The Adventure of the Tardy Pediatrician
I mentioned recently that Demon Child #1 has lost her appetite. We are still not sure if it is a typical almost-three-year-old thing or if it's a result of her new medication, which we began about the same time her appetite started going away. Her neurologist insists that Depakene is supposed to increase her appetite, but we scoff at that!
So we've been worried, and various scales haven't helped, since one may say she's losing weight (we don't want that!) and others may say she's holding steady. We don't know. A few weeks ago we took her to the pediatrician because we thought she might have an ear infection, and we got her weighed. So we figured if we got her weighed at the doctor again, that would trump any other weighing we had done independently. We also wanted to rule out any other reason for her lack of appetite before we went after the medication. Norah also needed to go in for her "I'm new to the world!" check-up. So I called on Monday and made an appointment for Tuesday at 1.30 pm. That's 13.30. 90 minutes after high noon. As you can tell from the title of the post, that will be a consideration later on.
We arrived at the office at about 1.15, because the last time I was there, I got there a bit early and they actually took me on time. They have a board on which it tells you if the doctor is behind. On hers it said "on time." Hah! So we waited for a bit, and at about 20 minutes to 2 we went into the back and Mia got weighed and measured and Norah got weighed and measured (she was down to 6 pounds 12 ounces, which is fine since newborns tend to lose some weight in the week or so after they're born until they start gaining it again). The nurse told us the doctor would be right in (hah! again) and we hunkered down to wait.
Back in Oregon, we had a good doctor. He liked to talk (a lot) to each patient, and he did a good job diagnosing you and making you feel better. I asked him once why doctors ALWAYS run late. He told me he had to fill out a lot of paperwork, he sometime got called to the hospital, and people would call him during the day for unsolicited medical advice about all their problems. Make an appointment, people! Anyway, he had cut the number of appointments he made down to something like seven per day, and he had stopped taking managed care patients (he had a pathological thing with managed care). He was able to make sure he saw everyone pretty much on time that way. Our pediatrician has not gone that route, apparently. By 2.30 I was fuming. Mia was behaving fine, but she was very tired. One of the nice things about her is that when she gets tired, she doesn't get cranky like many kids, but she does turn into a zombie. She was sitting there dazed and spacey, and I was very glad I hadn't given her her medicine before we came, because it would have been worse. Norah was okay (she's a newborn, after all - feed her and she's happy). I'm not a terribly confrontational person, but I was on the verge of going postal. I have less of a problem with waiting if it's just me - I'm an adult, after all - but making little kids wait is just annoying. I finally went out to the front desk and told the nurse we had to leave. I didn't yell or anything, but I did take sleepy Mia out and just said that she was tired and had to get a nap and if I could reschedule for some time in the morning when a) Mia wouldn't be so sleepy; and b) her doctor might be less behind, then all would be well. As we were getting Norah dressed (she had to be naked to get weighed, and Krys simply wrapped her in a blanket because she knew the doctor would want her naked), the nurse came in and said the doctor would be with us "in a minute." So if we could just stay? Like suckers, we said yes.
He actually came in about eight minutes later, which in doctor language is close to "a minute." He's a very nice man and he's a good doctor, but Jesus! We found out that Mia had actually gained a little less than a pound in three weeks. She weighs 30 pounds and is 38 inches tall. He said her body mass index is fine, which was a little surprising. He said when kids lose their appetite, they watch them for 2-3 months and keep checking them for weight loss. But other than that, she's fine. That was a huge weight off our minds, and we have decided to let her eat however much she wants. If she eats it, fine. If she doesn't, fine. She still needs to eat a little for her meds, but she usually eats a little at each meal, so we're going with that. We're still not happy with her meds, because we think it has caused her appetite loss (and she still has seizures), but we'll deal with that in a few weeks when we check in with her neurologist. He said her levels in her blood were still a little low, so we increased her dosage of Depakene to 10 ml a day instead of 9. We'll see how that goes. If it doesn't work (it hasn't yet), we'll demand he put her on a different medication. There are more than the two she is on out there on the market, after all.
Norah was fine. Krys was fretting because she hadn't pooped in a couple of days but was farting rather stinkily. He said that happens sometimes, and she should try some rectal stimulation. How fun is that? Usually you have to cruise the bars in Provincetown for that, but not Norah! Everything else checked out okay.
So the girls got a clean bill of health, I got to leave without killing anyone, and Mia had a very truncated nap. This is why you make your doctor appointments as early as possible. One of life's lessons, free of charge!
So we've been worried, and various scales haven't helped, since one may say she's losing weight (we don't want that!) and others may say she's holding steady. We don't know. A few weeks ago we took her to the pediatrician because we thought she might have an ear infection, and we got her weighed. So we figured if we got her weighed at the doctor again, that would trump any other weighing we had done independently. We also wanted to rule out any other reason for her lack of appetite before we went after the medication. Norah also needed to go in for her "I'm new to the world!" check-up. So I called on Monday and made an appointment for Tuesday at 1.30 pm. That's 13.30. 90 minutes after high noon. As you can tell from the title of the post, that will be a consideration later on.
We arrived at the office at about 1.15, because the last time I was there, I got there a bit early and they actually took me on time. They have a board on which it tells you if the doctor is behind. On hers it said "on time." Hah! So we waited for a bit, and at about 20 minutes to 2 we went into the back and Mia got weighed and measured and Norah got weighed and measured (she was down to 6 pounds 12 ounces, which is fine since newborns tend to lose some weight in the week or so after they're born until they start gaining it again). The nurse told us the doctor would be right in (hah! again) and we hunkered down to wait.
Back in Oregon, we had a good doctor. He liked to talk (a lot) to each patient, and he did a good job diagnosing you and making you feel better. I asked him once why doctors ALWAYS run late. He told me he had to fill out a lot of paperwork, he sometime got called to the hospital, and people would call him during the day for unsolicited medical advice about all their problems. Make an appointment, people! Anyway, he had cut the number of appointments he made down to something like seven per day, and he had stopped taking managed care patients (he had a pathological thing with managed care). He was able to make sure he saw everyone pretty much on time that way. Our pediatrician has not gone that route, apparently. By 2.30 I was fuming. Mia was behaving fine, but she was very tired. One of the nice things about her is that when she gets tired, she doesn't get cranky like many kids, but she does turn into a zombie. She was sitting there dazed and spacey, and I was very glad I hadn't given her her medicine before we came, because it would have been worse. Norah was okay (she's a newborn, after all - feed her and she's happy). I'm not a terribly confrontational person, but I was on the verge of going postal. I have less of a problem with waiting if it's just me - I'm an adult, after all - but making little kids wait is just annoying. I finally went out to the front desk and told the nurse we had to leave. I didn't yell or anything, but I did take sleepy Mia out and just said that she was tired and had to get a nap and if I could reschedule for some time in the morning when a) Mia wouldn't be so sleepy; and b) her doctor might be less behind, then all would be well. As we were getting Norah dressed (she had to be naked to get weighed, and Krys simply wrapped her in a blanket because she knew the doctor would want her naked), the nurse came in and said the doctor would be with us "in a minute." So if we could just stay? Like suckers, we said yes.
He actually came in about eight minutes later, which in doctor language is close to "a minute." He's a very nice man and he's a good doctor, but Jesus! We found out that Mia had actually gained a little less than a pound in three weeks. She weighs 30 pounds and is 38 inches tall. He said her body mass index is fine, which was a little surprising. He said when kids lose their appetite, they watch them for 2-3 months and keep checking them for weight loss. But other than that, she's fine. That was a huge weight off our minds, and we have decided to let her eat however much she wants. If she eats it, fine. If she doesn't, fine. She still needs to eat a little for her meds, but she usually eats a little at each meal, so we're going with that. We're still not happy with her meds, because we think it has caused her appetite loss (and she still has seizures), but we'll deal with that in a few weeks when we check in with her neurologist. He said her levels in her blood were still a little low, so we increased her dosage of Depakene to 10 ml a day instead of 9. We'll see how that goes. If it doesn't work (it hasn't yet), we'll demand he put her on a different medication. There are more than the two she is on out there on the market, after all.
Norah was fine. Krys was fretting because she hadn't pooped in a couple of days but was farting rather stinkily. He said that happens sometimes, and she should try some rectal stimulation. How fun is that? Usually you have to cruise the bars in Provincetown for that, but not Norah! Everything else checked out okay.
So the girls got a clean bill of health, I got to leave without killing anyone, and Mia had a very truncated nap. This is why you make your doctor appointments as early as possible. One of life's lessons, free of charge!
posted by Greg at
5:13 PM
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