Wednesday, February 07, 2007

The Pharmacy is Now Open

Zane's current daily medication regime. *

Zane is sick. He’s doing a bit better – maybe. You’ll notice that I say this without much confidence. We had to take him to the urgent care last night and back to the doctor today.

It appears that he has some sort of infection (probably sinus), and his asthma is flaring up quite a bit. He’s on a ton of meds, including the dreaded Orapred– but at least we feel that we have a clear course of action.

We’ll see how it goes.

As I was sitting in the Urgent Care last night, it came to me that there is a predictable course that the doctor-mama relationship follows every time we seek urgent/emergency treatment.

Stage 1 – Sizing Each Other Up
The doc and I spend a few minutes getting each other’s measure.
I’m looking at things like how does s/he interact with my child, how competently s/he does the exam, and if they seem to “get” asthma. The doc watches me for signs that I’m using the urgent/emergency care as primary care for my child (I’m not) and also looks for “hysterical mama” syndrome.

(I’ve yet to figure out how to navigate this line well. When you’re kid is having trouble breathing, you want to seem appropriately concerned but not kooky. It’s a tightrope, really.)

Okay, we're getting a feel for each other here, let’s move on to…

Stage 2 – Fact Gathering
The doc asks me multiple questions about Zane’s asthma.
Some of them will be insulting – i.e. Did you give him his prescribed asthma medicine today? But at some point s/he becomes suitably impressed with all the meds Zane is on and gets that we’re dealing with the Real Deal Holyfield Type of Asthma.

I’m watching to make sure that the doc doesn’t say anything egregiously wrong, like But I don’t hear him wheezing, after I’ve already explained that Zane doesn’t typically wheeze, he coughs. He has cough asthma. It’s a tricky little variant, but it's not unheard of.

I also look for a very thorough exam, and if we’re in the ER, I expect them to order a chest x-ray to rule out pneumonia. If they don’t bother to tell me how well he’s moving air or skip asking me about allergen exposure, I mention the allergen information and ask about the air.

Most days, this leads us to…

Stage 3 – I’m Competent. You’re Competent.
The doc and I start to feel pretty good about each other.
I know that they are taking Zane’s asthma and allergies seriously, and they acknowledge that I’m a parent with a pretty thorough understanding of my son’s health issues.

We both relax a bit, and get cracking on taming the asthma beast, moving into…

Stage 4 – True Partnership
This is where it really works.
I can ask I’ve-always-wanted-to-know questions like, Why does the breathing treatment seem to work so much better here than at home? (Answer: because they’re pushing oxygen at the same time.)

The doc asks things like, Do you usually push a double-dose of the steroid at the outset? (Answer: Sometimes).

If we’re really in a state of synergy, the doc will call Zane’s allergist for a consult – and he may drop by to our Abolish Zane’s Asthma Party.

It’s all rainbows and marshmallows and good feelings, and we’re all satisfied with the process. (Except Zane who is most likely still having some breathing issues.) We acknowledge that none of us has all the answers, but we work together to get Zane’s breathing back under control.

Ah, bliss. Bliss induced by a medical crisis, but bliss nonetheless.

When it works, there is minimal hassle. My kid gets good care, and I feel respected. The doc usually lets us take Zane home as long as I agree to do whatever s/he tells me to do. (Within reason, I suppose. They’ve never asked me to sacrifice a duck to the Lung God to get my boy back to health. I might balk at that. I mean, the Lung God clearly has it out for my kid. I refuse to abase myself and appeal to this cold deity of retraction and cyanosis).

Last night, however, we got stuck in Stage 2, and I became adversarial. It wasn’t pretty, and I’m not proud of myself. (I was right, but that's really not the point - or at least not all of it.)

Fortunately, my inability to form any type of working relationship with the medical staff didn’t have any ill effects for Zane. Of course, it didn’t help him either. We had to take him to his pediatrician today to figure out that he has an accompanying infection, etc.

Therefore, I hereby vow to get to third base – uh, I mean stage 3 – with any and all doctors that I interact with on Zane’s behalf.

Unless they piss me off. In which case, I’ll just do my best.

*If you feel the need to comment on the amount of medication that Zane is on, please, please say something supportive like, Wow! That’s a lot to handle. Hang in there! Please do not say, You shouldn’t be putting all those chemicals into his little body. Have you thought about the side effects? I have, and I do. All the time. We’re a little desperate in our household these days, and we’re doing the best we can.
See, the preceding is just a wee taste of the defensiveness and attitude that I took with me to the urgent care last evening. I’m working on that.


Andrea said...

That looks like my medication cupboard. Different drugs, same volume.

You know what? Some of us need chemicals to live. Anyone who can't handle that fact is welcome to donate their pancreas to me and see how well they live without drugs.

I mean, yeah, side effects suck but ... not as much as death.

(I hope it's clear that I"m directing this at anyone who would give you grief for treating your chld's medical condition.)

L. Noelle said...

What a great post, as usual! Are you a professional Writer? You should be. First, off, I too, have had to, and still have to, go through all of the above forementioned Stages everytime I encounter a Doctor! I will definitely keep these in the forefront of my mind next time we need a Doctor. I usually get stuck at Stage 2 also, where the Doctor is Condescending and assumes, because I'm merely a "MOM" and not a Medical School Graduate, that there is no way I could possibly understand the complexities of Medicine or the Human Body!

Stop by my blog if you can, today. You might be interested in the post!

SRH said...

Ummm... Honey? Sweetie-pie? I understand the whole third base thing with El Doctore... his strong jaw and smoldering eyes... the way he cares about Z's health... but the allergist?

Kristi said...

Poor baby. I hope he starts getting better today. RIGHT AWAY.

jotcr2 said...

Hmmm, bought back memories. It is such a hard thing giving the meds, let only managing them inbetween feeding and getting up in the morning. Sheena is down to 1 set of meds morning and night. Yeah. For a while there, I was crushing tablets, and administering about 5 or 6 different drugs. You'd debate with yourself should I give it before or after food, because will she just vomit it up anyway. Well a few months down the track, the good news is that the meds worked in our case. Just the 1 set of meds to hold her.

Anonymous said...

I'm so sorry. I hope he starts feeling better.

S. said...

I don't know whose razzing you about the meds, but eff off to them! Like a previous reader said, some of them help us to live.
You do what you gotta do!

Hang in there. I hope Zane feels better soon.

zulhai said...

If it helps, I get the same treatment from new doctors, and I am a Pediatric R.N. After 15 years, I've developed some patience. -- Mostly because I know that eventually they all become my Love Slaves.
There is nothing much you can do about people who criticize your parenting. I suppose they mean well and want to help, but unless they have kids with a chronic medical condition, they have no f---ing idea, thank you very much.
On the positive side, having sickly kids forces you, or I should say ME to be the absolute best parent possible. Maybe if my kids weren't as needy, I wouldn't be as willing to give up my own selfish concerns. As it is, I'm forced to pay a lot of attention to them. They payback comes at times like tonight when my 12yr-old's teacher called to tell me what a pleasure my daughter is to be around, how smart, considerate, etc. Hey, you're welcome, I said.
Kids, they suck the life out of you.

Zany Mama said...

Fuck...thanks for the support you guys. I almost don't know what to do with all this love. I'm not sure how to respond.
(But apparently it involves dropping the f bomb).

It's clear - and thanks. I'm probably just projecting my own doubts and self-criticism onto other folks.

Or maybe not. My ears are still ringing from the pediatrician's continued referencing of the massive amounts of meds that Zane is on.

Either way, I know that we're being very aggressive with Zane's asthma treatment. We have to be - and I'm not willing to change that.

Thanks! I'll definitely stop over.

Maybe we can start a support group for mom's who need to get to stage 3!

One of us has to be willing to do whatever it takes to ensure our boy's health.

I am that kind of parent.

Thanks,I think he is starting to feel better. Maybe. Possibly. I hope so. (Knock on wood)

Welcome, welcome! Thanks for stopping by.

Should we ever get to a place where we do one set of meds morning and night for any significant length of time, I might be willing to re-evaluate my position on the Lung God.

That being said, I think that is completely fantastic for your daughter and your family! Yay!

I think that Zane is probably doing better than SRH and I right now - we're both loopy tired. (Hence the use of the f word above.)

Many thanks - I think Zane is definitely doing better today. By tomorrow morning, we should be over the hump. (Fingers crossed).

"unless they have kids with a chronic medical condition, they have no f---ing idea, thank you very much."

True dat.

SRH just wants me to add his vehement support of your assertion that kids suck the life out of you. Consider yourself vehemently supported.

Sue said...

Poor little Zane. That's a lot to keep straight and a lot for him to handle. I never like medicating my children, but you do what you have to do. Both my girls are on Prevacid and we have allergy meds for both and epi-pens for Kayla. As Mom's we do what we have to to keep them safe and healthy and enjoying life.

I had to laugh at your doctor stages. It's so true, especially for Moms who are on top of their child's medical care. I have to say I'm so lucky with their Ped. She really listens to me. So do their allergist and gi doc actually. I really do appreciate that, especially when you hear horror stories from other people.

I hope Zane feels better soon.

zingerzapper said...

Okay, here is my idea. Print off your blog and hand it to the Urgent Care doctor the next time you go in. Put your hands on your hips look her/him in the eye and say, "can we quit f****** around and take care of business? Let's just start out in Stage 3 and save us both a lot of time. I think once they see the craziness in your eyes they will realize you are either a mom of a very sick child (who is cute as everything) or one crazy crack smoking lady. Either way you might get what you want. Love ya. By the way you did great at receiving all of that support. Good job!

Zany Mama said...

Thanks for the wishes. I think it's because we have such a great relationship with Zane's pediatrician and his allergist that I get so frustrated with my other experiences. I've actually gotten quite used to doctors talking to me as if I'm competent and trusting my judgment re: Zane, so when other docs don't get on board quickly, I'm probably a little testy. Or a lot testy - depending on the day! :)

I'm not sure I'll take in the blog, but I may use your quote. Good one.

Christy said...

Wow that is a lot of drugs, are you sure you need to be giving them all to your kid (only joking).
I admire you and what you go through. I have a perfectly healthy kid, he's never been sick. But Jo is my sister and via her I'm discovering a wonderful world of blogs out there.
I'll be stopping by regularly! Love it and keep up the good work.

Zany Mama said...

Thanks for stopping by! We're a little weird over here, but some folks find it suits their tastes. If you like whining, belligerence, and the occasional funny observation, you should fit right in. (And what that says about you, I'm not sure.) :)

And you know what? I hear that even those perfectly healthy children occasionally cause their parents angst and grief, so I'm sure you'll relate.