Diagnosis and drugs

After some debate mid-week last week on whether or not Gabriel needed to see a doctor, I decided to call our pediatrician’s office and run things by the nurse.  It turned out they did want to see him.  I hesitated, expecting I would spend a decent bit of money and time (sitting in a place full of other sick kids) just to be told that it was a virus and would clear soon.  But we were headed into a weekend (a 3-day weekend at that), and I didn’t want to end up in the E.R. if we were dealing with a secondary infection, so I made an appointment for that afternoon.

I arrived with a rather chipper little boy who had not had a fever all day.  When we finally saw the doctor (I really like our pediatrician, but I really dislike the wait times in that office!), he spent a loooooooooong time listening to G’s lungs.  Or, rather, trying to listen to G’s lungs, while the patient squirmed and wriggled.

In the end, the doctor couldn’t get a great read on things, due to patient non-compliance (in retrospect, the behavior might have been partially due to pain he experienced while taking a deep breath).  After coughing, G’s lungs mostly sounded good, except for one spot in his lower right lung, which was maybe okay, but maybe not.  Based on that, our ped made a “soft diagnosis” (his words) of pneumonia and sent us home with a prescription for azithromycin (Z-pac, except the liquid, kiddy version).

[When I had pneumonia in middle school, I’m pretty sure the diagnosis was confirmed with an x-ray, but an x-ray was never raised as a possibility here.]

I was less than thrilled with the uncertain diagnosis and the prescription of a pretty hard-hitting antibiotic, especially given Gabriel’s seemingly-improved state.  I filled the prescription, but we decided to take a wait-and-see approach.

All was good for the next 24-hours: no fever, improved mood and energy, and improved appetite (still a runny nose and a cough, but coughs often linger for quite awhile).  We were able to get outside and take advantage of the beautiful weather on Saturday morning, and I thought we had dodged the antibiotic bullet.

Not so fast.  Late Saturday afternoon, Gabriel’s temperature spiked again, and we decided it was time for the drugs.   He spent the evening on the couch, feeling rotten, and ate next-to-nothing for dinner.

We put him to bed, and there was some coughing in the first few hours, but he settled down to quiet sleep, and then, miraculously, 4:30am came and went with NO coughing! (He’d started coughing around that time every morning for the previous seven days, semi-asleep, but unable to stop coughing until he got up.)

Since then, he’s been fever-free and more-or-less cough-free at night.  He’s clearly feeling better overall, and his appetite is back.  [He barely ate at all last week, which is not his usual, and he wasn’t even interested in noodles (as much as he’s a great eater, under normal circumstances, he would eat noodles day and night if we let him.)]  This is enough evidence for me that there was something bacterial going on and that the antibiotic was warranted.

He took his final dose of the azithromycin yesterday (PSA: If you start taking antibiotics, finish the whole darn course).  Other than some loose stools, his body seems to be tolerating the drug.  In general, I think antibiotics are still over-prescribed, but it’s good to have them there (and effective) when you need them!

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7 Responses to Diagnosis and drugs

  1. I am glad he is feeling better! I don’t know if I’d do a z-pack again. When I had the never ending cold-flu-secondary infection last year around this time, I was prescribed z-pack in week three to address a secondary sinus infection that arose. It gave me heart issues, anxiety, and made me feel awful. I finished it, but if they recommend it again, I will likely ask for an alternative. I’d taken it numerous times in high school and college (when I used to smoke, I’d get a nasty bout of bronchitis each winter) and don’t recall any issues at all.

    • Melissa @ HerGreenLife says:

      Yikes, sounds like your last round of that antibiotic had some unpleasant and scary effects. Hope it at least cleared the infection! I’m not sure if Gabriel would be able to tell us if he was experiencing those, or other, unintended effects of the drug, but we haven’t observed anything unusual, so I’m hoping for the best!

  2. EcoCatLady says:

    So glad he’s feeling better. I tend to agree that antibiotics are over-prescribed, but the real problems with antibiotic resistance aren’t from human use, they’re from agriculture. Anyhow, when you need them, they’re a total lifesaver (literally).

    I was on near constant penicillin for a year as a kid because I just kept getting strep throat. Finally after about half a dozen rounds of it, a few of the moms got together and complained loud enough to make them culture the entire school. Turned out that my best friend was a carrier! Once she got treated my problems went away. I can’t help but wonder though, if all of that antibiotic use at such a young age contributed to my problems with food allergies. Anyhow, you might want to supplement with some probiotics to help him get his “flora” back in order.

    • Melissa @ HerGreenLife says:

      Good point about the agricultural use. Sorry to hear about your childhood experience — long-term affects, like allergies, are certainly one of my concerns. G’s been eating yogurt (although that isn’t the always the best source), and he had some homemade sauerkraut last night.

  3. Rebecca | Seven2Seven8 says:

    @EcoCat – totally agree that the problem with atbx is largely agricultural (what are my problems with Farm Inc? let me count the ways…) but wholly agree with Melissa that there are also problems linked to failure to complete the round of treatment by people who “feel better!”

    @Melissa – it was a little scary, and I was probably a bit on edge because one of the atbx I was prescribed after my brown recluse bite in 2012 gave me an all-over body rash. I tend to note and report side effects carefully after that.

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