Good health is something Americans value. In fact, according to PBS, the average American spent $8,233 on medical care in 2012—not including the amount spent on health insurance. You’d think we would know the ins-and-outs of something to whichwe devote so much time and effort. But many of us aren’t comfortable with even the basics of healthcare when should we take our children to the doctor? When should we call the nurse? When should we use over-the-counter (OTC) medications?
Getting the care you and your family need often comes down to common sense and good communication. Here’s some information to help you better navigate the world of medicine.
When should I take my child to the doctor?
Perhaps because we don’t want to seem like we’re over-reacting, many parents can be uncertain when to visit the doctor. According to the American Academy of Family Physicians (AAFP), you should contact your doctor immediately if your child has constant vomiting or diarrhea, a severe headache, a sore throat, ear ache, or stomach pain. Other symptoms that should send you to the physician’s office include a stiff neck, loss of appetite, a pale appearance, wheezing or problems breathing, or unresponsiveness.
When is fever a concern?
According to Dr. Carly Thompson of Premier Family Physicians, many parents are uncertain about when fever is a sign that something is wrong. “By far the most common call we get is about fever,” says Dr. Thompson. “A good general guide is that when fever is above 102° in children older than six months, you should see a doctor.”
Dr. Thompson says “it’s not actually how much fever the child has that is concerning to the doctor, it’s more the way the child is acting.” If a child has a fever of 104°, but Tylenol brings it down in 45 minutes “and they’re running around, playing, eating and having wet diapers—then it’s clearly not an emergency,” explains Dr. Thompson. She also cautions that extreme symptoms combined with fever can mean a trip to the Emergency Room. “If you’ve given them Tylenol and the fever has not come down in an hour, or if they are difficult to rouse or inconsolable—not just fussy, but crying, crying, crying—those are reasons to go to the ER.”
The AAFP also advises that in very young children, even a lower fever can be a cause for concern. They advise calling your doctor right away if there’s a rectal temperature of 100.4° or higher in a child three months or younger or a fever of 102° or higher in babies three to six months of age, even if they don’t seem sick.
Dr. Thompson points out that these recommendations apply only to immunized children. “Unfortunately, there are quite a few unimmunized kids in Austin,” she says. “These kids are not protected against serious bacterial infections, so they always need to be seen when they have a fever.”
We’ve been to the doctor, but there’s no improvement. Now what?
“It’s a smart thing to leave the doctor’s appointment with an expected plan,” says Dr. Thompson. “Patients should always ask their provider, ‘How long should I expect this illness to last? If it’s not getting better, what do I do next?’”
The AAFP advises writing down what your doctor tells you and calling your doctor if you get confused about the treatment.
“Your doctor should also tell you when to return to the workforce or to school or to daycare,” says Dr. Thompson.
When should I contact my doctor’s nurse?
The AAFP reminds patients that when the doctor isn’t available, patients should be able to talk to the physician’s nurse.
“A nurse is a great help when parents have questions as to whether or not their child needs to be seen,” says Dr. Thompson. “Do we need to come in today? Do we need to go to the ER? Can we just wait for a few days?”
Dr. Thompson also reminds parents that the nurse is a good source for other information. “A nurse can tell you what’s a safe dose for a child based on age, and also can tell you things to watch for,” continues Dr. Thompson. “And call the nurse when you don’t remember the next step—like when your child can go back to school. If you’ve forgotten something, the nurse can let you know what the doctor’s notes say to do.”
What about OTC medicines?
Drug stores and grocery stores are full of aisles of over-the-counter medications. But the AAFP cautions that just because these medicines are for sale doesn’t mean they are harmless. In particular, cough and cold medicines can be harmful for children.
The AAFP reminds parents to get their doctor’s approval, before they give OTC cough and cold medicines to children younger than four years of age, or give more than one OTC cough or cold medicine to a child at the same time. And never give a child an adult OTC medicine.
“Some cough suppressants have cardiac side effects, and there have been deaths associated with overuse of cough medicine in kids,” cautions Dr. Thompson.
Not sure which OTC to pick? Ask the pharmacist. “Pharmacists know about each medicine and interactions between medicines,” says Dr. Thompson, “and what symptoms each medicine will help.”
The OTCs that concern Dr. Thompson the most are the ones labeled natural. “People see ‘natural’ on something, and they assume that it’s safe,” she says. “But ‘natural’ is another way of saying that the Federal Drug Administration has not approved that medicine. They’re not regulated, so the products can have variable quantities of the active ingredient in them. I just think people have to realize that ‘natural’ doesn’t always mean ‘safe.’”
Sara Rider is a native Austinite who has worked with physicians and hospitals throughout Texas. She frequently writes freelance articles on health topics for newspapers and magazines.