Am I being unrealistic?

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My teenage blind and autistic son had his first grand mal seizure in May. It occurred at school and they sent him by ambulance to the ED. After many tests, he was put on Dilantin. Working with his pediatric neurologist, the dosage was worked out to get optimum blood levels.

He has had two seizures since then. Both times I have called the doctor only to be told to take him to the ED to have his dilantin level drawn. I asked the doctor if it would be possible to just order the lab so we can skip the ED trip. The doctor acted as if I was nuts for asking!

It just seems like alot of trauma to put my son through. Not to mention the fact that ED's are very busy places and I don't see that we really need to be there for hours waiting on dilantin level results.

SO, am I being unreasonable to want to just be able to go to the lab and have his blood drawn without having to go through the ED process, questions, and bills?

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Considering we here at all nurses do not give medical advice...I can give you human advice here!

It seems that you and your doc have a communication probelm...and perhaps the Doc didn't give you the reasons behind their wanting your child to go to the ED each time. I would schedule time so that you can understand their rationale, and if not satisfactory to you...seek out another Doc that you feel comfortable in communicating with!

MD's are giving you a professional service...a very vital one, so communication is important. If you feel that the lines of communication are not there...best you find another that communicates in a way you understand and can communicate with!

Good luck to you and yours!

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I didn't think I was asking for "medical advice" exactly. I was just wondering if maybe we had to go to through the ED to get documentation of the seizure.

Like perhaps the insurance wouldn't pay for the extra Dilantin levels without good reason?

That was just one possiblity that sprung into my head...

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Specializes in Emergency & Trauma/Adult ICU.

ER staff cannot "document" a seizure which occurred at home any differently than a PCP.

If it is during the hours that an outpatient lab is available I would absolutely insist on going there, if that is the doc's only reason for sending you to the ER. If he feels the child needs monitored, then IMHO he should directly admit your son.

A phone call is in order so that you & the doc can get on the same page in regards to your son's treatment plan.

Peace to your family.

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i don't see why it necessitates an ed visit.

btw, dilantin levels can be in the therapeutic range and still, can have seizures.

and no, i don't think you're being unrealistic.

it sounds like maybe they want to eval any residual effects from the seizure?

best of everything.

leslie

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Specializes in DD, Geriatrics, Neuro.

In the past when my daughter has had a seizure, I have always been able to get a telephone order either from her neuro or the peds doc on call for a stat phenobarbital (which she isn't taking anymore...2 weeks and counting) draw at the lab. No ED visit needed.

Ask him to explain his rational behind the ED visit. My DD's neuro patiently explains his rationals to me for everything I ask about (at my request :) ).

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Specializes in ER/ ICU.

The only reason I could think of is to prevent any complications that could happen. Suction setup is available as well as IV access, Respiratory support, etc.. It's probably more from a legal standpoint than anything.

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