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I hate it when Dr's take a Dr. House approach to things.

Call me neurotic, ocd, whatever, but I want a test ran to confirm your diagnosis before you prescribe my child medication.

My dd has been sick since january. Horrible cough, extreme fatigue, fevers, swollen lymph nodes, lost 5 lbs and generally feeling like shit.

The dr. Looked in her ears and throat and listened to her heart and lungs. Didn't feel her lymph nodes at all.

He said he didn't hear typical pneumonia sounds in her lungs, and then diagnosed her with atypical pneumonia and prescribed antibiotics. He said if she's not better in 5 days to bring her back in.

Wtf? No tests, no chest xrays, nada. And I have a miserable, lethargic child on my hands who has an upset stomach because of the antibiotics....and who has been sick for nearly 4 fucking months.

/rant

*update*

I took her back to the dr today (last day of antibiotics) because she has a rash on her face. The dr ordered blood work and called with the results. Totally normal except for elevated percentage of lymphocytes. She has also lost another pound since Thursday. He now thinks she has mono, not pneumonia. Which means she was put on antibiotics for nothing. *sigh*
by on May. 2, 2013 at 10:41 PM
Replies (61-63):
Jack_Squat
by Silver Member on May. 7, 2013 at 1:34 PM


Ooooh I see. That makes sense. Maybe I will go down and get copies of her labs from August, January and yesterday. 

Quoting DestinyHLewis:


Lol. The manual differential is just that, done by a person. The normal (standard) full diff they run is known to be not very sensitive, and has many flaws that effect the results. For your standard everyday stuff, it's not a bad tool. However, given your daughters past 4 to 5 months. I would think a manual diff was called for. The monospot is 100% called for. 

Quoting Jack_Squat:

I don't even know what that is.

Man, I need to go to medical school lol


Quoting DestinyHLewis:

Do you know if they did a full manual differential? 


Quoting Jack_Squat:

He ran a cbc with full diff, a metabolic panel and some test for inflammation.





Quoting DestinyHLewis:


They performed a differential WBC, but didn't run a monospot? Something is not right here. 



Quoting Jack_Squat:


Her percentage of lymphocytes are elevated, not the actual number. If the actual number was elevated, there would be cause for concern, but it's just the percentage. I specifically asked about leukemia because my niece was just diagnosed with it last week, and her lymphocytes were the only thing that was high, but the Dr. explained that there's a difference between the number of cells being high, and the percentage of cells being high. 




Quoting DestinyHLewis:


Elevated white cell counts are indicative of a lot of things. She needs to be tested, and if its negative, you have to find a new Dr. This stuff drives me NUTS! Aghhhhhhhh! I feel so bad for your dd. 



Quoting Jack_Squat:


I have no idea why. He said the elevated lymphocytes are pretty indicative of mono.



Quoting stormcris:

Wait what ....there is a test ...a very quick test to confirm mono there should be no thinking about this. Why did he just not give her the monospot?



























grandmab125
by Gold Member on May. 7, 2013 at 1:41 PM

 Well, if you're going to wait to see him again, at least try to insist he orders a chest ex ray to see if a radiologist can determine the cause of the cough.

Do you have any major medical centers or hospitals near you?  If you do, try to get an app't with a dr at one of them.  If you don't, see if there are any pulmonologists in your area.

I certainly hope some one figures this out soon.  I feel really sorry for your poor daughter.

Quoting Jack_Squat:

I have googled them, and I trust that the dr is able to properly read lab results. He went pretty in depth explaining them to me, and I specifically asked about leukemia. I'm not confident that it's mono since he didn't do the test, but I will give her a week and take her back again if she is not better and has lost more weight, and he will do more extensive testing.


Quoting grandmab125:

 


Quoting Jack_Squat:


 


Whooping cough has a distinct noise that she does not have. Her bloodwork does not reflect leukemia (the percentage of lymphocytes are elevated, not the actual number, and that is indicative of an infection like mono). She has never been exposed to HIV. 


 


Quoting grandmab125:


 Get a copy of those blood test results, and take her immediately to another dr.  I can't believe you've waited this long, and not obtained another opinion.


Mono does not normally cause a cough, but it normally causes a severe sore throat.


There are several diseases that involve a fever, cough, raised lymphocytes, swollen lymph nodes, extreme lethargy and weight loss. (1)  Whooping cough, Leukemia, HIV.


Did that scare you?  Good, now get her to another dr immediately.


 


 


 Google some of the things I mentioned.  Whooping cough does not always have that distinct "whoop" in older kids.  It does, however, in infants and little children.  And as others have mentioned in this post, mono normally gives you an extremely sore throat.  I also have never seen a kid or adult with mono, who had a horrible cough along with it.


My daughter had mono when she was 16.  Quite often it is caused by the strep bacteria.  In fact, her boyfriend had strep, and she ended up with mono.  She slept all of the time, and could barely swallow.  She also never had a cough.  Being that she was 16 and spent a lot of time in her room, I didn't realize she was sleeping so much.  She didn't tell me about her severe sore throat, until she couldn't stand it any more.  She had to quit her summer job, because it took most of the summer to get over it.


Personally, I would take her to a different dr to get another opinion.  Since you don't seem to think this dr. was very good at his job, do your daughter a favor and have another dr. check her out.  You have to be your family's dr these days and advocate for the best healthcare you can get them.  Question drs all of the time.


 


 

grandma B

stormcris
by Christy on May. 7, 2013 at 4:29 PM

Right but he did order the test.

Quoting mehamil1:

Probably because of her age. It happens a lot in teens and adults, not so much children. When I had mono I went to the hospital and they said I had a throat infection and gave me anti biotics. My mother called our regular doctor and he diagnosed me with mono over the phone and said to take me back to the hospital and get a monospot test. 

It's easy to miss. From what I understand. I was sick though, that can be really bad if you don't catch it. 

Quoting stormcris:

Wait what ....there is a test ...a very quick test to confirm mono there should be no thinking about this. Why did he just not give her the monospot?


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