The Runaround

Here is a very long and most likely boring exchange between me and my doctor with a little discussion afterwards. I am on the verge of tears and I have the best insurance in town. I really don’t know how people without insurance effectively navigate the medical world.

Hi Dr. L,

Warren took Satchel in yesterday to see you, but saw the NP instead. Satchel has been coughing and throwing up regularly for over two months. On his first visit to your office, he saw Erin and she prescribed Tussionex and an antibiotic. (I forget which one.) When the Tussionex & antibiotic were used up, he continued coughing.

A few weeks later, I brought him in again. This time you saw him, but it was brief and Jiro was going nuts so I didn't even get to talk to you. You said you thought Satchel was wheezing and diagnosed him with "Reactive Airway disorder," gave him a steroid shot and a sample of Singulair. When the samples ran out, you called in a prescription for me, even though I expressed concerns that I didn't think it was working. You asked me to tryit for a few more weeks and keep a chart. I did both.

Satchel has continued to cough and even wake up in the middle of the night and vomit several times a week. He also vomits in the evening and in the morning. There is a coughing fit followed by vomit at least once every other day, if not more. He does not seem to be gasping for air when he coughs, but the cough will not go away.

Warren brought him in yesterday like I said and Erin said she heard no wheezing and prescribed a decongestant (Sudal 12) and an antibiotic (Zithromax). I don't understand why he is being prescribed antibiotics for the second time when he has no fever or other objective signs of infection (green, brown, or dark snot).

He doesn't appear sick and has not slowed down in any way over 8+ weeks. I would think if he had a bacterial infection, it would have worsened over the past few months. I am really frustrated and I just want my child to stop coughing and puking everyday. Please advise.

Thank you,
SG


Stacey,

I would be frustrated also. The Antibiotics are a good idea for such a difficult situation. I would finish that course. Get my nurse to help set you up for Chest X-ray if he has not had one. I think he will need to see an allergist for a pediatric pulmonary specialist after the x-ray, even if it normal. It sounds more like asthma than anything, but should have been responsive to our aggressive therapy. I will speak with EG about this so when you call she will know what you need.

Allergy: WW Taylor, MDPulmonary: no recommendation, check your insurance book

Dr. L

Dr. L,

Thanks. I will call and set up an appointment for an X-ray. Should I give him the Sudal 12 or go back to the Singulair or neither?

Stacey

Stacey,

Erin is trying to dry the drainage up, I like giving him the Sudal, theAntibiotic and the Singulair. But, if you see the allergist or pulmonologist, discontinue all meds for four days before appt.

Dr. L

I really don’t like the idea of pumping my three and a half year old full of multiple medications. I called the allergist who was very nice and he said I should go to the Pulmonary specialist first. He gave me a name, number, and offered to call on my behalf if I couldn’t get an appointment within the week. I was quite pleased until he said, “Has your son had his DPT shot?” When I said no, he replied, “Well then we really need to get him in fast.”

So that freaked me out and I googled “Diptheria.” I can pretty much rule that out without a medical degree I think. But thanks for the mini-freak out/self-flagellation session!

The Pulmonary guy says he doesn’t see patients who don’t know how to use an inhaler. I asked, "Well how do I know if he can use one if he's never had one?"

The ever so helpful receptionist said, "I don't know, but the doctor doesn't see anyone who doesn't know how to use one."

Which I guess means they don't think he's sick enough to see them?

Now I'm waiting for the allergist, Mr. Vaccination, to call me back.