No, really, you have Asthma. You. Yes, you.... the reader of this post.
Because, according to what I was told at The Big, Giant Kids' Hospital around here that shall remain unnamed (but that you can probably guess), if you've ever had a respiratory infection, you have Asthma.
Isn't that neat, folks?
This answer wasn't forth-coming right away, of course. This was after lots of "Whys, What-Ifs, and Buts..." from yours truly. I'm probably a doctor's worst appointment of the day since I challenge them so much. But my line of questioning got the Doc to explain, the definition of Asthma has been changed. Apparently to include EVERYONE. Because if you've ever had a respiratory infection, you might have Asthma, so they just changed it to say you have Asthma, so they can treat you for Asthma, and then, in the case that you have REAL Asthma, well, you would already be treated for it.
Isn't that darn convenient for the medical world. Does anyone else see those giant dollar signs floating around in the air or is it just me? I must be hallucinating...
So let's back up a minute here.
I had scheduled an appt for Riley to see a new asthma doctor in September. I scheduled this in May, but if you have a truly sick kid and want to go to the Big, Giant Kids' Hospital Docs, you better hope your kid ain't that bad, 'cuz you're gonna wait for that appointment. This would be the 3rd Asthma Doc I would be taking her to. And I had a new approach.
I called them and lied. Said this was the first time she was being seen for Asthma. Said that she had some respiratory illness when she was 2, and that the ER doc had said she couldn't be tested for Asthma until she was 4, and now she was 4, which were all true.
I gave them the facts, that 3 times, one month apart each, in early winter of 2013 when she was 2 yrs old, she had been to the ER, and diagnosed with 3 different respiratory illnesses. She had been given the diagnosis of RAD (reactive airway disorder), which at the time I was ok with, it simply reflected that she had experienced a cluster of respiratory illnesses in a short period of time.
Then I lied. I did not disclose that she had been seen and tested for pulmonary function by 2 other doctors. I felt bad about lying. But I wanted a clean slate approach. I had learned from seeing Doc #2 that going in with records from Doc #1 means you're likely to get the same answer, just on her letterhead.
So after all that waiting for that appt, we went. Her additional history was that she had no major issues since early 2013. They tried telling me that if she had been around a lot of other little kids, she probably would've had more exposure, a chance to get sick. I told them she had attended a full year of 3 yr old preschool. "Oh" she said. "Well that sure would be full of germs." I also mentioned there were 2 more siblings who were not present. She agreed that a household of six can definitely host some germs.
They told me that the pulmonary function test could be done, but that the national database of comparison for the results starts at age 5, meaning any data would be skewed because of her age. (The previous two docs had both done the PFT, at age 2 and 3, and given me results that were less than desirable, which was probably due to the fact that they were comparing them to 5 yr olds.)
So we did the PFT. I crossed my fingers that Riley wouldn't blow my cover and say she had done this before. She didn't. And she was a rockstar with following the instructions, of course.
Her PFT showed 100% lung functioning. None of the "deficient lower lung function due to severe asthma" as one doc had said.
They also did the scratch test for environmental allergies, as they could be a trigger for asthma.
Nothing came up. Lucky her, to not have the animal danders and pollen allergies that I suffer from.
Great, I thought.
The Doc reviewed everything with me. No ER visits since early 2013. Lots of exposure from own household, community, preschool with no adverse illness resulting. No environmental allergy triggers. 100% lung function on the PFT.
In the clear, surely, right? My whole goal of coming (besides the fact that I had fired her last Doc for all the food allergy non-information she gave me about RJ) was to get the "Rule Out," the answer that nope, she doesn't have asthma. Thanks for coming. See you never again.
Of course, although I surely don't WANT my child to have asthma, if it turned out that a 3rd Doc said she did, and had the data and tests to prove it, I would accept it and manage it and account for it in everything we did, like the responsible Mom I am.
I was in good spirits, as everything seemed to be looking up.
The Doc left the room, came back and handed me a folder with the hospital's name on it, and inside were some print-outs.
"Managing Your Child's Asthma"
"Riley's Treatment Plan"
Two prescriptions - for a daily steroid inhaler and more albuterol.
With a smile on her face, she started to sweetly explain to me that even though her PFT was great, and we've had no problem for well over a year, Riley probably still has Asthma.
I think I was more confused than mad at this point. "I don't understand," I said. "How you can tell that she still has Asthma?"
"Well, we don't really know."
"So then why does she get the diagnosis of Asthma? Why do you want her on a steroid inhaler?"
Another sweet smile.
Trust me, that smile was not returned.
She has to think about her answer, and she says, "Due to the new definition that we talked about earlier, we can't be sure that Riley won't have another problem. It's better to use the medicine and prevent it in the meantime."
"So..." I say, "you want my kid on a steroid every day to prevent something that we don't know for sure she has? Isn't it more likely that in early 2013 she had a virus that caused the respiratory illness in her small, 2 yr old, still developing lungs, and that perhaps that virus didn't fully clear, and flared again the next month, and the next until she finally got it out of her system?"
Am I being an asshole? Maybe. I feel like one. But there is this incredulous feeling in me, I just cannot believe that a Doctor, who went to medical school, who swore under the Hippocratic Oath to HELP people and never to do harm, thinks this is the best option for my kid.)
"Well, it's a very light steroid. It really doesn't do much," she retorts. She's getting a little defensive now.
"If it really doesn't do much, than why bother at all?" I quip. "My husband and I are not the type to run our kids to the doctor for every scratch and sniffle, and we consider medicine to be a last-resort. We believe that allowing the body to manage and deal with most common germs is beneficial for us, in addition to eating right and avoiding processed foods in order to boost our immune systems, and actually, we're much healthier in general since we've adopted this attitude. We really don't want Riley on a steroid, or anything for that matter. And based on the results of her pulmonary function test and her history for the past year, it doesn't look like she has Asthma to me."
Doctors love being told how to their jobs, let me tell you. I watched that sweet smile drip right off her face.
"Well, I'll just give you the scrips instead of calling them in to your pharmacy, you can choose later if you want to fill them..." she says.
She leaves the room.
I can't help but wonder, does she really believe all this? Are all the Docs in this particular hospital care network like this? I want to yell at someone, so I decide we'd better get on out of there right quick. We check out at the desk and they ask me if I need another appointment. "NO!" I shout, probably a bit too loud. We head out, and don't look back.
In relating this to my primary care doc at Riley's 4 yr old well check a week later, I gave her my true opinion. We've had her for years, she's heard all my doctor stories, she knows how I feel about all this. Sometimes I apologize, after all, here I am doctor-bashing to my doctor. But I believe her response to me is genuine (probably why she's still our Doc, right?). And so I ask her, "Aren't doctors supposed to be curing people? And not handing out medicine like candy??"
"Yes!" she nods, emphatically. And I believe her. But while saying so, she has raised her hand, the hand with the manila folder, to cover her mouth, as if someone else in the office might hear. I don't think she realized she did it, but it was quite telling. The whole culture of doctoring is in trouble, my friends.
I've also been telling this Asthma Doctor story to my family and friends, and each time I find it just as incredible and sad. There was a whole waiting room full of parents and children, some tiny babies, too. How many of them are there but don't need to be? How many have been scared into thinking something terrible is wrong with their child? How many are simply trusting these doctors, while wondering why every kid they know sees a specialist now for one thing or another or sometimes a whole bunch? How many are playing into the "trend" of having sick kids, managing appointments and treatments and complaining on Facebook about how tough their life is? It's very similar to the "allergy epidemic" where doctors are over-diagnosing with false-positives on tests and assumptions of cause, and fueled by the ever-present threat of liability. Some of my thoughts and frustrations on the allergy "epidemic" can be found in a previous post
here.
Should the blame be on some of these doctors? Are they really that ignorant of the body, the immune system, the effects of unnecessary medicine? Are they "forced" into this mindset by hospitals and offices and maybe even colleges that create their culture based on funding by pharmaceutical companies? In our area, new giant buildings are popping up in every corner, hospital care-networks, they call them. They advertise more than you could ever have imagined getting from a hospital 20 years ago. Private rooms, cable TV, a restaurant-esque fully-customized menu, technology and gadgets galore, etc, etc, etc. There are whole businesses making wild amounts of money off furnishing and stocking these new outfits popping up, not to mention the jobs to build, clean, run and staff them. But are this many people really that sick? Or is business just booming and no one at the top making billions wants to stop the gravy train?
I hate sounding like I'm anti-establishment, anti-doctor, anti-technology, anti-medicine. But I can't help feeling like things are more than a wee bit out of control in the medical world. Liability-based thinking has led us to a dark place where everyone is sick, no one can be cured, more meds and treatments and appointments are needed to keep everything funded, and a bunch of someones somewhere are getting awful rich off of all these "ill" people.
No matter what anyone else decides, I believe that I'm lucky to have been blessed with enough intelligence to analyze our data and make informed decisions about our family.
Oral antibiotics are considerably rare in this house. Instead, we increase our water intake (which is all we drink anyway), we make soup, we add black pepper and garlic in great amounts to our food. We allow fevers to do their jobs (but would seek help for a fever 104 or above), we rest and get fresh air. We eat probiotics and avoid processed foods, and we avoid all dairy for the duration of the illness. We gargle with salt water and flush out our boogies. We don't use over-the-counter meds to "alleviate" the symptoms that our body uses to tell us it is trying to fight a bad germ. We don't use sanitizer, ever. Except maybe after using port-o-johns....yuck! We're not in fear of coming in contact with a daily dose of germs from routine things around us. We do wash our hands, but not excessively. Our colds and flus are short, colds never travel down and become major coughs, and no one is worse for the wear. Perhaps it's luck, but I think it's a good chunk of education and personal health management.
We've gotten rid of some doctors:
Chase's GI issues are non-existent, after some major diet changes and some teaching from his parents. If the hospital had its way, we'd still be going to 3 month follow-ups, and he'd still be on medicine, doing the gut work for him instead of he and his body working together for resolution.
Here's the link that mentions that briefly, it's the same post as Riley and her docs, which is linked below.
Riley doesn't have Asthma. If she did, we would see shortness of breath and symptoms with running, and other times when she is very active. If she did, we would have had some respiratory issue at least once, probably more, during the last year and a half where she had, dealt with, and rode out WITHOUT MEDS, at least 7 colds. But, as I just laid out in this post, the Doc at the Big Hospital wants us to put her on two daily inhalers, one that pumps a steroid into my little girl's developing lungs, just in case she has a problem that may or may not be real problematic Asthma. No thank you! If you're curious, here's my
post on Riley and her doctors from before. Mind you, I was still pleased with the second doc at that point... until she saw my son for his supposed "food allergies." If I hadn't raised any questions, we'd be scheduled for 3-month follow-ups appts from now until forever, and Riley would be on two daily inhalers, possibly affecting her behavior, sleeping habits, daily energy levels, long-term lung-function and development. She'd be subject to X-Rays of her lungs periodically throughout her life to "check" for asthmatic symptoms. She'd "have Asthma," meaning I would feel obligated to list this on future forms, to tell all of her activities, sports, and bible camps and they would possibly make a liability-based decision and limit her participation based on this one word. The label would affect her whole life. When she isn't showing ANY signs of it.
RJ doesn't have any food allergies at the moment. If we'd stayed with the first allergist, our house would probably still be peanut and tree-nut free, having been frightened into believing the worst from the doctor who couldn't give us a solid answer. We'd also be keeping him away from cantaloupe and other melons and the fruit bar in general, frightened of the red-hivey reaction with welts that he got a few times, and in part due to his inability to communicate at his young age to tell us exactly what he was feeling.
Here's the link again for the first of those posts. Our down-to-Earth, super-practical, old-skool 2nd Allergy Doctor helped us get an answer, quite easily, I might add, and so now we don't have to live in fear of food and cross-contamination, like so many other parents who could possibly be in the same situation as we were, where there is an assumption of an allergy based on inaccurate results. Please don't think for a moment that I'm down-playing the actual, rare life-threatening allergies that some do have, because I'm not. Even just feeling that we were there for that brief amount of time back in February was so terrible and scary and draining that I wouldn't wish it on anyone, and for all those true-allergy Moms out there (who need to wade through the mess and opinions left by the wolf-crying Bumper Sticker Moms) who need to make sure their child is safe every day, well, I give them loads and loads of credit.
Because I am challenging some of the educated and respected doctors of our society, I review all the info with myself often. Sometimes I doubt myself, and have to review and review again and again. If I'm wrong, I would be making poor choices for my family's health. But I don't think I've made any poor choices yet. I've made my own educated, researched, reviewed, and informed choices, even though I would never advocate for anyone else to "be their child's doctor." What's right for me may not be right for someone else.
I do encourage every parent or person to ASK questions, bring their OWN research, GET a second opinion, or a third, and DON'T settle for an answer if you don't think it's correct. Just because someone has successfully made it through medical school, doesn't mean they're able to make the best decision for YOUR child every time and you have every right to challenge their decision or go somewhere else.
Thanks for reading another super-long post by the Mom with 4 kids who don't have GI issues, Asthma, or food allergies. Anymore, that is...
