What do the profilers say?

[clueless]

Originally posted by BlueCrab:

From Dr. John Meyer's autopsy report in regard to the thyroid (at the base of the neck):

"An occasional isolated area of chronic interstitial inflammatory infiltrate is seen."

Also from the autopsy report in regard to the trachea (the main air passage in the neck):

"There is mild chronic inflamation in the submucosa of the trachea."


Hi. This is my first post on this forum, though I used to hang out at the Laci Peterson forum.

I am a medical transcriptionist and I come across the term (and variations of the term) "chronic interstitial inflammatory infilrate" regularly. Though I have little experience with the thyroid specifically, in my experience it refers to a disease process. (The examples that come to my mind are that chronic bronchitis can leave "chronic interstitial inflammatory infiltrate" in the lungs or that chronic sinutitis leads to "chronic inflammation" of the sinuses.) While it is possible that it can refer to chronic trauma (as in the vagina), it seems to me like neither chronic disease process nor chronic trauma could be ruled in or out with the information available.

I would also like to add that chronic inflammation of the vagina can be caused by chronic yeast infections or urinary tract infections as well as sexual abuse. Some people have been known to have vaginal irritation/inflammation from prolonged exposure to chemicals in a swimming pool or hot tub or even bubble bath, bath salts, etc.

Also, a friend of mine has a daughter who has chronic sinus related issues (sinusitis, ear infections, tonsillitis, etc.) and almost every time she is put on an antibiotic she gets a yeast infection. It is possible that JB had something like this going on as well.

BTW, the hymen can be broken by vigorous physical activity such as riding a bike, playing soccer, jumping on a trampolene, etc. I'm not sure about an enlarged hymen, however. Common sense says that could only be caused by sexual activity/molestation, but I don't know for sure.

OK, to the point. Well, I don't have one really. So far I've only been reading here a short while and don't know enough of the facts to have an opinion as to whether or not she was molested (though it certainly is possible) let alone whodunit yet. I just wanted to throw my :twocents: in. Make of it what you will.

Clue


PS: I claim no medical expertise, but maybe more (medical) knowledge than some.

BlueCrab, this post isn't really directed at you. I just used your post to pull out the quote "chronic interstitial inflammatory infilrate".

 

[narlacat]

Hi Clueless
Welcome to the forum

As you mention, there are numerous other reasons besides sexual abuse that may have caused the problems that JonBenét had going on.
I'm just a bit doubtful of all the other reasons because of the way that little girl ended up.
I go with the experts that say sexual abuse had taken place prior to the night of her death.

 

[clueless]

ooops. I didn't mean to post it twice. I was trying to edit it. :doh:

Clue

 

[clueless]

narlacat,

I agree.

If she was indeed regressing in her potty training to the point of soiling her diapers, the most likely reason (at least in my mind) would be sexual abuse. I have done transcription for several years for many different types of doctors (radiology, gastroenterology, gynecology and pediatrics among others) and I have never come across a child as old as 6 regressing like that. Many children wet the bed at an older age, but extremely rarely actually soil themselves. I'm not saying it doesn't happen, I've just never come across it. If my memory serves me well (though it often doesn't) even the poster who seems to have experience with this involved a much younger child. Please correct me if I'm wrong.

Clue

 

[narlacat]

Clueless
Alot of posters may question if JonBenét actually did soil her pants and poo poo in her bed.
LHP was the one that said that.
I just don't why LHP would have lied about that.

 

[clueless]

I'm not saying LHP lied. I meant that I don't know because I haven't been reading long enough to know it myself. I was just going by what I read from other posters about the soiling incident(s) rather than what was in a transcript or book.

Clue

 

[aussiesheila]

Originally posted by BlueCrab:

From Dr. John Meyer's autopsy report in regard to the thyroid (at the base of the neck):

"An occasional isolated area of chronic interstitial inflammatory infiltrate is seen."

Also from the autopsy report in regard to the trachea (the main air passage in the neck):

"There is mild chronic inflamation in the submucosa of the trachea."


Hi. This is my first post on this forum, though I used to hang out at the Laci Peterson forum.

in my experience it refers to a disease process of chronic nature. While it is possible that it can refer to chronic trauma, it seems like neither could be ruled in or out with the information availble.

Hi clueless,
In your experience as a medical transcriptionist you say you have come across "An occasional isolated area of chronic interstitial inflammatory infiltrate is seen." in reference to a disease process of a chronic nature but not in reference to chronic trauma.

Then you go on to say that "neither could be ruled in or out with the information availble". I have to disagree with this particular statement. From what I know about the thyroid gland and it being part of the endocrine system, it has wide ranging influence on many organs of the body and if it becomes diseased in any way a person gets fairly sick.

So what I am saying is that if JonBenet's "occasional isolated area of chronic interstitial inflammatory infiltrate" in her thyroid was the result of a disease process she would not have been the robust little girl she was. This is the information we have which I think enables us to conclude that the "occasional isolated area of chronic interstitial inflammatory infiltrate" in her thyroid was therefore likely to be the result of chronic trauma.

 

[Camper]

Originally posted by BlueCrab:

From Dr. John Meyer's autopsy report in regard to the thyroid (at the base of the neck):

"An occasional isolated area of chronic interstitial inflammatory infiltrate is seen."

Also from the autopsy report in regard to the trachea (the main air passage in the neck):

"There is mild chronic inflamation in the submucosa of the trachea."


Hi. This is my first post on this forum, though I used to hang out at the Laci Peterson forum.

I am a medical transcriptionist and I come across the term (and variations of the term) "chronic interstitial inflammatory infilrate" regularly. Though I have little experience with the thyroid specifically, in my experience it refers to a disease process of chronic nature. While it is possible that it can refer to chronic trauma, it seems like neither could be ruled in or out with the information availble.

I would also like to add that chronic inflammation of the vagina can be caused by chronic yeast infections or urinary tract infections as well as sexual abuse. Some people have been known to have vaginal irritation/inflammation from prolonged exposure to chemicals in a swimming pool or hot tub or even bubble bath, bath salts, etc.

The hymen can be broken by vigorous activity such as riding a bike, playing soccer, jumping on a trampolene, etc. I'm not sure about an enlarged hymen, however. Common sense says that could only be caused by sexual activity/molestation, but I don't know for sure.

Also, a friend of mine has a daughter who has chronic sinus related issues (sinusitis, ear infections, tonsillitis, etc.) and almost every time she is put on an antibiotic she gets a yeast infection. It is possible that JB had something like this going on as well.

OK, to the point. Well, I don't have one really. So far I've only been reading here a short while and don't know enough of the facts to have an opinion as to whether or not she was molested (though it certainly looks possible) let alone whodunit yet. I just wanted to throw my :twocents: in. Make of it what you will.

Clue

PS: I claim no medical expertise, but maybe more (medical) knowledge than some.

----------->>>Welcome clueless. What folks that have a nutritional background know is that antibiotics kill the friendly bacteria in the body. Leaving an open door to receive the inevitable yeast infection. Pro biotics are used following and even during antibiotic procedure, and most particularly AFTER treatment with antibiotics for quie some time to build up and to destroy the yeast infections.

However nine years ago when JonBenet was having problems that may be connected with the entire hypotheses here, use of pro biotics to restore a persons friendly bacteria was not widely accepted or even known.

I personally can conclude that since most likely pro biotics were not used after antibiotic treatment, that the yeast infection was not totally destroyed and reared its head after for some time, equaling most likely repeated infections or chronic if you will.

For periods of time, doctors were saying our bodies were resisting antibiotics that previously worked. I do believe since those types of comments were made, WE have become smarter and hence the use of pro biotic treatment to permanently rid our bodies of the invaders introduced by the antibiotic in the first place that reduced our bodies ability to defend its ownself as nature planned it all in the beginning.

Poor or incomplete quality of nutrition may have played a factor as well. 6 year olds can be picky about their food intake.


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[narlacat]

I'm not saying LHP lied. I meant that I don't know because I haven't been reading long enough to know it myself. I was just going by what I read from other posters about the soiling incident(s) rather than what was in a transcript or book.

Clue

Sorry Clueless, I didn't mean it to sound like you were saying LHP lied.
The soiling of the panties was known to Patsy, so that much is definetly true.
She mentions how her and Nedra referred to it as 'dirtying'.
I think it's only the poo pooing of the bed that gets questioned, and that's because it came from LHP.

 

[clueless]

Hello all.

narlacat: No problem. Thanks for clearing that issue up for me.

camper: I concur.

aussisheila: Actually the quote "An occasional isolated area of chronic interstitial inflammatory infiltrate is seen." was from BlueCrab. I come across "chronic interstitial inflammatory infiltrate" in my job quite frequently. I have not heard it worded exactly they way BlueCrab has it quoted but different doctors tend to word things somewhat differently. (For example: some doctors will say "chronic interstitial infiltrate" while another will say "chronic inflammatory infiltrate" and yet another will word it "chronic interstitial inflammatory infiltrate" when they are all referring to the same chart.) My work deals mostly with the lungs when I hear this particular reference, but occasionally other areas of the body as well. I really don't have a lot of experience dealing with thyroid issues, but I would actually tend to agree with you that if JB had chronic thyroid issues - as opposed to a traumatic injury - that she would have been quite sick. But then again it may depend on the severty of those issues. Without having her entire medical history I think it would be quite difficult to know for sure what it was.

 

[Nehemiah]

. If it was determined that she was molested before her death, Burke would have been taken out of the home. This didn't happen.

When I worked child protective services, I removed children from the home who had been sexually abused, yet at times left the siblings.

 

[clueless]

Ok, so I've been thinking about the bowel incontinence issue and I can't believe I didn't think about this before. Camper's mention of the antibiotics got me to thinking about it. Let me explain in more personal terms and see what you think.

About three years ago my grandmother got pretty sick and had trouble with being constipated. She didn't tell anyone for months, so she ended up getting pretty sick by the time the family found out. (She lives alone and would pretend to be fine when anyone visited.) She was finally diagnosed with diverticulitis and a blockage in her colon after admitting that she was sick. She had part of her colon removed to remove the blockage about two years ago and afterwards was put on antibiotics, which of course got rid of all the bacteria (good and bad) like camper was talking about. (Which is what made me think of it, btw.) She was not put on any pro biotics at that time. A year or so later she ended up having constant diarrhea (literally every 15 - 20 minutes and she couldn't always make it to the bathroom). She finally saw a specialist who figured out it was because she had never had the pro biotics and it progressed to ulcerative colitis. She now has to take Asacol forever to help stop the diarrhea.

So there's the story. I realize that my grandmother's case is much more severe than what JB probably would have had (if she had it at all), but it could explain how she could have been having the bowel incontinence and it not be related to sexual molestation. It could also fit in with the vaginal irritation due to the yeast infection we have been discussing.

So IF..... JB had chronic sinus infections and had been placed on antibiotics (possibly mutliple times) with out the pro biotics to counter the negative effects, it could have lead to a yeast infection/vaginal inflammation as well as a digestive irritation (?) that could have caused occasoinal soiling/bowel incontinence.

I am by no means saying this is what happened to JB, but it is a possibility or at least something to chew on (though chewing seems kinda nasty to think about since we are talking about poop........). I would think, though, that she would have been noticeably sick if that were the case. Then again, if it were a much more mild case it could look like minor stomach upset because all anyone would see would be the soiling and maybe that she minght not have much of an appetite. (With my grandmother her appetite would come and go.) Then again, my 8 year old doesn't always feel like eating at every meal either, so her appetite might even look normal. This is completely hypothetical, of course.

I still haven't had a chance to read through the transcripts or books about this particular subject yet. Does anyone know if anything was said about the consistency of the soiling? I know it's kinda gross, but it would help to know. I mean, if it was poop it would mean one thing and if it were more like diarrhea it could mean another.

I don't know. Can you tell it is way past my bedtime?

Clue

 

[clueless]

I just noticed on another post someone mentioned "skid marks". Could it have been that JB had "skid marks" in her underwear and it has been referred to as soiling? Having "skid marks" would be enough to need to change underwear and be cleaned up but certainly would not indicate a bowel incontinence problem, let alone be caused by molestation.

clue

 

[aussiesheila]

Hello all.

narlacat: No problem. Thanks for clearing that issue up for me.

camper: I concur.

aussisheila: Actually the quote "An occasional isolated area of chronic interstitial inflammatory infiltrate is seen." was from BlueCrab. I come across "chronic interstitial inflammatory infiltrate" in my job quite frequently. I have not heard it worded exactly they way BlueCrab has it quoted but different doctors tend to word things somewhat differently. (For example: some doctors will say "chronic interstitial infiltrate" while another will say "chronic inflammatory infiltrate" and yet another will word it "chronic interstitial inflammatory infiltrate" when they are all referring to the same chart.) My work deals mostly with the lungs when I hear this particular reference, but occasionally other areas of the body as well. I really don't have a lot of experience dealing with thyroid issues, but I would actually tend to agree with you that if JB had chronic thyroid issues - as opposed to a traumatic injury - that she would have been quite sick. But then again it may depend on the severty of those issues. Without having her entire medical history I think it would be quite difficult to know for sure what it was.

Hi clueless, well I think we're all guessing a bit here - I know I am - or at least extrapolating from what we do know. It is very interesting reading what you have to say. Thanks.

 

[aussiesheila]

narlacat,

I agree.

If she was indeed regressing in her potty training to the point of soiling her diapers, the most likely reason (at least in my mind) would be sexual abuse. I have done transcription for several years for many different types of doctors (radiology, gastroenterology, gynecology and pediatrics among others) and I have never come across a child as old as 6 regressing like that. Many children wet the bed at an older age, but extremely rarely actually soil themselves. I'm not saying it doesn't happen, I've just never come across it. If my memory serves me well (though it often doesn't) even the poster who seems to have experience with this involved a much younger child. Please correct me if I'm wrong.

Clue

Clueless, I must say I also thought soiling at such a late stage was pretty unusual and certainly, when taken together with her other symptoms, highly indicative of sexual abuse. It seems however, that most people choose to put all the symptoms down to more benign reasons.

Do you have any experience working with doctors who have treated sexually abused children?

 

[clueless]

Sorry it has taken me so long to reply. I've been very busy the last few days.

I think that JB soiling herself at such a late stage is not only highly suspicious but would indicate to me that something extremely stressful was going on in her life. That could be molestation or believing that her mom would die from cancer or ..........fill in the blank. I would think that it would have to be at least borderline traumatic for her to regress like that and not just a routine every day kind of stress. However, that conclusion is going on the assumption that the soiling was poop and not diarrhea or just skid marks. If the soiling was one of the latter two, there could be a more innocent explanation.

As I stated above, I transcribe for several different types of doctors. However, I don't type each docter every day, so I don't see any one doctor's entire patient load. I work with a group of girls and we all take turns doing different doctors so that we don't get burnt out typing the same thing day after day. Also, for most doctors (the radiology excluded) transcription is more like a summary of the visit. You know how when you go in to see a doctor the nurse takes notes and he takes notes? All of those handwritten notes go into the chart as well as the transcribed page I type. Usually the nitty gritty specifics would be on the handwritten page and not necessarily in the typed report.

For the pediatrician, I would say that 85 - 90% of the patient load would consist of either routine check ups or "cough, cold and runny nose" and the gyno about 95% consists of annual exams, check ups for birth control and irregular periods.

I have not come across molestation exactly. I have encountered a few cases of statutory rape where the girl was 12 - 15 and the man was an adult. In two cases that I remember more specifically, one girl was 13 with a 25-year-old male and a 15-year old girl with a 40-year-old male. Usually, the girl will admit to the relationship to the doctor (when the parents are out of the room). In one case the girl only admitted it after it was found out that she had an STD. She later said that she had oral sex with him. (Like that makes it any better!) In most cases the parents are angry, of course, but I have seen some where the parents knew about the relationship and even though they weren't necessarily happy about it, they still let the man come over to visit and/or spend the night. In all of these reports there was nothing dictated about a rape kit being done, but that doesn't mean that it wasn't. In the cases that I recall, when a pelvic exam was done the report would say something like "pelvic exam was performed". Specifics don't always get dictated but may have been in the handwritten report done and shown on a diagram. A lot of times the doctor, especially a pediatritian, also has to look at the behavior of a child. That does often appear in a report such as "the child was playful". Often the doctor will say something about how the child and the guardian interact as well.

Other physical abuse also may or may not show up in report I type. For example, if a child has bruising (and how many don't?) the doctor may say "the child has multiple bruises" or "there is bruising on arms and legs bilaterally", but not say the size, specific location or any other details. Of course, the details may very well be in the handwritten notes. As we all know, most kids have bruising just from playing so the details aren't always necessary. A doctor will likely mention it just to have it on record in case a pattern develops. This is, of course, excluding a child who has excessive/severe bruising at several exams with or without a history of broken bones. A case like this would definitely be dictated to go in the report I type. Also, if a doctor suspects abuse, they would not say that specifically to be typed and they would not say if the suspicion was reported to authorities. (That doensn't mean that it hasn't been reported.) And yes, they are required to report, but they may want to make sure they have enough medically supported basis to turn it in. They may want to watch the situation over a couple of visits to be sure.

I hope this helps answer your questions. Sorry I've been so wordy today. I'm in a talkative kind of mood.

Clue

 

[clueless]

I just read over my previous post and realized I didn't really say anything about the gyno(cologist) I type for.

I actually haven't come across any rape or suspected molestation cases with him. He is an older doctor and was used to doing all of his reports by hand. He doesn't like to dictate, so all of his reports have a set template and very little detail information is included.

I do know that a gyno can tell when you go in for your annual exam if you've had sex earlier that day due to vaginal inflammation or vaginal irritation. As far as I know, most of the gynos won't say it, but they know. There's something to think about when it's time for your next yearly. (To all you female sleuthers.) I'm not sure if they could tell if you had sex the previous day or not. I don't really know how long the irritation/inflammation lasts afterward. I guess it may also depend on how vigorous it was. I would guesstimate that for molestation to show up on an exam the victim would have to be seen fairly quickly (say 24 hours?), unless there was trauma or tearing.

Clue

 

[aussiesheila]

Sorry it has taken me so long to reply. I've been very busy the last few days.

I think that JB soiling herself at such a late stage is not only highly suspicious but would indicate to me that something extremely stressful was going on in her life. That could be molestation or believing that her mom would die from cancer or ..........fill in the blank. I would think that it would have to be at least borderline traumatic for her to regress like that and not just a routine every day kind of stress. However, that conclusion is going on the assumption that the soiling was poop and not diarrhea or just skid marks. If the soiling was one of the latter two, there could be a more innocent explanation.

As I stated above, I transcribe for several different types of doctors. However, I don't type each docter every day, so I don't see any one doctor's entire patient load. I work with a group of girls and we all take turns doing different doctors so that we don't get burnt out typing the same thing day after day. Also, for most doctors (the radiology excluded) transcription is more like a summary of the visit. You know how when you go in to see a doctor the nurse takes notes and he takes notes? All of those handwritten notes go into the chart as well as the transcribed page I type. Usually the nitty gritty specifics would be on the handwritten page and not necessarily in the typed report.

For the pediatrician, I would say that 85 - 90% of the patient load would consist of either routine check ups or "cough, cold and runny nose" and the gyno about 95% consists of annual exams, check ups for birth control and irregular periods.

I have not come across molestation exactly. I have encountered a few cases of statutory rape where the girl was 12 - 15 and the man was an adult. In two cases that I remember more specifically, one girl was 13 with a 25-year-old male and a 15-year old girl with a 40-year-old male. Usually, the girl will admit to the relationship to the doctor (when the parents are out of the room). In one case the girl only admitted it after it was found out that she had an STD. She later said that she had oral sex with him. (Like that makes it any better!) In most cases the parents are angry, of course, but I have seen some where the parents knew about the relationship and even though they weren't necessarily happy about it, they still let the man come over to visit and/or spend the night. In all of these reports there was nothing dictated about a rape kit being done, but that doesn't mean that it wasn't. In the cases that I recall, when a pelvic exam was done the report would say something like "pelvic exam was performed". Specifics don't always get dictated but may have been in the handwritten report done and shown on a diagram. A lot of times the doctor, especially a pediatritian, also has to look at the behavior of a child. That does often appear in a report such as "the child was playful". Often the doctor will say something about how the child and the guardian interact as well.

Other physical abuse also may or may not show up in report I type. For example, if a child has bruising (and how many don't?) the doctor may say "the child has multiple bruises" or "there is bruising on arms and legs bilaterally", but not say the size, specific location or any other details. Of course, the details may very well be in the handwritten notes. As we all know, most kids have bruising just from playing so the details aren't always necessary. A doctor will likely mention it just to have it on record in case a pattern develops. This is, of course, excluding a child who has excessive/severe bruising at several exams with or without a history of broken bones. A case like this would definitely be dictated to go in the report I type. Also, if a doctor suspects abuse, they would not say that specifically to be typed and they would not say if the suspicion was reported to authorities. (That doensn't mean that it hasn't been reported.) And yes, they are required to report, but they may want to make sure they have enough medically supported basis to turn it in. They may want to watch the situation over a couple of visits to be sure.

I hope this helps answer your questions. Sorry I've been so wordy today. I'm in a talkative kind of mood.

Clue

Don't apologise Clueless, it's all very interesting.

To my mind it is very suspicous that JonBenet had this problem and I am very surprised that Patsy did not mention it to Dr Beuf. It suggests to me not only that JonBenet was sexually abused, but that Patsy actually knew about it. I cannot understand a mother not wanting to get to the bottom of all her problems. I would have thought she would have been taking her to specialist after specialist and not just accepting Dr Beuf's reassurances that everything was "normal" for a girl her age.

 

[sissi]

I don't believe soiling was a problem of Jonbenet's. If LHP saw something like this on her bed, and used her hands to "create the approximate size " , a stupid cop would say, is that the size of a baseball, a grapefruit etc. I doubt it was ever "3d". Having just cleaned up an entire house following a "Norwalk" like virus, I can assure you, children of all ages can be sick enough to not "make it to the bathroom". This soiling information should be listed among items that are rumored.

 

[tipper]

I don't believe soiling was a problem of Jonbenet's. If LHP saw something like this on her bed, and used her hands to "create the approximate size " , a stupid cop would say, is that the size of a baseball, a grapefruit etc. I doubt it was ever "3d". Having just cleaned up an entire house following a "Norwalk" like virus, I can assure you, children of all ages can be sick enough to not "make it to the bathroom". This soiling information should be listed among items that are rumored.

I agree. A child cannot pass a fully formed bowel movement the size of a grapefruit. Although a bout of diarrhea could easily leave a staiin that size.