Blog Archives for category Appointment – Katie
Katie is never nervous. She does amazing.
Owen, on the other hand, is always really nervous (he thinks everything will hurt) and then afterwards he says “That was easy!” This photo is obviously after he was done.
They got their cleanings done in the procedure room because it wasn’t being used…so they got a TV on the ceiling!
Katie is still a much better patient than Owen. He freaks out at the smallest thing—he said the hygienist’s rotating toothbrush hurt and then he was throwing a mini fit because he doesn’t like the taste/feel of the flouride treatment—he was whining a little and needed four glasses of water and looked like he was going to be sick; Katie just goes on like nothing even happened.
I took both kids in tonight—Owen for his regular 6-month checkup and Katie for her first ever visit. She loves brushing her teeth so I didn’t think she’d have any problems with it…but you never know.
They were both excited to go, and it started well with them playing in the waiting room!
Then we had a brief introduction with both the hygienist and dentist in their office and then it was off to the chairs!
Owen was first…
And Katie was intrigued.
And got closer…
I asked if she wanted to hold Owen’s hand and she said yes.
Owen did REALLY well (which I would hope, as he’s done this about four times), and then it was Katie’s turn!
“Look mama! Clouds!” (There were clouds painted on the wall!)
Glasses and bib—so far, so good.
She didn’t seem nervous but I asked if she wanted Owen to hold her hand and she said yes.
Katie seeing herself for the first time. I love the look on her face!
She was a total rock star. They were able to do a full cleaning (as opposed to Owen’s first visit at age four when they only got about three teeth done).
Then they both got seen by the dentist and were told they need to brush twice a day (instead of just once) and start flossing…and Owen NEEDS to stop sucking his thumb as his teeth are already out of place (Katie’s are perfect). She said this is THE time to stop as his bottom two teeth are still coming in and his top two are loose (I bet both will be gone by Christmas—one might be gone by this weekend) so the new ones will come in straight. (We’ve told him and showed him pictures of what can happen and he knows he needs to stop—and even catches himself—but it will still be challenging because he’s still just five years old.) Then they got their goody bags and were SOOOOOO excited about the toothbrush and stickers and toothpaste—and Owen got a toy truck and Katie got a little mermaid! They were in HEAVEN.
So overall they both did AWESOME and I loved the staff—we’ve had nice dental staff before, but you can see a difference in a regular dentist who sees kids vs. a pediatric dentist.
Granted it could be worse, but still. Ugh.
I recently got a bill for $109 for two of Katie’s appointments…where we didn’t see her primary care provider (though I didn’t know that at the time). You see, when we moved, I dutifully went to the Tricare website and picked the clinic/doctor I wanted AND THE SITE LET ME PICK the one I wanted, so when we got the confirmation letter, I admit I didn’t look at it closely because WHY WOULD IT BE ANYONE OTHER THAN WHO I PICKED? (And also, by that time, I think we had already seen the doctor.)
But apparently the letter confirmed the REAL doctor Tricare had assigned me (that I didn’t get to pick). And when I called Tricare to ask about it, they assured me I was covered and it was all taken care of, even though it was a point of service appointment. Phew, okay. But calling them today, I find out that, well, I WAS technically covered, but only for X amount and the rest was from my own out of pocket expenses. Lovely. That’s a big chunk of money I wasn’t planning on spending on something that could have been 100% covered.
It started off great, then hit a rough patch, then ended great so overall I’m happy.
The hospital is super easy to get to and only takes about 15 minutes—and there’s plenty of parking in the attached parking garage. Everyone was super friendly, the hospital was very nice, and the pediatric area was easy to find. There was plenty of seating for kids and adults…with kids shows on the TV.
We were there about 25 minutes early in case we had to fill out paperwork, and I was surprised when they called us back almost immediately to get Katie’s vitals. They were going to put us in a room but none happened to be ready so we got sent back to the lobby…
THE ROUGH PATCH
…where we sat for 20 minutes until I finally went up to the desk to ask (at military facilities there’s always a sign saying to let the staff know if you’ve been waiting more than 15 minutes). When I told her what doc it was, she immediately kind of laughed and said “He’s always slow…THOROUGH.” /sarcasm on/ GREAT. /sarcasm off/ No, I know being thorough is a good thing, but always running behind is not. If he’s always that thorough they should schedule the appointments accordingly.
Katie passed the time playing with the other kids in the waiting area.
So we kept waiting. And waiting. At 15 minutes past our appointment time (and 30 since vitals) we got put in a room. I wasn’t thrilled…but overall it still wasn’t TOO bad. So we waited. And waited.
And had time for three snacks and a drink.
Ten minutes, 20 minutes, 30 minutes. At the 1-hour-past-my-appointment mark I went out into the hallway to see if I could get an update from anyone…and the doctor was actually in the hall headed to our door. As I started to politely question about the delay, he was already apologizing and explaining that the previous patient had been an acute case—apparently his staff missed signs of low oxygen (?) and he had to rally everyone to get it taken care of and have it be a teaching moment.
THE GREAT ENDING
It turns out I REALLY REALLY like him—he’s very personable, I felt very comfortable with him, and he was amazing with Katie… She was sitting on his chair when he came in, so he got on his knees (down to her level) and examined her right there instead of making her get up on the exam table. He explained everything he did as he was doing it. Just his entire bedside manner and tone of voice was comforting and knowledgeable.
So, his thoughts? Her ankle is fine and we don’t need to see a specialist. He was poking and prodding and she never winced even a tiny bit and it wasn’t swollen and he could see no reason to refer her. His only thought was that it might possibly be Lyme disease (as that affects joints) but since it was just the one joint and no others and no other symptoms, he immediately ruled it out. He did say that if it gets worse then we can revisit it, but for now, just keep giving her Tylenol when it’s swollen or if it seems to be hurting her (which it rarely does). He said he sprained his ankle when he was a kid and it gave him troubles for many years but there wasn’t anything to do for it. He even said if he did refer us, the pediatric orthopedist would say we were wasting his time. He had said he has three young girls himself so if he thought there was ANYTHING wrong at all or ANYTHING at all to be gained from a referral (or more x-rays or tests or whatever), he wouldn’t hesitate. But he just didn’t see it with this case.
I then mentioned that the other doctor had noticed a heart murmur and said it wasn’t serious but that it should continue to be watched. Within about four seconds of listening to her heart he said “Yes, she has a definite murmur.” However, it wasn’t in her armpits and it disappeared when she stood up—and he diagnosed it as a very common Still’s Murmur (also known as a vibratory murmur). He said she was a very healthy little girl and we had nothing to worry about.
On the way out, I briefly mentioned big brother Owen and his GI issues so we chatted for a minute about that—and he told me two of his girls were on the Miralax regimen as well. So I feel good about that aspect when we need to take Owen in.
So, it all ended on a positive note, though I think the wait could have been handled better (why can’t ANYONE in any doctor’s office ever tell waiting patients what’s going on when something like this happens?). And I think I’ll be much happier with them than the first office I had picked from a hat. Score one for Tricare!
Katie wanted to play in the water!
She remembered the office and immediately went to the toys.
Exploring in the room:
Enough exploring—time for tech:
The doctor said she seems perfectly healthy. She did notice a VERY SLIGHT heart murmur that she wants to get checked out eventually (she wants to get the ankle figured out first) but it’s nothing critical and she’s sure it will likely disappear.
Weight: 30 lbs. 7 oz. (was 26 lbs 7 oz.)—86th percentile (was 78th)
Height: 36″ (was 33-1/2″)—88th percentile (was 90th)
Head: 19.6″ (was 19″)—93rd percentile (was 90th)
And for the sibling comparison, at 24 months, Owen was:
Weight: 38# (greater than the 97th percentile)
Height: 39″ (greater than the 97th percentile)
She only had to get one shot and Owen was VERY concerned that he didn’t want to watch. I told him he didn’t have to, but he should to see that it’s not a big deal. (He is still freaked out about shots, even though the last time he got them he realized they weren’t a big deal.) So I held Katie on my lap and the nurse did it in three seconds and Katie squawked just a bit and then she was more enamored with the blue band-aid than anything…and Owen was saying “See Katie? It wasn’t bad at all!”
Since Katie’s X-rays came back negative, the Doctor then wanted to do bloodwork to determine if any of her whatever levels were elevated… Increased levels of whatever might point to arthritis or a blood borne reason for the continued inflammation.
Tom took her to the lab and SHE WAS A ROCK STAR. The nurse was a bit nervous when Tom told her it was Katie’s first time, but Katie didn’t even flinch or wince and it was over just like that. Yay Katie! But what she didn’t like? The tape holding the cotton ball on!
I took Katie in to get her ankle checked again. The new office is only about 12 minutes from us via back roads—but of course it feels farther because I have no idea where I’m going yet (comparatively, it took 20 minutes in Jacksonville).
She liked the waiting room.
A decent picture of her new hand-me-down cousin outfit.
Playing peek while waiting for the doctor.
Of course, they were running behind today…so by the time we saw the doctor, we had been there almost an hour and a half (they wanted us there early for new patient stuff, even though I told them I had printed all the forms and filled them out, then we waited in the patient room for quite some time). That said, the doctor was nice and apologized for running late. And Katie was very good the whole time between playing, watching videos on my phone, and looking at books.
The doctor looked at her ankle and agreed it was swollen and agreed we should get new x-rays. She also asked if Katie had been sick lately—or, really, if any of us had been—and I said no. She said she wanted to take a strep test! Wait, what? Yes, a strep test. She said it was a long shot, but it was a quick and easy test to rule out some type of arthritis. (She explained it and I googled later, and strange as it may seem, the same bacteria that can cause strep throat can cause swelling and joint pain. And since it had been going on so long, she wanted to rule it out.) Katie didn’t love the strep test, but she was a trooper and recovered quickly. (On that note, the nurse who performed the test didn’t have greatest bedside manner in my opinion—she was older and very matter-of-fact-get-the-job-done which worked, but didn’t give me any warm fuzzies.) The results were negative, so then it was off to a walk-in imaging clinic for x-rays.
This is where we were spoiled in Jacksonville—the x-ray clinic was literally three buildings down from the pediatric clinic. Today it was a 15-minute drive (of course in the complete opposite direction from home). It was approaching nap time, so I had to decide whether to wait and do it another day or just bite the bullet and finish it in one day. I decided to finish since Katie was being really good. So we had another 15-minute wait after the drive and then Katie was a ROCK STAR getting her x-rays—just like before. The tech had me stand next to her and hold her still but there really was no need—Katie didn’t move a muscle for either x-ray. (I tried to get a picture of her laying there nice but of course she started playing with her feet.)
It was over in about three minutes and she got two Elmo stickers and was happy. And then stayed awake for most of the ride home but fell asleep about three minutes from home. THREE AND A HALF HOURS AFTER WE LEFT. Egads.
So now we just have to wait to see what the x-rays show and then likely get a referral for a specialist depending on what they see.
So Katie has been limping off and on for a few weeks now so we finally took her in (Tom came with me because he’s off this week). The doc agreed her ankle was swollen and guessed it might be a fracture so sent us for x-rays. Thankfully they came back clear, but the only recommended course of action was ice, rest, elevation, and ibuprofen (yeah, like ice, rest, and elevation are really going to happen) and to check back in two weeks if she was still limping. I guess that’s better than having to get a cast, but I’d almost rather have a definitive solution (i.e. cast) as opposed to “wait and see.”
She was a little poop at the appointment, though—you know her normal super talkative self? Who never shuts up and is always smiling and laughing? When the doctor came in, she turned to stone. No smiles, no giggles, no hi-fives, not ticklish…it was the craziest thing.
But she was a ROCK STAR getting the x-rays—she just layed quietly on the table (it helped that there was a pillow so she pretended to sleep!). The radiologist said she wasn’t used to kids who stayed that still.
Finding stuff to get into while waiting for the doctor.
She got a wipe and was blowing her nose!
Weight: 26lbs. 7oz. (was 23lbs. 15oz.)—78th percentile (was 66th)
Height: 33-1/2″ (was 32-1/2″)—still 90th percentile
Head: 19″ (was 18-3/4″)—90th percentile (was 88th)
And for the sibling comparison, at 18 months, Owen was:
Weight: 32.5# (96th percentile)
Height: 35″ (97th percentile)
I didn’t have any concerns, so I was surprised when the doctor told me that she was on the edge with her language skills—that she’s on the later side of language development. Hoo boy. So was Owen.
Interestingly, I hadn’t read Owen’s same-month appointment blog entry, so when I was reviewing it to write this post, I was amazed at what I read:
We told her we were a bit concerned about his speech (or lack thereof) and she asked us some questions and from everything we told her (him knowing some letters, numbers, etc.) she said she wasn’t REALLY worried (yet) but that she agreed it wouldn’t hurt to get him evaluated.
Wow. So at 18m we had been concerned with Owen’s lack of speech development and he already knew some letters and numbers! Katie doesn’t know any letters or numbers.
She should be copying (imitating) two-word phrases like “Mama eat,” “Owen play,” and “What’s this?” AND saying “two or three words that represent different ideas together” like “See dog,” “Mommy come home,” or “Kitty gone.” But the doctor didn’t seem very worried—she just told me to spend more time reading with her and always talk to her. I guess it could be worse…but we’re keeping our fingers crossed.
Really? Eight line items ranging from $26-$200 for a total of $962…FOR A 15-MONTH WELL VISIT?! Of course the allowed amount is half that and we pay nothing, but that’s still $&#% INSANE.
I couldn’t even remember all the things they did to warrant that many line items so I had to look them up (in order, as seen above).
- 99392—Periodic preventive medicine re-evaluation (Birth-24 months)
- 96110—Developmental testing, limited (e.g., Developmental Screening Test II, Early Language Milestone Screen), with interpretation and report (I think this was asking ME questions. Or maybe reading my answer on the questionnaire?)
- 90657—Influenza virus vaccine, split virus, 6-35 months dosage, for intramuscular or jet injection use
- 90670—Pneumococcal conjugate vaccine, 13 valent, for intramuscular use
- 90647—Hemophilus influenza b vaccine (Hib), PRP-OMP conjugate (3 dose schedule), for intramuscular use
- 90700—Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTap) when administered to individuals younger than 7 years, for intramuscular use
- 90460—Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first vaccine/toxoid component (New 01/01/2011)
- 90461—Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine/toxoid component (List separately in addition to code for primary procedure.) (New 01/01/2011)
So, if I’m understanding 7 and 8, they charged $260 for administering the immunizations?! For less than five minutes. What a racket.
Katie’s 15m well-visit was today, and she passed with flying colors! He asked if she was eating her fruits, veggies, and meats (yes), if she could throw a ball (yes), if she knew five words (yes), and if she was walking on her own (yes, running!).
Weight: 23lbs. 15oz. (was 21lbs. 11oz.)—66th percentile (was 65th)
Height: 32-1/2″ (was 30-1/4″)—back up to 95th percentile (was 80th)
Head: 18-3/4″ (was 18-1/2″)—88th percentile (was 65th)
And for the sibling comparison, at 15 months, Owen was:
Weight: 28lbs. 12oz (95th percentile)
Height: 34″ (Above 95th percentile)
Head: 48cm (75th percentile)
Katie has allergies and is now on a low dosage of Zyrtec. I’m sure that’s what Owen’s snot and coughing is about, too, but it wasn’t his appointment so the doc couldn’t really do anything official. But, Owen was allowed to get his flu shot…and holy cow was that a drama. Of course he didn’t want a shot and just about pulled the “stiff as a log you can’t move me” crap, but I managed to get him in the room and as I’m literally shoving him to lay down on the table and keep him from flailing about and he’s screeching and snotting all over, the shot was done and over and he was like “That was it?” Yes, you little shit, I told you it was no big deal. (He whined louder and longer than Katie and her four shots!)
Then Owen had his follow-up with the GI specialist next door. He was 60.2# and 46-1/2″ tall. Unfortunately, there’s nothing else to do besides keep on keeping on—it took a year to stretch out his colon so it can take just as long for it to shrink back. And in the meantime, we just have to deal with the messy undies and have him keep trying to poop. I do officially have to do a mini clean out every other week—hoping enough gets done over the weekend so it doesn’t interfere with school.
Weight: 21lbs. 11oz. (was 20lbs. 14oz.)—down to the 65th percentile (from 81st)
Height: 30-1/4″ (was 29-3/4″)—down to 80th percentile (from 97th)
Head: 18-1/2″ (was 17-3/4″)—down to 65th percentile (from 79th)
For comparison, Owen’s 12-Month Check-Up was:
Weight: 26# 4oz (95th percentile)
Height: 32″ (95th percentile)
Head:47cm (75th percentile)
I’m REALLY glad she isn’t following in his statistical footsteps anymore!!
Once again, the milestone questionnaire they give you is a joke. I mean, sure I know if she’s walking along the edge of the couch, taking a few steps on her own, or saying a few words…but how on earth would I know if she “reaches for a Cheerio inside a closed clear plastic container”? And I haven’t had her attempting to scribble yet, so that makes me feel like I’m slacking. And those are the only two things that I remember—I should have taken a picture of the form.
But she passed everything with flying colors. She didn’t even make a peep when they poked her finger for the iron test! (And as usual, she pulled the band-aid off within minutes.) And she only squawked for like 30 seconds when she got her two immunizations.
The doctor was impressed with the foods that she eats and that we’ve already transitioned her to whole milk…and said we need to try to get her off the bottle by her next visit. I know, I know—I wish she already was but she has ZERO desire to give up the bottle.
Well the pediatrician says impetigo or herpes so she’s being treated for both. It’s still contagious, but not as bad as molluscum.
That said, I texted my sister the diagnosis (and of course I didn’t get her text until I left the office) and she said “It’s not herpes if it’s on her finger, too.” Hoo boy. So now I’m leery if these docs don’t even know something that seems basic… But I guess we’re covered either way with the meds (one twice a day for seven days and one five times a day for 10 days).
We were also referred to an ophthalmologist since it’s by her eye so that’s this afternoon.
Ugh. That was painful.
Our appointment at the eye doctor was 1:15 and as a new patient I had to be there at 1:00. Fine. We got in about 1:25 so not bad. Then it was AN HOUR AND A HALF LATER by the time the doc came in. Oh, at about an hour someone finally came in and said “He just got back from surgery, he has one quick thing to do, then he’ll be in.”
What? JUST got back? At 2? So why the hell were we scheduled for 1:15? (They didn’t say emergency surgery.) And then it still took another 30 minutes.
The pediatrician didn’t say “Good news, they squeezed you in!” so I assumed we had a normal appointment. Apparently not.
So let me just tell you HOW MUCH FUN it was with an already over-tired baby WAY beyond her nap time and an energetic 4yo cooped up in an exam room. Thank heavens Tom met me there and could help out. I may have lost my mind otherwise.
And the actual doc part? Seriously two minutes. GRRR. One squirt of dye in her eye and a quick look with a blue light to see if there were scratches. Nope, okay, use this ointment. See you in two weeks.
Then Katie was out within two minutes of me starting the drive home.
Weight: 20lbs. 14oz. (was 18 lbs.)—81st percentile
Height: 29-3/4″ (was 28-1/2″)—97th percentile
Head: 17-3/4″ (was 17-1/4″)—79th percentile
For comparison, Owen at 9 months was:
Weight: 22lbs. 10oz. (50–75th percentile)
Height: 30½” (95th percentile)
Head: 26″ (95th percentile) He really did have a big head!
So they were actually about the same at 6m, but at 9m, she’s smaller! YAY!
I got to check YES on everything on her milestones sheet, so the doc said she is doing perfectly. She also wasn’t due for any vaccinations, but we apparently missed something at 6m because they were out of it, so she got it today. It was just one quick shot and she cried for two seconds but that was it. GOOD BABY!
Katie had to get her flu booster this morning and it was still COLD so she got to wear her new monkey hat (from Gramma Jean, if I remember right).
Weight: 18 lbs. (was 15 lbs. 15oz.)—between percentile 75 and 90
Length: 28-1/2″ (was 25-3/4″)—99th percentile
Head: 17-1/4″ (was 16-1/2″)—75th percentile
For comparison, at six months Owen was:
Weight: 19 lbs. 7 oz.—so 1 lb. 7 oz more!
Length: 28-1/2″—the exact same length!
The doctor said everything looks great. She was just ever-so-slightly concerned that she hasn’t started solid foods yet, so suggested we try real foods instead of jarred baby foods (like yogurt puffs, grain puffs, mashed potatoes, avocado, etc.) and if she’s still not eating by 9m, then we should see a specialist. But I’m not worried.
She did really well with her shots—hopefully because I dosed her with Motrin before the appointment. She got two vaccinations and a flu shot (with a booster due in 30 days)…then fell asleep when I was halfway through my Sam’s Club trip.
Weight: 15 lbs. 15 oz. (was 13 lbs. 4oz.)—between percentile 75 and 90
Length: 25-3/4″ (was 23-1/2″)—between percentile 75 and 90
Head: 16-1/2″ (first measurement that I have)—between percentile 50 and 75
I prepped her with Ibuprofen this time…and it seems to have helped overall (no bouts of screaming once we got home). However, at the time, it was a different story. First, strangely, she absolutely FREAKED OUT when the doctor checked her ears. Screaming like she’s never screamed before. The doc said everything was fine, so then it was off for the immunizations (another room at the clinic)…where she started screaming as soon as I set her on the table. And then boy did she scream. BOY DID SHE SCREAM. Probably twice as loud and horrific-sounding as when she was getting her ears checked. It definitely made me grateful for what little crying she actually does at home. Then it was over and she stopped crying by the time I had made her next appointment and we were walking out—and she fell asleep by the time we walked to the car. Good baby.
Just for comparison, at four months, Owen was 16 lbs. 1 oz. (so only 2oz different—and they were using an old skool scale (vs. digital) so it may have been off just a bit) and he was 1/4″ taller…so they are almost identical!