Unnecessary Medicine – Trying not to Demand Magic

I have never been one for taking medicine unnecessarily—the overuse of antibiotics resulting in the development of resistant strains of bacteria, patient drug dependence, and false hopes, the list of reasons goes on and on. I would nod in agreement each time I read an article condemning people for demanding medicine for themselves or their children to hurry  illnesses that would heal without medication.

But last weekend my one-year-old twins got sick, and I came within less than a second of becoming one of those raging, med-loving parents I’d calmly condemned.

First came mucus flowing like rivers of grossness from twin toddler noses. We stocked up on tissues, gently pushed slimy hands away from our faces, and dealt. Then, the vomit arrived, and we stopped dealing quite so well. By Saturday evening, M was vomiting everything he drank as soon as it went in, and his brother punctuated M’s spit up with his own eruptions.

We went to the ER, where they took x-rays and gave out ondansetron (Zofran). It was magical. The vomiting stopped, and M finally got real sleep.

On Monday, the diarrhea began in earnest, and the vomiting returned when the ondansetron ran out. They drank and immediately liquid flowed out both ends at an alarming rate (though I’m not sure what wouldn’t be an alarming rate). They were miserable and sticky.

I called the clinic, expecting to get sent to the ER or to get a prescription for that magical medicine. My children were uncomfortable and losing fluid so fast that I expected them to turn into raisins. I was certain that the doctor could make it better.

(By this point, I assume that experienced parents are rolling their eyes. But, I’m a first time mom and this is their first serious stomach bug. I get a little leeway to overreact, right? Right?)

The nurse detailed the home care necessary to prevent dehydration and keep them comfortable, none of which included getting more magical vomit-stopping medicine.

“But what about ondansetron?” I asked, “they gave it to M at the hospital, and he kept liquid down.”

“We don’t use that,” she said calmly, “he will stop vomiting eventually.”

“But, how will they stay hydrated if they can’t stop vomiting?”

“You need to push the fluids. . .”

She continued talking, and my blood boiled. My babies were in pain, and here was someone with the ability to make it stop, and she was blabbing on about bland foods, and milliliters of fluid as if it was perfectly fine that they continue to hurt and cry. What the hell? All logic fled, and my inner two-year old took hold (I WANT MEDICINE NOW!!!!!).

I almost exploded, but stopped just before the words left my mouth, because suddenly I got it.

This sense of helplessness and frustration is why parents insist on medicine for their children when that medicine is not a good choice. It is why they seek out supplements and “therapies” that have no proven efficacy. No one wants to see their child in pain, especially when there appears to be a way to fix it. What an ass I’d been to judge them and not see that before.

I have been immensely fortunate to consistently have doctors who don’t push unnecessary medication, including my primary care doctor who pointed out that NIH studies are easily available online, and that these sources make far better reading for learning about treatments than forums, neighborhood chats, or even most consumer-oriented websites.

This led to my current policy of trusting my doctor but researching for my own edification, which dovetails nicely with my habit of avoiding alternative medicine. As a fan of primary sources, I now take the following routes when trying to learn more about a medicine or condition:

• Medical condition or medicine: National Center for Biotechnology Information.
• Alternative medicine: Quackwatch, Rationalwiki, (and if Natural News recommends it, I run the other way because that shit is crazy)
• Medical treatment: CDC newsroom, NCBI, and Nurses’ forums  (I’m dead serious. These discussion groups are where the people giving you care talk without holding back on the efficacy of that care. Use of ondansetron in children, for example.)

Finally, there was the nurse on the phone, who was used to dealing with worried families and gently refusing to provide them with whatever magic bullet they had heard would help. Ondansetron is designed to treat nausea from chemo, not to make my kid comfortable. The ER prescribed it for an off-label use that had only been studied in emergency rooms, so the lack of studies in doctors’ offices was why my pediatrician did not prescribe it.

It’s all logical, and when I finally let my sensible brain out from the clutches of my inner two-year old, I understood and appreciated their caution.

Unfortunately, medical caution isn’t the only consideration in parents’ need for magic medicine. There are parenting and financial considerations too.

For parents who work outside the home, there is a financial reason to need a speedy recovery for children. Because most child care settings require sick children to stay home for the greater good, having a sick child during the work week requires a parent to stay home as well.

Those fortunate few with flexible work environments may telecommute, but for most parents, a sick child means using sick leave PTO, or unpaid time off. The last option is particularly problematic for lower income parents, who ironically are most likely to only have unpaid time off as an option. They cannot take the time off because their income provides their family with basic amenities like heat, food, and electricity. So, they are stuck finding other solutions (when I taught middle school, children frequently stayed home to care for their younger siblings, which caused a ripple effect of hardship from the original child’s sickness).

Parenting considerations are also an issue. Viruses pass quickly through a family, and parents find themselves in a race against their immune systems to stay healthy at least until their children are well because parents cannot provide adequate care to their sick children if they are themselves sick. This is especially of concern for parents of infants and toddlers who dehydrate quickly.

Further, sick parents who need rest to recuperate cannot get that rest if they are also caring for a sick child.

For example, as my children’s primary caregiver, I cannot afford to get sick. But, because I handle the bulk of their care, I am chronically exhausted and perfectly situated to catch whatever they get.

I joined them in their sickness yesterday, and as I fight my own body aches, nausea and general yuckiness, I consider it a parenting win that I haven’t accidentally puked on either of them yet (parent of the year, riiiiiiiight here). But, other than being more empathetic to parents who demand medicine or seek off-beat alternatives, they’re just not much I can do.

So, the flood of bodily fluid continues unabated, and we’re all cranky at our house. But, I’m trying to be patient, and just as the nurse said, the twins are on their way to wellness without unnecessary medicine.

Image: Sponge