You may know my 6 year old son has a heart condition requiring him to take medication 3 times per day for the past 6 years. As a registered nurse and mother, I have learned some valuable lessons when seeking medical care for his SupraVentricular Tachycardia (SVT).
This past month, I realized the Beta-Blocker he was on since 6 months old was no longer working for him. Designed to prevent his heart rate from going much above 200, his medication normally kept his heart beating around 230 when he had an episode of SVT… until… this last episode. The heart rate monitor read 280 and my son who normally remains unaffected (and calm) and is able to convert out of the fast rhythm grabbed his chest and moaned, “Oh my heart!”
He eventually converted back to 115 and we both breathed normal again.
Time for another visit to the pediatric cardiologist.
The medical assistant was new and recorded his weight on the hallway scale.
Because his weight literally determines the dosage of his medication, it is important for this to be recorded correctly.
I knew he had just gone through a growth spurt, so I asked what his weight was. The MA looked down at the chart and replied, “76 lbs.”
My heart skipped a beat.
I asked her to repeat the weight because in fact he only weighed 56 lbs. Somewhat annoyed, she returned him to the scale, redid the weight, and sheepishly said, “Oops – this thing wasn’t over all the way” as she scribbled over the 76 and replaced it with a “56″.
Listen. Ask. Take Notes. Advocate.
20 pounds is a BIG deal when the child weighs only 56 pounds! That is almost half of his weight in error.
She then asked me about his medication and I told her the name of the medication and that he took 2 of the 10mg tablets in the morning, 2 in the afternoon, and 2 at night. She looked up from the chart and confirmed, “So he takes 6?” Well… in medical terms – no. He takes 2,2,2. NOT 6. However, I assumed she was writing the correct thing.
The cardiologist walked into the room, sat down, opened the chart and alarmingly asked, “Please tell me you are not giving him 6 tablets at one time!”
When I confirmed I was NOT giving him a dose of 6 tablets (which would probably kill him), he scribbled out what she had written.
Wow -
In today’s world of medicine, it is ultra important that we have advocates attend appointments and hospital stays at our side.
- Medical staff are busy and distracted.
- Medical staff are only as good as the people who report to them. An error at the basic level can lead to a fatal error at the top.
- Knowing the basics of weight (in kilograms is best), medication dosages, medical issues and allergies can literally save a loved ones life.
- Listen and ask questions.
When my tiny infant son was only 6 months old, his heart beat at 306 beats per minute in the Intensive Care Unit. Unable to get his heart to convert to a normal rhythm, they started an IV to administer the heart-stopping (literally) drug of Adenosine. The drug stops the heart and restarts it (hopefully) into a regular rhythm. I have had more than one colleague tell me they were never comfortable giving that drug. Patients who have received Adenosine will tell you it is a feeling of doom and one you will never forget as your heart stops. My friend’s nephew needed to be resuscitated when he was given too much Adenosine.
So imagine my horror to hear the nurse turn to the other and quietly say, “Have you ever given Adenosine?” When the nurse shook her head, instructions were quietly given to push the drug FAST.
I will NEVER forget that moment. It haunts me. It is what makes me an involved parent.
I ask my pediatric cardiologist every visit what the appropriate dose of Adenosine is for my son’s weight. I write it down and carry the dosing chart with me. He often replies, “Oh Anya, the ER staff will know what to do and what to give.”
No, I disagree.
In an ideal world we could blindly rely on the medical community to do the right thing at the right time with the correct calculations to fit our health history, weight, and age. But in my first-hand experience I have witnessed too much both as a busy hospital nurse and as a parent to blindly trust.
I was reminded of all this today when writing a post on why pre-travel consultations are important with a travel health specialist. How powerful is it to know the proper procedure for rabies bites? What if the proper procedure wasn’t being done due to a shortage of supplies in the area? Will you trust your health blindly to others who may not even speak your language?
It is true that in many cases, we must trust the medical system. But understanding basic knowledge has the potential to save a life. Protect your family’s health. Pay attention, ask questions and don’t ever stop being an advocate for a loved one.
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