LB had an appointment with the GP after school today. He’d had a liver function test to check out the medication for his newly diagnosed epilepsy. The doc said that there was a bit of a problem because the blood level showed that the drug was at a level that suggested it wasn’t being effective. Instead of a level (of something but no idea what) of between 40-80, LB’s blood showed 25.
The options were to up the dose to a level at which it was effective, continue the dose (but it wouldn’t be achieving anything) or stop the dose because, as it wasn’t working and he hadn’t had a seizure for three months, he didn’t need it. It was up to me to decide.
Whoa. Hit me with the first example of non paternalistic decision making I’ve ever experienced when the stakes are so high, why don’t you?! The potential of tonic clonic seizures or even stronger medication with hideous long term side effects.
I got the doc to talk me through it all again, and once it became clear that upping the medication was only really treating the medication, as opposed to preventing seizures, I decided to keep the dose as it is until we met with the neurologist again. I’m a bit suspicious of stats at the best time and didn’t really buy the 25/40-80 stuff. So the outcome of my first patient weighted decision making; defer the decision.
So home, kettle on, dig out school diary to find out the latest happenings in the sixth form.
“LB has been brilliant today. He has an egg to look after as part of our work on trust and bring back tomorrow hopefully in one piece”.
“Wow! An egg of trust? LB! Where’s your egg matey?”
“In the bin.”
“What? Whaddaya mean???”
“It’s in the bin, mum.”
And it was. Crushed. Barely retrievable.
“Why did you chuck the egg away, LB?”
“Cos I’m ANGRY WITH THE SCHOOL. They wouldn’t let me do what I wanted to do”, he fumed.
“Yeah, well sometimes you have to do what you’re told, matey”, I said, putting on a pan of water to boil a new egg of trust. “And sometimes you wish you were told what to do…”