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Dec. 18th, 2006 08:31 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
rivkaAlex got a nasty cold over Thanksgiving. She had a persistent, dry, hacking cough afterward, which, as often happens following a cold, lasted for weeks. A couple of days ago, the cough started to get ugly, and ramped up with tremendous ferocity. This morning she coughed so hard that she vomited.
So this afternoon we saw one of our pediatrician's partners. She diagnosed Alex with a sinus infection that has been, in the doctor's very words, "seething" since Thanksgiving. It is now causing the dreadful cough, and has also backed up her Eustachian tubes and started an ear infection. Although the AAP now recommends that most ear infections not be treated with antibiotics, it seems not to apply in our case. Alex now has a big bottle of bright pink, bubblegum-scented, sludgy, but apparently tasty Amoxicillin. We also bought her a bottle of combination antihistamine and cough syrup to help her sleep. (The sinus infection drains when she lies down, so she feels much worse at night. Plus, as a special bonus, antihistamine = sedation.)
The doctor's visit went surprisingly well. Alex's 15- and 18-month checkups were utter nightmares. She started crying and clinging the moment we stepped into the exam room, and graduated to hysterical sobbing when the nurse tried to measure her or the doctor tried to examine her. Developmentally normal, our ped was quick to assure us, but still a wrenching battle that left all three of us unhappy and drained.
A couple of weeks ago, coming home from our last trip to Elmira, Alex suddenly initiated a game of "doctor." She had her nail clippers, which have a magnifying glass at the business end, and announced that she was going to use them to peek in her doggy's ears. We spent about 45 minutes on that car trip examining each other and her doggy. Several times since then she has initiated doctor play, as well - always a monotonous (to me; it's endlessly fascinating to her) rehearsal of a well-child visit. One of the children's librarians found us two picture books about going to the doctor, and she's been demanding them up to five times a day.
We started to prepare her yesterday for the likelihood of a doctor's visit today. She was excited to leave for the appointment: "Go to doctor! Go to doctor!" While we were in the car, we talked about things the doctor might do. (Peek in ears, peek in mouth, listen to chest and back.) We also brought her favorite of the two doctor books with her, and re-read it in the waiting room. When they brought us back to the exam room, although she didn't cry, she clung to Michael pretty tightly and rested her head on his chest. We walked around and around the room looking for things that were the same as in her book, talking about what Thomas (the main character) did with the scale, the blood pressure cuff, the tongue depressor, and so on. It seemed to help so much. Alex was calm when the doctor came in. She let her listen to her chest and back without protest, and accepted the ear exam. She only cried when the doctor wanted to look in her throat. Throughout the exam, we kept talking about what Thomas did in the book, and how Alex was being just like Thomas.
The doctor responded very well to what we were trying to do. She let me hold the tongue depressor, for example, instead of insisting on putting it Alex's mouth herself. She even engaged Alex with the book - she flipped through to find out what happens at the end (Thomas gets stickers from his doctor), and told Alex that she could have stickers at the end too. But really, I think most of the work was done by Alex, through play and through hearing and talking about the stories.
You know, they say that "children work out their issues through play," and it always seemed a reasonable enough idea. But it's something else to see how amazingly well it can work in practice.
Oh, and additional good news: we weighed her, and she's gained almost two pounds since the first week of November. That takes her up to the 25th percentile for weight. Yay!
So this afternoon we saw one of our pediatrician's partners. She diagnosed Alex with a sinus infection that has been, in the doctor's very words, "seething" since Thanksgiving. It is now causing the dreadful cough, and has also backed up her Eustachian tubes and started an ear infection. Although the AAP now recommends that most ear infections not be treated with antibiotics, it seems not to apply in our case. Alex now has a big bottle of bright pink, bubblegum-scented, sludgy, but apparently tasty Amoxicillin. We also bought her a bottle of combination antihistamine and cough syrup to help her sleep. (The sinus infection drains when she lies down, so she feels much worse at night. Plus, as a special bonus, antihistamine = sedation.)
The doctor's visit went surprisingly well. Alex's 15- and 18-month checkups were utter nightmares. She started crying and clinging the moment we stepped into the exam room, and graduated to hysterical sobbing when the nurse tried to measure her or the doctor tried to examine her. Developmentally normal, our ped was quick to assure us, but still a wrenching battle that left all three of us unhappy and drained.
A couple of weeks ago, coming home from our last trip to Elmira, Alex suddenly initiated a game of "doctor." She had her nail clippers, which have a magnifying glass at the business end, and announced that she was going to use them to peek in her doggy's ears. We spent about 45 minutes on that car trip examining each other and her doggy. Several times since then she has initiated doctor play, as well - always a monotonous (to me; it's endlessly fascinating to her) rehearsal of a well-child visit. One of the children's librarians found us two picture books about going to the doctor, and she's been demanding them up to five times a day.
We started to prepare her yesterday for the likelihood of a doctor's visit today. She was excited to leave for the appointment: "Go to doctor! Go to doctor!" While we were in the car, we talked about things the doctor might do. (Peek in ears, peek in mouth, listen to chest and back.) We also brought her favorite of the two doctor books with her, and re-read it in the waiting room. When they brought us back to the exam room, although she didn't cry, she clung to Michael pretty tightly and rested her head on his chest. We walked around and around the room looking for things that were the same as in her book, talking about what Thomas (the main character) did with the scale, the blood pressure cuff, the tongue depressor, and so on. It seemed to help so much. Alex was calm when the doctor came in. She let her listen to her chest and back without protest, and accepted the ear exam. She only cried when the doctor wanted to look in her throat. Throughout the exam, we kept talking about what Thomas did in the book, and how Alex was being just like Thomas.
The doctor responded very well to what we were trying to do. She let me hold the tongue depressor, for example, instead of insisting on putting it Alex's mouth herself. She even engaged Alex with the book - she flipped through to find out what happens at the end (Thomas gets stickers from his doctor), and told Alex that she could have stickers at the end too. But really, I think most of the work was done by Alex, through play and through hearing and talking about the stories.
You know, they say that "children work out their issues through play," and it always seemed a reasonable enough idea. But it's something else to see how amazingly well it can work in practice.
Oh, and additional good news: we weighed her, and she's gained almost two pounds since the first week of November. That takes her up to the 25th percentile for weight. Yay!
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Date: 2006-12-19 03:19 am (UTC)I'm hoping we're done with ear infections for a while, because the local rule is tubes after 4 infections in less than 6 months or 6 infections in a year ::sigh::
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Date: 2006-12-19 03:55 am (UTC)That's kind of an odd rule. The AAP recommendation is based on the fact that most ear infections are viral - which means that antibiotics don't help, even if you're under two. But it shouldn't surprise me that pediatricians aren't a monolithic body, I guess.
Poor David. I hope he is finished for a while.
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Date: 2006-12-19 04:58 am (UTC)*nods* "Tis why I mentioned their specific definintion - red, painful, bulging eardrums don't get antibiotics - only if the appearance shows pus. Believe me, we've had two episodes of fluid buildup likely due to a virus that didn't progress to a full-blown infection requiring antibiotics. And all three docs in the group know I have an otoscope, and that Mama knows what infection vs fluid buildup looks like. As a result, they get me in pretty darn quick if I call ::chuckle::
I've been threatening to breastfeed the next one to age 20 if it'll prevent the dang ear infections (David didn't have one until after he self-weaned at about 9 months or so).