The Joys of a Teaching Hospital

Eliza had a check up with her pediatric GI on Friday. Since he is at a teaching hospital, there is a Fellow who you are seen by before Dr. R makes his appearance. Now I don't mind in theory "helping" these folks to become better doctors, but sometimes they seem to be incapable of looking beyond what they have been "told" is correct by some text book. Eliza has historically been constipated so she has been on one medication or another for the problem. Dr. R. had switched her from lactulose to miralax about 6 weeks ago. Given that Eliza is only taking 2 to 3 ounces at a time it was virtually impossible to get the right mixture of miralax for Eliza because she can't consume 8 ounces at a time which seems to be the minimum amount of liquid you can mix this stuff with to avoid a nasty grainy mixture. So after some trial and error, I switched Eliza back to lactulose and she is happily pooping once again ... which brings me back to the pediatric GI Fellow. Dr. Fellow, I'll call him, kept adamantly insisting that miralax could mix with anything and that I should really be using it instead of lactulose. After listening to his testimonial to miralax, I finally asked him if he himself had ever in fact tried to mix it with anything, let alone a fairly thick formula like Resource JFK 1.5. Indeed he had never tried to mix miralax with even water. I suggested he give it a try before he lecture me on my "inability" to get the stuff mixed properly and to be cautious before he told another parent how to administer one medication or anonther unless he himself had tried to get the same thing into a very annoyed toddler. Ahhh the joys of a teaching hospital.