Expat Magazine

When It Comes to Your Health Care, Trust Your Instinct!

By Expatdoctormom1 @ExpatDoctorMom

I started this website after I saw a need in the community.  A need for people to feel like they were getting the care that they deserved.  Along the way, here is what I have found, the answer lies within you.

Sure, I can help guide one to make educated decisions about medications or procedures but it is you who usually knows if a particular doctor is right for you or if something is just not right with you or your child.

I would like to highlight this using two patient examples (with confidentiality left in tact).


Case 1

Over the summer, I received an email right at the tail end of our holidays.  It didn’t seem urgent so I didn’t get back to the patient until our return.  The mom was worried about her infant refluxing and not gaining weight as fast as he should.  She also noted that her infant was “wheezing”.  She had seen two doctors who told her her infant was normal.  In assessing her case, I initially thought the child could probably benefit from a reflux medication.  But, with a normal exam by two doctors thought anything beyond reflux was not likely.

I offer my advice/guidance via email.  I have refrained from taking phone calls, as I would be inundated with calls not to mention that I simply don’t have the time to talk on the phone throughout the day.  Well this mom persevered.  She knew something was not right. And her persistence alerted me that all might not be as it sounded.  I agreed to a phone conversation.  We actually spoke for a long time.  During the conversation, two things became clear: 1) her baby was not wheezing but was exhibiting stridor and 2) the stridor was ongoing for at least an hour after meals.

Stridor is a harsh, high-pitched sound made on inspiration or expiration.  If you do yoga it is the similar to the sound you make while Ouija breathing.  It is not normal for an infant to be stridorous for an hour after feeds.

I gave her the name of an ENT to consult with and unfortunately the infant has laryngomalacia, an underdevelopment of his larynx or voice box.  Which for this infant is also associated with reflux and failure to thrive (aka failure to gain weight).  With time, this may go away but for now, the infant will need treatment of his reflux and close follow up.

This taught me two things 1) always trust the mom’s instinct and 2) that corresponding via email may miss things clinically.  Because I value instinct and intuition, I will commonly ask a patient “What do you think is wrong?”  Sometimes the patient’s fears are valid and we can pursue further evaluation and sometimes the fears need to be explained which will make them go away. For example, a woman’s best friend dies of breast cancer.  She comes in thinking she has breast cancer.  I would evaluate her based on her risk and reassure her that her friend’s cancer doesn’t have anything to do with her individual risk.

So as a parent, trust your instinct when it comes to your child and their health.  If the doctor doesn’t ask your fears then state them!


Case 2

A woman emailed me to say that she was weepy and depressed only in the second half of her menstrual cycle.  She felt it was PMS.  But unfortunately now her symptoms were affecting her life.

I cannot tell you the number of times a spouse has brought in his wife and said: “I love her dearly but please FIX her!”  The first thing I did was reassure her that she was not alone.  Her diagnosis as she did not have symptoms whatsoever the first half of the month was likely PMDD: Pre-Menstrual Mood Dysphoric Disorder.  A fancy term for PMS.

I emailed her the latest information on what does and does not work to treat PMDD.  For the record progesterone (aka Duphaston) has not been shown to work in studies.  Although, it seems to be prescribed here A LOT.

Unfortunately her doctor was away for one month.  She saw another doctor who felt she had Major Depressive Disorder (MDD), a completely different diagnosis.  This doctor referred her to a psychiatrist.  The patient didn’t feel this diagnosis was accurate and emailed me again.

I asked her to trust her instinct after I redefined both diagnoses.  The patient deferred going to the psychiatrist and will await the return of her regular physician.   Ultimately, this spares her having Major Depression on her list of problems and spares her from being advised to take an anti-depressant daily which with PMDD can be avoided.  She trusted her instinct and so should you!


 Your turn

What do you think?


 Photo of me and my son at one of the happiest times of my life during my magical year off with him! He is trusting I will catch him when I throw him. Was also 5 weeks pregnant with our daughter at the time.

Back to Featured Articles on Logo Paperblog