I met Tanya last month at a writing conference. She’s an author and podcaster who mainly interviews other authors about their work. We got to talking so much that she recorded a second session on the books that have inspired me. I hope you’ll take a listen.
Well-Unwell
Or sick-not sick.
I think I’ve covered
this topic in a previous blog post, but either I’m totally mistaken or not
using the right search terms.
When they’re evaluating a patient’s conditions, physicians
don’t just take the patient’s word for it.
They look at the vital signs. How
is the temperature, pulse-ox, respiration rate, blood pressure? Within the normal range? That’s good.
If not, they’ll investigate further.
Patients can have a sign that’s way out of whack and be perfectly
fine. That’s hard to accept when it
concerns our family members.
Something else doctors consider is the patient’s demeanor. A teenage girl chatting on her phone probably
isn’t doing too badly. The same goes for
a child bouncing off the exam room walls.
(Unless, of course, it’s drug-induced.)
Doc’s having an interesting second year of med school. He spent most of autumn in two-week
rotations—neurology, OBGYN, pediatrics, and psych. Psych was hard—a lot of suicidal teens and
messed up families. One poor young man
was in there because he’d used a sweatshirt to cover the toaster, and that
started a fire. He was attempting to
block the aroma from coming out of the toaster because he was hungry and had sneaked out of his room to get something to eat.
The stepmom only permitted him to come out of his room for one hour per
day and she didn’t feed him much. The
bio dad allowed this. No idea where the
bio mom was. Doc said the kid was incredibly
bright. And no one would report the
situation to DCFS because life within that system would be worse. We truly need a reset in this country.
Pediatrics was a lot more interesting. An ER physician from Primary Children’s
Hospital (it’s officially got a different name now, but no one local uses it)
shared a few fun facts. Like I thought I’d
previously covered, this physician reviewed the importance of looking at the
patient and the vital signs to determine the scope of treatment to be
rendered. Of course, one of the
challenges in dealing with children is that they can present with weird
symptoms. Anyway, he was discussing body
temperatures and flat-out stated that a child can have a temperature of 106°F
and not be truly sick. If that child is
running around, playing, happy, he’s not truly sick. On the other hand, a child may have a
temperature of only 101°F and yet be in real trouble. One simply must consider the whole picture.
After the lecture, Doc showed him a picture of Ellie’s
baby. She was nine months at the time
and had suddenly developed a moderate fever and rash on her head. I had just written that series of articles on
rashes, and nothing matched up, other than the point that a lot of viruses are
accompanied by rashes. QOTPE showed that
same image to her boss (former nurse, now bakery shop owner because she
couldn’t stand what was going on in medicine), and the latter was quite alarmed
and disturbed that Ellie hadn’t taken her baby to see a pediatrician. She thought it looked like measles. (It wasn’t.)
The ER doc looked at her photo and pronounced that she “wasn’t
sick.” Meaning, not truly sick.
“Look at her. She’s
smiling. Truly sick children don’t smile and play.”
About a month later, Ellie called again. Her baby had fallen off the bed and hit her
head. Again, Ellie was distraught. The Google doctors all asserted that she
needed to get her into the ER right away.
They live 2 hours from the closest hospital, a tiny facility. It took a little longer to talk Ellie down
off the ceiling this time. So we
Facetimed, and she showed the red mark on the back of her head. Not even a bump. Then she showed me her baby. Smiling.
Happy.
“She’s just fine.”
And then for good measure, I shared with her
the free webinar by Duration Medical that I blogged on a year ago. And it basically came down to this: absent any obvious clinical findings,
persistent changes in behavior, alertness, or vomiting, there’s nothing to
worry about.
When our family members present with potentially serious
illnesses or injuries, we can’t cherry pick a sign or symptom to worry
about. We have to look at the whole
patient to determine whether he or she is truly sick. And fortunately, most of the time they won’t
be.
Links to related posts:
Toddlers to Teens:
Medical Emergencies in the Backcountry and Beyond
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