Trusting my instincts

Posted on 13. Mar, 2011 by pinky in Pinky

I realize that not all my parenting decisions are mainstream. But never for one moment think that any of them are made lightly or without a lot of research.

I am a nurse, I had to study science at varsity. I like research and good logical reasoning. So when I make a decision it always takes pros and cons into account and looks at risk. The thing with most medical decisions is that there is risk no matter what you do. One just has to decide which risk you are willing to live with.

As some of you know Titus and I were struggling a bit with breast feeding. On Thursday we saw a Lactation consultant. She was lovely and spent 3 hours with us. I think we have the hang of feeding with bigger boobs now. Still hurts at times but definitely better than it was.

Titus had a little blister on his lip that started on Tuesday. I thought it was maybe because he latched wrong. Then it opened and was yellow and more appeared so we decided to go to the GP on Thursday afternoon.

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She thinks it is Impetigo and needs antibiotics but because he is only 11 days old she does not want to give it without some guidance. So she refers us to Blaauwberg hospital to see the Paed on call in the ward.

  So we went to the Paed ward and saw a Dr who rubbed Yme and I up the wrong way. Granted I had my hippy pants on and I have pink hair but gosh this woman was condescending. She is VERY medical and seems to be a worse case scenario kind of person.

She was worried that the lesions/ulcers were septic and that she thought he had a risk of being septic inside and wanted to admit him and put him on IV antibiotics and do 5 million tests. She said it could be lots of things including herpes ( which he could only get if I had vaginal herpses at birth – i nearly smacked her for that one) She was also questioning my choices about birth. She kept saying he was prem. He was born at 37+5 so close to 38 weeks and weighed 3.41kg – hardly prem. She questioned if I had vax’ed him yet, and actually I do give the BCG and birth stuff I just wait a week or 2 and seeing as he is at home it is okay. I think she thought I was some person that refused all medication without thinking or knowing why I did things. She had a whole fight with me about Vit K and asked if I had heard about Haemoragic Disease of the newborn, I have read more than most on Vit K, research papers and all sorts, I have spoke to people and again made an informed decision.

He is slightly yellow but my Dad ( a prof of family medicine) had seen him on the weekend and the midwife was keeping an eye on him, she implied that because we had not had him checked we were neglectful and his liver was prem blah blah blah.

So anyway I am on a medical insurance policy and Liberty does not answer phones after 5pm so we could not get authorization for admission and they wanted us to pay R6000 deposit to get him admitted. Hahaha ja right.

Anyway I phoned dad and sent him pictures (which I should have done first but did not want to take advantage of him being a Dr all the time) and he said straight away that it is Impetigo and that with a antibiotic injection and then oral antibiotics and topical cream he should be fine, Yme and I chatted to him about the risk of it being a general sepsis and we were happy that with no other signs, no fever, no lethargy, feeding well, weeing and pooing well and being alert and happy that it was unlikely that he was septic and that for tonight we did not want him admitted.

She wanted us to go to the government hospital with an 11 day old baby and sit and wait with all those germs, the risk to him seems greater to me than waiting one night and phoning the medical aid in the morning. I am also not convinced I want him admitted at all.

She wanted us to sign that we were refusing treatment, which I said we were not we were saying that on the clinical signs that night we did not want to go to a government hospital and that if he got sicker we would obviously take him in. She tried all sort of scare tactics but really she just came across to me as young and neurotic, like she tests for everything and over treats. I understand she wants to be careful but part of being a Dr is knowing when to panic and when to trust your gut and follow the clinical signs. She said we had to sign that we take responsibility for refusing her treatment, we made it clear that we ALWAYS take responsibility for him, that it is our responsibility alone.

I trust my dad and I also think that life is about making decisions based on the info you have on hand and then later if new stuff happens then you reassess and see if you need to do something different. I am so the wrong person to try the I am the Dr and therefore God thing on.

She did give us the antibiotic injection and a script for the oral antibiotic that my dad suggested even though she at first wanted to not give it just to make a point that if we did not do it her way it was no way. Anyway we got his billiruben checked to make her feel better and we got the antibiotics injection and the oral stuff for tonight.

He was fine overnight. It is not easy being a parent.

( as a note a friend  @cazpi has had a baby at Blaauberg Paed ward does not like the Dr we saw today too, she also says she is neurotic and over treats, so that made me feel better that is was not just me that did not like her. She really really got my back up)

Yesterday we got an appointment  with a Dr that works with a friend Suzanne’s Paed, her guy was full – but she has seen this Dr too and liked him so I felt happy going to someone that was recommended.

I was very honest and said i was there for a second opinion as i really had not liked the Dr the night before, but that if there was any reason i was happy for him to be admitted i just did not think that the symptoms last night warranted spending the night in a government hospital or paying R6000 for their bed.

Anyway so he looked at Titus and did a much more detailed examination. She just seemed to panic and wanted to order a million tests and admit him. He was happy that on the clinical signs we carry on with the oral antibiotics. The fact that he had no fever, he was feeding well, he had no tachycardia or lethargy or anything else that might suggest an internal infection. He did not think that admission was necessary and said we should see a huge improvement in 3-4days.

He did repeat the biiliruben just to check as she had not ordered the test that splits the level, there is congugated and uncongugated and then a total. The total does not actually tell you if the dangerous one is high. He also did some tests to see if there was any signs of internal infection. The tracked down the Billiruben test from the night before and if was 205 which is not actually a problem at all and does not need light which she said he needed.

Anyway we did all the bloods and also he changed the antibiotics from a huge dose that was really hard to give a tiny baby 3 times a day to a smaller does 4 times a day. We get it in with LOTS of screaming.

I was very impressed with his manner, he actually interacted with Titus and treated him and a person and was kind to him, this other woman was offish to me and showed no warmth at all. I think  we rubbed each other up the wrong way from the start. She is obviously not comfortable with people that do anything but what they are told or totally to the book.

Yesterday afternoon I got an email from Dr Theart who i saw him that morning, he said the Billi is slightly higher than the day before but still not high enough for lights, and the dangerous one is low. If still yellow on Monday maybe we recheck. But all the other tests were clear, No internal infection and NO septic baby. Look i know it might have been a risk in her mind but there have to be clinical signs to support your decision. There was no need to threaten me that he would be dead in 2 days. I think what got to me was that I was just saying that based on the signs last night we made a decision for last night, we were not making a final decision on his treatment, we would watch and see and in the morning reassess. To me her clinical examination skills are poor and she just relies on tests to make a decision and not on being a Dr with good skills at diagnosing. Being a clinical nurse specialist and assessing patients and having to make diagnoses myself and watching highly skilled Drs I know what constitutes a good assessment.

it felt good to know that we were right in trusting our gut. I am glad i did have my dad to discuss it with, you do for a moment doubt yourself if someone says your baby is going to die. It would have been horrible not to have that backup. I spoke to my Dad tonight and he is a profession and lecturer and teaches students how to do just what she failed to do, how to be good clinitian and learn how to look for patterns and look for groups of signs and learn how to make decisons. He suggested that I write her a carefuly worded letter expalining what happened since we saw her and explain without being nasty and getting her back up the things that we did not like. I am not sure that it will do any good, it is not going to change her, but he thought the feedback and the chance to reflect on what she did was worth writing it.
What do you think, would you write to her?

So R3000 later he is fine. I had a moment at the path lab when my card was declined that i had a small panic. We don’t have that extra in a month. I will have to go and put all the bits together to pay that bill in the 24 hours we have. I then put my last R20 in the car with the petrol light on and had a little sob in the car. I think it was the built up emotion of worry and fighting and proving we were right. But we are home, we have more than most and thanks to my amazing parents and my full freezer of food my mom cooked for me when she visited a few weeks ago we will be fine. I can ask them if we battle, they are amazing, it just takes the wind out of your sails when you skate so close to the edge with money. And to think how much of it was because some woman panicked. BUT still better than the bill if he was admitted for nothing.

Then my awesome friend @cazpi came in the afternoon and I managed to chat and get it all out. She even read to the Pinklets while I washed the dishes that had piled up.

His face today – much improved
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32 Responses to “Trusting my instincts”

  1. Sharon 13 March 2011 at 3:43 pm #

    GRRRRRR!! I’d write her a letter, but I am not nearly as diplomatic, patient and kind as your dad. I’d let her have it in no uncertain terms along with suggesting she return to medical school for the classes she missed on making a proper diagnosis and beside manner. Thank goodness for your dad! So glad that Titus is ok and also glad the feeding is going better now. Now I must be off to google impetigo :-)

    • pinky 13 March 2011 at 4:35 pm #

      I would write if I thought it would do any good but imagine she will just dismiss it as hippy nonsense. I might write to the GP and hospital though

  2. Cazpi 13 March 2011 at 3:43 pm #

    WOW what an improvement! :) So chuffed for you – not only cos he is improving, but also cos it’s a big “stuff you” to the Paed [not normally so vocally violent but wow Sally - "Dead in 2 days" - nasty horrible scare tactics for her incompetence!]

    I think you should go as far as calling the hospital management to be honest. Her way or the high way is NOT acceptable. And I fully believe you should add her name here – or at least tell anyway who asks NOT to use her. [I do].

    Such a relief that Titus is so beautifully on the mend! Rest nicely in the knowledge that your Mommy instincts are 100% spot on – always. Big hugs.

    • pinky 13 March 2011 at 4:16 pm #

      Caz, Yme also said we should write to the hospital and explain what happen and why we were unhappy with her care and will never use their hospital again

  3. Julia 13 March 2011 at 4:09 pm #

    Sjoe…you’ve had such a rough time. I think that you have every right to be cross with this lady paed. I would also have been totally p’d off with her.

    Firstly, the hospital is meant to phone for auth on your behalf, whether or not it is after hours. I have never phoned for my own auth number unless it was for a planned procedure like an operation. The Medical Aid normally has people who work after hours for stuff like this.

    Secondly, I cannot believe that she told you that your baby will be dead in 2 days. Seriously. What kind of Dr does that? It sounds to me like she panicked and stopped hearing what you had to say.

    I think that you did the right thing to trust your gut. And I think that perhaps you must write her a carefully worded letter as she does need to realise that she was wrong and must learn from it.

    So glad he is on the mend and that your feeding is going better. I’m sure it will continue to improve with time. Just hang in there. You are doing wonderfully.

    ps..Must tell you that my 3yr old was also home this week with Impetigo. When I googled and saw those images I nearly died! He is on also on AB along with a topical cream and Deselex for the itch. He is doing really well – his sores have also cleared and he is so going back to school this week.

    Hugs.xx

  4. A Daft Scots Lass 13 March 2011 at 4:23 pm #

    ALWAYS trust your motherly instincts…Mum always knows her child best.

    Handsome wee Titus has great parents and is very lucky.

  5. HippyDi 13 March 2011 at 4:30 pm #

    I’m really glad I saw this and even happier that you stuck to your guns. Did this woman not know the amount of experience in this field that you have?

    I agree with @cazpi , you need to place a complaint with the hospital, her attitude towards you is inexcusable and I dread to think how she operates with a new mother who is going through problems with a baby for the first time – she sounds like a real bully !

    Also I’m thrilled that Titus is getting better, & who knows the hospital might give you a refund – although somehow I doubt it .

    Just know that you are a brilliant mom ;) xxx

  6. Wenchy 13 March 2011 at 4:44 pm #

    I do think arriving in pink hair probably set the tone and the dr didn’t think much further than oh my god the poor kid.

    Good that you stood your ground. x

  7. Nadia Williams 13 March 2011 at 4:57 pm #

    Sally and Yme, what a horrible experience to have had to go through. My heart goes out to you. I just am deeply concerned over other parents subjected to the same treatment as you got from this doctor, who do not have the knowledge and resources you had available to avoid being panicked.

    Lara was somewhere between two and three years old when she got very sick (pneumonia) and spent almost a week in hospital. It was an extremely traumatic experience for her, more so than for most kids, as not only was she ill and in a strange environment, the fact that usually she slept snuggled between her mommy and her brothers made it worse for her than for other children. The nurse on duty, not aware of how attachment parenting works and therefore just how bad this experience was for this little girl, was not particularly sympathetic.

    Later, we learned that the specific doctor we’d seen was quick to hospitalise. A family member’s child got pneumonia too, and managed to treat the child at home under very close supervision from their doctor, in order to avoid the trauma of hospitalisation. I want to stress that it was a matter of watching minute to minute and being competely prepared to take the child to hospital, but the doctor was willing to first try home treatment as he was sympathetic to how stressful it is for a child to be admitted.

    I’d also like to mention that in my experience here in Ireland, doctors consider antibiotics a last resort. The attitude is always, where illness is concerned, to first opt for alternatives to antibiotics. Where there’s any chance it could be viral, they’ll suggest rest, pain relief and patience, and only look at antibiotics if there’s no improvement within a certain amount of time. THe dr has repeatedly explained that avoiding antibiotics as far as possible means they work better when they are the appropriate treatment.

    So in that light, her all-guns-blazing approach sounds alien to that spirit of avoiding over-treatment so the treatment works when it really is needed. Hospitalisation should always, always be the last resort, too, because every person admitted when another route was possible, deprives someone of a bed who really does need one (I don’t know if that’s an issue in SA, but here there is an ongoing crisis that there simply aren’t enough beds available. People spend hours and hours in chairs or on gurneys in A&E waiting for a bed in a ward; I had to sit in a chair in A&E 27 hours last year when admitted with a quinsy. Not a nice experience under the best of circumstances, downright horrible when you’re sick and in pain).

    I view writing a letter not as an opportunity to vent your feelings, but fulfilling what is almost a duty to notify whoever is in charge that this woman is acting incorrectly on a personal interaction and a medical treatment level. Your complaint on its own may not make change happen, but if someone else were to take the same step, your voice will add to theirs and give enough weight to the concerns you raised to hopefully prompt action.

    As for Titus, the second photo already shows a dramatic improvement. I’m sure he’s going to be fine. The two of you as parents have done the best for him by not rushing him into a hospital, with is associated health and psychological risks, at the drop of a hat. Well done, and I hope you will both get a chance to rest and recover in the coming days.

    • pinky 13 March 2011 at 6:39 pm #

      Thanks Nadia, I will write to the hospital and the GP. So they are aware of her conduct.

  8. Nadia Williams 13 March 2011 at 5:00 pm #

    Also, whether you look like Evita Bezuidenhoudt or you have a rainbow-coloured mohawk and wear a clown suit, the doctor’s job is to treat everyone with respect, to listen to what they say and make judgements from that, not from her own preconceived notions on what a parent should look like.

  9. Gina 13 March 2011 at 6:50 pm #

    I would so very definitely report that dr. How dare she!
    So glad Titus is on the mend.

  10. Cazpi 13 March 2011 at 7:21 pm #

    Just a btw: one kid that was there when we were – treated by her, HAD to be hospitalised every time he got sick. He was 18months old, and his mom said he had never spent an entire month without being in hospital, cos the anti-biotics didn’t work anymore. Frightening.
    I like the Mohawk idea of Nadia’s – might pop in, greet her, with one of my own lol.

    and ps: next time I do dishes? lol

  11. Barb 13 March 2011 at 7:55 pm #

    He is looking so much better! Glad it is healing quick xx

  12. cassey 13 March 2011 at 8:16 pm #

    I’m glad to read that you’re going to write the letter/s. Isn’t there an ombudsmen for doctors/hospitals? If there is you should send a letter to them too.

    Yay for Titus being better, and for you in knowing to go with your mommy instincts.

  13. Tania 13 March 2011 at 8:40 pm #

    Hi there, all I kept wondering as I read this is how many firsttime Moms she’s scared the living shits out of.
    Good on you for sticking to your gut and I agree, write the hospital a letter!

    Incidentally, Isabel had pneumonia last year this time and ended im hospital on a antibiotic drip, only for our paed to go off and leave us with someone similar to your doctor. In the end I had a standup fight with him in the ward and when he walked away the other parents actually clapped hands. Was very funny looking back on it. Doctors are a vital part of our lived, but they should treat us with respect and remember that they are not God.
    Take good care!

  14. Tertia 13 March 2011 at 9:04 pm #

    What a terrible experience for you, how terrifying. So glad you are all ok and on the mend. Write a letter to the doctor and copy the hospital. You might not change her behavior but it might make a difference to the next parents who follow.

  15. Fiona 13 March 2011 at 9:44 pm #

    Sorry to hear your terrible ordeal. I know how you feel, when I was sick the last few weeks I too had enough of the megadose approach of the usual docs and only by my persistence have I found a better doc who is having to deal with the neglect of my other doc’s. My sister is a qualified herbal medical doctor and I will chat to her, she will be willing to help you with some referrals and treatment. I will chat to her in the morning. Sorry your 1st few weeks has been so hectic. I will contact you and perhaps we can come and play with the little ones while you rest, I will chat to “cazpi” to see when we can arrange,

  16. Esther 13 March 2011 at 9:53 pm #

    Wow, bad experience. But you came out tops. When I read the first part, I said “Impetigo”. Simeon and Joshua both had it in White River. Mostly because of pre school/day care. Sometimes, if it got worse I would take them for antibiotics, other times I would treat it with breast milk!!

    I would write the dr that letter. Maybe it might just maybe change her attitude. Especially if she knows that that pink hair is on top of a mother who really cares, and knows how to and when to question medical advice.

    I wish doctors would realise they are consultants in our health and that is why we see them. To give advice and to let us decide what is best.

    So, sterkte with everything.

  17. Jane Teather 13 March 2011 at 10:40 pm #

    Hi
    I toom one look at the photo and said impetigo before you did. The children gave it to me 7 years ago and now I find it often resurfaces when I am stresses. Oral antibiotics and an injection does seem overkill to me as I treat mine with antibiotic cream but I suppose they were being careful because of his age. Apparently we all carry impetigo germ/virus? up our noses! BTW the children’s has never come back – only mine. And it sounds so medieval.

    I would write to the hospital. I never did after Freddy’s experience and I have always regretted it but at the time I was too overwhelmed by being rushed in with him. (He had cellulitis when he was 7 months old). Make sure you put on all your qualifications at the end though. She sounds the sort who will pay more attention if you do.

  18. Sandi 14 March 2011 at 1:08 am #

    So glad it wasn’t anything serious & it’s all clearing up nicely. I would write her a letter but LOL, I don’t think I would manage to be very nice :-)

  19. Angel 14 March 2011 at 7:45 am #

    I am so sorry that she was so mean and judgmental Sally! Unfortunately it happens rather often and it took me years to come to the realisation that I should and could argue with a doctor if I don’t agree with them!

  20. Jenty 14 March 2011 at 8:06 am #

    What a horrific experience!
    Luckily you know what you know, and your dad could help you.
    Really really glad that Titus is getting better, and his face looks a lot better now

  21. blackhuff 14 March 2011 at 8:39 am #

    From what I read from your experiences, this Pead is a b***. And to let you sign a form which states you are refusing treatment is so …. don’t even have a word for it. Sorry that you all had to go through this.

  22. Robi 14 March 2011 at 9:08 am #

    Poor chicken. And poor you. It must be a horrible thing to deal with. Well done for standing up for yourself though. Mommy Badge +1!

  23. cat@juggling act 14 March 2011 at 9:56 am #

    My opinion – she is an overly concerned about her professional insurance type doctor – the worst kind because their concern is with themselves and not their child. And to top that she is prejudiced! I will write to the hospital though, per email and copy her.

  24. Shane 14 March 2011 at 10:41 am #

    First off! I am soooo Glad Titus is healing up so nicely! :D

    On to madam doctore… having family & a friend in the medical profession I can only say that they are under a lot of pressure, be it making sure nothing happens to a patient (or their child), chances of being sued for any mistake and any ‘young’ person in a position of ‘authority’ has to battle the imminent onset of a god complex.

    She was out of line and deserves feedback… if you want to blow off steam give her hell but don’t expect it to achieve much – if you want to see her grow and perhaps give future patients a better experience than yours then try to be constructive by keeping it factual not emotional.

    I would include the photos of how well Titus is responding to the treatment in any communications you send. It says far more than words could ever convey.

  25. Vannessa 14 March 2011 at 1:13 pm #

    Hi, I have used Blaauwberg hospital and found the care there to be excellent so would hate you to label the entire hospital bad because of one doctor. And I have had my share of bad experiences in hospitals. I also have friends that work there and they do complain about certain doctors thinking they are gods but there are many good ones. I am really sorry that this woman caused you to have such a bad experience. Having lost a child already(in another hospital) I would have been inclined to believe her and rather played on the safe side and it could have been totally unnecessary. I would appreciate it if you could send me her name so that I know to avoid her in future.

  26. Tanja 14 March 2011 at 10:31 pm #

    He is looking so much better Sally!
    Well done for sticking up for Titus & you guys!

  27. MeeA 15 March 2011 at 10:09 am #

    Ja, hey… Had I been in your shoes, I may very well not have resisted the urge to slap her over that herpes comment.
    That said, I agree with those who’ve suggested that you write the letter to the hospital, copying the doctor, bearing in mind as Shane said, to keep it factual, not emotional.

    Glad the little guy’s on the mend – he’s unbelievably cute! :)

  28. Bobbi Janay 17 March 2011 at 6:00 am #

    I am so sorry you had to deal with this. That is insane. I would def. contact the hospital and file a complaint.

  29. Karla Roux 24 March 2011 at 12:46 pm #

    Hi
    My 2nd baby was also born at Blaauwberg Netcare Hospital. The same doctor send us for 4 tests (as a result of slight yellowness), but the count was not close to the danger limits. We are still at a paed at Blaauwberg netcare, but with Dr Grindlay. He is a great doctor and also treats the children with lotz of warmth and takes his take during visits. He also doesnt want to see the baby often, only when he can add value.
    Good luck! You’re not alone!
    I was at the funeral, curly black hair, short..was in matric with Yme.
    Do you guys stay in Tableview? We do. We can get together sometime? I’ve got lotz of baby stuff I can pass on. Do you have a reliable breastpump? I can give you one.
    My cell number is 084 5874746,
    Karla

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