jenn- Posted February 23, 2015 Share Posted February 23, 2015 My youngest was diagnosed with Flu B on Friday by his pediatrician. We normally say no to Tamiflu, but the strain going around has 104-105 degree fevers, so I got it for him. It worked really well on this strain and he was hard to contain in confinement by Saturday. He shares a room with his brothers so Sunday one woke up with it, and this morning my other boy woke up with it. I tried to get the pediatrician to just call in some Tamiflu for them, but he will only call in a half dose prophylactic amount unless they come in and get a positive flu test. That's another $85 just to confirm the flu before paying for the Tamiflu. My DH think this is insane to have to go into the office as our old dr would have just called it in for the other kids. He has always been a very conservative, making us come in when the other guy wouldn't have. So... In this situation, would your doctor require an office visit for each family member when one has already had a positive flu test? Would you expect them to call it in? Quote Link to comment Share on other sites More sharing options...
TammyinTN Posted February 23, 2015 Share Posted February 23, 2015 I use to work for a pediatrician and when there were several kids in the house and someone else got it..he would just call in a script or sometimes just give the mom a paper script to use if it happened. He was an older Peds and very mellow. Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted February 23, 2015 Share Posted February 23, 2015 Our dr would probably just call it in for us. Quote Link to comment Share on other sites More sharing options...
Daria Posted February 23, 2015 Share Posted February 23, 2015 Is this a new pediatrician? I found for my pediatrician, for my medically needy kid, it took time for us to form a relationship and get to the point where they'd trust me enough to provide medication in a situation like that. The reality is that it's risky for a doctor to provide prescription medication without knowing that it's going to the right patient, and that it's the right diagnosis. If they don't know you from Adam, they don't know that you're describing symptoms accurately, or that you aren't really claiming your kid is sick so that you can sell the meds to someone else. Quote Link to comment Share on other sites More sharing options...
Harriet Vane Posted February 23, 2015 Share Posted February 23, 2015 Tamiflu is a "big gun" medically speaking. It's not like he's prescribing a little amoxicillin. I think the doctor's position on this is reasonable. That said, $85? Can you just get the test without seeing the doctor?? Quote Link to comment Share on other sites More sharing options...
fairfarmhand Posted February 23, 2015 Share Posted February 23, 2015 ITA about the dr/patient relationship Can you just go in and get the kid swabbed without seeing the dr? Quote Link to comment Share on other sites More sharing options...
Kathryn Posted February 23, 2015 Share Posted February 23, 2015 We haven't encountered this, but I have many, many friends who've succumbed to the flu this year who see all sorts of different pediatricians and doctors. ALL of them were offered Tamiflu prescriptions for the entire family when one member got ill. Quote Link to comment Share on other sites More sharing options...
jenn- Posted February 23, 2015 Author Share Posted February 23, 2015 Tamiflu is a "big gun" medically speaking. It's not like he's prescribing a little amoxicillin. I think the doctor's position on this is reasonable. That said, $85? Can you just get the test without seeing the doctor?? The $85 is 2 dr copays and two lab fees. And no, he won't do that. He will want to listen to lungs at bare minimum. Is this a new pediatrician? I found for my pediatrician, for my medically needy kid, it took time for us to form a relationship and get to the point where they'd trust me enough to provide medication in a situation like that. The reality is that it's risky for a doctor to provide prescription medication without knowing that it's going to the right patient, and that it's the right diagnosis. If they don't know you from Adam, they don't know that you're describing symptoms accurately, or that you aren't really claiming your kid is sick so that you can sell the meds to someone else. We've been with the practice for 2 or 3 years now, but we are not a sick family so we do not see him often. I do appreciate his caution at times (we would have missed oldest boy child's LD if it wasn't for his insisting on testing before ADD treatments), but kid with flu+ 2 with high fevers= they got the flu. We haven't encountered this, but I have many, many friends who've succumbed to the flu this year who see all sorts of different pediatricians and doctors. ALL of them were offered Tamiflu prescriptions for the entire family when one member got ill. And that is what our old guy would have done. Why did he have to change from family practice to ER :crying: Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted February 23, 2015 Share Posted February 23, 2015 yes - they'd 'make them come in for a positive test. that said, in January, dd's fiancé had strep. she was sick at the same time, with a sore throat. she had both the quick strep test, and a culture. she was negative. two more of us came down with sore throats - I ended up with both a quick strep and a flu test. both negative. Quote Link to comment Share on other sites More sharing options...
Joker Posted February 23, 2015 Share Posted February 23, 2015 Our doctors actually write a script for everyone in the family when one of us has tested positive for the flu. We can either decide to either take it as a preventative or wait until we are sick. Quote Link to comment Share on other sites More sharing options...
Alice Posted February 23, 2015 Share Posted February 23, 2015 We haven't encountered this, but I have many, many friends who've succumbed to the flu this year who see all sorts of different pediatricians and doctors. ALL of them were offered Tamiflu prescriptions for the entire family when one member got ill. They were probably offered Tamiflu prophylaxis rather than a treatment dose for the other family members. They are different dose amounts and lengths of treatment. A lot of doctors will offer prophylaxis to everyone in a family, others will only offer it to high-risk members of a family or if one family member is high-risk. That's different than calling in a treatment dose for other members of the family. I'm a pediatrician. I would most likely make you come in and get swabbed. I can see both sides of the coin though and realize it's a pain for people to come in with sick kids, especially when they know what it likely is. The reasons are both medical and legal. From a medical standpoint, it's most likely flu but not necessarily flu or not necessarily just flu. We've all gotten burned with a patient who we assumed had one illness but really had another....the kid who the parents swore had to have strep because brother had it and the symptoms were the ones he always had with strep. Then we call in an antibiotic, kid doesn't get better at all and has a horrible allergic reaction to the antibiotic. I've seen that happen. In general, we like to know as much for certain as we can that we are prescribing a medication appropriately. Tamiflu has a whole bunch of potential side effects, some are just annoying, some are more troublesome. No one wants to prescribe it unless it's truly needed. The other issue is that we want to make sure that the patient isn't sicker...secondary bacterial pneumonia is fairly common with flu, a lot of kids wheeze with flu...we want to make sure that we are fully treating the patient. From a legal perspective, we are in a much more precarious position if we call something in without seeing a patient. "Doctor, did you listen to Billy's lungs?" "No! You just called in Tamiflu?" "You didn't realize the patient had pneumonia? If you had seen the patient might you have prescribed an antibiotic also and prevented his eventual admission to the ICU?" "You prescibed Tamiflu and the patient had seizures. Did you test for flu?" "No! Why not? Do you even KNOW that the patient had flu? NO! "Etc. It seems ridiculous and yet the reality is we work in a litigious society and are always at least somewhat aware of how our actions and decisions would look to a jury. The patient-doctor relationship does make me more comfortable calling something in. Both because I will know the patient and because I am less worried about the legal aspects. Quote Link to comment Share on other sites More sharing options...
SparklyUnicorn Posted February 23, 2015 Share Posted February 23, 2015 No clue. I wouldn't even go to the doctor for flu unless there were complications or extreme symptoms. And I'm with you. Given you had one test positive for flu it is ridiculous to make you come in with sick kids. Quote Link to comment Share on other sites More sharing options...
Joker Posted February 23, 2015 Share Posted February 23, 2015 They were probably offered Tamiflu prophylaxis rather than a treatment dose for the other family members. They are different dose amounts and lengths of treatment. A lot of doctors will offer prophylaxis to everyone in a family, others will only offer it to high-risk members of a family or if one family member is high-risk. That's different than calling in a treatment dose for other members of the family. I'm a pediatrician. I would most likely make you come in and get swabbed. I can see both sides of the coin though and realize it's a pain for people to come in with sick kids, especially when they know what it likely is. The reasons are both medical and legal. From a medical standpoint, it's most likely flu but not necessarily flu or not necessarily just flu. We've all gotten burned with a patient who we assumed had one illness but really had another....the kid who the parents swore had to have strep because brother had it and the symptoms were the ones he always had with strep. Then we call in an antibiotic, kid doesn't get better at all and has a horrible allergic reaction to the antibiotic. I've seen that happen. In general, we like to know as much for certain as we can that we are prescribing a medication appropriately. Tamiflu has a whole bunch of potential side effects, some are just annoying, some are more troublesome. No one wants to prescribe it unless it's truly needed. The other issue is that we want to make sure that the patient isn't sicker...secondary bacterial pneumonia is fairly common with flu, a lot of kids wheeze with flu...we want to make sure that we are fully treating the patient. From a legal perspective, we are in a much more precarious position if we call something in without seeing a patient. "Doctor, did you listen to Billy's lungs?" "No! You just called in Tamiflu?" "You didn't realize the patient had pneumonia? If you had seen the patient might you have prescribed an antibiotic also and prevented his eventual admission to the ICU?" "You prescibed Tamiflu and the patient had seizures. Did you test for flu?" "No! Why not? Do you even KNOW that the patient had flu? NO! "Etc. It seems ridiculous and yet the reality is we work in a litigious society and are always at least somewhat aware of how our actions and decisions would look to a jury. The patient-doctor relationship does make me more comfortable calling something in. Both because I will know the patient and because I am less worried about the legal aspects. Ours have always been the exact same medicine. Same dosage and length. Same prescription, just times four. I'm so grateful because we've all needed it twice. Quote Link to comment Share on other sites More sharing options...
SparklyUnicorn Posted February 23, 2015 Share Posted February 23, 2015 Our doctors actually write a script for everyone in the family when one of us has tested positive for the flu. We can either decide to either take it as a preventative or wait until we are sick. Now that's an awesome doctor! Quote Link to comment Share on other sites More sharing options...
jenn- Posted February 23, 2015 Author Share Posted February 23, 2015 They were probably offered Tamiflu prophylaxis rather than a treatment dose for the other family members. They are different dose amounts and lengths of treatment. A lot of doctors will offer prophylaxis to everyone in a family, others will only offer it to high-risk members of a family or if one family member is high-risk. That's different than calling in a treatment dose for other members of the family. The reasons are both medical and legal. I hate the cost, but this is what I tell my DH. I think we are just spoiled from the other guy who was our dr for over 10 yrs. How fast does a positive show up? One twin had a rising temp this morning so I gave him Tylenol, and now he has perked up. He isn't presenting as extreme as his brothers did. No clue. I wouldn't even go to the doctor for flu unless there were complications or extreme symptoms. And I'm with you. Given you had one test positive for flu it is ridiculous to make you come in with sick kids. Normally, I'm with you about going with the flu. I am going to get him to give my daughter a preventative dose as she has two important things coming up this weekend and next. Then we are going to cross our fingers. My younger twin has a weak stomach and if we can't keep his temps down, he's throwing up. The older twin has some breathing issues that only really bother him when he is sick, and right now his temps won't come down with the fever reducing meds. Quote Link to comment Share on other sites More sharing options...
Pippen Posted February 23, 2015 Share Posted February 23, 2015 Our pediatrician would require a positive test. Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted February 23, 2015 Share Posted February 23, 2015 My youngest was diagnosed with Flu B on Friday by his pediatrician. We normally say no to Tamiflu, but the strain going around has 104-105 degree fevers, so I got it for him. It worked really well on this strain and he was hard to contain in confinement by Saturday. He shares a room with his brothers so Sunday one woke up with it, and this morning my other boy woke up with it. I tried to get the pediatrician to just call in some Tamiflu for them, but he will only call in a half dose prophylactic amount unless they come in and get a positive flu test. That's another $85 just to confirm the flu before paying for the Tamiflu. My DH think this is insane to have to go into the office as our old dr would have just called it in for the other kids. He has always been a very conservative, making us come in when the other guy wouldn't have. So... In this situation, would your doctor require an office visit for each family member when one has already had a positive flu test? Would you expect them to call it in? Yeah, that is idiotic. The only time I needed this, the doctor (my long term doc too, a family doctor; the more I read, the more thrilled I am that we never used a ped) was happy to call it in for the next one. Your husband is right. They used to be able to operate on common sense, but today, so many of them can't do ANYTHING unless a lab test confirms whatever it is. They can look straight at a desperately ill person and say, "The lab test says you are fine." I got this same stupid runaround recently on a different issue. "Come back and pay us a whopping amount again to confirm what we all already actually know". Nope. I just went somewhere else, and actually got some service and some common sense. Find someone like that - a local clinic, maybe? Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted February 23, 2015 Share Posted February 23, 2015 Our doctors actually write a script for everyone in the family when one of us has tested positive for the flu. We can either decide to either take it as a preventative or wait until we are sick. That is perfect. But this assumes that the doctor trusts you to use common sense. It used to be normal (I'm old) but so few remember normal. Quote Link to comment Share on other sites More sharing options...
jenn- Posted February 23, 2015 Author Share Posted February 23, 2015 And the big shocker is... They have the flu. Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted February 23, 2015 Share Posted February 23, 2015 And the big shocker is... They have the flu. I'm astonished. No way. ;) Quote Link to comment Share on other sites More sharing options...
bibiche Posted February 23, 2015 Share Posted February 23, 2015 And the big shocker is... They have the flu. Better safe than sorry, though. Especially for a little one with breathing issues to begin with. FWIW, my ped wouldn't have called it in either and I am glad of it because it demonstrates to me that she is extremely thorough. Wishing your family a speedy recovery all around. Quote Link to comment Share on other sites More sharing options...
jenn- Posted February 23, 2015 Author Share Posted February 23, 2015 Well the rest of us are waving the white flag and we each had our respective doctors (one being the pedi) call in a preventive dose of Tamiflu. He was willing to do that as long as she wasn't showing symptoms yet. I will say that when the youngest went in, the doctor was amazed at how good his lungs sounded. Today, the older two boys sounded like cr@p in them. Quote Link to comment Share on other sites More sharing options...
kitten18 Posted February 23, 2015 Share Posted February 23, 2015 They were probably offered Tamiflu prophylaxis rather than a treatment dose for the other family members. They are different dose amounts and lengths of treatment. A lot of doctors will offer prophylaxis to everyone in a family, others will only offer it to high-risk members of a family or if one family member is high-risk. That's different than calling in a treatment dose for other members of the family. I'm a pediatrician. I would most likely make you come in and get swabbed. I can see both sides of the coin though and realize it's a pain for people to come in with sick kids, especially when they know what it likely is. The reasons are both medical and legal. From a medical standpoint, it's most likely flu but not necessarily flu or not necessarily just flu. We've all gotten burned with a patient who we assumed had one illness but really had another....the kid who the parents swore had to have strep because brother had it and the symptoms were the ones he always had with strep. Then we call in an antibiotic, kid doesn't get better at all and has a horrible allergic reaction to the antibiotic. I've seen that happen. In general, we like to know as much for certain as we can that we are prescribing a medication appropriately. Tamiflu has a whole bunch of potential side effects, some are just annoying, some are more troublesome. No one wants to prescribe it unless it's truly needed. The other issue is that we want to make sure that the patient isn't sicker...secondary bacterial pneumonia is fairly common with flu, a lot of kids wheeze with flu...we want to make sure that we are fully treating the patient. From a legal perspective, we are in a much more precarious position if we call something in without seeing a patient. "Doctor, did you listen to Billy's lungs?" "No! You just called in Tamiflu?" "You didn't realize the patient had pneumonia? If you had seen the patient might you have prescribed an antibiotic also and prevented his eventual admission to the ICU?" "You prescibed Tamiflu and the patient had seizures. Did you test for flu?" "No! Why not? Do you even KNOW that the patient had flu? NO! "Etc. It seems ridiculous and yet the reality is we work in a litigious society and are always at least somewhat aware of how our actions and decisions would look to a jury. The patient-doctor relationship does make me more comfortable calling something in. Both because I will know the patient and because I am less worried about the legal aspects. This all makes perfect sense. Thanks for chiming in Alice. :) Quote Link to comment Share on other sites More sharing options...
Tap Posted February 23, 2015 Share Posted February 23, 2015 I work in pharmacy and I would never expect a doctor to write a prescription for a strong medication like Tamiflu without seeing the patient first. There are too many other complications that come along with cough/cold/illnesses that need to be looked at before such a strong medication with known side effects is prescribed. I feel that the doctor was doing a good job by not just randomly prescribing it. In my pharmacy, not one of us employees would even take Tamiflu for an uncomplicated bout of flu. No pharmacist I have talked to would recommend a patient to ask a doctor for a script, unless there was a very specific reason for it. Like a person who travels for work or someone who has an immune compromised person at home. Quote Link to comment Share on other sites More sharing options...
Cera Posted February 24, 2015 Share Posted February 24, 2015 Our doctor calls in tamiflu for anyone else in the family with symptoms if there is one member with a positive flu test. Quote Link to comment Share on other sites More sharing options...
Gentlemommy Posted February 24, 2015 Share Posted February 24, 2015 They were probably offered Tamiflu prophylaxis rather than a treatment dose for the other family members. They are different dose amounts and lengths of treatment. A lot of doctors will offer prophylaxis to everyone in a family, others will only offer it to high-risk members of a family or if one family member is high-risk. That's different than calling in a treatment dose for other members of the family. I'm a pediatrician. I would most likely make you come in and get swabbed. I can see both sides of the coin though and realize it's a pain for people to come in with sick kids, especially when they know what it likely is. The reasons are both medical and legal. From a medical standpoint, it's most likely flu but not necessarily flu or not necessarily just flu. We've all gotten burned with a patient who we assumed had one illness but really had another....the kid who the parents swore had to have strep because brother had it and the symptoms were the ones he always had with strep. Then we call in an antibiotic, kid doesn't get better at all and has a horrible allergic reaction to the antibiotic. I've seen that happen. In general, we like to know as much for certain as we can that we are prescribing a medication appropriately. Tamiflu has a whole bunch of potential side effects, some are just annoying, some are more troublesome. No one wants to prescribe it unless it's truly needed. The other issue is that we want to make sure that the patient isn't sicker...secondary bacterial pneumonia is fairly common with flu, a lot of kids wheeze with flu...we want to make sure that we are fully treating the patient. From a legal perspective, we are in a much more precarious position if we call something in without seeing a patient. "Doctor, did you listen to Billy's lungs?" "No! You just called in Tamiflu?" "You didn't realize the patient had pneumonia? If you had seen the patient might you have prescribed an antibiotic also and prevented his eventual admission to the ICU?" "You prescibed Tamiflu and the patient had seizures. Did you test for flu?" "No! Why not? Do you even KNOW that the patient had flu? NO! "Etc. It seems ridiculous and yet the reality is we work in a litigious society and are always at least somewhat aware of how our actions and decisions would look to a jury. The patient-doctor relationship does make me more comfortable calling something in. Both because I will know the patient and because I am less worried about the legal aspects. Totally agree with practicing medicine this way. It's a PITA to bring sick kids to the office, but I would rather be safe than sorry when giving my children any medication. Quote Link to comment Share on other sites More sharing options...
plansrme Posted February 24, 2015 Share Posted February 24, 2015 He may have changed his policy, but last time we went to him with flu, our ped would not even prescribe Tamiflu. His advice was, "Get over it." We learned to go to the after-hours or drugstore clinic with flu symptoms. And he wonders why we only show up in his office every three or four years. Quote Link to comment Share on other sites More sharing options...
Ali in OR Posted February 24, 2015 Share Posted February 24, 2015 I'm sorry you are dealing with flu. This is a rough winter for that. Since you mention breathing problems, I just want to add that there seems to be a lot of secondary pneumonia after this flu, at least around here. Just be on the alert for it. My dd had flu then pneumonia (I had bronchitis then pneumonia--it's possible my bronchitis was a flu virus), neighbor/friend's teenager also got pneumonia after the flu, and I hear it's been running through dd's school too. For dd, the signs to go in to check for pneumonia were increased coughing, especially at bedtime, and the fever wouldn't go away--6 days of fever. For me it was shortness of breath and fever when I hadn't had any with the bronchitis. For both of us, fever was gone after 1 day of antibiotics and we were then on the (longish) road to recovery. Hopefully you'll be spared the complications and be done with the flu in a few days. Oh, and we kept our other dds healthy by keeping them separated from sick dd--moved a mattress to the living room for the one who shares a room with the sickie. Quote Link to comment Share on other sites More sharing options...
jenn- Posted February 24, 2015 Author Share Posted February 24, 2015 I'm sorry you are dealing with flu. This is a rough winter for that. Since you mention breathing problems, I just want to add that there seems to be a lot of secondary pneumonia after this flu, at least around here. Just be on the alert for it. My dd had flu then pneumonia (I had bronchitis then pneumonia--it's possible my bronchitis was a flu virus), neighbor/friend's teenager also got pneumonia after the flu, and I hear it's been running through dd's school too. For dd, the signs to go in to check for pneumonia were increased coughing, especially at bedtime, and the fever wouldn't go away--6 days of fever. For me it was shortness of breath and fever when I hadn't had any with the bronchitis. For both of us, fever was gone after 1 day of antibiotics and we were then on the (longish) road to recovery. Hopefully you'll be spared the complications and be done with the flu in a few days. Oh, and we kept our other dds healthy by keeping them separated from sick dd--moved a mattress to the living room for the one who shares a room with the sickie. My DH and I are presenting more like bronchitis. Neither of us have fevers, but I do have the exhaustion thing going on today. I will definitely be on the look out for pneumonia. Typically there is a period where it looks like they are doing way better before they get knocked on their rear ends again. Quote Link to comment Share on other sites More sharing options...
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