Inadequate Service from GP's office, WWYD?

[bumbershoot]

Got sick on Tuesday, is still sick. Sounds like a normal cold to me. And yes, some of our colds have a sore throat component (even though the ear nose throat guy that took out my tonsils SWORE that I wouldn't get sore throats after having them out).

I think the doctor prescribed antibiotics recklessly and stupidly. There should ALWAYS be a culture WITH results before antibiotics. Antibiotics are strong drugs with heavy and negative consequences, and shouldn't be prescribed lightly.

I think that you guys focused on suppressing the symptoms repeatedly, and if this happened in my household I would not be surprised that it turned into pneumonia. In my understanding pneumonia is the body's reaction to an illness that isn't working itself out; and I would expect that if I were keeping a family member from coughing, lowering the body's temperature as the body struggled mightily to raise it, etc etc etc. Every step of the way, his immune system was stopped in its tracks.

And of course this is a very common thing to do in America with western medicine being all that we're exposed to. We hardly know what else to do. To allow someone to cough, to allow someone to go through a fever, those are almost unknown here. It's hard to know better. So in the future...cough the stuff up. Drink nice teas ("throat coat" is lovely for a sore throat with its slippery elm and marshmallow root). Eat garlic, support the immune system. I personally have had great results with wrapping up in warm blankets and just sleeping the fever off, but then I LIKE the hallucinations (when I get sick I get SICK) LOL. With DS, if he wants to wrap up we let him, if he's uncomfortable with being so hot then we (he's only 6) or he will take a nice tepid bath (and I've been known to take a tepid bath myself, if I'm tired of the heat while I'm fevering) to lower his temperature gently, slowly, and naturally. Eat more garlic. Cough more stuff up. Get it up and out, support the immune system with what it's doing.


So obviously I'm livid with your doctor, b/c he helped to thwart your son's immune system, and didn't do a culture (or at least didn't wait for results, as my pediatrician always did) before letting your son start antibiotics.

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.

Yep! And they'd be right.

They can also mess up the body's systems so that a virus can take hold and complicate matters even more.

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?

What it is depends on how it started. So if they'd done a culture and waited for results, they would have known what was going on.

I would not be scared right now, but I'd be doing everything I could to help his body heal from this. Getting the gunk out (NO cough syrup, first off) being the first priority.

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.

The in between that the nurse above and I are talking about is not wrapping him up to "sweat it out", but also not chemically lowering his body's attempts at heating up his body. It's letting him fever but also with him wearing cool clothes. A way of thinking about fever is thinking about how we will wash things in hot water to reduce the germs on the items. The body's trying to "wash" itself, and it's doing that by heating itself up. Not everyone wants to go the route that a friend of mine does (drinks a shot or two of blackberry brandy, wraps himself up, sleeps through the fever and wakes up peachy keen), but just having a fever isn't horrible, and using the drugs isn't something that should necessarily be done for every fever.

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.

Again, this isn't "so long" to me. This is a pretty normal illness arc to me. I wouldn't beat myself up over that sort of thing. A month ago DS and I had some bizarroland cold that took a full week to really get through, then we were wiped out for another week! The third week we were so used to being lazy that we just were lazy, and the fourth week we got tired of being lazy and finally felt 100%. I'm at home and we homeschool, so we CAN do that sort of thing, to really truly and totally get through a cold, so we know what colds can be like...most of my other friends with work and school-school can't do that, MUST use drugs, and so think that colds are short-lived things. And how could they know otherwise, since they can't do it. But I'm telling you that I know that colds can last quite awhile and it can take a bit to get back to 100%.

When did he have his tonsils out? I had mine out at 20, and from that point on, my illnesses have been FAR worse, and FAR more lung-based, than they were before. Which only makes sense. After all, the tonsils are the body's first-line defense system (well, the nose is the first if you're breathing through the nose). Their job is to catch the crud and take care of it right there, to not let it enter the respiratory system. So your son and I don't have those defense systems anymore; it only makes sense that things are going to get to the lungs now. Fun fun! I sure do regret my choice to have my tonsils out, and what I can do NOW is to support my immune system in the most natural ways possible. And that's what I really urge you to do with your son now.


My hubby is Korean, and his mom swears by spicy bean paste soup with bean sprouts and red pepper flakes. She also swears by marrow soup, but we are vegetarian and that's not acceptable, LOL. But if you can find a good Korean restaurant that sells spicy soups with bean sprouts, those have been invaluable to us when hubby's home to make the soup for us! Packed full of antioxidants and vitamins.

 

[C.Ann]

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.

I'm so sorry to hear that you are going to need surgery.. Can this be done out-patient - or will you be hospitalized for it? Do they know what caused it?

I'm allergic to penicillin too - along with a slew of other drugs.. My doctor is great about remembering my allergies; my extreme sensitivities to many, many meds (even OTC stuff) - but just to be safe, I remind her every time and she's very nice about it.. No "attitude"..

I used to get pnuemonia at least twice a year from the time I was 25 until I was almost 50 years old.. Was hospitalized several times - and always coughed so hard that I would end up breaking at least one or two ribs - sometimes more.. One time I had started seeing a new PCP and got the PA instead.. They had an x-ray machine right there in the office and he found a broken rib.. Prescribed cough medicine with codiene in it, had me come back in a week, did another x-ray and found 2 more broken ribs! At that point he very gently asked me if I was a victim of domestic abuse!! I almost fell off the table - LOL..

Don't know what happened when I turned 50, but I never had pnuemonia again - nor have I ever broken another rib - or any other bone, for that matter..

I know the healthcare system is a mess - and some doctors have an overload of patients - but when peoples lives are at stake, they simply have to make the time somehow.. If the ER's can do it, the PCP's (and specialists) should be able to find a way to manage their time (and patient load) as well..

Let me know when you're going to have your surgery.. I'd like to say a special prayer for you - if you don't mind..

 

[krcit]

The thing that bothers me the most is that they refused to see you. I've been going to my pediatricians for over 15 years and they have never refused to see one of my kids. If they had, I would switch Drs. I am not one of those who rush their kids in with every sniffle so they know that if I'm concerned, there is a reason for it, just like you sound OP, so that aspect of the whole thing is just so wrong to me. I hope he feels better asap.

 

[Tinker'n'Fun]

The thing that bothers me the most is that they refused to see you. I've been going to my pediatricians for over 15 years and they have never refused to see one of my kids. If they had, I would switch Drs. I am not one of those who rush their kids in with every sniffle so they know that if I'm concerned, there is a reason for it, just like you sound OP, so that aspect of the whole thing is just so wrong to me. I hope he feels better asap.

First, I am not even sure he knows I called. I am positive that the front office is and was at fault. He has never refused to see me or the kids ever before, I have been sent to the PA, but never refused. I know who I spoke to on each of the days. I am disabled so I am at the office very often and know them all well. Two of the Three times, I spoke with the nurse of another Doctor in the practice. I am not trying to say my doctor is perfect, but until Monday I don't know if he knew about this.

I now will admit, with this post, I am really scared. Not sure if I should give DS his antibiotic tomorrow or not. I believe I will call the pharmacist as they are the most knowledgeable about the meds themselves. If they have any concern with him taking it, I will call the doctor on call (It will definetely be a doctor and they call you specifically) and or I will be at the walk-in clinic. I have to admit, while I asked questions and pushed today, I didn't ask enough. I don't have the knowledge to totally understand how to treat DS. His fever is much lower tonight and hasn't gone over 100.2 since this AM. He said he feels the wheezing now, but I am not sure if that is because the drs. noticed it (both the PA and the dr. that read the Xray). Wheezing scares the bejeepers out of me. If he sounds really bad, no matter what I will take him to the ER. I am just hoping to make it through the night without any events. His cough is calm at the moment, so no cough medicine is needed.

I really want to thank everyone who posted. All knowledge is helpful. I have been an extremely lucky mom like I said and this is the first time he has been this sick. He had his tonsils out at 5 and actually came out of surgery asking for chicken wings.

I have to totally give props to parents who care for kids who are sick a lot. Not sure how I would handle it. I guess I need to educate myself (without google) and find out how pneumonia is treated properly.


As for the question regarding the soccer league, the dr. stated he is out of gym for at least 4 weeks from his first clear film. Not sure if that is normal for pneumonia, but she said he will be very tired etc. This would leave him out of more than 1/3 of the winter season which is broke into two sessions. He would play the second section.

I just wish I could make this all go away. Guess that isn't happening!

 

[C.Ann]

I now will admit, with this post, I am really scared. Not sure if I should give DS his antibiotic tomorrow or not. I believe I will call the pharmacist as they are the most knowledgeable about the meds themselves. If they have any concern with him taking it, I will call the doctor on call (It will definetely be a doctor and they call you specifically) and or I will be at the walk-in clinic. I have to admit, while I asked questions and pushed today, I didn't ask enough. I don't have the knowledge to totally understand how to treat DS. His fever is much lower tonight and hasn't gone over 100.2 since this AM. He said he feels the wheezing now, but I am not sure if that is because the drs. noticed it (both the PA and the dr. that read the Xray). Wheezing scares the bejeepers out of me. If he sounds really bad, no matter what I will take him to the ER. I am just hoping to make it through the night without any events. His cough is calm at the moment, so no cough medicine is needed.

I really want to thank everyone who posted. All knowledge is helpful. I have been an extremely lucky mom like I said and this is the first time he has been this sick. He had his tonsils out at 5 and actually came out of surgery asking for chicken wings.

I have to totally give props to parents who care for kids who are sick a lot. Not sure how I would handle it. I guess I need to educate myself (without google) and find out how pneumonia is treated properly.


As for the question regarding the soccer league, the dr. stated he is out of gym for at least 4 weeks from his first clear film. Not sure if that is normal for pneumonia, but she said he will be very tired etc. This would leave him out of more than 1/3 of the winter season which is broke into two sessions. He would play the second section.

I just wish I could make this all go away. Guess that isn't happening!

Awww.. Don't be scared.. It actually sounds like he might be coming back around again..

Call the pharmacy tomorrow about the antibiotic.. If anything happens between now and then - or before you talk to the doctors office again on Monday - just go ahead and take him to the ER - or an Urgent Care facility (if they have an x-ray machine available - call ahead to be sure)..

If you're not used to dealing with your kids being sick, it can be very, very frightening.. But you're doing a good job - you know what to look for - and you have a plan.. Can't do much more than that..

Cut yourself some slack - or you'll be sick next! And make sure you get some rest tonight!!!! I promise I will include your son in my prayers tonight..

 

[Tinker'n'Fun]

Awww.. Don't be scared.. It actually sounds like he might be coming back around again..

Call the pharmacy tomorrow about the antibiotic.. If anything happens between now and then - or before you talk to the doctors office again on Monday - just go ahead and take him to the ER - or an Urgent Care facility (if they have an x-ray machine available - call ahead to be sure)..

If you're not used to dealing with your kids being sick, it can be very, very frightening.. But you're doing a good job - you know what to look for - and you have a plan.. Can't do much more than that..

Cut yourself some slack - or you'll be sick next! And make sure you get some rest tonight!!!! I promise I will include your son in my prayers tonight..

I guess since this brought out tears, I really am a bit tired and stressed over this. Thank you for the prayers they are greatly appreciated. DS said he is going to bed and that I should too. He said the wheezing is freaky but nothing he can't handle (he such a little man). I guess the not sleeping all week has finally taken its toll....

 

[heatherwillmom]

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.

I highly disagree with this statement. Overall, mid-level providers, like PA's typically spend more time with patients that the doctors do. Many clinics are ran by the PA's. The doctor just stops by occassionally while the PA does most of the work. At our pediatricians office, we usually preferred the Nurse Practitioners because they spent more time with us & our children.

 

[heatherwillmom]

I had 2 different friends whose children were seen bytheir pediatrician, not the PA. Both were told that their children's cough was nothing to worry about & no x-rays were done. Both of them took their children to a different doctors office & saw a Nurse Practitioner who x-rayed them & diagnosed them with pneumonia

 

[krcit]

I guess since this brought out tears, I really am a bit tired and stressed over this. Thank you for the prayers they are greatly appreciated. DS said he is going to bed and that I should too. He said the wheezing is freaky but nothing he can't handle (he such a little man). I guess the not sleeping all week has finally taken its toll....

get some sleep and hopefully tomorrow your ds will be feeling better. It stinks when they are so sick...so scary. Keep us posted.

 

[Hannathy]

it sounds like he is doing really well!! he is responding to the meds if his fever is down. He is wheezing more because the mucus is breaking up and getting looser in his lung. You don't want him non stop coughing but you do want him doing a lot of deep breathing and a little coughing is helpful.

Encourage him to take some nice deep breaths and to blow our thru his lips like he is whistling several times and hour.

call and ask about the med but I would not stop giving it to him without something else in it's place because that is just going to make it harder to kill the infection. (it's one of the ways super bugs get going because you give them just enough to learn how to resist it and not enough to kill them)

I also have to disagree about the PA. I like them a lot and have also found they spend more time with the patients. I also have to object with going to the ER with non emergency things. It really makes it hard on the staff to be open for the true emergency cases.

 

[dis-happy]

I highly disagree with this statement. Overall, mid-level providers, like PA's typically spend more time with patients that the doctors do. Many clinics are ran by the PA's. The doctor just stops by occassionally while the PA does most of the work. At our pediatricians office, we usually preferred the Nurse Practitioners because they spent more time with us & our children.

Time spent with the patient sounds more like a function of the front office scheduling.

It was the PA's (who are overseen by a Dr. for a few hours each morning) at my dd's college health clinic who almost killed her 3 years ago. They mis-dx what turned out to be mono for over a month. In the end they rushed her by ambulance in the middle of the night due to what they said were breathing difficulties (they even gave her an asthma inhaler earlier in the day even though she told them repeatedly she doesn't have asthma problems). She had trouble breathing because her throat was so swollen from the mono. How did this almost kill her? It turned out her spleen was extremely swollen as well, quite an unknown danger for someone who rides and jumps a horse several times a week (one fall and she could easily have bled to death within minutes).

Added to a couple of other incidents involving PA's and I'm happy to skip over them and go directly to the MD who has more training and knowledge. Never had a problem with lack of time and care during an office visit, they have all been terrific at listening to me if I think something is "off", and when a big issue is at hand, they have no problem suggesting a visit to a specialist (as in, they know their limitations). I do spend time trying to find the best doctors I can, however, and that pays off (and the reason I am a high stage cancer survivor). Honestly, if you were dx with cancer tomorrow, would you want to see a top oncologist personally or a PA in the same office who might spend more time talking to you? I'd prefer to trust my life with the person who has the greater knowledge and schooling.

A few summers ago there was a virus going around our area that started off with virus symptons, then turned into pneumonia. 4 out of 5 members of my family including my dh (but not me!) got it, one after another with a couple of weeks in between. By the time I was in there with my 3rd child the ped said "it's a virus". But she listened to me when I said what my experience had been with the follow-up pneumonia, and since this particular child also had a heart defect, agreed to start the antibiotics sooner rather than later (even though she said she didn't think it would do any good). Indeed, it stopped everything in its tracks, the only child who didn't get way worse before he got better.

More than anything, I'm horrified for the OP that her child was getting worse and the office refused to see her. Every single time I've brought a child in for something like that the ped. ALWAYS tells me that if symptons worsen to come back in asap. It's insane that they wouldn't make an appt. for her.

 

[disfan07]

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

Not necessarily. That's a bad general statement. It all depends on the doctor.

MY internist is my gate keeper for my other 7 doctors. She talks to them constantly. She know sthat I dont present with normal symptoms for anything, especially my asthma and she listens to what I say is wrong rataher than just going by test results. I dont go to the ER unless it is the middle of teh night or a holidy.

I have had a fever for 2 weeks (low grade), plus stomach problems and headaches in addition to other symptoms all for 2 weeks. I finally gave in and called my internist on thursday. When I talked to her and told her what was wrong she had no problem telling me how stupid she thought it was for me to wait this long and that she was scheduling me to come in monday even if it was after what was supposed to be her last appointment. Now granted, she thinks i'm stupid for waiting because I have asthma, plus I am on methotrexate but I figured it was just a virus. But this is how amazing my doctor is. She knows I dont want to see anyone but her so she accomodates my schedule.

I routinely spend more than 10 minutes with my doctors: Thsi is how long a normal appointemtn is (sometimes they are longer):
Internist 20-30 mins
Cardio 20 minutes
Pulm. 20-30 mins
Derm. 45 mins
Immunologist. 1- 1 1/2 hours
GYN. 30 mins
Neuro 30-45 mins
neurosurgeon 20-30 mins

Maybe this is out of the ordinary but none of my doctors would ever just spend 10 mins with a patient.

As to PAs...well, I do think there are good ones. At the private hospital we used to go to in Virginia, we had one amazing one in the ER. I havent dealt with any since we moved. The specialists here dont have PAs and I'm not sure if my internists office does but I refuse to see anyone but her anyways so its a moot point for me

 

[Pea-n-Me]

I've had something very similar happen to me and no, I didn't change care teams over it.

With that said, I can see issues on both sides that weren't ideal. For one thing, I can't imagine a care team giving antibiotics to use "just in case". If symptoms aren't better, it warrants being re-seen and decisions about further treatment made then. So that to me is an issue. I have to wonder if this particular care team is overwhelmed with patients if they're giving out treatment just in case and refusing appointments. That might make me change.

OTOH (and I assume you want honest opinions, will try not to "lecture") some of your responses seem rigid and uninformed so some of the responses you got, IMO, might have been an attempt to try to educate you that, in the emotion of your son's illness, didn't come across well - on either side. For instance, you seem to think that because your son is "healthy" (as is most of the population), he wouldn't get pneumonia. Healthy people do get pneumonia, unfortunately. And an important FYI is that chronic sinus disease can often lead to prolonged upper respiratory illnesses and those can sometimes then turn into lower respiratory illnesses - I know this because I live with it (my DH) even though you might not be able to find it in a textbook and why the suggestion of vaccination makes sense here as well, but that's up to you and I won't get into it as I respect people's right to refuse. Just something to keep in mind as you go forward. (I'd also wonder at 15yo why your son's taking liquid motrin, especially where he can take pills. And the "poor child" and "I'm always right" comments makes me wonder how you came across to others, but I guess that's neither here nor there and just pointing out how they came across to me.)

At any rate, the fact that he had a cough with no fever for a while would indicate to me that it was probably your average, run of the mill cough/cold. It seems from your OP that the fever was new the day he went to the doc's (Mon), or possibly over the weekend, etc.

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.

First sign it's getting more serious now, although it's possible the motrin and tylenol was masking a fever (but unlikely if he now had one but was presumably still taking the motrin/tylenol). But hint of more seriousness, regardless, is prolonged symptoms, now with fever. Which I presume is why PA gave antibiotics to use "just in case" - ie that person know it could turn into bronchitis or pneumonia.

The way pneumonias begin is that viral or other illnesses, often in the upper respiratory track, cause changes and irritation to the lower respiratory track that allow infections to "take over". This happens over days. Things change and opportunistic germs grow. So the course of your son's illness doesn't seem like it would be out of the realm of possibility of URI turning into pneumonia, which is what happened to me as well. (In my case I was not prescribed antibiotics by the NP, and later, when I re-presented with worsening symptoms and saw my doc, she was p'd I'd had no XRay and no antibiotics, and by that time my heart rate was elevated to 150 and it took me many weeks to recover. And btw, this is not a post against NPs or PAs because I've had some great care by them for me and my family, as vice versa I've had great and not so great care by doctors as well. It happens. And I think it happens/can happen everywhere. They're all people, and nobody is perfect. With that said, I think the type of practice they practice in is important. There should be good teamwork - including not being afraid to ask others' opinions - supervision and leeway for seeing patients when needed, not turning away.)

Pneumonias can be caused by viruses, bacteria or other organisms, but antibiotics are usually given because unwanted bacteria often appear. Read more here: http://www.medicinenet.com/pneumonia/article.htm Cultures are not usually done before treating pneumonias. Further, our pediatrician doesn't even use CXRs to diagnose pneumonia as she trained in a place that didn't have an XRay machine and became very good at diagnosing pneumonias based on other things, so an XRay is not an absolute, but it is helpful to see actual views for certain if the tool is available. Experienced practictioners know when they're seeing pneumonia, BUT pneumonia does take a while to develop AND nobody wants to jump the gun on giving antibiotics unnecessarily SO... it's a judgement.

HTH somehow. And I hope your son feels better soon.

 

[C.Ann]

Just checking in to see how your son is doing today.. Hopefully much better - and you both got a good nights rest!

 

[Tinker'n'Fun]

I've had something very similar happen to me and no, I didn't change care teams over it.

With that said, I can see issues on both sides that weren't ideal. For one thing, I can't imagine a care team giving antibiotics to use "just in case". If symptoms aren't better, it warrants being re-seen and decisions about further treatment made then. So that to me is an issue. I have to wonder if this particular care team is overwhelmed with patients if they're giving out treatment just in case and refusing appointments. That might make me change.

OTOH (and I assume you want honest opinions, will try not to "lecture") some of your responses seem rigid and uninformed so some of the responses you got, IMO, might have been an attempt to try to educate you that, in the emotion of your son's illness, didn't come across well - on either side. For instance, you seem to think that because your son is "healthy" (as is most of the population), he wouldn't get pneumonia. First of all, I don't mind honesty, and none of this post bothers me, but I feel I should respond. The post that he is usually healthy has to do with the fact that I was not prepared for the diagnosis of pneumonia. I am not oblivious to the fact that healthy people get sick. It just caught me off guard. Healthy people do get pneumonia, unfortunately. And an important FYI is that chronic sinus disease can often lead to prolonged upper respiratory illnesses and those can sometimes then turn into lower respiratory illnesses - I know this because I live with it (my DH) even though you might not be able to find it in a textbook and why the suggestion of vaccination (DS has received the Flu shot twice, both times with a bad reaction, he no longer receives it at his Doctors recommendation) makes sense here as well, but that's up to you and I won't get into it as I respect people's right to refuse. Just something to keep in mind as you go forward. (I'd also wonder at 15yo why your son's taking liquid motrin, (He takes pills and liquid, and prefers the liquid with the fever as it seems to take the fever down a bit quicker, he takes 4 tsp or 400mg of Motrin which is the correct dose for his age/weight)especially where he can take pills. And the "poor child" (poor child is my response as his mother, I would think that I am not the first to use those words when talking about their child) comment makes me wonder how you came across to others, but I guess that's neither here nor there and just pointing out how it came across to me.) This is an internet board, and how I came across to others, really doesn't matter, getting advice on how to handle the situation is invaluable to me, and for the record, while I am defending myself, your post did not upset me, just was worded in a way that I felt the need to respond.

At any rate, the fact that he had a cough with no fever for a while would indicate to me that it was probably your average, run of the mill cough/cold. It seems from your OP that the fever was new the day he went to the doc's (Mon), or possibly over the weekend, etc.



First sign it's getting more serious now, although it's possible the motrin and tylenol was masking a fever (but unlikely if he now had one but was presumably still taking the motrin/tylenol). But hint of more seriousness, regardless, is prolonged symptoms, now with fever. Which I presume is why PA gave antibiotics to use "just in case" - ie that person know it could turn into bronchitis or pneumonia.

The way pneumonias begin is that viral or other illnesses, often in the upper respiratory track, cause changes and irritation to the lower respiratory track that allow infections to "take over". This happens over days. Things change and opportunistic germs grow. So the course of your son's illness doesn't seem like it would be out of the realm of possibility of URI turning into pneumonia, which is what happened to me as well. (In my case I was not prescribed antibiotics by the NP, and later, when I re-presented with worsening symptoms and saw my doc, she was p'd I'd had no XRay and no antibiotics, and by that time my heart rate was elevated to 150 and it took me many weeks to recover. And btw, this is not a post against NPs or PAs because I've had some great care by them for me and my family, as vice versa I've had great and not so great care by doctors as well. It happens. And I think it happens/can happen everywhere. They're all people, and nobody is perfect. With that said, I think the type of practice they practice in is important. There should be good teamwork - including not being afraid to ask others' opinions - supervision and leeway for seeing patients when needed, not turning away.)

Pneumonias can be caused by viruses, bacteria or other organisms, but antibiotics are usually given because unwanted bacteria often appear. Read more here: http://www.medicinenet.com/pneumonia/article.htm Cultures are not usually done before treating pneumonias. Further, our pediatrician doesn't even use CXRs to diagnose pneumonia as she trained in a place that didn't have an XRay machine and became very good at diagnosing pneumonias based on other things, so an XRay is not an absolute, but it is helpful to see actual views for certain if the tool is available. Experienced practictioners know when they're seeing pneumonia, BUT pneumonia does take a while to develop AND nobody wants to jump the gun on giving antibiotics unnecessarily SO... it's a judgement.

HTH somehow. And I hope your son feels better soon.

As for the rest of the post, thank you for the information you provided re: pneumonia and how it progresses. As I stated originally, I am not educated on the disease and refuse to freak myself out with the grave information that google provides.

 

[Tinker'n'Fun]

Just checking in to see how your son is doing today.. Hopefully much better - and you both got a good nights rest!

Thank you for checking in C.Ann. I decided it was in my best interest to get off the internet last night and get some sleep. DS's fever seems to be gone. . He is coughing more, which I am reading/learning from this thread is normal. He still feels like he is wheezing when he coughs. I gave him cough syrup this morning to "treat the symptoms" which is what the PA requested I do. While I am not sure if this is a good thing or not, he is more comfortable, and that is what matters for today. I am hoping that the day stays as it is now and I will take him directly to his Doctor in the morning. I will then make the decision on whether or not we need to change or not.

I have learned a bit from here, but I am still not sure how I should approach the doctor or the situation. Guess in life, the "Dis" board is not going to give me that answer. Only I can do it. I will let you tomorrow how things a going. I am sure your prayers were heard last night.

 

[Pea-n-Me]

A response to the response. Glad you didnt' take offense. Just trying to help in pointing out both sides of the situation.

What you might say to the doctor is that you are upset at the way this was handled. Be prepared for defensiveness on his or her part.

Guess in life, the "Dis" board is not going to give me that answer.

Maybe you're not trying to be sarcastic, but this is somewhat offensive to those who've taken time to try to help you in three pages of posts. I spent the better part of an hour writing out my post. I'm sorry you haven't found the answer you're looking for.

 

[Tinker'n'Fun]

A response to the response. Glad you didnt' take offense. Just trying to help in pointing out both sides of the situation.

What you might say to the doctor is that you are upset at the way this was handled. Be prepared for defensiveness on his or her part.


Maybe you're not trying to be sarcastic, but this is somewhat offensive to those who've taken time to try to help you. I spent the better part of an hour writing out my post. I'm sorry you haven't found the answer you're looking for.

Here's the full quote from a post to C.Ann:

"I have learned a bit from here, but I am still not sure how I should approach the doctor or the situation. Guess in life, the "Dis" board is not going to give me that answer. Only I can do it. I will let you tomorrow how things a going. I am sure your prayers were heard last night."

I guess I don't see where the problem is. I was being far from sarcastic. The quote was not to you but to someone who was offering prayers and my response was in regards to that. I admitted that I "yes ME" had not figured out how to handle the situation, but I "yes ME" admitted that I learned a bit from here, and I think that I have taken the time to thanks those who helped me with information, including you.

So for those who feel that I am being sarcastic, nasty, unappreciative of your advice, please accept my apology. I was extremely tired and stressed last night. I was posting out of fear for something I had no true knowledge of. I thought that I was being considerate in my posting. Ultimately our writing styles and or ways to communicate vary extremely. I really hope that I haven't taken your posts out of context and called you on it.

 

[Pea-n-Me]

My intention was not to further upset you. It was just to point out some things, possibly in writing style but on the chance it was similar IRL, that may have contributed to impeding the communication between you and your care team. That's all. Oh, and I also don't think your a crappy mom. Stuff happens. Good luck with your situation, truly. And take good care of yourself today, too.

 

[C.Ann]

Thank you for checking in C.Ann. I decided it was in my best interest to get off the internet last night and get some sleep. DS's fever seems to be gone. . He is coughing more, which I am reading/learning from this thread is normal. He still feels like he is wheezing when he coughs. I gave him cough syrup this morning to "treat the symptoms" which is what the PA requested I do. While I am not sure if this is a good thing or not, he is more comfortable, and that is what matters for today. I am hoping that the day stays as it is now and I will take him directly to his Doctor in the morning. I will then make the decision on whether or not we need to change or not.

I have learned a bit from here, but I am still not sure how I should approach the doctor or the situation. Guess in life, the "Dis" board is not going to give me that answer. Only I can do it. I will let you tomorrow how things a going. I am sure your prayers were heard last night.

So glad to hear that!!

Would have helped if I had your son's name last night, but I remembered your screen name (which is really unusual), so I ran with that.. I'll say another one tonight - that all remains well - and you find the ability within yourself (I'm sure it's there) to know just the right thing to say tomorrow - as well as making your decision in regards to what you feel comfortable doing (or not) in terms of this particular practice..