Just finishing up my 5 of 7 days on call to cover the Christmas holiday. I hope I’ve paid my dues to my partners for at least a couple of years. Here’s a random sampling of some of the patients I took care of during the weekend plus:
12/24 3:30 PM cough
12/24 5:17 PM cough and shortness of breath in 6 month old with bronchiolitis
12/25 7:45 AM discharged newborn from hospital
12/25 4:03 PM Out of town family needed antibiotic change that triage unable to call in because the family was out of state
12/26 8:25 AM Initial check on new baby
12/27 9:05 AM Follow-up check on baby and discharge to home
12/27 10:15 AM Call from parent about 3 1/2 year old with chronic constipation
12/27 3:21 PM 5 year old bit into tongue in moon walk. Need to know if they need to go to ED for stitches. No active bleeding. Patient turns out to be family friend. Called to reassure that he could go without stitches.
12/27 5:24 PM 22 month old with bronchiolitis with cough.
12/28 10:30 AM Six year old with sore throat. Seen at Urgent Care out of town. Strep test negative. Getting worse and wants medicine. Called in Amoxicillin. (Bad doctor. Bad doctor. Calling in antibiotics for probable viral illness. Getting tired and resolve to uphold tenants of Ivory Tower medicine getting weak)
12/29 4:45 AM Six month old teething and screaming for past hour. Would like to go to ED. “OK?”, Nurse Triage asks. “Sure.”
12/29 7:08 AM Notification of new baby at hospital
Looking through the triage documentation, I’ve noticed Benadryl popping up in the advice section with frequency. With all of the FDA’s warning and cautions about cold and cough preparations especially in the less than 6 year old set, I wonder what those of us on the front lines are left with to advise suffering patients and their parents during cough and cold season. What does Benadryl do for coughing, runny nosed kids except sedate them? Is there any evidence to suggest it helps cold symptoms? (Funny, I thought antihistamines were for allergies.)
I’m feeling like my hands are tied this sick season – limited to raising heads, vaporizing air, rubbing Vicks on hands (and feet). Have prescribed a few more nebulizers than past years and probably more antibiotics than were necessary to try to give my patients some relief while the FDA cats are sleeping it off with a healthy dose of Nyquil. Can bet that none of them are parents of young children with colds. May have to resort to some of my grandmother’s concoctions – hair of the dog with honey – to get us all through. While I agree that there is no real scientific evidence that cold meds give symptomatic relief, I do believe there is some comfort to patients with viruses by getting some much needed zzz’s.