J u l e e
Drama Llama
Posts: 6,531
Location: Cincinnati
Jun 28, 2014 2:50:47 GMT
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Post by J u l e e on Aug 11, 2014 16:21:12 GMT
Thank you so much, everyone, for reading this and your comments. We should all be in the same room together talking about this - at the very least so you could see my head nodding at all the different comments. There are so many things to comment on that I won't even try to do the quote thing, I'll just try to touch on them all.
My daughter isn't on any medication that would affect this. And he had no bloodwork or anything in front of him. She hasn't started her period yet. I completely tried to give benefit of doubt to the bedside manner of a new doctor who was older and not American. That's why I was really asking in the first place - more of a "Am I just sensitive and is this how doctors handle this kind of thing?" because it could just be the way it's done. He had her charts and actually said everything was within normal range, however near the very low cut off end (not his medical words). And on the charts it shows her past ages and percentiles too, with a little X moving steadily up the chart. So it has always been this way - no sudden changes that would cause alarm.
I would absolutely want a medical professional to be on the alert for and make me aware of anything unhealthy and/or dangerous medically. I'm less bothered that he mentioned it, because of course, it's his job to do so - more the way it was done and the assumptions made, and of course, the complicated messages of eating and words like skinny, that my daughter really internalizes negatively (she's a long story in herself - really hates any attention on or conversation about her, to the point of being really awkward about it).
I would think he'd ask about her eating, activity level, etc. Or suggest supplementing her regular diet with something else (I don't know, I'm rambling). But, "You're skinny, you need to eat more." didn't seem so much like medically valuable advice, but more like a weird way to address a preteen girl. Maybe skinny was his way of saying "underweight" but I missed it because of how I react to that internally.
I'm going to go back up and see if there's anything else I missed. Oh, and I won't be writing a letter. That was such a rash thought, I guess.
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J u l e e
Drama Llama
Posts: 6,531
Location: Cincinnati
Jun 28, 2014 2:50:47 GMT
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Post by J u l e e on Aug 11, 2014 16:31:47 GMT
melissa, these are her exact measurements 59.6" tall and 76 lb 4.5 oz. BMI for age percentile 5.83. Then a chart that shows a healthy weight for BMI for age percentile between 5 and 85. Her chart shows her between 25th and 50th percentile for height (the chart is so small I can't tell the increments in between) and around the 13th for weight. All withing the normal range on each chart. Is that not correct? Thanks everyone too, for not talking to me like I'm an idiot. I'm really processing this out loud as I type, so I appreciate the comments of all kinds. And mostly, I'm not trying to be offended by the doctor. It just seemed an odd way to deal with this. I have one child, so I've never gone through this before and none of her other doctors have shown concern throughout her life.
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Sarah*H
Pearl Clutcher
Posts: 4,015
Jun 25, 2014 20:07:06 GMT
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Post by Sarah*H on Aug 11, 2014 16:55:19 GMT
Weight is such a hard topic, we all bring our own issues and background and history to the discussion and it makes it hard to talk about. I agree that the doctor's delivery and bedside manner were terrible. But I also agree with Melissa that he was right to bring it up if she is falling towards the bottom of the charts. My daughter's pediatrician raised similar concerns about dd's size and lack of growth at her last appt. (and in fact I talked about it afterwards with Melissa to get her perspective!) Because it was about her overall lack of growth and not just her weight, his concerns didn't raise my hackles. I'd say maybe just give him the benefit of the doubt and realize that while he should have been better with his delivery, his intent was in the right place.
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Post by epeanymous on Aug 11, 2014 17:04:14 GMT
The problem with the delivery is that I know in my field that client satisfaction is related less to result and more to communication, and that clients are more likely to follow your advice when it is communicated appropriately and effectively. That is a hard pill to swallow (no pun intended) when you are an educated professional and believe/know that you are giving appropriate advice, but communicating appropriately with people isn't just some frill, it is integral to the job.
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Post by samcro on Aug 11, 2014 17:25:45 GMT
I don't have a problem with him saying her nutrition needs to be looked at, but obviously he didn't have that in mind at all. Just to eat more. Anyone with any kind of nutritional background (and a physician absolutely should have that if he is dispensing comments about weight) knows there is so much more to health and nutrition than just eating more. BTW, some people just are very thin by nature. To see if this is the case, perhaps he should have done some blood tests to see if she is deficient in any nutrients, etc. Heck, even a simple lipid panel could tell a story that one cannot see from looking at a person.
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akathy
What's For Dinner?
Still peaing from Podunk!
Posts: 4,546
Location: North Dakota
Jun 25, 2014 22:56:55 GMT
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Post by akathy on Aug 11, 2014 17:39:59 GMT
I consider the word skinny an insult the same as the word fat. I am very underweight and that word makes me crazy. The doctor was totally out of line and if he had concerns about your DD's weight he could have told you privately or used better language to address it.
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Post by Darcy Collins on Aug 11, 2014 18:21:00 GMT
Just for comparison, I looked up my daughter (who's numbers were very close to yours). She was in the 11th for weight and had been in the 18th the year before. Incidentally, she had gained 6 pounds that year. I think of the difficulties with the growth charts is that it is assuming the big gains for puberty. My daughter is a late bloomer, and really hadn't hit the big jump up yet, hence her numbers falling.
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inkedup
Pearl Clutcher
Posts: 4,837
Jun 26, 2014 5:00:26 GMT
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Post by inkedup on Aug 11, 2014 18:24:43 GMT
Perhaps the doctor could have been more sensitive, but I don't really see anything terrible about what was said or how it was said. It's no different than hearing that your child is overweight. You might not want to hear it, but you probably need to.
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Post by Darcy Collins on Aug 11, 2014 18:41:53 GMT
melissa, may I ask which growth chart puts a 12.5 year old girl who weighs 76 pounds between the 1st and 3rd percentile? I think my pediatrician uses the CDC charts, and everything I found onlline seems to also put that weight in the 11th percentile. I was wondering if charts had been updated or something since my daughter's appointment.
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Post by flanz on Aug 11, 2014 18:56:42 GMT
Hugs to you Julee. Weight is clearly a hot button issue for so many of us. As a mom whose daughter became anorexic in her early teens, I must tell you that I was clueless at first. My beautiful, healthy girl took a "Health" class in junior high and started eating less and less. She and most others are/were so very susceptible to the media's bombardment of images of super skinny photoshopped models depicted as "normal" and normal girls and women as "fat" and curvy women as obese - along with the all important peer acceptance and peer pressure, it can take its toll. I just ask that you keep your radar up and don't think your always thin daughter can't succumb to the horrible messages she may be hearing telling her she needs to be even thinner.
that doc was not appropriate, but I think you probably needed to hear his message and bring this issue to the forefront of your mind. I was SHOCKED that our daughter ended up so ill and i had no idea until it was pretty far along!! Puberty is rough on our kids and on us! Their bodies are changing so quickly at a time when they are needing to separate themselves from their moms as they learn to become independent individuals... it's all so very complex. I'm very happy to report that our daughter is healthy and thriving, but we went through some very scary years. I'm not saying at all that you are on that path, but just asking you to remain alert to changes in your daughter's behavior.
(((HUGS)))
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melissa
Pearl Clutcher
Posts: 3,912
Jun 25, 2014 20:45:00 GMT
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Post by melissa on Aug 12, 2014 3:27:40 GMT
I used a chart I had at home (not there now). It is likely not to be the most recent. Using the CDC chart, I am still getting around the 5th percentile for weight and 35th for height.
Once again, if this is the typical body habitus for your family, it's not as concerning. If it's the growth curve she's always followed, also not concerning.
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Post by dulcemama on Aug 12, 2014 3:36:42 GMT
I think it could have been said better but is something that needed to be discussed. And at 12yo, your DD is ld enough to be included in these conversations. I also think it gives you an opportunity to direct the way your DD thinks about this issue. She will likely hear about her size from her peers and others around her, not always in the nicest of ways.
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