Thursday, May 11, 2006

Emergency Room : do not expect too much

Akira is very different from Wisnu. He does not cry a lot eventhough he bumped his head into the wall or fell down while crawling. He never got cranky but still had good appetite, drank the same amount of milk, ate the whole portion of his meal when he got the chicken pox. We took it for granted he would be in the good shape despite the fact that Wisnu, Alexa and some other people living at the same house were catching a cold.

We hardly took Akira out because we were trying to protect him before he got the complete Indonesian vaccination. Japanese government only required few kinds of vaccination for babies less than a year: DPT (3 times), BCG, and Polio (1x). On the other hand, Indonesian babies –even less than a year—will have to be injected with DPT (4 times), BCG , Polio (4 x), Morbili, HiB (2x), Hepatitis B (3x). For a month in Jakarta, we did not have a chance to visit a pediatrician to consult, until last Friday.

Last Friday was really the whole day for Akira. In the morning, mbak Anis, the nanny, reported that Akira had a temperature—38 degrees celcius and he refused to eat. We needed to take him to the doctor soon but the clinic would open at 5. We did managed to see dr. Srie Enggar in Duren Tiga Hospital and the doctor said Akira had somewhat inflammation in his throat. Akira was given antibiotics and vitamins.

We got home by 7 p.m and got Akira drink his medicine. Surprisingly at 10 p.m his body temperature raised by 40.2 degrees celcius and his body was trembling. We ran him to the emergency unit at Harapan Kita hospital because we thought this was the only hospital who has the stand-by pediatrician around the clock.

When we arrived at the Emergency Unit, there were two children and an adult waiting for the doctor. As soon as the doctor showed up, we mentioned that Akira has a temperature. The doctor touched Akira’s forehead and surprisingly he said, “The temperature is very high. I suggest that he be hospitalized for observation.” Aji and Ibu were taken aback. How could he say so without checking Akira’s throat, or at least check with the thermometer to see Akira’s condition? Aren’t he supposed to examine a patient before deciding something???

Aji was speechless. Ibu took a deep breath and said, “ Wait, doctor, for your information, our son had never been this sick back in Yokohama, by the way, we just arrived here a month ago. As the matter of fact, we saw a pediatrician this afternoon and she said it’s due to the change of weather, our son had tonsils inflammation. The doctor prescribed Amoxylin (antibiotics) and some other medicines. We took our son here because we were afraid that he might get a seizure because of high temperature.”

The doctor looked relieved – we wonder why—and finally uttered, “ All right then, just continue taking the medicine. It might take some time for the antibiotics to work. Give your son paracetamol (medicine to reduce his temperature) every four hour if he still has a temperature. We are going to give him a suppository paracetamol from his rectum now.”

Aji and ibu agreed. So we waited for the suppository paracetamol. One of the nurses even suggest that we wipe Akira’s body with warm towel to help reduce the temperature. She even showed us how while waiting for the medicine. Akira looked calmer and better.

Then we asked a prescription for more suppository paracetamol, as it is more effective for high temperature. After that, we headed home.

We got home by 11.30 P.M and checked Akira’s body temperature—still 39 degree celcius but he already happily clapped his hands and babbled. He did not look like a baby who was having a high fever. We almost could not believe that we just ran him to the ER where we could find no good pediatrician but merely a general practitioner who had no much idea about handling babies for emergency situation.

The things that we learned from the incidence was that as patients or the family of a patient we need to try to state our opinion instead of leaving it to the doctor's decision. Beside that, a big hospital such Harapan Kita does not guarantee effective treatment, let alone the Emergency Unit. Doctors are only human beings, anyway. What do you expect for Rp 50,000 ???

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