The day my dog was fat

So I got in the elevator one day on my way to work. 

It stopped and picked up an older gentleman on the way down who greeted me kindly, so I decided to return conversation. I asked if he was going somewhere exciting. He said work, and he loves work. I asked of he worked downtown, since most people who live downtown with us also work downtown.  He said no, he works in Richardson.  Then he asked me of I knew what ideology was.

I thought a few moments, silently wracking my brain for what the word ideology could mean, but came up with nothing so I said no.

"It's the study of how the body hears"

"oh! Audiology" I said, "that's really cool."

He just smiled and we got off the elevator.  Which is probably a good thing because I would have either made myself look like a really big idiot if I told him I was a pediatrician who didn't know what an audiologist was.  Or I would have talked about how I just didn't hear him very well, at which point, he might suggest I get my ears checked.

Sigh.

But, nothing was said, which is probably for the better.

And, as if to remind myself of how silly I felt, my first patient of the morning needed a referral to an audiologist.  

At which point I just smiled.  

And thought of ideology.

...................................................

I get tons of call backs from the pharmacy, usually asking to substitute a drug or checking on the dosage I wrote for.  

But last week I got a call to explain what the "l" [lowercase L] I wrote in my prescription was for.  I pulled up the electronic prescription I sent, and couldn't find an "l" in it at all.  The pharmacist, said:

"yeah, it's there right in front of the 2.  you wrote 'use every "l" 2 hours' "

I'm pretty sure that's a "1" not an "l."

I can see how similar they look.  The number one and the lowercase letter L.  But no, it says "Use every 12 hours, not every l 2 hours"

Deep breath.  No laughing.

Move on with the day.

I'm not the only silly one.

.......................................................

One day, I took my dog to the vet.  It was just for his yearly exam, he got a blood test, a poo test, and updated his shots.

I kinda felt like a proud momma taking her little boy in for his 2 year old well-check.  He just hit 2 years old, and stopped really growing fully.  He is eating better and he finally doesn't look like a sack of bones.  He behaved so well, he didn't even cry for his shots.

Precious.

He was very nice to the nurse and the vet.

But the vet told me he was fat.  He has gained 6 lbs in the past year.  He got a bit taller too!

I couldn't believe what she was saying.  MY dog can't be fat.  Look how skinny he looks compared to the other dogs.  He runs and plays.

HE.

IS.

NOT.

FAT.

Which is the same "denial" phase a lot of my parents go through when I tell them their kids are actually fat.  Only they say: "No, they're the skinniest kid at school.  Every other kid is fatter than my kid."  And I have to remind mom that even though her kid is the skinniest, he is still fat.  It's just that all the other kids are even fatter.

So now, I'm feeling like a horrible parent.

How did I let my precious kid get fat?  I just wanted to make sure he was well-fed.  He was all skin and bones when I rescued him.  I gave him a full bowl of food every day.  And recently we've been measuring his feedings, making sure we don't give him too much.

Yet, he is still fat.

Oh, poor dog.

So then I tried to rationalize with the vet.  "We only feed him 2 cups a day, is that too much?!"

The vet said her 65 lb dog eats 3 cups a day.  And that my now 27lb dog is less than half her dog's weight so he should eat less than half her dog's food.

She said try him on 1 cup a day and then adjust it if necessary.

One. Cup. A. Day?

Poor fat dog is now on a diet.

And I feel like it's cruel.  I keep wanting to slip him treats and extra food to make sure he isn't starving. (although I don't, because I know better)  This must be why all the moms at my clinic still let their kid eat chips and sodas and ice cream.  They feel bad about their kids not being allowed to eat chips AND french fries at every meal, so they slip them more snack food so they don't starve to death.

And finally, I realize how hard it is to be the mom of a fat kid.

They're your precious baby.  And yes, they need to lose weight so they don't run into health risks.  But they're your only kid.  You don't want to have to starve them.  You don't want to have to deal with this "diet thing."  You don't want your kid to have to be hungry.

Every day, even when I'm not at work, I learn more and more about how to be a better pediatrician.

It's a hard balance.

I should start reminding my parents they're not horrible parents just because their kids are fat.

.........................................................

But

Some days I just have really bad, difficult parents.  

My favorite kind of difficult parents are the ones that are only difficult because they are mildly ridiculous.  Like the mom that cusses 8 times during the visit, then when I'm about to leave tells me that her son has the "worst behavior she's ever seen."

"See look, look at how he be crossin' his arms right now and givin' you a mean look, that's not normal for an 18 month old, is it?"

"Well," I start, "He must pick up behavior somewhere, Maybe you can think of someone at home that acts like that, that crosses their arms, maybe someone he looks up to..."

Mom just crosses her arms and says "I can't think of a single person that do that.  He's always around people that are real nice, people that would be good influences on him and all."

Well, I don't know.

What do you want me to tell you?!

...

Or another mom, that is yelling at her 6 month old, that she hasn't fed in 6 hours, to stop crying as we try to talk about her 3 year old.

She is worried because he won't let her potty train him.

At the same time, her 2 year old, (born in the same year! Irish twins!) crashes into the 7 year old and starts screaming, and the 4 year old whines in the corner.

You seam to have a lot on your hands, maybe it would be easier to leave some of the kids at home and we can just focus on your 3 year old.

She stops listening to yell at all of her kids to shut up so she can listen to me, and then asks me to repeat myself.

Perfect, this is going really well.  I can tell already, that this mom is going to be receptive to 100% of the things I tell her to try today...

She's one of those parents I give very specific instructions to, then make a print out of those instructions, so she can take maximum impact of all the things I try to tell her about potty training, like "stop liquids after dinner time" or "go potty twice before bed to ensure his bladder is completely empty."

She takes my printout and hands it to her 2 year old to appease him, who immediately sticks it in his mouth.

Mmmmm.  Tasty printer ink.

I can see that I'm getting no where with this mom.  I can't even communicate with her because of the circus of children clambering around the room.  She then yells at everyone to be quiet again while she abandons talking about potty training and focuses on how terrible her children are.

They won't listen to her at all.

Really?  They seem to be such perfect angels, I couldn't tell.

I cautiously suggest parenting classes, how they could be a good resource for her, to which she responds that she has already been to 2 classes, and they did no good.

Hmmm.

I don't exactly know what she thinks I can tell her during her visit that would possibly help her out more than an entire parenting class.

She finally gets fed up of all the screaming that she says she'll try my tips and come back.

I can hardly wait to see her again.

...

But then some days I have the parents that are downright mean.  These are the worst kind of difficult parent I see.

Thankfully, I don't have to deal with many of these.

On occasion I have parents that yell at me because they want antibiotics and I don't think they're necessary.

Or parents that tell me my Spanish is terrible.

(To which I always want to reply that their English is equally terrible and at least I'm TRYING to learn a language that isn't the official language of the country I live in, and they're not even doing that, but I politely hold my tongue.)

And once, for the very first time this week, I had a parent that flat out refused to see me.

I walked in, she looked at me, and asked if I speak Spanish.  Most parents are so thankful that I speak Spanish, they don't care how many verbs aren't conjugated correctly.  But this lady, without hearing me speak more than 2 words, flat out refuses to see me.

She tells her oldest daughter, in Spanish, to tell me to leave and get another doctor because I don't look like I can help her.

I reply to her in Spanish, that I understood her perfectly, and I can speak enough Spanish to do a full exam and there aren't any other doctors at the office anymore because it's past 5 pm.  She tells me to leave, and to get someone else.

Because I don't look like I can speak well enough.

I leave the room, letting the door slam behind me just before the tears start to fall.

Can she not see how hard I'm trying?

Does she really think just because I'm white and I can't roll my RRRs that I can't help her child?

Thankfully, one of my Hispanic co-workers is still in her office charting.  She sees my face and asks what is wrong.  I told her how the patient refused to see me because I'm not Hispanic, and I can't speak Spanish fluently.

She gets mad at first, telling me how she's going to tell the lady off, and then she just takes a deep breath and tells me it'll be ok.

Some people are just like that.  They just want to have someone of their own race to see them.  And no matter how good I am, or how good my Spanish gets, it won't change the fact that I'm not Hispanic.  And that's ok.  Because I'm still a great PA.

I finally wipe up all my tears as my co-worker goes to see the patient.

....

I've decided there isn't much I can do to change a bad parent, especially in one office visit.

But I can still be the best PA I can.

...................................................

Most people are private about their private parts.

They keep them covered by not one, but two layers of clothes.

Some don't.

In the office, so far, I've seen kids that refuse to wear underwear (usually a 3 or 4 year old little boy) and girls that wear shorts and underwear beneath their pants (usually they're girls who play volleyball or soccer).  I've seen my fair share of 15 year old boys who are so embarrassed to drop their pants for a well-child check.  

But sometimes I see weird stuff.

Like the grandmother of two teenagers who came in for well child checks.  I told younger sister to cover her eyes while I checked her brother's private parts.  But before I could do anything grandma says, 

"Oh, Honey!  We don't hide nothin' in this family."

Now, what am I supposed to say to that?  

So I just said "Oh, ok," and kept moving.

Poor kids.

And my favorite thus far:  The 6 year old who came in with "a rash inside his privates."  Now, I'm thinking, with all my knowledge of anatomy, that it would be awfully hard to see inside his privates.  But thankfully, once I get into the room, I see that it's a rash on the outside of his privates.  And mom is pretty sure it's just bug bites.

Yes, bites with an S.

As in multiple.

Poor kid.  Not only does he have bites, in an uncomfortable area, but now he has to show his privates to multiple people, just to get some treatment.  

Thankfully, we got him taken care of.

All the more reason to advocate bug spray.

....................................................

And now the fun part:

Events in the past 2 weeks:

Awesome party at the newly-refinished Team Armstrong house.  They promised us a ping-pong table.  When we showed up, we had multiple pieces of a table that had bested the Armstrong family.  But the architects got together, and 2 hours later we had a completed folding ping-pong table!  Fun night :)

Brothers.  Happy to see each other.  Looking at the camera because they thought I had a treat in my hand...

We took the puppies to White Rock Lake.  At Sunset.

But mom, I don't wanna go home!!  They had so much fun romping in the water!

Setting up for a few house guests!  We had 10 people in our little apartment! Lots of Chicken Salad!

So, first I got my hair cut.  

And since I was feeling all fancy, I decided to go to Nieman Marcus to go dress shopping for a wedding I have the first weekend in August.  

Then I looked at the price tags and decided I was shopping in the wrong place.  So I took a picture of me in my second-favorite dress.  I was afraid if I looked at a picture of me in my favorite dress I would lust for it.

He knows how much I love to match.  We went shopping at Bed, Bath, and Beyond to use up our final stack of gift cards.  Cutest. Couple. Award.

Date-night Sushi!