First the back story, of course.
I haven’t talked much about Quinn lately. I’m not even sure I want to be talking about this on the blog right now, except I want to talk about what happened this morning, and if I don’t tell you a bit about Quinn that I’ve not been telling you, then none of what happened this morning could really be told.
So, Quinn. Shortly after he came home from Vietnam he started saying English words: Mamma, Dadda, hi, hello, more, all done, amen, and maybe a couple others. For a while he would throw himself at Matt’s legs and say, “Hi Dadda!” when Matt would come home from work. His enunciation was always crystal clear the first time he would say a word, but pretty garbled thereafter. And then? He just stopped talking. Well, not entirely. He still says, “more.” He stopped signing, too, except for “more.” Though, a week or so ago, he started saying, “that.” But now he’s stopped.
If he hadn’t said any words up to this point I would probably only be mildly concerned. However, the fact that he was saying words and has stopped, has left me just slightly more than mildly concerned. I’m being serious there. I’m not all in a tizzy about this, just slightly more than mildly concerned. When I took him to his 18 month appointment two weeks ago or so (I was a few weeks behind on that, naturally), I casually mentioned the concern to the nurse practitioner. I didn’t know we weren’t actually seeing the doctor that day. For future appointments I will make sure we do, because I wasn’t really fond of the snippy nurse practitioner who seems to think I’ve sentenced my children to certain death by not having them vaccinated against chickenpox and the flu. Anyway, she referred us for a hearing test.
Specifically, she referred us to our county health department. Why? Why? Why not refer us to a private audiologist of some sort? I don’t know, but this morning we went off to the county health department for Quinn’s hearing test.
Except when we got there? The audiologist told us that after she was finished we would be seeing “Dave” and then seeing the doctor. Umm . . . okay then.
So she did two tests and said he passed them both. One was the hearing test they do in the hospital on newborns. I don’t know what the other was, but it involved sticking something in his ears for a second. Then she put the little beepy headphones on him, but said she knew he wouldn’t get it and she wouldn’t be able to actually test his hearing that way, so, though he passed the first two tests, she couldn’t rule out possible mild hearing impairment.
Fine. Whatever. I can fully accept the fact that he could have mild hearing impairment, but that wouldn’t explain why he was talking a bit and now almost never talks. I know he hears. If I hand him the diaper I just took off of him and tell him to put it in the trash can, he does. If he opens the basement door and I tell him to close it, he stands there ignoring me. But when I tell him to close the door or have a time out, and then I start counting to three, he slams that door shut. So he hears, and he understand. Whatever is going on with his speech, I really don’t think it has a lot to do with his hearing.
After the audiologist we go to Dave’s exam room. I still have no idea who Dave is, technically speaking. I only know that he is two years older than God and thinks it is odd that my son was talking but then stopped. You think, Dave?!?!? He then asks me if I can have Quinn take the sippy cup out of his mouth for a second. When I do that, I hear Dave muttering to himself, “No signs of cleft lip or palate.”
For the love of all that’s holy, Dave! You couldn’t have asked me about that? I mean, it is no big deal to take the sippy cup away from a child who was only sucking on it because he was feeling insecure about his surroundings, but still! Anyway, after that brilliant observation, Dave gives me an article on how to talk to your baby and a list of “Things to DO,” and “Things NOT to do” to encourage language development. Because, you know, obviously the other four children who were with me, the children who I had to keep telling to stop talking, are all blithering, mute idiots.
Not to disparage Dave too much, but I am the mother of five children. FIVE. I may not be two years older than God, and I may not have a background in whatever it is that man actually does for a living, but I know how to talk to children in a way that encourages speech development. For the love of God, I wish some of them would freaking shut up every now and then, because I did such a damn good job of helping them learn to talk.
It’s not rocket science.
But Dave didn’t really tick me off that badly. No, what really got me was the meeting with the doctor.
As I said, I thought we were going out for a hearing test, plain and simple. I had no idea we would be meeting with a doctor who would want to check Quinn’s ears. I mean, why? I just had him in for a well check and they looked in his ears then and didn’t seem to see anything wrong, but whatever.
So we go into the exam room and the doctor looks in his ears and declares, “I can’t see anything. There is too much wax and junk in there.”
Umm . . . okay. Then he goes on to say that I’ll have to bring Quinn back, but he’d prefer that we not wait until he’s back in our county, he’d prefer that we bring him to the actual office in the closest Thinks Its a Big City. Right. And why didn’t the pediatrician just give us a referral to do that to begin with?
Then the doctor goes on to explain that, yes, bringing him in to the office would be best since they couldn’t do a hearing test on Quinn today because, you know, this county health department isn’t set up for that.
Excuse me? He just had two tests done by the audiologist.
Right, the doctor said, but those weren’t hearing tests. If they had been able to test his “actual” hearing, they wouldn’t have sent us to see the doctor. Then I explain to him that from the moment we first met the audiologist she told us we would also be meeting with the doctor. So what was the point of telling me we were coming here for a hearing test if, in fact, everybody knew from the beginning that they wouldn’t be able to test his “actual” hearing?
And . . . AND???? If his ears are so freaking filled with wax, why didn’t the nurse practitioner mention this to me at the well check?
The doctor said perhaps there wasn’t wax then.
“Two weeks ago? You’re saying this all developed in two weeks?”
“Umm . . . well . . . umm . . . I don’t know . . . “
Translation: Country doctors/nurse practitioners suck.
To summarize: I spent the morning getting five kids ready and schlepped them out in the rain to a COUNTY HEALTH DEPARTMENT, and we lost an entire morning of school time so that Quinn could have a “hearing test” that doesn’t test his “actual” hearing in order for an ENT, whose office is an hour away, to refer himself to me and tell me to clean my kid’s ears out in the meantime.
Also, because I am slightly more than mildly concerned about Quinn’s speech development, I had called the county’s early intervention folks and scheduled an evaluation for this Friday. I was absolutely loathe to do this because I don’t want to be “in the system” and because (sorry, I know I’m about to offend some people here, but my feelings are what they are and this is my blog) county early intervention programs, like the county health department, are microcosms of socialized medicine/services. It is to their advantage to find something wrong with my son because they need children with “delays” to justify their jobs and expand the socialized system. I am glad they are there for the children who really do need them, I am; but in a case like Quinn’s I am afraid there is too much wiggle room and fear that they would err on the side of justifying their jobs. See, if there really is a problem, I want to know. But if it’s just a kid not wanting to bother with talking because he has four older siblings and two parents who know what he wants anyway, I don’t want somebody to slap a label on him just to make themselves feel needed.
Despite these feelings, I scheduled an evaluation because, if my son really does need help, I want to get it for him (though after the evaluation I’d find private providers if needed and pay out the nose if I had to, because I feel that strongly about socialized medicine).
So I asked the doctor who had just referred himself to me if doing the evaluation this Friday would be wasting even more of my time since we still haven’t ruled out a hearing issue. He hemmed and hawed about how he’s not sure what all they screen for in those evaluations and it probably doesn’t all have to do with his speech development and . . .
I interrupted him to explain as clearly and politely as I could that my only concern with my son is his speech development and I’m none to happy that the early intervention folks plan to screen for other things as well since there are no concerns there, and I only scheduled the appointment for speech purposes (even though I know they will screen his motor skills and heaven knows what else).
The doctor then ‘fessed up that doing the evaluation this Friday, before hearing issues could be ruled out, would be premature given the concerns I have. So I have cancelled that.
And now . . . now I want to call the pediatrician’s office and find out what exactly they saw or didn’t see in my son’s ears two weeks ago. I also want to know why they didn’t just refer me to the ENT to begin with. I also want to know who my girls are scheduled to see on Monday and who Tank Boy is scheduled to see the following Monday.
I don’t know if I’m going to, though. Should I? And is it acceptable to ask them to put a notation in my records not to refer us to the health department, but rather send us straight to an actual doctor’s office, assuming there is an actual doctor in this God-forsaken section of the world, because we do have insurance (even though it’s pretty crappy – yeah, the big three aren’t going down because they take care of their salaried folks)?
Right. So I’m just royally p.o.ed about all this. I’m p.o.’ed that they wasted my time. I’m p.o.ed that my pediatrician/nurse couldn’t mention the developing wax problem. I’m p.o.ed that they all scheduled a hearing test for a 19-month-old knowing full damn well that they weren’t equipped to do what needed done. I’m p.o.ed that they shuffled us around to three different people after leading me to believe we were only going for a hearing test. And I’m p.o.ed because now I know my tax dollars go in part to pay Dave, the man of indeterminate expertise who may already be dead due to causes incident to age, to hand out photocopies of common sense crap to mothers who obviously know how to talk to their children. (Could I have fit even one more preposition into that sentence? I think not.)
My current plan is to spend the weeks between now and Christmas making sure my son’s ears are good and clean. I will pay close attention to see if there are any improvements/changes in his speech during this time. If things improve I will chalk it up to ear wax. If things don’t improve I will make an appointment with the ENT/audiology office after the first of the year. If all that shows that his hearing is fine I will find a private early intervention specialist to do an evaluation. If such a thing exists around here. Hell, maybe I’ll just take him to the veterinarian. I’m sure the care can’t be much worse.
I’m still not sure what to do about the pediatric practice we go to. Maybe his ears were clean two weeks ago? What are the chances?
And George, you don’t have the password anyway.