Is our doctor going to be overwhelmed?

[WindyCityMom]

3yo DD has an appointment next week with our family doctor.  I fear that she'll either be overwhelmed or look at me like I have three heads and dismiss me as "reads too much on the internet".  Though that is most certainly not the case here and she's otherwise an excellent doc, so...

DD has the following issues that need to be addressed:

-Overeating.  A LOT.  This week I am going to write up a journal regarding her food intake.  We don't know what the cause could be.  It's not a growth spurt either.

-Sensory issues.  She has a horrible time with a lot of things, and it has progressively gotten worse.  Too much to go into detail.

-Dermatillomania.  DD is a skin picker and picks herself until she bleeds.  It has recently taken a huge turn for the worst.  It's pretty bad, to say the least.

-Possible food allergies.  DD acts weird with gluten and has been constipated since she was first offered food containing gluten as a baby.  She also has a big ol pot belly (despite being skinny) and we're not sure if that's related to a possible gluten intolerance or her overeating.

-Referral to an eye doctor- DD is extremely clumsy, and we just found out her sister is farsighted.  When I was 4, I remember having vision problems though I didn't get glasses until age 11 (we saw a horrible eye doctor and my mom took me somewhere else when i couldn't see the board and was failing my math class, and found out I couldn't see well at all and probably couldn't for some time).  I'd like to rule this out for DD, or help her if she needs glasses.  She frequently squints and walks into things.

-Possible athsma.  DD gets very wheezy whenever she gets the slightest cold and often needs an inhaler.  She has trouble running because of being out of breath and refuses to run at her playgroup and gymnastics class because of this.  A few months ago she also had pneumonia, and they told us that it was very possible that she had athsma.  I'd like to get her doctor's opinion on this, since she does go to a sport activity (gymnastics) which is also a drop-off class.... if it's possible that she could have an athsma attack, I'd like to know.  If she needs an inhaler or something, I'd like to know as well.

Is this wayyyy too much to talk about at a doctor's appointment?  I'm hoping to put together the journal as well as a list with the sensory issues.  I'm also going to bring in a paper with the bloodwork she should have done to check for Celiac Disease.  Will the doctor think anything odd of me if I bring in lists?

I'm so overwhelmed. 

[ecoteat]

Who cares what she thinks of lists. All of your concerns are valid. Start off by telling her you have a lot of concerns so you can both budget your time during the appointment to discuss everything you need to. It sounds to me like a lot of these things are connected--you may not have a big long list so much as a bigger underlying problem causing all kinds of issues. If you don't get a helpful enough response, maybe a naturopath would do a better job connecting all the dots.

[wishin'&hopin']

Send in the list ahead of time so that the doctor/office know that you'll need a longer appointment scheduled than that usually apportioned for a well child check.  

[The4OfUs]

Originally Posted by wishin'&hopin' 

Send in the list ahead of time so that the doctor/office know that you'll need a longer appointment scheduled than that usually apportioned for a well child check.  

 This.

[WindyCityMom]

The only thing is, if I do that, our appointment will get pushed back further.  DD really needs to get checked now for the eating issue- she needs bloodwork done. 

[wishin'&hopin']

Perhaps give the doctor the list and ask the doctor to address the concerns that are most pressing and then schedule an additional visit.  Otherwise the doctor may not be able to adequately address your concerns without doing a disservice to the patients scheduled for visits after yours.  

[ecoteat]

How long do you get for an appointment? DH and I were both at the doctor yesterday about our flu and we had two back to back 30 minute appointments, so we just did the appointment together for the full hour. I don't know how we would have had time to discuss anything else, really, even with that much time. Maybe you should start out with the eating issue, mention the other concerns, and make another longer appointment. It will certainly take time to get to the bottom of all this, so you'll need to prioritize.

[sbgrace]

I make lists similar (not quite as wide range but something like that--with all my concerns). I hand them to the doctor on the outset so we can prioritize/save time. The vast majority of those concerns are likely going to be referrals..not things the pediatrician will be addressing in this same visit him/herself. I'd do it, I've done it, I don't seem to overwhelm doctors, maybe they hate me and I don't know!

Do you need a referral to get an eye exam? Most health insurance excludes eye exams unless it is traumatic eye injury. If you have vision insurance it likely includes a yearly exam (ours does) but it's not part of your health insurance and doesn't need referral. Young babies/toddlers into even preschool in some cases are farsighted by the way. In most cases it's developmental. So your youngest being farsighted doesn't mean anything at all re: your oldest. Still, you had early vision issues and she squints...so checking seems important! I just don't know that the pediatrician needs involvement.

Maybe you could sort of prioritize--I want to talk with you about her overeating and which doctors might be able to help us with the skin picking. Can you get a referral to an appropriate person for the asthma and possible allergy/gluten (celiac???) issues if he/she feels that is outside their scope. Sensory issues if you want to see an expert would be occupational therapist referral. Your insurance may not cover this at all...ours doesn't. You may still need a referral though. So most of your things are referral based. For the asthma pulmonology is best but some doctors will prescribe if they hear a wheeze as in some areas pulm. is a long, long wait. The gluten thing is harder--this is GI related--and it sounds more like something major like celiac (ped. can test if willing but only if she's presently consuming gluten and has been--if she's been off the tests are not accurate) or something less "major" like intolerance than allergy to me based on your description. She could be eating though due to reflux or something. I wonder about GI (does she struggle with constipation not consuming gluten or have other digestive things?).

I would try to be succinct and bring it all up in written form. If the pediatrician wants to handle some and schedule a follow up he/she can do that. It sounds like you're most concerned about the eating so make sure the doctor is aware it's your top priority (if I'm reading right and it is) on the list. With my son and major issues like that I often do come in knowing we'll have follow up appointments but bringing it up now allows the doctor to order labs, refer if necessary, ask you to keep certain records, get a stool sample, or etc. So I would bring it up for sure.

[californiajenn]

Naturopaths generally give you an hour long appointment and would probably be a great fit for your needs. They are fully credentialed doctors, they just now how to do more than prescribe meds. Your daughter very, very likely has food sensitivities and I would look into that asap.

[WindyCityMom]

Originally Posted by californiajenn 

Naturopaths generally give you an hour long appointment and would probably be a great fit for your needs. They are fully credentialed doctors, they just now how to do more than prescribe meds. Your daughter very, very likely has food sensitivities and I would look into that asap.

I would love to see a naturopath.  Only we're really tight on money and have medicaid, which I don't think covers naturopathy.

sbgrace- I actually need a referral in order to have vision services covered, we have Medicaid.

I think I'll make a concise bulleted list for the doctor.  We've had long long appointments before, like when my youngest DD tested with high lead levels.  Either way, I'll see if there's any way we could schedule a follow-up appointment.

[Otto]

Originally Posted by californiajenn 

Naturopaths generally give you an hour long appointment and would probably be a great fit for your needs. They are fully credentialed doctors, they just now how to do more than prescribe meds.

In Illinois, anyone can call themselves an "N.D." There is no credentialing or regulation whatever.

[sbgrace]

WindyCityMom,
Bullet list sounds good--that's what I usually do. Prioritize most important at top and I'd list the things that only need referrals you believe at one point so you've got less points. Good luck--I hope the appointment is very helpful.

Originally Posted by californiajenn 

Naturopaths generally give you an hour long appointment and would probably be a great fit for your needs. They are fully credentialed doctors, they just now how to do more than prescribe meds. Your daughter very, very likely has food sensitivities and I would look into that asap.

In some states, yes. In others anyone can call themselves a naturopath. In our state you can't be licensed in naturopathy at all.

[mbravebird]

When I look at that list, I think that an underlying cause for many of your concerns could be gluten intolerance. So I'd prioritize that. Overeating, potbelly, compulsive/anxiety picking, sensory issues, asthma...all could be gluten related. Really!

[Marnica]

Id also like to add that if the celiac test comes back negative this doesn't mean that gluten is not an issue. You have have gluten intolerance which can cause all the things you have mentioned, and not have celiacs disease.

Have you tried an elimination diet for your DD?

As for ND's only 14 states, the District of Columbia, the US territories of PR and the US virgin Islands have liscensure. They are Alaska, Arizona, California, Connecticut, Hawaii, Idaho, Kansas, Maine, Montana, New Hampshire, Oregon, Utah, Vremont and Washington.

[shelley4]

i'd also like to add that if your DD is NOT eating gluten, then the celiac test can come back as a false negative.. she must be eating gluten, daily, for blood work to show a positive.  if the blood work is positive, then you'll likely be sent for a biopsy, which is the only iron-clad way of diagnosing Celiac.  if those come back negative, it's still very possible to have a gluten intolerance without Celiac disease... and i agree, gluten could very well be causing many of your concerns.

i hope you get answers soon!