Pediatric Blog
It’s frightening when your child awakes from sleep and vomits and complains of “head pressure.” The non-medical parent will likely think the child has a “stomach flu.” The parent who is a pediatrician (referred to as a “pediatrician parent” for the rest of this piece) instantly thinks of increased intracranial pressure as the cause. Trying to perform a fundoscopic examination at 3 am on a child who just vomited and was in total darkness just minutes before is an impossible task. Pediatrician parents should not and cannot handle such a health crisis on their own.
This scenario described above just happened in my home this week. Pediatrician parents can share several stories like this … when their child had a seemingly typical, not-so-unusual symptom and the worst possible diagnosis comes to mind. Vomiting without fever and without diarrhea is particularly scary. Besides a brain tumor, the pediatrician parent will also consider diabetic ketoacidosis in the differential for such a presentation.
Why can’t it just be a “stomach flu?” Why won’t Timmy just get fever and diarrhea with this too, so we know it’s “just a virus.” Why isn’t everyone else in the family getting sick, or any of his friends? The list of major diagnoses (cystic fibrosis, leukemia, brain abscess, mastoiditis, seizure disorder, blindness, deafness, and so on) that I have considered for my own healthy children when they’ve displayed various common symptoms that all other children will experience at some point in their childhood is daunting.
In order to survive these frightful times, the pediatrician parent has to turn to their child’s pediatrician. The pediatrician parent has to put trust and faith in the history-taking, examination, and diagnostic skills of the pediatrician. Non-medical parents do this every time they bring their children to see one of us. Following through on the prescribed treatment plans is equally important. The pediatrician parent’s urge to dictate the evaluation and management of their own child has to be controlled.
Pediatrician parents must put the burden of diagnosis and treatment into the hands of their child’s trusted pediatrician. This week, I turned over this burden to my child’s very trustworthy pediatrician, and it made all the difference in the world.