Doctors - Fair Oaks,CA

I did hear on the radio over the weekend that there are new guidelines for prescribing antibiotics for cardiac patients and now some may not need the antibiotics. I have no idea what the guidelines are though.

It sounds like you are pretty concerned as I would be so maybe you should talk to the DDS. They can certainly write an rx for the antibiotics as well as the pediatrician.

Please follow through with it since you are uncomfortable with it. It's too important not to.

I've worked with doctors for almost a decade. There are some great doctors and some not-so-great doctors. Some belong in their profession, others perhaps not. All are smart - you can't get into med school and get licensed without being bright. But, not all have great bedside manners. He sounds like one who's tired of being a doctor.

Here are some facts about practicing medicine today:
1. They're not making much money
They work really long hours, sometimes 7 days/week, have mountains of paperwork, battles with insurance companies, are "on-call" as you experienced through the emergency service, and spend little time with their families. All that, and they make a fraction of what other people would who put in that much time + having close to $300K in debt when leaving med school.

2. Medicine is still as much an art as it is a science.
Anyone who tells you differently has a dark hat over their eyes. They are scientists, but talking to patients, trusting their instincts and making decisions in the patient's best interests is an art.

3. Doctors can be wrong
My OB/GYN dismissed a swollen lymph node on my collarbone as something he wasn't very "excited" about. It ended-up being cancer. Not his fault - he's an OB, not a lymph node specialist. So, I had to trust my instincts and seek another opinion. I had to do the same when my Oncologist recommended radiation therapy after chemo and everyone else said no. 3 other opinions from other lymph experts, and I went against his advice. He wasn't necessarily wrong, but I had to make the decision in my best interest.
It is your job, though, to make sure you understand what's been discussed. I know an Endocrinologist who is originally from Ghana. Though English is his native language, he knows most of his patients here in Indiana don't understand them, so he writes everything they discuss down. If your son's cardiologist doesn't, you need to start doing it for your son to avoid these situations.

5. It's OK to get a new doctor
If you don't like his bedside manner, ask to change to a different cardiologist. Even if you're in Kaiser Permanente, you don't have to see him for your son's cardiac needs.

Good luck. I'm guessing the stress of having an ill son makes your emotions a little more raw, and that's OK. You love him and want to see him well. Be his health advocate! This doctor sounds like he may need to be replaced.

Dear J.,
You need to get yourself together and find a new Pediatric Cardiologist. He sure is not the only one you can take your son to. Your son's health comes first, and if he is bothered by you asking him questions to what he had told you, then maybe he needs to retire!!! Sit down and write him a letter, let him know how unprofessional he was with you and how you will not tolerate that attitude!
The fact that he is the doctor doesn't mean he can treat you anyway he pleases! This is YOUR son NOT his!!! So my friend, find yourself a new doctor. Go for a second opinion, since if I was you I wouldn't trust him anymore, he tells you one thing and then another! No way!!! Go elsewhere!
And when you find a new doctor, make sure that it is someone that really cares about his patients and explains you in details the condition and treatment to follow for your son.
Many blessings

P.S. My father has had open heart surgery and when he goes to the dentist to get a tooth pulled out or for a rootcanal, he needs to take antibiotic a day before and about 2 days after.

I sympathize with you. I have to talk with doctors on a daily basis at work, and I've had them yell at me, hang up on me, accuse me of being unprofessional, not of which was warranted or true.

That being said, something to keep in mind... was it truly an emergency? You have to have respect for what is an emergency and what is not. Having an answering service call him for a dental antibiotic prescription seems like a non-critical situation, unless it was a dental emergency. You probably knew about the appt ahead of time, and could have planned appropriately. When you call the doctor after hours, they don't have the chart available, and maybe he didn't even remember exactly the details of your son's case. Usually, the nurses are the ones who call in the prescription, and if you call the office 24 hours ahead of time, they will take care of that for you with no problem.

None of that excuses the doctor's behavior, of course, I just say this so you can maybe see the other side of this. I have had to take call as a pharmacist, and I can tell you there is nothing more frustrating than having someone call you for something that could have easily been taken care of earlier in the day. I have no problem being contacted in case of an emergency, but waking me up in the middle of the night because your unit is out of Tylenol, when there is plenty in the rest of the hospital? A little ridiculous (and yes, it has happened to me). Perhaps that doctor was in the middle of a true emergency, do not take it personally.

I don't want you to think I am unsympathetic, truly, I am. I was very upset recently when a doctor told the hospital administration that I was unprofessional, and it was hard not to take if personally (although he is well known to be a problem, and no one had issues with me). If you are uncomfortable with the doctor now, then by all means, get a new one. If, however, you have had a good relationship with him until now, and you can get past this, maybe you should give him a second chance. And just respect that the after hours call should be for a true emergency.

well that certainly wasn't good bedside manners...pooh on your cardiologist. Ask your pediatrician for a referral for a new cardiologist. There has been new studies and the boards back it up that you don't have to take antibiotics for children and people who have heart problems....This new finding was enforced about 3 years ago...I guess you old cardiologist decided now instead of 3 years ago to let you know about this.

My daughter had a mitral valve prolapse...but has pretty much healed itself..and we are now releaved of going to the cardiologist....but at first I was wary about leaving the cardiologist as well with the dental information too...I guess as mothers we are so protective of our babies and to let go...and go into the "unknown" world of being a normal kiddo when going to the dentist is scary...

you migh want to also talk with your dentist and let them know what is going on too....they may be wary of performing a cleaning on your child especially if he/she has additional heart problems.

The good thing is...you can always get a 2nd opinion. Also talk to your pediatrician maybe he mioght be a little more warm in explaining to you why the cardiologist reacted the way he did..

It sounds like the answering service deems it an emergency - not you. I would make sure that information was conveyed to the doctor.

As for the doctor's attitiude, part of being a doctor is being on call 24/7 and he had a really poor response to that fact. I would talk to him about that (maybe you were the 10th 'emergency' that day) and, depending on his responses, find another doctor.

My daughter had a minor heart problem that has been resolved for now so I may not be in the same situation as you but thought I'd share some thoughts. I'm sorry you feel so bad about this. Did the cardiologist really tell you to quit bothering him? That's rude! You are a concerned mom with questions.
It may be helpful to make an appointment with the cardiologist to go in and clarify what he needs you to do when you go to the DDS (dentist?). If you don't feel comfortable with your cardiologist anymore you can ask your pediatrician to refer you to another.
If your son is just getting a dental check up or getting his teeth cleaned, I'm not sure why he would need antibiotics like amoxicillin. The cardiologist may have been referring to dental work like a root canal or tooth extraction when he wanted you to have antibiotics for your son. Dentists can also prescribe medications. You can even ask your dentist to talk to your cardiologist to clarity the situation and maybe those 2 can figure out something. When I first started seeing my daughter's dentist, she actually delayed my appointment to call my pediatrician so that they could be sure about what they can and cannot do with my daughter because of her heart condition.
Doctors are not supposed to prescribe antibiotics over phone. Since your pediatrician has no orders from your cardiologist, he couldn't do that. When you call the pediatrician, they may not be in the office and may not have access to your charts so even if you had orders from the cardiologist, they may not be able to look it up.
Take a deep breath. I hope you feel better soon. Hope this helps.

Sorry you have had to deal with doctors with poor bedside manner. I do, however, appreciate DanaW's comments about physicians these days (all true!!) As a cardiologist myself (adult though, not pediatric) I am in a position to speak a little to the issue of antibiotics. I don't know what exact defects your son still has, but it is true that the guidelines have relatively recently changed regarding antibiotics to prevent endocarditis from dental work. They include the presence of:
1) artificial heart valves
2) a history of endocarditis
3) some congenital heart disease including:
--cyanotic heart disease that is not repaired on incompletely repaired
-- repaired congenital heart disease with a prosthetic device for 6 months after the procedure
--- any repaired defect with a residual defect near the site of a prosthetic patch or device
4) heart transplant patients with valve disease
(please note, coarctation of the aorta is not on this list =)

I hope this eases your mind a little bit, but either way, you should definitely change doctors to someone who listens to your concerns and eases your mind about YOUR son.

Hope that helps!

I am sorry to hear what you are going through. Do you know there are ways to get your sons body healthier and stronger so his little body will work better? If you would like to help your son rebuild his immune system to get him stronger let me know and I will work with you and introduce you to one of our nurses that I work with. We are wellness consultants and have a passion to help our children get healthy and stay healthy.

Many blessings.

N. Marie
____@____.com

Change doctors ... pure and simple. Regardless of the problem, no doctor that you go to for guidance and care should ever patronize you or make you feel confused or scared. Quite the opposite. They are here to alleviate concerns and fears for you. I have a daughter that had an interrupted aortic arch and VSD -- and has a differential in size between her aorta and atrium which may or may not need future repair. We have a VERY, VERY good cardiologist who has told us that she must always take an antibiotic before dentist appointments. In fact, our dentist double and triple checked that she had an RX and had taken it before they cleaned her teeth. Your pediatrician, dentist or cardiologist should be able to write this RX for you. Above all ... get a new cardiologist.

As a pediatric nurse I have a few comments from a professional view and some as a mom.
Your pediatrician should have been able to respond to your question if they have the notes from your child's last visit. It is included in the plan.

If your cardiologist had been up all night saving an infant, he may have had a very long day and does not realize how he came across.

As a mom, I would recommend you get a copy of the notes from each visit for your records, in case your insurance coverang changes or the MD retires/leaves practice.

Before leaving the practice, I would get a phone visit or a consultation and let the MD/office staff know what happened and how it affected your relationship. No one wants to loose patients especially if it was an avoidable incident.

I would turn him into the correct place ... don't know what that is for a cardiologist. And I would get a new doctor, no one should have to put up with that.

.

WOW ~ I am so sorry that your Dr. treated you that way. My son had heart surgery just over 5 years ago now, and I know that it used to be common practice to prescribe the antibiotics before going to the dentist. My dentist always prescribed them though, I never needed to call the cardiologist to get the prescription. Anyways, at my sons last yearly follow up with the cardiologist, he told us that the studies had proven that taking the antibiotics actually had no benefit and it was no longer required before my son received dental work....Hopefully that eases your mind as far as the dentist goes. As far as the cardiologist goes, if this is not his typical behavior, maybe he was having a bad day, and if the answering service paged him stating that it was an emergency then maybe he was just caught off guard.....we all have bad days, and maybe if this is not his typical behavior you should let this one slide.....