Expert: David Olson, MD - 9/7/2007

Question
Hello Dr. Olson,
 I am going to try to write this in an outline form so it may be easier for you to follow.
 *Daughter born over 3 months premature
 *Eventhough no damage was seen on the brain (2 MRI's)she was diagnosed with extremely mild diplegic CP in her legs.  She was in leg braces but isn't now. Just problems with balance, at times.
 *She's very happy and bright. Scored in the 90th % on  acheivement tests this spring.
 *For @9 months now, she has had bad headaches, lots of stomach pain (sometimes with vomiting), sore throats, easily fatigued and irritable.  The new symptom is bad underarm odor.  It is offensive - we are washing arm pits several times a day!  There is no sign of pubic hair or breast enlargement.

Her MD says it's "probably" migranes because of the stomach issue's.  I'm not so sure anymore with the onset of body odor, fatigue.  I keep putting the thoughts of cancer in the back of my mind somewhere.  I know that you cannot diagnose without seeing her & getting a complete physical.  But, do you have any thoughts on the symptoms and can you direct me on how I should approach her MD?  I have a very good relationship with her MD and usually he orders blood lab work & tests on her, etc.  Lately, he has not and I think it's related to the insurance "nightmare" that MD's are facing now!  Common sense tells me she needs to be checked for diseases and I would hope that my insurance carrier would agree!
I am sorry if I rambled throughout this email.  I am just a concerned parent & I welcome and look forward to a response from you.

Thanks & have a great day!
Dragonfly

Answer
Hi, Dragonfly,

If your doctor is not doing appropriate tests because of insurance concerns, you need a new doctor.

Of course she needs a thorough evaluation and at least some basic blood tests.  I am not sure how the underarm odor fits in, if at all.  I see lots of normal healthy girls this age with underarm odor.

I suspect if you approach your doctor and express concern, he will order a blood count at least.

good luck, Dr. Olson