FW

[tipper]

5 or 6 times in a three year period? That doesn't sound to me. But I remember that was a lot of arguing about that ten years ago.

Your view is at odds with "other pediatric experts."

 

[BrendaStar]

Your view is at odds with "other pediatric experts."

But not at odds with being a mother and have taken a young girl JBR's age to a pediatrician. Any one who has raised a girl will know what I am talking about.

 

[tipper]

http://www.drpaul.com/library/VAGINITIS.html

: Vaginal Discharge Common In Young Girls

DEAR DR. PAUL: My four year old daughter seems to have a lot of discharge. Even though she is bathed every day, but the end of the day her panties are messy, almost greenish tinged. I don't know if it is normal for this age, or should I be concerned?

PEDIATRICIAN DR. PAUL Answers: This is common problem in girls less than 8-9 years of age. Although it is impossible for me to make an exact diagnosis, I will describe the various possible causes of vaginal discharge known as "vulvovaginitis". The exact treatment will depend on the cause. The term vulvovaginitis refers to inflammation of the female external genital area. Inflammation can occur in any of the following ways:

Irritation

Irritation from bubble baths or the use of strongly scented soaps. Other products than can irritate the area include soaps, detergents or softeners used to wash the underwear. Wearing tight fitting nylon underwear can also result in irritation.

Another cause of vaginal irritation in young girls has to do with the way the anal area is wiped with toilet paper. We recommend that wiping be done from "front to back" rather than "back to front", as the latter way can spread fecal matter and bacteria to the genital area.

http://www.netwellness.org/question.cfm/4507.htm

Question:

My 9 yr. old daughter was diagnosed w/vaginitis (no fever, urinalysis clean). We followed the on-call dr's. advise; plenty of fluids, baking soda sits baths. She started to feel better w/in a week so we discontinued therapy. Soon after symptons returned. Her regular peditrician suggested to continue w/sits baths for 21 days. After that, if there was no improvement use Gynalotrimen (or similar). Well, my daughter is not feeling any relief, still feels the need to urinate frequently & is complaining of itching & some burning on urination. I'm still giving the sits baths but have now begun the Mycelex7. Could there be any other problems we are unaware of? (This problem has been going on for @ least 3 wks. She is frustrated w/being "sick" for such a long time)

Answer:

"Vaginitis" is a commonly diagnosed in children. Sometimes irritation of the vagina in children may be due to a true infection, either bacterial or yeast. More often it is just a nonspecific irritation due to a host of factors. Sometimes children may not be wiping from front-to-back. Wiping in the other direction brings bacteria to the vaginal area promoting infection. Some children may be chronically in damp but not wet underpants. If a child waits too long before urinating small amounts of urine may leak out and lead to irritation. In some girls, some urine may actually pool in the vagina and lead to dampness once the child arises. Vaginal irritation, especially if associated with urinary frequency or urgency may also be related to relative constipation. Even if a child is having a daily bowel movement, if he or she is not emptying completely, the stool that is left behind can lead to all these symptoms. Most parents are surprised (and skeptical) that subtle constipation can lead to urinary symptoms. Initially therapy usually involves sitting in warm water several times a day in conjunction with proper hygiene (wiping from front to back), wearing loose fitting underwear and making sure the genital areas are dry. It will help to place the child on a high fiber diet. If symptoms persist, then an anti-yeast cream may help. With a normal urine sample, urinary tract infections are not the cause of her symptoms. Once the present symptoms are controlled, further episodes can be prevented by proper hygiene and bladder/bowel habits.

http://www.drgreene.org/body.cfm?id=49&action=Display&articlenum=897 Nonspecific vulvovaginitis (where no causative organism or irritant can be identified) can be seen in all age groups, but it occurs most commonly in young girls before puberty. Once puberty begins, the vagina becomes more acidic, which tends to help prevent infections. Nonspecific vulvovaginitis can occur in girls with poor genital hygiene and is characterized by a foul-smelling, brownish-green discharge and irritation of the labia and vaginal opening. This condition is often associated with an overgrowth of a type of bacteria that is typically found in the stool. These bacteria are sometimes spread from the rectum to the vaginal area by wiping from back to front after using the bathroom.

 

[BrendaStar]

Nowhere does it say medically that the five or six vaginal exams were for vaginitis. That interview only talks about one specficallly. And, if that were true, then Dr. Buef should have sent JBR to a specialist to check her out for diabetes.

 

[sissi]

I've had girls, "whadayawanta know"? That girls get infections all of the time? For every antibiotic there is usually a yeast infection. I once asked the doc why it didn't seem to happen to other kids, he said, "oh it does, the moms may not be alert to the symptoms, or they wait for "tincture" of time to heal, and it will". Costumes, oh lord, were they a "breeder", new tights, costumes and hours of practice and one could be assured of an "itch". To avoid this,
Don't wear too tight pants
Buy cotton underwear
Take your pantyhose or workout gear off as soon as you get home
Always clean your genital area from front to back…to avoid spreading bacteria to the vagina

 

[Moab]

A 2 second Google search would have given any of you the correct answer instead of speculation...

I hadn't noticed, but you're right, we haven't heard anything about the pediatrician lately.

I don't think the pediatrician has disappeared but I did read the he is no longer practising, retired I believe.

The pediatrician and his records has since disappeared. Something to think about.

The good doctor is alive and well and still practicing medicine.

http://63.225.116.107/~bcms/Beuf.htm

 

[aussiesheila]

http://www.drpaul.com/library/VAGINITIS.html

: Vaginal Discharge Common In Young Girls

DEAR DR. PAUL: My four year old daughter seems to have a lot of discharge. Even though she is bathed every day, but the end of the day her panties are messy, almost greenish tinged. I don't know if it is normal for this age, or should I be concerned?

PEDIATRICIAN DR. PAUL Answers: This is common problem in girls less than 8-9 years of age. Although it is impossible for me to make an exact diagnosis, I will describe the various possible causes of vaginal discharge known as "vulvovaginitis". The exact treatment will depend on the cause. The term vulvovaginitis refers to inflammation of the female external genital area. Inflammation can occur in any of the following ways:

Irritation

Irritation from bubble baths or the use of strongly scented soaps. Other products than can irritate the area include soaps, detergents or softeners used to wash the underwear. Wearing tight fitting nylon underwear can also result in irritation.

Another cause of vaginal irritation in young girls has to do with the way the anal area is wiped with toilet paper. We recommend that wiping be done from "front to back" rather than "back to front", as the latter way can spread fecal matter and bacteria to the genital area.

http://www.netwellness.org/question.cfm/4507.htm

Question:

My 9 yr. old daughter was diagnosed w/vaginitis (no fever, urinalysis clean). We followed the on-call dr's. advise; plenty of fluids, baking soda sits baths. She started to feel better w/in a week so we discontinued therapy. Soon after symptons returned. Her regular peditrician suggested to continue w/sits baths for 21 days. After that, if there was no improvement use Gynalotrimen (or similar). Well, my daughter is not feeling any relief, still feels the need to urinate frequently & is complaining of itching & some burning on urination. I'm still giving the sits baths but have now begun the Mycelex7. Could there be any other problems we are unaware of? (This problem has been going on for @ least 3 wks. She is frustrated w/being "sick" for such a long time)

Answer:

"Vaginitis" is a commonly diagnosed in children. Sometimes irritation of the vagina in children may be due to a true infection, either bacterial or yeast. More often it is just a nonspecific irritation due to a host of factors. Sometimes children may not be wiping from front-to-back. Wiping in the other direction brings bacteria to the vaginal area promoting infection. Some children may be chronically in damp but not wet underpants. If a child waits too long before urinating small amounts of urine may leak out and lead to irritation. In some girls, some urine may actually pool in the vagina and lead to dampness once the child arises. Vaginal irritation, especially if associated with urinary frequency or urgency may also be related to relative constipation. Even if a child is having a daily bowel movement, if he or she is not emptying completely, the stool that is left behind can lead to all these symptoms. Most parents are surprised (and skeptical) that subtle constipation can lead to urinary symptoms. Initially therapy usually involves sitting in warm water several times a day in conjunction with proper hygiene (wiping from front to back), wearing loose fitting underwear and making sure the genital areas are dry. It will help to place the child on a high fiber diet. If symptoms persist, then an anti-yeast cream may help. With a normal urine sample, urinary tract infections are not the cause of her symptoms. Once the present symptoms are controlled, further episodes can be prevented by proper hygiene and bladder/bowel habits.

http://www.drgreene.org/body.cfm?id=49&action=Display&articlenum=897 Nonspecific vulvovaginitis (where no causative organism or irritant can be identified) can be seen in all age groups, but it occurs most commonly in young girls before puberty. Once puberty begins, the vagina becomes more acidic, which tends to help prevent infections. Nonspecific vulvovaginitis can occur in girls with poor genital hygiene and is characterized by a foul-smelling, brownish-green discharge and irritation of the labia and vaginal opening. This condition is often associated with an overgrowth of a type of bacteria that is typically found in the stool. These bacteria are sometimes spread from the rectum to the vaginal area by wiping from back to front after using the bathroom.

Yes Tipper you have posted some very good explanations of how vaginitis can arise but you haven’t posted ALL of them.

The last one of your links, unlike the first two which presumably are answers to mothers written in ‘nice’ magazines, is a reference article and it mentions another possible cause of vaginitis “Sexual abuse should be considered in children with unusual infections and recurrent episodes of unexplained vulvovaginitis. “

I did some Googling myself and came across this article

Comment in:

* Am J Dis Child. 1990 Oct;144(10):1073-4.

Urinary tract symptoms and urinary tract infection following sexual abuse.

Klevan JL, De Jong AR.

Department of Pediatrics, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pa.

During a routine follow-up visit, 428 victims of sexual abuse and their caretakers were asked about genitourinary complaints. Symptoms elicited included vaginal pain, increased urinary frequency, dysuria, and enuresis. A urinalysis was performed for all victims with symptoms, and those with positive or equivocal urinalysis results had a urine culture done. Urinalysis and urine culture were performed on a control group of 53 consecutive asymptomatic victims. Twenty percent (85/428) of the victims complained of one or more genitourinary symptoms. The most common symptom was vaginal pain (51%). Of the symptomatic victims, only 2 had a urinary tract infection. None of the 53 asymptomatic control victims had a urinary tract infection. There was no significant relationship between the presence of genitourinary symptoms and repetitive abuse, genital trauma, vaginal contact, or gender of the victim. However, patients younger than 6 years of age were more likely to have genitourinary symptoms than older patients. These findings indicate that urinary tract symptoms following sexual abuse are common but that urinary tract infection is quite uncommon. Our study does not support routine screening of children for urinary tract infection solely because they have been sexually abused.

 

[Nuisanceposter]

I think by now it's safe to assume that JonBenet had been being molested for a while and that Patsy had to have at least suspected something if she kept taking her daughter to the doctor again and again. I cannot possibly fathom why Dr. Beuf didn't suspect it himself.

 

[sissi]

I don't believe it's "safe to say" at all, there is absolutely nothing in her pediatric records to suggest she was a victim of molestation.
However, I will agree, since there are two camps of doctors, one saying molestation occurred only at the time of the murder, the other suggesting molestation occurred within three days of the murder,there is a possibility that on the 23rd. someone touched her. My opinion still stands that the bulk of the evidence suggests IMO that the crime on the 25/26 was the only crime. If we are to consider that something occurred within the few days before her murder, we can substantially reduce the suspect pool, while allowing for a motive for murder ,as well.

 

[aussiesheila]

http://jfjbr.tripod.com/truth/bynum.html

SAWYER: But what about those reports that JonBenet's pediatrician, Dr Beuf, saw JonBenet 30 times in three years?

BEUF: Before your call, I sat down with her chart and counted. It was 27 times.

SAWYER: This is the first time Dr Beuf has gone over his records publicly.

And is that unusual to see a child that many times?

BEUF: Not with the kinds of problems which this child had. The majority of them were for sinus infections and for colds.

SAWYER: And by majority you mean?

BEUF: Probably 20 of the lot. I counted three in which she'd complained of some pain in urination. And the rest of them were cold, strep throats, sinus infections.

SAWYER: So many he said, there was some concern about asthma.

How many times did you give her a vaginal examination?

BEUF: Well, it was five or six times in that three year period.

SAWYER: We asked him to specifically review all notes that might pertain. He agreed, citing the frenzy of uninformed speculation. Be warned, these are a doctor's clinical notes about a young patient.

September 1993 a call about vaginal redness, possibly associated with recent diarrhea.

April 1994 a visit about a problem perhaps related to the use of bubble bath, which can be an irritant.

October 1994 a routine physical. No problems noted, though some indication of occasional bedwetting. Dr Beuf says 20 percent to 25 percent of children that age wet the bed.

March 1995 abdominal pain and fever. Tests and exam showed no problem.

August 1996another routine physical with a vaginal exam. The doctor said everything checked out as normal. We asked what he made of this number of complaints?

Would that be unusual?

BEUF: For a child that age, certainly not. They don't wipe themselves very well after they urinate. And it's something which usually is curable by having them take plain water baths or learning to wipe better. But if you have 4yo kids, you know how hard that is. The amount of vaginitis which I saw on the child was totally consistent with little girls her age.

SAWYER: If there had been an abrasion involving the hymen, you would have seen it?

BEUF: Probably. I can't say absolutely for sure because you don't do a speculum exam on a child that young at least unless it's under anesthesia.

SAWYER: Did you see in any of these examinations any sign of possible sexual abuse?

BEUF: No, and I certainly would have reported it to the social service people if I had. That's something that all of us in pediatrics are very acutely aware of.

SAWYER: And some other notes. Dr Beuf says he last saw JonBenet Ramsey in November 1996, and that was a checkup for a sinus infection. A couple of other things. Dr Beuf says he has turned in people he has suspected of physical and sexual abuse in his career, and that he not only looks for physical evidence, but personality changes in the children involved. And he says he saw none of that with JonBenet Ramsey. And PrimeTime consulted other pediatric experts about JonBenet's records, and they agreed with Dr Beuf's analysis that there was nothing unusual there for a girl her age. When we come back, we will take you to the Ramsey home

In his television interviews the pediatrician said he saw JonBenet about 30 times (27) over a 3 year period

He said the majority (20) of visits were for sinus infections and for colds and strep throats



When asked if he had seen an abrasion involving the hymen

he answered "You don't do a speculum exam on a child that young at least unless it's under anesthesia"

I think you have to take from that somewhat evasive answer that he wants it to be publicly believed that he didn't ever examine her internally.

So IMO if he hadn’t done an internal exam on JonBenet he was in no position to have stated to the police with respect to her having possibly been sexually abused "Absolutely, categorically no. There was absolutely no evidence - either physical or historical" as he says he did.


He said he gave JonBenet five or six (IMO it was probably seven) vaginal exams over a three year period

For the two vaginal examinations where he detected a problem his explanations were - vaginal redness was due to recent diarrhea and an unspecified problem was due to the use of bubble baths

For two routine physicals where he included vaginal examinations (I will assume that is routine) he noted everything normal

For another vaginal examination he performed because of abdominal pain and fever (why?) he does not note a result

Also there is at least one more vaginal exam for which he did not reveal the result. Maybe they were more indicative of sexual abuse than the others and so he avoided mentioning those particular results.


He said he counted three visits in which she'd complained of some pain in urination. But no mention of what he thinks might have caused this.


He said the amount of vaginitis he saw on JonBenet was totally consistent with little girls her age

the reason he gave for this during the interview was "They don't wipe themselves very well after they urinate" !!!!

Did he make this gaffe because he was getting a little flustered during the interview, flustered because he had something to hide? OK I’ll give him the benefit of the doubt. Maybe the transcriber was too embarrassed to type defecate.




His notes stated ‘some indication of occasional bedwetting’

According to Patsy and Linda H-P it was more than ‘occasional’. I don’t know what Patsy told him, maybe she did report that it was just ‘occasional’ but I’m not quite sure about that....


He said 20% of children wet the bed at that age

He was talking about four year olds. Why? JonBenet was not four, she was six. What about six year olds?

I would think that if 20% of six year olds are still wetting the bed for most of them it would only be about once or twice a year.

I would like to know what percentage of six year olds wet the bed night after night after night, so frequently that the mother either puts the child to bed EVERY night in pullups or makes up the bed EVERY night with a waterproof sheet and washes the sheets EVERY morning.


He made no mention of JonBenet’s frequent urinary incontinence during the day.

Was this because Patsy did not mention this to him or was it because he wanted to keep quiet about that because it was too difficult to explain?


No, that pediatrician was far too dismissive of all JonBenet's symptoms, constantly using terms that minimised the severity of them, kept medical records that were very scanty on detail, and in those interviews made comments that were altogether too vague and gave answers that were too evasive for my liking.


IMO there is no way he can so adamantly reject outright the possibility that JonBenet, with her cluster of symptoms, might have been sexually abused and not expect to have himself suspected of having deliberately failed to protect poor JonBenet.

 

[Nuisanceposter]

At six years old, she had virtually NO hymen. That doesn't happen from everyday six year old play, that happened from having been sexually abused. The coroner found old and healing wounds in addition to fresh ones in her vagina. I believe those old ones could have been incurred days previous to JB's death, such as on the 23rd. When you consider the bed-wetting and the questionably frequent trips to the doctor for a urinary infection (no evidence of a current infection was found during autopsy), it starts to look like she was obviously being molested to me. The autopsy report indicates that the vaginal penetration she endured was not from penile penetration, but it clearly appears as though someone was was doing something to her, and that Christmas night when she died was not the first time. Now I find it impossible to believe this little girl was masturbating, certainly not just moments before her death, so *someone* was doing something to her. The medical evidence is there in black and white.

 

[Eagle1]

Both children were bedwetters, and it could have been from an allergy. To milk or something.

I agree with Nuisanceposter, though, that evidence of abuse was found, and the gardener said she started crying when telling him that she wished her dad was at home more. I think Aussieshiela also is right on about this starting with some group of "friends" because JR was away so much. PR may or may not have known what was actually happening. At JonBenet's age, I'm not sure she'd have ever heard the words needed in order to tell anyone. Some kids in therapy use dolls to tell the story, I've read. There would be tension about using the words even if they knew them.

 

[sissi]

At six years old, she had virtually NO hymen. That doesn't happen from everyday six year old play, that happened from having been sexually abused. The coroner found old and healing wounds in addition to fresh ones in her vagina. I believe those old ones could have been incurred days previous to JB's death, such as on the 23rd. When you consider the bed-wetting and the questionably frequent trips to the doctor for a urinary infection (no evidence of a current infection was found during autopsy), it starts to look like she was obviously being molested to me. The autopsy report indicates that the vaginal penetration she endured was not from penile penetration, but it clearly appears as though someone was was doing something to her, and that Christmas night when she died was not the first time. Now I find it impossible to believe this little girl was masturbating, certainly not just moments before her death, so *someone* was doing something to her. The medical evidence is there in black and white.

Nowhere have I read that she had "virtually NO hymen". Would you please state the source?

 

[why_nutt]

So IMO if he hadn’t done an internal exam on JonBenet he was in no position to have stated to the police with respect to her having possibly been sexually abused "Absolutely, categorically no. There was absolutely no evidence - either physical or historical" as he says he did.

A good and true point. Look at Patsy herself. She had cancer in her body much earlier than 1993. She kept going to doctors in Charlevoix and Boulder for pains and problems she had no idea were related to it, and none of them diagnosed her cancer. When she had her initial hysterectomy, even the doctor who actually cut her open and looked at her insides failed to see the cancerous tumor behind her pelvic bone. So, according to the Beuf way of thinking, that would mean that Patsy had no cancer on the day she signed onto the clinicial trial at the NIH, right?

Of course not. What she had was undiagnosed cancer. Lack of diagnosis does not mean lack of medical condition needing to be diagnosed and treated.

 

[Nuisanceposter]

Nowhere have I read that she had "virtually NO hymen". Would you please state the source?

Hmmm, I am unsure of the exact phrasing used, but that came from Dr. Cyril Wecht's book, Who Killed JonBenet Ramsey? I'll go read through it again and come back to either give you the exact page and paragraph or to correct myself.

 

[tipper]

Autopsy:
"The hymen itself is represented by a rim of mucosal tissue extending clockwise between the 2 and 10:00 positions. The area of abrasion is present at approximately the 7:00 position and appears to involve the hymen and distal right lateral vaginal wall and possibly the area anterior to the hymen. "

 

[Eagle1]

Most of us have raised little girls, with bubble bath and the works, but I don't ever remember any pediatrician ever doing any vaginal exams. Of course we had no complaints that would suggest a need for one.

None of our friends' little girls had that kind of problem either, correct? It's probably comparatively unusual in the general population. Doctors probably have done no studies regarding what percent have these problems.

Personally, I would have taken JonBenet to another pediatrician for a second opinion instead of always back to the same one. I do think it's suspicious, though I can't think she killed her.

 

[dingo]

Most of us have raised little girls, with bubble bath and the works, but I don't ever remember any pediatrician ever doing any vaginal exams. Of course we had no complaints that would suggest a need for one.

None of our friends' little girls had that kind of problem either, correct? It's probably comparatively unusual in the general population. Doctors probably have done no studies regarding what percent have these problems.

Personally, I would have taken JonBenet to another pediatrician for a second opinion instead of always back to the same one. I do think it's suspicious, tphough I can't think she killed her.

I have raised a daughter without the problems jbr had,we had plenty of bubblebaths.the more suds the cleaner the bathtub.Considering Patsys recall on JBR.S bath scheldule ,hygiene was,nt of great importance to her[unless there was a paegent in the near future].Maybe the lack of bubblebaths lead to JBRS chronic inflamatioms.

 

[Eagle1]

Yep, you may be right. I didn't think of that possibility.

 

[tipper]

Most of us have raised little girls, with bubble bath and the works, but I don't ever remember any pediatrician ever doing any vaginal exams. Of course we had no complaints that would suggest a need for one.

None of our friends' little girls had that kind of problem either, correct? It's probably comparatively unusual in the general population. Doctors probably have done no studies regarding what percent have these problems.

Personally, I would have taken JonBenet to another pediatrician for a second opinion instead of always back to the same one. I do think it's suspicious, though I can't think she killed her.

http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=3726

Vulvovaginitis means inflammation or irritation of the vagina and vulva (the opening of the vagina).

Mild vulvovaginitis is a very common problem in young girls. It will affect most girls at some stage and for some may be a recurrent problem.

The things that may cause vulvovaginitis are:

• The lining of the vagina and vulva can be quite thin in young girls and this can lead to it being easily irritated.
• Moisture / dampness around the vulva. This is made worse by synthetic fibre underwear, tight clothing, wet swimming costumes, and obesity.
• Irritants (soap residue, bubble baths, antiseptics etc). In most girls this is not a serious problem and it will usually improve with simple measures. It may recur now and then but will improve as your child gets older.

In most mild cases, no tests are necessary. In some persistent cases the doctor may advise a swab be taken for testing. The results are not always helpful.