Stream of Consciousness Sunday: Cute Doctor

Doctors should not be allowed to be cute nor charming. I think this should go doubly for urgent care doctors.

You see, I dragged my sorry ass into the urgent care yesterday morning. I was full on crusty sick. I had crusty eyes, sinus infection breath (even though I brushed my teeth twice and used mouthwash), and smelled of night sweats. It was nothing an attractive man should have to see.

Of course I get there and get called in by a very cute man. He could have totally been a Cutie for your Tuesday. I thought FAIL! Then he starts talking to me and smiling and it turns out he is also charming. If I had more pride I would have turned around and walked away. Let the sinus infection heal itself. But I have no pride so I stayed and let himself do his job.

Because it is their job. They see nasty sick people all the time, right? Of course it hurts a lot more when a cute doctor asks if your ear itches, because apparently there is a decent amount of wax inside, than when a 70 yr old mothball smelling doctor says it.

But I did feel shitty enough to just shrug at it. I don't know why I would care in the first place, except I do think I was a Jewish Mother in a past lifetime because I just love me a cute doctor.

Anyway, I got my gnarly sinus infection diagnosis, which is awesome, and my antibiotic prescription. Note to self though, if I ever become single I am showering before heading to the urgent care. You just never know...

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Doctor me Happy

So I have fallen into the Brazilian way of the doctor. Oh how the Brazilians I know love to go see them!

I mean look at me, I broke my baby toe. Given it hurt like a bitch slap to the foot, but still, it's just my baby toe! But no, like a good girl I went to the orthopedic and had it x-rayed and taped. The doctor told me I had to come back and get it taped professionally.  How often? Once a week for 4 to 6 weeks!

I find that a little surprising. I mean, it's been a while since I've used the American medical system but my old doctor would never have given me such care! Hell, I hardly got that much attention when I had a kidney infection.

Still, while it's good to be taken care of, it can also go overboard.  And you know what, I have. My poor boys are so comfortable with their pediatrician that they run into to say hello when we arrive at the office.  The routine of getting checked is so known that the doc might as well be cuddling with them on my couch, that's how big of a deal it is to them.

Stuffy nose for 2 weeks, go to the doctor. Sore muscle, go to the doctor. Cough cough, x-ray and go to the doctor.  Stub your toe because you are a damn ass, go to the doctor.

I'm starting to think that we're going a bit overboard down here.

That being said, my boys are lucky. Their pediatrician is mellow enough that he almost never orders any tests at all and goes it the old school way. Wait and see. Hell, I usually wait at least 3 days, if not 5, with a high fever before even taking them in.  FYI, in our pediatrician's office, it's only high after 102. Even then, that's not that high.

Compare that to my doctor. I went in with one funny level on a blood test and an irregular cycle and I had to do 2 ultrasounds and numerous blood tests. Numerous.  I'm glad she's thorough but sometimes I wonder if it's a bit too much. One of these days I may get cancer. Sure, it could happen. But at the rate she's going, it's going to be because of x-rays and ultrasounds!

I know I could choose another doctor for myself but my irrational maternal fear of dying and leaving my kids behind nips that in the butt. Where's my anal insurance coverage making sure I don't get the care I could potentially need without knowing it? Oh wait, I'm in Brazil. My insurance company actually takes care of me.

Then again, this is all coming from a Mother and wife who's dealt with fever seizures, stitches, pneumonia, ear infections, skin infections, foreskin/penis infections, staph infections, and a spontaneous pneumothorax. I guess anyone would fall into the "cautious" zone after that.

Which way do you go with your medical care? And does your insurance let you be as cautious as you would like? 

My Preschooler is Taking Illegal Drugs??

When our pediatrician in Brazil recommends a medicine, it never crosses my mind to see what the United States thinks about it. I mean, a medical professional told me it is the best thing to give to my kid, can't be that different, right?


Wrong. I have given my children two different medications that are illegal in the states.  Say what?!  The first time this was pointed out to me was during a visit to the states, shocker.


My youngest had Infant Reflux and was on Motillium (Domperidone). He had pneumonia, awesome during vacation, and I had to inform the US doctor of all medication he took on a regular basis. Her response was that Motillium is not allowed in the US, she hoped I brought enough for the trip (I did, duh), and that it works wonderfully for gastrointestinal issues.  


Not too bad.  Of course, I got online to search why. And you know, it was nothing too shocking. Just the American system taking care of it's people and anything that may be questionable. Heaven forbid let the people it could really help use it. Of course not, we are not responsible, nor are our doctors, and nor are our pharmacies. No, I'm not being sarcastic.  The nation of pill poppers needs to be watched by big brother.   


The second medication is a smidgen more alarming.  My oldest suffers from fever seizures, still at 4 yrs old.  And it is a freakin' scary ass thing to see. Not to mention, how quickly his fever can go from 99 (37) to 103 (39.4).  It just shoots right up like Hugh Hefner after a Viagra.  


Our Pediatrician recommended we ditch the Ibuprofen and give him Nolvagina (Nolvagine).  Ok, I really didn't want to experience the fright again so I was on it. When my 4 yr old had one while we were walking home from school, we were sent to a pediatric neurologist.  


I was ready to hear anything she had to say. And you know, it was good. Tests came out clean. We just couldn't let him run a fever.  Give Nolvagina at 99 (37) and repeat it every 4 hrs if need be, every 6 if the fever stayed under control. 


So we're in the states for an extended vacation and low and behold, both kids get sick. No biggie but we have a fever situation for the oldest. Since it's not his first fever this trip, we are running low on our Golden Fever medicine. I figure, we must have it in the states, maybe it's just prescription or something.  


Oh no it's not prescription.  Nolvagina/Nolvagine (Metamizole) has been banned in the US since 1977. 30 other countries followed suit.  And while Brazil isn't the only country that still allows it, it is one of the top users.  


I bet you are wondering, well what's the problem.  The story is that Metamizole causes Agranulocytosis. Agranulocytosis is an acute condition involving a severe and dangerous leukopenia (lowered white blood cell count), most commonly of neutrophils, causing a neutropenia in the circulating blood. It represents a severe lack of one major class of infection-fighting white blood cells. People with this condition are at very high risk of serious infections due to their suppressed immune system.


Well there you go.  That's peachy with a side of pear.  With a little more Wikipedia research, I found that the incidence rate of metamizole-induced agranulocytosis is between 0.2 and 2 cases per million person days of use, with approximately 7% of all cases fatal 


Ok, nothing too shocking. Not 1 in 4 or anything crazy like that. 


What now?  I think I'm going to go with my doctors back in Brazil.  At the very least, both these medications were given as a last resort after other things didn't work.  And you know what, they do work well. Nolvagina kicks my kid's fever's ass every time, and that is not an easy feat.  


Eventually, as my youngest, my oldest won't have the seizure issue, fingers crossed. Then it won't even be the issue. For the time being, it seems the lesser of two evils. 


How would you feel about this?  Would it freak you out if you were prescribed a medication that is banned in your home country? 

Mashed Potatoes with a side of Hemorrhoids

So what's for dinner tonight?  Steak and mashed potatoes.  Awesome! Some down home cooking for this lady and her family.

Did I mention that the potatoes are powdered and come in a bag?

I will never forget what a proctologist once said to me in Rio de Janeiro (see post here TMI).  He went off, "You Americans and your Instant Mashed Potatoes! Who the hell doesn't have time to make real Mashed Potatoes! And that's why you have hemorrhoids, that and your sauces."

I was like, Dude, you summed up all our food right there: instant, powered, and sauce.  Thank goodness he didn't mention hot dogs and potato chips.  I would have had to throw down then.

But he was so right!  As fast, fun, and easy for the whole family as that envelope of powdery goodness can be, it's kind of nasty.  There really can't be any potato in that bag.  Trust me, I've burned potatoes down to powder and it doesn't look like that.

I can't lie though, I'm tempted to use them.  It's just so easy.  Rip, pour, and mix. I don't even have to use milk. It's uncountable calories, saturated fat, and no nutrition mixed into one tasty side dish.  I can't image the trouble they went to finding the right mix of chemicals to get that real butter flavor. Now that's effort with a capital I-will-not-let-one-drop-of-real-food-get-into-this.

Oh well, when in Maryland, do as the Marylanders do.

I'll just call the above mentioned doctor when I get home and make sure he does entire families.  At least this time I can convincingly tell him that I am not having anal sex, just eating instant mashed potatoes. I don't know which he'll be more annoyed with.

Missing jeitinho

I am having a serious case of the missings.  What am I missing?  Jeitinho!  Jeitinho, if you do no know already, is a sassy Brazilian way of bending laws, rules, and boundaries.  While it's not always the best thing for a government, it's pretty awesome using it day to day.

You see, I'm in the US, the consumer capital of the world.  I would like to buy things. Normally, that is not a problem, unless you want something you need a prescription for.

I, myself, would like to stock up on contacts. I can save a pretty penny buying them here. I basically get 4 boxes for the price of 1 back in Brazil. Awesome! So, I talked to my Brazilian Optometrist and got him to write my Rx out exactly like Americans do. Everything was perfect.

That was, until, I spoke with 1800 Contacts. It appears that the contacts prescribed for my right eye are discontinued.  No, they can not switch it to another brand. No they do not want my money.

Helly! Jeitinho? Switch it. What's the big deal!  I even went into Walmart and asked there. They were going to just switch it but the computer wouldn't let them add my doctor. Again, Jeitinho! I don't know about them, but when I worked in sales, I made the sales happen.  Get creative. Put a local number.  Mess with the address a bit.

Of course my All American family reminds me they could get in trouble for doing that. Why?  Because I'm going to get high off my contacts? Oh no, wait, it was an excuse to charge me $200 for another check up, just to make sure they could switch to an equivalent.

Youuuu Whoooo, I'm the buyer here.  My Doctor isn't the one who should decide the brand, I should. I should be able to switch based on saving a dollar or getting a free sticker if I want.  It's like prescription and generic.

Oh well. 1800 Contacts, you can kiss your $100 goodbye.  I'm taking me, my crappy eyes, and my Brazilian Rx to a small local Optometrist and see if I can Americanize the jeitinho and get me some cheap contacts.

You know you are sick in Brazil when:

1. You have a blanket up to your neck while everyone else is under the fan with their shirts off.

2. You are told to go see a doctor and NOT self medicate, as all good Americans like to do.

3. You are informed by your doctor that while the antibiotics you picked for yourself would have been perfect in the states, they are not the best option in South America, as the bacterias here are stronger.  Do you mind switching, there will be no harm no foul?  Of course not! She could have said you need to take donkey stool and I'd ask if it was available in powdered tablet form. 

4. You did not get told off for self-medicating!  In so many words...

5. When the doctor asks you about your symptoms and you complain that you feel like you are dying, she compliments you on your Portuguese.

6. You want to cry because you want a Popsicle.  You are informed that you can't because cold is bad for your sore throat. You say but you always ate them when you had a sore throat as a child.  Response: Maybe that's why you always had sore throats as a child. Touché. 

7. You are automatically given Floratil (healthy bacterial tablets) when you are given antibiotics. Just say no to the poops! Amen!

8. You have started to like the taste of Própolis.

9. The quantity of tea that you have been given is not helping Floratil from #6 do it's job.  

10. Someone suggests you may have a macumba (actual term fez um trabalho/did a work) from Candomble.

What did I forget?

Mother/Mother-in-law MD

I was reading a blog post about someone´s mother-in-law MD situation.  You know the one, where your MIL thinks she´s a doctor and tells you what you, your husband/wife/partner, and children have.  My MIL is pretty good about this. She doesn´t tell me what we have, only advises us on how to treat it.  Being I´m outside my own country, that´s not totally unwelcome.  Given, some of the treatment ideas in Brazil are down right crazy to me, none-the-less I´m a girl who needs some Brazilian treatment guidance. 

The one who´s the MD in our extended family is my Mother. My mother is a sometime blog reader of mine so, in case she reads this, Yes Mom I´m talking about you. 

Seriously, any and all ailments I can think of we have in our family. It´s an anomaly that my family has managed to survive long enough to continue breeding.  We have GERD, ADD, OCD, Manic depression, cancer, asthma, thyroid disorders, heart disease, alcoholism, allergies, and ear infections to name a few. 

I love my Mother, and (Mom this is for you) I enjoy getting each and every diagnosis.  I find it useful, and if not, humorous.  It happens. 

Now on the other hand, I don´t know how my husband feels about it. He´s so Carioca he could have a heart attack without knowing. Actually, he is so mellow that he walked around for 3 days with a collapsed lung and developed bacterial pneumonia before going to the hospital.

You know, when you say that out loud it makes you wonder if he´s super mellow or just a little bit retarded.  I´m going to go with mellow because he´s my husband and I love him.

Anyway, to those of you with the MIL MD issue, don´t take it to heart. It´s caring with a capital short bus and giant gold star. 

Here´s the original article for you curious readers: My Mother-In-Law the wannabe doctor

A few of my favorite things

These are a few of my favorite things, whiskers on kittens, store bought mittens, and waiting for 2.5 hours at urgent care...

For starters, everything is A-Ok, which is kind of annoying after over 2 hours.  I spent the weekend with chills and a fever, plus shortness of breath.  It was voted on by my husband and mother and decided that I needed to get checked out today. This voting system shows I´m even more Brazilian than I thought.

So it´s a virus.  Thankfully so.  I hate taking antibiotics or any medicine for that matter.  Of course, after about 1.5 hours in Urgent care, your mind starts going a little crazy. You start thinking that they´d better find something, anything.  It could be anemia, a parasite, tennis elbow, a pimple, I don´t care what it is but after this long FIND SOMETHING! 

It´s so frustrating to know you "wasted" time. Of course it´s not wasted. Better to be safe than sorry. Then again, I would have preferred my unsafe and sorry ass in bed watching a movie during my free time but what´s done is done. 

It just all comes down to my kids. Sure, sure, blaming the little ones again.  But it is their fault.  I have two little men I adore and that makes me realize that I have to be immortal. There´s no way around it. I can not break their hearts, I can not trust anyone else to raise them like I do, and I just basically have to be here forever.  That need for immortality, oddly enough, just seems to accentuate the fact that I am, in fact, mortal. 

Ah well, what can you do?  You get sick and see a doctor. They get sick and they see a doctor. Hell, my kids look sideways and they see a doctor.  They really shouldn´t expect any less from their Momma. 

Love my Medical Care in Rio de Janeiro!

I have to say that I love the private doctors in Rio de Janeiro!  Love them! 

If you love them so much, why don't you marry them?  I would if I could but they just won't have me. 

I had to repeat my youngest's stool test to see if his little pest was gone.  Still here.  Rafa is a great source for good food and fun. 

So I called his pediatric gastrologist's office and she wasn't there.  You'll never guess what happened next!  They gave me her cell phone number!  I called and left a message.

Ah, too good to be true. There was no way I'd actually get to talk to her that easily. Wrong again, she called me back within 15 minutes to talk about my son!  And she's a specialist!

She perscribed the meds over the phone and like magic, it's all taken care of. 

This is the norm here!  I have all my doctor's cell phone numbers, except for the regular pediatrician but screw him.  I do have his home number. 

You can get in touch with any medicial professional at any time. It's the way the job works down here. 

Now, I'd hate this if my husband was a doctor. I get pissed when he gets work calls at 8pm, imagine me in the middle of the night. But he's not so not my problem.  

So note to self, if you marry a doctor in Rio de Janeiro, don't be surprised if he gets a phone call from me in the middle of the night.  Not to worry, it's not that kind of call. He already said no.