Post #2-Update

Update on my 1 month old from last night. Parents brought him to ER sometime in the wee hours when his temp hit 102.5. Thank God they did the right thing once. Work-up in ER showed WBC count only 12,500 with no bands, the LP was bloody and the urine is still pending. He was admitted to pedi ward and my partner is there now trying to convince them to let us do an I&O cath for urine. Parents want to go with a bag specimen only. So sorry I gave this difficult case to my partner, but it sounds like she's handling it with her usual grace. I will go now to the hospital to see a normal newborn of mine so she doesn't have to do that around office hours. Then I'll go off to my real love, volunteering at SHCS. More about that later.

I'm Starting a Blog!

So, I decided while driving home tonight that I would start up a blog. For the first time. I've really enjoyed writing for many years, since I finished academia and didn't have to write for scholastic purposes. Now, I'm a practicing pediatrician in a metropolitan area in California for 25 years and want to write about my life and interests. Maybe someone will read this, maybe not, but I'm excited to do something new at this stage of my life. The event that inspired me to write tonight was a work experience that frustrates and angers me but I want to do the best I can with it. A one month old shows up at 4 PM with a history of fever 101.4 at home, 100.9 in office, a little irritable, no other symptoms. I sent him to the lab next door for a CBC and blood culture, but the parents refused when they found out it would have to be drawn by venipuncture instead of heelstick. Back to the office, I told them the labs were important, they need to go to the hospital to get them now since it's after 5 PM, and they will need to go to ER tonight if temp rises over 101. They go home without going for the labs, saying they will show up tomorrow AM (Saturday naturally) for office follow-up. In talking to my partner who will be on call tomorrow, we see in the chart that Mom was GBS positive at birth. Great, now we have to worry about GBS sepsis. Now what do I do? Call the parents and try to explain about the GBS, even though they have the low IQ problem and the lack of trust and respect that leads to lack of compliance? Hope for the best? Pray the kid's immune system can handle it, or it's just a virus/environmental heat/reaction to the Hep B vaccine I gave 4 days ago? Give Rocephin IM just in case when they show up tomorrow? Send them to ER right now just in case? Don't have their phone# now that I'm at home anyway. Great. Well, I decided I would stop writing and call the partner and work this out or I'll never get any sleep on my off-call Friday night when I'd rather be watching the opening ceremony of the Olympics. anybody else out there relate to this?