The nurse called today and told me that my daughter had a temp of 102. She said that her throat did not look well at all either. She mentioned that strep is going around.
I went up to the school and picked her up and the nurse walked her to the front office to drop her off. She told me again that her throat looked real red. She also mentioned again about strep and said there is a stomach virus going around too.
My daughter’s PCP can see her pretty much anytime because they accept walk-ins. I took her to the doctor almost right away. We came home for maybe thirty minutes and then went to the doctor. Her doctor looked at her and said her lungs were clear. I told him what the school nurse said and he looked at her throat and said it looked fine. I thought that was so weird.
He tried to do a cotton swab to check for strep but the first attempt failed. It scared my daughter and she started crying. The second attempt failed because she knew what was going to happen and tensed up then she would not let him get the sample. The doctor did not force the issue and just said he would give her some antibiotics to take for ten days.
Her doctor is very kind and has a great bedside manner but he is not the aggressive type and really noticed it in this situation. I like him because she had bronchitis last month and with the medication he prescribed she was well in pretty much just one day.
I would have really liked to find out if she had strep or not though. I also thought it was weird that the nurse said one thing and the doctor said another. He kind of indicted whether it was a virus or strep then she would need antibiotics. Has anyone else had different diagnosis like this and what would you have done? Would you insist on getting the sample or just accept the prescription and move on?
Update today: My daughter threw up this morning when she got up. I checked her temp and it was 97.4. I called the doctor and he said I can stop the antibiotics unless she is running a temp. If she a temp then continue with the antibiotics. I really think she just had a stomach bug.
He should not prescribe antibiotics for a viral infection, and he should not treat for strep if it is undiagnosed. Some doctors are in the habit of prescribing antibiotics for everything just to make patients feel like they are doing something, but that is what has caused all of the drug resistant bacteria. Of course, unless you daughter opens her mouth he can't diagnose strep.
He said if it were a VIRUS, he would give antiobiotics? Are you sure you understood that right? Viruses don't respond to antibiotics...
The nurse knows that strep is going around. That's something you can take to the bank, mom. One reason why doctors do strep tests is because strep throats don't always have "white stuff" on them to tell the doctor that it's strep. Tonsillitis is a possibility as well, and it's not the same as strep.
I will tell you that my kids don't always have a fever with strep. They don't always have a terrible sore throat with it either. They sometimes are nauseated instead. If they came home with a stomach ache and drug around at home instead of enjoying playtime, I knew something was up. I'd run them down to the doc after school and get a strep test. One time the doctor told me that my son's throat didn't look like strep at all, but to make me feel better, she would do the strep test. When she came out to the waiting room a bit later, she apologized to me in front of all the moms out there and told me that to her surprise, my son DID indeed have strep. She told me that my mom's intuition was good.
Sometimes you just have to know your kids.
I tell you this so that you have a bit of an understanding why the doctor isn't necessarily agreeing with the nurse. Also, you should know that if you get your child to the doctor TOO soon, that strep won't necessarily show up. That happened to my college son last year at the end of exams. He felt poorly, with a sore throat and nausea, papers to write, a theatre play to act in (bad timing having to be onstage while feeling like this!) The school nurse did a strep test, but it came up negative. He came home and went to his family doctor for his yearly physical right after exams, and I told the doctor about what had gone on, and he decided himself to take another strep test. THIS TIME strep showed up.
If your daughter weren't non-compliant with the strep test, you could take her back next week for another strep test, but I have a feeling that she'll be just as scared next week as she was today. Go ahead and give her the antibiotics. Strep is nothing to play with - my sister at 5 years old was misdiagnosed (the doctor assumed it was viral) and ended up with scarlet fever. It was scary - her skin sloughed off and she looked like one of the zombie people, and it also affected her joints and she couldn't walk for two weeks. NOT as scary as rheumatic fever, but still really serious. You do NOT want to mess with strep.
I hope this helps - you can tell that my family has dealt with this plenty.
Dawn
I would want the test done, because without it, you're being prescribed medicine she might not need. Antibiotics do nothing for viruses, they only fight bacterial infections.
As for the school nurse, it's great she told you what it *might* be, but she can't diagnose your child just by looking at her. You need the doctor to confirm that with an actual test. School nurses are fantastic - but don't take her suggestion of what it might be as an official diagnosis. She just has lots of knowledge of what other kids are sick with, not what your kid truly has.
I never give my kids antibiotics without confirming that they have a bacterial infection, and one severe enough to warrant the use. Antibiotics are overused, and as a result there is a huge problem with drug-resistant bacteria.
Strep needs to be cultured--even if it makes the kid cry. We (2 nurses and I) had to restrain my 6 year old so our Ped could swab his throat. He gagged and cried for about 5 seconds afterwards, and then was just fine.
Ear infections need to be seen with the scope, and we only treat them with antibiotics if it is a moderate to severe infection.
I'm sorry, I DON'T like your doctor.
You don't just throw antibiotics at an undiagnosed condition. Different infections need different antibiotics. And viruses don't respond to antibiotics at all. It's foolhardy to give antibiotics for strep without a positive test.
He might be kind with a nice bedside manner, but he needs to bring a nurse in to assist with swabs and things that he's too nice to get done.
I would insist on a diagnosis. Many insurance companies won't pay for drugs without one, so that means that SOMETHING is being written on the clinic notes. I have a problem with that if what is being written isn't the truth.
shame on that nurse for diagnosing/suggesting without a swab test. Many viruses can mimic strep, & a simple round of allergies/drainage can create a red throat like strep. Neither case requires antibiotics.
shame on you & your daughter for not cooperating with the doctor's attempt to do the swab test. Children need to learn the importance of cooperation when it's for their good, especially with medical needs. & I'm surprised the dr was doing the test....usually it's the nurse!
& shame on the doctor for saying one thing (not strep), & still prescribing antibiotics. In his defense, quite often to avoid arguing with parents, drs still give antibiotics when not really necessary. Sometimes it's the only way to get the family out of the room! Doesn't make it right....
So, to answer your question....yes, I would have insisted on my child cooperating with the dr.
& it's time for you to decide: who's in charge? You or your child. The school nurse or the dr?
Nurses cannot diagnose unless they are APRNs. The nurse was more than likely just letting you know that strep was going around and that your daughter was complaining and presenting of symptoms similiar to strep.
She probably was just mentioning that the stomach virus is going around just as an FYI to you - your daughters symptoms are not of a stomach virus I am sure she knew that
If my daughter was suspected of having strep and they could not obtain a culture - I would prefer that she be prescribed the antibiotics vs letting it go. untreated strep can be very serious resulting in heart problems later on. While it is true that you do not want to use antibiotics when not necessary due to causing antibiotic resistant bacteria - in this case I would agree with the doctor.
IF it's a virus, it's ridiculous to give antibiotics. They have no effect on a virus, and it's just an expense for the patient, AND it helps to build a whole array of "super bugs", bacteria resistant to antibiotics. It's possible that the doctor decided to treat for strep or other bacterial infection since he couldn't get a culture. However, he said the throat looks "fine" and still gave you meds? Sometimes doctors give meds because the patient (or the parent in this case) wants SOMETHING to do, or because the doctor PERCEIVES that the patient is demanding it. Sometimes they just do something for the sake of doing something. Another option might have been to let your daughter play in the other room for a little while, and try the culture again. It might not have worked, but then again, if he saw no signs of strep, he might have thought it was pointless. But then again, why give antibiotics?
You can wait it out without the meds, or give the meds "in case".
I also find it odd that your daughter had bronchitis and responded in a day from the meds. That makes no sense given what real bronchitis is and the hold it takes on the person. She might have been at the edge of it with a mild case, but as a long-time sufferer of bronchitis, I can tell you it doesn't turn around in a few days usually. I'm now bronchitis free due to cellular nutrition but I remember well those weeks and weeks of coughing uncontrollably!
It sounds like you're not sure about this doctor - you want him to be more aggressive in some ways (whatever that means - you mean with the culture?) but you also like his laid-back bedside manner. There is value in each approach, and maybe there's also a happy medium. I'd say to either talk to the doctor again (they call back - you don't have to go in again), or find another doctor you feel you and your daughter can connect with.
I know the school nurse had a different approach, but sometimes they are under pressure to get sick kids out of school so that 200 other kids aren't exposed. So she might have overreacted. Or sometimes different practitioners have a different view of what constitutes an irritated throat - it's kind of subjective.
Our nurse always tells us the bugs going around when we pick up our sick kids.
I watch my kids and see if I notice any symptoms then take them in as appropriate.
So take the school nurse's words as a heads up not a diagnosis.
I was with the doctor until he said stop the antibiotics.
Strep can be very serious. I have lingering arthritis damage from delayed treatment of strep throat. The strep spread to my heart and when my body attacked it, it also attacked my joints and I was practically bedridden for a while.
The best thing to do is to swab the throat. If that is truly traumatizing, then go ahead and take the antibiotics. I don't do antibiotics for a virus unless the symptoms have not cleared after a week to 10 days. At that point, a secondary infection is likely. Of course, this may vary a bit. If one suffers frequent infections, the doctor may want to administer the antibiotic prophylactively (sp? Lol.)
I wouldn't give my kids antibiotics unless they *really* needed it, complete with a positive medical diagnosis - none of this "give her antibiotics just in case" stuff. I can't say I agree with your doc's method. I would have insisted on getting a successful swab to confirm any diagnosis.
Agree with Sue H. 100%.
Does she have "strep breath" ??
Well, if she does have strep then the antibiotics will take care of it. I am a little surprised that he prescribed meds when he said there was nothing wrong with her. Did she still have a temp of 102 at the doctors office? I would just give her the meds and keep her home from school tomorrow. Hope she feels better.
The doctor is more experienced and thus skilled at making a diagnosis. Sounds like he is treating her as if she has strep. So the diagnoses is not different. It's just that one was a suggestion to have checked out with her doctor and the other was a decision on the doctors part to not cause emotional trauma by forcing a test. Based on his looking at many red throats he thinks it's not strep but wants to treat it as if it might be.
I see no problem with this scenerio. "Knowing" whether or not she has strep is not essential. Forcing her to undergo the swab is more damaging then just treating the infection in the doctors estimation. However, you have the right to say no. Next time talk with the doctor and decide whether or not to agree.
As to concern about over using antibiotics, a one time use in this situation is not over using antibiotics for your daughter. The issue is giving an antibiotic every time someone is sick. Taking an antibiotic this time will not build up an immunity to the drug. Now, if he gives her an antibiotic every time or most times she sick then I'd be concerned.
I suggest that we have to trust our doctor to know what's best. We should ask questions so that when we agree we feel comfortable. Next time ask the doctor what you've brought up here.
I'm glad you now know what is going on with your daughter. Doctors are not clairvoyant and made a decision based on what presented yesterday. He corrected treatment today based on more information.
