Would you like fries with that spinal tap?
This was an interesting weekend for my son and daughter-in-law. Momma, and the two kids have been passing bugs back and forth; typical and common for families at this age. Both kids had fevers.
They called their pediatrician; he said take the 2 month old to the ER for a checkup. This is where they got caught in the meat-grinder mentality of modern hospital medicine.
My grandson’s chest x-ray showed slight pneumonia, but the doctor wanted to do a spinal tap to rule out meningitis. The baby had no other symptoms to justify this. The pneumonia in the x-ray was cause enough for diagnosis and treatment.
According to the CDC, there will be approximately 1500 cases of meningococcal disease this year in America. Yet, did you know that if you take an infant into the hospital with a rectal temp of 100.5 or greater, it is an automatic spinal tap to diagnose meningitis?
The ER doctor, Dr. I. M. Arrogant, informed my son that there was just a 1 in a 1,000 chance of temporary motor nerve damage from the spinal puncture. Now those are good odds. Better than winning the lottery!
The parents refused the invasive insertion of a razor sharp needle into a perfectly good and functioning spine, since the baby was not fussy, had a good appetite, and had no other symptoms indicative of meningitis. Next, without explaining what or why, someone came in to start an IV on the baby.
My son asked for the justification for the IV. After it was explained about the IV antibiotics, this apparently sent up a red flag that the parent was “allowing the IV.”
Dr. Khan Dissending came in with guns blazing, saying,
“I don’t know if you have kept up with the media, but courts have been siding with hospitals on issues like this. Child protective services will come in and take control of the situation. So if you don’t agree to the 48 hours of observation and antibiotics, we will consult our lawyers. The courts will side with the child.”
By refusing the spinal puncture and discussing the IV, a label was attached to the family. Every doctor who came into the room thereafter prefaced their dialog with “I understand you have an aversion to modern medicine.” My son replied, “No, not at all. We have an aversion to excessive medical treatment.”
I’m sure there must have been a dozen residents waiting in line to practice their spinal puncture skills on my grandson. Their hopes now crushed, they wait for the next kid to practice on. Hopefully, those parents will be more pliable.
In situations like this, be sure to say, “We only want what’s best for our child. But if you want to talk legal, give me a moment so I can call my lawyer, and the local news media. Is that what you’re telling me to do?”
If there are no other symptoms, spinal puncture is an un-necessary test that has major risks:
* Severe prolonged headache;
* Damage to the spinal cord or nerve roots; resulting in weakness, numbness, and/or paralysis;
* Risk of neural infection from puncture site;
* Spinal tap is not recommended when epidural infection is suspected.
Doctors operate on the grounds that they can treat a patient based only on what they can prove (formulary). Since they can’t prove meningitis, they have to treat what they know, which is pneumonia. Fortunately, the bug that causes pneumonia is similar to the one that causes meningitis, and is susceptible to the same antibiotics. So they treated the pneumonia with ampicillin and cefotaxime (the same drugs you give for meningitis).
And of course there are just a few minor side-effects of cefotaxime you have to watch for:
* Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue);
* bloody diarrhea/stools;
* decreased urination;
* fever;
* hoarseness;
* irregular heartbeat;
* pain, swelling, or redness at the injection site;
* red, swollen, or blistered skin;
* seizures;
* severe diarrhea;
* severe nausea or vomiting;
* stomach pain/cramps;
* unusual bruising or bleeding;
* unusual tiredness;
* vaginal irritation or discharge;
* white patches in mouth;
* yellowing of the eyes and skin.
As to the meningitis and pneumonia bugs. The most common causes of meningitis:
* Group B streptococci (during the first 2 mo of life)
* Neisseria meningitidis (meningococci)
* Streptococcus pneumoniae (pneumococci)
The most common cause of pneumonia:
Steptococcus pneumoniae
Since you can’t use an antibiotic beyond what it is prescribed for, I’m sure the doctor wrote on the chart that he was treating the pneumonia; thus killing two birds with 1 stone (the pneumonia, and possible meningitis as well).
It would have seemed logical to get a culture on Mom and little sister, too, so you could see if all three are sharing the same bug. If so, then start everyone in the house on antibiotics, kill the bad bugs, and stop the sharing. Probiotics need to be taken by all to re-populate the good bugs killed off by the antibiotics.
Without accompanying symptoms, and in non-emergency situations, suggest to the doctor that they seek a diagnosis without the spinal puncture.
Also anytime you go to the hospital, always take a voice recorder. Tell the staff, nurses & doctors, that you are recording all discussions when they walk in the room to help you remember instructions later. This will keep them on their toes, decrease their condescending tone, and, if necessary, make it easier to file suit later.
The best scenario is to have a medical staff that is mindful of the parents, explains rationale, and uses appropriate people skills. Forming working relationships with parents is better than threatening them with child protective services and lawyers.
better to be safe than sorry if the kid have died from not get the test then yall would havve been mad at the dr.i see why you didnt do the test but better to be safe than sorry.