Pediatrician can never see us, so UC/ER only option....so instead, I ask you

[okinawama]

For many different reasons, 9 times out of 10 my 10 month old sons pediatrician can't see him when he's sick because all of his appointments for the day are taken. So, that means we either have to go to Urgent care or the ER. Urgent care is open from 10-3 M-Th, so more times than not, our only option is the ER.

So, all that to say...my son has a terribly junky cough and completely stuffed nose and a low grade fever. He has multiple coughing fits each day, but is always able to breathe through it. This has been going on for about 3 days. We are doing all the of the standard stuff (steam, vicks on the feet, fluids, nursing...) but things aren't improving. My question is, how do I know when this has turned from a traditional cold, into something more? I keep googling, and things like pertussis, RSV, bronchitis, pneumonia...and honestly, it all sounds the same. It *could* be a run of the mill cold, or it *could* be this terribly life threatening sickness....how DO I KNOW?! All appointments on Fri. as well as Monday are taken.

In your experience, what are the signs that this is crossing over from run of the mill cold, into something worse?

[KpbS]

Since he has the low-grade fever it makes me suspicious that he is battling something more than a cold with cough. I'd try to take him in if possible--are there any other after hours/ped clinics near you that you could try before the ER? Even in a neighboring town?

Hope he feels better soon!

[crl]

Military medicine, right? I am so sorry. I would go to the ER and ask specifically about each illness you are concerned about and push for any tests you think they should do (check oxygen levels, blood work etc) and be careful they aren't prescribing something inappropriate for an infant or that he is allergic to. (On more than one occasion I stopped a ER doc in a military hospital from giving me an antibiotic I am allergic to.)

Catherine

[nrp]

First off, if it is possible to look for a new ped, I would. Never being able to get in for a sick visit isn't acceptable!

I usually gauge a couple of ways. First, how is he acting? Is he a lot more fussy than usual or lethargic? If he seems to be tolerating the cold well - playing, eating, acting pretty normal - then I usually don't worry. The other thing to look at is his respiratory rate. When he is relaxed, count his breaths per minute. If over 60, that warrants a trip to the doctor/urgent care. The junky cough, stuffy nose and fever alone wouldn't bother me.

Have you tried Motrin? Babies over 6 months can have Motrin, and I have found it to be more effective at fever reducing and making my DC comfortable than Tylenol.

ETA: How high is his fever and for how long? If it is over 100.4 for more than two or three days and/or not brought down by Motrin or Tylenol, then I would probably go in. Otherwise, fever is just his body's way of batting the virus and is not dangerous in and of itself.

[MommyAllison]

I'd go in. DS had RSV when he was 8 months old, and since we caught it early, we avoided the hospital and just treated at home. Once he started the breathing treatments he improved quickly. The thing that made me call for an appt with him was that I noticed that the little spot in the middle of his collarbone was sinking in when he breathed. It wasn't very drastic, and I think that often happens when kids have colds and are stuffed up, but it set off my mommy alarm and we took him in that afternoon.

And fwiw, our first ped (whom we loved) became more and more impossible to get in with, and we switched because of it. So if I were you, I'd start looking for a new pedi. It's not fair to you or your kids to never be able to get a sick appt!

[novmber]

is the cough "barky" at all - it could be croup - that usually presents with a mild fever - my DD got dx'd with this yesterday in our urgent care - she came down with a cold on weds and was running hot (highest was 100.2) and then developed a cough. i heard a bit of a bark on friday night and was planning to take her in saturday regardless. her cough was way worse on saturday - much deeper and junky sounding. hugs.

[novmber]

definitely try to check for retractions (you can google that i'm sure) - that is serious and means they are laboring some to breathe

[squimp]

For me a fever of more than 2 days would be really unusual and I'd want to see someone.

I also agree it might be time to find a new ped. Ours is busy too, but they set aside times very day for sick kids.

[okinawama]

first, thanks so much for all the replies!

Unfortunately, we have no other option for switching peds. I SO wish it were an option! I have had to go to the ER to have ear infections, croup and hand foot and mouth diagnosed....all things that *should* be able to be taken care of in a dr's office...

His fever is very low, high 99's to 100.5 ish, I'm not medicating it (yet). His breathing seems fine except after a coughing fit, that's when his respiratory rate is goes up. He doesn't appear to be struggling to breath in anyway. It's not a barky/croupy cough (unfortunately, my older son had that early this year).

Sleep isn't good, but it's not because he's coughing himself awake, he is waking very frequently, moaning for a minute or two and falling back asleep. He does this at least 15-20 times a night. I'm assuming stuffy nose wakes him or even possibly a little pain (maybe soar throat....ears?). His appetite is decent, but his nose is stuffy while nursing (which we do try and do in a steamy bathroom as often as possible, but really....it's so not practical) and during a meal he's coughing pretty frequently, so he's no eating as much but he shows the desire to eat.
ETA: I take it back, he's coughing himself awake like crazy during his nap. Gah...

[sweetsue98]

I just took my DD to the ped for the same symptoms a few days ago and he said it was bronchitis. My rule is when I'm starting to get uncomfortable with her symptoms I call the ped office. If they suggest I bring her in and don't have an opening I ask to be squeezed in. Hopefully your DC feels better soon!

[jellibeans]

Military medicine, right?

If you are military, I suggest using www.tricareonline.com to get an appt. I can usually get one using the online system even when I call and they tell me that there are no appts.