Thursday, January 8, 2009

Time to change pediatricians

We’re going through a tough week. River got his Hep-A vaccine a few days ago. Perhaps it was a mistake to give it to him with a cold coming on, but it has been affecting him very strongly. The fussiness, arched back of being upset and sore body parts came immediately after the shot (when the kind passserby told me I should be reported to the police for allowing him to cry). Since then, the cold symptoms have increased (runny nose, not eating like usual) together with pretty constant fussiness, clinginess and fitful sleep.

It was the flower-shaped raised rash-like thing on one of his hands that caused me to call the doctor.

We’ve gone to a pediatric group since he was born that I have been less than thrilled with. I put up with it because River hasn’t had any major medical issues since his early thrush and this office is a 20 minute walk from our house. I figured we’d stay for convenience sake as long as he was receiving frequent vaccines.

Until Mark took River to his 12-month appointment and the doctor told us that no, we couldn’t separate the MMR into three shots because they didn’t order it that way. Mark asked if there was another place we could do it and the doctor didn’t offer any ideas.

So I finally had a reason to call around. I found a small office only a few blocks further away that would separate the MMR. Not only that, they’d give River a Hep-A shot (for travel we are planning) without making me fill out paperwork and wait a week for an unfriendly nurse to evaluate my request.

So we went to the new doctor, a Russian woman, for the shot. Initially, I thought we’d go there just for the shots. It’s a hassle to change over completely, and of course a risk we’d tick people off and not be able to go back to the first group.

So when I had a question today, I called our original doctors first. They have a nurse on duty for questions and that easy availability is one thing that attracted us to the practice. Though I wasn’t too impressed with her answer a few months ago when I called after River’s first allergic reaction. “Neither sesame nor tuna are common allergens,” she told me. A quick Google search proved that wrong.

I gave them another chance today. Without asking River’s name or looking up his file, she immediately told me that what was wrong with him “has nothing to do with the vaccine.” I don’t think I even told her which vaccine we got. She said 100 is not a fever and that he must be teething. I told her he doesn’t act this way with teething and she said he must be getting a molar.

I called the new doctor. She herself called me back, an MD who remembers River and his particular circumstances. Her take was that it’s a combination of a cold or virus and the vaccine. She said his body is probably developing an immunity to hepatitis A and that is why it is acting as it is. Of course, having a cold prior to that didn’t help. She suggested we give him Tylenol and plenty of fluids. We should watch the thing on his hand and if it’s still there in a few days bring him in.

I see a reaction like this to one vaccine and I’m reaffirmed in believing that three live viruses at once is too much for his system to handle. The second doctor agrees. She thinks my concern of an overload to the immunological system of having to fight off too many viruses at once is valid.

The first office makes me feel like a pesky mother, which I’m not. I think I’ve called three times since he was born, including today. They also make me feel like I’m incompetent and can’t possibly evaluate options for myself. They go by the book, which doesn’t take into account individual circumstances. They have a my way or the highway policy. Worst of all is that they have given me WRONG information at least three times now.

I’m ready to make the move to a small, friendly, individual-oriented practice. It may not have the factory-like efficiency of the larger office nor the variety of expertise available. But we will be seen as people. We can develop a relationship with the doctor and become more than scheduled appointments. Someone will listen to us, as parents who care and do our homework. And we can listen to the doctor with more trust, knowing that we’re not just being recited a textbook. As a bonus, I like that she’s Russian and is able to look beyond what the U.S. AAP recommends, which I think can be limiting.

It’s taken me a while to get here, but now I feel relieved.

How have you found your doctors? Do you feel your pediatrician listens to you?

1 comment:

Eleanor Q. said...

Its hard to get over the pesky mother feeling, but you have to be the best advocate for your child. If you don't feel that the pediatrician is responding the way you'd like, and you are having a better vibe with someone else, then its totally fair to switch to someone else. I think a lot of parenting (in my few months of experience) is about feeling confident with what you are doing. Go with a doctor who supports you.