Sunday Morning Truths From The ER

[llpoolej]

I am really pretty slow to go to a doctor over most anything. Only one of my kids has been to the emergency room, and that was due to a fever of 105.5 that I could not get down with tylenol, advil and bath's. I figured that I might just fry his brain if I didn't go. He broke out in a rash a few days later and it was roseola. No biggie.

Anyhow, that being said. I blew off a cold when my son was 11m to the point he lost way too much weight and his ears were so bad they were about to burst. They gave him two shots of rocephin there in the office.

His ear infections did NOT resolve with time. He need antibiotics, or it was horrible for him. He ended up getting a tonsilectomy/adnoidectomy at age 4. Not for ear infections, but because the tonsils were blocking his throat, causing apnea and serious snoring. Best thing we ever did for the kid. He hasn't had an ear infection since.

When I get strep(positive on culture) I get antibiotics. I feel human again in 24 hours. But, I so rarely go to the doctor for colds, it really is a non issue. Heck, since I had my thryoid out a year ago, I don't think I have had a cold!

And yes, I have had the real flu. Once that I can remember when my kids were 2. It was HORRIBLE and I didn't even have the energy to speak on the phone for 2 weeks. That is major for me!

[JokerGirl]

Scuba diving with an ear infection is probably the worst thing A couple years ago, right after I got my certification the opportunity came up for me to go with my father to his oncology meeting in Kauai. I was fine until the 2nd day that we got there (probably the recirculated air in the packed 747). My first chance to go diving in the ocean and I get sick.

Finally, on the last day my ears were feeling well enough that I thought I'd be fine equalizing the pressure in my ears to do a 90ft dive. We drive to the south end of the island for my dive and all of the sudden this tropical storm starts looming overhead about to threaten my dive!!!! Thank heavens, the dive master rushed me and a few others out to our dive location where I got a chance to dive FINALLY. Began having trouble with my ears (figures) but was able to clear them enough to where it was uncomfortable but not painful.

Ended up seeing a white w/ black spotted moray, lots of turtles, a pregnant shark, and had a relatively large octopus on my arm.

Ear infections are the worst luckily I still got to take my first dive in the ocean!!!!

[JokerGirl]

Oh and I feel your pain Joey.

My mom's an ER nurse, brother is an ER surgeon, and my Dad is an oncologist. The heavy use of antibiotics these days is only causing more harm than good in the long run. Starting to see the so-called "super" bugs more and more. The ONLY time my dad will prescribe me a z-pack is if I'm blowing out neon green snot

[O'Man]

Otitis media (middle ear infection) can caused muffled hearing while fluid sits in the middle ear. Eventually it drains through the Eustachian tube to the throat. There is a concept floating about that constant middle ear effusions during the age of speech development may hamper that development, but others disagree.

I had terrible hearing as a child until I went through the 4th grade, twice. Then I had the fluid drained from my middle ears, with the tubes, and could hear. Test results showed 30% normal hearing left & 20% normal hearing right, before the operation, and 85% & 90% afterwards. I still remember hearing crickets at night, and many other sounds, for the first time after the operation.

I was a big kid, and back then bigger kids sat in the back of the class, which made hearing more difficult. I had a hard time with school, mostly, because I could not hear anything. I did become a good lip-reader though. I had speech therapy to help with pronouncing certain words, and to this date I cannot spell anything by sounding it out. I picture how it should look instead, and am frequently wrong. . . so thanks to the smart people for spell check. For me, that operation improved my quality of life, and helped me do better in school.

It seems to me that medicine is full of exceptions, and I do not question viral versus bacterial test results & when antibiotics should be used and I fully understand that doctors frequently have to deal with patients that demand treatment whether or not it is really needed. I understand that over-prescription of antibiotics is adding to the development of tougher to kill bugs that will cause problems, and that if someone goes to the doctor looking for a "cure" that they can become cranky when none is offered.

This situation does go both ways though.

I personally have been seeing a cardiologist, who seems like a nice guy, but does not want to accept that my atrial fibrillation is causing me problems. Yes, I can live with it, if I have no alternative, but the lack of sleep, the chronic fatigue, the shortness of breath, the continual flipping & flopping of my heart in my chest, the inability to feel normal is getting old, and making me feel real old & depressed. It is irritating to have a medical professional ignore your comments & treat you like you are stupid. I even asked this guy about treatments that I had read about and I was spoken to like I was an idiot, and he did not offer any opinions, other than remarks that were meant to keep the status quo.

Fortunately, there are options and with some effort you can get second opinions. My experience has been that any profession has high & low quality participants, and that so much of it involves personal choices, likes & dislikes.

[crzy4reefs]

I never took anything when I got an ear infection only happened a few times,


I'm hoping that since I breast fed my son he won't get ear infections, that's one of the things I read in a few books,

is this true joey? also zack has had only 2 cold so far (he'll be 2 in January) and even then they weren't that bad a lil runny nose and loss of appetite


But we are for the most part so set on taking medication for every little thing we get.

[wiszmaster]

i had an ear infection a few years ago, doc put a tube in my ear, and tried to 'flush' the inner ear out, i'd guess..... that was the MOST excruciating pain, to the point that 3 or so nurses had to hold me down, i was screaming off the top of my loungs, and passed out.

the tube ended up falling out almost 2 years later - i was able to 'blow' air through my ear for another 8-10 months after the tube came out.
This was about 2+ years ago ... and am still having issues with that ear.

I'd love to go diving, but affraid that i will have issues. When under water, my right ear does not equilize, or pressurize/pop ... i have to manually hold my nose, and blow ... and then when it does pop underwater, last time i did it in a pool, @ 6' ft depth, it HURT! sharp stinging sensation like someone just stuck a needle in my ear.

[wiszmaster]

Originally posted by wiszmaster
was able to 'blow' air through my ear for another 8-10 months after the tube came out.

when holding my nose, and preassurizing my ears, my left would pop, my right was not, and pass air - if you put your ear up to my right one, you could hear the air passing ... was quite entertaining sometimes

people used to ask me if i could breath throught it if i kept my mouth & nose shut ... ROFL

[llpoolej]

I think ear infections have more to do with exposure(like at daycares) than they do breastfeeding or not. My friends who breast fed until their kids were a year old had kids who needed tubes they were so bad

I only breastfed 6 weeks and my daughter never had any and my son didn't get them until 11m, and then sparingly. They were just BAD when he did get them. I think that was due to the adenoids blocking the ability to drain

Joey, I have to say, when I read this it just really makes me think of some of the treatment I have received from endocrinologists. The "You are just as stupid patient and I won't listen to what you say as you are just too dumb to deserve my advanced degree attention."

Patients can be stupid no doubt, but, doctors can have serious God complexes and do incredibly wrong by their patients. I love my GP(who listens and *talks* with me) I love my OB(who, also listens and *talks* with me) and I love my son's physiatrist(who is a woman and has conversations with you) I have YET to meet an endocrinologist I find worth anything.

So, along with your stupid patient rant, I can thrown in the stupid doctor rants.

I honestly find a way not to go to the doctor if I can. I go to my (now) yearly GP appt and I take my kids if they have a cold that doesn't clear up for 2 weeks. I don't use the ER. I have personally been 2x's in my life. My son once and my husband once when he was electrocuted and fell twenty feet.

[crzy4reefs]

well maybe when he goes to preschool then we don't do the whole daycare thing, my mother in law watches him ( i drop him off at her school she's a special education kindergarten teacher, it's an integrated class 1 reg teacher 1 special ed and they each have an assistant.) then Eric picks him up.

[llpoolej]

They older the child gets, the less likely of ear infections due to the eustachian tubes being larger and draining better. That is why babies have so many. My son got them whenever he had a cold. My daughter never got them. My kids didn't get a cold until they were almost a year old, which is why his first one was when he was 11m.

[crzy4reefs]

yeah my son was a lil over a yr before he got his first cold and it really wasn't that bad, loss of appetite but he was fine 2 days later. then he got his second one at the age of 17months, and that was it only those two colds so far......, so we'll see.

[JokerGirl]

I think it also depends on how narrow the passageways your nose are.

I was breastfed religiously, sent to day cares until I was about 6-7 years old. Never got chicken pox, or the measels (even though I was purposely exposed to them) but I get ear infections really bad. I'm 21 and I still get an ear infection every time I get sick. I think it has to do with the fact that I have a very narrow nasal passage so it doesn't take much to get me stuffed up and my ears clogged.

[llpoolej]

I will be shot for this opinion, but, I think the major benefits of breastfeeding are immunities WHILE breastfeeding(if Mom has them to begin with) and th ease of digestion. Beyond that, I feel the rest is LLL hype.

I honestly despise the LLL and the militant way the members deal with mom's. Having been a NICU mother, believe me, they are ROUGH.

Breastmilk is the best because it is tailored to the digestive needs of infants. Formula is not going to make your kids stupid and fat though. I was exclusively raised on formula and have never weighed over 125lbs(and I am 37) my IQ is way up there and I was rarely sick as a child. I had an ear infection at age 8 and a heating pad took care of it(but it HURT!)

Kids are way fatter now and it has to do with the way they eat NOW vs how they were fed as infants. People my age almost ALL were bottle fed crappy formula and you rarely saw a fat or sickly kid. You just didn't hear of constant ear infections or have kids that were obese in the 70's.

I would say the rule is breastfeeding and the exception is bottle feeding. It has reversed the feelings of the late 60's and 70's. Then you were poor and uneducated if you breastfed, and now, it is you are poor and uneducated if you don't.

Doesn't do a kid a bit of good to breastfeed if you feed them chips and cokes as a gradeschooler as a regular snack and don't read to them.

And don't be surprised if Zack isn't sick all the time when he starts school. Kids have to build immunity at some point and they will get colds and illnesses when in a group of others. Mine rarely get sick now, but, were sick for quite a bit of the winter when they started mothers day out at age 3. It is just an exposure thing.

A special ed preschool will be less germy than a regular one. Parents of special ed kids are much more viligant about keeping their kids healthy and at home. Been through too much not to.

[joeychitwood]

Originally posted by llpoolej
Joey, I have to say, when I read this it just really makes me think of some of the treatment I have received from endocrinologists. The "You are just as stupid patient and I won't listen to what you say as you are just too dumb to deserve my advanced degree attention."

Patients can be stupid no doubt, but, doctors can have serious God complexes and do incredibly wrong by their patients. I love my GP(who listens and *talks* with me) I love my OB(who, also listens and *talks* with me) and I love my son's physiatrist(who is a woman and has conversations with you) I have YET to meet an endocrinologist I find worth anything.

So, along with your stupid patient rant, I can thrown in the stupid doctor rants.

I understand your concern. However, when you go to the ER, do you want a "friend" and someone who will reinforce your preconceived beliefs, or do you want someone who will treat you with the most up-to-date, evidence-based medical care?

I've never done anyone a favor by giving them a drug they did not need. However, I've seen people harmed and even killed by allergic reactions to antibiotics given for viral infections just to make the patient "happy."

My rant was not about stupid patients. It was about preconceived notions, all of which have been perpetuated by doctors who were afraid to disagree with their patients and were more concerned about keeping the customer happy and coming back than to take the time to tell them they did not need antibiotics. It's the fault of the medical system and doctors who don't have the guts to do what is right.

[amcarrig]

Originally posted by joeychitwood
Many Emergency Physicians, especially in the academic setting, treat throat infections based on clinical findings only. They don't even check a strep screen. They look for fever, swelling, trismus, (pain or inability to open mouth wide,) exudate or pus, lymph node swelling and other constitutional findings.

Untreated bacterial throat infections (not necessarily strep) can occasionally lead to serious infections like peritonsillar cellulitis or abscess. In the case of the abscess, otolith will lance the pus pocket and drain the infection. You may have been developing this condition, in which case you'd have to see a specialist.

75% of the disorders we see in the ER will eventually get better with time. The trick is to know which ones won't.

I did have a strep screen and I could see puss pockets on my tonsils(?) when I opened my mouth. It was nasty. Thanks for the info doc. I hope to never get strep again but feel like I'm better prepared if I do!

[Sk8r]

I'm with the tough-it-out school of thought until it heads for my lungs. Then I hope for antibiotics. And as the veteran of a lot of ear problems, I've never found they help that much.

Then there's my skating friend, who's complained of toothache until she fell on the ice, hit her head really hard [helmet] and apparently knocked loose an impaction in her sinus, which started to, well, drain, aided by a lot of saline. This woman had had two courses of antibiotic this year for different problems, neither one of which had touched what likely had been a long-running and hidden problem, likely since last January---oh, the toothache? Diminished as the sinus started ridding itself of the problem. Mild concussion apparently has some benefits.

[crzy4reefs]

we eat healthy in this house as well my son has never had nor will he have soda, sugar or your basic crap foods.

i breastfed him till he was a yr of age then we weaned him on to whole milk. My thing with breast feeding is they are they that's what your breast were made for, and is essentially the best thing to feed your child if you are able to. no one forced me into breast feeding, i did it cause it was a natural thing to do is all.


and yes no matter if the child is breast fed or formula fed if you feed them junk foods they will get fat........allot of breast feeding information is basically hype from LLL.

[emilye2]

Julie-My kids were both sick for about 6 months straight when Claudia started Pre-K. It's a little germ factory! I give more cold medicine to the girls now when they are going to be at school. It's no fun to be there with runny noses and an endless cough. But on days they don't have school they get to suffer.

[crzy4reefs]

it's a special education kindergarten class my mother inlaw teaches, there are regular ed and special ed children, and he's dropped off there around 2:30 and she leaves the school around 3:15-3:30.

he'll be going to a regular ed preschool class. but i think him spending this much time in her school is helping him some. at least i think so lol.

[batguano]

Originally posted by Nina51
i used to get strep as a child, often. i was sick all the time. i don't remember taking medicine. mom used to give me warm tea, probably laced with a little whisky so i'd sleep. i turned out perfectly normal in every sense of the word.

Reasonable minds could differ!

[JokerGirl]

Speaking of lacing your kids with a tad bit of liquor to put the kids to sleep. My Dad's favourite is "Triaminic Green". It's not OTC in the US but in Canada it is hahahaha It's Children's cough syrup with codeine in it. If you ask him about it all he says is, "Oh that was wonderful stuff"

[xraydoc]

Im just glad that I dont have to see patients anymore, just their pictures.