Opening communication pathways with child development doctor

Yesterday I had the first appointment with the child development doctor since Yirmiyahu was ten weeks old.  I wrote about that appointment at the time – it wasn’t a positive experience for me as I felt patronized.  I wanted this appointment to be different and consciously prepared mentally for it, to assume that those involved had our best interests in mind, etc.  I actively relaxed just prior to our meeting, to release any tension and negativity, picturing us communicating openly and with mutual respect, and with a positive conclusion to our meeting.

Despite bounding in with lots of good energy and openness, I very soon felt myself getting more and more guarded.  This began when I had to change Yirmiyahu’s diaper, and mentioned that I needed to go downstairs to get some cream since the skin on his bottom was bleeding.  When I came back she asked about this, and I told her that he’s sensitive to the corn syrup in his formula and his skin gets easily irritated as a result of this sensitivity.  She told me not to tell her medical reasons for why it happens, as that’s her job.  Then she asked a number of questions about the bleeding, how do I know it’s not internal, etc.  I’ve mentioned this to a number of doctors in the hospital, his regular pediatrician, his naturopath and his osteopath, and never had this reaction before.  Though I answered all of her following questions as accurately as I could, I was uncertain why what I said was a problem and decided to just answer what was asked without volunteering anything else.

She kept asking me questions and I was increasingly feeling like she was testing me and waiting to jump on a wrong answer.  When she asked about him eating solids, I told her about his difficulty in eating and my efforts in this area.  She asked me why I think he’s not eating so much.  I told her I have no idea, that’s just how it is – I was concerned that if I said anything, she’d tell me why I was wrong.  She asked me repeatedly and I told her, ‘I don’t know, what do you think?’  But she didn’t answer, she just asked me again what I attribute it to.  So finally I said, ‘I have no idea, maybe because he has a high palate?’  (I took Yirmiyahu to an osteopath last week for his first visit, and this was one of two possibilities that she raised for the feeding difficulties.)

The doctor told me his high palate isn’t relevant, and then went on to say it’s because of his gross motor development that he pushes the food out of his mouth.  I listened for a few more minutes, wondering why she couldn’t have just said this in the beginning without grilling me to tell her why it’s happening.  I had a sense of deja vu from the first visit, when she asked me why I thought his breathing was raspy – I told her I thought he was allergic to his formula and she told it wasn’t possible (though later testing showed I was right).  By this point I wasn’t feeling very open or positive at all.

I kept trying to shift my thinking and get into a better headspace and it just wasn’t working.  The next time she asked me a question like this, I finally said, “Why do you keep asking me what I think if when I tell you, you say that it’s not relevant?”  This unleashed a long response about how she’s a medical doctor and she doesn’t know where I get my information and can’t accept what I say at face value or she would be negligent and she can’t help it if I feel threatened by her.  I repeatedly tried to clarify my point and it was frustrating because I felt she kept misunderstanding my intention, despite my efforts to be clear and respectful.

At this point the physical therapist who was in attendance for this meeting finally said to the doctor, “Can I tell you what Avivah is trying to say?”  She rephrased what I said in a way that the doctor understood my concern.  The doctor apologized and then explained why she was asking so many questions; she said she wasn’t trying to be condescending or minimize me and her intention was to make me feel included in the discussion.  I reciprocated by sharing with her why I wasn’t volunteering more information.  This opened the conversation up to a much better level, as the doctor and I were honest with one another while being respectful of the other and the environment became very synergistic.

It wasn’t easy to have the courage to try to communicate with this doctor, especially when it seemed she was repeatedly not understanding my concern, but the fruits of this effort led to some very positive results that will benefit Yirmiyahu and me.  Namely, he will receive therapy locally twice a week, with a speech therapist and occupational therapist joining his physical therapist for these meetings (one extra person at each session).  (This is something I advocated very hard for in the beginning and was repeatedly told that it was unncessary.)  The doctor also suggested that there be extra focus on developing cognition rather than just gross motor skills, which is also what my priority is.  This means that I can stop traveling to Jerusalem for supplemental therapy every two weeks, which is physically exhausting and time consuming as well as expensive.  He’ll be getting basically the equivalent of all the services he’s currently getting, but it will all be within a five minute walk from my home and with the same therapists so the continuity of care will be improved.

Since Yirmiyahu was four months, I’ve taken him almost weekly for reflexology and massage, but with my travel to Jerusalem I had to schedule this less frequently.  He was getting massage at Shalva, but now we’ll be able to resume more regular visits to our naturopath.  Financially, it works out about the same since each trip to Jerusalem is approximately equivalent to one session at his naturopath, but he has more time and services with our naturopath.  So there’s actually a gain all around for me and Yirmiyahu.

I now feel very positively toward this doctor, and I think she feels the same way toward me, that we are partners in working together to help Yirmiyahu. This is how it should be but it’s a very different feeling than we began with.  In the end, my original hope for a productive meeting happened, despite it seeming totally impossible in the middle!


3 thoughts on “Opening communication pathways with child development doctor

  1. Kuddos to you-I know what it is like dealing with some of the doctors in IL and it took alot of courage to return and be honest. It sounds like you have maximized the services in the North which is much better for your entire family-less travel time etc. Continued progress with your sweet boy!

  2. You are such an amazing person! You have so much patience and are always advocating for your children; a true inspiration to the rest of us! Thank you for your blog, for sharing your wisdom with the rest of us. I don’t know if you can get it in Israel but there is a diaper cream called Triple Paste…I discovered it when one of my children had a bleeding bottom…it is the only thing I use now…it works very well. Continued hatzlacha.

  3. I would echo what Ron said except even better than Triple Paste brand is the yellow, original formula of boudreax’s butt paste. Not a nice name but my pediatrician recommended it after I tried 10 other types and I have never used anything else since. It’s like a nes that a bad case of diaper rash at night looks nearly 100% better in the morning. No idea if available in Israel though.

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