Ubat Sarah
Last Tuesday, I made an appointment to see a GP for Sarah. Her eczema on her body was worse than ever. She was scratching most of the time and woke up at least twice in the night. Her epaderm emollient was always by her side. She even applied it herself. I felt so sorry for her especially because she didn't cry.
The clinic was within walking distance, but it was raining. Making it difficult to push Sarah in the pushchair and carry Amar and holding an umbrella at the same time. I decided not to become a Superwoman and had to "tebalkan muka" and asked for help from Kak Haz and her family. (Babah was oncall for a week so couldn't come home)
I sent Amar to the Malay family who lived 30 doors away from our house and took Sarah to the clinic for a 4.20pm appointment.
The GP examined Sarah's eczema and prescribed
- antibiotics (Flucloxacillin) to be taken 5ml, 4 times a day and
- a mixed cream consisting Diprobase, Fucidin and Diprosone to be applied twice a day.
The GP asked if Sarah is allergic to any type of antibiotics? I didn't know how to answer the question because Sarah has never taken antibiotics before. And how would I know if she is allergic to flucloxacillin afterwards because she already has inflammed skin and some rashes now?
I also asked the doctor how many days should Sarah take the antibiotics?
The GP said, "5 or 6 days." Dalam hati said, 5 ke 6 ni because I thought kena ambil for 7 or 14 days? and pandai-pandai asked, "Not 7?"
The GP said, "5 or 6 is ok."
"What about the cream?" I asked further.
"You can use it until she's better." The GP replied after a pause. "But I want to see her again after one month." Continued the GP.
I just wanted to be sure because from my brief research, there are some side effects on taking steroids on a prolonged basis. I didn't ask further because I didn't want the doctor to think that I was trying to be clever. And didn't want to be labelled as an ordinary patient who chose not to listen to her doctor. Tak pelah, balik nanti boleh tanya Babah or boleh call Auntie De or even Dr In The House ;)
Returning to fetch Amar, I was feeling quite satisfied that at least Sarah has a prescription from the doctor. The medicines have to be collected from Dhaliwal Pharmacy, a long walk from home. I just had to ask for extra help from the Malay family to look after both kids while I quickly run to get the medicine from the pharmacy.
When we reached Kak Haz's house, she was busy cooking for her children. She said it's her daily routine before she goes out to work again in the evening. So I discarded my thoughts on leaving the kids there.
My second option was to ask help from our next door neighbour. Still with a "thick face", I rang their doorbell. But no answer. ~Tak de rezeki~
It was still early evening, around 7pm. I was preparing the kids for their bedtime when our doorbell rang. It was our next door neighbour!!! Her daughter needed help with her school homework. And I said I needed help to get the medicine. She was more than happy to take us in her car the next day.
The next morning, we went to the pharmacy. The pharmacist managed to prepare the antibiotics and epaderm in 10 minutes. But the mixture of the three medicine (the important one) will only be ready in one week's time.
I was quite frustrated, Sarah has to wait that long for the cream. There was no point in arguing, they said one of the ingredients were not in stock and also because of the long public holiday.
As usual Sarah has no problem taking her oral medicine. This time, she was even more excited because the flucloxacillin is pink in colour.
Since yesterday, we started to give Sarah Pyriton as well. During the day, we didn't see her scratch that many times. But last night, she woke up at 4 in the morning and started to scratch until 6!! Babah applied some epaderm. But that didn't stop her from scratching. She has also started coughing, so we gave her cough syrup too. Just imagine the doses I have to remember and the time of the day that I have to give her the medicines.
I'm glad that we are going to get the cream from the pharmacy today. Babah is coming home from work later today to drive us to the pharmacy. He's not staying over in Kettering. Yippee...
6 comments:
As I had posted earlier (it must be in your comment box somewhere, :p),
I'd suggest:
1) Syrup Clarytine
2) Short course of syrup prednisolone
3) Elomet cream (mometasone)
I read earlier that Amar is asthmatic so no wonder Sarah has eczema.
DITH;
I do not know how to retrieve the missing comment. :(
I did some homework reading up about elomet and clarytine syrup. Don't want to reply and make myself sound clueless or stupid.
Some medicine are not sold over the counter in the UK. Normally you have to get a written prescription from your GP first and then the pharmacist will issue out the ubat.
~Leceh~
However, I thought I've seen clarytine brands on the counter at a pharmacy. Will ask them when we go there next time.
I was reading the possible side effects on taking mometasone. the article said, they are not common but can occur. (eg: acne, skin sores, burning, itching....)
menakutkan. but i'm sure the other ubats have the same possible side effects.
To Auntie De and Babah: How can I ask our GP for mometasone?
We can buy over the internet though 15g for £25.
Also, how is mometasone different from diprosone or hydrocortisone?
(i'm guessing one answer; it reduces itchiness and inflammation)
Sorrylah everyone, trying to get a free consultation pulak. hehe.
my two sen:
from what i could see, i think sarah's eczema has started to become lichenified, which means topical steroids will invariably be included in the list of treatments. and yes, there are side effects to using topical steroids such as those u mentioned, but is more of a problem with prolonged use, and the use of more potent steroids. its a balance between the problems with side effects and keeping the inflammation under control. it does however seem that sarah needs the treatment and therefore benefits outweigh the risks.
id start out with first line stuff like hydrocortisone and see if that helps before going on to more potent steroids such as mometasone, bearing in mind that sarah is still only 2+.
if the use of more potent steroids is warranted, then have a chat with your gp, get it on prescription rather than buying it on the internet. or if u want to buy it, ask babah tu see if he can get it at staff price at his hospital pharmacy! :)
(kalau kat msia i dah cakap kutip kat klinik bandaran, heehee..)
my two sen, mama sarah. hope it's useful
Yes I agree that Hydrocort should be the firstline cream. But the way Nisak described the lesions sound quite extensive thus I suggested Memotasone.
True, Elomet is potent but as far as I know it has amongst the lowest absoption factor and apparently safe for kids.
:)
well, sarah may need more potent topical steroids, and i think the gp may have plans already to start her on stronger stuff if the current less potent meds don't help by the next apointment.
the way i understand it, absorption factor (absorption into the systemic circulation) does not count when we are dealing with the local side effects that mama sarah had mentioned, i.e. acneiform eruptions etc etc.local side effects are still seen more with prolonged use and more potent stuff. it is the systemic effects that are lessened wtih low absorption.
my opinion anyway :)
Dear friends;
Auntie De Your two sen will be paid later. And DITH, I'm assuming yours is FOC. Thank you very much.
I have read and read and read again your comments and advises. Paying reference to the dictionary and medical encyclopedia websites frequently to grasp the meanings of some words both of you used.
Last nite, I dreamt that I was nervous entering an examination room because I have not finished revising my Kumar and Clark textbook.
Nasib baik mimpi.
Anyway, Thank you once again for both of your written opinions and babah (verbally). I value them very much. (Panjangnya introduction)
I have started to apply the 3-in-1 cream on Sarah. BAdan/tangan dia dah tak luka. Her nanah dah gone.
Cuma bila nak tidur, dia start garu again. I have to apply epaderm to moisturise her skin. (tp garu juga kdg2)
And still wake up in the night at least once to garu. tapi i have to say, not as bad as before.
If her condition tak improve, I will consult our GP about the possibility of prescribing sarah mometasone + clarytin.
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