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Northern California Babies
Meritage
member
Would you switch pedis?
Meritage
member
Just something that's on my mind. After 8 days in the hospital, my son is now home and recovering well. He'll still have 14 days of IV antibiotic treatment that I will administer at home 3x a day, but he is on the mend and we are so thankful!
I'm not feeling super confident in my pedi though. He started a fever on Friday night, and it remained ~102 all weekend. Monday, he went to the pedi. Pedi said it was an ear infection, prescribed antibiotic, and sent us on our way.
I called on Wednesday, said he's not improving at all, and pedi said to wait another day. He had trouble sleeping at night, had to sleep upright in chair, complained of pain in his lower stomach, clearly had issues breathing at night, and it was very scary. I thought many times late at night that I should jump in the car and take him to the ER.
We went back on Thursday, still no improvement, and this time, pedi thought he was coming down with pneumonia, prescribed new antibiotic to deal with it, and sent us on our way.
Still no improvement, so on Saturday, we went to the minor emergency clinic. Doc was suspicious, ordered chest x-ray, and told us he has pneumonia, it's bad, and this kid needs to be in a hospital.
Turned out it was so bad, he needed surgery. He's much better now, but I'm not so sure about the pedi anymore. I don't totally blame him either. I think he did the right things, and I know an x-ray is a last resort for a young child since you don't want to expose them to radiation. I just think that maybe he could have done more at our appt on Thursday when I told him how difficult it was at night.
I dunno. WWYD?
This discussion has been closed.
Re: Would you switch pedis?
Well....it's a lousy situation, but I wouldn't change based on this alone. One reason being the viral form of pneumonia isn't that uncommon in kids, and the treatment is exactly the same as it is for an ear infection. So even if the symptoms say pneumonia, it's not uncommon to not do the chest xray if there is an ear infection because the treatment is the same - you're killing both (potential) birds with one stone. Now, the appt on thurs...wouldn't be completely out of line to have had a chest xray at that point. but also not completely unusual to try the next antibiotic, either. I think C's situation was pretty rare and unfortunately one of those situations where it looked rather common and the doc thought he was doing what was best - and would be best in 90% of the cases.
It really depends on your relationship with him. With our old pedi, I think I had reservations from the start and this would have been a deal breaker. with our current pedi, I'd chalk it up to a rare situation and let it be. but you need to trust your kiddos doc, so if this is going to affect that (understandably), then it's probably best to change.
I switched for a lesser situation. DD had horrible symptoms and he kept saying, "Don't worry about it." I did have a second pediatrician that I signed up with (because we frequently visit my mom in another county and I wanted a pediatrician over there in case something happened while we were over there) so I took her to get a second opinion. And yes, DD had something going on. It wasn't quite as serious but the fact that it was overlooked and it could have escalated made me lose faith in that doctor. So I switched and never looked back with regret. I love the new pediatrician, even though we have to drive 45 minutes to get there.
You do what gives you the most peace of mind.
I would want to know more details, like if he checked a respiratory rate and oxygen saturation.
But if it was me, I would switch just based on the feeling of not being sure about him. To be unconfident in your doctor is the worse feeling!!!
It is really hard to find a good doctor pediatric or adult. It seems most/all are trained just to treat the symptoms and not search for the cause to solve the bigger problem. As my mother has always told me, you tell the doctor what you want done, what you suspect and be persistent & mean if you have to.
If you feel like switching, switch but the chances of finding a really good pedi are generally low
Yes, I would change.
You know I went through a similar unexplained fever with Alex recently- his turned out to be nowhere near as serious as Carter's and I'm switching pedi's over it- because it COULD have been.
I need someone who listens to me and doesn't make me feel like a freak.
So sorry you had to go through this, S. Sending tons of love.
H
This alone would make me change pedis. I think it super important that you are able to trust your doctor and there are so many doctors out there that it is so not worth it to stick with one who has lost your confidence.
I'm so glad your little guy is home and recovering. What a scary ordeal this must have been for all of you
Big hugs.
Two things bother me, but I am probably a little "conservative" or overly cautious as doctors go.
For one thing I probably would have just seen him back when you were concerned on Wednesday if there was no improvement in two days.
Second when he saw your DS on Thursday, he did note that he had pneumonia, which is fine and he treated without an xray which is also fine, because if you KNOW there is pneumonia you don't always need an xray. I am wondering if he checked his oxygen saturation with the little finger test that is so easy and quick to do. There may have been signs of respiratory distress already, that he or she missed, that would be my concern.
Yes, I would switch. And in all honesty I'd probably blame him...maybe not completely but I'd be angry with him and I doubt I could ever trust his opinions again.
I'm so sorry you had to go through this, but I think it's a good reminder for all of us to not always take the doctors at face value, and to trust our instincts as moms.
One question, did he listen to his lungs any of the times you brought him in? Considering the severity of your sons lungs it should have been easy for the Doc to hear it. If he didn't even bother to listen to them those times that you came in, then I would switch in a heartbeat. If you have loved your doc up to this point then I would take a little time, see how he responds to what has happened (if he's blase about it then switch, if he feels horrible maybe another chance).
Did you talk to the Docs in the hospital at all about the antibiotics RX'd and their opinions on why the pneumonia progressed so severely while he was being treated with antibiotics.
The course of action taken by your Dr. doesn't sound unusual to me (without knowing if he listened to the lungs at the visits) so I guess some of the questions I would have for my own doc, why did he continue to get worse even after being put on antibiotics, would the treatment have been more effective had a 2nd antibiotic been added instead of being changed. Most importantly, does he (your own doc) wish he had handled it differently in retrospect and why or why not? Not that it changes anything but docs should always been learning and so how he views the entire unfolding of events would tell me a lot about future ability to trust.
I can't imagine that he diagnosed Pneumonia without listening to his lungs, and these things can progress very rapidly, if an empyema forms (pus around the lung). I actually had a child recently, 7 yrs old, came in with fever for three days, looked fine, lungs sounded great, sent home, seen back three days later, still with high fever, did xray, bloodwork and urine, had pneumonia, sent home on antibiotics, still looked great, came back two days later (I was not there) seen and sent to hospital for admission, still not any better, and xray getting worse. So it can happen, I did more than most people would have done and found the pneumonia but it can still get worse.
As I said though, he should have checked his oxygen with the little finger test. It seems a little weird that he got admitted that very same night and the doctor didn't see any respiratory distress (labored or fast breathing, low oxygenation), but it's possible.
For me, it would depend on how much you liked/trusted your pedi before all of this went down. I totally LOVE my pediatrician and if something like this happened to me, I'd call him and ask him to call me to discuss it. I'd point blank ask him how "we" could have missed something that turned into something SO serious. And then depending on how he responds, base my judgment on that.
You may remember that I switched OB's after I lost my 3rd child (Ryan is my 2nd). And I did it only after I felt the "fake compassion" coming from her and her (IMO) lack of suitable care knowing my history. I ended up LOVING my new OB and am soooo happy that I switched. I just couldn't imagine getting PG again and being in her care knowing that she didn't review things like u/s and order necessary meds to ensure a viable pregnancy in a high-risk patient.
It's sort of the same thing with the pedi - but since you're not a doctor and you can only go off of the advice given here and your own gut, I'd probably switch because you might always be second-guessing him. But then again, would you also second-guess the new pedi?
Thanks ladies! I really appreciate all the advice. Truth is, switching isn't all that easy is he's a freakin' family member! DH has a huge extended family, and our pedi is married to one of his many cousins. He's not particularly close to them though, and out of all the many cousins in this area, we're the only ones that use this pedi. He isn't all that convenient, which is why the other family members don't use him. Super nice guy though. Could always use the convenience card to switch if needed.
Also, aside from this major illness, our kids have been really healthy and we only see him on well child visits, and we haven't had any complaints there. When everyone's healthy, there's no reason to complain about your pedi. :-)
The only other somewhat major decision we've made with him is to get the helmet to reshape my younger son's flathead when he was 9 months old. We're still not sure it was needed, and only did it because there was nothing to lose. Insurance covered it 100% and pedi felt strongly that we should do it, but we thought his head was just fine.
Anyway, some of you mentioned some sort of oxygen test. He never did this - only listened to his lungs with a stethoscope, thought they sounded diminished, and suspected pneumonia. He was very lethargic at the visit.
As for why the antibiotics didn't work, I was told in the hospital that oral antibiotics won't work with such a severe case and my son needs antibiotics through an IV (which he got at the hospital and continues to get at home).
I do like the way SweetieP phrased it "how we could have missed something" and will definitely bring that up to him at our next visit.
Thanks again! Really appreciate all the feedback!
Doesn't matter. This is business. He should understand that and support it. You need to have a doctor that you have full confidence in and meets your method/style of care. If he freaks out about it, it just shows that he's not professional.
For all of the medical situations that I've run into with my own health, a good doctor will always tell you to get a second opinion and seek the care provider that works the best for you. It's business.... not personal. The patient comes first.