Parent of the year #23

[skeptic53]

Just saw a 5-year-old boy with influenza, a patient of one of my partners. His father brought in a huge bag of food and had given the boy and his slightly older sister powdered donuts, Pringles potato chips, Skittles candy, and Coca Cola. I asked the boy to stop eating while I examined him and he cried, the father remonstrated with me. I explained I couldn't examine his throat and tonsils with his mouth full of food. The father still felt I was out of line to ask the kid not to eat during the exam. Even after drinking some Coke there were potato chip fragments all over his mouth. He wanted a cup for his Coke, he looked at me and hollered "Cup! Cup! Cup!". I said "What is the magic word?" He said "Cup! CUP!!" I put the cup back on the shelf and he finally said "Please". His height is at the 90th percentile, his weight and body-mass index are way, way over the 95th percentile. The two kids trashed the room while waiting for the flu test result. When they left there were potato chips, candy wrappers and powdered sugar all over the exam table, the floor, the corner bench, my roll-around stool and my work counter. It took us 15 minutes to get the room clean. If this family were my patients, I'd give them a written and verbal warning that they can't litter exam rooms like that. Instead I sent an email to my partner. I feel very sorry for those kids, to me it is borderline abuse to feed kids a diet like that and not to exert any control over their behavior. I'm just glad they are not my regular patients.

[Monterey Jack]

WTF? Who the hell lets their kids eat when they're having their THROATS EXAMINED at the doctors?! That'd be like me chewing gum during a dental exam. What a horrible father.

[seigus]

SCs in the making.

[wolfie]

Definitely needs to be recorded in the patient files for both children that the sperm donor feeds them at inappropriate times. I can just imagine this scenario:

- Child is scheduled for surgery, has NPO order starting midnight the night before.
- At home, child complains "I'm hungry!", and gets fed a large meal to tide them over the time they'll be unable to eat due to being on the operating table.
- Surgical team is unaware that NPO has not been followed.
- Child aspirates own vomit while under anaesthetic (what NPO is supposed to prevent by leaving nothing TO vomit).
- Sperm donor sues for malpractice.

[An Haddock]

Definitely needs to be recorded in the patient files for both children that the sperm donor feeds them at inappropriate times. I can just imagine this scenario:.

As Dr. House says: Everybody lies.

[Sparklyturtle]

I'm rather surprised the patient didn't throw up during the examination. I know when I have the flu I certainly don't feel like eating like that. I can see Wolfie's scenario happening as well. I transcribed many reports where the patient hadn't abided by the NPO status (nothing by mouth) and surgery either had to be postponed or canceled.

[notalwaysright]

This was so cringe-worthy I just can't even. So I'm going to go away, bye bye.

[Irving Patrick Freleigh]

When I had my go-round with H1N1 in 2009, I was too busy shaking like a leaf and sweating through my sheets to eat anything, much less mass quantities of junk food. Shit, my appetite didn't really return for a week after the worst was over.

I'm the wrong kind of amazed at this kid.

[Aria]

I'm rather surprised the patient didn't throw up during the examination. I know when I have the flu I certainly don't feel like eating like that. I can see Wolfie's scenario happening as well. I transcribed many reports where the patient hadn't abided by the NPO status (nothing by mouth) and surgery either had to be postponed or canceled.

It's amazing how many people can't possibly go 24 hours without food.

[Sapphire Silk]

I remember this three year old that came to the ER with an earache. She weighed 80 pounds. EIGHTY. Eight. Zero. At THREE.

The kid was whining because she wanted a Coke. The ER doc said to the mother, "you let this child drink Coke?"

Mother of the year said, "It's the only thing she'll drink."

Doc: Why don't you give her milk? Or juice? Or water?

MOTY: I can't get her to drink anything but Coke.

Doc: WHO'S THE PARENT??? YOU'RE THE PARENT! Quit giving her Coke. Your child is morbidly obese, and if you don't start controlling her diet, she won't live to see her high school years.

Doc then instructs me not to give the kid any Coke, not that I would have. I was silently cheering inside and I'm a hard ass anyway.

Of course MOTY left crying she was going to file a complaint. I don't think Doc gave a shit. I loved working with her. She was ten kinds of awesome and not just because she didn't take any shit from EWs and SCs.

Definitely needs to be recorded in the patient files for both children that the sperm donor feeds them at inappropriate times. I can just imagine this scenario:

- Child is scheduled for surgery, has NPO order starting midnight the night before.
- At home, child complains "I'm hungry!", and gets fed a large meal to tide them over the time they'll be unable to eat due to being on the operating table.
- Surgical team is unaware that NPO has not been followed.
- Child aspirates own vomit while under anaesthetic (what NPO is supposed to prevent by leaving nothing TO vomit).
- Sperm donor sues for malpractice.

And the sperm donor would lose. Part of the OR checklist is to ask to make sure nothing was eaten or drunk after midnight. If the sperm donor lies and says "no" then it's all on him, even in states that don't have contributory negligence.

[MoonCat]

Ugh, my blood sugar went up just reading that!! Yuck.

I think the kid down the street has parents like that. He's around 8 or 9 years old and is huge. His parents aren't small, either. At least he tries to run around, though. I guess some exercise is better than none, but I wonder wth he eats.

[jedimaster91]

It's amazing how many people can't possibly go 24 hours without food.

Some people have medical reasons why they shouldn't go that long without eating at least a little something. I know I get hypoglycemic if I don't eat every few hours. Last time I had a bout with it, I got dizzy, the shakes, nausea, and according to the people I was with I got very pale. Initially I thought I was just overheated or dehydrated as it was summer and we were in the middle of an intense renovation project. I had eaten lunch, but it wasn't a particularly big lunch and I was burning a lot of calories painting, moving furniture, etc. After downing a couple big glasses of water didn't help, someone found me some nuts to eat and that made me feel much better almost instantly.

Though when I have a medical thing that I have to fast for, I try to schedule it either early enough in the morning that I can get it over with and eat afterwards, or late enough that I can eat beforehand and have enough time for it to clear. My plan when I went into labor with Minion was to swing through the Golden Arches for one of their chicken sammiches to eat on the way. But the drive through line was at a stand still and I was in no condition to get out and go in to order, so I just said screw it, I want my epidural. The epidural allowed me to sleep through most of labor, so I didn't notice how hungry I was until it was all over. A ham sandwich and a bag of chips never tasted so good, lol.

[WishfulSpirit]

When I had my go-round with H1N1 in 2009, I was too busy shaking like a leaf and sweating through my sheets to eat anything, much less mass quantities of junk food. Shit, my appetite didn't really return for a week after the worst was over.

I'm the wrong kind of amazed at this kid.

I got that a few years back and I will never forget it. I did have a bit of an appetite, but getting up to open a can of soup, zap it, and get back to the couch had me shaking like an aspen leaf. I didn't want to move for another 3 hours I was so tired from my harrowing 10 foot journey to the kitchen.

[Seshat]

Even people who have medical reasons not to be nil-by-mouth totally can be provided with a suitable alternative. But you must - must! - discuss the situation with whomever is advising you about the surgery prep, and abide by whatever rules you're given.

Worst case, you can get a nice stay in a hospital beforehand and get 'food' through an IV when you need it.

[siskaren]

I remember this three year old that came to the ER with an earache. She weighed 80 pounds. EIGHTY. Eight. Zero. At THREE.

I've occasionally seen episodes of Maury (don't judge me ) where they have morbidly obese preschoolers on, and some of the MOTYs actually seem to be proud of the fact that they feed their kids whatever they want, whenever they want. Or they're defiant - "My kid says he's hungry - I'm not going to tell him no!" (Never mind the fact that they just had a meal an hour ago.)

I'm curious though - what's a more normal weight for a three-year-old? Half that? Less?