Thursday, November 27, 2008

The Fine Art of Preventative Medical Malpractice

It's 11:30 p.m. and despite my dire need for sleep combined with the consumption of a fair bit of alcohol, I am not sleeping. Why am I not sleeping and why am I drinking caffeinated diet coke? I'm glad you asked. As I stated in my last post, my 14-year old had a tonsillectomy two days ago. He is sleeping upright in a recliner (to minimize swelling) and it is my turn to sleep on the couch. He fell asleep about an hour ago, and I noticed that he seems to breath in about two deep breaths and then no breaths for 10 seconds (I counted with the tick of the clock, so I am not exaggerating). I find this rather scary. I told my husband. I told my husband, who like many men, think moms are over-protective.
Not to be dissuaded, I decided to call the doctor. I don't care if I wake them up. It's their job and that's why they get paid the big bucks! I explained what was going on to the on-call doctor. He said to ease up on the Percoset, because that can cause breathing irregularities. I said "so I shouldn't be freaking out?" He said " no, but if you have any concerns, take him to the ER." So I asked what kind of sign should I look for that would send me to the ER. In a tone that suggested I am an idiot, he said, "if you are concerned. I'm not there so I can't make an assessment." I felt like saying I wouldn't be calling if I wasn't concerned, and you're the medically-trained professional, and I don't really know when it becomes a dangerous situation since I didn't go to med school and you don't have to be here because I accurately explained what was going on. But I didn't. I said thank you, hung up, and immediately said to my husband, "these guys sooooo cover their ass."
In the evening of the procedure, my son kept complaining that he couldn't breath well and that it felt like there was a glob of blood in his throat that he couldn't get up or down. So, I called the doctor and described the symptoms. (The doctor that did the procedure was on call that night.) He said that Aidan's uvula was swollen and he should not be lying down. (This would have been useful information to have when they sent us home after the surgery). And, strangely, he added the comment that he wasn't here, so he couldn't make an assessment. That was the first time that I hung up the phone and said that they were sooooo covering their asses.
I get that doctors face malpractice suits and that their insurance rates go up. While everyone would like to blame this on the lawyer, I blame it on the malpractice. If they didn't commit malpractice, no one would sue them. Most people understand that medicine is not an exact science and outcomes will not always be the same. Malpractice occurs when a doctor does someting, or does not do something, that is an accepted thing under the particular circumstances (this is not the legal definition, but I don't do malpractice law and it's 1 a.m.)
So I would assume that the Pediatric Ear, Nose, and Throat office would have done so many tonsillectomies that they would recognize common results and would know when something was serious enough to go to the ER. By turning over the medical judgement to me, they are absolving themselves of responsibility. So when Aidan begins to have slower breathing or this pattern goes on for one hour, or two hours, or three hours, I won't know if he needs to go in and since they said they can't make an assessment, they are clear. Fuckers!
So, in my non-medically trained way, I woke Aidan up so that he would breath regularly, turned on House (which, ironically, is his favorite show), and gave him a big glass of 7-Up. He's not very happy with me right now, but, too bad. The doctors opted out of this situation, so I have to take over. And I don't know squat except that as long as he is awake, he is breathing and I don't have to be in a constant state of panic.


Charmaine said...

When in doubt, take the kid into the ER.

Can't be too safe. Plus, you have insurance so what's the harm?

SSP said...

just tried to call you - i am at the denver airport - so sorry to hear about the fun times....however, don't panic. I absolutely agree that doctors DO indeed suck and they HAVE absolved them selves of ALL liability by accepting none of the responibility...but mama knows best. You will know when it is time to take him to the ER. I guess if I had people hacking away with sharp objexts in the back of my throat, I'd feel a little blood clogged myself....Tell him to breathe through his nose if he can - isn't that a totally different airway?? take care....get off the phone! love ya

Briana said...

I kept my poor son up for a couple hours that night (when awake, he breathed normally). Finally, he fell back asleep and then resumed his irregular breathing, though not as bad as before. When his cough got worse and became more phlegmy, I considered the possibility that he had inhaled some of his vomit on the first day and was developing pneumonia. I also considered that it could be an expected consequence of surgery. However, I now knew that calling the surgeon would be a waste of time. He would say (now say it with me), "if you are concerned, take him to the ER." I figured that since the pediatrician's office was open, they might be more helpful. Turns out, pediatricians get really pissed when surgeons pass their patients on to other doctors since the patient is the surgeon's responsibility until they have recovered. She confirmed that Aidan's lungs and heart were fine, which is all that I needed to know, but she made it quite clear this wasn't her case. So what do you do when you pay good money for health insurance, pay good money for office-copays, etc., and doctors won't give you anymore information that you will find in a medical guide from Barnes & Noble? I decided that I needed to go to med school. Naah!