Friday, September 30, 2011

The doctor will see you now...

This past week has been our 'off' week (no schoolwork), or what I call "Appointment Week" so that it doesn't give the impression that we aren't doing anything.

Here are some doctor appointment ideas that have worked well for us:

I purposely schedule appointments (if possible) for the last week of the month.  This works well for me for several reasons.  I have a crappy memory will have difficulty remembering appointments if they are scattered all over the month.  Knowing that they will all be the last week of the month helps me to feel a little more at ease during the rest of the month because I won't have that nagging feeling that I am supposed to be somewhere.   It helps while on the phone or at the doctor's office to know exactly which week to flip to when scheduling.  This also minimizes disruptions on school days.  Any time we have to drop what we are doing to run somewhere, by the time we get back the day is lost.  It is very difficult to get the wheels grinding again.

I schedule appointments first thing in the morning.  The kids are little angels (HA!) early in the day.  I can expect (for the most part) to have their cooperation and for them to be fairly mild-mannered at this time.  It also means that you won't have to wait in a waiting room for very long.  Doctors are notorious for getting progressively more and more behind as the day drags on.  If you have an appointment in the early - mid afternoon range, you are only asking for trouble.  I've walked out on two different occasions when my wait time had stretched beyond an hour.  It's obvious that as I am sitting there, struggling to keep four kids under control, that the appointment won't go well either.  If your kids are antsy about seeing a Dr. (mine aren't) then they don't have to spend all day thinking about it.  The Dr. will also be at their most pleasant - they haven't put in a long day yet, and they will be more likely to stay and chat for a few moments.  Which is why they get behind in the first place.  Great for you, but sucks for the rest of the people later in the day.  So get out your appointment calendars, get those coveted first-thing-in-the-morning time slots and you are good to go!

Schedule with purpose.  Think about what might be happening during the appointment.  If I know a shot is going to take place, I shoot for a Friday appointment, or a day when I KNOW that there is nothing going on the following day.  My kids tolerate shots pretty well, but the day after is always a crap shoot.  Sometimes they are fine, other days they are cranky, tired and occasionally feverish.  This typically peaks at 24 hours after the shot, so that is why I keep the next day free from errands or other appointments.  You are just setting yourself up for a difficult day, otherwise.  The older they get, the less this matters.  I am actually doing a happy dance because Colin just finished his last round of baby shots.  I have been contending with baby shots and their aftermath for four years now.  I am ready to be done!!  (As for the whole immunization argument, I am a daughter of a retired immunologist.  I would be disowned if I didn't immunize his grandkids.)

Group appointments together, geographically.  Since you are lumping all of your appointments together in one week, you will most likely have more than a couple.  We see a variety of people in three different cities.  Jordan sees a children's psychotherapist and a children's therapist/counselor in an adjacent city twenty minutes away.  They both work in the same practice, so I schedule the mid-morning appointments back-to-back, and only on a Tues or a Thurs.  One appointment is a quick 20 min. and the other is an hour.  I leave him for the hour-long one, and drive a half-mile down the street to a park, where the little kids can play, instead of shushing them in the office waiting room for the whole time.  We have a quick lunch at the same park afterwards, and then drive on to karate class, which is four minutes away.  That way, we are only driving back and forth one time.

Enlist your spouse or other family members to help.  This is where you might want to consider scheduling at the very end of the day.  My husband scheduled an appointment for me this week to see the podiatrist that he has been going to this past year.  This doctor's practice is in the same city that my husband works, 45 minutes away.  Instead of dragging all four kids into the examination room with me, my husband stays with them and takes them to a park.  We can pull this off by scheduling the appointment late, so that all he is missing from work is the last hour or so.  This currently backfires for us just a little bit, because it totally disrupts nap time, but in the grand scheme of things, this is the best way.  The same routine is used when I have to go to the dentist.  My ob/gyn is here in our city, and well, you really don't want a pint-sized peanut gallery for that, so grandma steps in to help.

Keep the kids occupied.  We have a bag that is loaded with coloring books, stickers, wikki-stiks, crayons, card games and a couple of books.  It stays in the car so that we have it available for any appointments or restaurant visits.  During those long waits in the examination room we play iSpy (I Spy an otoscope!), do physical challenges (who can hop on one foot for 30 seconds, who can hold their breath the longest, and so forth...) One time I tore the paper off of the exam table, crumpled it into a ball, and we played hot potato.  You could also fold up paper airplanes.  There are all sorts of things you can do with tongue depressors as well.  Just be sure to stash them before the nurse see you.  And that doesn't mean put them back in the jar you got them from! (Jordan).

Communicate with your kids why you/they are seeing the doctor in the first place.  I can't stand it when I see pushover-parents begging or bargaining with their kids in the waiting room about their impending visit.  They disguise the fact that a shot is coming.  They even lie about it.  I have always been up front and no-nonsense about it.  "Yeah, you will be getting a shot today.  No big deal."  I give a quick run-down of how the appointment will go.  "The nurse will measure your height and weight, take your temperature and listen to your heart.  The doctor will listen to your heart and lungs, feel your tummy, tap your knees, look into your eyes and ears (this would be a great opportunity to introduce medical terminology by naming equipment)".  By doing so, you reduce anxiety about the appointment.  By the time Jordan came into my life, he had developed quite an aversion to needles.  So bad in fact that two adults had to hold him down when he needed a shot.  I don't think this was a nature thing - this was pure nurture, and I can tell by phone conversations exactly who it was that continued to fuel this anxiety.   It took a good 2-3 years to diffuse the situation and make the experience a non-event.  But even now, the damage has been done.  I routinely have to send Jordan out of the room whenever one of the other kids is getting a shot because Jordan is in the background yammering away about what is about to happen and so forth.

Choose a small practice over a big practice.  You will be more likely to get appointments when you want them - especially in an emergency.  You get to know everyone.  The receptionist at the pediatrician's office knows that I like to stash the kids in the car first, then come back in and settle the bill and make another appointment.  After they have been cooped up in an examination room for an hour, they completely terrorize the unfortunate people in the waiting room by running all over the place, operating at full volume.  I just take them to the car and they burn off the energy in a safe, confined space.  Plus, the office is so small that you can park ten feet away from the front door.  So I can see them.  I just don't have to hear them.  :)

Bring snacks and drinks.  We plowed through six bananas the other morning while we passed the time in the waiting room at a regional lab facility.  Jordan was there to get a blood draw (a routine event based on the meds he is taking).  We spent about 15 minutes waiting (this was not an appointment we could schedule, but we did show up first thing in the morning) and the kids spent most of the time with food in their mouths - which in turn makes it difficult to be loud and obnoxious.  I saw several older folks smile as Colin said 'tankyou' to Owen after he handed him a banana, and Owen responded with a 'You're welcome!".  One lady even said, "You have such polite and pleasant children!" (snigger)

Don't offer candy as a reward for a good visit. Visit a park for 30 minutes instead.  What kids need is a way to burn off energy and any built-up anxiety -not a sugar high.

Gone are the good times when I could revel in a trashy copy of People while biding my time in the waiting room.  Now I have to sit there, ready to pounce if one of the kids starts running around, jumping from couch cushion to couch cushion.  It is not fun, but I least I have numerous ways to lessen the stress of it all.  What I hate most about doctor visits is when twenty different pairs of eyes are on me when the three year old starts to holler because his sister is hogging their chair/their book/the snack box, whatever...  but it is a good a time as any to model for them and teach them how to be respectful in such a situation/environment.  You just stand up and scream.  (on the inside...)

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