Thursday, December 22, 2011

New Pulmonologist

Today I took Dean to a new pulmonologist at the VCU Medical Center, Dr. H. Joel Schmidt. He was recommended by a local mom, and after our last experience with Dr. Yu at UVa, it was time for a change. We waited for a long time in the exam room after a very prompt check-in. As you probably know, doctors' offices aren't always known for being on time, and our experiences with specialists have been all over the place as far as timeliness goes. After over an hour, I peeked my head out into the hallway and asked a nurse if she knew how much longer we could expect to wait. She was amazed that we hadn't been seen yet and turns out that we'd been forgotten! Two different doctors each thought the other had seen us. I was mad, but amazingly not too much so, and the staff was all very apologetic about the wait. The nurse said that we should never have to wait more than 20 minutes - I told her I agreed! I'm just going to start asking now, because this is not the first time we've been overlooked somewhere. I know, it happens.

Anyway, Dr. Schmidt was great. He was very kind, worked well with Dean, really listened to me and was willing to defer to any docs like Dr. Miller or her pulmonologist, Dr. Wagner, who were more familiar with PWS. He thought we absolutely did the right thing by going for the tonsil/adenoid surgery and was also not satisfied with Dr. Yu's recommendation just to go on oxygen at night and not try to find more answers. Obviously, he was thrilled to hear that Dean has not been needing oxygen since the surgery (other than when he was sick)!

Dr. Schmidt basically agreed with the plan that our pediatrician gave for Dean both to manage and prevent respiratory illness. He revised the plan a bit and we're going to see him again in 3-4 months after Dean has his sleep study and visit with the folks in Florida (we're going at the end of January). So, the plan is:

-Continue with daily inhaled steroids (currently using fluticasone)
-Continue with daily pulmicort via nebulizer (which Dean will now do with the mask on. Woot!)
-At the very first signs of sickness (this was humorous - he said, "I don't know how you mothers know that your kids are sick so early on, but you just do. Do their eyelashes curl a different way or something? What's the secret?" :)), give albuterol *at least* 4 times a day, up to every 4 hours if needed. He gave us a spacer to use with an inhaler to cut down on the time it takes, since albuterol in the nebulizer takes about 20 minutes each time.
-When Dean is sick, increase pulmicort to *at least* 3 times a day

So nice to have a plan, a doctor who is interested in *preventing* and not just treating illness, and he is kind, humble, and knowledgeable to boot! Three cheers for Dr. Schmidt!

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