Thursday, November 3, 2011

Drugs Are Bad, Mmmkay?

Jack has an upper respiratory infection and a double ear infection.  On his post-visit summary, it said he could have Tylenol and Ibuprofen for pain and fever, and Robitussin or Robitussin-DM for his cough.  Awesome.  Except they didn't list any of the doses.  I asked for the Tylenol and Ibuprofen doses at the beginning of the visit, because he breached 20 pounds and I thought that was the level where they went up.  But I hadn't thought to ask for Robitussin.  The doctor didn't mention it.

So I did what I've always done since they took the doses off of the packages - I called the pharmacy.  "I'm sorry, Ma'am," she said, "I can't give out dosing information anymore."


I'm lucky to have insurance and to go to doctors who are part of a large network in my town - so I know that I can call the main number after business hours and talk to the on-call pediatrician.  I wonder what the 50 million Americans who don't have health insurance are supposed to do for their sick kids?  Guess?  How is that keeping children safe??

And I have had to wait up to an hour for a call back from the on-call doctor.  Time flies when you're having fun, but time slows to a snail's pace when you've got a sick screaming baby in the middle of the night.

Sure, I could do the math - 20 pounds of kid, X mg per pound, Y mg per teaspoon.  So you multiply 20 by X to get the amount they need, and divide that number by Y to get the number of teaspoons (or the fraction of teaspoons).  Right?  I get it.  But a frazzled parent with a screaming sick baby should not be forced to do algebra in the middle of the night.

I could also Google, but I don't think it's a very bright idea to trust my kids' livers to Dr. Google, do you?

I've heard various reasons why the dosing information has disappeared.  One explanation is that it's to prevent overdose.  I don't understand this logic at all.  "A bunch of parents gave their kids too much of this medicine, so rather than tell you how much is safe, we're going to make you guess/call around and wait up to an hour for an answer/do algebra."  Um, or you could tell me the safe amount, because I am a good parent, and the parents who suck are going to overdose their kid whether it's on the package or not.

I think the real reason is liability, and that seriously pisses me off.  Kids are suffering because companies don't want to risk getting sued when some moron with a 6th grade education misreads the label and gives her kid 1/4 cup instead of a 1/4 teaspoon.  The problem with our society is that somehow the drug manufacturer is liable for stupid parents' mistakes.

Look, kids get sick.  And my philosophy on medication has always been, "If I'd take medicine (Tylenol, etc.) for something similar (toothache, cold, etc.) then I'm going to give it to my baby if s/he has the same thing!"  I never had any plans to keep their bodies pure and free of medicine.  Medicine, when used properly, is an amazing benefit to being a modern parent.  Can you imagine what it must have been like for parents 100 years ago, before they had fever reducers, to watch their kids suffer and not be able to do anything for them?  Horrible!  I've heard parents of school aged kids say, proudly, "Oh, little Snowflake has never had any medication in his little life!"  Guess what, sister, there's no medal for that when your kid reaches age 18, and to me it sounds like little Snowflake has spent a lot of time needlessly suffering.

While we're overhauling this system, let's standardize the doses, ok?  If Jack gets 1/4 tsp of Robitussin, he should also take 1/4 tsp of Benadryl, 1/4 tsp of Tylenol, and 1/4 tsp of Ibuprofen.  And let's lose the whole tsp/ml/cc thing.  Pick one.  Stick to it.  For Pete's sake.  Better yet, let's make it by age - 1 cc for one year olds, 2 ccs for 2 year olds, 3 ccs for 3 year olds!  Or 1 tsp, I don't care, just pick one and be done with the conversions.

We've got to deal with this dosing stuff, because it's a real problem.  I have three kids.  I may be able to remember song lyrics to songs I haven't heard in 15 years, but I can't keep the doses for everything straight for all three kids.  Especially when they're constantly changing as the kids grow.  And if the currently available decongestants aren't safe for kids under 6, could someone please develop some that are safe?  Preferably today, if possible?


Kathryn said...

Next time call me! I have an excellent drug manual at my fingertips and I know how to calculate all that dosage info. I even know how to calculate the max safe dose for infants and children. Please do call me! Don't wait an hour while you all suffer.

-cousin Kelly posting under my mom's ID since you took off anonymous posting and I can't get my account to work..ugh

Anonymous said...

Evernote. I put all dosages for all meds into Evernote (with the age range acceptable if known). I <3 Evernote almost as much as I <3 Google.