What a Difference a Doctor Makes

[Guest guest]

My son, , is 7 yrs old started fevering this year. When I

realized it was becoming a pattern I requested testing done and my

ped ran basic blood work as well as Lyme disease and Epstein -Barr

tests.

The only odd thing they found was a mildly elevated ESR. That was

enough to concern my ped.

We started at infectious disease. That doc was convinced we had a

viral sinus problem due to allergies and started Nicky on claritin.

This based on all of his symptoms being above the neck & his eczema

on his body. He also just happened to have a fever during that first

visit. When she ran blood work his ESR was fine but he had a low

neutrophil count--so she was convinced we were dealing with a virus.

Fortunately the ENT/Allergist didn't agree and a CT scan proved he

had no sinus problem.

On to the Rheumatologist. My ped wanted me to see Dr. Gottlieb. She

could not get me in until mid July. He called her and nothing could

be done so she suggested we meet with her colleague-Dr. Eberhard.

That appointment was in May--and was a complete waste of my time.

Dr. Eberhard rotated every body part she could and sat down, looked

at me and said he has . Thats it. She told me we could try

prednisone, cimetidine or tonsillectomy. She told me to ask the ENT

about doing the tosillectomy. She told me to research online-

and come back in a month for a follow up.

When I called her the next day to question some things I read about

she told me that if I didn't like that diagnosis then have

someone test him for cyclic neutropenia.

OK --so I talk to my Ped and he tells me to make the follow up with

DR. Gottlieb since I had a month or so to get an appt.

Now here it is Mid-July and I see Dr. Gottlieb.

She takes us in for the exam, rotates every body part. Jokes with my

son. Marvels at his flexibility ( he is apparently hyperflexible--a

condition that really exists). Then she sits down with me and asks

all sorts of questions--including our families nationalities (

finally-someone asked.!) She then commented on his neutropenic

episode and said he need to be tested for IGD and Cyclic neutropenia.

She said she only uses prednisone for emergency situations--going on

vacation, parties etc.. She frowned at a tonsillectomy--said she

prefers to use that for severe cases and as a last resort.

She took blood for the above tests and said he needed to go for blood

work 1x per week for 4 weeks or until he fevers---to check for cyclic

neutropenia. Then if all is negative she would like to try cimetidine.

If after a trial of cimetidine he doesnt't respond she will then

start genetic testing. She says she won't do that right away since it

is very costly--over $600 per testing--though they would try to

convince insurance of it's necessity. She explained about genetic

mutations and that it could skip generations-so we can't rely

completely on family history.

I mentioned the NIH to her and she said it is a great thing and did

say there was a long wait to get in.( I told her it would take that

long for me to save enough money for the genetic testing anyway--LOL)

So now it is 1 & 1/2 weeks later. His initial blood work was fine with

a slightly elevated ESR ( 20)--we expected a fever last Tuesday and

it never came. This past Monday's lab work was all OK with an ESR of

30. He fevered on Tuesday and was back to normal by Wed evening. So

we are going to start cimetidine this weekend. We have a follow up in

Sept at which time she will evaluate the effectiveness of the

cimetidine.

I am amazed a how different 2 doctors in the same practice could be!!!

Mom to age 7