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Arctic Mama

How long to keep medical records?!

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I’m drowning in Benny paperwork, from every ologist and therapist to pediatric appointment summaries and vaccinations.  And now I’m filling out social security disability and Medicaid stuff and just have SO MUCH TO RIFFLE THROUGH.

 

Medical mamas and informed people, please help me get this under control.  Most of the older providers they just want start of treatment dates and any significant reports or labs/imaging procedures.  Does this mean I don’t have to save every office visit’s paperwork?

 

 

heeeeelp!

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Would it be possible to take a picture of each page and save it on your computer and in the cloud? Then if you need a copy of one you could just print it off.

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With his issues, I would save it all until he is about 10yo and then start whittling through after that.  Like you mentioned, I would keep a journal of all important findings and treatments. 

For my daughter, it is really hard when the doctors ask me about things that seem insignificant at the time, but now are considered important details.  I don't remember other than 'I remember her being at xyz school when that happened so it was about 5th grade'.  LOL, most of the time it is sufficient, but I wish I had better records. 

Another thing that I foolishly did, was to assume the doctors office maintained records of things like immunizations etc.   She had to repeat some shots becuase when the office scanned in digital records, there are a few pages missing in her file.  It literally say, page1, page 2, page 6, page 7....etc.  One of those was the second page of her immunization history.   My sister had the Entire medical file from her daughters birth go missing at the hospital she was delivered at.  She has birth trauma that was diagnosed later and by then, the file was completely missing.  With digital records that is less likely, but can still happen.  

Our pharmacy used to save computer records for 8+ years, and now it is only 3 years.  Ds had travel vaccines done 7 years ago.  Luckily, I printed them off and had a paper copy of them.  Our company was bought out and the new company did computer upgrades. No one knew that part of the upgrade was a purging of old files.  we keep 3 years of paper files on site and the remaining 10 years required by law offsite.  The problem is, that without a prescription number to find the appropriate paper file, they are pretty much useless.   We have filled over 100,000 prescriptions......there is no way someone could go through an find the appropriate file. I am sure that this same situation is common elsewhere as well. 

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I would be tempted to set them up in binders by year if you can find the space, and keep them as long as Tap suggests. I didn’t use to be as paranoid as I am now, but electronic medical records have been far less than a raging success and at the rate doctors and hospitals are either leaving the profession, retiring, being bought out or going out of business I now know multiple people who have lost ALL of their kids’ medical and/or immunization records in the last three years. I now get paper copies of everything. I tried scanning but it was too much work, so they go into our filing cabinet, but if it were more I’d do the binder and designate a shelf. 

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Afraid I agree with keeping paperwork.  Weed out those extra HIPPA papers, etc but keep the rest.  I just did adult disability for my daughter and had to reference things from years ago.

Also......the hive needs a Benny update and picture ?

 

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Speaking as someone whose kids lost all their records from an office moving, and then the next office closing suddenly, keep everything. I had to pay for my older kids to get titers to prove immunizations for college. 

Although I don't recommend keeping the records as long as my dmil has- 10 years and counting after the passing of my fill. :laugh:

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I have everything (and I mean everything) from birth to about age 11. Requested copies of any and all forms, clinic notes etc. From about 11 on I've been making notes for myself and keeping only major things (testing reports, surgery notes, new diagnosis, updated plan of care etc). One thing I wish I had done from the beginning is keep a journal with notations of things he did. Things that seemed minor back then, I would love to look back and see the progress. I am currently working on organizing boxes of medical files and it is quite overwhelming. I'm in process of making a notebook of all important test results, growth charts, surgeries etc so I can carry that with me when needed. I used to carry a 4" notebook with sections for each specialty. Now I carry what's important for each doctor. Of note for us - most of Joseph's doctors have been with him for between 10 and 16 years so there is a knowledge base there. As we are nearing transition to adult care in the  next several years, I'm hoping the one concise notebook will have the information needed. There is just so much paperwork with these special kiddos. Our pediatrician is up to the 8th volume of charts for Joseph - each one is about 3 - 4 inches thick!

As a complete side note. My mom kept major medical info on my brother and I forever. I actually had to pull out a doctor's record from my files dated in the 70s to use when filling out a form for myself. 

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You need two things.  A summary system and a records system.

Create a document, maybe a chart in Word.  Maybe a table in a OneNote document kept on your phone.  It should be chronological by date and include the following information:

  • Date
  • Doctor
  • Doctor contact information
  • Diagnosis
  • Treatments prescribed
  • Notes (your impressions, results of treatment, side effects, anything else that is significant to remember regarding this visit and the aftercare)
  • Any other information I've forgotten that is clearly asked for in the paperwork, such as symptom tracker diaries, etc. Depending on the length, this might be a separate document.

Then you need a way to store the other paperwork in case you ever need to reference it again.  This could be the form of a binder, or a file binder, noted with the start & finish dates of the records therein, where you simply 3-hole punch and add the records to the back of the binder in chronological order. You could also scan the information and keep it electronically, though you really want to make sure you have remote backup system set up because it is EASY for a power surge to wipe a harddrive. Having a 3-hole punch on your desk and adding things to the back of a binder takes far less effort IME, even if it does take more space.

You might also wish to have a separate binder for the insurance Explanation of Benefits statements, both so you can reconcile the bills ("Yes, I paid that on March 14th with check number 2435, and I paid the second thing you're double billing me for on May 9th with a Visa debit card, confirmation #6436958;" AND so you know when you've met the deductibles and maximum out of pocket limits for insurance.  "No, I'm not paying the $20 good faith payment you ask for even though my insurance doesn't require a copay because I know we've already met our maximum out of pocket for this year."

 

You will also find the "health summary" document is a really good thing to keep for everyone. Especially if you keep it in something like OneNote.  It's not only helpful to remember which meds you've tried and what year your kid had their tonsils out, it's also super helpful if anyone ever needs to apply for life insurance. 

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The clinics themselves will save things.  But I've saved records forever that explain information that I think might be helpful down the road, even years to come.

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I have a binder that is just for taking to (in my case) IEP meetings and some appointments.

I went to a class about how to make the binder, and took a huge bag and put a binder together.  I’m pretty sure based on a Wrightslaw book.

Anyway it is like Katy said with a front page with a list of some things, and then some things 3-whole-punched and put behind binders.  

It has been very nice to have.  

I want to say some people make copies for the binder and keep originals in a “year” binder or box so their things are still together chronologically too.  

It has been helpful to have some things available in the binder.  It is right there for people to look at!  

 

 

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2 hours ago, Katy said:

You need two things.  A summary system and a records system.

Create a document, maybe a chart in Word.  Maybe a table in a OneNote document kept on your phone.  It should be chronological by date and include the following information:

  • Date
  • Doctor
  • Doctor contact information
  • Diagnosis
  • Treatments prescribed
  • Notes (your impressions, results of treatment, side effects, anything else that is significant to remember regarding this visit and the aftercare)
  • Any other information I've forgotten that is clearly asked for in the paperwork, such as symptom tracker diaries, etc. Depending on the length, this might be a separate document.

Then you need a way to store the other paperwork in case you ever need to reference it again.  This could be the form of a binder, or a file binder, noted with the start & finish dates of the records therein, where you simply 3-hole punch and add the records to the back of the binder in chronological order. You could also scan the information and keep it electronically, though you really want to make sure you have remote backup system set up because it is EASY for a power surge to wipe a harddrive. Having a 3-hole punch on your desk and adding things to the back of a binder takes far less effort IME, even if it does take more space.

You might also wish to have a separate binder for the insurance Explanation of Benefits statements, both so you can reconcile the bills ("Yes, I paid that on March 14th with check number 2435, and I paid the second thing you're double billing me for on May 9th with a Visa debit card, confirmation #6436958;" AND so you know when you've met the deductibles and maximum out of pocket limits for insurance.  "No, I'm not paying the $20 good faith payment you ask for even though my insurance doesn't require a copay because I know we've already met our maximum out of pocket for this year."

 

You will also find the "health summary" document is a really good thing to keep for everyone. Especially if you keep it in something like OneNote.  It's not only helpful to remember which meds you've tried and what year your kid had their tonsils out, it's also super helpful if anyone ever needs to apply for life insurance. 

I think the chronological system is what I’ve been missing.  We have had literally dozens and dozens of appointments and it’s overwhelmingly impossible to summarize or even pull dates and times from them.  I have all the records by specialty, but they get muddled and lit of order and quite frankly we are past a team of paper and it’s getting heavy.

 

I almost need a spreadsheet thingy where I could select the specialty and display all appointments by them, if need be, but have it in order chronologically for each incident too.  Anything exist like that? Is Onenote really the only thing?  I’ve never ‘gotten’ that tool *blush*

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The spreadsheet idea may be a good one. You can have a "page" per month and label the file by year. Perhaps a quick note/ reminder of what dx was and treatment options offered with a reference in which binder the hard copy is - or just have the binders with hard copy correspond to the spreadsheet by months and years.

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Okay, you have short-term needs and long-term needs.  In the long-term, I think keeping things by year works (I am guessing though I have much less paperwork than you do and haven’t needed to go back to it really yet), you can go back into it if you need it years from now.

But in the short-term, do your specialists ever need to see paperwork from another specialty? If they don’t in particular, I would want to make a binder for each speciality, copy things into that binder that seem like they are going to come up soonish, and put other things in a year box.

I don’t know if that makes sense for your situation.  I have 3 basic entities, and they all are interested in different things, with just a little overlap.  Two of those entities have stuff pertinent for them in one binder.  For the other entity I still have a large reusable grocery bag with stuff in it and some folders.  That grocery bag also has stuff that I might need to look at, that is paperwork I have been given. 

I don’t think I have long-term figured out, but I do have something where I can have access to what I need short-term and have stuff I take to appointments and meetings so that I can put my hands on information that I want to provide in the moment.

But I don’t know if that kind of thing comes up for you in that way, you might not have the same needs.  

I think though if you are organizing by specialty, there is a reason for that and go with that, if it has positives.  If someone in a specialty needs to be able to look back and see what was done a year or two ago and things like that, and you can have that paper.

If you’re not seeing things like that I think going to chronological could work and then a tab for each specialty in a binder with particularly important things?  That is more like what I have probably.

But I have less papers overall and fewer pertinent papers, it sounds like, so it can actually go into one binder with a tab for different things.  

But I think it does sound like there are two different things, info for current medical/health/development needs, and then info for long-term documentation.  So one system may not be able to do both these things at once, in a way where you can just touch each thing once and file it away.  It might take shifting things around..... it takes shifting things around for me as things start to be outdated and maybe just one or two things can stay in the “current” binder.

Anyway — the spreadsheet might get you a lot closer to being able to touch things once and then file them away.  

 

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I don't know about other devices, but OneNote is free on Apple & iOS.  I LOVE it.  I have a notebook for every aspect of life, from medical records to the sort of project ideas I used to keep on Pinterest (before Pinterest started spamming up the service with ads and deleting images).  As long as I sync the notebook I'm in before I walk away from the computer or close the app, when I open it on another device, it pops up with the refreshed information. Which is great if you go to a new specialist and they want every doctor you've seen in the past 3 years -you have all the contact information in your phone, and you don't have to wonder if you forgot any of them, or what specialty you listed the genetic specialist you saw last month under.

In terms of medical it's great because I can pretty quickly reference information - we didn't try this drug because we had an allergic reaction to this related one.  We didn't try that drug because the side effects would not be worth it with the other medical stuff going on.  The Cleveland Clinic protocols list these 4 drugs we haven't tried or ruled out yet, would those be good?  Is there new research I should look up?  If I found new research I can either copy and paste the document or copy and paste the whole study as a PDF attachment so I can easily email the study TO the provider as we are discussing it.

So for example I have a "To Do" list broken down by where the errand is, what I need to do there, and other lists prioritized by importance - an urgent A list, a sometime this week B list, a maybe sometime if I have a spare hour C list, etc.

When I'm in the kitchen and realize we need more milk I just go to whatever device is closest and add it to the grocery list.

I also keep current sizes for everyone in the family at the bottom of the list.  So if I happen to be at a garage sale or charity shop or the Dillards Clearance Center I know right away if I should buy something or if it's already too small for the kid in question.

When a friend recommends a book I go to the library website to see if it's there, note the call number and location, and add it to my library list, which really speeds up library visits.  If it's not there I might add it to an Amazon wish list.

One tip I do have about it though - when you watch the how to videos Microsoft makes it seem as if the ability to create a horizontal layout, instead of one long vertical document is good.  It is NOT good if you spend more time opening OneNote on your phone or iPad than on a laptop or desktop.  If you're opening on a vertical device you won't find the horizontal information without scrolling sideways.  For some reason they haven't corrected this on mobile devices.  That aspect is like a bad webpage from the 90's - before HTML had automatic word wrap.

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I wouldn't complicate things by having different binders for different specialists if you have the summary table.  Especially if it's digital like OneNote, because you can simply search the table and you'll instantly know the last time your kid saw that doctor, so you will find the records easily.

Also, IME doctors aren't going to take YOUR records.  They'll have you sign a release and order copies of the records from the other doctors themselves.

Besides, it is much easier to keep up with a system where you open the envelope from the doctors office, pay if need be, 3-hole punch and file in the back of a binder than it is to sort everything into multiple files or piles or whatever.  If you have to do that you'll get behind and lose documents.  With a chronological system even if you don't take the time to turn back 5 pages and put the bill with the patient handout from the visit, you'll still know the bill arrived about 2 weeks after the visit and roughly where it is in the notebook.  You won't need to sort anything unless you're preparing to see a social security judge or something, and even then it will take less than two hours of going back and putting everything into exactly chronological order.  At that point you could even index the months so it would be really fast to find documents if you need to.

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A few thoughts......we've got a few medically complex kids, and one is now in his teens....  Just YESTERDAY we were asked about specific things that happened 10+ years ago, and asked for records.

1. You're going to need a paper archive.  We keep a series of banker's boxes.  I'm a minimalist, and I hate this, but it's a necessity.  I go by years, with subdividers by specialty. Anything that goes in the paper archive gets tagged into a spreadsheet.  The spreadsheet summary is carried in the binder.

2. You're going to need an active binder system.  In the active binder system, I keep a lot of what is in the digital system.  I also keep a calendar in the front, a summary of my paper archive (important documents, indexed by date, but also listing provider and relevant information).  I also keep a copy of the original document in the paper archive of really key things--latest OT results, latest IEP, latest bloodwork, latest neuropsych report, whatever that may be for you. I have one section with paper so that I can take notes in meetings. I have a to-do list section.  It's my medical "brain" and whatever is pending and current goes here.  When you are stressed and sleep deprived and in high stakes meetings, your binder brain should be able to carry you through.

3. You're going to need some type of digital access to your most recent/relevant stuff.  In this I keep the stuff I constantly refer back to: current med lists, step-down calendars if he's on steroid or other protocols, IEPs, most recent reports, most recent MRIs/scans/whatever, a list of ALL providers and their contact information including address and phone number, any insurance authorizations for specific things, etc. IME, when you see the same providers over and over, they become cool with you just showing them relevant docs from your digital archive rather than doing a formal HIPPAA release and having stuff sent over from other medical providers. Likewise I always keep a master disk of relevant MRIs, and that has saved my bacon more than once.  Doctors lose info or can't navigate their own systems easily. If they can't find the info, sometimes they make bad decisions unless you catch them. BTDT, earned the dang t-shirt.

4. You're going to need a financial archive.  We have been asked for financial documents up to three years old (including EOBs).  If you are doing a medical tax deduction, you need to keep it for seven years.  If you ever try to get life insurance, they will ask back ten years. It's ridiculous. The financial archive is the easiest--I keep a simple spreadsheets of ins and outs, checked against EOBs.  I keep a pending file of stuff that is needing to be corrected or that is waiting for information.

 

Things I do not keep:

1. Every single prescription summary sheet from the pharmacy that details drugs. I keep the financial sheet, I do not keep the 10 pages that tell me the drug will kill or maim me.

2. I do not keep old eyeglass prescription info. I do keep a list summary of how prescriptions have changed over time, on a single sheet of paper, but I don't keep all of those documents.
 

3. I do not keep every well child summary where there is no other information other than height, weight, temperature, and other normal info. All of that is charted in subsequent well child summaries. I keep abnormal summaries and I keep the most recent summary.  Likewise, I only keep the most recent vax record because all previous data is charted there. 

Every year when I do my taxes, I archive the previous year's medical financial stuff and toss out the 8 year old stuff.  I then reward myself when I realize that that file was 3" thick and I survived another year of dealing with EOBs and billing departments.  My best advice is to get an IKEA filing cabinet. The files get thick quickly, and you're in it for a marathon.

 

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I’m officially too sleep deprived and overwhelmed to deal with all this, BUT I’M TOTALLY COMING BACK TO IT LATER.  Thank you for the suggestions.  We do have a bunch of people who take copies of my records, which is why they’d become a mess,  but just removing a few files and packing them would be easier than having the whole darn thing all the time.

To add to the overwhelming pile and on a side note, I discovered his CP rehab doctor thinks he is a probably GMFCS level IV, which she hasn’t verbally ever talked about but was in her notes for our last visit.  I’m gutted.  And now I’m going to take a well deserved nap since our early intervention coordinator and SLP just left.  

I’m tired of medical right now *cries*

 

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The main thing is to keep the original safe in the archive; bring the photocopy with you in the binder.  I have each document together in a sheet protector....fewer pages to flip through. As long as the document is <10 pages, it will fit in one protector.

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7 hours ago, Ottakee said:

Afraid I agree with keeping paperwork.  Weed out those extra HIPPA papers, etc but keep the rest.  I just did adult disability for my daughter and had to reference things from years ago.

Also......the hive needs a Benny update and picture ?

 

Honestly, the most recent one I have aside from the grumpy picture from last night is this one, where big brother was a nonplussed champion as Benny hurled up everything he ever ate straight into the couch and floor.

 

It just about sums up my mood for today.

7A092A79-9353-4850-876B-875FFA5BEE22.thumb.jpeg.a5b421aa8d28d61993feb81abc8bcbe6.jpeg

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4 minutes ago, prairiewindmomma said:

Big brother is a champion.  Looks like he mostly missed the couch.  Sorry, that must have been not fun to clean up.

It had totally soaked in under brother’s leg, but he was cool.  That was when Benny was gagging from RSV a week or two ago and vomiting every feed. It was less than awesome, but I’m glad we don’t have downstairs carpet!

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We are better now, except for little big brother having a cold.  Thankfully when Benjamin woke up from nap he seemed a little more behaviorally normal than last night and this morning.  He says hi while watching Totoro with sissy:

 

932CF97B-F4B1-48BB-8C44-59F9866F7106.thumb.jpeg.a81e840b92ffc003bfe39591b9fdf126.jpeg

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Scan everything and put on a usb drive.  

My DSIL has taken my DN(14) to a specialist recently for issues.  The specialist wanted all his records from birth.  Thank goodness she doesn’t throw out anything medical as several places they used had closed or lost the file. 

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Before I forget, I think you might like this: https://www.amazon.com/Case-Mighty-3-Inch-Zipper-D-146-BLK/dp/B007SQZHKW  The zip around means that things are less likely to get lost being tossed around in a backpack or diaper bag and that little fingers have to work a bit harder to get at stuff. The left side is good to shove a calendar or other files into; the right side makes for decent note taking, document archive, etc.

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44 minutes ago, prairiewindmomma said:

Before I forget, I think you might like this: https://www.amazon.com/Case-Mighty-3-Inch-Zipper-D-146-BLK/dp/B007SQZHKW  The zip around means that things are less likely to get lost being tossed around in a backpack or diaper bag and that little fingers have to work a bit harder to get at stuff. The left side is good to shove a calendar or other files into; the right side makes for decent note taking, document archive, etc.

I have that in a four inch.  It works great but gets heeeavy.

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I would also pull out medications he's been on and make a list. As an adult who had multiple hospital stays and medications over the years, I'd love to know now what all I've been on, for what and why it was discontinued. I requested my records from my former GI (started seeing at age 3) and got over a ream of paper sent to me, but unfortunately, that is not everything, only what they deemed worthy to save. 

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He is getting So big....and as cute as ever.  Other than being I'll, are the tube feedings working well?

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Also, I am seeing from comments that it makes a difference my son’s needs aren’t really medical and I’m not really doing medical stuff with him.

For our situation I need a binder and I need to take it and I need to have it available.  If I don’t there are times when something is going to be done that was already done, or it’s going to contradict in some way what somebody else is doing..... it’s hard to explain but my son needs consistency and people working together and that can mean them adjusting so that they can be more consistent.  And everybody agrees consistency is good so they are happy to adjust, it’s just they need to know.  

For the most part this is coordinating treatment/therapy/behavior goals between school and private therapy, and things we are prioritizing as a family.  

So it’s not medical, but it’s stuff that many people whose kids have medical needs also have to do if they are going to be dealing with school or IEP stuff, or private therapy, and especially if there needs to be coordination between various therapists.

For us especially with behavior and language there needs to be consistency or else it can just confuse my son, but there are times there are 5 different legitimate choices that could be made, but it needs to be that one is picked and then everyone goes along with it, because otherwise he is doing things one way with one person and then another way with another person.  And for him that is not good!  If it worked out fine it wouldn’t matter, but he needs things to really be on the same page.  

So there are times to say “but so-and-so is doing this,” and it’s not that something is wrong, it’s just not on the same page with what random other people are already doing.  

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I don't know if this will be helpful...but I'm going to say it anyway.  I'm 60.  When I was born, I had ALL KINDS of issues.  And my parents nearly went broke trying to find ways to help me.  My dad moonlighted, my mom often didn't even have time to get dressed for days on end, finding ways to soothe and take care of me.  (I'm telling you this not because I remember it or want pity, but for context.)

Mom saved all my medical records...no not every printout (which they did not have) but the pertinent information.  She saved every bit of every thing that was done to and for me.  The doctors were doing the very best they knew at the time, and the care was provided by a top-notch (at the time and still to this day) pediatric hospital.

When I was about 50, my parents moved and cleaned out a lot of their stuff, including files.  Mom found these records she forgot she had.  And I looked them over and found out a LOT about how I had been treated (and did research and found that it was all the Best Medical Practice at the time).  I found that I had been regularly using an asthma drug that retards learning.  That I had been given massive amounts of steroids that very likely stunted my growth.  That for some reason (I don't know why because that was not recorded, back in pen-and-paper days), I had been given phenobarbital.  ???  Really?  But yes, really.  And these were all done to help me, according to the medical practice of the time.  

It doesn't necessarily help me now in a reparative way but it does help me understand some of the things that happened to me along the way.  No *wonder* I wasn't singled out with the other smart kids to get into AP classes--I was busy trying to breathe, using a drug that impeded my mental processes.  OK . I'm not stupid.  Somehow it helped to know that.  And that I was given massive amounts of steroids and my growth was stunted--OK, I'm not 5'10" like I probably should have been, but neither was I left in the misery that was my life because the steroids helped. 

All that to say, I'm glad Mom kept the records.  It didn't do much to fix things, but it did help me interpret my past, AND it made me a lot more critical (not criticizing, but critical) as to thinking that modern science will have all the answers in the time we are living through it, and maybe there is something to be said for doing the best you can, and asking a few more questions than you might, otherwise.  (As an example of the last:  when I was a kid, bottle-feeding was considered THE BEST WAY to bring up a healthy infant.  Removal of all allergens was THE BEST WAY to prevent and help cure allergies.  True story.  Now I have a little bit of a raised eyebrow when anyone starts to yammer on about THE BEST WAY to do anything.  My mom and dad loved me and busted their butts to find ways to help me.  And that love and care matters a lot more to me now than what *today* would be considered malpractice.  KWIM?  So the records, yeah...keep them.  Scanning is cheap and easy and small footprint.  

And, just for the record, I did get some reparative help on the phenobarbital-related consequences, even 50 years later.  

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On 5/8/2018 at 8:11 PM, Ottakee said:

He is getting So big....and as cute as ever.  Other than being I'll, are the tube feedings working well?

Feeds are going well overall.  Oral feeds,  not so much.  Feeding therapy is a total pain and he blocks and fights every bite.  No fluids by mouth at all, no toothbrushing.  Sigh.

 

On the plus side, he really likes the pediasure and tolerates it well, and hasn’t had any more infections at his stoma recently.  Yay!

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We’ve done phenobarb, Patty Joanna.  If you don’t mind me asking, what side effects have you suffered?  It is generally considered one of the safest drugs to give neonates and very well studied.  We had to have it for initial seizures and it definitely caused some temporary side effects while we took it, but he seemed to be fine once we weaned off a few months later.

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17 hours ago, Arctic Mama said:

We’ve done phenobarb, Patty Joanna.  If you don’t mind me asking, what side effects have you suffered?  It is generally considered one of the safest drugs to give neonates and very well studied.  We had to have it for initial seizures and it definitely caused some temporary side effects while we took it, but he seemed to be fine once we weaned off a few months later.

 

Ill have to go look it all up.  My memory for this stuff is terrible.  The thing that I do recall is that the phenobarbital was used for something unrelated to what theynow know to use it for ...  Le sigh. 

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