Clinic Concerns

Ratatosk

Administrator
Staff member
I've posted before on this site about how we get concerned with the local care our son receives. When he was born, we were fortunate that he had a bowel obstruction and had to be lifeflighted to a children's hospital in the city that is an accredited facility. During our 4 week stay we got to learn about cf, cpt, medications, etc. got to know members of the CF team, found a wonderful doctor. We've always been concerned about the care we receive at home. Orginally we were happy to hear that they had a CF team, CF clinic, but after attending a few times and comparing it to the facility in the city in terms, we became even more concerned -- community waiting room, more reactive that proactive -- won't go into details since I've said it all before...

Yesterday at the CF walk, my MIL, who is a nurse stayed behind to help and was suprised to see one of her former nursing students at the walk. Her son was one of the most recent newborns diagnosed from the newborn screening that our state started in January. The mom indicated that after reading the article about our family in the paper and the care we give DS -- CPT 3-4 times a day, nebs, etc. she became concerned about the lack of care they were receiving -- contacted the local respiratory care facility and asked that they teach her how to do CPT. They still don't do nebs. She asked my MIL and the CFF rep and a CFer from the City if maybe she should check out the CF center at U of MN. My MIL told her she needed to be more proactive in care for her son. Another new parent said that her son cultured staph in February, but the doctors at the local CF clinic said not to worry about it. They'll deal with it in JUNE!!! when she goes to CF clinic. They do CPT, but also no nebs. And just enzymes for meds.

Add to this the $790 bill we got for outpatient care at our last local CF clinic -- that doesn't include the $189 for each doctor (3), xrays, labs, dietician.... This was a 4 hour long appointment in which 2-3 hours was spent in an exam room. Money isn't really an issue when it comes to keeping our son healthy. But with our concerns about the local clinic, what we've just heard from two new parents -- we're ready to bail out of the local CF clinic. Originally we thought it was important to develop a rapport with the local "CF" doctors. But now we're torn.

We could continue to go to his peds doctor who is part of the CF team, we could try to find a new doctor within the same clinic system or there's another hospital/clinic facility in town and I've heard one of the primary care doctors in Family Practice has two sons wcf. We still go to our CF doctor in the City, but we need to have a local physician, since it's not feasible to run to Minneapolis (3 1/2 hour drive) for every little childhood illness.

We're thinking long an hard about this, just weighing our options. Tomorrow I have a regular appointment with my GYN and think I'll mention my concerns to him and see if he has some suggestions or can refer us to someone else.

Liza
 

Abby

New member
Liza,

We have just a regular pediatrician for my dd. When she is sick and I'm worried that it's cf related, I will usually call the cf clinic (almost 2 hours away) and let them know that I'm taking her to the ped. My ped. is great in that he always corresponds with the cf clinic, they send him updates on her visits, what meds she's on so he's never guessing or I forget to tell him about one. Anyway, if he believes the probelm is cf related, he will call the cf clinic and consult with them, they are always more than happy to help out this way. He deals with any other non cf related issues on his own though, like last week when she had pink eye and an ear infection. No real need to deal with the cf clinic for those issues, although we did tell them at our clinic visit a few days later.

DD is also the peds only cfer, so they try to schedule her visits when the healthy kids are there, like in the mornings when they do just well-baby visits and such. They try to see the sick patients only in the afternoon. We also sit in the waiting room for a very limited time before they have us in an exam room.

I don't know if that helps you at all. I would go with your instinct though, if you are uncomfortable with the current situation, then change doctors. They really shouldn't have a bunch of cfers in the same waiting room, same exam rooms, etc.
 

anonymous

New member
We took my kids last year from Texas to Univ. of Minn. to visit your clinic. It is excellent! My kids clinic here is very reactive when I want to be proactive. I plan on using both clinics, going to Minn once a year. I would definitely make the drive if I were you at least a few times a year!
Sharon, mom of Sophia, 4 and Jack, 2 both with cf (their picture is on the Great Strides brochure - can you tell I am proud of them?!)
 

anonymous

New member
Liza, you mentioned that the nursing student's son still doesn't do nebs. Now I'm a little concerned ... my daughter is 8 months old and receives regular care from our CF clinic. We've been in probably 10 - 12 times in these 8 months, and no one has ever mentioned nebs. Is that something that should be done for everyone, or is it prescribed for patients that have had issues that require it?

Ellie has never cultured anything, or had anything other than a common cold. Our clinic is accredited and highly thought of, and they have been extremely responsive to Ellie's care. The doctor that she sees is supposedly one of the best in the CF field, and everyone talks about him as if he is a genius. I would be surprised if there are treatments Ellie should be getting that they have not told me about, but I wanted to make sure.

Thank you!

-- Jenica
Mom to Abby (2, w/o CF) and Ellie (8 months, w/CF)
 

anonymous

New member
Our primary CF doctor in the city told us that cfers are born with normal lungs; however, with increased infections, the lungs get damaged, scarred... So it's important to keep the mucus moving, practice good lung care. We've been doing CPT with nebs 3-4 times a day since he was at least two weeks old. As far as using albuterol and atrovent or other bronchiodialators -- I think some clinics use inhalers instead, some feeling doing CPT is adequate.

I've always been uncomfortable with the local nonaccredited CF clinic -- got spoiled with the one in the city and was a little shocked with how different things are locally. I don't mind the drive to the city for regular appointments, and if DS gets an ear infection or I'm worried about something I can call there and get a response fairly quickly. With the local clinic we have concerns with the cross contamination issue and lately I can't help but think our time might be better spent going else where. It's stressful, it's a struggle dealing with some of the egos, having to call numerous times to get lab results...

I do like the regular peds doctor, but so often when we ask a question, he defers to the pulmonologist. We asked about swimming lessons last summer and were told to ask the pulmonologist, who discouraged it because of the potential for mold in the locker room. I just hate the idea of "burning our bridges so to speak".

Liza
 

wuffles

New member
Jenica - don't stress about the nebs for the time being. Many people with CF don't take regular nebulised treatments. I only take them when I have an infection flare-up. If you are concerned you can always ask your doctors about them and ask why they haven't recommended them for Ellie.
 

anonymous

New member
Thanks, Liza and Emma for the nebulizer info. I will definitely ask about it at Ellie's next appointment. We were just in last week and her next appointment isn't until beginning of July, so I might actually call in to the nurses line and just see what they say. Our doctor, like I mentioned before, is supposedly just a genius, but I find that I relate a lot better to our nurse, and have a better rapport with her.

Thanks again!

-- Jenica
Mom to Abby (2, w/o CF) and Ellie (8 months, w/CF)
 
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