After a day (or make it a week) like this I begin to think I chose the wrong profession. I should really have an M.D. or R.N. after my name.
Most Ukrainians I know rush to the doctor at the first sign of a cold. Pharmacies are on nearly every street corner and practically any drug you want can be purchased without a prescription. Nevertheless most people admit that many doctors have bought their degrees and many of the medicines in the pharmacies are fakes or ineffective because of improper handling. That's where I come in. I have a book on my shelf, Where There Is No Doctor, (which I've fondly renamed Where There Are No Good Doctors). I also have access to information in English on the internet and a sister who does have a few of those letters after her name (and she actually studied for those credentials). This is what makes me "qualified" to answer all sorts of questions.
Sunday a mom at church tells me about her two year who was very sick during the night with a high fever, rapid breathing, cough, and what sounds like retracting. They didn't take her to the hospital because I guess they're afraid that with it being a weekend there are no doctors in and they'll just be sent home (they tell me it's happened before). I promise to come over with some of the medicine I have for Matthew's asthma. When I arrive I count her shallow breaths at 40 a minute. She no longer has a fever and her cough has calmed down. I use my nebulizer but the albuterol is 10 months expired and doesn't have much effect. I think she could have bronchitis. I leave them with some albuterol and a baby spacer and teach them how to administer it. I also give them a steroid suppository to use in an emergency. Before leaving, I write down the medicines she's taking in order to check the ingredients and dosage on the internet. It turns out that the one medicine has a concoction of antibiotic, expectorant and something else I could never figure out what. The amount of antibiotic was 12 times less than what a minimum dose should be - but just right for building up a resistance to antibiotics and creating "superbugs".
The next morning I call to check on her. She's better but still breathing fast. I had talked to my sister for 40 minutes that morning and together we had come up with a plan. My sister told me how to listen to her lungs with a stethoscope, what sounds might indicate what illness, and what antibiotic and dosage she should be on if antibiotics are needed at all. I decide to leave the kids with some school work to do on their own and walk on over. I listen to her lungs and can hear a wheeze. I bring with me a different albuterol inhaler and spacer and give her that. It makes a marked improvement in her breathing. Since she's definitely improving and walking in sub-freezing temperatures isn't the best thing for her, I recommend that she use the inhaler every 4 hours. The mom agrees. By the next morning she's completely fine. She probably has a bit of asthma since this a repeated problem but now they have a spacer and inhaler to treat it with. I'm quite positive the doctor would have prescribed antibiotics which wouldn't have helped at all.
Today was a busy day of being "on call". An acquaintance called asking me about her sister-in-law's baby who is 2 1/2 weeks old and not gaining weight. Another friend called asking if I knew what to do for her 7 year old son who stuck his tongue to a frozen pipe and now it's white and swollen. Another friend discussed with me her 2 year old's symptoms which sound like a urine infection. Yesterday we gave advice about how to treat gout.
It really would be useful if I was trained to answer such questions. It's sad that all too often I know more (or can at least find out) than the doctors who really do have those letters after their names.