Knowing too much and too little

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  • #83500
    rydysrydys
    Participant

    I’m wondering if anyone out there feels like they know too much and too little when it comes to taking care of their family members. I’m a peds resident and I’m finding this a problem when my kids get sick. I often feel like I should be able to make a diagnosis and decide what to do–after all, my patients call me and I’m confident enough to give them answers. On the other hand, I’m a mommy and I can’t be objective about when to take my kids to the ER, etc. This came to a head for me last Saturday when my son broke his arm. The mechanism wasn’t great (he fell on some linoleum while running)and he didn’t seem to be in any pain, but he wouldn’t use his arm. Anyone else, I would have sent right away for x-ray, but I kept pushing it off and didn’t take him until much later! Fortunately the fracture wasn’t displaced and he was casted without incident, but now I’m left with the guilt of having made him wait so long. I’ve had similar issues in the past with my younger son who wheezes, deciding when to call the doctor, when to go to the ER, etc. Any advice?

    #83502
    GracieThreeGracieThree
    Participant

    Hi – I know exactly what you are talking about! I’m an internist with a toddler, and I know my peds limitations, but then same thing as you, I think “Nah, I’ll let that go a little longer and see how she does, I’m probably overreacting.” This very weekend my daughter had a runny nose, anorexia, was acting irritable off and on, started running low-grade fever Saturday night, etc. I was trying to decide Sunday morning whether I should take her in to be seen since it was probably just a virus, I was probably not being objective, etc etc etc. So I referred to “The Baby Book” by William and Martha Sears and saw (in layman’s terms) – snotty nose plus baby getting worse = time to call the doctor. I did, they said bring her in to clinic (great office! Open every day!) and she had bilateral OM! Based on her clinical presentation with previous infections, this was much less acute and she seemed more well – I thought for sure they would look at her and find nothing wrong. I guess as a physician mom, I am afraid of being pegged as a Nervous Nelly when my kid is sick. So you could try referring to a book written for lay-folk, which will be more of a recipe approach and leave you in less of an “Am I being objective?” quandary.

    Hope this helps – that book in particular has helped me so much.

    #83503
    EemaMDEemaMD
    Participant

    My husband and I have both found ourselves in similar situations. I am currently a 4th yr med student and he is in his 3rd yr of practice as a general/vascular surgeon. We have two boys, ages 8-1/2 and (almost) 4.

    The (bad) joke around our house has always been – are you bleeding? can you move it? – and… don’t worry, Daddy can always cut it off. I know we have both hesitated in the past to bring our boys in to see their pediatrician, quickly dismissing things that appear to be “minor” or “just a virus.” When we do bring them in, though, I honestly wonder sometimes if we are viewed as alarmist or whether our observations are actually taken more seriously.

    What is interesting is that my husband is the parent usually in denial, the first one to say, “No, he doesn’t have —–.” I am more of the fatalist, “Well if this is what is going on, I’m going to learn everything about it that I can.”

    Thank God our children are basically healthy, but it has already run the gamut between my youngest developing an idiopathic Type II RTA by 6 months of age, getting RSV at 18 months (requiring hospitalization), and several bouts with asthma since. The older one has already required a head CT, developed motor tics a year and a half ago, etc.

    Anyhow, what I try to remember is the old adage “The cobbler’s children have no shoes.” There is also one about physicians who treat members of their own family as having a fool for a doctor (though I don’t remember the exact words). My conclusion is that as a physician and as a mom, I can only do my best. And I have decided that as a mom, in dealing with my children, I need to put on my Mom hat and try to put aside the MD hat. They have a pediatrician we trust and like, and even if I feel silly or alarmist, I have learned to follow that Mom instinct and bring ’em in.

    My mom once told me to “go with my gut,” that it is usually right. I’m trying to follow her advice.

    Linda

    #83504
    mum2aaemum2aae
    Participant

    My husband and I are both in the medical profession – he is a surgeon and I am finishing my residency in geriatrics. We have two children and (touch wood) both are very healthy. However the few times we have dealt with fevers, roseola, odd rashes, and big bangs on the head – he is the denying parent (“they are fine”) and I am the alarmist (“what if it is …?” (fill in the blank with a life-threatening but very rare condition).

    I guess the best advice we got from other docs with kids was to find a good paediatrician who we trust, and to not treat our kids as patients. Trust your instincts as a parent and don’t worry about how you are being viewed by the other doctors. Just like other parents you are trying to do what’s best for your children – you just happen to have a bit of medical knowledge baggage! 🙂

    I actually find it even harder to diplomatically redirect neighbours and friends with medical concerns – especially about their kids.

    cheers

    #83506
    EemaMDEemaMD
    Participant

    Wonder if there is a connection between being a surgeon and the “it’s ok, they’re fine”/ denial mentality? 😉

    Or maybe it is just husbands in general… 😀

    Linda

    #83507
    womansurgeonwomansurgeon
    Participant

    I think there is a connection to that attitude and to being a surgeon (and to being a husband, but that’s a different forum…)

    By the time an acutely ill patient comes to our attention, they generally are in need of an operation – usually to save his or her life. So, in the absence of pulsatile squirting blood, writhing in pain or being unresponsive, we figure there’s not too much to worry about.

    Sadly skewed perspective, I realize…

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