Extended well-child and well teen physicals

RESULTS FROM POLL TO INVESTIGATE EXTENDED FORMS OF WELL-CILD AND WELL-TEEN PHYSICALS.

By Knut Holt http://www.abicana.com/health_information.htm

In certain areas the health authorities has begun to subject children and teens to extended well-child physicals where one performs several or all of the following procedures: inspections with optical scopes through all or several body openings,ultrasound examinations of most body structures, x-ray taking of joints, EEG and EKG. The kid is often given sedation or even general anesthesia during these extended physicals to make the kid cooperative and to hinder him or her from remembering. Still the kid will remember a lot of details around the procedures and sometimes also from the procedures themselves, because anesthesia never works perfectly, and the kid will always have some symptoms afterwards that tell a lot of what has been done. This poll has the aim of investigating experiences from such ordeals.

I have made a poll to investigate these practices further. Please take the poll if you have experienced something of the kind.

The address of the poll is:

http://www.misterpoll.com/polls/611395

You can also comment at the message board of the poll:

RESULTS FROM THE POLL

Girl, 11yo, North America, internal exams and pelvic exams to record bodily development

This is a report by a father about two exams her doughter went through in North America, 1980-1989, 11 year old and two years later, that was part of a clinical trial.

Rhe parents drove her to the exam at a regular hospital. We had had a routine check up and was given a leaflet about clinical trail looking for healthful volunteer females of a certain age to document changes over time in normal healthy girls.

Overview of the ordeal:

She had a pretty regular check at first in a standard exam room: Height, weight, blood pressure, blood tests etc. She was then taken through into a small room where she was put To sleep. After that she was taken into another room and positioned into stirrups. The nurses then slide her across onto a theatre style bed and she was positioned and secured into stirrups.

Preparations:

She was not allowed to eat some time before the exam. She got laxatives at home to clean out her stomach the day before the exam. She was given a gown but was naked under the gown in the time she stayed awake.

They placed her upon a simple examination table. They placed her upon something like a dentist's chair, but with devices to lift her legs onto. She was placed to lay on back with legs flexed up, spread and mounted upon two devices.

She got IVs, tubes into blood vessels, in an arm, got a device on a finger or a toe to measure pulse and oxygen in blood, got a blood pressure monitor wrapped around an arm or a leg.

She got anesthesia through tubes into blood vessels, and got anesthesia gas to breath in through a mask. She got some numbing and lubricating cream injected into her urinary opening. She was put completely to sleep.

External examinations:

They took chest x-ray pictures, stomach x-ray pictures. They examined her genitals with an ultrasound device. They took measurement of external genitals Labia, hood distance between anus and vagina.

Examinations through body openings:

They took specimens from her throut with a tube. They inspected the inside of her urethra and bladder with a scope. They took specimens from her urethra with a tube. They took specimens from her bladder with a tube. They took specimens from her vagina with a tube.

They took specimens from her anus with a tube. They inspected her through her anus with a rigid scope. The doctor explored her vagina with a finger. The doctor explored her anus with a finger. Mostly I recall them taking lots of swabs from orifices as study was about micro bacteria etc of healthy girls. To see what is normal I guess.

She had a tube going in through her anus. She just lay some time in a bed to recover. I had her underwear on after the exam. Not really we went back about two years later when she had first period as per instruction and the tests were all repeated to assess normal changes. After she came round nurse removed the cannula in arm listened to chest and then, let us go home.

THE SCHOOL SHE ATTENDED:

She attended ordinary daytime school.

COMMENTS

This seems to be a type of standardized exam for detailled recording of body development and health satus of children and teens. The standard seems to have been established in the 1950es, and essentially the same standard is used today, but updated as the technical development has proceeded. The procedure seemed to have been used for research and for examination of children with health problems originally, but it seems to be steadily more used as amandatory or recommended well-child procedures in certain communities at certain ages. These ages are typically 6-7, 11-12 and 14-15. The procedure is essentially the same for girls and boys.

As recorded here the exam consists of specific stages:

• Preparation with laxatives and other means at home.

• A simple ititial procedure consisting of measurement of vital signs and body paramenetrs.

. Induction of anesthesia, often in a special room. The type of anesthesia vary greatly from mild sedatives to deep sedation and even general anesthesia. In this account it looks like deep sedation with means of intravenous medication and gas (probably nitrous oxyde) seems to have been used.

• The kid is placed in a contraption with legs in stirrups and also easy access to the oral cavity and mouth. Here specimens of secretions and microbes are taken from all body openings. Cleaning procedures for body cavities, lubrication og bpdy openings, and local anesthetics to prepare for endoscopic inspections are performed.

• The kid remains in the same contraption or is lifted onto a surgical table, here also with legs in stirrups. X-ray pictures of certain body parts, ultrasound imgaging of most body parts and endoscopic exam through urethra, anus and vagina is done. In the later years endoscopic exam through the mouth down to the sstomach has been more common too. Examination with endosocpe through an opening made in the navel or just beneath is also sometimes reported.

• After the exam the kid will typically lay to recover some time with an IV, monitoring equipment, cathter and often a tube going in through the anus. It seems to be steadily more common to let the kid lay over night to recover. Here no catheter is mentioned, but she probably had it during recovery.

The tube through her anus is mentioned as in most reports. It might have several purposes. One is collection of digestive secrets for analysis. The tube might record bowel movements. It might provide that the colon is empty for air, rests of contrast fluid or other contents before going home.

In this case it seems like the parents were allowed to watch the exam or they were asked to participate in order to answars questions about the doughter that might arise during the exam. Cooperation by parents were fairly common at that period. Now doctors and all authorities are more distrustfyl against the parents and generally do not want parents to watch during more extensive examination of their kids.

Knut Holt