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Shanabana
Citizen
Username: Shanabana
Post Number: 229
Registered: 10-2005
| | Posted on Monday, February 27, 2006 - 10:11 pm: | 
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My 5 year old has a little potty training issue she needs resolved. Is there anyone "excellent" around here? Or should I just take her into the city and deal with my mediocre HMO? |
Meandtheboys
Citizen
Username: Meandtheboys
Post Number: 3104
Registered: 12-2004
| | Posted on Tuesday, February 28, 2006 - 6:33 am: |
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What is the "issue?" Have you ruled out any possible physical issues first?
Try Dr. Steven Tobias, Center for Child and Family Development in Morristown. |
Shanabana
Citizen
Username: Shanabana
Post Number: 230
Registered: 10-2005
| | Posted on Tuesday, February 28, 2006 - 12:18 pm: |
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The issue is terror when it comes to pooping in the potty. It's causing considerable distress, feelings of inadequacy, etc, because she's aware she's different from other kids. My pediatricians (she's had 2 since she was born) have always said it's plain old constipation, and deal with it using stool softeners. Now she's emotionally dependent on them too. Ugh. |
Shanabana
Citizen
Username: Shanabana
Post Number: 231
Registered: 10-2005
| | Posted on Tuesday, February 28, 2006 - 12:19 pm: |
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Oh, and thanks! I'll call Dr. Tobias. |
Meandtheboys
Citizen
Username: Meandtheboys
Post Number: 3106
Registered: 12-2004
| | Posted on Tuesday, February 28, 2006 - 12:34 pm: |
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I had issues with my 5-year-old and potty training and pooping in the potty, that turned out to be completely a physical problem. But it was one that started long before potty training, from the time he was an infant. I initially saw Dr. Tobias thinking it was purely emotional. If that had been the case, Dr. Tobias would have been great. I know other children who have had purely emotional issues, and he helped resolve them. Our problem was resolved by seeing a pediatric gastroenterologist. I wonder if you should maybe do both, to cover all your bases?
Just a thought. |
Bettina
Citizen
Username: Bettina
Post Number: 116
Registered: 8-2004
| | Posted on Tuesday, February 28, 2006 - 1:44 pm: |
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I'm confused, is Dr. Tobias a psychiatrist or a pediatric gastroenterologist?
By the way, Shanabana, I so sympathize. I've been through the same thing with my little boy. It was hellacious. He's okay now, though, thank god! |
Shanabana
Citizen
Username: Shanabana
Post Number: 232
Registered: 10-2005
| | Posted on Tuesday, February 28, 2006 - 1:56 pm: |
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I've often wondered if there was an internal physical problem, becuase she was so unable to poop when a baby. She never did that soft baby stuff, always grunting, taking at times a week + to poop. Pooping has been really stressful from day one. Now there's always blood in her stools, which my pediatricians have always down-played. I'll try to get to a gastroenterologist, too.
Tobias is the psychiatrist.
Bettina, with your son, did you just wait it out until he fixed the problem himself? |
Meandtheboys
Citizen
Username: Meandtheboys
Post Number: 3108
Registered: 12-2004
| | Posted on Tuesday, February 28, 2006 - 2:33 pm: |
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Shanabana, if you're interested the pediatric gastroentrologist we used was Misha Tyshkov. His office in Summit right by Overlook hospital. I'll try to look up the number, but you could also try directory assistance. I really, really loved him. My son was the same with the difficulty pooping and he ended up with a condition called encopresis, which Dr. Tyshkov was able to help us with almost immediately. If she's already traumatized about pooping, perhaps behavior modification isn't the place to start. Perhaps just making it easier for her to poop is the thing. Dr. Tyshkov prescribed a very mild, very effective laxative that we were able to be on for weeks at time. |
Shanabana
Citizen
Username: Shanabana
Post Number: 234
Registered: 10-2005
| | Posted on Tuesday, February 28, 2006 - 4:43 pm: |
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Thank you! Were you using Dulcolax, or was it something prescribed?
I'll probably have to go the route of the HMO for the physical stuff. If that doesn't seem promising, I'll try your suggestion in Summit. |
Meandtheboys
Citizen
Username: Meandtheboys
Post Number: 3110
Registered: 12-2004
| | Posted on Tuesday, February 28, 2006 - 4:50 pm: |
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It was called Miralax, and it's by prescription. Dr. Tyshkov takes my insurance (HMO), so it would probably be worth checking to see if he takes yours. |
Bettina
Citizen
Username: Bettina
Post Number: 117
Registered: 8-2004
| | Posted on Tuesday, February 28, 2006 - 5:22 pm: |
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Shanabana, with my son, it was mostly waiting it out. However, for him it was clearly a psychological issue where he had tremendous anxiety associted with the transition to using the potty. He had normal, daily bowel movements before that. I'm no doctor, though I am a psychologist, but I would think a gastroenterologist is needed, especially with the blood in the stool. My son took prescription laxatives, too, but just occassionally when he was really holding it in for days. You may be a calmer parent than me, but I would think you could use a little more help than just your pediatrician assuring you everything is fine. For my son, the laxatives made it so he could not hold it in and just as he was about to have an accident I would rush him onto the potty, then make a big deal about his "accomplishment". |
Pdg
Citizen
Username: Pdg
Post Number: 552
Registered: 5-2004
| | Posted on Wednesday, March 1, 2006 - 9:13 am: |
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Hi.
Not sure if this will help you, but I'd like to try! In my experience with my 5 y.o. son (who simply refuses to eat veggies, which is the source of his troubles), the bloody stool may be a result of slight tearing while straining or passing a very hard or large stool. My ped. called it anal fissures and also assured me it was not a "big deal" (I was completely freaked out the first time and was thinking the worst, barely able to contain my tears). The prescription was 20 minute daily soaks in very warm baths (I always add Aveeno oatmeal bath stuff b/c my son also has eczema), a teaspoon of mineral oil before bedtime but not too close to a meal, and push the fluids. I also would put a thin coat of Aquifor (like vaseline but better for healing) on his anus after the bath to help promote healing. When it hurts to go, its natural to just want to avoid it which as you know makes it worse when you finally do go! (poor kid! )
We have to do this every couple of months.
I'm sorry for your daughter that this is such a difficult issue and hope it is resolved soon! The good thing is kids tend to bounce back and forget all about "bad stuff" like this once its over! Good luck!!!
PS. Another tip - Whole Foods sells a great tasting "Yummy Bears" brand fiber supplement that goes a long way toward quickly helping my kids ocassional constipation. It tastes like gummy bears and they just love eating them. I notice gentle results within 24 hours. This may help wean your daughter off the need for laxitives. |
Meandtheboys
Citizen
Username: Meandtheboys
Post Number: 3113
Registered: 12-2004
| | Posted on Wednesday, March 1, 2006 - 9:34 am: |
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We also use a juice that's fortified with lots of fiber. Comes in juice boxes and my kids seem to like it and accept it as just another kind of juice. You really just need one juice box per day to make a difference. This was also recommended by Dr. Tyshkov.
http://www.fiberjuice.com/
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Shanabana
Citizen
Username: Shanabana
Post Number: 235
Registered: 10-2005
| | Posted on Wednesday, March 1, 2006 - 9:44 am: |
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Thanks, we'll try all of the above. She's a trooper, and I'm sure that she'll get over it. It is the case, however, that I've gotten to the point of urging her to the extent that I think I might be hurting the situation. Of curse I would never punnish her,but I do have serious conversations, and have brought up the specter of enemas at the hospital if it gets too bad. Poor thing! |
Meandtheboys
Citizen
Username: Meandtheboys
Post Number: 3114
Registered: 12-2004
| | Posted on Wednesday, March 1, 2006 - 9:53 am: |
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Um, yeah, I think you need to stop that. Maybe if you just back-off for a while don't talk about it or let be an issue, give her all the extra stuff discussed here, and see what happens.
One thing I did learn from Dr. Tobias that I think could be helpful is to make the child be responsible for cleaning up their own accidents, if and when there are any. This way you are not whisking away the mess, and they will hopefully learn not to have accidents simply because they don't want to be faced with cleaning it up. And you must always remain neutral and unemotional about it. Cleaning up the mess should just be a fact, not a punishment or a battle.
I won't go in to the gory details of how we accomplished that here, but if you'd like to hear them, let me know and I can P/L you all about it! |
Pdg
Citizen
Username: Pdg
Post Number: 569
Registered: 5-2004
| | Posted on Thursday, March 2, 2006 - 10:15 am: |
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Shabana - don't feel too guilty, it's obvious that you love your child and want only to help her.
I was told by a counselor that telling my perfectionist 6 yo to "Just do your best, honey!" Very likely is HEARD by her as "Do the best." I thought I was encouraging her to relax and have more fun, and here I was stressing her out even more! SO MUCH GUILT!!!
It's so darned hard to know what young kids are capable of understanding, but I think I've finally learned not to try to explain so much and keep things very, very simple with fewer words. (Of course it's much easier to practice than to preach, but I'm "doing my best!") |
Shanabana
Citizen
Username: Shanabana
Post Number: 236
Registered: 10-2005
| | Posted on Friday, March 3, 2006 - 12:57 pm: |
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I really do try not to pressure her. I pretty much repeat, "it's important that you try," and "it'll happen one day, honey," but also try to emphasize that there ARE some health ramifications if she chooses not to poop for 5 days at a time. She's never gotten to the point of having accidents. She insists on a pull-up. When she turned 4 we stopped using pull-ups (this transition to panties had worked for peeing at 3 years), but she just did the poop routine in the underwear. I got tired of cleaning that, so we returned to pull-ups for number 2.
She's got a bizarre routine of running around, barracading herself behind furniture, shutting and opening doors, hitting the "child's pose" on the floor, etc. This can take like a half an hour. I've tried to limit the pooping terrain to the bathroom, but inevitably she emerges and sneaks into another room, and then sometimes back into the bathroom again. I think she feels the need to run is hampered by the toilet (indeed, she's right).
I got some insight by looking up encopresis. I'll try to create a more regularizing schedule for her. |
Shanabana
Citizen
Username: Shanabana
Post Number: 237
Registered: 10-2005
| | Posted on Friday, March 3, 2006 - 12:59 pm: |
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God, I just realized that my description of her routine makes it sound like she's got an OCD! |
Bettina
Citizen
Username: Bettina
Post Number: 118
Registered: 8-2004
| | Posted on Friday, March 3, 2006 - 2:18 pm: |
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Don't worry, she doesn't sound like she has OCD. I did find it helpful to insist my child remain in the bathroom.
I think you sound like you are doing a great job staying as calm as possible. I found that soooo difficult. |
JLA
Citizen
Username: Janea
Post Number: 7
Registered: 6-2005
| | Posted on Friday, March 3, 2006 - 2:45 pm: |
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It's good to know that other families have these problems. Last summer my 4 yr old decided (after a nast tummy bug) to start witholding and my 2 yr old who was determined not to wear diapers any more just couldn't poop on the toilet. They had a high fiber diet anyway, so we had more problems with accidents than most people here. Some things that helped were:
Giving them a high step in front of the toilet to push against, or even just holding their feet.
Not leaving on fun trips without going to the bathroom first. They understood that it's more fun without an uncomfortable tummy, and they reduced the risk of using yucky bathrooms or having an accident. This wasn't used as a punishment, we always went on the trips, but some were delayed slightly.
Rewarding EVERY poop that made it into the toilet. This also helps you keep track of what's going on if they come looking for a reward each time.
Hope this helps. |
Pdg
Citizen
Username: Pdg
Post Number: 591
Registered: 5-2004
| | Posted on Saturday, March 4, 2006 - 8:45 am: |
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Wow! I decided to order the juice & fiber the afternoon of 3/2 and it arrived the morning of 3/3!!! And that was with free shipping!
I hesitated b/c you have to order a case of 27 for $38. My son (who refuses to eat anything veggie except pumpkin pie) has turned his nose up at other juice "tricks" I've tried, like the fruit & veggie juice mixes at Whole Foods, I think they're called V-ruit?
The great news is, he didn't even blink and is drinking happily as I write! (Purple grape was my choice). I can't believe how easy it is to get 10 extra grams of fiber into him!  |
Meandtheboys
Citizen
Username: Meandtheboys
Post Number: 3146
Registered: 12-2004
| | Posted on Saturday, March 4, 2006 - 10:52 am: |
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Yup, Pdg, customer service is great and shipping couldn't be any faster.
I think the fact that the juice comes in "a box" goes a long way toward fooling the little ones in to thinking it's just the same old, same old.
Brought one to give to my little one with his lunch when we were out yesterday, and he just couldn't wait to get his hands on that "boop boop box." Juice boxes are a big novelty for him and he sucked it down in about 30 seconds!
Let us know how everything "comes out!"  |
Lizziecat
Citizen
Username: Lizziecat
Post Number: 1084
Registered: 5-2003
| | Posted on Saturday, March 4, 2006 - 2:22 pm: |
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I'd like to get the juice for my granddaughter. How many boxes are in a case? |
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