How typical is it this?

[PuppyFluffer]

I have a 3 year old who had a fever and congestion and I didn't like what looked like labored breathing. I took her to my one of my first choices of health care providers, my chiropractor, for a listen. She thought her lungs sounded a little noisy and suggested I go to one of the family practice docs I see just in case it was headed towards pneumonia.

The family practice clinic has a walk in for their patients so we went there. We were first seen by a nurse type person who took a general history and her temp via ear thermometer- 102.9F. Then the physician assistant came in. She looked her over and said she's got a fever, we'll give her some Tylenol to bring it down. She then looked in her ears and said she has an ear infection.

I declined the Tylenol and she stiffened up and got huffy and told me about dehydration and febrile seizures.....

How common is it to go in to see a doctor with your child and have them TELL you we WILL give her Tylenol, then have the nurse show up with a dose poured in a little cup?

After a little discussion, she left the exam room and called the doctor up.

[ttcintexas]

I took my daughter in when she was about 6 months. The nurse took her temp, came back with Tylenol and told me to give it to her--before the doctor ever even saw her. I do think her temp was pretty high--like between 104 and 105. I simply told her I would wait to talk to the doctor. As well as using the ped, I use a homeopath. My ped was open to my not giving my DD Tyelnol, having told her I gave her a remedy per my homeopath. She just said to watch her closely. Anyway don't know how common, but you'd think the doctor would want to examine the child first. Hope your DD feels well soon.

[sbgrace]

I'm shocked the chiropractor didn't pick up on the ear infection. I'm guessing she just did a lung check and didn't actually do any adjustments. You might go back. For some kids they can help the ears drain.

I've never been offered tylenol at a doctors office for either of my kids (sometimes with really high fevers/ear infections). I don't think it's that common. And it should have been no big deal to decline it. I'm sorry the PA was so huffy. You declined and the PA sent the nurse in with the cup of meds anyway or am I misunderstanding that?
Was the doctor better or you just saw the PA?

[lovebug]

thats common here...

however most the moms i know would not have turned it down ether, so its a catch 22 i guess. if they are not going to turn it down they are going to offer it

i think you handled it well! i am sorry she treated you the way you said she did. its sad that lots of Docs are so mainstream...

[Kailey's mom]

Very common in my experience; either tylenol or motrin if dd has a fever when I bring her in

Originally Posted by PuppyFluffer

I have a 3 year old who had a fever and congestion and I didn't like what looked like labored breathing. I took her to my one of my first choices of health care providers, my chiropractor, for a listen. She thought her lungs sounded a little noisy and suggested I go to one of the family practice docs I see just in case it was headed towards pneumonia.

The family practice clinic has a walk in for their patients so we went there. We were first seen by a nurse type person who took a general history and her temp via ear thermometer- 102.9F. Then the physician assistant came in. She looked her over and said she's got a fever, we'll give her some Tylenol to bring it down. She then looked in her ears and said she has an ear infection.

I declined the Tylenol and she stiffened up and got huffy and told me about dehydration and febrile seizures.....

How common is it to go in to see a doctor with your child and have them TELL you we WILL give her Tylenol, then have the nurse show up with a dose poured in a little cup?

After a little discussion, she left the exam room and called the doctor up.

[PuppyFluffer]

sbgrace, the chiro DID catch the ears. She said one was red and the other was a little red. She said they could be red from the fever and the congestion. She mentioned that there could be an infection but she wasn't leaning strongly in that direction. Dd had no complaint of ear pain.

Here's the order of things.
Check in.
Go into exam room.
Male nurse comes in, takes temp and a history of the illness.
PA comes in, introduces herself, does an exam of neck, listens with stethoscope etc. Stands back and tells me "She has a fever. We are going to give her something to bring that down right now." I didn't decline immediately, I let her go on talking. When she mentioned bringing the fever down again, I said I was declining the Tylenol. Then she stiffened and went into the fever talk. Shortly later, male nurse open door and sets down the dose on the counter. PA said to him "Mother is refusing"

Obviously they passed in the hallway before the PA came in and he gave her a report on the fever and she told him to get it.

My main concern was her lungs and possible lung congestion and her respiration. She was belly breathing and retracting when coughing, which was concerning to me. I wanted to know what her o2 sats were and I asked them to check her with the pulse/ox thing. She said they might not be able to get it because her finger is so small. I asked if they had a ped one and she said no. We were discussing this when the nurse came with the Tylenol and the PA went out into the hallway with him. I was trying to listen to them. She was obviously miffed with me that I'd decline and now I'm requesting that they check her oxygen saturation level. I had to bring it to her attention that dd's breathing was not normal for her. I heard her tell the nurse to go get the doctor.

The doc is an osteopath that I'd seen once before. I have no idea if he remembered me or not but I set my kids up with a well visit with him after a horrendous experience with my 12 month old son at Children's Hospital in Wash DC where we simply went for observation and got slammed with an abuse allegation and forced xrays and eye exam to prove he "hadn't be shaken and thrown to a hard surface". He's cool with the no vax issue and if he remembered anything about meeting me, he would have remembered that I am not fond of being strongarmed by the medical community.

He was ok. He said I could "give Tylenol at my discretion". He wanted an antibiotic for the ears. I didn't refuse the prescription, but I wasn't planning on giving it to her. It's there at the drug store if I need it. I wasn't going to make any further waves by asking him to explain why he wanted an antibitotic for an ear infection when the child has no history of ear infections, is not complaining of any ear sensitivity, the entire family is at the tail end of colds (viral infections which are not helped by antibiotics). I am not willing to trash her intestinal flora for what is most likely a fluid accumulation from the viral cold we all have.

There is a BIG difference between offering a medication and TELLING a parent they ARE GOING TO GIVE a medication. I have a huge issue with the power the medical community assumes. They seem to forget that I am a consumer, paying for their opinion and that I didn't sign over any legal parental decisions at the door. I am simply paying them for their educated medical opinion.

I have kept in touch via phone with my chiropractor all weekend with updates. Dd's fever lowered yesterday. She's picking up energy and appetite but still naping through out the day. She sees the chiro today to get her ears looked at and adjusted if she will tolerate it. She's a bit of a reserved child and might not tolerate an adjustment. We'll see.

[Addy's Mom]

Never been offered Tylenol or Motrin, even with high fevers, by a pedi. I find that pretty shocking.

[PuppyFluffer]

My issue was not that it was offered but that it was assumed that they had the power to give it....that I would just let them do what ever....

I'm trying hard to have positive interactions with the medical community, really I am, but over and over again it fails.

So, do you think it's reasonable that I'm put off by their assumption?

[tanyalynn]

I'd be really ticked by their assumption. That would probably be a deal-breaker for me, unless I was sure I could deal only with the reasonable people in the practice and I just didn't want to do the work to find another office (or for whatever reason you're mostly stuck with this place).

I've got an actual pediatrician for the kids now, and she would NEVER treat me like that, or presume to tell me what to do. I think it's weird--if I wanted to give Tylenol, I could do that at home, why would I be in a doctor's office for it? But yes, the assumption that _they_ are deciding on the course of treatment, that's offensive.

I've also got a couple DOs that I can visit that wouldn't treat us like this, no one in our years-ago pediatrician's office had this type of attitude and they were pretty mainstream in many ways. I think it shouldn't be hard to do better.

If you can, I'd shop around. If there's a doctor in the office that you really like, you could write to them about the interaction and see if they think it was reasonable, but I'd probably still expect the same treatment from those individuals, I have low expectations for change.

[PuppyFluffer]

I did shop around for this practice. When I asked them if they were comfortable treating a family that was vaccine free, the woman who answered the phone said "Yes, that's a personal decision." That was the right answer for me!

This doc is not my main health care provider. I have a very alternative family practitioner and a wonderfu chiropractor, whose knowledge base extends very far beyond just chiro. She's also mother to something like 10 kids, so I trust her personal experience as well. These two are my main go-to people. My regular doc is not available on Fridays, hence I used this guy as my backup.

I expect to take my kids to him for an annual well check and not really use him unless there is something that requires a hospital trip. He's got hospital proviledges, is part of a large practice with 24 hour call up help, has a dr on call overnights and has a walk in clinic for minor to moderate issues for their patients. They are also with my insurance so I only pay a $10 co pay. I had an experience this summer with the mainstream medical community that pushed me to find this sort of coverage if an emergency came up again.

Since I don't use mainstream care, I just didn't know if this presumptious action of the PA is typical.

[KatWrangler]

Never been offered Tylenold at the Ped. We have lived in 5 different states too.

[PuppyFluffer]

If it was going to happen, I'd expect it quicker from a ped than a family practice. This is a medical group with a family practice, a cardiology group and an infectious disease group.

[PlayaMama]

Originally Posted by PuppyFluffer

My issue was not that it was offered but that it was assumed that they had the power to give it....that I would just let them do what ever....

I'm trying hard to have positive interactions with the medical community, really I am, but over and over again it fails.

So, do you think it's reasonable that I'm put off by their assumption?

i took my ds to the doctor when he had a high fever and they gave us tylenol.

here's the deal. when you go in to see them you are basically saying, "i don't know how to handle this on my own. please help me."

so, they tell you what to do to help your kiddo.

i really don't find it that shocking that she said that nor that she would expect you to take her advice. nor am i surprised that she was miffed. it's like, you saying, "help me please," and then saying, "well, not _that_ kind of help."

i'm do appreciate hcp that suggest rather than tell but i really don't think it's that out-of-line.

[FireWithin]

I have been offered it. I'm no longer with that practice.

We were at our family doctor today. She kept on telling me multiple times that for the issue my son was having it would be very appropriate for me to give him motrin or advil. I think she kept on repeating it because she knew I usually don't do meds (and I won't do it now), but I have the information I need so that I can handle it more holistically.
I don't love this doctor, but she is the best I have found so far, so I am going to stick with her.

[PlayaMama]

mammo2sammo- what do you do for pain if not medication?

sorry i know this if off-topic but i'm curious!!

[sbgrace]

I would be put off by her attitude to your declining (I assume you did it in a natural and normal way) but not so much by the offer (though I and others haven't seen that).

But there are all kinds of personalities in the world, you know? I would not paint the mainstream medical world with broad brushstrokes based on experiences with particular providors, no matter if there are 3 such experiences or whatever. People are people. I've had some absolutely wonderful mainstream doctors (geneticist is one, neurology is another) in our lives. Good people, saw me as part of a team with them in caring for my child, etc. And I've had some yuck experiences too. My worse HCP experience was actually with a very non-mainstream chiropractor who was condescending and acted very much like you experienced when I refused one of his suggestions among other worse things. He was beyond horrible. But I don't assume all chiropractors are like that (have worked with two ones).

Anyway..yes I'd be ticked with the attitude of that PA (PA, right? not the nurse--those are different things with different educational requirements).

[FireWithin]

Originally Posted by PlayaMama

mammo2sammo- what do you do for pain if not medication?

sorry i know this if off-topic but i'm curious!!

I think it is tricky and Ihaven't always been successful.
I use homeopathy and something called castor oil packs.
I also massage the area, to help release tenion.
He is getting his big kid molars right now and I am not ok giving him the total amount of motrin she is suggesting (it is a months long process for him).

[PuppyFluffer]

Playamama, the concern that brought me in was my dd's respiration, not her fever or ears, though I certainly expect them to inform me of all that they find. My chiro called the clinic, identified herself, gave my dd's name, expressed what she was seeing and her concerns and why she was recommending that I bring her to them (lung noise, possible pneumonia and difficulty breathing).

I expect doctors to recognize that I am a consumer and that they are being paid to give me their opinion and their suggestions based upon their long education and experience. I don't expect them to think I turned over parental rights at the door and that I've given them my permission to do anything to my child without having a discussion about the reasons why and the effects of what they wish to do. It's called informed consent and it's a foundation of any medical care - one i see dissolving.

Playa, you said: here's the deal. when you go in to see them you are basically saying, "i don't know how to handle this on my own. please help me."

Actually, no I don't think that I don't know how to handle something on my own just because I walk into a doctor's office and want their opinion. Maybe that is the whole crux of the issue here. I am coming from a very different place. Im' really big on taking personal responsibility for myself and my family. Just because I ask for another's opinion (a very educated opinion at that) does not mean that I relinquish my right to disagree or not that their advice.

It's really a respect issue for me. No where but in a medical setting do you give a total stranger access to your body in such a wide open manner. I think that there should be some understanding that this is a situation where you extend some general respect for the patient's body by not doing anything to them without first explaining what you intend to do. I think the same respect should extend into offering medication. Offering is fine, telling a patient or a parent that they are taking something is where I have an issue. If doctors had respect for a patient and their right to make their own decisions, I wouldn't have the impression I do. It exhausts me that I have to deal with the attitudes I am presented with then I exercise my rights to make medical choices - which are based upon my own research - much of which is peer reviewed, published in medical journals data - that simply happens to be counter to what the doctor standing in front of me is saying. In this instance, the data is pretty overwhelming to leave a fever alone as long as the patient is comfortable. Decreasing fever via Tylenon/Motrin slows down the immune response that is being activated to fight the infection, thus prolonging the duration of illness. (and I can provide links to this if interested) It's not like the PA even bothered to ask me WHY I was declining. I don't wish to assume what she was thinking but from her body language and her alarming tone as she talked of dehydration and febrile seizures....she appeared offended and then seemed to be employing scare tactics to sway me to give her the Tylenol.

As for painting the whole community with a broad brush, I can only go on my own personal experiences. I had a very good experience in 2000 with a broad team of doctors treating a mysterious infection in my neck. Outside of that, my interactions have been frought with lack of respect and assumptions and disrespect - all of them.

This is my first experience in a mainstream doctor's office and I was just curious if this assumption was common.

[KatWrangler]

Not all the Doc offices and Docs are like this. In all my experience with Docs for myself and the all the specialists DD1 sees I can only think of 2. One was a Ped's office and the other was a Pediatric Neurosurgeon. Well I could add a third in, a Urologist whom was very nice, office was very nice, but I didn't like his thoughts on the care of my daughter's bowel and bladder.

So what did I do? Found a different Pediatric office, found a different Neurosurgeon. The Uro I was looking for another, but then we moved.

[PlayaMama]

when you declined the tylenol did you say why?

look, i know it feels better to have someone ask your opinion first instead of telling you what to do. no one that i know really likes to be told what to do.

BUT i think you could look at it from her perspective and maybe understand why she would respond that way. she's coming in and seeing your child with a high fever. you decline the meds and she sees you making a choice that she believes hurts your daughter. it's not like you are asking her what type of carpet she recommends for you living room.

i can see why she got huffy.

i think it's also pretty standard to medicate a fever that high. i personally don't give meds unless the kiddo can't sleep through it but it's not like she was trying to medicate a 99.5 temp or something.

i think it's obvious that you felt disrespected by the visit. i don't think that's conducive to a good partnership with a hcp. i also don't think that the majority of hcp have that type of manner but i don't think it's uncommon for them to act like experts and patients as being willing to follow their expert opinion.