Inadequate Service from GP's office, WWYD?

[Tinker'n'Fun]

DS15 went to the doctors Monday night, he had a stuffy nose and sore throat for a few weeks, but no fever. On Monday morning, he started with a severe cough that hurt him enough to beg to go to the doctors.

They gave him a cough pearl to take and said Motrin for the fever (102.4). He saw the PA and she also gave DH an antibiotic and said if he wasn't better by Thursday to start him on it.

Tuesday: Couldn't keep his fever under control even with piggy-backing Motrin and Tylenol.

Wednesday: Cough worse, fever still high, started antibiotic. This is the LONGEST DS has ever had a fever, he is very healthy.

Thursday: 4 doses of antibiotic, and fever is now higher. Contacted Dr.s office, they said I was jumping the gun. Tried to tell them that I never am wrong and this was not normal. They would only call in Cough syrup with Codeine, would not see him.

Friday: Still high fever, we even tried sweating it out. Now he is really feeling crappy and the cough syrup is almost gone. (They gave a small amount). The poor child has gone through a huge bottle of Motrin (he takes liquid) and still no improvement. They would not see him. I insisted on coming in on Saturday, said I would sit there until they saw him....

Today: Went to the office. They said, could be viral, etc. They heard some wheezing in his lungs, but thought it was nothing. Asked me if I wanted a flu test, I insisted. Negative by the way. Got a lecture about not getting the flu shot even though he tested negative. Asked if I wanted a chest Xray for the wheezing, I said YES. This PA said his amoxicillin would not treat bronchitis and ordered Levaquin and more cough syrup, but still said we should wait it out.

So we go get the Xray. DS has pneumonia in the total left lower lobe and is considered at least moderate.

I am calling the office to see his Doctor on Monday and get more answers as to his meds, any other treatments we should be doing and the mis-care we received.

How would you handle it, and do you think they were in error not seeing him? I am really close to the situation.. I am his Mom afterall!!

Thanks for any advice.

 

[DebD4T]

At the very least I would find a new doctor.

Almost the very same thing happened to a friend of mine about a month ago. She started with a cough. Went to the doctor. Told to just take cough medicine. A few days passed and she felt worse. Went back to the doctor. Doctor prescribed antibiotic for her. She also went for a chest xray. Doctor said she saw nothing. After 2 days of antibiotics she felt even WORSE!! She started having trouble breathing. It got so bad that she made her DH drive her to the ER. They ended up admitting her with pneumonia. She was in the hospital for 3 days.

 

[tvguy]

Well, I'm really split on this.
First, it is critical you trust your doctor.
But.......if it's viral, there really isn't anything your doctor can do. Sounds like he was proactive by giving an antibiotic just in case it was bacterial. Although some would point out that an antibiotic won't do a thing for a virus, and giving an antibiotic could also contribute to resistance to antibiotics.

 

[Tinker'n'Fun]

Well, I'm really split on this.
First, it is critical you trust your doctor.
But.......if it's viral, there really isn't anything your doctor can do. Sounds like he was proactive by giving an antibiotic just in case it was bacterial. Although some would point out that an antibiotic won't do a thing for a virus, and giving an antibiotic could also contribute to resistance to antibiotics.

I agree on the antibiotic aspect. He never really has had to take them very often in his life. A few ear infections as a baby, and he has chronic sinus disease and has twice been on a 21 day augmentin treatment. Other than that, just a few here or there in his 15 years.

You bring up a point that confuses me very much, how does one know is it is viral pneumonia or bacterial pneumonia. They have put his on a strong antibiotic, so I am thinking they feel it is bacterial and missed it?

These are the questions I need to ask on Monday. But if I can have more knowledge before the visit, I will feel better.

Oh and I forgot, I tried to google to get information, but since the articles all sound like a death sentence, please don't recommend that. My nerves can't take that!!

 

[The Mystery Machine]

I would get a new doctor. Mainly because your son had pneumonia and the doctor was not able to diagnose it by ear. That is alarming to me.

On top of that the doctor berated you for not getting a flu shot or telling you that you are jumping the gun, which I find disgusting.

 

[RNMOM]

Being a nurse, I can understand both sides of this. I have also had pneumonia 4 times and it is not fun. It can come on very quickly also.

Fever is the body's way of fighting off the virus/bacteria. It isn't necessary to try to bring it down UNLESS the patient is uncomfortable. DON'T 'sweat it out'. That is only going to drive it higher. Keep him lightly dressed and give him lots of fluids and rest. The cough can also last for several weeks even without the pneumonia.

Did you use a vaporizer or humidifier? He needs increased moisture to soothe the airway and help the coughing. Use lots of cough drops, hard candy, chewing gum, anything to help stimulate saliva will also help the cough.

When you take antibiotics it takes 24/48 hours to start bringing down the fever. That is probably what they meant when they said it was too soon for him to be seen.

I had a similar issue with my own doctor once. I stayed with him even though I knew I had pneumonia. He did an EKG, spirometry and then finally the chest xray. I had 4 lobes involved and it took a long time till I felt better.

If he has viral pneumonia it won't respond to the antibiotics but they will help prevent a secondary infection.

I hope he feels better and plan that he won't be back to his normal energy level for several weeks.

 

[Tinker'n'Fun]

Thanks for the replies so far.

He hasn't seen his dr. yet, just the PA. I am going to give him the chance to see DS and tell him about what happened. Just need to make sure what I say isn't just Mom talk and is on point.

As for his energy level, I have contacted his soccer coach for his indoor league (Nov - Jan) and removed him from the roster. I really want my son to heal. He was a little upset at first, but I think he is relieved, I truly believed he feels really that bad right now.\\

Oh and we only lasted 8 hours of sweating out the fever. We figured out that was not for us very quickly, Motrin is our friend.

 

[dzorn]

Are you giving Tylenol for the fever or just Motrin. You can give both.

I would choose a new doctor. Of course I would have insisted on being seen again or going to the ER when he worsened.


Denise in MI

 

[C.Ann]

DS15 went to the doctors Monday night, he had a stuffy nose and sore throat for a few weeks, but no fever. On Monday morning, he started with a severe cough that hurt him enough to beg to go to the doctors.

They gave him a cough pearl to take and said Motrin for the fever (102.4). He saw the PA and she also gave DH an antibiotic and said if he wasn't better by Thursday to start him on it.

Tuesday: Couldn't keep his fever under control even with piggy-backing Motrin and Tylenol.

Wednesday: Cough worse, fever still high, started antibiotic. This is the LONGEST DS has ever had a fever, he is very healthy.

Thursday: 4 doses of antibiotic, and fever is now higher. Contacted Dr.s office, they said I was jumping the gun. Tried to tell them that I never am wrong and this was not normal. They would only call in Cough syrup with Codeine, would not see him.

Friday: Still high fever, we even tried sweating it out. Now he is really feeling crappy and the cough syrup is almost gone. (They gave a small amount). The poor child has gone through a huge bottle of Motrin (he takes liquid) and still no improvement. They would not see him. I insisted on coming in on Saturday, said I would sit there until they saw him....

Today: Went to the office. They said, could be viral, etc. They heard some wheezing in his lungs, but thought it was nothing. Asked me if I wanted a flu test, I insisted. Negative by the way. Got a lecture about not getting the flu shot even though he tested negative. Asked if I wanted a chest Xray for the wheezing, I said YES. This PA said his amoxicillin would not treat bronchitis and ordered Levaquin and more cough syrup, but still said we should wait it out.

So we go get the Xray. DS has pneumonia in the total left lower lobe and is considered at least moderate.

I am calling the office to see his Doctor on Monday and get more answers as to his meds, any other treatments we should be doing and the mis-care we received.

How would you handle it, and do you think they were in error not seeing him? I am really close to the situation.. I am his Mom afterall!!

Thanks for any advice.

That is terrible! I can only imagine how upset you are.. As I was reading your post, I kept thinking "It's going to be 3 days.." Okay, "maybe 4 days.." Well, "5 days at the very most and then he'll snap right out of it.." When it reached today I was

But the one thing that really jumped out at me about what went on today is the prescription for Levaquin.. Please watch him very, very carefully with that.. When I worked in the doctors office, I can't even begin to tell you how many people suffered severe intestinal problems from that medication - severe enough to be hospitalized.. If he starts having diarrhea, stop the medication, call the doctors office and insist on something else.. God forbid it's bloody diarrhea, take him to the ER right away..

I can't even think clearly enough to suggest how you should handle the doctors office because I'm far too concerned about your son right now.. This is not a good situation - he should not have been sick that long (kids are so resilient they usually bounce right back in 3 or 4 days) - and now this..

I will say a special prayer for him tonight - but please, watch him very carefully.. Not only in regards to the diarrhea, but any other changes at all.. I don't mean to scare you, but I'm concerned..

Please keep us posted on his progress as time permits..

 

[Tinker'n'Fun]

That is terrible! I can only imagine how upset you are.. As I was reading your post, I kept thinking "It's going to be 3 days.." Okay, "maybe 4 days.." Well, "5 days at the very most and then he'll snap right out of it.." When it reached today I was

But the one thing that really jumped out at me about what went on today is the prescription for Levaquin.. Please watch him very, very carefully with that.. When I worked in the doctors office, I can't even begin to tell you how many people suffered severe intestinal problems from that medication - severe enough to be hospitalized.. If he starts having diarrhea, stop the medication, call the doctors office and insist on something else.. God forbid it's bloody diarrhea, take him to the ER right away..

I can't even think clearly enough to suggest how you should handle the doctors office because I'm far too concerned about your son right now.. This is not a good situation - he should not have been sick that long (kids are so resilient they usually bounce right back in 3 or 4 days) - and now this..

I will say a special prayer for him tonight - but please, watch him very carefully.. Not only in regards to the diarrhea, but any other changes at all.. I don't mean to scare you, but I'm concerned..

Please keep us posted on his progress as time permits..

I will keep a very close eye on him. He is eating, not great, but eating. He is taking in tons of fluids. He takes one pill a day and his first one was at 12 this afternoon. I will make sure DH broaches the bathroom situation with him and tells him any changes must be told to us immediately.

Most of all I do feel like a cruddy mom letting it go so long. He doesn't get sick often, and this is his first real illness other than having his tonsils out. His is happily playing his Xbox right now, and temp time is soon.


As for the other question, we have piggy-backed motrin and tylenol when it doesn't go down as quick or as long as I would like. I truly can not wait until Monday to sit in the office and look into the doctors eyes to truly see what is going on! I am very upset over this whole situation.

 

[Hannathy]

ARe you sure you are giving the right amount of motrin for an adult if he is taking liquid? that would be a lot of motrin. Are you giving liquid tylenol also?
make sure you are giving enough.

A cold or illness can turn into Pneumonia very quickly. In other words not be there in the morning and by night have turned into pneumonia. And not all wheezing means pneumonia.

What I would do is give him his meds let him rest, lots of fluids, eat what he wants. See how he is on Monday.

I'm not sure why you canceled soccer, I think that was very premature. He should be able to play in about 2 weeks, maybe not in a whole game but play some. He is 15 he will bounce back quickly.

I wouldn't change DR's over this.

 

[PatsGirl]

I am definately on the "don't treat it with antibiotics unless absolutely necessary" team and think the doctor was reacting appropriately EXCEPT.....

why wasn't the treatment (or lack thereof) explained properly and why weren't you told what to look for just in case? Not to mention that he berated you for not getting the flu shot? We also do NOT get a flu shot so that would have just p'd me off to start with. I'm a true believer in letting the high temp cure the ailment and pneumonia unfortunately does come on VERY VERY quickly but your doctor seems to lack a bedside manner at the very least.

 

[heatherwillmom]

DS15 went to the doctors Monday night, he had a stuffy nose and sore throat for a few weeks, but no fever. On Monday morning, he started with a severe cough that hurt him enough to beg to go to the doctors.

They gave him a cough pearl to take and said Motrin for the fever (102.4). He saw the PA and she also gave DH an antibiotic and said if he wasn't better by Thursday to start him on it.

Tuesday: Couldn't keep his fever under control even with piggy-backing Motrin and Tylenol.

Wednesday: Cough worse, fever still high, started antibiotic. This is the LONGEST DS has ever had a fever, he is very healthy.

Thursday: 4 doses of antibiotic, and fever is now higher. Contacted Dr.s office, they said I was jumping the gun. Tried to tell them that I never am wrong and this was not normal. They would only call in Cough syrup with Codeine, would not see him.

Friday: Still high fever, we even tried sweating it out. Now he is really feeling crappy and the cough syrup is almost gone. (They gave a small amount). The poor child has gone through a huge bottle of Motrin (he takes liquid) and still no improvement. They would not see him. I insisted on coming in on Saturday, said I would sit there until they saw him....

Today: Went to the office. They said, could be viral, etc. They heard some wheezing in his lungs, but thought it was nothing. Asked me if I wanted a flu test, I insisted. Negative by the way. Got a lecture about not getting the flu shot even though he tested negative. Asked if I wanted a chest Xray for the wheezing, I said YES. This PA said his amoxicillin would not treat bronchitis and ordered Levaquin and more cough syrup, but still said we should wait it out.

So we go get the Xray. DS has pneumonia in the total left lower lobe and is considered at least moderate.

I am calling the office to see his Doctor on Monday and get more answers as to his meds, any other treatments we should be doing and the mis-care we received.

How would you handle it, and do you think they were in error not seeing him? I am really close to the situation.. I am his Mom afterall!!

Thanks for any advice.

This was very poor treatment of a child! As a Primary Care Provider, I can say that I always insisit that parents or patients let me know if they aren't better in a couple of days. If they aren't, I want to see them back. By the way, Levaquin isn't recommended for anyone under 18. It can cause tendon ruptures or slow bone growth. I really hope that you find another Primary Care Provider

 

[C.Ann]

I will keep a very close eye on him. He is eating, not great, but eating. He is taking in tons of fluids. He takes one pill a day and his first one was at 12 this afternoon. I will make sure DH broaches the bathroom situation with him and tells him any changes must be told to us immediately.

Most of all I do feel like a cruddy mom letting it go so long. He doesn't get sick often, and this is his first real illness other than having his tonsils out. His is happily playing his Xbox right now, and temp time is soon.


As for the other question, we have piggy-backed motrin and tylenol when it doesn't go down as quick or as long as I would like. I truly can not wait until Monday to sit in the office and look into the doctors eyes to truly see what is going on! I am very upset over this whole situation.

You are not a "cruddy mom".. You were staying on top of things from day one - following instructions.. You shouldn't have to be the "doctor" -that's what you pay them for..

I prefer to give the benefit of the doubt whenever possible, but they clearly dropped the ball on this one.. Once your son is well again, you and your DH might want to seriously consider whether or not this is a doctor's office that you want to manage your son's medical care..

Again - not a "cruddy mom"..

 

[C.Ann]

This was very poor treatment of a child! As a Primary Care Provider, I can say that I always insisit that parents or patients let me know if they aren't better in a couple of days. If they aren't, I want to see them back. By the way, Levaquin isn't recommended for anyone under 18. It can cause tendon ruptures or slow bone growth. I really hope that you find another Primary Care Provider

Unreal!! Shouldn't have even been prescribed for a 15 yr. old??

We only had adult patients in our office and after seeing what happened to them, I swore I would never, ever take this medication - no matter what..

 

[heatherwillmom]

Anytime someone has a severe cough, especially with a high fever, a chest x-ray should be done. Even if the flu test was positive, they waited too late for treatment. The anti-viral medication that works on the flu (it doesn't cure it, just lessens the severity), has to be started within 48 hours of symptoms. It is standard practice if anyone has a fever & cough, a flu test should be done. It only takes 10 minutes to run.

 

[dis-happy]

Your problem was seeing the PA. Ever since my dd's pneumonia was mis-dx by the office PA I always insist on seeing one of the doctors in the practice and NEVER the PA.

 

[Jennasis]

I have a cousin who's pnuemonia was misdiagnosed as a STRAINED BACK by the ER docs. When she finally convinced them to do some chest films she was pretty bad off and wound up in the ICU for days fighting the pnuemonia.

 

[arminnie]

FYI - next time just take him to ER. Doctors these days just don't treat much of anything - they just do routine checkups. They usually send sick people to ER.

I've had horrible sciatic pain - waited 6 weeks to see my doctor. She told me to come back Dec.1. I went to ER Wed. as I just couldn't wait another month with the pain I was in. The ER doc confirmed that half of their patients are there because they can't get in to see their doctors. He even called my doctor and tried to get her to see me earlier with no luck.

I have great insurance. I didn't go to ER for "free" care. ER diagnosed a cyst on my spine that requires surgery. It would have taken my doctor at least a year to figure that out. And she consistently gets rated the best internist in the state.

Years ago I had augmentin prescribed to me - a big NO NO for someone allergic to penicillin. I spent 2 weeks in the hospital trying to recover from that.

I had hideous pneumonia - could barely, barely breathe. The doctor refused to see me and told me to go get some robitussin. I literally almost died.

And I don't think these are awful, awful doctors. It's just the way that medical practices are run these days. Way too many patients per doctor.

 

[JoiseyMom]

A friend of my just dealt with this a few weeks ago, her DS8 was sick and had a bad cough and fever. She finally had to insist on a chest xray, and he also had pneumonia! He was home for 10 days! ANd this was her pediatrician, not a PA. We have also told her to switch doctors! If she hadn't insisted on the xray, who knows what would have happened.

I hope your DS feels better soon!