How do I help my college freshman know when to seek medical help? My son is home for the weekend and he showed me his feet which have some really horrendous skin issues going on. I took him to a doctor’s appointment last month for a physical and he showed his doctor his feet and she prescribed some topical medications for him that seemed to work initially, but his feet are now worse than ever. I’m appalled by the condition of his feet, and am really surprised he didn’t take some action about this earlier. He knows how to contact his doctor, and has known her his entire life, so it’s not a matter of being uncomfortable with her. I feel like he just doesn’t know what types of problems require follow up with his doctor.
I can no longer communicate directly with his doctor because he’s over 18 (though I can make appointments and she made a point of coming out to chat with me after his physical), and am not sure the best way to make him understand what’s serious and what isn’t. Any advice? I’m making notes of points that I want him to cover in an email to her that I’ve asked him (and he’s agreed) to send to her.
Are his feet really a serious medical problem or a cosmetic issue? Not seeking medical help is a medical decision. He chose to live with a problem that wasn’t really bothering him. A lot of people do it and it isn’t always the wrong thing to do. Plenty of people go to the doctor only to be told they need to wait for the problem to pass on its own. If on the other hand, it is bothering him and he didn’t go to the doctor, I would ask him why and make sure he has a doctor close to campus.
Your son can sign something that allows you to be involved in his healthcare. My 18 yo son has signed that with various doctors because he’s got a number of medical issues and doesn’t mind me being involved…for now.
Haha – good luck. My younger kid fell on campus and hurt her arm. Didn’t want to go to Urgent Care (campus clinic closed). Her logic: “It doesn’t hurt as much as the time I shut my hand in the car door, and that wan’t broken.” I insisted (from across the country). She relented the next day, and sure enough – it was broken.
Another time she cut herself with a box cutter by accident (also when campus clinic closed). She sent me a photo, but ignored my advice to seek stitches. Eventually it got infected, requiring multiple Doctor visits and antibiotics.
My older kid (25) sliced off the tip of her thumb with a new kitchen device recently, couldn’t get it to stop bleeding, and she resisted going to the urgent care as well when I told her to. (She also sent a photo – a grisly side effect of the smart phone, I guess!). Also ended up requiring multiple dr visits, although at least she eventually did go the same night as the accident.
These are kids with health insurance, too. And Urgent Cares that take the insurance less than a mile from where they live.
Regarding signing for your involvement, my youngest signs that for her health insurance annually. I make sure it is on file and up to date. But every clinic will require their own form signed as well , and it probably is only good for a year.
@gettingschooled - That’s really my concern. It’s clear to me that it’s a medical issue, but I think he saw it as a cosmetic issue and didn’t want to be a whiner. He’s pretty stoic - AND he’s been very busy. As I type this, he is in the process of sending his doctor an email (through a special online healthcare set-up) and plans to give me his user name and password to the healthcare site so that I can help follow up. His college is only about 30 miles from home, so he can have nearby doctors, but I need to take him because he has no transportation. He’s willing to do what I ask, but I really want to find a way to help him know how to recognize serious situations on his own.
In our family we really tried to cram all that sort of basic life training stuff into the first 18 years.
It doesn’t apply in this case, but one tactic if your kid reports an injury to you but doesn’t want to get it checked is to ask them to contact campus security. They have some medical training, and can help evaluate if the student needs immediate or follow up medical care.
I went through this with my D a couple of weekends ago. She had a bad cold. It took 20-questions-via-text to figure out her symptoms, and another day for her to realize that “Advil” = that gigantic bottle of Costco ibuprophen she had brought to school. But I came to the conclusion that she just wanted some TLC from Mom, that she had her BF, suitemates and sorority sisters to take care of her in situ.
I realize not the same as gnarly feet!
@justonedad - we covered a lot of things like high fever, persistent sore throat, cough, vomiting or diarrhea, but open oozing sores on his feet just wasn’t on our radar. He’s had issues with eczema in the past, but was always assured that they were minor. It’s not a matter of being ignorant of health issues. It’s a matter of learning the tipping point between an annoying condition and a potential for a serious condition.
I have faith that the OP’s son will learn to take care of himself. But some people never do, like my husband, 61 years old, who prefers to be coddled and have someone make a big deal about his injuries and illnesses before he’ll take the time to consult a health-care professional.
Some people are just like this - I have a relative (60 so no excuse for being young) who recently fell down some stairs - took her a week to finally see the doctor and find out she had fractured 4 ribs! Another who wouldn’t see a doctor with an obvious broken foot.
One piece of advice is to have your child check with a friend. sometimes a second opinion (from somebody other than a parent) is a good thing. On occasion, my daughter’s friends have decided (as a group) that somebody needed to go to the ER - things like rashes, allergic reactions, eye injury, etc.
Your child should know locations of the college health center, a nearby urgent care place, and the nearest ER. The urgent care place is great because they usually have expanded hours and treat patients quicker than an ER. They will also send to a hospital if required.
I see this kind of thing all the time. I’ve also heard colleagues tell stories of college students who refused to seek care or holed themselves up in their dorm room while ill and then died from horrible illnesses like meningitis, etc. because no one was checking on them.
For this instance, you could email the Dr. (since you now have access) and kindly request that the Dr. review guidelines with him for seeking medical care such as:
-cough that worsens or persists longer than X amount of days
-shortness of breath
-rash that does not improve within X amount of days or that worsens/changes characteristics, etc.
-pain that seems out of proportion to the injury or pain that persists beyond X days
-etc. etc. etc.
I always review a list like this with my high school aged patients and I also advise them not to hole themselves up in their dorm room when they get ill. Flu season is the WORST! I sometimes will send college students back to their parents house while they are sick. I worry about them in the dorm. Additionally, I advise all parents to prepare a sick basket when they are leaving for college full of soup, Gatorade, ibuprofen (in limited amounts…they will often just keep taking ibuprofen instead of seeking care!); a thermometer, decongestant, etc. You could take it a step further and type of a list of signs and symptoms that indicate further healthcare is needed, laminate the list and put it n the bin or basket for quick reference. I’m sure most kids these days hit the google for their symptoms, but a typed up reference list might hold a little more weight.
It’s a new learning curve. My kids were never sick as kids, and we didn’t go to the doctor much. One did break her arm and I didn’t know it for two weeks. Yep, I’m that good of a mother. When we went to a recruiting visit, all the other kids and parents were asking questions about trainers and taping and ice baths after practices, and I thought ‘What a bunch of whiners. Just walk it off.’ Well, that daughter uses the trainers a lot, and has become somewhat of a pampered princess herself.
Other daughter fainted and boyfriend insisted she go to the ER. $1600 later, she’s now instructed to go to college clinic first, then urgent care if necessary, but fainting doesn’t make it necessary or at least call me first. ER is a last resort, usually requiring a paramedic to take you there. This daughter did successfully arrange her own eye exam and buy glasses. Progress.
OP, does your son’s school have a clinic? If so, he should get himself set up there. Going back to his old doc might be inconvenient for him.
At our house it is Advil and hot and sour soup from the Chinese take out. It that doesn’t fix it, then you need to go to the doctor after 2 weeks.
As someone who visits ERs a lot… I do have to disagree with the 2nd part. Yes, ERs should be a last resort but they certainly don’t usually require a paramedic. (And no, I don’t abuse the ER system. Every ER visit I’ve ever had has resulted in a hospital admission that lasts at least a day… and I’ve been in an ambulance less than 5 times.)
Urgent cares are great for things that can’t wait until your doctor opens (colds, infections, minor injuries, etc) but they are not great if you’re in a great deal of pain, have a very high fever, break a major bone, etc- and generally none of these require an ambulance (unless you can’t find someone to drive you).
Knowing when it’s appropriate to go to the doctor and when it’s not is a great life skill. Knowing which level of clinic you need is also a great life skill. In general though, we’re bad at this regardless of our age. IMO, a good rule of thumb is that if it’s something that interferes with your daily life and isn’t a known condition that just needs to be attended to at home (like a cold), then it’s time to go to the doctor.
I typically call and ask my doctor (or her nurse) whether I should be seen for whatever my specific concern is.
The urgent care in the hospital I was in recently did not do any stitches - so any wound requiring stitches would require an ER visit (this was in Boston)
I agree that if you were not sick much as a child when you go to college you have less experience with sick visits and may not know what service to use.
there is a learning curve, for sure. 
but technology is great these days. since he has the ability to email his doctor, presumably he has a way to send an attachment (or picture in body of email). have him take pictures of his feet and send them…then the dr can make the call as to whether he needs to be seen or if he just needs a different prescription.
i’d continue to stress the point that while it might seem minor today, it has a potential for a major problem. its his body, and he only gets one…its his job to take care of business.
and also stress he isn’t “bothering” anyone-doctors are paid to be “bothered”.
hopefully its nothing that a new cream wont fix.
I meant the ER is the last choice for my kid in her learning process. She is probably closer to the Urgent Care (small town, she just didn’t know it was there, boyfriend panicked, took her to the ER. School Clinic, Urgent Care, Call me, ER is the order for her.
There has been a news report running this week about ERs that are not connected to hospitals (although sometimes run by a hospital) in our town. People think they are Urgent Care offices, but they are not. One guy went with a splinter under his thumbnail, and the bill was about $4000. Just walking through the door is over $600 because it is the ER. Urgent care would have been $150 - I’ve been twice in the last 6 months with two people with sliced fingers). Our Urgent care does stitches, and then the fee is $300, but superglue is just the $150.
Did it stick?
Most of what I tried to teach my kids didn’t stick – especially if it was taught out of context or if I was the one making the decision.
You could sit down with your teenager and review the criteria for deciding whether a particular health issue requires a doctor’s office visit, and you can even discuss the subject when you (or the kid) has a health problem that’s in the gray area, but until the day comes when the kid has to make the decision himself/herself, that information is likely to fly right over the kid’s head.
At least in my experience.
Teach them the 3 day rule…if it doesn’t clear up in 3 days, go to the doctor!
But it is good to for them to know where there first line of doctor is…my oldest who had graduated had a high fever so we said you have to go to the doctor. But she hadn’t picked out a doctor so we looked at the closest walk in clinic to her. Later she gets a bill because she went to an our of network doctor and was surpised.