Wednesday, August 6, 2014

A Surprisingly Emotional Reunion!

Today Audrey had a check up with a family practitioner, Dr Sara Johnson, who I tried switching to 8 months ago, before she was hospitalized. It was a very emotional reunion for me and I did not expect that!

I had been contemplating switching care providers for Audrey for awhile now because there were several minor issues that I had with our current pediatrician. A few of them: she was very cautious and initially unsupportive of us removing the feeding tube and said several times "she needs to start gaining more weight or we'll have to do something" even after it was apparent that Audrey was doing just fine without it; she really pushed the speech therapy idea staring at 18 months and labeled Audrey "speech delayed" in her chart (we were not so concerned and wanted to wait until she's two, especially as she been on the later end of other developmental milestones and with all the medical trauma she's been through I wouldn't be surprised if that delayed it further), and she pushed night weaning claiming that "night nursing causes cavities," which is not an evidence based claim (see here).

I also had a feeling that this doctor was too focused on Audrey's past medical history, and while she was great during the crisis, we really needed someone who would look at Audrey now and not at Audrey 6 months ago. She is a normally developing toddler now and deserves to be treated like one.

So I was in search of a new doctor. I was open to anyone but preferred a family or nurse practitioner as I've heard they tend to be more laid back than pediatricians and they can see the whole family. I actually had forgotten about the very compassionate and kind doctor (Dr Sara Johnson) we had seen briefly for Audrey's 12 month check up and whom had been recommended by our local API group (attachment parenting international - see here for more information on what attachment parenting is.)

You see, I am very picky when it comes to who my family sees. If there was a pediatrician version of a homebirth midwife who took our insurance, I would be the first signed up! Because of our parenting and lifestyle choices, I'm not comfortable with just any provider. They have to, at the very least, be respectful of our family's choices and preferably supportive of them. But I don't really need any parenting or lifestyle advice. What I really need is someone who will weigh and measure my kids, look at their eyes, ears, mouth, check their lungs and heart, take Audrey's blood pressure (indication of how her kidneys are doing), and ask if I have any concerns. Because honestly, I research the hell out of things like child development, breastfeeding, normal eating and sleeping behaviors, discipline, and carseat safety and may actually have more knowledge on our choices than a medical professional does. I really don't need them to ask about her sleeping habits or tell us how we should discipline. And if I do have questions on these things, the first place I go is the local API group, not the doctor.

So along with my long list of musts I ran into another problem. All the good providers that my friends were recommending were not taking new clients! I ran into this problem before when Audrey was a newborn and we had to switch from the wonderful care of our midwife. Ryan advised that I just stick with our current doctor because he said, "all doctors suck." Which I am mostly inclined to agree with. In case you can't tell, we are generally not a fan of the mainstream medical community in this house. But I knew there were good providers out there and I needed to find someone I could trust in case we did need medical care in the future.

I was browsing in the Intact MN private group (a grassroots organization that provides research based information on circumcision and intact care) in the list of Intact Friendly providers and came across Dr Johnson's name, thinking it looked familiar. I realized I had also seen it in a recent list of AP friendly providers, so I went to see if I could schedule an interview or appointment with her. Looking at her profile picture on the Fairview website I realized that this was the doctor Audrey had seen at what was supposed to be her 12 month check up! Now I wondered if it would be awkward or weird to try to switch back to her. Would she remember us? Would she think Audrey would be out of her scope of practice given her history? I tried to schedule an interview but apparently they only do that for newborns. Because once you find your care provider, you aren't supposed to ever switch or anything. So I scheduled a regular check up for her and had a short summary of her medical history ready to go.

After Audrey was weighed and measured (22 lbs 9 oz by the way!) Dr Johnson came in and asked, "Do you remember me?" I was really surprised because I thought I would have to ask that! And "Oh my, look at her! She looks amazing!"

She said she had been following along on Audrey's case through the Fairview system because it had made such a big impact on her; this very sick child with a really puzzling case and a very loving, attached mom. I actually got really emotional and started crying, which I did not expect at all. It was surreal to walk into this clinic where we had been only 8 months ago in such a different scenario. I will always remember that first visit: weighing Audrey and finding she was only 13 lbs, asking Dr Johnson, "is she failure to thrive then?" and crying so hard when she said "yes." She was so kind then and I remember her looking upset and very empathetic. And now, here we were after such a long and difficult journey, in such a different place.

After catching her up to speed on Audrey's journey and looking at the notes in her chart she agreed with me that waiting until 2 to reevaluate her speech is a good plan. And that her rate of growth is fine. And she asked about her night nursing, "is she nursing a couple of times at night but overall sleeping 10 to 12 hours?" with no mention of nursing causing cavities or suggesting we wean. She just has a very laid back and relaxed demeanor while also coming across as very caring and compassionate. She even sat down on the floor with Audrey and interacted with her while looking her over! And Audrey didn't want her ears checked so she said "we'll just skip it, she's had a lot of check ups lately." She seemed to understand the trauma that all the medical testing and procedures have caused Audrey and was very respectful of that. She seemed to "get it" more than any other doctor we've seen.

I'm relieved to have found a trustworthy provider, whom I will soon be seeing for a physical myself. And I'm so excited to see what our future holds!