks like.

We were seen quickly. From the front desk, to triage, to a room. We moved and never once sat down. While the nurse was half way through taking Oliver’s vitals (weight, temp, and heart rate), the doctor walked in to see the boys.

Without so much as a word or single question to us, with Oliver’s diaper still open from that awful rectal temp, he said to us “oh yes, that’s definitely candida;” otherwise known as a yeast rash.

He asked no questions. At no point did I have any questions about their medical history, including any allergies. Nothing.

The doctor proceeded to explain treatment as he sat down, away from my children…

“What you need to do is retract them, and clean inside to prevent an infection[…]”

You have to know, at this point, I’m wondering what their penis has to do with the trash that is on their butt? Seriously, the rash is nowhere near their penis, nor is it on the top, visible part of their testicles. I have no idea why we’re talking about retraction.

Okay, I admit. I flew off the handle at this guy. I did not handle myself well. I told him he’s wrong, flat out. And when I explained why you DO NOT RETRACT, he attempted to back pedal and claim that’s not what he said.

Too late.

At that point, he blew all credibility with me. And I jumped down his throat. I hate that I cannot trust a medical professional to give proper medical advice. Advice that I know is WRONG! When I called him out for being wrong, his only reaction was to “write a prescription and refer us to a doctor, on the other side of the hospital.”

To add further insult, he suggested that the rash was caused by infrequent diaper changes. To me, that’s just short of telling me that I’m a neglectful mother. You want to see mad? Suggest that again!

I asked that he give us the prescription, and we’ll be on our way.

But, The Story Doesn’t End There!

I am so passionate about circumcision. I am so passionate that my license plates read “No Circ” and I have a decal on my car that reads “Intactivist. Bring Home Your Whole Baby Boy. Oppose Circumcision.” And, I’m anxiously waiting the arrival of my license plate frame that says “Ask me about circumcision!” Are you getting this visual? Passion, no that’s an understatement to how I feel about circumcision.

My concern, at that moment standing there getting incorrect treatment information from this young doctor, is not for my sons. As my friend Melissa put it this morning, when I told her the story, I know my sons are safe. They’re fine. And that’s not where my concern lies. My concern is for the mom and child that come in behind me, receive this advice, and don’t know better.

See, the truth is, I’m not a big fan of the AAP (American Academy of Pediatrics) or their ethics. But, when I can use a medical organization against a doctor, I will. And what I knew he was instructing me to do as “sound medical advice” was not only wrong, but against the recommendations of the AAP.

My mission now, was to prove it.

After just 10 minutes of going directly to the sources, I had the information I needed. Not only on the proper care for an intact penis, but the rash as well.

Armed with this information, I called this morning to issue an formal complaint. The woman I spoke to in risk management was very polite, courteous, and truly listened and understood my complaint. But, my biggest thing for her was the fact that I was not just some rambling mother. I was armed with facts, and information from the “gold standard” of pediatric medical advice. And that, that needed to be seen! She allowed me to send her an email with my supporting documents. That email is quoted here in full:

NAME OMITTED,

Thank you again for taking my call this morning. I appreciate very much the time you took to listen to my complaint, and ensure proper follow up.

Below is the link and quotes from the specific pages I’m sighting. The website is HealthyChildren.org which is a website by the American Academy of Pediatrics, for families.

It is my belief that if a website from the APP can clearly point out the proper care for an intact penis, and causes for this type of “yeast” rash, a medical professional should be proficient in the same knowledge.

Care for an Uncircumcised Penis

From the second paragraph, please note the text in bold:

As a boy becomes more aware of his body, he will most likely discover how to retract his own foreskin. But foreskin retraction should never be forced. Until the foreskin fully separates, do not try to pull it back. Forcing the foreskin to retract before it is ready can cause severe pain, bleeding, and tears in the skin.

Thrush & Other Candida Infections

From the second paragraph:

Very low birth weight babies are susceptible to candidiasis as well.

With this statement, I’d also like to reiterate the fact that my twins were born at 35 weeks weighing in just barely over 4 lbs. They are low birth rate babies, with not fully developed immune systems, and this is the third time this rash has occurred in their 7 months of life.

Having said that, I’d quote the following from the first paragraph of the same page:

When these organisms overgrow, they can cause infections (candidiasis), which sometimes can become chronic.

Had Dr. [name omitted] taken proper medical history, it would be my hope that he would be knowledgeable in this information, to not have attempted to blame me for not “changing their diaper more often.”

I realize that with the vast information on the Internet, doctors are often faced with parents who want to have their doctors follow procedures and information from “Dr. Google.” I would ask you both to know and understand this was not my intention. However, it is my intention that when it comes to the proper daily care for my children, I am well versed to ensure both their health and safety. And probably the height of that for me is the intact penis.

Please deliver my sincere apology for my improper delivery of information to Dr. [name omitted]. And, I would again say to both you and him that my concern is not for the incorrect medical advice that was provided to me; instead, my concern is for the mother and child that arrive at the hospital, are provided with this advice, and are not as knowledgeable in this area as I am.

Again, I thank you for your time and attention to this matter.

Best Regards,

Kathryn Rawson

The woman has acknowledged receipt of my email, and ensured that this information would be provided to both the doctor and his supervisor (the ER attending doctor).

What’s My Point?

As parents, we are the only advocates for our children. There is no one more effective in advocacy than the voice of parents, and I’d bet more specifically, a mother. Be the incident an intact penis, or something else, we need to be armed with information. And though we still need medical professionals to pick up where we can’t (i.e. write a prescription!), it doesn’t give us a right to not know. There is too much information at our fingertips to not be informed.

Furthermore, I’d submit to you that is also our job to share information. Just because a doctor has attended medical school does not mean they are 1) God 2) know more than you or 3) know your children better than you. Your CHILD does not have a voice in their medical care. It is up to you to be INFORMED and TAKE ACTION. And if not for the safety of your own child(ren), than the safety of others who may not know they need to be more informed in a particular subject.

Lastly, and probably most importantly, trust your Mommy gut. There is nothing wrong with teaching anyone, including a doctor.

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