Is this normal?

[mommax3]

I took my youngest to the doctor today. This is the fourth time he has been sick (sore throat, swollen glands, fussy, not sleeping, low-grade fevers) in the past six weeks. I am always slightly ashamed at how long I "wait and see" before taking my kids in, but today reminded me why I am that way. I am wondering if this is fairly normal, or if things are better in the civilian system.....

I called the "central appointments line" (per procedure) at 7:45 this morning. I was on hold for 20 minutes. I told the lady that finally answered the age of my child and gave a brief description of his symptoms, and told her he had been sick since Thursday and was not getting better. She put me on hold again :!: to check for a peds appt. She came back about a minute later and said that she didn't show any peds appts. available until tomorrow, but that she would transfer me directly to the peds clinic so I could check with them myself. On hold again. The phone got answered by an operator twice because the peds clinic wouldn't answer, but the operator transferred me back to the clinic number each time. Finally an answer.....the peds clinic told me they had no appts. available until the next day and that I should go to the acute care clinic on base (our base doesn't have an ER anymore).

So I loaded Nathan up and we went to the acute care clinic. There were two people ahead of us and I was there for two hours. I saw a doctor (family practice, I think) for maybe 5 minutes. She looked at Nathan's throat, felt his glands, looked at the rash he has on his face, looked in his ears and told me there was fluid in one of them, (does that mean infection, btw?) so she would give me amoxicillin which would clear up any throat infection and take care of an ear infection. I asked her if she was going to culture his throat (I had strep 13 times growing up) and she said she didn't want to, that the antibiotic would take care of it if it were present.

Then it was off to the base pharmacy for another 25 minutes to wait for the antibiotic. By this time, Nathan's 6:45 dose of Tylenol was wearing off and he was starting to fuss/whine.

Finally, I got out of there and got him home. Did I mention that it is rainy, windy, and 40 degrees here today? And DH and I have been up several times a night with Nathan since Thursday night?

Anyway, besides needing to vent, I really am wondering if this is a familiar scenario in the civilian world as well. My oldest had just turned two when DH became active duty, and he didn't get sick much, so I don't have a lot of memories of taking him to a civilian pediatrician. When DH was a resident, things moved quite a bit more quickly since we saw pediatricians at a huge medical center and not a small base. DH tries to facilitate things for me when he can by calling the pediatrician that we like directly and getting an appt. that way, but he had surgery this morning and couldn't help.

So....your experiences?

Sally

[PrincessFiona]

Sally,

This is exactly why I hate going in to see the pediatrician in civilian life too!

On my first post-partum appt. with Aidan 9which was stupidly just the day after he was discharged and had just seen the pediatrician ) I waited for well over an hour for my appointment and then waited so long in the room that I just finally left. I was exhausted, still recovering from a c-section and was peeved that I had to pay a co-pay to sit and wait and not even have a nurse or someone pop in and tell my that there would be this long delay. Then I was treated like a crazy woman when I said that I need to go...I just could NOT sit there any longer. There is this attitude that as a sahm you just have all day to sit in the peds office or something.

I know that it has to do with teh fact that they have to bill so much each day and see a certain number of patients in order to make their income, but I tend to avoid going to the pediatrician now unless a limb is falling off. I figure they will probably just tell me it is a virus anyway...

And btw...I think that they should have cultured his throat...of course, I'm not a doctor....but it seems to me that more and more they are treating ear infections w/o antibiotics...I dont' know..it just seems funny to me to not have cultured it.

This isn't limited to peds though....I once called my ob because I was running late. I knew I was going to be about 10 minutes late to the appt. because Thomas was running late. He was coming home to watch the kids and wanted to call ahead and find out if that would be a problem that I was now late or if I should reschedule. I waited and waited and waited on the line...NOTHING...still was waiting by the time Thomas made it home (10 minutes?) so....I went ahead and headed out the door in case she could see me a little late, and called on my mobile. I was on hold for the entire 10-12 minutes that it took for me to get there and finally someone answered when I was in the parking lot and was indeed 15 minutes late. I thought it was ridiculous that I had tried for nearly a half an hour to speak to a person.....

For-profit medicine just doesn't work.

kris

[Michele]

I just have to pipe in my little rant....

Vet medicine is blamed for all of the antibiotic resistent bacteria out there and as a result we are totally limited by what we are allowed to prescribe. When "real doctors" prescribe antibiotics for anything and everything!!! It's so not our fault!!

Sally, he should have been cultured! If he's been sick so often, there's something else going on than a simple infection. Either his immune system isn't up to par or the antibiotics aren't appropriate for the infection he has. I think you should still make a followup visit with your regular pediatrician to address the fact that he's been sick so often.

[PrincessFiona]

Hey Michele,

My husband is an absolute fanatic about antibiotic misuse/abuse by physicians. He sits on a committee that actually evaluates the antibiotic use of physicians in the community and then talks with them about their misuse. He's the first one to scream about inappropriate prescribing and misuse by patients being responsible for antibiotic resistance...too bad the vets are having to take the rap....that is ridiculous.

kris

[mommax3]

I thought he should have been cultured, too. I fight my tendency to question docs because I don't want them to think I am being a "doctor's wife" or take it out on my husband in some way......he does not have a high opinion of the way the acute care clinic functions in terms of how they treat female patients and would rather that they would be seen at the civilian ER because he trusts those docs a lot more. Since I had strep so many times as a child, I have always had a horror of one of my kids having the same tendency. So far, that hasn't been the case.....but I think it would have been nice to have known, for documentation reasons.

However, I think this is the first time Nathan has ever been prescribed antibiotics in his little life, so I don't think it is the end of the world that he is on them without a definitive diagnosis. The other times he has been sick recently, he has started bouncing back after about the third day, which is not happening this time. I am supposed to get his ears re-checked in two weeks. The only way to see the pediatrician we know/like (who is very conservative about the use of antibiotics) is for DH to pull strings and I hate for him to do that when it isn't an emergency. Also, I know (through the grapevine) they are down to one pediatrician at the clinic right now (usually there are three) because one is on maternity leave and one took a month off to get married.

Anyway, hopefully things will be looking up around here in about 24 hours due either to the antibiotic or to time, the great healer!

Sally

Sally,
From a documentation perspective, I would want to know as well. And the rapid strep test is so quick and relatively easy to do. I think there are typical symptoms of strep -- sore throat, fever, white stuff on the tonsils, and bad breath. Maybe she based her decision on that? Still, why not just culture it? I agree with you.

You guys are making me grateful for our pediatrician!! Their office runs smoothly, usually on time, and they provide great care. I hope we can easily find someone we like when we move.

[SueC]

I didn't read all the other posts but our experiences at a teaching hospital are very similar. We take our kids to a ped. at the clinic at the med school where my husband works (we like our pediatrician and I do kind of feel like I should support the academic process) but last time I went (when Maya ended up having pneumonia) we were there for a total of 6 hours!!! My husband (who wasn't able to come over and help me with my 2 sick kids since he was busy at the hospital) was so frustrated with how inefficient the ped clinic is when I told him about our day. Every time we see the pediatrician, we start out by seeing the med student, then the resident, and finally the attending. I compare this with going to a concert and seeing the opening acts vs. the real band, not to offend the students or residents, I know they are still learning, but the attending exudes so much more confidence. Anyhow, back to my original story, both the kids ended up falling asleep on a bench in the waiting area while we were waiting for the doctor to read the chest X-ray. Then we still had to go get the prescription filled--thank goodness I've got my own little supply of antibiotics at home so I could just send my husband to the drug store before she needed her second dose. Another gripe I have with where we go is that we see somebody new each time, unless it is an appointment that we specifically scheduled with our ped. If he is on the unit that month, there is no chance we will see him. My friends that go to regular pediatricians don't seem to have to wait as long and do have better continuity of care than what we get, but like I said I do like our pediatrician so I'll keep going there.
I hope Nathan gets better soon Sally--that sounds like a frustrating day, especially if the weather isn't great to be out and about with a sick kid!!!

Sally, I totally understand your feeling about "wait and see" in terms of taking your kids to the pediatrician. I am completely in that camp. I hate going to the drs. office because I feel like with most common illnesses, there isn't much you can do except for let it run its course. So unless my kids have "glazed over, near death" look, I do not call the pediatrician. Of course, I take it for granted that my husband is a pediatrician but from my experience, he is very hands off and basically I let my mother's instinct tell me when it's time.

I have gone to the University's clinic, which was awful in terms of wait time, and have learned that beside from well-check ups, that was a place to avoid. The wait time is horrendous and line-up of people you have to see before seeing the scheduled doc is ridiculous. Since then we've switched to a more convenient, private practice doc (both in terms of time and location). The longest we've had to wait was an hour and it was because a previously scheduled child had to admitted to the hospital and the dr. apologized profusely for the wait.

My motto has always been and always will be, if you don't like what you have do deal with now, go somewhere else. I hope the military gives you alternative docs to go to.

[mommax3]

Thanks for the responses. The good news is that after his FIRST dose of antibiotics yesterday, he took a three hour nap. He was restless and crying out for about the first half of that time, but then he settled down and when he finally woke up, he got out of bed and came out of his room (which is normal) instead of lying there crying for me, which he has been doing since he got sick. When I picked him up, I noticed that his shirt was damp all over, like he had been sweating. He didn't run a fever yesterday that I know of, but it was like his fever broke or something. He has been making great strides ever since and slept pretty well last night, only crying enough that I had to go in one time.....a vast improvement!

So maybe antibiotics were the right choice.

Anyway, given our normal pattern, that will be our last trip to the pediatrician for a while.......maybe we will only have to go back one or two more times before we leave the Air Force!

Sally

[Michele]

So maybe antibiotics were the right choice.

Sally, I'm sorry, I didn't mean to imply that antibiotics were the wrong choice, just that the doc should've culture and known what he was treating. I'm glad he's feeling better!

I asked Russ about it and he said they are taught to give antibiotics because it is the "standard of care" and if they don't they could be liable.

[mommax3]

Michele,

I didn't read your response to mean that you thought the antibiotics were the wrong choice......I was already questioning that in my head since I am wary about their overuse. Don't worry about it!

Sally

[peggyfromwastate]

i have to jump in here b/c sally are you talking about your 2-yr-old? when izzy was 2, she got sick with similar symptoms, AND having been thru Steven's chronic sinusitis, ear tubes, etc, we have really used lots of antibiotics. it was obvious that izzy's throat hurt, so we asked the doc if she maybe had strep thrat. he said very very unlikely b/c kids under 3 are practically never diagnosed with strep. he in fact said that it's really rare until age 5 or so. given that, perhaps you may feel more confident in the treatment? i know i felt better knowing that info...

btw, as far as civilian urgent care, my experience has been that they usually could not fit us in for a same day unless it was critical. going to a urgent care clinic wasn't an option b/c they weren't covered by our insurance. we dreaded sick kids on a friday afternoon, which meant we were stuck with a tedious er visit and a $75 copay, not to mention copays of up to $30 a pop for drugs. But we did have "bargain" insurance at only $950 a year, of which we paid $415 and mac's employer paid the rest! I'm not saying you'll miss military doctor offices-- just brace yourself for insurance!