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Don’t Dose So Fast!

Big Girl is sick. Yesterday she had a swim lesson, and did amazingly well. (So did Little Girl.) It was a tiring 30 minutes for everyone involved, though — including the mommy who had to shower them both at the swim school — so when we got home, Little Girl went down for a nap and Big Girl went into her room to read. I went to write. When I was done, I walked out of my office and noticed the unnatural silence. Everyone was asleep — including Big Girl. Hmmm. Weird, since Big Girl hasn’t napped since she was four. I went in to wake her, and realized immediately that she was warm. A fever. Uggg.

Big Girl hasn’t been sick a lot in her first seven years. Colds and sniffles? Sure, but her visits to the doctor over the years have been for other things like traumatic incidents or weird symptoms like the time when she was not quite two that she stopped walking. (It was diagnosed as toxic synovitis, a virus that causes hip pain.) Or that same year when she tumbled off of a Little Tikes chair and got a concussion. Oh, and there were the two sets of stitches — one inside her mouth and one on her chin when she was three and four-and-a-half, respectively. So when I took her temperature and realized it was almost 102, I called the doctor. Nervous Nelly, that’s me.

He was really nice, but told me that it was probably viral, and that I should take a wait-and-see approach. If she was still sick by the middle of the week, I was to call for an appointment. And that even if it was strep it would probably go away on its own. Yes, it’s true, and why a lot of doctors are rethinking the automatic dosing that typically accompanies strep. It used to be that kids with a sore throat would rush into the doctor, who would invariably give antibiotics for strep because of the risk of rheumatic fever. However, as this article, Antibiotics for Strep Do More Harm Than Good in Emergency Physicians Monthly points out those guidelines were made in the 1940s when the country was in the middle of a rheumatic fever epidemic.

Meanwhile, according to research (and in this case the WebMD website): “Strep throat will go away in 3 to 7 days with or without treatment…The benefit of delaying the start of antibiotic treatment for a day or two is that your body is able to build up its own immunity to the infection, possibly reducing future occurrences of strep infection. It also reduces the chance of building a resistance to antibiotics.”

This is probably why she never got sick very much. I let her immune system flex its muscles, and called in the big guns for blood, lameness, and head injuries. (And spots and dots like the rash she got last summer. Oh, and Little Girl’s scary-high temperature of 104, because that just isn’t right!)

This is also why I’m really glad my doctors take a wait-and-see approach. I am hoping that this will be the case again, and that it’s simply a viral infection that Big Girl will get over in a day or two. Her nose is running, and she is coughing a bit, so I am thinking that’s hopefully what’s going to happen. I will watch her temperature, keep an eye out for any changes, and keep feeding her popcorn and strawberries, her two favorite, “Mommy, I’m sick!” foods.

Does your doctor take the wait-and-see approach or just dole out antibiotics? Have you ever considered asking, “What would happen if we wait a day or two?” I’d like to know. Oh, BTW: This wait-and-see approach works for my kids and their individual needs. I am certainly not suggesting anyone ignore doctors or withhold medical attention or treatments from their kids. Being sick is no joke, and I would highly recommend that everyone collect as much information as possible and make decisions based on what works best for your family with the help and advice of those you trust. Be informed. Be smart. Take health seriously!

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