Friday, May 04, 2007

What A Difference A Clinic Makes

We had a Ben health crisis this week. Monday night, he started wheezing again and running a fever. It hadn't improved by morning, and it seemed to be getting worse. He was wheezing hard, and his respirations were 60-80 breaths per minute. After my last bad experience with bringing him in when he was like that, I convinced Chester that it could wait until morning to bring him in.

You see, we were in the transition phase of changing pediatricians. Ben's first appointment with his new doctor was for Tuesday afternoon. Ben's old doctor, though a very nice, sweet man, never bothered to really treat Ben's breathing issues, even though they landed him in the hospital last October. That wasn't the sole reason we decided to switch, but I kept getting the feeling that more could be done if they'd take the time. As long as it wasn't RSV, they didn't care.

Chester brought him in to the walk-in clinic downstairs from his new pediatrician, and the difference was amazing. They actually took us seriously, and they actually treated the problem. Unlike before when we were scolded for worrying about his breathing, the new clinic people gave him a dose of steroids immediately and sent him home with a nebulizer only after his ox-sat levels had improved.

As for the new pediatrician, Dr. Sarah. Wow. We had a follow-up with her yesterday about the wheezing, as well as a well-child checkup. She was in the room with us for no less than 45 minutes. She wrote up an action plan for dealing with Ben's asthma (yes, there's finally a diagnosis) and avoiding crisis events in the future. Ben will probably be on a controller medicine for most of the year, but we're okay with that.

Everybody is a lot happier now in our house, especially Ben. We're still on the "sick plan" that Dr. Sarah wrote up, and he has to have albuterol several times a day and pulmicort twice a day in his nebulizer, but he's getting used to the process, and he seems to understand that it helps him breathe better. For the first few minutes of putting the mask up to his face, he actually holds it there and breathes deeply. Of course he gets bored and squirmy, but we're figuring out ways to deal with that. (When both medicines are in the nebulizer chamber, it takes no less than thirty minutes to finish it).
For me, I feel much more reassured about my son's health. I know that if there's a crisis like that again, there'll be a clinic and a doctor I can call who will 1. remember who Ben is and 2. take my concerns seriously. I can't tell you how many times we went to the old walk-in or called the nurses line about Ben's breathing in the last year. Since it's their policy not to write down notes when a parent calls with a health concern, the staff never really saw a pattern. And the walk-in staff didn't contact the primary pediatrician to inform them of a problem or flag the chart for them. On Tuesday, the new walk-in clinic was in contact with Dr. Sarah throughout the morning to keep her updated on what treatment option they were giving us.

AND... Dr. Sarah had actually read through his charts from the old clinic and had MADE NOTES and talked to me about the areas that she highlighted. I was glowing with pleasure after the visit.

One good thing I gleaned from the talk about asthma. Children who develop asthma symptoms before their second birthdays are far more likely to outgrow it. I'm hopeful this won't be an issue that Ben has his whole childhood. So far, he just has episodes when he gets a cold. Exertion doesn't seem to bother him.

And by the way. My little guy got his first skinned knees on Monday. I was so proud, I cried a little. He's growing up so fast. (But not as much as I thought. He's lost two pounds since his last visit. That's normal, but it still surprises me. He's only 22 pounds and 30 inches tall.)