Tuesday, November 2, 2010

Have Your People Call My People

We had a great Halloween this year- perhaps a little too good. We have been so busy with trick-or-treating events that my kitchen floor has been a wee bit neglected. Still, October was a great month and we are looking forward to a more sedate November.

Spiderman had to go to the GI doctor yesterday, because his Nexium prescription is running out. Our visits to the GI doc generally involve brief discussions of Nolan's progress, weighing him on a scale, and a lollipop.

When the ENT did Nolan's bronchoscopy, we discussed his Nexium routine. Our morning routine was absolutely fine, but I found out that Nolan had been receiving his nighttime medication incorrectly. We were never really instructed on how to give the evening dose, so we were giving it to him just before bed. As it turns out, he should receive it 30 minutes prior to his evening meal.

I am WAY too scatterbrained to remember to give the child his medication at 4:30pm, so we set up a little alarm clock to go off at the appropriate time. It has been working like a charm, and we're readjusting to the new medication regime.

We know that the Nexium is doing a LOT of good for Nolan. He's a little older than 36 months, but I used the birth-36 month growth chart to show how much he's gained since starting the medication. It has literally been a Godsend for him.

His height is starting to drop a little (going from the 50th% to the 25th%), but this is likely due to the fact that he was a low weight for so long. His body has a lot of "catch up" growth to do.

The appointment was going swimmingly until I mentioned that our ENT wants to do a pH probe on Nolan to rule out active reflux before embarking on the supraglottoplasty for the laryngomalacia.

The GI doctor was a wee bit ruffled by this and didn't understand why the ENT would do the pH/impedance probe. Apparently, I entered a turf war I didn't know existed. The GI doc stated that if the ENT is going to handle the reflux, then she would discharge Nolan from her care and hand him over to the ENT for follow-up. She wouldn't write a prescription refill for the Nexium, because if the ENT is going to handle the reflux care, then the ENT should write the prescription for the medication refill.

The net result of the appointment is that I drove for two hours with two small boys, chatted about Nolan's wonderful progress on Nexium, then walked out of the appointment with a dozen phone calls to make. And without a Nexium prescription. Luckily I have enough to cover the rest of this month, and we see the ENT on November 15. To be honest, I would prefer for his ENT to handle his care entirely, because she is aware of how difficult Nolan is to diagnose and has been a champion for him from Day One.

The GI doctor is going to call the ENT doctor today, and then I am supposed to call the ENT and the GI docs on Wednesday to figure out the solution to the epic "GI vs. ENT Turf War." Hopefully we'll know who is taking charge of his reflux care by Wednesday.


Julia said...

Oh, bother. I guess if you spend all day every day dealing with patients, then you start to tune the patients out, and issues like this turn more on ego than good patient care. Whatever. I hope the ENT is able and willing to "take over" the reflux care, and that Nolan gets his Rx refill soon.

tammy said...

That's ridiculous. Sure, why not endure figuring out whose territory Nolan's Rx belongs to on top of enduring everything else you're dealing with. Oooo, I would've had a hard time walking out with my mouth shut. Sounds like someone's ego was hurt and that it may be better for all if the ENT takes it over anyway. We're talking about a three yr old's health here. If you can't tell, stuff like this from PROFESSIONALS really gets my goat. Hope it all works out for you without too much trouble.

Joey @ Big Teeth and Clouds said...

Oh gosh. Sounds like the ENT hurt the GI doc's feelings! It might be a blessing if the ENT is better doc for you. I think those issues can be covered by the "throat" part.

rouchi said...

Its so tough for the parents when the parents are caught between the egos of 2 doctors.Why can't it be more of a"lets do it together"?Good for patients, doctors and community in the larger picture. BTW, you have a really cute spiderman, hmmmm