Wellness Visits: A Magical Place To Communicate

As 2015 gets earnestly underway, many of us are working to keep resolutions we made to better ourselves and our family as the new year continues to unfold. In case health is a part of your resolution or focus, here are a couple very quick reminders for check-ups and interactions at the doctor’s or practitioner’s office (3 tips below). I’m going to sound very much like a pediatrician here: wellness visits and check-ups add great value to preventing things. So much better than having to do the hard work of reversing problematic changes. This isn’t just about vitamins (which children don’t really need) and shots (which children wildly benefit from). This is about communication.

Well-Child Visits And Check-ups

Wellness visits often get forgotten when things are going well (hurrah!) yet they serve a grand purpose on tracking health and wellness by working to create prompts and services that prevent illness. The numbers (from vision, hearing, height, weight, body mass index, and vital signs –blood pressure, temperature, respirations and pulse) help track trends and provide alerts. They help reduce bias in our thinking as parents and pediatricians. As parents we can have a tendency to both unintentionally ignore warning signs of health risks or over-analyze perfectly normal developmental phases. Case in point: half of parents of overweight/obese children underestimate their child’s weight. On the other end of the spectrum, 1 in 7 parents believe their normal-weight child is too skinny. As a reminder, reading a growth grid has a lot less to do with numbers than it does trends. The import lies in following lines; is your child tracking, are they growing at the right rate, do they deviate or “fall-off” the curve? Here’s a quick video where I explain how to interpret the growth grid if you want to learn more.
Importantly, these visits also facilitate a place to bring up the questions that nag at you. Often those things are about habits, sleep, anxiety, body size/shape, school work or mood — or just how a child sees the world. Use the prevention visit to squelch anxiety of your own. What parent doesn’t have something pulling on their sleeve of worry while raising another human? The task of parenting is always somewhat monumental and the job description is always shifting as our children grow. The stakes are high when a child’s life is guided by another.

The moment you realize your children remember everything is also the moment you reconnect w the reality that parenting is a high-stakes job
— WendySueSwanson MD (@SeattleMamaDoc) March 8, 2013

Having Data Changes Behavior?

We’re learning more and more how wearables (those activity tracking devices on my wrist like many others) may change behavior and ultimately health. My hope is that a visit for a wellness check-up with your pediatrician can do similar things by bringing into focus a time and place to discuss concerns and anxieties you or your child has about physical and mental health.
Regular well-child visits can also potentially prevent future suffering. When your pediatrician sees your child on a regular basis, they’re more likely to notice subtle changes in health. A study published in 2013 showed kids who missed more than ½ their routine visits had double the risk of being hospitalized for conditions that potentially could have been avoided. It also found that children with underlying chronic health conditions who missed routine visits had triple the risk of hospitalization.

3 Tips For Maximizing Your Time During Your Child’s Visit

Doctor’s appointments can be short, rushed and full of emotion for everyone involved. With such a brief amount of time playing such a big part in your child’s health care navigation here are a few ways to potentiate the time you have together:

1. Set an Agenda. I mean really, give it a title and a theme. What is it that you really want the answer to? This can be easy and straightforward (“I just want to make sure everything is going well” to “The one thing I want to know today is will Julie’s tic remain for a lifetime, and if not, why?”). In the week leading up to your visit write down any questions that pop in to your head and ask others who have a huge stake in your child’s life (your partner, a grandparent, a babysitter or aunt or uncle). Let your child’s community weigh in and support you. Once you do this planning (I seriously don’t think this needs to take more than 10 minutes) see if there’s an underlying theme or topic that keeps popping up and put it on the agenda. Make notes for yourself on paper (off your phone) so you can hold onto it during the visit and not feel you’re being rude looking away from those in the exam room. Share the agenda/title/theme with the nurse or medical assistant that rooms you to help prepare the visit.
2. Take Data Home. If your pediatrician has an electronic health record (most do at this point but the incentives for pediatricians are different from for adult providers so some have taken more time) get a print out of the growth grid, the vision, hearing, vital signs and immunization record.  These data can be powerful for you — both as a reminder of great health when you worry but also a key piece of data for negotiating. For example, when your child begs to get out of the booster, check the height on the record from the visit together that you’ve brilliantly stashed in the kitchen desk or on the side of the fridge. Your child not 4 foot 9 yet? No dice…
3. Get Out. If you’ve got a teenager (say 13 years or up) get out of the exam room for a part of the visit even if the pediatrician doesn’t ask you leave (most will). Your child deserves a pediatrician’s focus and time all alone to ask scary, embarrassing, or even unexpected questions. So many parents feel they know everything about their child when they have an awesome, open-minded, and lovely relationship. However, in my experience I’ve yet to meet one who does. This is all very natural and important and a part of normal teen development. It’s part of adolescence to pull away and have individual ideas/needs/concerns and not share everything with a parent who adores and protects you. This is especially true when it comes to mood, sexuality, pressures, and anxiety. Let your child into the luxury of building a relationship with a pediatrician over time who can support, encourage, and help steer them into healthy choices even when mistakes are made.

This post was written as part of the Happy New Year, Healthy Kids series for The Inspired Treehouse.