Daily Foglifter:  “Spectrum”–A broad sequence or range of related qualities, ideas, or activities

I had a very busy week last week with the kids home from spring break.  In addition to all the shopping trips we had to make as a family, we also had to go the doctor’s office.  More specifically, the psychiatrist’s office.  No, it wasn’t for my pending emotional breakdown.  It was for my autistic son who has been having some obsessive compulsive issues.  Why in the world I made that appointment when I would have all five kids, I couldn’t tell you.  Although, any psychiatrist worth their salt would suggest it has something to do with my pesky martyr complex.  But, I digress.

I took all five kids to the psychiatrist’s office and got there on time, only to wait for 1 hour and 45 minutes.  My kids were uncharacteristically awesome.  Of course, I made everyone take their Nintendo DS and forbade them to sit within arm’s length of one another, but they could’ve complained.  They didn’t say a word.  It was a proud moment.  There was a funny moment in the waiting room.  A little old crotchety man in a wheel chair, oxygen tank firmly attached, was irate and summed up what everyone was thinking.

Why make appointments if you’re not going to keep them?  It’s very inconsiderate and he’s a SHRINK for God’s sake!  He should know better!

I love old people.

Well, they finally called Mikey’s name and I took the baby and told the rest of the kids to sit quietly in the waiting room while I go see the doctor.  The nurse asked me, “They won’t get up and go outside, will they?”  Um, no.  We may be in a psychiatrists’ office, but they’re not crazy. Of course I didn’t say that.  I opted for the more polite answer of, “No, ma’am.”  She didn’t look like the type who would take a joke very well.

We were ushered into the Doc’s office and were met by a very pretty med student who would be observing.  Another ten minutes passed and Doc finally made his appearance.  He introduced himself and stretched out his hand, but before I could return the courtesy, his pager went off and he went to the phone.  I waited another five minutes for his conversation, which was medical in nature, to end and then he flipped open Mikey’s file.

• Doc:  “Who referred you?”  Me:  I answered.
• Doc:  “What’s the problem?”  Me:  “We need new meds for some obsessive-compulsive issues related to his autism.”
• Doc:  “How many children do you have?”  Me:  “Five”  Doc’s pager goes off and he makes another ten minute phone call for another obviously more important concern than ours.
• Doc:  “Is the father in the home, or is it just you?”  Me:  “I’m married to the children’s father and we have always lived together.”
• Doc:  “Who diagnosed autism?”  Me:  Dr. _________.”
• Doc (to Mikey):  “How are you?  Do you do well in school?  Do you get good grades?  Do you like school?  Do you feel okay?”  Mikey answers all his questions and the Doc turns to his student and says, “There are no signs of Autism.  His previous doctor had a reputation for misdiagnosing Autism.  That’s why she moved to Florida.”  I wasn’t looking in a mirror, but I’m sure the look on my face was one of shock and awe.
• Doc:  “What makes you think he has Autism?  Has he had psychological testing?”
• Me (stammering):  “It began with sensory issues, loss of speech, no eye contact…He’s had tests, when he was three and last year.”
• Doc (to student):  “Do you see the problem?  Sensory issues…a lot of toddlers have this.”
• Doc (to me):  “Does he have outbursts?  Is there a history of depression in your family?”
• Me (still reeling)”  “Yes to both.  But he’s not moody.  He only gets upset if his expectations aren’t met or he feels like he was cheated because things didn’t go according to his plan.”
• Doc (again to the damn student):  “Depression can present many ways…blah, blah, blah.”

Mikey's First Year in School Age 3

I’m not sure at what point I became invisible, but he was talking to this student as if he knew what in the hell he was talking about and that I was inconsequential.  Or very dumb.  Did he think I wouldn’t notice he said that Mikey’s diagnosis was wrong?  That what we thought was autism for the past 8 freakin’ years was a matter of a genetic disposition to depression?  Did he expect me to accept that and say nothing?

Apparently he did.  Every time I tried to explain what led to Mikey’s diagnosis, I was cut off by another dumb phone call or a stupid, uninformed asinine opinion of his.  An opinion he formed in a total of 10 minutes with me and my son.

To make matters worse, I was completely blind-sided.  I had no idea that I would be challenged on my son’s diagnosis.  I was completely unprepared for that.  I didn’t bring in the mountains of documentation I’ve accumulated over the past 8 years.  For God’s sake, I could barely form a coherent sentence, between my shock and his dismissal of anything I had to tell him.  I’m not sure when he decided I was an idiot who wasn’t worthy of his attention, or even his comments, but I suspect it was around the time I said I had 5 children.  What intelligent person has 5 children in this day and age?  Everything he said was to his student.  She at least had the decency to look embarrassed about it.

I was trying to collect my thoughts when he started talking meds.  He believed me about the OCD, (“It’s another way depression presents itself.”), and was writing Mikey a prescription.  It was what I went there for and as I was really too angry to speak or even to know what I wanted to say, I took the prescription and ushered Mikey out of there as the benevolent Doc took yet another phone call.

I’ve been thinking about what to do for the last four days.  The meeker and non-confrontational side of me says not to worry about it.  What we wanted was meds for a condition the Doc actually believes Mikey has.  We got it and as the only requirement will be to do periodic med checks, it isn’t necessary for the Doc to agree with the diagnosis of Autism.  The meeker and non-confrontational side of me is an idiot and a coward.

Mikey is not depressed.  He has Autism.  While it is encouraging to think that even a doctor can’t tell by speaking to him, it’s more insulting to be summarily dismissed.  That man has no idea the hard work it’s taken to get Mikey to this point. He wasn’t there for the sensory integration therapy when Mikey would scream his 3-year-old lungs out because he was forced to touch sand or shaving cream.  He wasn’t there when Mikey would stare off into space when I spoke to him.  He didn’t witness the hand-flapping, the echolalia, the made up language.  He certainly wasn’t there when Mikey used to bang his head against the wall or the floor in order to feel something.  That man doesn’t know anything about my son.

He will learn a great deal the next time we meet.  I have videos, reports, test results, IEPs, and a ton of other paperwork.  He may not want to listen to little old me, but he will be forced to look at the history.  He will have to acknowledge the validity of my son’s diagnosis.  He’ll see the tremendous effort put forth by his parents, his teachers, his Occupational and Speech therapists, and above all, of Mikey himself. Of course, I’ll be respectful.  If, as I fear, he still doesn’t want to listen, I can be something else, if necessary.  If you’re not sure what I’m talking about, here’s a hint:  It starts with a “B” and rhymes with “itch.”  While it’s not my nature to resort to this, I am quite capable of it.  Just ask my husband.

Picture Day is Stressful for Autistic Children

If all this fails, we will have to find another doctor.  If there is one.  Because Mikey has a disability, he is on Medicaid.  This was extremely helpful when he was younger and needed the OT and Speech therapy, but it’s not served us as well the last few years.  Finding a doctor, particularly a mental health professional, that accepts Medicaid is difficult.  Of course it is.  With what Medicaid pays, I’d be reluctant to accept it, too.  The wonderful world of government health insurance at work, but that’s a discussion for another day.

Autism Spectrum Disorder is not a cut and dried diagnosis, hence the use of the word, “Spectrum.”  Those on the spectrum have a myriad of easily recognizable symptoms–non-verbal, no eye-contact, no social interaction, sensory integration issues, and stimming.  Some autism cases are very severe and represent what people typically think of when they hear the word “Autistic.”  Mikey presented with all the classic signs of Autism when he began Early Intervention Services.  He began school at age 3 and even attended summer classes so that his therapies could continue.  A lot was required of him and he benefitted from the constant “training.”  I thank God every day for the wonderful doctors and teachers who helped him.  I never thought it might hurt him in the long run.

If this doctor refuses to support the diagnosis of Autism, it will go into his chart and could potentially complicate his future.  Mikey may appear “normal” but he still has issues related to his Autism that will undoubtedly affect his ability to work and live independently.  He will likely depend on his disability benefits.  If Autism is ruled out, these benefits will disappear.  Not because he isn’t Autistic, but because he isn’t Autistic enough.