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!

I can’t go into all the messy, nasty, painful details because he’s not going to love that I am writing about him in the first place. However, this has been a part of our lives for so long it had to make it to the blog.

This week he will go for an MRI so the doctor knows exactly what he’s dealing with. The operation is next week, we hope. I’m used to the drill by this point. He’ll go to the hospital in the morning. They will give him anesthesia. They will operate for an hour or so. He will spend an hour in recovery. Then I will take him home with a prescription for something that, if we sold them pill by pill, could probably pay for his entire surgery. The same pills that, once he takes them, will stop up his works so he has to take all sorts of laxatives and fiber to reverse the damage. The same pills that, after only taking them for a week the last time, gave him the jitters, kept him awake, and made him feel like crap because his body was already addicted to them. Thank goodness he lives in Organic Land, where his crazy wife tells him not to fall under the spell of the evil Western pharmaceutical companies. But I digress.

Since this process started six months ago, I’ve seen a lot of good, a lot of bad when it comes to modern medicine. The prices for one thing. The bill was the best part. The first operation cost $7,167. JUST for the hospital. NOT counting the doctor’s fees. It cost $992 for the 45 minutes he was in recovery! Except we have insurance, so after the insurance write-offs, the entire operation cost us $1,804. Only. And if we didn’t have that insurance? Take that operation and times it by four. Then add the other $2,500 per operation for the doctor. We’d owe almost $50,000. People, I know everyone is against healthcare reform, but there’s something wrong with that picture.

Back to the medicine. I’ve already covered the aftercare — pain killers that hook you in so quickly you can end up with another problem before you recover from what ails you. And the surgery? Eh. The anesthesia sort of sucks. The first time was fine. The second time they gave my husband too much medication and he was outright sick when he woke up. He was in recovery so long I started getting nervous and demanding to see the doctor. Ooops, we gave him too much, was the answer. Sorry. Or how about the operations? Three times was not a charm. Each time the operation that was supposed to work didn’t. Each time the doctor let my husband make the decision for the less invasive fix even though the more invasive one definitely would have worked the first go-around.

The doctor, all doctors, don’t really DO very much anymore except cut, which leads me to another  aspect of his care — everyone’s care, really — that really pisses me off: The treating the problem without looking at the big picture. Take my husband’s diet. Sure, he eats the organic stuff in our house. But he doesn’t eat any whole grains, no veggies, no dairy other than pizza cheese. No fruit other than orange juice. His food groups are beef (meat sauce), pizza, peanut butter and toast, and Joe’s Os. I am not exaggerating. After the first operation I told the doctor this, and asked if changing diet could help my husband heal. I was hoping he would tell my green-phobic husband to take better care of himself. The doctor didn’t want to give that advice, though. Sure, he said, he should eat good food, but he stopped short of telling my husband to take better care of himself. Just, “Here’s the pain medication. He’s going to need it.”

And that kind of half-assed care can be found all over America and the world. How about one  375-pound guy I know who keeps hurting his knees? His cure to date: surgery and physical therapy. No one has the guts to tell him that his knees wouldn’t get screwed up so much if he lost 200 pounds. Or the diabetic I know who can’t get her wounds to heal, but no one tells her to stop eating so much crap. Or the friend’s kid with ADHD who pounds caffeine and preservatives, watches tons of TV, and never goes to bed? Sure, he would benefit from an organic, all natural diet, and a 7 p.m. bedtime. But the doctors are too afraid to ask the parents to make such a difficult choice. Diet and lifestyle aren’t even on the table. Here, take some Ritalin. Yes, I know that healthy people who never smoke and eat raw foods often drop dead of a heart attack, stroke, cancer, or worse when they are still young. It happens. All the time, actually. But you can’t tell me that what we eat and how we live doesn’t have an affect on how we feel.

[The above language is judgmental and, although I believe doctors are not doing a good job of taking care of people rather than focusing on the problem at hand, I know my husband's problem is not because he won't eat his broccoli. I am just really upset that we are still dealing with this annoying, painful problem that is messing with all our heads.]

Getting back to my hubby: I yelled at him tonight as he was peanut buttering two slices of organic bread. After eating six English muffin pizzas. Where’s your fruits? Where’s your vegetables? He yelled back that he ate all the organic crap in the house, and he did eat healthy. Maybe he’s right. Maybe I’m wrong. At this point, I just want my husband to feel better. But when he does I’m hoping he’s willing to see a nutritionist. It can’t hurt, right?

My husband’s rebuttal: The doctor wanted to do the invasive surgery first. Your husband opted for the less invasive options first so he had less of a chance of PERMANENT INCONTINENCE at 36 years old. You are complaining about cutting but the other “surgeries” were to *avoid* cutting. They were surgical procedures to manipulate the area into healing on its own.

I don’t eat candy, I rarely drink soda, I don’t eat cakes or pastries or ice cream. I don’t eat anything with high fructose corn syrup in it, or hydrogenated oils. I don’t eat enough green vegetables. Oh well. I’m 6 feet tall and have spent almost my entire life under 180 pounds. My blood pressure is 120 over 80 and my bloodwork is always perfect. Clearly, my awful eating habits and unhealthy lifestyle are to blame. And of course my evil doctor with all his right-wing conservative “medical degrees” is the problem. Could never be that I just wound up with a difficult to treat condition out of bad luck.

Not a bad place to be hanging out with an ear infection.

Little Girl got a fever on Saturday. We never would have known aside from the fact that she felt like a hot water bottle when we picked her up. We took her temperature. 104.2 degrees. Wow. We called the doctor. Did she have any other symptoms, the doctor wanted to know. Coughing? Sneezing? Boogie nose? Nope. “Okay, well, just give her alternating doses of Motrin and Tylenol, and keep an eye on her. If she has a high fever without symptoms for more than 24 hours, she needs to be seen.” She could have a urinary infection, explained the doctor. By Saturday night, though, her fever was down. Sunday, she woke up with an almost normal temperature, so we went out to the beach to enjoy the beautiful Indian summer here on the Island. That night, however, her temperature was back up to 104. She fit the criteria in my book: 104 after 24 hours. I took her over to the after-hours doctor service my doctor suggests.

After doing an exam, that doctor said Little Girl’s ear was red. She had an ear infection, she said, and she was going to prescribe antibiotics. My doctors, I explained, always liked to wait a few days before giving antibiotics for an ear infection. In fact, Little Girl has never been on antibiotics. The doctor was firm, though, and wrote a prescription for amoxicillin. By that time her fever was down to 100. Taking everything into consideration — the lower fever, the lack of pain, the fact that she was playing peek-a-boo with the fish on the wall — I decided to wait to talk to my own doctor before filling the prescription. Monday morning rolled around. Little Girl’s fever was hovering around 100 without the benefit of Tylenol when I made the call. Going on that information, my doctor said I could wait until Wednesday to give the antibiotics. They would take another look at her ear, and make the determination then.

My doctors are not bad doctors for doing nothing. In fact, they are doing something pretty impressive. They are following a set of 2004 guidelines published by the American Academy of Pediatrics and the American Academy of Family Physicians. The guidelines cover treatment for acute ear infections, asking doctors to use an antibiotic-free treatment plan for most kids, treating them with pain relievers and observation for the first 48 to 72 hours. If pain is moderate to severe, and if fever is high, treatment may be indicated. However, if the fever goes down — which it usually does — no treatment is necessary. (They do suggest antibiotic use for babies younger than six months, but even then they ask doctors to prescribe the most basic antibiotics.)

This wait-and-see approach is smart because more than 80 percent of ear infections clear up on their own. And there’s another benefit to avoiding antibiotics, according to a May 2009 Consumer Reports blog: Fewer ear infections in the future. “If children had taken antibiotics, there was a 63 percent chance they’d had at least one subsequent infection. The risk was only 43 percent for children who’d been given an inactive placebo,” according to the magazine.

The reason for this change in protocol is simple but scary: Over-prescription of antibiotics has created superbugs — nasty, antibiotic-resistant germs like MRSA that can cause big problems. Ear infections are the main cause, according to the University of Texas. “Ear infections are the driving force behind antibiotic resistance, a troubling medical issue, as physicians often administer antibiotics for the painful, persistent ailment.” I was actually surprised to read that one U.K study found kids under five are still prescribed antibiotics 2.2 times, on average, per year even as researchers and scientists call for less use of the drugs.

So we’re going back to the doctor tomorrow to get Little Girl’s ear checked out. She’s been fever-free since yesterday. She’s running around. She’s laughing. She’s eating and drinking. I think we made the right decision — with our doctor’s help.

Please note: I am not a doctor, and I don’t profess to be. I am a crunchy mom who believes in and supports Western medicine. I’m not saying to skip the doctor if your kid has a fever. Self-diagnosis is not smart or advisable. It can even be dangerous. (Trust me, I ask my doctor’s opinion before making medical decisions for me or my children. I think I called my pediatrician more during Little Girl’s first year than I did for Big Girl’s!) However, if you’re sitting in the doctor’s office being handed antibiotics, it’s not a bad thing to ask — if your doctor is prescribing them for a simple ear infection — what he or she thinks of the AAP’s ear infection guidelines. Sometimes, it’s as simple as saying, “What would happen if we waited to treat this?” Doctors want to be helpful. Parents want to help their kids. This can result in doctors doing something to appease parents. They may not want to give an antibiotic, but do so to make the parents — not the kids — feel better.

What has your doctor done for ear infections? Do you routinely get antibiotics? Do you insist on treatment because you hate to see your kids in pain? I’d love to hear about it. Want to learn more about avoiding ear infections? Check out this smart Consumer Reports story.