What is the best way to talk to the pediatrician without the patient/kid hearing?

[Tap]

We are switching doctors and I want to talk to ds's new physician at his well child check next week. I don't want to have ds hear me talk to him. Ds15 is having some symptoms that are odd to me and I don't want him to worry unnecessarily if it is nothing. DS has had a very stressful fall and I don't want to add to it. What is the best way to talk to the doctor without ds? If it wasn't for his crazy autumn, I wouldn't worry and just chat in front ds but this year is different.

 

Since I know this will evoke some people's curiosity :):

 

He has a very slight yellow tint to his eyes. It has came and gone for a year. I thought I was imagining it until it has now happened enough times that I know it is real.

 

He has had random abdominal pain off and on for several years (3x year maybe) and the urgent care doc who saw him while in pain diagnosed a 'hot appendix'. Since then ds has noticed it happens if he has more sugar (or maybe fat) than usual. ie Eating 3 donuts at a party.

 

At his physical last year they found blood in his urine, which his doctor assured me was from being a competitive athlete in heavy training at the time.

 

We were quite certain that he had mono last year and since he swam through it without knowing at first (we thought he was stressed out and thus tired) the effects of exhaustion lasted 6mths. He was never tested because the doctor felt his symptoms were definitely mono and it was several months after the initial infection.

 

A couple of things that bother me are that the 'hot appendix' and 'mono' diagnosis are just by educated guess and not confirmed by any test. Adding these to his yellow tinted eyes, and it makes me wonder if we have missed something...or maybe nothing.

 

PS We are only switching docs, to follow our previous pediatrician, who moved back to our state after a 2 year hiatus. She isn't accepting new pts right now, so we are going to a different pediatrician/internal med doc until she is. It is a hard clinic to get into, LOL so we need to move while we can.

Edited November 26, 2009 by Tap, tap, tap

[BMW]

I have had to talk to the Dr. without my son hearing... but they've been younger. I wrote my concerns out on paper and when we checked in I told the receptionist that these were concerns of mine that I didn't want my son to hear discussed. The Dr/Nurse proceeded and if they felt it warranted discussing with me, they excused my son to the waiting room (son was 12).

 

Perhaps you can call ahead and ask the nurse for advice. If they know ahead of time, the Dr. can look for signs of what you are concerned over and if it warrants further testing can proceed tactfully with your son from there. Then, if there is a concern, the son doesn't know about it until the Dr. brings it up... if there is no concern, nothing will be brought up... just my rambling thoughts...

[ProudGrandma]

SOme doctors will let you make an appointment without your child to visit with them first. Or, can you visit with the doctor over the phone? Just a thought.

 

Kathy

[Tree House Academy]

Can you call the doctor's office and leave a message for him/her to call you at home? Or doctor will do this after hours and he usually calls with the child's chart so you can talk to him and he can look at the records. A 15 year old is going to notice other attempts, I am afraid.

 

If ds knows about all the symptoms, will it really bother him to hear you ask the dr about them? He may have wondered himself. The yellowing sounds liver related (of it is anything at all). I am sure the dr will want to do some testing.

[Crissy]

Can you call ahead and let them know that you'd like to see the doctor privately before the appointment? They could call you in first to go over 'new patient information' or some such excuse, then call your son in after you've spoken?

I would be sure to speak ahead of time to the nurse, not just a receptionist. Explain to her your concerns regarding both the health issue, and your desire to keep your son from worrying.

[ConnieB]

I would call the doctor's receptionist and ask her what their procedure is for this situation. I guarantee you are not the first mom to need this so the office probably has a particular way that they prefer to handle it, and it will be easiest for everyone if you can follow their established way. I'm sure they would accomodate you if you chose to do it your own way, but if you follow the way they've always done it, then it is bound to go more smoothly.

 

For your own sake, I'd jot down notes so you don't forget something.....kinda like you did here and if there are some that you didn't tell us about include those. It's easy to get in front of the doctor and suddenly forget one or two points you wanted to discuss....either out of nervousness, or perhaps from responses he gives, or just because you feel a time crunch (I love our doc but always feel like I'm taking up too much time, lol). It's important to tell the doc all of these things, because while we non-medical types may think it's all different there could be a link that will make diagnosis easier (or not). It's amazing how different parts of your body react to a particular disease, seemingly unrelated, but then diagnosis can wrap them all together.

[Pippen]

I would call the doctor's receptionist and ask her what their procedure is for this situation. I guarantee you are not the first mom to need this so the office probably has a particular way that they prefer to handle it, and it will be easiest for everyone if you can follow their established way. I'm sure they would accomodate you if you chose to do it your own way, but if you follow the way they've always done it, then it is bound to go more smoothly.

 

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I agree. At our office the typical process is for the doctor and parent to step out into another room for a few minutes for discussion so if kids are younger another adult needs to be along to assist.

[Julie in CA]

We are switching doctors and I want to talk to ds's new physician at his well child check next week. I don't want to have ds hear me talk to him. Ds15 is having some symptoms that are odd to me and I don't want him to worry unnecessarily if it is nothing. DS has had a very stressful fall and I don't want to add to it. What is the best way to talk to the doctor without ds?

I know it's not exactly what you asked, but I don't think that at age 15 I'd cut him out of the discussion. Since he already must realize something's going on, it might even ease some of his stress to address the issues openly, but in a casual way, i.e. "One of the things we've been wondering about is ________."

For a younger child, I'd do it in private, but 15 is waay over that point. At 15 you're going to be teaching him how to take care of his own health, and know how to face things like this in the future. My dh wasn't taught that, and his method of dealing with all things medical is to pretend that they just aren't happening--and denial isn't really a good way to deal with it, kwim?

[Dobela]

At 15 I would have wanted to have this conversation with the pediatrician and my mom at the same time. Most likely the ped will come back and ask your child direct questions about how he is feeling and all that anyway so it won't be like the conversation will be a secret. The only reason I might consider having a private conversation with the new ped is if you don't think you will be able to keep your composure. At my last appt with my son's ped, I needed to talk to him about the serious learning problems that he was having and how the evals were turning out. The nurse stayed with my son and I went to another room with the ped. Then, when I cried, my son didn't know it and we covered my concerns on even keel.

[Pajama Mama]

I think at 15 your child should be involved in a conversation about his own health. The things that you mentioned are reasonable issues to bring up to a doctor. I think it would be a life learning experience for your son. You and he together make a list of concerns for the doctor. It would teach him to listen to his own body and convey these concerns to his doctor. In just a few years he will be going to a doctor without you. Teach him what to do so when he's a young adult he will go to the doctor when needed and be able to accurately convey any concerns.

[Denisemomof4]

I'm shocked to hear your last dr. didn't run tests.

 

As a PP mentioned, I'd call ahead of time to leave a list of concerns if you feel that your son shouldn't be involved at this time. I do hope this dr. runs tests and can give you a definitive answer.

 

There's a good chance the dr. will have questions to ask your son.

 

I hope everything checks out well and he's feeling better SOON!!!

:grouphug:

[Janet in Toronto]

I agree with the posters who think the conversation should be held with the ped and the child at the same time.

 

On a side note, wrt the symptoms....my optometrist has mentioned in the past that yellowish tint in the eyes can be due to high cholesterol. He should also have a liver function test.

[SonshineLearner]

Here's the weird thing... Legally, I think he's entitled to talk to the DR without you... HMmm... maybe you should both talk to the Dr:-)

Carrie

[Tap]

Normally, I wouldn't think twice about having him involved. I absolutely encourage my kids to be involved in their health. But this fall has just been one thing after another for him and I really don't want him to worry about unnecessary things. ~~ He has had 2 mentors die only a few weeks apart Sept/Oct (1 cancer, 1 hit and run), started public highschool, got sick/behind in school and will find out this weekend that his cousin (3mths older-and 1 mile away) tried to commit suicide a week ago (I am fairly certain she will tell him at Tday). That is enough for any 15yo to deal with in 10 weeks.

 

I expect the doctor will ask him questions. That is fine, but ds isn't aware that I think his eyes are yellowish nor that I am wondering about this at all. He is going to a yearly well child visit and due to some family history, he is used to intimate questions and more invasive exams than a typical child may experience. So, this is very, very normal to him. He is a very, very easy going kid and I don't think he will thing anything is amiss, at. all.

 

What I hope to see happen, is that I can give the doctor a heads up about my concerns, he can examine him, question him, and order a blood draw. What I don't want to happen is for the doctor to verbally throw out possible diagnosis when we won't even have a basic blood draw to go by. I don't know this doctor, so I have no idea if he is a 'think out loud' sort of doctor. Ds has bouts of insomnia, and (like a lot of adults) in those times he dwells on things. I don't want the doctor to give him any ideas to dwell on. :001_huh:

 

I just went through this with dds shoulder injury. One doctor told us the only reason to order an MRI, is if we were considering surgery, but then went on to say that it may be a good idea anyways....so now she is concerned that that means he really thinks she needs surgery...UGh...she doesn't. But now she has been worrying for nothing.

[Remudamom]

Call on the phone. And only idiot doctors don't run simple mono tests if it's suspected.

[Jean in Newcastle]

The thing is, even a teen isn't going to usually think of liver problems, mono, high cholesterol even if they hear that the whites of their eyes are yellow. We do because we're Moms and we've had more health experience. I think the advice to call reception and ask for their procedure is good, though. But be warned that their procedure for a 15 year old may be to automatically have them involved.

[Cindyg]

When my son was younger (too young to be left alone), dh and I would go together. One of us would take ds to the waiting room while the other talked privately with the doctor.

 

Now that ds is older (12), certainly old enough to be in the waiting room alone, I would feel weird about asking him to leave so that I could talk to the doctor about him.

 

I would probably arrange for a private phone consultation in that situation.

[Cera]

I would try to call the doctor ahead of time to let him know about your concerns. If you give him a heads up and also let him know it has been a hard fall for your son he can approach everything gently and include the tests he needs as fairly routine for a 15yr well child check.

[Laura Corin]

Two options: call in advance; get DS to stand outside the door and talk to the doctor before he comes in. I think involving your son would be better though.

 

Laura

[Alice]

If you really want to be completely secretive I'd call the office ahead of time and ask for the doctor to call you back before the appointment. You can then explain the symptoms and why you don't want your teen to hear the conversation.

 

My opinion though is that most of the time teens are pretty savvy and realize that something is going on and this just makes them more stressed as they worry about why something is being kept secret. The doctor will have to do a more thorough physical and history than usual if they are doing a good job. He/she might want to ask specific questions about some of the things you mentioned (blood in urine, fatigue) which could be made to seem like just part of the exam but most teens will pick up on the fact that the questions are more specific than usual. And from your story I'm sure the doctor will want to order bloodwork and possibly other tests. Those need to be explained in some way to your son.

 

What I have found is that when I've tried to keep a certain line of thought secret from a teen and the request of their parents it always ends up being a bad thing. They figure it out and then are more worried and stressed than they would have been if we'd been open in the first place. It's similar to what I've found when seeing a patient for something like headaches. Most parents are worried about brain tumors even if they don't come out and say it. If I decide a CT scan is necessary they know one of the things I'm looking for is a tumor. I used to not mention it thinking that I didn't want to worry them unnecessarily. I've learned though that they are already worried and it's better to be open and say something like "I know you are probably worried about a tumor since that's what most people think about. I think that is unlikely given x, x and y. However, to be safe I think we should do a CT scan because of x. " This reassures them more than just ignoring the elephant in the room.

 

IMO, the best thing to do would still be to call and talk to the doctor ahead of time and to explain the symptoms and the reason why you are worried about your son hearing the conversation. Then the doctor can address them in the exam room but in a way that is open and reassuring. He/she will know not to bring up really scary diagnoses but also to address the possibilities in a way to reassure your son. "I'm going to order some bloodwork to check our your liver because I think we should just be safe. Sometimes Mono can cause some inflammation in the liver and it's possible you had that. Overall though you look fine and I'm not too worried." Or whatever the case may be.

 

The thing is if you send the bloodwork and it is something more concerning that leads to more tests etc. it becomes harder to reassure your son that it's ok if you have started out with keeping things secret. It makes it harder for him to trust you and the doctor.

 

I realize that I'm coming at this from a doctor perspective and not a parent, as my kids are little. So I haven't had to walk in your shoes and I'm sure the situation is tough.

 

Hope it all turns out to be simple things and he is well.

[JFSinIL]

I would call the office and let the staff know YOU need to speak privately with the doctor before your kid goes in. If they would not have time for that, tell the nurse your concerns and ask her to make notes on your son's chart to alert the doctor.

[KidsHappen]

Call ahead of time. I have had to do this before and it wasn't a problem at all.

 

Given your son's symptoms, I would want him checked for gall bladder & liver problems. Those two things are most likely to cause jaundice and pain after eating higher fat foods.

[Tap]

 

IMO, the best thing to do would still be to call and talk to the doctor ahead of time and to explain the symptoms and the reason why you are worried about your son hearing the conversation. Then the doctor can address them in the exam room but in a way that is open and reassuring. He/she will know not to bring up really scary diagnoses but also to address the possibilities in a way to reassure your son. "I'm going to order some blood work to check our your liver because I think we should just be safe. Sometimes Mono can cause some inflammation in the liver and it's possible you had that. Overall though you look fine and I'm not too worried." Or whatever the case may be.

 

 

I think this is the best course of action too. I hadn't thought of alerting the doctor to my concerns, for the purpose of the doctor watching what he said/reassuring the child. LOL The benefit of talking to him ahead of time was always to ask him to not discuss random diagnoses, not actually being a reassuring doctor :0) I think I have got a little too used to the clinic we left that was a 'get'em in, get'em out' type place, with very little personality left in the doctor.