|
Post by cmcgowan on Dec 1, 2008 16:00:15 GMT -5
Hello.
I have a concern about Keirsten my 3 1/2 year old . Just wondering if it is related to being hypopit or not. She has been potty trained sense she was 2 except at night. In the Morning she is socking wet. Through diapers, blankets and sheets. I have to change her most of the time once in the middle of the night. Then last night I ran out of diapers at bed time and the stores were closed in our town. I thought I would just lie down a thick blanket and some towels knowing I would have to get up to change it at least once, but little did I know I would be up over 5 times to clean up her and the mess. It just seams like a lot of times to go potty in the night. I have even tried not letting her drink to close to bed time and that seam to make no difference at all. She goes potty several times a day, but she drinks a lot during the day. I am not concerned that she is not night time potty trained ( even though my other two were before that age) but that she has to go so often. She has been tested for DI in the past and it has been fine. Just wondering if it was related to being hypopit. Her meds are GH 0.6, TH 50 mcg, corteff 2.5, 2.5, 5 Thanks, Carolyn mom to Keirsten 3 1/2 hypopit
|
|
|
Post by justaustin on Dec 1, 2008 20:52:15 GMT -5
Sounds like our 4.5 year old daughter. Potty trained by ate 2.5. Drinks and pees all the time if she has her way... We tried to see if she could stay dry at night 6mos ago. NOT!! TOO many linen changes.
Two months ago we started again. We wake her up before we go to bed. She is staying dry. Occasionally she will get up on her own. Her ADH hormone should be increasing. Should be highest at night.
How long ago did you have her ADH tested? Have you had fasting glucose and fasting insulin checked? Laurie
|
|
|
Post by cmcgowan on Dec 1, 2008 21:49:42 GMT -5
She had the antidiuretic hormone tested about a year ago, but it came back fine. She does does not take antidiuretic hormone, I was told that she does not have DI. She just takes GH, TH and Cortef. Is it possible for her to have developed DI. I was told by the Dr that if she does not have it now that she most likely will not develop it. I was also told when she is congenital hypopit she also has a less like chance of having DI. We have had fasting glucose done a couple of times not on purpose. It has been below 20 at times. Very scary. She has big troubles with hypoglycemia so she is not allowed to fast for any test. She ends up having a seizers if her sugar get low. She has done better with her sugars now that we have her GH up and given her a higher amount of cortef at night. They have tested her insulin when she has had a low and it has been there was no insulin. That is how it is suppose to be right?
|
|
|
Post by justaustin on Dec 2, 2008 15:46:22 GMT -5
I'm sure Chris and Lee will have more to add. Here's a start.
Two things come to mind with extremely low glucoses. I've seen single digit glucoses with folks who are end-stage liver failure at death's door in ICU. I don't think that's the case. I think that more likely is she isn't on enough cortef. Hypoglycemia is strongly associated with cortisol insufficiency. Do you have her ADH results? Don't settle for "normal". Normal and optimal are not the same. Her ADH should be increasing as she gets older. It is also highest at night. 6 months may make the difference.
Another association with night time enuresis is sleep apnea due to enlarged tonsils and/or adenoids. Does your daughter snore? Does she have large tonsils? Our son didn't stay dry until after he had his huge tonsils and adenoids removed at age 4.5. He struggled to breathe while he slept. Could only sleep with mouth open..
What is your daughter's sodium and potassium. Have you had aldosterone/renin tested? Follow Chris' recommendations for testing.
Laurie
|
|
|
Post by cmcgowan on Dec 2, 2008 16:27:55 GMT -5
Is and ADH test the same as a Renal Function Panel? If so here are her results Renal Function Panel Electrolytes Sodium, Serum 137 (135-146) Potassium 4.2 (3.8-5.1) Chloride 105 (98-110) carbon dioxide 22 (16-26) Bun Creatinine Glucose Urea Nitrogen, Blood 10 (3-14) Creatinine 0.3L (0.5-1.2) but under that it say patient is <18 years old. Unable to calculate. random glucose 72 (65-99) calcium/ 9.9 (8.5-10.6) phosphorus 5.2 (4.0-8.0) albumin 4.1 (3.6-5.1) protein 6.2 (4.8-7.8) globulin 2.0 (2.0-4.0) A/G ratio 2.0 (1.0-2.5) Ast 34 (3-35) bilirubin 0.4 ALT 13 (3-40) Alkaline posphatase 140 (50-270) This was done in July of 2007
|
|
|
Post by justaustin on Dec 2, 2008 16:52:17 GMT -5
ADH is not part of the renal function. ADH is Anti-Diuretic Hormone or Vasopressin level.
Certainly kidney function is looked at when evaluating fluid status.
Does your daughter crave salt? Does she sweat a lot in the heat? Does she avoid the heat? Your daughter's sodium is on the low end.
I think she needs to have aldosterone and renin tested, IMHO.
Laurie
|
|
|
Post by cmcgowan on Dec 2, 2008 17:35:52 GMT -5
Keirsten does not function well in the heat at all. She seams to crash and looks bad. She crave all kinds of food and is constantly eating, but is small for her age. 3 1/2 she is 23lbs I have asked the Dr about her aldosterone and renin tested, but was told it was not necessary. I will ask again when we go in the beginning of January and a ADH test. Thanks Carolyn
|
|
|
Post by justaustin on Dec 2, 2008 17:58:54 GMT -5
Where do you live?
Don't ask, insist.
Laurie
|
|