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Thursday, October 3, 2013

Assumptions Interfere with Realities - A Lesson from Nathan's Doctor's Appointment

I mentioned in earlier blogs that my son Nathan requires frequent medical monitoring for "Nephrotic Syndrome."  He was diagnosed right before school started when we went to a new doctor for school physicals.  The condition necessitates treatment with a medication called Prednisone, which is a steroid.  As with many medications, the Prednisone has an added side effect of increased blood pressure.  So we added Captopril,which is a blood pressure medication. The medications can be hard on the stomach, so Renitadine is also part of Nathan's routine.

We have been going to the same clinic for over two months now.  At the end of each visit with Nathan's doctor, we go to the front desk to make an appointment for the following week.  The same person assists us each time and provides us with a copy of Nathan's appointment schedule so I can give a copy to the school.  For the past three weeks, the scheduler has commented about Nathan's frequent visits and wonders why he keeps returning.  I explained that he requires follow-up for his high blood pressure.  Last week I explained that the HBP is the result of another medication he takes. 

This week the appointment scheduler said, "Oh Nathan.  What are we going to do with you?  Maybe we need to have you eat some oatmeal or cheerios every morning."    Now I could have come unglued at this point for a few very righteous reasons:
  1. My child's medical condition was really none of her business.
  2. She was being very unprofessional in addressing my child and making recommendations.
  3. This person had no medical authority or understanding of my child's medical needs or the side effects of the medications.
  4. The comments were way beyond her scope of responsibilities.

However, that's not me.  Unless you have severely maligned my child or my family with inappropriate actions, responses, or gestures, I prefer to use these moments as "teachable opportunities."   Perhaps it's the teacher in me.  But I chose to explain my son's condition so she could understand why we keep returning.  I didn't have to do this.  HIPPAA regulations back me up regarding medical privacy.  However, not everyone recognizes that certain comments might also be considered an invasion of privacy.

I calmly explained that the medication Nathan takes causes the High Blood Pressure.  She responded, "Isn't there anything else he can take or something else they can do?"  Again, I held my breath and calmly stated, "No.  This is what we need to do right now."  She smiled, handed me the new appointment schedule for next week, and said, "Hope you feel better, Nathan.  We'll see you next week."  I thanked her, smiled, and responded, "We look forward to seeing you next week too.  Thanks for your help." 

Every day we are called upon to make choices regarding how we will respond, communicate, and share our experiences with our fellow humans.  In this situation, I felt so much better when I was able to teach instead of elevate my own blood pressure via altercation with the scheduler.  Sometimes we just have to take the time to communicate.  The style of communication might allow others to recognize that assumptions can interfere with realities.  There are so many elements that can occur in someone's life.  It's not up to me to judge.  It's up to me to provide whatever comfort I can and move on from there.

Here are some links regarding "Nephrotic Syndrome."

For More Information

American Kidney Fund
6110 Executive Boulevard, Suite 1010
Rockville, MD 20852
Phone: 1-800-638-8299 or 301-881-3052
Internet: click to view disclaimer page

American Society of Pediatric Nephrology
3400 Research Forest Drive, Suite B7
The Woodlands, TX 77381
Phone: 281-419-0052
Fax: 281-419-0082
Internet: click to view disclaimer page

National Kidney Foundation
30 East 33rd Street
New York, NY 10016
Phone: 1-800-622-9010 or 212-889-2210
Fax: 212-689-9261
Internet: click to view disclaimer page

You may also find additional information about this topic by visiting Medline Plus at