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.
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
This is great info--thanks!
ReplyDelete--Melanie