Max's Visit to the Eye Doctor

   A couple of weeks ago Max & i visited our "Dr. Eyes."

A Word About Insurance and Medicaid

 Last fall MyGuy and i decided to dropMax from our insurance, since he has Medicaid now.  That was definitely a mistake.  DO NOT DO THIS IF YOU DON'T HAVE TO.  Turns out our eye doctor doesn't do Medicaid.  (Neither does our dentist, but, in her case, we just have to find a new one.  Stupid me, seeing Medicare options on the paperwork means something totally different.)
  Anyway, our eye doctor is willing to work with us.  Discount for being uninsured, that brings the exam to maybe $360, i think the receptionist said.  Ok, we can do that.

PreExam Discussion with Max

  i hadn't realized Max's eyes were bothering him, but in the pre-exam run-through, he indicated yes.    "Do you ___see fine  ___have trouble seeing?
  "Do your eyes hurt ___sometimes ___never ___ all the time?
  "Do you still see spots (floaters)?  ___yes, the same  ___yes, a bit more often  ___yes, a lot more often  ___not at all any more"
  His answers were a) have trouble seeing, b) all the time, and c) yes, the same.
  The last didn't surprise me, but the first two did.

Interview with the Technician

  A young woman, the tech - i know she has a more precise title, but i forget it - went through the preliminaries with Max.
  She was wonderful (and i say that not to diss the eye doctor - i've been with him since i was 16.).  She addressed Max first on all occasions, turning to me only when necessary.  Most of the time, i was an unnecessary appendage in the room.  Which is fine with me.  This was Max's appointment.  He needs to develop his skills with interviewing professionals.

Interview with "Dr. Eyes"

  The skills for working with someone like Max were doubtless part of her basic training.  Not so, apparently, "Dr. Eyes" himself.
  Well, it's not the first time we'll need to educate a doctor.
  i should say first that Max has progressed a great deal in self-advocacy skills in the year or two since he's seen "Dr. Eyes," though he doesn't present that way.  i'm sure this was part of his reasoning in addressing primarily me.
  Dr. Eyes did greet Max first. And sometimes he spoke with Max, but after a certain point in the exam, he turned to me, and stopped talking to Max.
  This was a problem, especially since it coincided with their difference of opinion on what should happen next.  And i didn't figure it out until later.

The Difference of Opinion

  Dr. Eyes is a very nice man.  He wanted to give us every break he could.  His diagnosis was that Max does not need a new prescription. He has your basic winter dry eyes.
  No need to use the phoropter to test the prescription.
  But Max, with his limited communication skills and definite ideas, KNEW that he needed a new prescription. And that he needed to be tested with the phoropter.
  But here was Dr. Eyes, turning his attention to Mom and preparing to dismiss us.


  Max became frantic.  First he grabbed the phoropter, then he slammed it around.
  i said, Max, you may not do that.  It is a very expensive piece of equipment.
  Max stopped  immediately.  He got wide-eyed, and looked around the room.  There was nearby another piece of equipment, with a cord running between two parts of it.
  He karate-chopped the cord.
  Ripping a cord out is not damage, right?
  Dr. Eyes quickly offered  - again speaking to me - to get some sunglasses for Max.  Yes, that might help, though it wouldn't address the issue.
  As he went for them, i realized the problem.

Well, this is a fine pickle.

  i want Max to have what he needs.  i want him to communicate.  He NEEDS to communicate.  But i can't reward THIS  sort of communication.  This is a frequent dilemma!
  The drop-in sunglasses told Max that the visit was indeed over, and he was willing to take my keys and go wait in the car.  i got him to choke out an apology to Dr Eyes, who was able to replace the cord.

In the car,

we discussed Max's behavior and the doctor's recommendations: blink more, read & do screens from a couple of inches farther away, use eye drops for moisturizing.  i told him firmly that Dr. Eyes would have done that test if he had thought it necessary, but it had looked to him like it wasn't.  If Max tries the doctor's recommendations for a few weeks, and things aren't better, we can go back.  But he has to try these things first.
  Later we bought eye drops, and Max has been using them.  i think he's been blinking and reading from farther back too.
  It's about time to check with Max again & see how he's doing on this.


No comments:

Post a Comment

i look forward to your comments! Thank you for sharing them.