Adding drug-resistant bacteria into the world.

Today I went to our favorite Children’s Hospital to get a prescription for a sedative for Edda for our 18 hour flight… She doesn’t sleep through the night at home yet and when she gets extra stimulated, then it gets impossible to coax her to sleep. Our geneticist prescribed chloral hydrate which was used for the last home leave trip and her EEG.

By the time we were finished with that appointment, her temperature skyrocketed to 40.4 so I just wheeled her down to the emergency room for a quick once over. I love, love, love this emergency room. I was in/out in about 90 minutes complete with drugs, observation and the whole thing was $40 US dollars. Crazy.

Anyhow, the doctor took a look at Edda and said that the infection was probably viral and that I would just have to treat the fever with Tylenol and Motrin. This is the weirdest thing about hospitals. In every book they tell you, fever over 40C, run, run, run to the hospital. I get to the hospital and after an hour of Tylenol and Motrin, Edda’s fever dropped to 39.5 and the doctor was sending me home for “fever management”. So I asked how he could tell it was viral vs bacterial. He said that he couldn’t really and that if it persists for a few days, then we would do further testing. I prodded him some more and asked if I could have some antibiotics. Man. He seemed reluctant and I know all about over prescribing of antibiotics, but hey, Edda’s sitting in the stroller all listless with a temp of 39.5, you bet I want to alleviate her suffering. So I behaved badly and got antibiotics for a viral infection.

Edda crying in shower

I showered Edda down at the hospital to try an bring her temp down.

It’s so quiet around here without my boys – the Martin men who talk, talk, talk.

Oh, did anyone read the NY times article about parents using genetic screening to pick out offspring with genetic defects? Granted, dwarfism and deafness aren’t exactly extremely debilitating genetic defects, but still it’s weird. I’ve read blogs by parents who think their kid with genetic anomalies are perfect the way they are and that they wouldn’t change anything about their child, but damn, if I could find that guanine somewhere, you bet I shove it into every cell of Edda’s body.

Boo hoo, I’m sick too and I’m going to bed. Good night.

8 thoughts on “Adding drug-resistant bacteria into the world.”

  1. I can guess what the doctor was thinking about the fever, if you’re interested.

    The first question is, does the kid look sick – listless, no energy, no eye contact, not playing, etc. If so, treat, admit, antibiotics. The scary thing is “serious bacterial infection.” Blood in the bloodstream, meningitis, etc.

    If the kid looks ok, look for a source. Chest xray if there’s a cough, check ears, urine depending on age/history, appendicitis, etc…

    In the kids that look well, the rate of serious bacterial infection is low, especially if they’ve been fully vaccinated (including against strep.) So it’s assumed to be viral and those kids mostly need follow-up. This refers to kids age 3 months to 3 years. Before the Prevnar vaccine, they used to do more, because kids would look well but have serious infections. Does that make sense?

  2. That said, can’t blame you for the antibiotics, etc. As a doctor, i can tell you it’s a constant struggle – between public health effects of too many antibiotics versus the patient in front of you. You hate to miss anything.

    Now with Kaixiang, I haven’t decided what we’ll do when he gets sick – probably take him in. I don’t want to be his pediatrician –
    A, i’m not trained for it, and B, it’s hard to be objective. I know two docs who missed stuff on their kids. One waited overnight on a broken arm, one couple (both docs) missed a hole in her heart – needing open heart surgery when she was 26. Whoops.

    Long answer for something that wasn’t even asked! Hope you’re both feeling better!

  3. Heh. reminds me of a funny story. A friendd of a friend had broken her arm, and basically her parents who were both doctors was like, eh, it’s fine. The funny thing of course, was on the the parents was in orthopedics – if i’m getting my specialities correct. 🙂

  4. Sorry guys, you know I just had to jump on my soapbox for this one. Ah, pediatrics. The reason why I try to avoid it. You’re treating the hysterical parents, and not actually the kid…

    But I’ll really boil down and simplify the explanation… most infections are viral. Antibiotics usually treat the parents and not the kid. Parents feel the abx helps because by the time they get to the doc’s, get the script, get the abx filled, and start giving the abx, the kid would have gotten better anyways as their immune system fights off the viral infection. Parents just attribute it to the abx making their kid feel better.

    If I ever have kids, and they have a cold, I’m going to suck it up and tell them not to be such little sissies. =)

  5. actually, I think the more interesting question is this: Doris, if you knew it was a viral infection, why did you still want the antibiotics?

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