Who’s The Patient?

It’s odd making the transition to observer instead of active-participant in a growing child’s doctor appointments.  I’m accustomed to being the one to provide information when I’m in an exam room with my children.  Kids grow up, though, and things change.

My daughter’s rheumatologist talks to her, not so much to us.  When my daughter shrugs her shoulders and says, “I dunno,” the doctor doesn’t turn to me or my husband for our input; she rephrases the question and pushes my daughter for an answer.

As we sat on the sidelines and eavesdropped while the rheumatologist talked with our daughter a few weeks ago, I reflected back over the years.  Our other daughter was only three when I took her to an allergist.  I remember interrupting him as he was explaining the scratch-test to me, and asking if he would please explain it to my daughter instead of me, since she was the patient.  He looked quite startled and turned his head to look at her, but only got two sentences out before his head gravitated back to me.  He just couldn’t do it.

My daughter’s rheumatologist is definitely different.  I love how she treats my daughter like an intelligent person capable of explaining what’s going on in her body, but it’s weird to not be included in the dialog.

It was interesting, this new way of doing things, when the doctor asked if our daughter thought her prescription was helping.  My husband and I have both seen a difference:  less pain, better appetite, more activity, happier kid.  It hasn’t brought complete pain relief, but it’s definitely an improvement.  We weren’t asked, though.  Our daughter – the person who was asked – wasn’t sure if the medication was helping.

The rheumatologist suggested that she stop taking it.  Give it two weeks.  If there was no change, no need to continue a med that wasn’t making a difference.  If she did notice a difference, then after two weeks a different NSAID might be better.

That seemed like a sensible plan.  My daughter (who hates taking pills) was delighted to have the doctor tell her not to take her prescription and looked forward to her two-week reprieve.  The day after her appointment, she loved not taking a pill with her breakfast.  The following day, she came downstairs and announced dejectedly, “The medicine was helping more than I realized.”

My husband and I recommended that she take her medicine, but she’d heard that she should wait two weeks before making a decision and didn’t want to go against what the doctor had said.  It was Saturday, so we couldn’t call.  Monday morning, first thing, I phoned and left a message.  When the nurse called back, she told me of course your daughter doesn’t need to suffer for two weeks!

The kid even got to pick whether she stuck with the existing prescription or switched.  Of course she stuck with a once-a-day pill instead of going to twice-a-day, but the particular med she’s taking isn’t that important.  The point is that she chose.  She’s the patient, and she’s learning to make her own decisions regarding her health.

Given the awful day she had earlier this week, my daughter came to me and asked if I thought it might help to try the other prescription.  Although I’m tempted to phone my daughter’s rheumatologist, I don’t think it’s time to do that yet.  It was a one-day problem, not a definite worsening of symptoms.  Trying a different medication seems like a reasonable first step.

A few months ago, my dear daughter announced that we could make her go to the doctor now, but once she turns eighteen she’s never going again.  I suspect that was an expression of frustration with the cards she’s been dealt, not her true intention, but I need to realize that it’s not too long until she’ll be autonomous.  She could choose to never see another doctor.  Instead of imposing my opinions and decisions on her, I’m trying to guide her in making good choices (healthcare and otherwise) so that when she has the legal freedom to make her own decisions, she chooses wisely.

A Little Housekeeping

I recently discovered that my spam filter caught a number of legitimate messages people have sent me about this blog.  My apologies if you sent me a message and didn’t hear back.  I’m working my way through the folder; if you don’t hear back from me by Monday, please try again using the blog form.  I’ve added a contact form to the About/Contact page in hopes that this won’t happen in the future.

In general

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Now, back to our regularly scheduled programming.