While I have been working over the holidays I have not been the most popular doctor around town. With that being said I need to explain.
As everyone knows the Christmas holidays fall right at the beginning of the winter SICK SEASON. The pediatricians office never really stops and if anything it gets busier as families are trying to get out of town, or are trying to get well in time for holiday activities which may include big family plans which may include out of town guests. This is a perfect storm to spread germs as well as families fly around the country and gather together.
While working over the holidays, I have found myself having to be the bad guy by recommending that families cancel their airline flights and trips to see the grandparents or for others to cancel their vacations to far away destinations. All of these cancelled plans were due to children in the family who were too sick to travel. The majority of these patients have one of the numerous viral upper respiratory infections that are currently TNTC (too numerous to count).
I am seeing children with rhinovirus, respiratory syncytial virus (RSV), meta -pneumovirus and the first few influenza cases of the season. These viruses may sometimes cause children to wheeze and some of the sicker children may even be hospitalized.
In most of these cases, children may be treated at home with rest, lots of fluids and some children may need nebulizer treatments to help their breathing. For those in the hospital the treatment is the same although the hospitalized children typically need oxygen. The rest of the treatment is really about letting the virus run its course, and that is really frustrating, as there is not a doctor around who can tell you what a virus is going to do.
Since you can never tell when and if a child's breathing will deteriorate, I had to recommend that several families cancel their trips. What if you are in the middle of a plane flight at 30,000 feet and your child who has already been coughing and wheezing suddenly turns blue? It is just too risky.
At the same time I had to put a child in the hospital who had traveled from out of town to visit family, and once here they worsened and required hospitalization. They are now in the hospital far away from home and the dreams of a big family reunion were squelched, unless you can fit everyone into a tiny hospital room and let them all be wearing a mask in the family picture. (Not the best picture for the holiday card).
With all of this being said, I know that all of these children will ultimately be fine and their plans will get re-booked or re scheduled, but disappointment is never fun, especially during holidays.
So if your child is sick and your doctor recommends that you stay home or change your plans just remember that they feel as badly as you do, it is never fun to be the scrooge during the holidays.
That's your daily dose for today. We'll chat again tomorrow.
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