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Doctor Advice on Common Concerns

By Benjamin Green, MD

Baby Screaming
Photo courtesy of nathansnostalgia

Just over 1 year ago, my wife and I attended our first PEPS gathering. The wide-eyed and anxious parents, with glazed over looks in their eyes, all nodded to each other with that unspoken acknowledgement: “I know. This is harder than it looked”.

My wife is also a family doctor and prior to having our son, we thought we’d have this parenting thing figured out pretty quickly, after all we had been counseling and caring for kids for years. However, just like everyone else, once he arrived we were wide-eyed and anxious, and quickly developed that glazed over look in our sleep-deprived eyes. We began to doubt our past advice to other parents. Were we too dismissive of their concerns? Were we even properly informed of all there is to be a parent, and qualified to offer parenting advice?

We ultimately came to realize that caring for a child, as a doctor and as a parent, is a matter of perspective. And for us, that was initially very hard to reconcile. The beauty of PEPs was that it allowed us to validate our own parenting concerns (for which there were many), among a group of peers. While yes, our group looked to us for doctoring advice from time to time, we often looked (and still look) to them for parenting advice. For that we are eternally grateful.

So, what was that priceless doctoring advice that we offered to our friends and brothers-in-arms? Well, the topic that comes up so often with little ones, is “When should I be concerned in the middle of the night?” The answer is somewhere between “Never” and “Always”. As a doctor that specialized in after-hours house calls to kids’ homes, often in the middle of the night, the good news is that for most common concerns, a little reassurance, education, and home remedies are all that may be needed.

What should you do about the following issues, when they invariably come up in the middle of the night?

EAR PAIN: A great example of a common nighttime issue (and yes, it absolutely is an issue for all involved). In most cases, over the counter pain medications (like acetaminophen or ibuprofen) are all that may be needed to achieve a restful night. In many cases, no further treatment is even needed. However, there is a really helpful prescription ear drop that works like novocaine (dulls the ear pain, though does not make your ear numb and unable to talk).

Good news! Ear pain rarely needs to be seen in the Emergency Room.

COUGHING: Here’s another common nighttime issue with ramifications for everyone. For bothersome coughing (and not concerning coughing: see below), a spoonful of honey (as long as your child is over 1 years old), has actually been shown to help more than most everything else.

When should you be concerned? When your child is coughing so much that she is vomiting, she is breathing really fast, or she is having any trouble talking, then she should see someone immediately, even in the middle of the night, and that means a call to 911.

And lastly, what about the dreaded abdominal pain? Is it constipation, a virus, or the dreaded appendicitis (infection of the appendix)? Generally, when your child has pain that is not going away (or getting worse), he is having fevers, and his appetite is gone (he wouldn’t even eat that favorite ice cream sundae), then you should have him seen in the Emergency Room. In those cases the likelihood of appendicitis is pretty high and a trained professional should absolutely take a closer look. If on the other hand, your child is eating well, bouncing up and down, and has a tummy ache, the good news is most of the time, he can be managed at home, and he will likely recover soon.

In all these cases though, I want to make sure parents know that these are general examples, and if you are ever unsure, don’t hesitate to ask a trusted provider. Hopefully, most of the time, you and your little one will be able get back to bed soon.

Well, our PEPS group still meets pretty regularly, now 15 months later. Our group has had rare visits to the Emergency Room (in fact, we had to take our own child there once; thankfully he’s fine), and the level of anxiety has been tempered somewhat. And just this past week, our PEPS group met for our annual holiday gathering, with our 18 month-olds toddling around, oblivious to their doctor (and lawyer, and teacher, etc.) parents’ perpetual worries.

About Dr. Ben

Benjamin Green, MDBenjamin Green, MD, is a family physician and Medical Director at Carena Medical Providers. A Seattle-based physician, Dr. Green has delivered over 3,000 house calls to adult and pediatric patients for urgent and primary care (and has pet quite a few dogs and cats in the process).

He has helped Carena to usher in the era of the Virtual Visit, recognizing the immense potential of virtual care to improve patients’ lives. Dr. Green is active in ensuring superior clinical quality among the virtual health care team, all the while emphasizing patient satisfaction.

He lives in Seattle with his wife, also a family physician, their one year old son, and 4 year old labradoodle. “I choose to be a CareSimple provider because I believe that virtual care is the absolute right thing to do for patients as it provides a new option for care precisely in their time of need.”


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