Today I went with my brother to his 6 month check up appointment. It was a children’s ward, so there were toys for him to play with in the waiting room…something which I definitely made sure I got right into! It’s always nice to see a child having fun! He was first called by the nurse who took his height and weight. This made me reflect on the importance of doing this for every child as it allows the doctors to see if their growth is normal and if not could possibly help a diagnosis. It was also an efficiently procedure that his height and weight was taken before he saw the doctor as the doctor could then look over these measurements prior to the consultation.

After that he was called by the consultant. The unit seemed to be quite busy today as quite a few nurses and junior doctors popped their heads through the door in order to ask the consultant for advice. This allowed me to appreciate the importance of team work and teaching doctors and healthcare professionals who have a position below yours. During the consultation, the doctor took details on how my brother was coping with three of his Medicines: Omeprozol, Montelucast and the a regular antibiotic he was taking. He was originally placed on Omprezul to prevent reflux from feeding and has been on it ever since he was born, but for the past two months he hadn’t been taking it and had been fine without it. The doctor was informed of this. When he was first born his lungs were underdeveloped and this made feeding difficult, but now feeding was no longer a problem so he was able to stop taking this Medicine.

The Montelucast was also another Medicine he has been on ever since he was born. It’s a Medicine used for respiratory problems and was given to him to help clear his airways to prevent him coughing at night. My mum told the doctor that my brother was still taking this medicine and asked him when it would be appropriate for the dosage to be reduced so he could eventually be weened  off it. Clearly, nobody wants to be on medication if there is a way of them coping without for several reasons, one of the main ones being that taking long term medication can have side effects. However, the doctor assured both my parents that Montelucast is a harmless drug which doesn’t have side effects so it would be better to wait until the season is over just to be sure that he doesn’t catch any infections. The fact that the doctor explained his reasoning as to why he thought his patient should remain on this medicine for the time being was much more effective than him just dictating what had to be done. It’s very important that doctors work with their patients (or their patients’ parents) rather than taking a position of authority with them.

As for the antibiotic, neither the doctor or my parents were in any sort of hurry to take him off that. During the first year after he was born, he spent a lot of time going in and out of hospital for various infections he had caught (the fact that he has Down’s Syndrome means that he has a severely weakened immune system, so even something as simple as a cold could potentially be fatal for him). But during that time, he had two major chest infections which resulted in him being hospitalised in the high dependency unit for over a week on both occasions. The type if infection he had was very serious and the doctors who took care of him made us aware that these episodes could have potentially left him with permanent lung damage. Following this, it was suggested that he is placed on a permenant antibiotic which he can take three times a week. This suggestion definitely proved to be worthwhile as since then he has not suffered from any infections. 

We are planning to go abroad in just under two weeks, so my parents’ main concern was managing with the medication upon the possibility that he catches something abroad. The doctor advised that if this was to happen he should take the antibiotic 5 times a week. I noticed that this piece of information was definitely reassuring and gave my parents confidence in taking him abroad. The main aim of these appointments with the consultant was to help educate the parents so they are able to recognise at what point the child has deteriorated too much and requires medical attention. This appointment definitely did achieve this.

Posted by:Life of a Medic

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