The biggest risks for kids are the same as for adults. They're just even more fragile and their dosing has to be carefully monitored. Long-term use can lead to liver damage. An accidental overdose could cause her problems breathing. And they'll probably cause her to have mood swings.
Euphoria's common with narcotics. Sometimes the swings can be to depression. You've taken then before. Kids are especially sensitive. The medication is basically designed to trick the brain. They don't take away the cause of the pain, they alter your perception of it. Sometimes that signal gets jumbled up badly and it can throw off the chemical balance of the brain entirely.
Every medication comes with risks, Alfie. That's why I want to know what her actual pain levels are. If they're off the charts, she's going to need something strong. If they're moderate, we can go with a moderate option.
This isn't a negotiation, Alfie. It's about what medication is best for her based on her symptoms. In very careful doses, narcotics can be helpful. I trust you, Tifa, and Duster can be very careful when it matters.
I understand you're worried about her, Alfie. Please just ask her what her pain levels are. This entire back and forth might be moot. I'll make a recommendation. You can take it or you can leave it and get a second opinion. Regardless, I'm happy to write a prescription for an NSAID for her, even if she might need something stronger.
And after you told me this isn't a negotiation, am I supposed to take you at your word? I do not feel confident that you wouldn't give her the stronger stuff, knowing that we wouldn't know the difference, because you know best.
Liver damage, euphoria and depression, chemical changes in the brain. I don't care if it's only a possibility, it's not worth the fucking risk here. Better in pain than dead.
You really think that little of me that I'd lie to you about this? When have I ever lied to you about something medical? When have I ever lied to you about anything?
[The 'you cock,' is left out, but heavily implied.]
Don't take your fear for her out on me. You're better than that, Alfie.
[And this is why we don't give uneducated, fearful parents full explanations of drug side effects. John's affront is growing by leaps and bounds. He's tempted to just tell Alfie 'fuck you' and sign off. That wouldn't be productive, though.]
Mr. Solomons, I don't treat people without their consent or without the consent of their guardian. Unless it's someone like the bloody Joker. I don't fake medications. And I don't know where the hell you ever got the I idea that I'm that kind of doctor. This is basic bloody medical ethics. Maybe that doesn't mean much to half the doctors here, but it sure as hell does to me.
No, you think it doesn't mean enough to me not to trick you for your own good. News flash, mate: Patients and their guardians make bloody awful decisions about treatment daily. My job is to give you an opinion and recommend a course of treatment based on that opinion. I can offer alternatives that I may not think are best, but that will still do something. If you choose one of those options, that's what we go with, regardless of my opinion.
Or sure, go and find another doctor who'll roll over and bow to the great Alfie Solomons instead of giving him the goddamn facts.
Bully for you. Ask her what her pain levels are, regardless. That's going to be the first question any of the doctors here ask. Also make sure you know her weight. That'll be important for dosing.
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What are NAIDs?
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Nonsteroidal anti-inflammatory drugs. Basically, I'm talking about things like ibuprofen or aspirin.
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It's in her hands. She has trouble writing sometimes, and she likes to draw.
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What sort of mood swings? Why would pain medicine cause that?
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I understand you're worried about her, Alfie. Please just ask her what her pain levels are. This entire back and forth might be moot. I'll make a recommendation. You can take it or you can leave it and get a second opinion. Regardless, I'm happy to write a prescription for an NSAID for her, even if she might need something stronger.
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Liver damage, euphoria and depression, chemical changes in the brain. I don't care if it's only a possibility, it's not worth the fucking risk here. Better in pain than dead.
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My opinion isn't negotiable. What I give her is.
You really think that little of me that I'd lie to you about this? When have I ever lied to you about something medical? When have I ever lied to you about anything?
[The 'you cock,' is left out, but heavily implied.]
Don't take your fear for her out on me. You're better than that, Alfie.
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If we were speaking out loud, with our voices, you could hear me say that in a tone that isn't accusatory. But it is what it is, mate.
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Mr. Solomons, I don't treat people without their consent or without the consent of their guardian. Unless it's someone like the bloody Joker. I don't fake medications. And I don't know where the hell you ever got the I idea that I'm that kind of doctor. This is basic bloody medical ethics. Maybe that doesn't mean much to half the doctors here, but it sure as hell does to me.
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Or sure, go and find another doctor who'll roll over and bow to the great Alfie Solomons instead of giving him the goddamn facts.
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