I just got off the phone from texting with the mother of a 3 year old patient of mine. It was late in the afternoon and her son had just started crying that his mouth hurt. I was texting her from the back of a car en route to the airport..the wonders of technology!
She was concerned because the pain had come on so abruptly, but she text me that he did not have a fever, had not had a fall or trauma to hurt his mouth, and that when he opened his mouth she could not see anything that would cause “obvious pain”.
I asked her a few more questions via text and recommended that she might try giving him a dose of ibuprofen and see if he calmed down and felt better, but I did not hear back from her for awhile.
It was then that I realized that pediatrics and parenting have quite a bit in common…one of the similarities being patience.
While she was concerned that her child had suddenly started crying due to some sort of pain, much of pediatrics is about watching and waiting. We parents all want to keep our children pain free, but sometimes things will hurt both physically, and as your child gets older, emotionally (which may be even worse to watch). A parents first instinct is to find the cause of the pain and “fix it”. Whether that means a band aid, a kiss on a boo-boo, or medicine.. “just make it better”.
But in many cases in pediatrics and actually all of medicine, it is about watching, following, and waiting, which is not as easy as it may sound. Doctors, parents and patients often have to “be patient” and see what evolves. Not all tummy aches are cases of appendicitis, not all falls cause a concussion and not all boo-boos result in broken bones (thank goodness!).
But for a parent to hear “let’s see what happens in an hour or so” may sound like a lifetime and waiting just seems crazy when there is a “doc in the box” on every corner. You may see where I am going with this.
So, by the time I heard back from this concerned mother, she was already at the nearby “doc in the box” waiting for a doctor to see her son, who by now had stopped crying. She had already put him in the carseat for the drive to the clinic before she read my text, so he had not even had any ibuprofen.
According to the clinic doctor (or nurse), the child “had an ear infection causing his pain” and she was given a prescription for antibiotics. Once the mother was home and I could talk to her I asked if they had prescribed medication for pain relief, such as ear drops and/or ibuprofen. She said she only had the antibiotic prescription which she had filled, but her child had stopped complaining of pain.
So, I was not there, and did not see her child, but I wonder if ibuprofen might have done the trick and alleviated his pain..and also kept him off of an antibiotic until he could be seen the following day in the office?
But in this age of “quick” medicine and a clinic on every corner, a patient/parent may not need to wait and see what evolves. I wonder if this “quick” medicine may be one reason we see antibiotic overuse . I’m just saying….