Sub-standard medical service

There are two things in life that I am extremely allergic to: being patronised and – somewhat related – being treated like an overprotective or paranoid or hysterical parent.

I got an unhealthy dose of both insults over the weekend.

It all started with the immunisations. All seemed well, Ella was fine that afternoon and night.

Then the next morning she woke up complaining about pain in her right thigh. It looked a bit red and felt a bit hard around the injection point, but I didn’t think too much of it. So we went out to the library and the mall, but Ella’s complaints got louder and it was obvious by then that her leg caused her considerable discomfort when she moved around.

I gave her some paracetamol and said goodbye to her when her dad picked her up.

That night, I had another good look at the leg and now noticed – by comparing it to the other leg – that is was quite significantly swollen from the crotch right down to the top of the knee and was quite red too. I still wasn’t overly worried, so put Ella to bed, without offering pain relief as my judgement was that she’d be fine without it.

The next morning the thigh was a tad worse rather than better. So I called the Health Advice line. A nurse took me through some questions, listened to my description of the symptoms and then advised me to see a doctor within 4 hours.

I got an appointment with the after hours doctor soon after. When it was our turn, I walked in with Ella, got her to hike up her skirt as I explained the course of events and the doctor took one look at her leg – from about a metre away – and said: “allergic reaction” and proceeded to prescribe anti-histamines and a cream. He advised me to see our GP within 2 days and send us on our way. My estimate is that the consultation had lasted no longer than 3 minutes.

I gave the anti-histamine to Ella that day and the next. I failed to read the label and the doctor had not warned me about it causing drowsiness. The teachers at school noticed though, but apart from not being her usual bubbly self, she’d been ok.

(Some of this next bit is a slightly altered version of the letter I ended up sending to the Medical Board, so excuse the dry style)

After school I visited our GP (the same one who gave the immunisation). The GP noticed me in the waiting room and enquired why we were there. I explained that Ella had had an allergic reaction to the vaccine. The doctor asked me to go have a chat to the medical student at his practice while he tended to his next patient.

A bit later he entered the room where the medical student, Ella and me were, walked over to Ella who was playing on the floor and said: “Does this look like a sick child to you?” He then turned to the medical student and said: “That’s what I advise parents to do. To step away from their child and ask themselves ‘Does this look like a sick child to me?'”

I managed to hide my annoyance at this most patronising comment and briefly gave him my version of events since we saw him last. He said he doubted that it was an allergic reaction, and that it could be a bleeding in the muscle. He did not explain this any further. Nor did he examine Ella. He then proceeded to look up info about the specific vaccine on the computer, explaining how to do this to the medical student. He was preoccupied doing this for a while and only very briefly answered when I asked relevant questions. I found out he had not made a note of which thigh he administered which vaccine in. When I asked him if it was likely or possible that this reaction could be repeated, he said he was sure it was a one off. He did not explain this comment. When I expressed a concern about not knowing the real reason for the reaction, he assured me he made a note of it and that that was enough. He then instructed me to go get Ella’s health record which I had left in the car.

When I returned and was waiting in the waiting room I realised that I did not get any advice on whether or not to continue the anti-histamine treatment.

So, when the doctor returned for the health record book, I asked him if I should continue administering the anti-histamines. He only shook his head as if I had asked a silly question. I asked if he thought she needed any further treatment and I got a similar response.

I left the practice feeling extremely patronised and as if I’d been treated like an ignorant, over-protective hypochondriac parent. On top of that, I did not obtain any useful advice nor an explanation of the diagnosis or the treatment. Treatment advice wasn’t even offered voluntarily.

I was fuming! I muttered about it (might have used a few profanities in front of Ella too) the whole way from the doctor to the take-away place and home. Poor Ella had to listen to a few tirades about the unfair treatment that night.

And what made things worse was that I was faced with the treatment dilemma. I’d seen two doctors in 28 hours. Neither of them had explained how they came to their diagnosis, in one case a final diagnosis was not given, neither did explain the rationale behind their treatment advice. Neither of them had examined Ella, other than looking at the swollen leg from a one meter distance. Neither of them had asked me any questions about the patient and all they knew was what I managed to tell them in the 30 second introduction when I walked into their consultation room. And both had given me completely contradictory advice.

I ended up calling the Health advice line again to explain what happened and to ask advice on how to solve my dilemma: should I or should I not continue the anti-histamines treatment? I do not have any knowledge about medical issues and do not feel fit to make such decisions about my daughter’s physical health without medical advice. The very nice nurse’s advice was to follow our GP’s advice but to monitor her condition closely and see a doctor if it got worse. I also managed to mention that I’d been treated like an over-protective hysterical mother and the nurse said something about it becoming a trend but that I should never let any doctor make me feel like that. That I, as a parent, knew my child best and knew when a trip to the doctor was justified. It was nice to get that reassurance.

Today I called the Immunisation Section of the Health Department. They confirmed that localised swelling and inflammation is a known side effect of both vaccines in question. They also told me that the symptoms usually resolve without treatment within a few days of the injections. I found out that the doctor should’ve given me information about possible side effects at the time of the immunisation. If he would’ve, it would’ve saved me all the trouble and lost time this caused me, not to mention the $145 for 2 unnecessary doctor’s visits. The nurse said she would call the practice to check if they had the info sheets that they were supposed to hand out to parents.

I wrote a detailed and well-considered letter of complaint to the Medical Board, which made me feel better. My next step will be to find a new GP. How could I trust someone, who seems to base his medical strategy on my perceived level of paranoia or hysteria, to look after my child’s health?

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Daily bread

Last week I was on a quest: to find the perfect recipe for home made bread. I had tried baking bread before and they never turned out right. I baked plenty a loaf in the breadmaker too, but I never really liked them very much. Definitely not as good as the bread from the bakery, which is probably cheaper anyway!

But last week I decided that I was not going to give up until I managed to bake the perfect loaf. I decided on letting the breadmaker doing the kneading, but give the baking job to the oven. I also made some no-knead breads. I made 6 loaves in 1 week. I was determined, I was not going to lose confidence. I baked the breads in the evenings and I have never felt so keen to have breakfast in the morning!

In fact, my excitement at every step of the process grew with each loaf. I checked every 10 minutes to see how much it had risen, I stood at the oven to watch it rise while it baked, I tapped it, examined and smelled it when it came out of the oven. And I was almost jumping up and down with excitement when I cut off the first slice.

I suppose it was hard to hide that kind of enthusiasm from Ella. She was so supportive. I asked her every morning if she wanted “mama’s bread or bread from the baker” and she never hesitated when she chose mine. Even when the loaves were coarse and dense or too moist or too salty.

And when I finally found the ultimate recipe (and said so about 10 times that morning), she declared it was the best bread in the whole world.

To be honest, I don’t think she cares much about what her bread tastes or looks like. She noticed how important it seemed to me to get it right and so her extraordinary empathy kicked in and she encouraged me.

Bless her cotton socks. (But now I’ll have to find a less biased taster to rate my bread!)

Of needles and icecreams

I took Ella for her 4yo immunisation round today. I had warned her a week ago about what was going to happen and again this morning. And I had promised her “an ice cream if she didn’t cry, a mere lollipop if she did.” I don’t feel bad about bribing her with food on this occasion. Sometimes the end really does justify the reward. And I don’t feel guilty about putting pressure on her to hide her feelings. As a huge generalisation, the modern Western culture is not one that particularly values consideration for others – unlike for example the Japanese – EXCEPT when it comes to reaction to pain. “Boys don’t cry” is still a much valued mantra, even if we have gender-neutralised it and extended it to girls.

I don’t know if I have ever mentioned this before, but my Ella does not do the “being stoic when in pain” bit well at all. She doesn’t actually care for it, even though I am becoming increasingly “mean” in my methods to try enforce the idea that it is NOT ok to cry and whimper over every little scratch or bruise. It goes against her drama queen aspirations, I think, and I fear that my rather insensitive reactions are having the opposite effect. I ignore her when she cries over falling over or bumping herself (unless it’s a “biggie”, but that’s different), I tell her to be brave – it’ll only last a minute, to toughen up and even that “nobody likes a crybaby”. All to no avail.

Back to the needles. The doctor was fabulous. Anyone who can engage in a conversation with my daughter about the differences between ponies and unicorns whilst keeping a straight face, immediately and unreservedly earns my sympathy. He was also very no-fuss with the needles. As soon as they were ready, he plunged them into her thighs. It was all over in about 2 seconds.

AND SHE DID NOT EVEN BLINK! Even though there was B-L-O-O-D, usually a reason to scream for a bandaid NOW. As he gave her her green jelly bean, the doctor said: “She is obviously a terrific kid”. I ignored the “you should see her at home” thoughts and just proudly smiled.

Afterwards she told me that it did hurt but she didn’t cry because she wanted an icecream. I think I even managed to not look smug when she told me. And I thought I had definitely deserved my icecream too.

First day of school

Yesterday was Ella’s first day of preschool.

She dressed herself without me even having to ask in the morning. Chose a skirt to wear herself, and it wasn’t pink! The only thing that she seemed a bit worried about was that we were going to be late and while we were walking the dog, she told me she wish she could just go to school NOW.

We arrived a couple of minutes early. I suggested Ella put her name tag on the ‘helpers board’, which she did. She explored the obstacle course/play equipment until the teacher opened the door of the class.

When we got inside, she walked straight up to the teacher – whom she’d never met before – and gave her the drawings she made for her last night and explained what was on them. “This is a person and he is scared of the monster. And this is a fairy.” Then she sat down at one of the tables and played with the playdough, reminded me to show her where the toilet was and then moved to another table to engage in a game that was set up there. That’s when I asked if it was ok for me to go and she just nodded, gave me a hug and a kiss and went back to her game.

In summary, she looked like she’d always been there. Not a surprise really. And it did make me feel proud.

When I arrived to pick her up at three, the kids were still inside sitting in a circle on little mats. After the assistant had opened the door, the teacher started sending them out one by one as she spotted their parents. When she called Ella’s name, Ella crawled towards me on hands and knees, then came to a stop at the other end of the circle and rested her head on the ground in front of me. When I asked her what was the matter she said something like: “I’m sad because we have to leave.”

Yes, school is a hit. As expected.

Lucky

This morning in the bathroom:

Ella – Mum, I want you to brush my teeth.
Me – Ok.
Ella – You have to do it, because you have hands too. Not just arms.

Ok?

Bushfires

The reason why I haven’t posted about the tragic Victoria bushfires up until now, is that I really try to keep this blog about Ella only and the reality is that she seems to be immune to the drama and horror of it all.

I have watched the news with her or sat next to her reading the paper on several occasions during the past week and she must have seen my distress at listening to/watching some of those stories. The only reaction I heard from her was her casually remarking “bushfires” on seeing the images of fires and scorched landscapes on tv, before diverting her focus to whatever she was doing.

I should be glad about her not being affected, but I kind of wish she would show more empathy…

Of course I try not to give too much detail, but I have told her the facts: there were massive fires, lots of houses were destroyed, and people died. I am glad she does not know the horrible details about how some of these people died nor understands the trauma that the ones that barely escaped suffered.

I did recently (it was around Australia Day) tell her about the 2003 Canberra bushfires and when we saw and smelt the smoke from the coastal fires soon after, she got quite scared until I explained the fire was far away and that it was ok because we could not see flames. Let’s just hope that the fires do stay far away (not just from us of course – also from others’ properties) and that she won’t panic next time we see/smell smoke as that is a regular phenomenon in any place in South-Eastern Australia.

The preschool saga

I’ll start at the beginning for those of you who don’t know the story at all. The first week of September, less than two weeks after our return from Belgium, I went to the local primary school to enrol Ella in the local preschool, which starts here in February. I was told I missed the first round of offers and that there was already a waiting list. They would contact me for the second round of offers. I asked if I could give a second and third preference and they made note of that. Finally, some time in December, I got a call to say that Ella was accepted for the preschool that I gave as my 3rd preference. It was only when I went over there to get all the info, that I discovered that this school had their 2 long preschool days on Thursdays and Fridays and not on Mondays and Tuesdays like all other preschools I know here.

I made a few more phone calls to the other schools, negotiated a few more administrative booby traps, ended up at the top of the waiting list for my second preference preschool – they did not actually have me on their waiting list yet! – and waited anxiously for the first week of preschool, crossing my fingers that one of the kids would not show up and cancel and free up a spot for my eager preschooler.

In the meantime I had to bring Ella to a daycare centre without 4 year olds on Monday and Tuesday. It was one of the hardest things I’ve had to do. Much worse than taking her to daycare for the first time! The first thing she said to me when I picked her up that first day and found her playing by herself in the sandpit with only 2 “babies” to keep her company was: “Noone wanted to be my friend today. Noone wanted to play with me.” Ouch! I felt like the worst parent ever…

So you can imagine my determination about making sure I secured a spot in a preschool that she could go to when all her daycare friends were at school grew stronger by the hour.

And this week my impatient waiting and persistent phone calls finally paid off. Ella will start preschool next Monday in the preschool one suburb away from our place! I went over there and met the teacher who seems exactly like a preschool teacher should be: gentle face, soft voice, friendly manners and the looks to match. The school itself is lovely too. The garden/courtyard is leafy and green and it has attractive modern play equipment. In the classroom I also saw details that pleased me, like a birthday calendar with name tags and a cork “teacher’s helpers” board.

I stopped at the school on the way home the other day to let Ella have a look from the outside and as we walked back to the car she said: “I wish the school was open all the days and all the nights.”

I’m sure she will do very well at school. And I am also rather happy about saving the cost of 2 days of daycare each week from now on. The money I will save would allow us to get take-away 4 times a week! Not that I’d want to eat take-away that often, but just to give you an idea…

Now bring on next year and kindergarten 5 days a week! And I will make sure I won’t miss the enrolment deadline then!