Worth the Wait

waiting-room-sign

Why you want the doctor you have to wait for…but not wait too long for.

When I tell people that I’m married to a pediatrician, the conversation usually goes something like this:

“Oh, that’s great that you married a pediatrician! Is he accepting new patients?”

Why, yes, yes he is! {Flattered feelings abound here.} We actually just moved, so he’ll be accepting new patients in Lewisville in March!

And then, the dreaded follow-up question:

Oh, and will I have to wait forever?”

This one is always a tough one for me to answer. As a parent, I feel you. Waiting in an office with a sick kid {when you’ve most likely been up most of the night, and didn’t want to risk puke in the car while you waited in the drive thru line at Starbucks, so now you’re tired, cranky, coffee-less and worried about your kid} is no fun. No fun at all.

It’s also not fun when you worry about the germs spread in the waiting room, the choice words of other stressed out parents while you wait that you know you’re going to have to explain to your kids later (“No, honey, we don’t say *!@: because it’s not nice. Yes, I heard that man say it on his phone, but it’s not something we’re going to say.” …all the while praying that tomorrow isn’t a church day because you know your kid will remember it. He doesn’t forget anything! He’s like an elephant! No, wait, how do I know that elephants remember everything again? It’s got to be a camel. No, camels retain water, not information…. “No, Noah, you can’t SAY THAT WORD TO YOUR BROTHER!!!!”), but I have to believe that there’s a balance here. You also don’t want the doctor who is like clock work, getting you in and out of his or her office in fifteen minutes with no one waiting. What happens when it’s your kid who needs the extra attention of the doctor? Or when it’s you who needs questions answered about a potentially scary diagnosis? What happens then? Will this doctor take the extra time necessary to be thorough, to answer your questions, even if it means falling behind? Or, second to that, will your time be shortened because he or she fell behind? Yuck.

Balance is Best!

I really, truly believe here that striking a balance is best. No, you don’t want to wait two hours every time you see your doc. What does that say about him or her ability and confidence as a physician? Yes, you’d appreciate a call when your doc is running late (so you can sit through that Starbucks line). Most days, we wait about an hour total, and we’re in and out of the car in an hour and fifteen minutes. But, sometimes you’re going to have to wait two hours, and you won’t get that phone call. Justin has had many a hectic days, days when everything seems to run like clockwork, and then, bam! A kid needs oxygen for asthma and it can’t wait until the hospital. A mom comes in bawling her eyes out because her newborn won’t. quit. crying. A dad calls after picking up his kid at day care because he’s broken a bone or bumped his head harder than dad thinks he should have. It just happens. It happens to you, it happens to me.  And when it happens,  I want the doctor who will be thorough, who will check out every square inch of my child and reassure me that my baby will be ok. Or, hopefully this won’t happen to you, will take every step necessary when it looks like things might not be ok, and will do so regardless of the repercussions.

Those scenarios take time; unexpected, precious minutes and seconds that are prolonging your visit. After that happens five times in a day, a doctor is going to get backed up. But, I think that kind of a doctor is worth the wait.

Tips for Waiting Well

Talk to the other parents.

Another reason you might be waiting that I didn’t mention above is that, if you’re waiting regularly, it might be just that your doctor is a really great, favorite doctor. That’s got to be for a reason. Does he or she just really love kids? Has he or she made a difference in the lives of those around you, waiting also? It’s worth asking the other parents who are also waiting for your doc. It might be that another parent in the waiting room can share a story with you about their baby, why they love the doctor, and give you a little perspective. Chances are, they’re there for many of the same reasons, and there’s bound to be someone there who has a story that will warm your heart and prompt you to hold your baby a little closer.

Side Note:

And, while we’re on the topic: If you’re not waiting for your pediatrician, why not? Is it because they have some secret about scheduling that most doctors don’t know about? Or is it there some other reason no one else in sharing the waiting room with you? Something to think about… Or, if you’re having to wait two hours every single time you go, that might mean something, too. Again, balance is key here. It usually takes us about an hour, from leaving the car seat to getting into the car seat again, at the doctor’s office. I never feel rushed, I feel like there’s extra time when I need it, and I saw a great doctor in Abilene and look forward to seeing our new one next week.

Bring something for your kids to do.

So, when you’re in the waiting room, please make sure that you check yourself. Yep, today it is acceptable to let little Gracie have ten more minutes of screen time (after she’s two, of course) so you can pray, for yourselves and for those precious lives being mended behind the door you’re so anxious to get into. And, bringing something for your kiddos to do will also prevent him or her from playing with any toys of the other sick kids, therefore hopefully preventing your kid from getting his germs. Or, if your kid is the trash can gripper of the day, prevent him from spreading his germs to those who just have an ear infection. Also, a snack will help kids. I’m always amazed at how many wrongs I can fix with a banana or some goldfish and some water.

What if I have a bad day?

And, when you blow up and lose it and have a bad day waiting, there’s grace for you. But, that grace will be more forthcoming if you apologize before you leave; everyone understands the fear that accompanies many pediatric visits. Apologizing always makes the receptionist’s job easier and will help her meet you with a smile the next time Gracie girl shoves macaroni up her nose…again. Take a breath, thank God for a great doctor, and when you’re coming in for a well visit, feel free to call and ask if your doc is running on time.

Yep, we vaccinate.

Note: All underlined words in this post are links to articles that reference the item I’m talking about. Click on them to see what I’m referring to if you’re lost. There are also links at the bottom of this [long-ish] post for those who are looking to further your knowledge about vaccines.

Hello everyone. Let’s take a little quiz. You could call it a personality inventory, a pop quiz, or an exercise in imagination. But, humor me and do it. Yes, I mean actually answer a, b, c or d. Don’t put yourself in between categories; no one likes those people.

Let’s say you and your family, along with a small group of friends, go to a fair. In the parking lot, you’re all crossing a lane together. It’s a group of about 10-15 people, some kids riding happily on shoulders, all kids anxious to get into the fair. Suddenly, a car comes down the lane a little to quickly. You can see your kids, could probably touch them if you moved ninja-style. In this situation, the car is moving quickly enough that it makes you uncomfortable. Do you:

a)    do nothing. Wait, there’s a car coming? Oh, well, your friends are responsible and you’re with a huge group, right?

b)   proceed cautiously sans ninja moves, stopping all conversation with adults, assuming the car will surely stop for such a large group, then let out a sigh of relief when the driver does apply the breaks just in time.

c)    Call for your child(ren), alerting them to the car and telling him/her/them to be careful.

d)   Move swiftly to your child’s side and grab whatever you can to make sure that the car comes nowhere near your child! Probably also calling his or her name in your ‘stern’ voice.

As you might have guessed by now, the four choices above represent stereotypes that are very, very broad. I’m not promoting one stereotype over the other, but I do believe that the same arguments apply to vaccines. I’ll let you figure out which one you are. 🙂 Me, I’m a safe D. But, I have alive children…and killer ninja moves.

We vaccinate our children on the CDC schedule. We do so for various reasons, one of which is that my husband is exposed to many things throughout the day and we want our children as protected as they can be, as soon as they’re able to be so. As a pediatrician’s wife, I hear various reasons why people are opposed to vaccinations or the CDC schedule. While I understand the doubts, questions and concerns, I have the benefit of living with someone who makes it his mission, every time, to make sure that what we’re doing with our own kids is still what we need to be doing. Justin lovingly researches every question I throw at him and answers patiently every. single. time. If you know me and my tendency to ask questions, you know this is a feat.

Justin also makes sure that the vaccines are still safer than the potential risk of exposure (or the illness itself) and that each vaccine has a low risk of poor outcomes, every time we get shots. But, to say that they’re risk free would be lying. So is not vaccinating, or vaccinating at a slower schedule. So is driving. So is eating. So is drinking water, tap or bottled. So is taking a walk. So is sleeping. It’s all got risk, but for us, vaccinating makes sense. Here are some things I’ve learned while Justin’s been a pediatrician that has help me understand.

0) I love my kids. This is reason zero because it’s the underlying reason why we do everything we do. At the end of the day, I couldn’t live with myself if my kids got something that I could have prevented. Period. To me, an alive kid is always better than a not alive kid, ASD or not. The potential benefit outweighed the potential risks. It’s why we don’t bed share. It’s why we leave our kids rear-facing until they’re two. It’s why I tried my darndest to breastfeed our biological kids until they were a year old. Also, the tiny part of me that looks at the bigger picture, as infrequent as that may be, looked at the kids that die from these diseases, all over the world. I couldn’t justify living in a place where preventing them was within reach, and I chose not to. This should not be your reason, unless you actually feel this way. And, if it is your reason, you can credit me for it! Ha!

1)   The mercury in the MMR vaccine has been taken out. So, you’re giving your kids more mercury when you feed them fish. Mercury was the ingredient everyone was so worried would somehow get into kids’ brains and cause autism. It’s gone now, so everyone can take a collective sigh of relief.

2)   The vaccines have been researched so much that they actually know when our bodies are the most receptive to them, meaning that they pose the least amount of risk at the time the CDC says to give them.

3)   Slowing them down doesn’t help your kid. See above. I’m not sure what toxins people say we’re overloading our kids with, but changing the schedule makes our bodies less receptive to them, exposes our kids to those illnesses for longer than necessary, and gives our kids MORE shots and office visits (read: exposure to whatever illness is in the office with us that day). In the words of my two year old, “No, no thank you.”

4)   The vaccines that we’re giving our kids are actually more refined and contain less stuff (Many of you seem to call them toxins…I’m not sure what toxins are, but I’m fairly certain it’s not a medical term.) than when we got them. For example, the pertussis vaccine contained about 3,000 antigens when I got it. Now, it contains 3-5. Yes, you read that correctly and can read about other improvements here.

5)   To be frank, to think that your kid won’t get an illness if you don’t vaccine because it’s too rare is, well, it’s not good reasoning. You probably also bed share, because you think that it just can’t happen to you. Well, that’s (again) not a risk I’m willing to take. you might not know it, but there are people in every community that don’t vaccinate. It’s scary to me to think that my kids, when they weren’t yet one year old, could have been exposed and possibly infected with diseases we’re trying to protect them from. Over the past four years, I’ve found out that several families that we come into contact with on a regular basis don’t vaccinate, but I didn’t know this when my children were under one year. Thanks be to God, nothing happened. But, if you’re going to choose to not vaccinate, please let people know. The diseases you could potentially be sharing are devastating, both to the kids you know and to the adults you’re around, specifically pregnant ones. To clarify, I’m not pregnant now, but when I was in my first trimester and pregnant with our second son, I didn’t tell anyone. I didn’t tell anyone until fourteen weeks, actually. It would have been a devastating loss to our family had I come into contact with something as seemingly harmless as the mumps, which has a risk of miscarriages, particularly in the first trimester. Do your research about who you may be harming, not just about the negative effects of vaccines for your kids from bad “research”. Bottom line: you never know what your kids will be exposed to. We give our kids the best chance possible.

6)   Another reason we vaccinate is because we would treat medically if our kids got sick. If Noah came down with pneumonia, we’d treat him with whatever necessary to make him better. If you’re in the same boat with us, why would you allow your kid to get mumps, whooping cough, etc, if you’re going to treat them (medically) anyway? We choose to be proactive so {hopefully} our kids won’t get these illnesses to begin with.

7)   A study also showed that our kids are smarter because we vaccinate. Laughable to me, but it’s at least solid research. (If you don’t know me, please know that this is simply to lighten the rest of this post. It is actually good research done over a period of about ten years on over 1,000 kids, and a good read if you’ve got the time.)

8)   The arguments against vaccinating don’t have good research. I have my Master’s degree and had to do a lot of statistics to get it. One thing I learned was how to recognize credible research, and how not to. I read Jenny McCarthy’s book. It’s full of the “Well, I know a guy…” theory. We’ve all heard it. Your neighbor’s brother’s best friend’s cousin’s great grandchildren’s nephew was the exception to the rule on something, and suddenly it discredits the expert from MIT. Wait, what?!?! How do we believe this stuff? One popular article that’s surfaced lately is this one. I’ve seen it on three websites so far, always dated the day I’m looking, and it’s always exactly the same. If you’re going to try to sway me, at least change some language. You’ve all heard the stories about the twins at the newborn nursery in some big city who had the unfortunate pleasure of being named “Orangello” and “Lemongello” (Orange Jello and Lemon Jello), but let’s not be so gullible when we’re talking about the health and safety of our kids. See this article when you want to know more about autism and when it develops.

9)   The first argument I ever heard was when Jenny McCarthy wrote a book about her son. In that book, she said that the same son who has vaccine induced autism didn’t socially smile back at her until he was five months old. That’s a red flag for autism, Jenny. Come on. No, that didn’t convince me to vaccinate, but it was at least a hole in the argument against vaccinating, and I looked more into those holes. I was more comfortable vaccinating than not, according to the things I was seeing, even though she played will on my new mommy emotions.

Overall, we vaccinate for many reasons, and the list is too long to spell out here. I’ve written it before, but it’s worth saying again: I don’t know how moms and dads survive if they’re not married to a pediatrician. Please ask your doctor if you have hesitancy. Your doctor knows your kids, your heart, and your reasoning.

I also hear several people who are interested in doing more research. I totally get that and encourage you to do so. Here are some medically viable places to get good information.

http://www.immunize.org/catg.d/p2068.pdf

http://www.cdc.gov

http://scholar.google.com (This is a site you can search for published articles. It’s awesome!)

http://www.pediatricsdigest.mobi

http://autismsciencefoundation.org/autismandvaccines.html

http://www.vaccinateyourbaby.org/index.cfm

Faith Versus Medicine: My Thoughts

Religion and Medicine

There’s a myth brewing in our society that I’ve tuned into recently, and it’s unsettling. This myth, this division, is the belief held by some that medicine and God are on two opposite teams of health care, and I believe there are two extremes.

Extreme 1: Doesn’t the Bible say that we only need faith the size of a mustard seed to move mountains? Surely I’ve got enough faith in God to have Him cure my cold, my strep, my whooping cough, or that of my children, right? I mean, how much faith does that require, an eighth of a mustard seed? A sixteenth? Lord, increase my faith and cure my kid/self/spouse/parent/etc.

Extreme 2: Medicine cures everything, and we should always take medicines for every ailment. After all, God wants us to be well and to be able-bodied to serve Him, right? So pop a pill and move on with your life.

I wonder, though, why these things are so often seen and perpetuated as enemies. Could it be that they’re not made to be enemies, but to be partnered? Should Christian doctors not pray before treating? Better yet, should they not pray that the Lord will heal without intervention first, then heal WITH the intervention? We, in the United States, seem to take for granted that the Z-Pack will work, that the Tylenol will fix our headaches and the baby aspirin will help our hearts. But, how did we get to this place? How did we get to where medicine is such an understood part of our our daily lives, to where we could have not only one medicine for allergies, but hundreds?

As I think about how medicines are created, I’m always astonished with the Lord’s hand in it all. I mean, does anybody else think, “Hey, there’s greenish blue stuff growing on my bread! I wonder what would happen if I ingest this? Would my earache get better?” I know I surely don’t. It’s my belief that this, too, was an act of the Lord and one He allows to keep happening, over and over again, as new medicines are being created.

I mean, let’s face it, when left to our own devices, human beings are not the most intelligent or disciplined people. Go all the way back to the beginning, you faith-filled people, and look at Adam and Eve. They had ONE rule, one thing God told them not to do, and it was pretty straightforward. It wasn’t as if God asked Adam to hold the stars in line, create water, build animals and keep them functioning! Nope, all they had to do was abstain, to not eat fruit from one tree. Yet, they couldn’t. And, if I’m honest, I wouldn’t have lasted as long as they did. So the fact that God allows us, as humans, to find medicines to help us is truly amazing; there’s no way we could have done all this on our own.

I also believe that God decides when medicines will and will not work. What other explanation do we have for the headache that won’t go away, for the chemo that won’t heal cancer, or, better yet, when they do? Isn’t it the Lord who numbers our days? I don’t know why medicines work some times and don’t others, but I believe that God’s hand is in it all. So, as we go from here, let’s choose to give credit not to inanimate pills, but rather, the One who made all pills possible. Further still, I’ll praise Him when they work and I’m able to continue work for HIS kingdom! Yes, we should absolutely thank the doctors and nurses that had to remember protocols in order to get us the medicines correctly, who had to listen to our complaints and ailments and sift through the muck to find the morsels. But, let’s not forget that God ordained that doctor, at His perfect timing, to remember the protocols in the precise moment that our lives intersected his or hers.

If you’ve made it this far in this post, you should know that I absolutely believe that there are fields of medicine in which we’ve taken it too far. I do not believe that every doctor is benevolent and seeking the will of the Lord; absolutely not. But, does God still use people, in His plan, who are not seeking Him and His glory, to point back to the heart of the Father and to carry out His plans? Absolutely. If that weren’t true, He’d never have used a human being because we’re flawed to the very core.

When Justin and I discussed this, we talked about various natural remedies that we try, such as honey instead of cough syrup for our kids over two years old (under two just cough all night and we sit up with them), but overwhelmingly he said that he’d prefer to let “all natural” parents just be that: all natural. He’d prefer doing nothing over doing oils, taking herbs, etc. Those things, for the most part, haven’t been tested or studied long-term and in broad spectrums, so there’s risk with all of it. There’s risk with medicines from your doctor, from not taking medicines, from taking remedies or not. There’s risk in medicine, in car rides, in nurseries, in bathtubs. So, we don’t give our kids medicines unless it’s really evident that they’re necessary. Hannah has had maybe two rounds of antibiotics in her 14 months of life, we don’t use allergy medicine often and pain meds are hard to find in our medicine cabinets (after teething, if I’m honest). But, I digress…

So, my call to Christians is this: Let’s trust the One who created our bodies and stop allowing this division to permeate our minds, hearts and churches. Let’s thank God for making our bodies truly miraculous machines, for creating the medicines we may or may not use that help so many, and praise Him. There is no risk-free way to care for our bodies in this broken world. It’s sad, but one day, we’ll be before the King, in the middle of golden streets with whole bodies who will be able to dance for eternity with no problems at all. That we can all agree on.

What to look for in a pediatrician…

Rachel and Justin Smith

Rachel and Justin Smith

One of the most difficult things for us as a family about leaving Abilene was the inevitable question of who Justin’s patients should use as their family pediatrician. It’s a tough question; who you choose to doctor your child is a tough choice for all of us. And, yes, we just had to do this again, as well. {Thanks, UT Southwestern, for the fantastic medical ethics class that you put your med students through that now means we can’t use Daddy as our doc….} The relationship you have with your child’s pediatrician should be one founded on trust and an understanding that your doctor wants your children to be just as healthy as you do. These doctors got into medicine to further the health and wellness of children, and they see it as their job to do just that with each and every family that walks into the waiting room. It’s part of the oath all doctors take, but pediatricians have a special propensity in seeking health because they are in on the ground level; their patients are brand new! In a place as special to our family as Abilene, it’s that much more difficult because your doctor isn’t just your doctor during well visits, but your doctor in hospital stays as well. So, here are some things to look for and ask about when considering who you’ll pick as your pediatrician.

1)   Their training. Were they trained at a place where they were exposed to all sorts of illnesses and that fostered their exposure to identifying even the most rare of illnesses? You can ask them, but you can also look up where they were trained and see how big of a program it was based on how many residents were there, and ask around about how good training programs are. Even if the training program wasn’t a large program, did they take a leadership role, or were they offered one?

1a) In their training, will they always give your child medicine, even if it isn’t called for? Will they allow your child to try to try to fight infections before giving medicine, if that’s what you’re wanting? Will they tolerate you giving your child treatments that they know aren’t good for it?

2)   Their team.  Are they practicing with other doctors who they can ask when they need help? Who will see you when your doctor is unavailable? Do you trust those doctors with your child, even for a single (most likely ill) visit? I have huge loyalty here because of how well Justin’s office treated us as a family, my kiddos and how they helped Justin develop from a baby pediatrician to one who is ready to practice and train others. You can read more here.

3)   Their tolerance. Will your doctor tolerate your questions when you’re asking humbly and trying to understand? Will he or she be longsuffering with you when you need to ask, again, why a medication is necessary or why your child isn’t getting one? And, your questions about their training and team?!?! As you seek to choose a doctor, he or she should be able to answer these questions, at the very least. If s/he isn’t willing to, how do you think this doctor will handle your questions about medications, late night calls, etc?

Now, it’s easy for me to sit behind my computer screen and type these things because, when I have a question, I simply shout, “Hey, Babe…”. I have no idea how I would survive as a parent who is not married to a pediatrician. Case in point, I had to take care of the kids for two weeks while Justin was finishing up in Abilene. I was LOST. So, please know that you’re not alone but that choosing a doctor for your family is difficult. I know that, but when you ask me, these are the things I know make a difference.

After you consider the aforementioned three points, the other things I’d say specific to Abilene is to consider what hospital your pediatrician admits to. Of course, I’m loyal to Hendricks; they were wonderful to our family and to our friends and to Justin’s patients. {For more info, see Justin’s blog post here.} Not only that, but they have a whole floor for pediatrics. Your kids will be taken care of by nurses who are trained in pediatric care, not just nursing. Plus, the rooms are HUGE and I’m partial to the play area for kids. It’s got karaoke.

Also, does the office staff work diligently to get your child in on the same day he or she wakes up or comes home from school ill, or will they send you to a walk-in clinic? {For more info on that, see Justin’s post here.} We’ve all had kids wake up sick, we’ve all had a kid come or be sent home from school sick and need to be seen. How will your pediatrician of choice respond when this happens? Is there opportunity for you to be seen on the weekends, should that happen? When you call after hours, will you be given opportunity to speak to the doctor if you think your child warrants it?

No office or staff is perfect. No phone line is perfect, every office staff and doctor should be allowed to have bad days. But, on the whole, I think that these things are the minimum of care allowable for kids, our kids. We worked hard to have them, to raise them, and to keep them well. It’s my opinion that your doctor should, as well.  All doctors are not created equally; if so, I wouldn’t know that the phrase “D still equals M. D. ‘ exists at even the best medical schools.