Charting on Sick Kids

Teenage Son (from here on out known as "TS") was still having abdominal pain yesterday. I called the doctor's office and left a message with the receptionist, describing his symptoms. (sidenote: I really like my doctor . . . but after going to several of my patient's doctors with her, I like his office less and less. SL gets into the exam room within MINUTES of walking in the door, and so do any other patients sitting there. It routinely takes more than 30 minutes to get into the exam room at my doctor's office, even if the appointment was set up far in advance.)


The nurse called back within an hour (another complaint; usually it's at least 2-3 hrs. before they call back), saying the doctor wanted to see TS for an office visit.


TS was very unhappy to have to go to the doctor; he's generally very healthy so not used to going. To make matters worse, the visit began with a blood draw. He HATES needles (which is much better in my mind than LIKING them!), but didn't want to hold my hand, or even have me near the table he was lying on when the blood was drawn. He DID, however, have his cell phone in a death grip . . . I guess somehow that helped him feel connected to and comforted by his girlfriend and other friends, who he'd been texting throughout the visit (when the doctor and nurse were not in the room, of course).


A few minutes after the blood was drawn, the doctor came in to examine TS. His tentative diagnosis leaned toward mono; his bowel sounds were normal, his WBC count was not up, and the location of the pain wasn't typical of that for appendicitis, although the doctor did say that often the appendix was in an atypical position, producing atypical pain. The doctor did a throat swab also, saying he'd had several cases of kids presenting with both mono and strep. YIKES!


A few minutes later the doctor was back with the diagnosis of mono; the pain was from his liver and spleen being enlarged and inflamed. The doctor talked about the importance of rest and avoiding any type of contact sport, like sledding (potential of running into a tree, but humorous as it's been 80+ degrees and any potential snow is months away!), belly flop contests, and bull riding. I appreciated that the doctor took the time to talk directly to my son, and answer any and all of our questions.


The strep test came back negative, but the rapid tests often give false negatives, so it's been sent to a lab. TS's throat isn't sore today, so I don't think strep is part of this illness.


Before the doctor left the room he said that he wanted to check liver enzymes, too. TS made a face at the prospect of another blood draw, but the doctor said that his nurses were used to him ordering additional tests after examining the patient, so they always drew extra blood right away--smart nurses! I was impressed.


The enzymes were up, so son is now on a decreasing dose of steroids. The instructions were not complicated--three tablets a day for three days, two tablets a day for three days, and so on . . . but I can't keep track of meds that have to be taken more than once a day, not to mention keeping track of how many days I've taken how many meds . . . so I made a medication chart. TS asked a very pertinent question; "Do I have to take them an equal number of hours apart, through the night, or just while I'm awake?"


TS has been happy to take it easy today. I think, however, in a few days he'll be itching to get back to his normal active routine! I'm thankful it wasn't something serious, or appendicitis . . . although TS did point out that if it would have been, he'd have been "better" much quicker.