Friday, April 3, 2009

Rant: Don't just go with the flow

I need to get this off my chest: Any doctor who gets irritated when you ask questions about a prescription with which you are uncomfortable does not need to be your doctor. Fortunately, here in the United States, there are lots of doctors; so don't feel stuck.

I'm certainly not feeling stuck nor am I heading back to the dermatologist Gabe and visited today for the dry patches on his skin. Generally, I'm easy to get along with. I can look past poor beside manner and general haughty attitudes most of the time. I also do, indeed, acknowledge that most doctors have spent quite a bit of time studying their niches of medicine, and that deserves a certain amount of respect and trust in regard to their diagnoses and treatment suggestions. But today's dermatologist can take his expertise and use it to help people who do not ask questions and have blind faith in prescription drugs. Sorry, doc, I'm not one of those people.

A few red flags were raised during our initial visit this morning.

1. He didn't knock before entering, and he proceeded to strut in and just start talking at me. He told me why we were there based on our newly formed chart, looked at Gabe for 10 seconds and began giving me instructions about how to manage Gabe's issue: eczema.

He didn't ask me any questions. He didn't inquire if I'd tried any of the methods of management he was suggesting. And he prescribed Gabe a topical steroid cream while recommending that I use it on his dry patches of skin.

Wait, what? Steroid cream for a 19 month old?

Here's the jest of the rest of the conversation:

****

Me: I'm not comfortable with that.

Him, totally perplexed: Why?

Me: Because that's an awfully strong prescription for a developing toddler. And I don't want to rub steroids on my child's skin because it will soak into his skin, and he's still developing.

Him: Well, if you use the medication correctly and according to my instruction, no harm will be done. The benefits will outweigh the risks.

Me, in my head: According to whom?

Him: Do you think I would prescribe something that wasn't safe?

Me, not wanting to get into a heated debate with his hot ego: Is there a natural way to go about solving this that doesn't include the use of steroid topical cream?

Him: Sure, but you'll read the label and see that the non-steroid cream has risks, too. And it's not as good. You'll then call me and say that I prescribed something that says on the label that it has been known to cause cancer in lab rats. Now, we have no evidence to suggest it would do this to humans, but this has to be printed on the label.

Me, incredulously: You're right. I wouldn't consider that a safe medication. Are there are natural things I could try?

Him, irritated and highly perturbed that I'm questioning his divine prescription authority: Well, sure, but we already talked about that -- using mild, non-scented soaps and lotions. (I already told him after he suggested this that we have never used anything but those types of products on Gabe's skin.)

Long silence.

Him, still irritated: Well, there's lots of stuff on the Internet I'm sure you could find as far as natural remedies. Some people claim tea tree oil cures their eczema. But I don't know about that. I'm not recommending that one way or another. I haven't researched that. And I haven't seen anything suggesting it could.

Me: OK, thank you for your time.

Him: Well, I would like to know if you plan to fill this prescription. I don't want to be sitting here wondering if you will or will not.

Me: I am going to do some research about the pros and cons of steroid use on toddlers and talk to our pediatrician.

Him: Well, you know that's not your pediatrician's speciality. He's probably going to speak negatively about this treatment. Most pediatricians would. It's just like antibiotics are not my speciality, so I wouldn't prescribe them comfortably.

Me: I understand your area of expertise, and I can appreciate that. I still would like to speak with our pediatrician, my husband and do a little of my own research. I like to understand the benefits and cons of any medicine I use on my family or me.

Him: Who's your pediatrician?

Me, trying to help this guy see if he knows our pediatrician: Dr. Elvove. He has a private practice in Libertyville. I believe he's been in practice for 30 years.

Him: I've never heard of him. But I've been doing this for 20 years, and I wouldn't prescribe something I thought was unsafe.

Me: Yes, I understand that you believe in this treatment, but I do not know if I'm comfortable with it.

Him: This is my area of specialty.

Silence

Him: Please call my office when you decide if you will fill the prescription.

Me: Yes, I will let you know.

****

Of course, you cannot get the real feel for this conversation without having witnessed his general body language and the tone of his voice, neither of which were pleasant or understanding. In fact, mostly he was very condescending and irritated.

I left the office piping hot. Since then I've calmed down, made an appointment with Dr. Elvove to talk with him about the eczema and generally decided that with John's help that we will not be returning to Dr. Mighty Ego Dermatologist.

It's YOUR (family's) health. It's YOUR decision to use prescription medication. And it's YOUR choice to return to a doctor and keep him employed as your physician. Don't make these choices lightly, and don't stand for treatment you don't agree with.

OK, rant over. Thank goodness it's Friday after a day like today. Who wants a beer?

Sigh ... have one for me, then.

7 comments:

  1. Oh this sounds JUST like me after I went in for Little Miss's well visit check after her pneumonia hospitalization and he wanted to put her on a twice daily inhaled steroid remedy. I am not comfortable with that. I had done research suggesting her MANY issues were actually a dairy issue, and he completely condescended to me. I haven't found a new ped yet (the one recommended was in Mundelein and I'm not quite up for that), but I'm working on it. And I haven't taken her to be tested for the dairy allergy because the allergist we visited a year and a half ago was an a%%. Good for you for asking questions - and for making the decision not to go back!

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  2. Those types of doctors should not practice on children. Parent's know things and have opinions and are in charge of their own child's well-being. Yes, there are those parent's who need absolute guidance from a medical professional, but some of us like to KNOW things for ourselves before committing to a decision that could effect our child's entire life. I'm with you.

    On Michelle's comment - Monsoon had awful eczema (a really bad spot on his face that looked like a deep dark birth mark, for one) from the time he was 2 months until we tried soy formula at 5 months - it started to clear up in a week. And he was only drinking maybe 2-3 formula bottles a week because I breastfed most of the time - but just that tiny amount made him break out. Maybe he's having a mild allergic reaction to something? You've probably already thought about that, but I thought I'd mention it just in case. (it did take us 3 months to think of it.)

    Hope you get it worked out in a way that you are comfortable with.

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  3. I detest doctors like that. I've already had several experiences like yours throughout my pregnancy. Good for you for asking questions though I KNOW they don't like that. Oh well-too bad for them. Besides being ill my entire pregnancy so far, dealing with the medical profession (for the most part) has been my biggest bone of contention. I will be interested to see what your peditrician recommends. Stay strong! ;)

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  4. Wow. Definitely a good opportunity for a second opinion.

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  5. Hi. I highly recommend reading this boo--might put your frustations into perspective.

    http://www.amazon.com/Raise-Healthy-Child-Spite-Doctor/dp/0345342763

    Dr. E recommends it, and so does Dr. Shaw!

    Is Gabe on a fish oil or butter oil? This is what I couldn't recall yesterday, it really helps Eli with his skin patches; reduces inflammation from the inside out. ;) HTH.

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  6. Did you try oat baths? The AC used to have a few problems, although his were caused by a low tolerance to dairy.

    Handful of porridge oats, in the end of a pair of tights or something, tie a knot in them, pop it in the plain water bath when little one goes in, and you can use it to wash him with.

    DON'T FORGET THE KNOT!

    That's really important....

    Hope this helps.

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  7. Ugh. Double Ugh.

    Ben's excema was directly related to dairy protein. Even trace amounts in food would trigger it.

    Suntan lotion makes it worse.

    I have used steroid cream on Ben for a total of 3 days in his entire lifetime. His pediatrician and I were very hesitant to use it but the excema got to the point that it was unbearable for Ben. My pediatrician told us to use it for the minimum amount of time it took to tame the excema and then switch to natural ways to maintain his skin.

    Here is how we maintain: Only use soap/shampoo every other day. Use said soap/shampoo at the VERY end of the bath, rinse immediately and remove child from tub. Use Dove Sensitive bar soap (careful of the eyes). Use Aveeno Intensive Moisture (for adults with blue lid) sparingly for moisture.

    Cut all dairy out of diet.

    Good luck momma. Ben is 3 and we still have flare-ups because of suntan lotion.

    ReplyDelete

There's nothing better than good conversation ... but not while talking to myself. Will you play a part in this discussion?

AND will you pretty please have your email linked to your account or leave it for me so I can respond?

Thanks for taking the time to make these thoughts into conversation.

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