autism and doctor visits

Yeah, you would think I would be able to prep my Bub for doctor visits pretty well considering I'm a nurse and all, right?  WRONG!!!!

As some of you know, Bub was looking like he had fifth's disease again, and had missed 3 days of school, so we go to the dr.'s .

before we go, we practice

take temp

open up and say "Ahhh"

look at ears.

listen to heart

He cooperates w/ momma, so we get ready to go.  Bub is very excited to take a ride, but when we get to the Doctor's office, Bub knows EXACTLY where he is....building of DOOM!

This is quite similar to Bub's expression once he realizes we are at the Dr office...

he doesn't want to get out of the car.  he doesn't want to go inside.  in the waiting room, he keeps trying to make a great escape out the door.  then we're called in and put in a exam room.  Bub is making lots of vocal stims and spanking himself.  I try to convince him to rub his bottom instead of hitting it.  he compromises by flopping on the floor and scooting his butt back and forth.  the horrible part of me thinks he looks like a dog w/ worms doing the butt-scrape thing....maybe the self-spanking stim is better for now?  sigh.
To stop this stim, I grab 3 tongue depressors, 1 for each of his hands and one for momma.  we practice opening up and saying "ahh"  Bub thinks this is fun.

then the lady comes in to take his V/S.  Bub is automatically wary.  He won't let her take the temporal temp, so I do it.  he grudgingly lets us put the probe on his finger to get his pulse and SpO2...after 3 attempts.  then off to the scales.  Bub is terrified of scales.  I have no idea why unless he is still associating it w/ getting weighed and fingersticked for hemoglobin at WIC, but we stopped doing that before he was 3....so I have no other idea why this is scary to him.  finally I say, let me hold him, and get on the scale then put him down so you can get an accurate weight that way.  Joy joy, I get to see I gained 7 lbs.  yayee me.

so now Bub is freaked, and we go back to the exam room by ourselves.  We start counting to 10, because that is calming to Bub, then we start naming/signing animals...another good time-passing calmer.  then the NP comes in, and Bub has instant wariness.  She smiles at him, he smiles back and makes a break for the door.  Bub's no fool, he know what comes next.

The NP and I talk for a few min about Bub's presentation and my guess of what's wrong.  She then shows Bub her stethyscope, Bub likes that, she lets him listen to his heart, then he lets her listen to his heart/lungs.  then she gets the otoscope.  No dice.  Bub starts screaming.  I try to hold him still, she gets one ear...I've got Bub pinned to the wall and the floor and she still can't get to the other ear.

So she goes to get reinforcements.  I have Bub's trunk and arms, another RN has Bub's legs, the V/S chick has his head.  Not only are we able to get a sight on the other ear, someone manages to strep-swab his throat as he is screaming in protest to the restraints we have all become.  I'm actually really impressed they GOT the swab.

Everybody lets go of Bub at this point and my poor boy collapses face-first into my shoulders, sobbing like we just beat him up.  It always breaks my heart that these visits have to be so traumatizing for him.  He then starts the self-spanking again.  I take this opportunity to point out the behavior and ask for meds to help or to get a referral to someone who is qualified to prescribe and monitor behavioral meds.  Bub is calming down and sitting on my lap, eying the NP w/ great suspicion.  I get the referral, the strep-swab result is negative. so we get to leave the exam room.  I tell Bub to sign thank you and good-bye, which he is MORE than happy to do since he knows his time in the torture chamber is now over.

We go to the business desk to pay, Bub is practically running to get away and because he remembers that there be lollipops on the business desk.  Bub doesn't even ask for candy, he starts reaching for the jar of lollies, so I stop him and make him sign "candy please".  He signs "cookie please".   really?  Dude, you know the difference...who do you think you are trying to fool?   After a quick correction, he gets it right and picks out a red dum-dum.  the lady at the desk offers him two stickers, his choice between iron man and Gweneth Paltrow is the sticker of Gweneth....maybe he does get the "hot chick" thing after all....hrm.....

Bub is so happy to be leaving the Doctor office of Doom that he willingly holds the door for some lady when Momma asks him to be a gentleman.  it was pretty cute. 

then he fell asleep in the car on the way home, so exhausting was the appointment.  poor kiddo.  I wish this was so much easier for him, but it's not.

Nubs