Doctors Know it’s Winter When…(Pedcast)

It’s really cold in Charlotte. When you listen to the news, you would think it has never been cold before 2014 and it has never snowed before. Oh well, they have to sell newspapers, don’t they? I’m your host, Dr. Paul Smolen, a board certified pediatrician with 32 years of private practice experience to date. This is my blog that I started 3 years ago that I dedicate to children and families. Topics ranging from the crib to the country club, from the womb to the workplace are discussed here as long as the topic that is relevant to children and parents. Last week I put up a post about how cold air effects a child’s respiratory system. If you missed that one, make time read or listen, and let grandma listen…I think she will agree with what I said ( In today’s post, I am going to go deep into a pediatric office in the dead of winter, when it is cold like it is in Charlotte this week.

Pediatricians instinctively learn after many winters that there are clues to the severity of illness in children that you don’t get from a medical history or a physical exam. You know it as soon as you walk into the room. When you are a pediatrician, you know it’s winter–really winter–when the children start visiting your office in their pajamas. If they have what I call the bed head… uncombed hair, things are probably a little worse. If they are wrapped in a blanket and holding a lovie, kick up the sickness index another notch. If they have both parents with them, you know that everyone is pretty anxious about their child, and the likelihood of a serious illness has bumped up a little more. Now, here is the biggest sign of significant illness to me… the child has all the things that I just mentioned, AND they are laying on the table and don’t sit up when you come in the room. They don’t greet you or acknowledge you have come to see them. The child feels so bad that they just can’t deal with the doctor. If a child has all these signs, my sickness radar is in full alert mode; pajamas with the bed-head, wrapped in a blanket, holding a lovie, accompanied by both parents, and laying on the table during the visit…Wow, watch out. For a child like this, I am going to do every test I can to make sure the child doesn’t have a serious illness. I’m going to listen to the parents tell the story of this child’s illness and repeat it to them to make sure I got all the details correct before proceeding. I’m going to do as careful a physical exam as I know how to do. I’m likely to do every test that I think is relevant that might help me sort things out. Entering a room like this is when I really earn my pay, bring my experience, and potentially can really make a difference.

So the next time you see your child’s pediatrician in the dead of winter, please be extra nice to her or him… they are undoubtedly tired and stressed. They are working hard to make sure you children stay healthy. And be careful what signals you send to the doctor about your child’s state of health:  pajamas, lovie, wrapped in a blanket, with both parents attending, oh my. That’s what winter means to me. This is Doc Smo, broadcasting from studio 1E in Charlotte, NC, hoping this cold winter chill doesn’t make your little ones ill. Until next time.