Wednesday, March 21, 2012

Needles and Drama and Stares, Oh My!

John had an appointment with a new pediatrician today. He recently had some questionable results on some blood work, and we decided to follow up.

I fixed lunch before we left, but John explained he wasn't all that hungry and requested we take the food with us for later. I agreed.

The pediatric practice is inside a complex for the Children's hospital, the Medical Mall and Erlanger Hospital. The place is a massive labyrinth of parking structures, long corridors and Charlie and the Chocolate Factory-style elevators.

We parked in a garage, rode an elevator up to the children's hospital, walked a long corridor, stopped at an information desk, doubled back on ourselves through a different parallel passage and took a different elevator down to the pediatric office. This is a large operation. The waiting room is humongous, with glass walls. There are two reception desks. I think checking in to give birth to Hannah was less rigorous.

We were taken back beyond the fire door into the group of exam rooms. The highest number on a door I saw was 15. I knew we were probably in for a long wait. Our appointment was at 1pm. I suddenly found myself with a cagey twelve-year-old, OCD enough to be wearing two watches, in an exam room until 2pm. He was already nervous. But suddenly the small room, his tired butt and his overwrought nerves had the best of him, about the time the doctor walked in.

Immediately, he pointed out she was an hour late and that she should be paying us for our time, while pumping his fists in the air. As she started taking his medical history and recording his current medications, he became very fidgety and started ranting about anything that came to mind.

"I'm starving to death. You people were an hour late and Mommy didn't feed me lunch."

The doctor raised a questioning eyebrow in my direction. I turned to my agitated son, "John, remember you didn't want to eat earlier. The food is in the car. You may eat it when we get done."

The doctor's hackles seemed to smooth. More run-of-the-mill questions peppered with increasingly louder rantings, "When I turn thirteen, which will be in September, September 22, I'm going to be able to watch PG 13 movies. Daddy let me watch Iron Man once and that was fiiiiiiiinnnnee, but, oh no, now, I'm not allowed to watch them. It's not even like I was scared. This place is a cage. I was taking the Miralax but sometimes you don't give it to me. It works okay when I have it."

The doctor had been doing a pretty good job ignoring all the venom and drama from the other side of the room but then turned to look at me and asked if we were going on and off the Miralax. I explained that, sometimes, he had it with lunch instead of breakfast.

It was a little reminiscent of when people used to ask him about homeschooling during a Monday appointment and he'd answer with, "Well, we haven't done school in a loooooong time." Yeah, Friday was a long time ago.

She decided we needed to do another test just to confirm the results were nothing to worry about, and left the room. There is no greater fear for John than the prospect of a needle piercing his skin. She left us trapped in the small room for about 25 minutes to really let the angst settle in. He threw his glasses across the room, causing one lens to pop out and slide behind the trashcan. He started rocking and wailing about how he didn't want to be a human experiment and how he had a God-given right to free will and his free will was to not have a blood draw.

I tried several things to calm him down and just tried to be calm and supportive. At last a woman stepped in the door carrying gloves and a couple of vials. Somehow, John had time to note her supplies and decide to bolt out the door behind her.

He. Was. Gone.

I explained he was very phobic and I would go find him. Unbothered, she sat down and said she'd be right there waiting. I stopped, first, at the restroom and found it empty. My heart started to race as I realized I had no idea where he would go. I went through the fire door and saw him through the glass waiting room wall straight ahead. The problem was, I couldn't get to him that way. I had to turn right, follow the wall about 75 feet, make a u-turn and go that distance on the other side.

About the time I made it to the open hallway, I noticed John standing in an open elevator, repeatedly and desperately stabbing at a button like people do in the movies when they are chased by the bad guys. I normally have a no-chasing John policy because that usually causes problems. Today, was not a day for standard policies. I sprinted that corridor in my silk Enwrapture skirt and flipflops, nearly diving into the elevator as the doors shut.

We rode the elevator to the basement, viewed the supply area and rode the elevator back up. I put my arm around John's upper back and scraped him off the wall of the elevator. A nurse in blue scrubs looked concerned, "Is everything ok?"

I thought, Of course, you mean not all your patients go for a jog right before their lab work?

As she followed along behind us, kind of strafing side to side with her arms out, lest John make another break for it, I noticed all fifteen of the waiting room occupants, including the receptionists, were standing in front of their chairs, craning to see the only excitement they'd had since they got there.

We got John almost all the way to the exam room when he grabbed a hand rail on the wall and started banging his head on it. Ms. Lily, the lovely, patient nurse who was about to draw his blood, the blue-scrubbed nurse and I somehow talked him back into the room.

Ms. Lily suggested John sit anywhere he liked in the room. She didn't even have to say that. John picked the floor, huddled behind a chair just in case he needed to whack her with it if she came too close. She calmly explained that we needed to try to get the blood in the office because otherwise they would go to the lab and someone would probably hold him down.

He went on about not being an experiment and free will and then he said that people who hold people down should be given a death sentence from God and should go to hell. Then he decided he'd rather go to heaven instead of going through this, maybe even hell.

"They say you only feel a prick, but I feel the prick and then the needle going through all the layers of skin and into my vein and then I feel it SUCKING the blood out and my arm is sore for weeks afterwards." I thought of how clothing tags bother many on the Spectrum.

Ms. Lily, calm and patient as ever, said, "John, we care about your health. You are not an experiment. And I don't remember ever being in the Bible that God said anything good about whacking people with chairs. Why don't you ask God to help you be brave, instead. It works for my daughter. He'll do it, every time."

I then suggested he stand up and he did and we hugged tightly a few minutes. Ms. Lily, went on the other side of the room and John willingly got on the exam table and did his usual, wrapping his legs around me and one arm.

Ms. Lily asked permission to come over and look at his vein and he agreed. She told him she wouldn't do anything without telling him first. He said, "Make sure Mommy is holding my elbow straight so it doesn't collapse. If it collapses, it'll bend in my arm and hurt way worse and defeat the whole purpose. And no more updates. Just get it done." He turned his head away from the victimized arm and didn't even flinch, as usual, during any of the process. In the end, he was happy-go-lucky and we left as if this was a normal doctor visit any child might have.
And he got to eat his lunch when we got to the car.

Asperger's word of the day: Sometimes, you just have to ride the wave.... And sprint in your flip flops.

1 comment:

  1. That's my pediatrician also. There is a definite problem with them running late, but I do like that you get a built in second opinion (mostly.) Generally a resident sees the patient first then the attending double checks/follows up, especially if there's something serious or questionable. Your also right there at the hospital if further tests are needed.