1. See next toddler with flu-like symptoms.
2. Try to figure out if the mom will only be satisfied by a flu test.
2a. If no, she just wants my opinion:
-It’s swine flu
-Discharge home
-Diagnosis: Swine flu, clinical
-Treatment: Motrin and tylenol; no one has any liquid tamiflu and it’s too expensive anyway
2b. If yes, I don’t care about your opinion I want a test go to 3.
3. Test for flu
3a. If negative:
-Good news! It’s not swine flu! It’s some other virus.
-Discharge home
-Diagnosis: Swine flu, test false negative
-Treatment: Motrin and tylenol; no one has any liquid tamiflu and it’s too expensive anyway
3b. If positive:
-Good news! We know what’s wrong. It’s swine flu.
-Discharge home
-Diagnosis: Swine flu, I mean it was proven by a test
-Treatment: Motrin and tylenol; no one has any liquid tamiflu and it’s too expensive anyway
4. Go to 1.
October 4, 2009 at 6:25 am
Ahhhh…….
October 4, 2009 at 6:59 am
Why aren’t you figuring out the healthcare reform mess for the folks in Washington?
October 4, 2009 at 10:22 am
And there’s your cost savings analysis for the health care reform debate!! Love it!
(Hope you’re feeling better, by the way – I thoroughly enjoy your blog!)
October 4, 2009 at 12:27 pm
Okay, but if it is swine flu and the mom is pregnant…then what?
October 4, 2009 at 9:48 pm
An emergency room physician was elected governor of Oregon a while back. I was optimistic that he might go on to higher office and cure all that ails us, but I think he discovered most of us are too ill.
October 5, 2009 at 4:31 am
There is some interesting data suggesting that keeping your vitamin D level optimal will prevent colds, flu and in particular H1N1 (swine Flu). The Canadians are taking the data very seriously and starting studies to see if Vitamin D can prevent Flu
Here are links to two interesting articles:
August 2009-Vitamin D3 deficiency and its role in influenza
http://archive.constantcontact.com/fs026/1102452079631/archive/1102685428884.html
Sept 2009-More on Vitamin D3 and influenza
http://archive.constantcontact.com/fs026/1102452079631/archive/1102728693089.html
If these links don’t work you can go to http://www.vitaminD3world.com and click on ‘In the news” to find the articles.
October 5, 2009 at 5:00 am
Hey all! I got very important site which contains all about Swine Flue. Check it.
http://doctoruncle.blogspot.com/2009/08/h1n1-flu-swine-flu.html
October 5, 2009 at 2:12 pm
#6
I realize this blog is not medical advice, and I am not using this blog (and the associated comments) as medical advice for me and I will not sue you for malpractice.
However, my personal physician has prescribed Vitamin D supplements and is testing my levels fairly regularly. Either he is on the same nut train as you or I have a really good HMO and doctor. I prefer to believe the latter for the placebo effect if nothing else.
October 5, 2009 at 3:50 pm
Very nice indeed!
Kinda like using the Nexus to r/o c-spine injuries, BUT….wait for it, they still want an xray even though you just explained to them until you’re blue in the face that there is no clinical indication for it…!
October 5, 2009 at 10:30 pm
Pharmacists compound oseltamavir suspension all the time. The concentration is different 15 mg/ml vs commercially unavailable product 12 mg/ml. The package insert for the capsules even tells the pharmacist how to compound it. If pharmacies say they don’t have it, they’re just being lazy.
October 7, 2009 at 3:13 pm
Didn’t know that, thanks.
November 18, 2009 at 8:27 am
aaw so sorry for ya!!! i was just surfin on the web and found this page hope you feel better!!!
October 6, 2009 at 12:43 pm
Hi 10/10.. please, please write smth .. I just cannot wait
. Bye-bye!!
It’s so much fun to read your stories. Especially in the middle of all this pathophysiology and pharmacology I’m forced to study at the moment.
Thanks a lot anyway
October 7, 2009 at 10:59 am
What about the mom that comes in with the mandatory flu test form that needs to be filled in before the kid can return to school?
October 9, 2009 at 3:41 am
ERP,
From my point of view, whoever wrote that letter or whomever is providing it is practicing medicine without a license.
October 9, 2009 at 6:57 pm
I just tell people that the flu test isn’t a good one (it’s somewhere between 10-70% sensitive according to the CDC’s site) and that even if it’s negative it doesn’t mean they don’t have the flu (and that they probably have the flu). Oh, and the test will require shoving a big q-tip up their nose and will be painful and will cost money and will take an hour. And it doesn’t matter anyway because this is a virus and you’ll get better on your own. And, finally, that I will give them a work/school note whether we do a flu test or not. Usually, that’s good enough for them.
October 12, 2009 at 8:41 pm
here in Dallas one of our pharmacies is compounding liquid Tamiflu for children. It’s an independent – not one of the big chains.
October 14, 2009 at 7:07 pm
Compounding Tamiflu is a pain in the ass, but I work for the largest chain in America, and we are going through compounded Tamiflu like mad…we have to call you to get authorization to change the Rx to the compounded form, or you can write on the Rx “pharmacist may compound” to avoid the call.
October 15, 2009 at 9:05 am
First there was a shortage of Tamiflu – now there is a shortage of some of the vehicles to compound the Tamiflu. I’m on my last 3 bottles of the liquid suspender/sweetener.
So – did Wags buy up all of it? They should have bought more vaccine instead. They’ve run out & we’re still immunizing.
Crazyeee (as Nurse K would say) fall for sure!
October 30, 2009 at 2:55 am
hi there, just my 2cents for giving tamiflu to small kids. My 2 year old daughter was diagnosed with swine flue (we live in africa) and not having the liquid form i had to divide the capsule powder in 4/4…i put the powder in a tea spoon diluted by water and straight after she had it i shoved a big spoon of Nutella in her mouth to take the yuck taste away. it worked really well! hope this helps others . I passed the sggestion to ur doctors and i know that many other moms used my suggestion and it works)(Nutela contains nuts so not got for nuts allergy!!)