I don’t mean to brag, but I have been through my fair share of doctors appointments with my kiddos. Between the surgeries my son has endured and the fact that my husband comes and goes with his military deployments leaving me to deal with everything on my own, I know quite a bit about the best way to make the appointment easier for the kids. After all, an appointment with the doctor can be incredibly stressful for kids, what with all the people poking and prodding you and asking a bunch of questions.

In an ideal situation, I would stress the importance of only taking one child at a time to the doctor, but since my situation is usually far from ideal I”m writing this with respect to taking a younger child to the doctor with an older sibling in tow.

Always tell the truth. If my kids are going to get shots, I tell them so and I also admit that it’s going to hurt. I also tell them that it’s important for them to get the shots and then I promise them a lollipop or ice cream afterwards. Yes, I bribe my kids, but shots hurt, right? When possible, like when flu shot time rolls around, I let them watch me get my shot first and then let them follow suit.

Let kiddos answer questions. This won’t work for babies, but toddlers can certainly answer some of the doctor’s questions. For example, if the doctor asks me, “Which of his ears hurt?” instead of answering his question I’ll divert it to my son and say, “Tell the doctor which ear hurts.” This makes him feel a little more in control of the situation.

Bring distractions. We’ll bring toys and snacks with us, and I always have a pen with me so the kids can scribble on the sheet paper the medical staff pulls over bed the kids sit on for their exams. When all else fails, I tell them stories or we sing silly songs while waiting for the doctor. I truly think that the worst thing you can do in this situation is to insist your child sits quietly while waiting for the doctor.

Become a favorite. I appreciate what our doctor does, so we’ve brought cookies before and really made an attempt to get to know the staff. I think this has helped a lot with getting us in and out quickly, and that’s incredibly helpful when you’re lugging a couple of ill kids around.

Medical appointments are a necessary evil of parenthood. Okay, maybe not evil, but not much fun nonetheless. With a little bit of prep and a lot of patience you can make these appointments much less daunting.

My son had hie ear tube surgery this morning. It was the third surgery he has been through, and considering he’s not even four yet that’s a pretty big deal. His first surgery was to put ear tubes in and remove his adenoids, the second surgery was to remove the ear tubes and do a skin graft onto his ear drum, and today’s was to put a tube back into one of his ears. I was really reluctant to do it and was afraid that his Ear, Nose, and Throat Specialist was being alarmist, but when he had his pre-surgery appointment with his primary physician the doctor took one look in his ear and said, “Oh yeah, surgery is the right decision.”

I had hoped to avoid anything like this while my husband is away on his military tour, but I couldn’t delay it anymore because my son’s hearing was starting to get affected. I went into this whole thing with a laundry list of problems that could go wrong. Remember that I’ve been through this with my son twice before so I knew the physical toll it could take on him, so I was bracing myself for the worst case scenario for everything. Well, maybe not the worst case, but I was prepared to deal with a lot of problems as a result of the surgery.

Sometimes, however, everything goes just right and parents are rewarded with best case scenarios.

I was afraid that finding someone to take my daughter for the day would be a big hassle, but my neighbor down the street who is moving in a week graciously offered to put her packing on hold for the day and take my daughter. She didn’t just watch her either; she took her to the park and out to lunch and made it a very special day for her.

My son remembered his last surgery and was not happy about it, so I waited until yesterday to mention that he would have surgery today. I was ready for him to freak out, but instead he started talking about the play room at the hospital and how he couldn’t wait to play with all the toys.

My son had to abstain from food or water starting at midnight last night. Since he’s the kind of kid who wakes up looking for his cup of orange juice, I was afraid he would be begging for something to drink. Instead, he didn’t mention anything and the surgery clinic actually called to ask if he could come in earlier, so that was less time he spent hungry and thirsty.

When it came time for him to go into surgery, I was afraid he would put up a struggle and cry for me like last time, but this time he was wheeled away without a protest.

The last time he returned from surgery he was distraught and inconsolable. He cried and whimpered and pushed against me for a good half hour or so, but today he came back into the room smiling, sitting up, and showing me the stuffed doll the surgery team had given him in the recovery room.

The last two surgeries he had, he was groggy and in pain for a few hours after the operation was complete. Today, he was actually up and dancing around in his hospital room. His appetite was raging so we went to lunch together and he was in good spirits.

As a parent, I usually brace myself for everything to go wrong and for things to be as difficult as possible. Once in a while I’m blessed with a day when everything actually goes smoothly. By the way, my son is napping comfortably on the couch while I type this, and he usually doesn’t nap anymore. What more could a mom ask for?

My son was just scheduled for a third surgery. Considering the little guy hasn’t even reached his fourth birthday yet, this seems like a lot to me. I hate, hate, hate the fact that he has to go and get another procedure done, but I know that in the long run it’s for the best.

It’s not like he’s having something very complicated done, and it isn’t like this is an emergency procedure to save his life, but it’s a surgery nonetheless and that always makes me nervous.

His first surgery – which was before he was a year old, was to put tubes in his ears, remove his adenoids, and to do some exploratory something or other down his esophagus.

His second surgery – which was right after his third birthday – was to remove the tubes from his ears and do a skin graft on his eardrum.

This third surgery – which he’ll have next month – is simply to put a tube back in one ear. Apparently his right ear just isn’t doing very well without the assistance of a tube and the doctor has concerns that the resulting hearing problems will inhibit his learning capabilities once he gets into a classroom setting.

I’ve had two surgeries in my entire life, and I’m 35. This poor kid is on his third surgery, giving him a ratio of one surgery a year.

I thought about saying no to the surgery. Ultimately, the decision is mine after all, and I would love to think that maybe his ear would just suddenly get better on its own and he wouldn’t need the surgery after all. On the other hand, I want him to have all the advantages of normal hearing and would rather he didn’t have to go from one ear infection to another.

Of course, all the usual thoughts go through my head. Is he going into surgery for no reason? Does the doctor just want to make money from insurance companies by doing one procedure after another? It’s incredibly frustrating to not know all the stuff doctors learn in medical school, so we’re essentially at their mercy when it comes to getting an opinion. It all boils down to trusting someone who knows more than I do.

It still makes me nervous, though, and I hate putting my son through it. In the long run I hope it’s the right decision.

Today was my 5 month “baby doctor” appointment.  I was wondering what the doctor’s office would say about my recent appointment with the high risk clinic and the “soft marker” they found for  Down’s Syndrome.

During an ultrasound at the clinic about 3 weeks ago, the technician told me that my child had an echogenic bowel.  Supposedly, this is considered a marker for Down’s Syndrome.  Since I am already of advanced maternal age, my risk factor for the syndrome is pretty high–about 10%.

I talked with the doctor today about the internet searches I’d done to research the condition.  I also talked with her about the abruptness of the doctor who’d come to discuss the ultrasound results with me.   Not only was the doctor abrupt, but he advised that I terminate the pregnancy as I have a 10% risk of having a child with Down’s Syndrome supposedly.  I was shocked, and I told her so.

The doctor I saw today explained to me that many things can cause a “marker” to show up during an ultrasound.  She also explained to me that the whole ultrasound thing is still an inexact science.  As we discussed things further, she admitted to me that she’d had a similar experience at the same clinic.  Her child had a marker show up during an ultrasound and they also advised her to terminate the pregnancy.  Her child is now 3 months old and is fine.

I am curious to find out–have any other women out there ever had a specialist  who advised terminating a pregnancy due to an ultrasound finding?

When you are pregnant, bleeding or spotting can cause a lot of worry and wonder.  Such experiences are supposedly common: about 1/4 of all pregnant women will experience bleeding or spotting during her pregnancy according to statistics.

How do you know that your bleeding is just “simply bleeding” and not a sign of miscarriage?  There are some clues that may help.  It should be noted that any time you are pregnant and are concerned, you should call your doctor.  If you are experiencing bleeding, please call you doctor for more advice and information immediately unless your doctor has otherwise directed you.

That having been said, you may wonder what it all means.  How DO you tell the difference between something scary and something mostly harmless? You may also wondering what will happen next. I have bled or spotted with almost all of my pregnancies.  I’ve lost some of those pregnancies.  This is what I’ve learned.

There is a difference between “old” and “new” blood.  This is one thing the doctors always asked me.  What is the color of the blood?  Red means new; brown spotting means old blood and doesn’t seem to be a “big deal”.

Another thing that doctors always asked me was how much bleeding there was.  That’s hard to gauge actually.  A good way to have something definitive to tell the doctor is to put on a pantyliner.  You can say that you haven’t soiled the liner and it’s been on about so many hours or you can say that you’ve been soiling through a pad every so many minutes.

Another thing that was very important to the doctors was if I was experiencing pain.  During my miscarriages, not only was I bleeding quite a bit, but I was also experiencing a significant amount of pain.  For one miscarriage, I felt the pain in my stomach. It felt like really bad cramps.  For the other miscarriage, I felt the pain in my back.

I found that one of the first questions that doctors ask about when you are bleeding is if you’ve had sex recently.  For some women, this can cause irritation, which can cause bleeding.  They will also ask you if you have reason to believe that you have an infection, which can also cause bleeding.  Fibroid tumors can also cause bleeding during pregnancy.

Some of my bleeding episodes have landed me in the ER.  For my last child, my fibroids were causing a lot of bleeding.  Even though the blood was brown, I was soiling through pads.  My doctor advised me to go to the ER for an ultrasound.  At the ER, they determined that our child was fine.

I know how scary bleeding can be during pregnancy.  Hopefully, you’ll never experience any bleeding!  Please note that above ALL else, you need to contact your doctor!

Monday was my first OB appointment.  I’ve had many people ask me over the years exactly what happens at the first appointment? What can I expect?  Read on to find out!

The first appointment is usually at least an hour in length.  Plan ahead and find a sitter for younger children if possible.  If you are concerned about the length of the appointment, you may be able to shorten it by completing some of the paperwork ahead of time.  You can download forms off of some doctor’s websites for just this purpose.

The first thing that happens at your appointment is that the nurse will ask you for a urine sample.  Usually, they test for protein or sugar in your urine.  Most offices also do a pregnancy test to confirm your pregnancy.  After this comes the part I dislike–they WEIGH you.  In fact, I dislike being weighed so much that I requested that they weigh me backwards! They complied.

After this, a nurse went over my family history and health history.  She asked about my husband’s family as well.  If you have had any pregnancies and deliveries before, they’ll ask about that.  Since I am of–ahem–advanced maternal age, they requested that I consider going for genetic counseling.   I declined the blood testing they offered to test for genetic problems because I’ve seen too many friends worry about false positives.  I asked if I could get a high resolution ultrasound to look for markers for Down’s Syndrome instead. They said yes.  I declined an amniocentesis test.

They took blood from me to test for different things like HIV,  which is pretty routine.

They did a quick physical and asked if they could do a Pap test.  I declined simply because I tend to bleed and I knew it would worry me, especially with my history of miscarriage.

Then they offered to do an ultrasound to see that the baby was where he or she should be and that everything “looked” ok.  I agreed.  They did an ultrasound on my stomach but really couldn’t see much because I am only 8 weeks along.  I agreed to a vaginal ultrasound.  We could see the baby and the sac.  We could see the heart fluttering too.  They printed out my child’s first picture for me to take home!

The doctor was careful to remind me that I still have about 4 weeks left to go until the first trimester is over, until then, my risk of miscarriage is still high.

For now, we wait an hope that I’ll be able to “keep” that OB appointment in February!

Yesterday, I decided to make my first “prenatal appointment”.  I actually found a new OB/GYN for myself and for my developing baby.

I spent last week looking at websites and trying to find a doctor that I felt would be a suitable “match” for our family.  My previous OB/GYN was pretty up front about sharing her negative opinions about the fact that I have a large family(I have children from a previous marriage and now my new husband and I have children as well).  While I appreciate her honesty, I didn’t appreciate the negativity.

Because of my history of bleeding and spotting, I’ll be seeing the new doctor during my 8th week of pregnancy, instead of during my 12th week.  I can download the new patient forms off the internet and fill them out for the first visit.  I am slightly overwhelmed when I see how many forms there are to fill out!  Who ever thought that paperwork was such an important part of a pregnancy?

Other than my husband, I’ve told my sister so far and emailed my best friend.  That’s it.  We’ve decided to wait until I am out of the first trimester before we tell the other children–that is if they don’t already figure it out.  My teens are pretty astute.  My “tweens” aren’t too far behind.  I’m thinking that telling my almost 16 year old that her mother is again expecting should be a very interesting experience!

As we remember 2008 and look forward to all of the wonders that 2009 will hold, I think of the child that we are expecting.  I wonder if our baby will be a boy or a girl? Given my history of miscarriages, I’m not sure I should even be thinking those thoughts yet.  At least not until after the first trimester is over.  Right now, I’m hoping for the best, yet I’m trying to prepare myself should the “worst” happen. Let’s hope that this pregnancy, just like the New Year, will be both safe and full of happiness.  Happy 2009!

I just surprised the nurse at my pediatrician’s office – and it won’t be the last time, I’m sure.

When she called to confirm Ashley’s 2-month well-baby visit, I asked if she could give me the names and manufacturers of the vaccines she would be receiving. “I don’t know!” the nurse said.

I asked if she could please look them up for me. She said she would have the information available when we came in for our appointment. Standing my ground, I told her that by then it would be too late, because we may wish to have specific vaccines special ordered. She said they couldn’t do that and I said I may have to go to a different pediatrician if they didn’t have our preferred brands. I explained the dangers of combining two vaccines containing aluminum, and that this could easily be avoided.

She seemed surprised but, to her credit, accommodated my request, calling me back within three minutes with the information.

Although she was surprised by my request, I was equally surprised that more parents don’t ask. Would you eat something without reading the ingredient list first? (Okay, many people do!) I wouldn’t. So I certainly wouldn’t let someone inject my daughter with something before I knew the ingredients.

Of course, having an ingredient list doesn’t mean anything if you can’t interpret it. That’s why I recommend The Vaccine Book by Dr. Robert W. Sears, for any parent who cares about what goes into their baby’s body.

My husband and I carefully considered what vaccinations, if any, our daughter should have. This book, along with other titles such as What Your Doctor May Not Tell You About Children’s Vaccinations by Stephanie Cave and Deborah Mitchell and How to Raise a Healthy Child in Spite of Your Doctor by Robert S. Md Mendelsohn answered many of our questions.

The Vaccine Book evaluates every vaccine on the American Academy of Pediatrics vaccine schedule, explaining the diseases each prevents, and what specific vaccines are available. It also provides an ingredient list for each vaccine.

In many cases, vaccinations are available from more than one manufacturer and the ingredient list, possible side effects and efficacy may vary. My husband and I are not afraid to request specific brands which have lower concentrations of potentially toxic ingredients or have fewer potential side effects.

The biggest selling point of The Vaccine Book, in my opinion, is it does not make decisions for parents. Instead, Dr. Sears talks about the odds of getting the disease if you forego the vaccination, the potential seriousness of the disease, and the potential for side effects from the vaccine, and then lets parents draw their own conclusions. It is objective and grounded in fact, unlike many other titles on the topic.

It does include technical details and some scientific information, but you can easily skip that to get to the heart of the information. All the information is neatly organized by chapter and divided into subheads, making it easy to find what you need.

My husband and I are not opponents of vaccinations, in general, but we also were not going to merely “follow the herd” with this important health decision. Will we make sure our daughter is fully vaccinated? Probably. But we will make the choice after knowing the pros and cons, not because everybody is doing it.

After reading the book, there are certain vaccinations, such as the one to prevent Pneumococcal disease, which I wouldn’t dream of skipping. Pneumococcal disease is a common bacterial infection that can have serious consequences. We’re opting to get the Hepatitis B vaccine only because it is shown not to have many side effects, so there’s little harm in the vaccine, although the odds of an infant contracting the disease are small.

If you are on the fence about vaccinations, thinking about “cherry-picking” the innoculations you want your child to receive, or just want to know what’s in a vaccine before your child receives it, this volume is indispensable.

Yesterday, we visited my dear friend and her brand new daughter who had just been born 12 hours prior to our visit. She still had that new baby smell on her!

I chatted with her mom and she told me that she couldn’t wait to get out of the hospital so she could get back on track. I just smiled. I know that feeling?somewhat. Due to the fact that I delivered with midwives, I was always home within 12 hours of the birth except for the birth of our last child. The midwife new I had very little family support and that my ex husband was not much help either. She let me stay at the birthing center for 3 days after the birth of my fourth child. I could have stayed longer, but due to an approaching ice storm, I chose to leave on the third day instead of risking driving my newborn home on icy roads.

I have to admit that while I was very excited to get home, I felt much better prepared to conquer the tasks and responsibilities waiting for me at home after being able to rest for 3 days. I say rest because constantly being monitored 24 hours a day isn’t very restful.

Everyone seems to have different ideas on this issue. I’d encourage you to do what is best for you. If you have a choice (sometimes you don’t have a choice – either your insurance company doesn’t cover for maternity stays after 24 hours or you or the baby are very sick), it’s best to make your decision carefully.

Should you stay as long as you are able to stay, or leave at the first chance you get? Here are some things to consider:

• How is the baby doing? – If he or she is struggling with weight gain, having trouble nursing, or looking yellow, you may want to stay extra time.
• Do you have Step B? – You may want to stay longer so that the staff can monitor your child to see that he or she doesn’t develop complications as a result of this.
• How was your birth? – If you have a traumatic experience, you may need extra time for your body to heal.
• How is the weather? – I know of women who have decided to leave the hospital early because there was a mandatory evacuation of their area due to a hurricane that was approaching. I’ve also known women who, under the same circumstances, chose to stay with their infants in a hospital that had made accommodations to deal with such a natural event.
• Do you have family support? – If your family is supportive, or you have a large circle of supportive friends, you may be able to get help during those first few exhausting days.
• Do you have other children? – If you have a large, young family to tend to, rest as much as you can after the birth of your baby.

I am not sure what my friend will decide. Her family lives locally and they are incredibly supportive of her and her young family. She is healthy and her birth was uneventful. Her daughter is doing well and gaining weight as she should. I won’t be too surprised if I get the phone call today announcing that they’ve returned home.

Do you have any recommendations for new moms? Should you stay where you delivered you child as long as possible—or should you go home as quickly as you can?

Choosing a doctor for your child is an important step to providing your child with quality health care. It can also be an overwhelming task.

The first thing is to find a doctor that participates in your particular health plan. I live in the United States where there seems to be numerous health care plans. Depending upon the plan offered by your particular employer, you may have an abundance of doctors to choose from, or you may just have a few. It’s important to call the doctor’s office to make sure that they are still participating in your particular insurance plan. Don’t trust the insurance company to have the most up to date information!

If you can, it’s helpful to find a doctor who has other partners in the practice. You can still choose one particular doctor to manage your child’s care, but it is nice to have other options if that particular doctor has a full schedule and your child is quite sick.

Some other things to ask about when looking for a doctor: does the office have extended hours? Do they have weekend and evening appointments? Is there a separate office for well child check ups? Can you schedule and appointment yourself, or must you go through a nurse triage line where the nurse determines if your child is sick enough for an appointment?

Lastly but certainly not the least to consider: is this particular office respectful to you? Do they value you as an important member of “the team”?

Finding the right doctor can be a lot of work, but the payoff for your labors is huge. When your child is sick or needs emergency care, you’ll be glad that you invested all that time finding the very best doctor to take care of your precious child.

My husband’s work insurance is changing, and if there’s anything less fun than floundering in an alphabet soup of HMOs, PPO and PCPs, it’s finding out that our pediatrician isn’t on the list of providers. After a minor panic attack (seriously, we love our doc) and a morning spent on the phone with the insurance company and the doctor’s office, the problem seems to be solved. (Although with insurance you never know.) But the close call got me to thinking about what I’d do if I had to look for a new pediatrician, and I came up with four W’s that I’ve used as a guide in the past:

WEB SITE

When researching new doctors, their Web site can give you a good idea what their practice is like. Our doctor’s site is super helpful: bios on all the doctors, nurse practitioners and staffers; patient forms that can be printed out in advance of visits; numbers and office hours; and news on recalls and other health issues. There’s even a monthly e-newsletter. The thorough, informative site gave me a good first impression of the practice.

WORD OF MOUTH

Of course, there’s only so much you can glean from the computer. References and the opinions of friends can clue you in to what the doctor’s office is really like. Are calls returned promptly? Do staff and doctors take time with each patient, or rush them through appointments? Is there a good selection of toys in the waiting room to distract little ones (and are those distractions necessary because it takes forever to get called back to an exam room)?

WORKING RELATIONSHIP

But even if all your friends rave about a pediatrician, it doesn’t necessarily mean she’s the one for you. Our first doctor was recommended by a friend, and while she was nice enough, the care was just … kind of blah. In fact, it was so hard to get an appointment with her that about half the time we saw someone else in the practice instead. Your pediatrician is your partner in taking the best care possible of your little one, and you need someone you feel comfortable with. Can you ask questions and not feel patronized or rushed along? Does the doctor listen to your concerns? Do they show respect and kindness when talking to your child?

WELL BEING

In the end, we chose our doctor because we believed we could entrust her with our children’s health and well being. She puts a premium on preventive care, and ensures that kids get proper exercise and nutrition. She (and every doctor in the practice) calls the day after appointments to follow up and see how the kids are doing. And when I left a phone message today to talk about our insurance dilemma, she called back literally within five minutes. And when she told me she could still be our doctor, it was another W: wonderful.

What do you look for in a pediatrician? if you have a good one, what do you like about them? And if you’ve had a bad experience, what has that taught you?

As a newly pregnant woman, you’ve no doubt heard from plenty of other women that you can’t “take anything” when you’re pregnant.

So when you get congested, have a cold, or indigestion, you probably figure you have to just deal with it. Even worse, if you feel exceptionally sad or anxious, you may feel that there’s just nothing you can do.

Well, your friends are both right and wrong. As pregnant women, in any trimester, what we take during pregnancy may affect our babies. But there are medications that doctors have determined are safe. And there are some medications that, though not the best for baby, will make for a happier, more sane mother.

The point is that you need to tell your doctor how you’re feeling. Don’t suffer in silence. Your doctor may indeed say there’s nothing that can be done, but you may find out there are some treatments that can safely help.

When I was pregnant, I was extremely congested. To top it all off, I got a cold. The congestion became unbearable, and no “natural” remedy worked. I suffered in silence, until the inability to breathe through my nose drove me crazy. Literally.

I drove myself to the pyschiatric ER, and they finally gave me something to help me breathe. My options? I would probably have had more severe panic attacks and possibly harmed myself and the baby, or they could prescribe me something to help me breathe. The choice was obvious.

Don’t let it get that bad.

Don’t assume your problem is nothing major, and don’t assume you have to be miserable just because you’re pregnant. If you’re having extreme sadness or anxiety, don’t assume it’s just all in your head.

Tell your doctor whatever ails you.

Ask for help if you think you need it. And change doctors if you’re not getting the help you need. You are the vessel for your baby. If you aren’t as comfortable as is safely possible, you and your baby may suffer.