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Monday, January 03, 2011

Finally a doctor that listens

Every since Sara got pregnant with Ayden there has been this real issue with doctors saying that she is now medically emancipated. My first thought about this is that if a 16 year old wasn't capable of comprehending medical issues such as pregnancy prevention then what makes people  so sure she is capable of making life changing medical decisions. I realize these laws are in place to prevent forced abortions or the right to have an abortion but put that issue aside and look at the general health and welfare of a 16 year old child trying to make medical decisions. I had no clue what to say to a doctor at 16 and I know that Sara doesn't either. She sits there and shakes her head yes the whole time, she never ask questions or tells the doctor details about what is going on.  Right after Ayden was born Sara had to change doctors, she wasn't allowed to see her pediatrician any more because she had a baby, she can't see the gynecologist (her gynecologist does gyno and regular family care also) but her gynecologist does not treat children unless they are pregnant. Needless to say she had to find a primary care provider. The clinic we use suggested a PA because Sara preferred a female provider.The first visit to the PA, Sara was told to stop taking her metphormin right away. This is medication that she has been on for about 5  years to control her insulin levels. When I went to see the PA with her to explain Sara's history and why she needs to stay on the metphormin, the PA turned to Sara and said " you are my patient, not your mom, I am not listening to what she has to say, do you want to be on the metphormin or not?" Sara replied that she wanted to stay on it because she don't like the way she feels when she is off of it. The PA relied with "well you will have to find another provider then" and left the room.

Sara always says she don't feel comfortable talking to the doctors about her health because even though they inist she is medically independent she don't feel like they listen to her. Today I went with her to see the doctor that I use when ever I don't have time to deal with the VA. I explained Sara's history to the nurse and then to the doctor. Both were a bit shocked that the PA tried to stop Sara's metphormin, both were a bit shocked at the PA's attitude as well, this PA is in the same clinic as the doctor we saw today.  The doctor instantly told us that first because Sara is and has been on metphormin then she needs to stay on it unless she was to loose a major amount of weight, then he would look at lowering her dose and eventually taking her off completely, however that would only happen if she was to loose to much weight which is very unlikely with her medical condition. Secondly the doctor ask her about depression after delivery. Sara just kinda nodded her head and smiled. He ask me, I told him that I feel like she has post pardom depression because she swears she don't cry a lot but I see her cry every time anyone says anything to her she tears up and even really cries, not to mention that she has been on bed rest the entire school year and had to do her school work from home, she has no job and all of her friends have became occasional text buddies and that is about it. She has to start back to school next week, be a mom, try to make adult decisions, pay bills and be in a relationship. It is all life stuff but stuff that you typically don't deal with at 16. At age 16 I had a job and school and rarely saw my parents because I was on the go, Sara is sitting at home wondering what life outside this box is like. It would depress me and I am far from 16. Sara has goals set, she is making plans and preparing for the future but at this moment she is feeling trapped to the point that just a few days ago she said to me that every time her boyfriend walks out the door to go to work she hates him because he gets to leave the house and she is trapped here. Not that she don't want to be around her family, but Sara is a lot like me and sitting at home 24/7 is not possible if we want to keep our sanity.  The doctor (who has 7 children) understood the emotional roller coaster that being on bed rest and stuck at home has on a person combined with the extreme changes that have taken place over the last few months. He offered her some anti-depressant medication and a medical plan for what happens if this isn't the correct medication, and a plan for what happens with her metphormine down the road. He assured us that Sara doesn't need to stop the metphormine, she is on the right path to get on her feet with her health and her life. He also told Sara that with any patient, even the adult patients, having some one close to them come to her appointments was not only ok but actually essential. As he explained to her, with all the things that most people have going on, typically the patient won't see the signs of depression, signs that their  medication isn't working. Even with the metphormine, Sara is very away of how the metphormine makes her feel and how she feels when it isn't working but she don't notice the need to sleep all the time and the emotional changes that I see in her when her metphormine isn't working.  Needless to say I am extremely happy that this doctor took the time to listen and talk to Sara and me like he understood rather than blowing us off.

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