Dove in the Rock

(that’s a Public Service Announcement)

My PSA of the day: Parents, do not ignore snoring in your kids. Snoring is not normal for children and can be a symptom of a nighttime breathing problem. Lou has been waking frequently of late, crying, restless, impossible to soothe. I hate feeling helpless when my child obviously needs something, but I don’t know how to comfort her or help. I’m the mommy! At the very least, my presence and my love should be comforting! Last night I spent the better part of the night next to her in her bed, and I noticed a pattern. She would snore heavily and erratically, then she would stop breathing for about five seconds, take a shallow breath, stop breathing again, then awake spluttering and choking, shift positions and go back to sleep. And begin the cycle all over again. SLEEP APNEA!

I’d never heard of this in children. I knew it could be a problem in overweight adults or those with allergy problems, but a kid? Lou also has mild asthma to which I always attributed any breathing problems, but in the moments when she would fully wake, her breathing was smooth and her lungs clear. It wasn’t her asthma.

So at 1:53am this morning I’m sitting on the laptop, eating a muffin and reading up on sleep apnea. I wanted to see if there were any positioning tips to help, like sleeping in a chair or with a wedge. Nope. For true OSAS (obstructive sleep apnea syndrome), the two options are CPAP or surgery. CPAP (continuous positive airway pressure) is a facemask strapped to your head and hooked up to a machine, that forces air past the obstruction so you can breathe and sleep. It is worn every night. Surgery is done to remove the obstructions, usually tonsils, adenoids, and/or excess nasal tissue.

I’m pretty sure Lou has true OSAS. One has to only hear her try to sleep to know it. In fact, I think I’m going to make a recording of her sleeping to play for the pediatrician, and maybe we can skip the sleep lab. As much fun as a nightly machine wouldn’t be, since most kids outgrow OSAS, I’m thinking I’d prefer it to surgery.

And now, on to the rant.

I went back to bed, but couldn’t sleep. I knew I needed to call the pediatrician in the morning, and I was dreading the confrontation. See, my kids haven’t seen the doc since January, when we took them in to get their general health checkups for our hoped adoption. We had a huge falling-out with our beloved pediatrician, Dr. B, when he got very angry and not-so-subtly called us irresponsible parents for our choice to delay vaccinations for our children and then only selectively vaccinate them (I’m not discussing our reasons in this post). He then subsequently refused to sign their forms stating they were in good health. We left, with E grinding his teeth and me crying and carrying unsigned forms. (See, I’d mistakenly assumed that the doc would disagree with us but recognize the limit of the professional relationship.) E then spent hours on the phone with almost everyone in the department, arguing the definition of healthy as being “free from disease” instead of fully vaccinated and not currently sick. He had the nurse send an email to every pedi in the practice (about 30 of them) to see if any of them would be willing to sign the forms. One, count ‘em, ONE doc was willing.

We got the forms signed, but the doc wasn’t one I’d like to be their regular doc. So today I must get Lou an appointment with a new doctor and interview him to see if he will be a good fit for our regular family pediatrician.

What do I want? I don’t think I’m asking all that much, to be honest. I want him to fulfill his role as a professional who gives me medical advice for my children, then ultimately lets me make the choice as the parent. I go to him for advice because he knows medicine better than I do, but I am the parent, I make the choice whether or not to follow the advice given. And I’m well aware that the American Academy of Pediatrics recommends fully vaccinating your child according to their schedule, but they’re recommending it, and that does not translate into coercion in my book. Ironically, the AAP also currently recommends breastfeeding your child at least until age 1 (a slim percentage of moms do), but I don’t see them forcing that on mothers. They also recommend no TV until the child is 2, but how many moms do that? Can you imagine the uproar if a pediatrician refused to be your family doc if you didn’t follow all of his advice to the letter? Can you imagine the uproar if pediatricians guilted and coerced and insulted those mothers who didn’t breastfeed until their child was 12 months? If they called Child Protective Services because your 18-month-old watched Sesame Street?

I think if you’re going to recommend full vaccination and recommend breastfeeding to age 2, you should heavily encourage them and educate parents on the pros and cons, but ultimately respect the parent’s right to choose for their child. Both have documented health benefits but both require risk or sacrifice that the parent must evaluate. Anything more than encouragement and education is overstepping the bounds of the professional relationship between doctor and patient.

Posted on October 11th, 2007 by Dove
Filed under: Kids, Learning, Rants