I am often amazed at what parents tell me about the pediatric care their children are receiving or not receiving in the U.S. One mother told me her daughter's pediatrician had never looked below the child's waist. I was appalled. I have found many abnormal things by doing a complete physical exam once a year on kids.
When I ask parents if yearly urinalysis are done, the answer is usually "no". Every child, even little ones, should have a yearly urinalysis done. I have been amazed at the many problems I have found by doing this. One teenager was not feeling well when I examined her, but I was unable to find anything wrong. I did check a urine, but it was O.K. I asked the girl's mother to bring her daughter back the next day. Once again, there was nothing specific I could find wrong. I asked for another urine and the mother said, "but you did one yesterday." I told her I would not charge for doing it, but did want another urine. The girl brought back a urine specimen that was brown. I knew immediately she had pyelonephritis. This can be extremely dangerous and I started her on antibiotics. The mother was very grateful and subsequently referred many other kids to me. I saw the teenager many years later in San Francisco when I was doing a book signing and was delighted that she looked so happy and healthy. So parents please insist a yearly urinalysis be checked on your children. A lot of problems could be found and helped.
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