Killian started having a fever on Saturday, but with no other symptoms so we just chalked it up to maybe some teething and didn't think much of it. When Sunday rolled around he was burning up, unbelievably fussy, and so clingy. I literally could not put the kid down. He just wanted to be held and slept in my arms all morning. I so wanted to just wait to see our own doctor on Monday, but when he decided to stop eating and drinking I got worried enough to call the office.
We were the last appointment of the day, which means the physician and staff were probably very anxious to get out and enjoy the summer day. Though that's not really an excuse for the physician's horrible bedside manner. I told her Killian's symptoms and expressed my concern that he may have another ear infection, to which her reply was, "I don't understand why he's had so many ear infections if he's not in day care.". Ok, well there's other ways to get sick besides being in daycare... but that's besides the point. So she looked in his ears and says, "Well, he doesn't have an ear infection. He probably just has Roseola. Call your doctor in two days if he still has a fever." Roseola? Seriously lady. So I said, "Well, if he's not in daycare and stays home with my husband and I every day where in the world would he get Roseola?" Then I politely suggested that there could be many other causes of fever in an infant other than an ear infection and Roseola (with no history of exposure), and asked if it was possible that he had a UTI. Her response was, "Well, he's circumcised. So I doubt it." Well if she had bothered to ask, she'd know that he wasn't circumcised (and by the way, being circumcised does not exclude you from having a UTI). So she reluctantly taped a sterile plastic bag around his genitals and we waited for him to pee (which was a while since he wasn't drinking anything).
An hour later, with no reassurance or really any at-home instructions from the "doctor" (I was about to ask for proof of her medical degree), I took my poor little man home. After two days of lots of Tylenol, Ibuprofen, and snuggling we get a phone call from the pseudo-doctor saying that "surprisingly" the urine culture grew out bacteria and he needs a catheter to get a sterile sample to confirm it and that I should bring him back to her. No way lady. I insisted on going back to my own doctor, who turned out not to be in the office and the other doctor there was on his way out the door. With the help of the very kind office manager at my office, she told me I could go to the hospital and get it done there.
By the way, I even had to ask the doctor why she wasn't going to treat the UTI with antibiotics. She said she wanted a more sterile specimen but even if she thought that he had an infection, it'd be prudent to treat it in the meantime to prevent serious complications like a kidney infection. If I hadn't of pushed her myself, I doubt she would have sent a prescription to my pharmacy. At this point I was beyond the point of frustrated.
I was pleasantly surprised, however, at how easily everything went at the hospital. The nurses were very kind and helpful. Even after having a tube stuck up his urethra, Killian was still smiling at them in the end. I was just happy to have the whole thing over with. We headed home, got his prescription (which caused an massive blow-out within 20 minutes after taking it), had a tubby, and went to bed. I'm still waiting to hear about the results of the new urine culture, but I'm just glad my little man is finally starting to feel better.
I tell my friends and family all the time who constantly question their own doctors to trust in their physicians, that they went through years of school and years of vigorous training and they aren't out to do you wrong. But I think after this experience, I realized that every once in a while (particularly when your gut instinct is telling you to), you have to question your doctor and push them a little. I think sometimes doctors just get so complacent with seeing such common illnesses or not finding anything wrong at all, that they don't think to look for anything else.
On my rotations I'm constantly asked by the attendings I work with, "What's the differential diagnosis?" For those who aren't a medical student, that just means, "What are all the possible things that could be the cause of the patient's symptoms?" And anything less than at least three probable diagnoses is unacceptable. Even though I was a mom at that moment in time in the doctor's office, my medical student side was surfacing. I wouldn't normally question the doctor like I did, but I knew something was wrong with my baby and if I hadn't said anything then he wouldn't be getting treated for his UTI now. Sometimes you just have to follow your instincts.
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