Wednesday, June 27, 2007

It's Always Good to Take Mental Retardation Off the Table

Thanks to Mr. WG, we submitted our paperwork to the developmental clinic with the year-long waiting list a while back. You'll be pleased to know that they still haven't called us. But that's OK, because my pediatrician told us that the director of the clinic, Dr. Amazing, also sees patients at The High Risk Clinic, where the waiting list is much shorter.

We called for an appointment a few months ago, and it was scheduled for this week. Last week, Mr. WG took the boys in for checkups with the ped, and he asked if we should keep the appointment, what with all the other developmental assessments we have been doing.

"You should see Dr. Amazing," the ped said. "She's worth seeing."

Now, it turns out that The High Risk Clinic is housed in a world-famous hospital that does some exceptionally cutting-edge work, but my pediatrician had told me that I would want to shower when I left the place. It was funny - the outside of the building, and the location, are fine. Even the open hallways are lovely. But when you step into The High Risk Clinic, you would swear you took a wrong turn and drove to some third world country.

I handed the receptionist my appointment slip, my insurance card, and my flex benefits debit card. She looked at me quizzically. "For my co-pay," I explained.

Her face brightened. "Oh! You're paying.

I hadn't realized it was optional.

Anyway, we waited a bit, and then we were ushered back into a room. A tech - there is just no way she was a nurse - came in to take D's vitals. Now, at The High Risk Clinic, you would think that some of the patients might have some special needs, right? Well, apparently this tech was brand new, because she just didn't get why D. resisted having his blood pressure checked, why he didn't want to open his mouth for the thermometer, etc. But we got through that part, and then Dr. NewAtThis came in to do a history and initial assessment.

Dr. NewAtThis mentioned that she had met D. once before, at the endocrinology clinic at Children's Hospital. So I new that she was REALLY new at this, but no problem. I am actually quite good at administering assessments, so I picked up the slack a bit.

When she dumped out the bag of stuff - toys and pictures and things - D. found the shape sorter and immediately stuck the square, circle, and triangle in the appropriate holes, naming each as he did so. But since the book lists the questions in a different order, Dr. NewAtThis ignored that and started with something else. A few minutes later, she returned to the shape sorter, but he was done with that. We struggled through the rest of the assessment, I handed her D's written history, we talked.

When D. reached his limits and refused to cooperate further, she said that she would be back shortly with Dr. Amazing.

Time passed. Slowly. D. began to let me know he wanted to leave. "I wanna go home. I wanna go see Daddy. I wanna go play Lynn. I wanna go see Nicole."

"Soon, soon," I told him.

After forty (FORTY!) minutes, twenty of which D. spent screaming and kicking me, I opened the door to the exam room and stood there, holding D. One of the nurses asked from her chair, "Do you need something, Mom?"

"I need to know how much longer it'll be. Because if it's more than about five minutes, I need to take my son home."

That nurse rolled her eyes, but another one said, "I feel you. I feel you. I do. You been real patient."

I actually had to ask her to repeat herself, because I wasn't quite prepared to hear "I feel you" from a medical professional. (OK, I'm a SNOB! I GET IT!)

Anyway, at some point, someone actually offered to try to speed Dr. Amazing along. I returned to the little room and tried to calm D. I was enjoying moderate success by allowing him to play with the otoscope and preparing my defenses (Well if you don’t want children to play with them, don’t leave them waiting in here for over an hour!) when the door opened and Dr. Amazing walked in.

D. held out the otoscope to her, and I very quickly figured out why they call her Dr. Amazing. “Would you like to check my ears? OK, go ahead. Very good. Can you check my eyes now? Good job! Can you check my mouth? Wow, you’re very good at this. Am I all better? What’s your name?”

At that point I softly told her that he wouldn’t answer that question. She nodded and continued with her patter, following D’s lead as he went to different parts of the room and touched and played with different things.

I have really never seen someone do that in an assessment – the way she immediately got on his level was amazing.

She took her time with the assessment, trying different things, letting me ask him questions when necessary. And then she told me that in his worst case, at the height of his tantrum, he was still using four and five word sentences, so that was good. She said that at his worst, he was still performing at above a 2-year-old level. At his best, he was at about a 33-month-old level with scattered skills to age level.

“If he’s performing at better than 70% of where he should be, that’s great, because it immediately takes him off the mental retardation scale,” she said, and I have to tell you that most of what happened after that is kind of a blur.

She wants to see him again in a year. She said that we are doing everything we can do, everything she would do if he were her child. And she’ll transfer us to the fancy clinic so that she can have access to all his other records via their super-cool computer system.

And that’s the story. Tune in next episode for the exiting Drama of Day Camp!


lisa said...

She sounds like a great doctor, I'm glad D had such a good appointment (well, except for all the waiting and other weird stuff).

Meira (comments AT voirdire DOT org) said...

Oooh, she sound like she was worth the hassle. I'm so glad. And how great is it to have Dr.Amazing tell you that you're doing a great job, and doing everything she would do if he were her kid? What a confidence boost!

Vandychick said...

Wow-she does sound amazing! Congrats on the great assessment.

Yana said...

Hey :) Be nice!
I'll be Dr. NewAtThis in a month.
In the Pediatric Intensive Care Unit.
And I'm scared as hell.
Guess, how many years does it take to become Dr. Amazing?

Apart from that, this is great news to read! :) Keep up the good thing.

And write some more.

Blu said...

You know, I'm relieved to hear that you found someone so awesome to check him out. I'm happy for you. :)