Tag Archives: pediatrician

How to Make the Most of your Visit with the Pediatrician

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This is a guest blog from Sheila Cason, MD. It was previously published on her site DrCason.org. Dr. Cason is a photographer, pediatrician, and mother of three. I have great respect for her advice and incredibly compassionate nature.

Photo by Brendan Riley, Flickr Creative Commons

Photo by Brendan Riley, Flickr Creative Commons

Whew! The morning is over and I’m at lunch, preparing for a busy afternoon.

With the ever increasing time crunch, pediatricians are forced to see more patients in less time. Often we are only given 10-15 minutes to get the history, do an exam, make a diagnosis, formulate a plan and then explain the directions to the family.

This may be fine if the chief complaint is ear pain. But what if it’s chronic abdominal pain? Or a seizure? Then it’s even more important to streamline the visit so we can help your child and you get some answers.

Here are some simple ways to make your visit go smoother and get what you need:

1. First off let me know if you are running late for another appointment. I try not to run late but it’s ineveitable sometimes. There have been times when I go into a room and the family is seething! It seems they missed an incredibly important meeting. If I can I will try to adjust the schedule and see you faster. Or I’ll just cut to the nitty gritty and get you out quickly.

2. Let your doctor know what you really want. If you really want antibiotics, you’re going to be mad when you spent all that time and didn’t get it. Let them know. Often I’ll compromise. If it’s viral and they really don’t need the antibiotics, I let them know. But if it’s a cold and it has been over a week and a half and it’s tough for them to return for a recheck, then I may give them a script to take with them. I give instructions to start only if the cold hasn’t resolved by two weeks. Surprisingly most people don’t abuse this and both parties are happy.

3. Prepare your child: Tell your child where they are going. If they are old enough then let them know exactly what we are going to do. Encourage the young ones and don’t threaten shots if they don’t behave! It scares them to death and then I have to spend a lot of extra time coaxing them to let me even come close.

4.Know your history: Often I have a grandparent come in and not know anything. We have to guess and muddle through the history. This can take a lot of time. If you can’t be there, write a note or give me a number that I can call to ask you some pointed questions.

5. Don’t have the doctor tackle every thing on the same day. If your complaint is ear pain and a cold then talking about your child’s short stature might be better addressed at their well check or another appointment. You’re only going to get frustrated that the doc is rushing you.

6. If you’re still not happy let the doctor know. Some people still look at me at the end of the visit, all worried. I know something is up. Most parents who have a child with 1. Headache: worry it’s a tumor 2. Bruises: worry it’s leukemia 3. Fever and a cough: worry it’s pneumonia. Because parents have told me their fears I have learned what bothers them. I can anticipate this and talk with them about it.

I hope this helps. I think that most people who are frustrated that the doc didn’t spend a lot of time with them, didn’t get what they needed. Communication is key! A pediatrician’s number one priority is making sure your child is healthy and you’re happy!

Do you have ways that make your visit go smoother and you get what you need?

Do you have tips for the doctor that will make the visit go smoother?

A Pediatrician’s Survival Story: Remembering the Children

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pediatrician, pediatric residency, child death, infant death
Photo by geishaboy500, Flickr Creative Commons

I have just turned on my computer. It is midnight. I should be trying to sleep right now.

My 5 year old is sick and I am on call for the next few nights. Fortunately, my daughter should get better in a day or two. She needs Tylenol for her fever, mama’s love and time to kick this virus. But as I sat in bed holding her and waiting for her fever to break, the memories of other sick children started to come back. I completed my pediatric training over 10 years ago. I have repressed the memories of that time for so long now. Slowly, painfully they have started to come back. I lived a different life then, and it almost broke me.

I went into pediatrics because it was the only thing I was passionate about. When I entered medical school I was determined to do anything but pediatrics because I was so crazy about kids; I didn’t  think I could handle children hurting and dying every day. As I went through my rotations: emergency medicine, family medicine, obstetrics, surgery; I quickly learned that I was always drawn to the children. As it turns out I am amazingly calm under pressure, and the intensity of taking care of severely ill or injured children was something I was really good at. I ended up matching at my first choice program at the Children’s Hospital of the Kings Daughters in Virginia. Then my life took a detour.

My intern year I married and divorced. I married someone who was broken, but trying to put himself back together. And I was just starting to break. During that time I learned about how resilient a child can be, but I also saw the cruelty of cancer, AIDS, whooping cough, lupus, drownings, child abuse… The lack of sleep, unrelenting hours, and the pain and death around me took huge tolls on my mind and my body. I gained weight, I felt angry, I felt sad, I felt anxious, and I stopped crying my intern year. I finally ended up on antidepressants. On my rare weekend off I drank and danced until the wee hours of the morning. The day after residency ended I hopped on a plane to California. I left my memories and my medication behind, and my new life began. I was 30 years old.

It took a few days to start living and eating healthier. It took almost 2 years for the anxiety to dissipate. It was probably 3 years before I cried again.

My friends here don’t know the “before” me. I have never drank my sadness away here. I have never danced on a table to forget the pain. I am thankfully quite boring now. I run or hike almost every day. I am a loving mother and kind wife. I am a better daughter. I have thought for years about how much I disliked the person I became in training. But the truth was I was a survivor. I always have been and I always will be. I believe I am strong enough to let the memories come back now. I can picture some of the kids faces now. I can hear their words. I remember hugging them. But I still can’t picture the parent’s faces. As a mother there is a limit to how much pain I can process. The pain of a parent losing a child is too personal. Maybe that memory will come back in another decade. I kind of hope it doesn’t.

When I started writing this I thought I would share some of my memories of the tragedies I experienced within the walls of that hospital. It turns out that they are still too personal for me. It is enough for me to know that I remember now. And I am better now. As for the parents of those children lost, please know that everyone who cared for your child was forever changed by the experience. We loved them too. Pediatricians did not choose this field of medicine for money or for glory. We chose this field because we wanted to heal children. There is a part of us that breaks every time that we can not. I may not always remember, but I will ultimately never forget.

Previously published on KevinMD.com, February 22, 2014

I want to thank my strong and compassionate friend Sheila Cason. She first wrote about her experiences on her blog, DrCason.org, years ago. Many of her memories were also my memories. I just wasn’t ready to face them yet.

I would also like to thank Dr. Nadia Wasylyshyn at the Children Hospital of the Kings Daughters. She was a great source of support for so many of us through those tough years. The high rates of depression and burnout are well documented for physicians in training. It is so important to find someone to talk to.