Yet Another Reason I Love Our Pediatrician

Nemo has been on Zantac since he was about 2-3 weeks old for reflux.  We have done the reflux thing with both Trout and Sunny before, so I feel like I'm more or less a pro at this.  When we saw the pediatrician last monday for Nemo's checkup she upped his dose of Zantac, which is weight dependent and God knows this kid is picking up weight faster than the other kids make dirty socks to pick up.  She told me to give it until Friday, and if he wasn't doing remarkably better, then to call and let her know and she would "do something else."  She mentioned both prilosec and prevacid - I hadn't really heard of using prilosec, but I had heard of the prevacid - used fairly frequently on my November 2006 babies board on Babycenter.  I assumed that's what she would do.

I called on Friday and told the nurse who answered that Dr. D had told me to call if the Zantac wasn't working well enough to make him a "normal" baby.  The nurse informed me in a rather snotty tone that Dr. D wasn't in that office that day.  I asked if Dr. D was in the other office, and she said "Yes, but she won't deal with this."  After the urge to drive down the street and throttle the woman had passed, I politely and calmly informed her that Dr. D had told me to call and that she would take care of it.  She offered to have one of the other doctors call me (there are 8 doctors in the practice) and I stated more forcefully that Dr. D had told me to get in touch with her.  I guess the nurse finally got the idea that I wasn't going away, so she asked for the chart number and my phone number and said the doctor would call me back.

LESS THAN 10 MINUTES LATER Dr. D called me back.  I told her that while Nemo was improved on the new dose of Zantac, he was still fussy and pulling his legs in and generally a cranky puss, particularly the last two hours of a dosing cycle.  She said she was going to call in to the pharmacy and have them make up some prilosec for him, and took the phone number of the Target where we get all of our prescriptions.  Now, I have some issues with Target, particularly their policy on sudafed products (okay, I can see taking my name and address and checking my drivers license and making me sign my life away if I'm trying to buy, oh, 8 boxes of sudafed tablets or something, because clearly the meth lab awaits, but for one bottle of pediacare drops for my infant?  Come on.), but I really really really like the syringe/no spill bottles for the medicine and the ring system for color coding family members, so I continue to use them. 

Five minutes later Dr. D calls back and tells me that Target will not make the medicine the way she wants it - they flat out refused to work with her, even though what she wants done is a basic thing and they have all the ingredients and technology they need right there.  Apparently, prilosec is not available in a readily accessible form for babies/children, so what she wanted done was to mash it up (or maybe open capsules?  I'm not a pharmacist so this is a bit foreign to me) and mix it in a suspension in some sort of chocolate syrup stuff so it is easy for the baby to take.  So she told me she called it in to a pharmacy near their other office who she knew would make it for her.  She also told me that sometimes insurance wanted to charge an exhorbitant price for it, so she would ask and if that was the case she would just call in prevacid instead, but she didn't want to do that because it comes in slow dissolving tablets, so to administer it you have to put it in your baby's mouth and hold his mouth shut (!) so it can dissolve.  She had also done this with her baby (she has a baby who is, I think 9 months older than Nemo) and said while it is possible it isn't fun, so she wanted to do the prilosec first.

I called the pharmacy and gave them my insurance information, and they covered it, just at the highest copay level.  I could live with that.  The hard part was getting all 4 kids out the door after dark in the rain in rush hour traffic to make it to the pharmacy in the next town over (which sounds like a long way but this is the DC metro area so we're only talking like 6 miles or something and anyway it's just one big damn suburb with different names for its parts).  The kids didn't have shoes on and Nemo needed nursed, so I nursed while I timed them - it took 25 minutes for 3 kids to locate socks and shoes and put them on their feet - mind you, I could see all 6 shoes and two pairs of socks and knew for a fact that the missing socks were rolled up, clean, in the sock drawer of the whining child who owned them, so in reality it should have taken, oh, 5 minutes or less, depending on how much screwing around they did.  25 minutes.  It's an art form, I tell ya.  We made it to the pharmacy with.......ready?........a whopping

THREE. minutes. to. spare. 

We weren't even IN the pharmacy that long.  The medicine is apparently not very stable, so it has to be kept in the fridge and shaken VIGOROUSLY (stressed by the pharmacist) and will only last 30 days, so be sure to get the refill exactly when needed.  You'd think I bought nitroglycerin in quantity or dynamite or plutonium or something.  Dr. D asked me to call today with a progress report.

By Sunday morning it was like a new baby.  He's awake more.  He's engaging more.  He's not fussing about his tummy hurting, only when he wants his diaper changed or fed or held or because he wants to play.  And he's playing, at least, as much as a two month old can play.  Still won't track too well, but certainly making and maintaining more eye contact.

In my experience, not too many doctors would go through the hassle of finding a pharmacy who will work with them to do what is right for the patient.  Most doctors would just do what's easiest and most convenient for them, which is just keep upping the zantac or switch to the prevacid despite the difficulty in parents administering it.  We love these doctors with a passion that borders on stalkerish - if you live in upper Montgomery County and are looking for an excellent pediatric practice, email me and I'll be happy to tell you who they are.

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In other news, we took the kids to a Japanese Steakhouse on Saturday night.  They loved the idea of the food cooking on the table in front of us, and because we are evil parents, we told our picky eaters that if they didn't at least try the food then the chef would throw his knives at them.  Little Man is now too smart for us - he figured out pretty quickly that wouldn't happen.  He ate.....white rice.  That's all.  He LICKED his chicken and decreed he didn't like it.  At least Trout ate an actual bite of the chicken before deciding that she didn't like it.  She DID end up liking the mushroom/scallion soup, so she ate that and her rice.  Sunny was afraid of the fire when the chef made it flare up to start the cooktop, but after a walk around the place wailing in my arms I was able to convince her there would be no more fire and she sat back down.  She loved when the chef threw an egg up in the air to make her fried rice, which she ate heartily, and she proceeded to eat....everything except bean sprouts and shrimp.  We had a lovely time and BigDaddyFish and I ate better than we had in months - I just don't have the time and energy to cook like that.  He could do it, but he's ... particular about the kitchen.  If every single dish in the house is not put away in the place that he deems "correct" and all the countertops and the kitchen table are not COMPLETELY clear, then he won't cook.  I think it's just an excuse and he's too lazy to do it, but whatever.

After dinner BDF and Trout went to see a play of Junie B. Jones and a Little Monkey Business at Imagination Stage, which he gave her for Christmas.  It was the last night and they got to stay for an autograph session/meet and greet with all the actors.  Because Trout's parents are morons they didn't take a camera, so Trout is a little mad at us, but she loved it - Trout said it was her "best Christmas present ever so far."  While they were gone I took the other 3 to Borders and only lost Little Man seven times when he ran off and only had to tell him no to buying anything other than a book seventy-two times, so it was successful and we got a birthday present for a little girl in his class whose party we went to on Sunday.  Then we went home and watched Ice Age: The Meltdown which they got for Christmas and which I hadn't watched yet, and I made popcorn.  It was a successful baby step toward the playing more, saying yes more part of my revolution.  During the movie Sunny sat down next to Nemo and said, "Mommy!  I am Nemo's best friend."  Good to know, since she keeps trying to kill him (bouncy ball snack, anyone?).

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Anyone else's husband have a habit of starting projects he can't possibly finish in the time he thinks it will take because he doesn't recognize the reality of life?  BDF decided the girls' room stressed him out so much he couldn't think or function so he decided to overhaul it Saturday afternoon.  I begged him not to, because I knew it would take too much time and the room wasn't bad anyway - the floor was clean and uncluttered and you could walk around just fine and the dresser drawers were organized, but he said it had to be done and would "only take a couple of hours."  I wish I had hours in my life that exist in BigDaddyFishLand.  They worked for about 4 hours on Saturday, and as of bedtime on Saturday (ten o'clock due to the play and movie) the girls' beds were still covered with crap and there was a stack of about 5 huge rubbermaid tubs on the floor blocking the dresser and a bin rack in my hallway.  Sunday I took Little Man to the birthday party (and Nemo) and left the girls home to finish their room.  We were gone about 3 hours round trip - half hour each way to drive, 2 hours for party.  Then I helped with some things last night for about 2 hours.  Anyone want to guess if it's done yet?

Comments

[crazyjane]

i'm not a pharmacist, but i am a certified pharmacy tech. i have worked in the pahrmacy for 12 years. i have never heard of a pharmacist refusing to make a compound for a patient. i would try to find a number for the corporate offices and call in a complaint. there is no reason for that at all.
basically when we make a prilosec liquid we open the caps and put the contents (tiny little balls) into the specified base liquid. however, these balls do not dissolve, and they tend to be heavier than the base, thus the need to shake very well. also if you are using a syringe to dispense to nemo try to be sure he gets plenty of the balls and not just the liquid base. it can be tricky if he's a squirmy guy. sound like he's feeling better, so you've probably been doing that already.
i do not work at target and don't really want to defend them but i do have to mention that the whole stupid sudafed thing is now federally mandated. it's not just target. apparently somebody in govt. thinks that all us moms are clearly the primary source of meth these days.

[Jean]

It's refreshing to here the story about your pediatrician FishyGirl. I haven't had the best experience which the medical system in this country (a whole 'nother blog I know!) but it's nice to know that there are still some genuine, caring individuals who have made medicine their profession and been able to keep their patients best interests at heart.

[Kim]

Grrr to the Target.

They also allow the pharmacy to refuse to fill certain prescriptions (such as the morning after pill).

I refuse to use them in spite of their lovely bottles.

[Her Bad Mother]

Sounds like a great doctor.

And, we have the same husband. Tho' his tastes run to knocking down walls and renovating bathrooms... which means that we've been missing a wall in our upstairs batroom since, um, JUNE.