Urban Mamas

"We're going with Disruptive Behavior Disorder," says the pediatric psychologist. She is young: the sort of young that goes with lots of experience working with parents and small children, seriously impressive degrees, knowledge, decisiveness. In fact, looking at her resume later, I decide she may be exactly my age. But her manner, her aspect, young.

The patient is my not-quite-three-year-old son, Monroe; I'd started this quest to get him diagnosed by a storied medical organization up on this hill of inquiry six months ago; for what? I ask myself in these spare moments after receiving the diagnosis. What did I expect? All pediatric psychologists and special education teams have for my children is a (damning) name for the symptoms I'm reporting to them. All they have is a knowledge -- from this brief interview, these questionnaires with acronyms and insufficient answer choices (there's no "it's complicated," or, "are you kidding me?" or, "but I love this kid with every inch of me" as options) -- that I've given them, that they've observed with the shapes and the little plastic bolt-and-nut. He can sort the shapes, he can screw the screw, he can tell you he's a boy and I'm his mama. He can say "I loff you!" and call blue "boo" and ask where "muffin" has gone ("my friend," I translate after a minute, a little boy only 11 months, Monroe was so sweet with him). He eats kale and garbanzo beans and picks raspberries right off the bush. He hits me, bites his brother so hard it bruises, stomps, throws things, breaks them, screams! screams! when he's angry. He's angry a lot, far more than is right.

What I wanted, I decide after much questioning myself, was a reason, if only a guess! a supposition!, something to look back to and say, "ahh," sorrowfully, to avoid next time, to purge from my life, from which to warn others away. I wanted to know how to wean this child so I can sleep better, manage better. I wanted a solution. Not a thoroughly bad name for what I already know.

Concern about mercury in vaccinations, the worry that they might cause autism, and a host of other what-ifs have many, many parents in Portland delaying vaccinations for their children -- or, in some cases, foregoing them altogether. Tales of chicken pox parties are common, and among the reviews of any local pediatrician is her attitude toward vaccinations. Results of a study that had originally been designed to study whether thimerosal produced an autism risk (this connection has been discredited) now say that children who undergo a delayed vaccination schedule, or who don't get all the recommended vaccinations, don't have any neurodevelopmental benefit -- in fact, they may do worse.

The study was conducted on children born between 1993 and 1997, and new vaccination schedules contain more vaccines that are formulated with less antigens; so the researchers believe the effect should be about the same now. It also doesn't necessarily suggest that vaccinations improve a child's brain development, as there is a correlation between parents' income and education levels, and keeping a vaccination schedule (at least in this study group -- I imagine in some neighborhoods in Portland, New York, Berkeley, and San Francisco today, the correlation is opposite, that is, parents with more education are more likely to delay vaccinations).

As a mama who generally kept her kids on schedule for their vaccinations, and has definitely suffered much in the way of neurodevelopmental delay, I'm happy to see this -- I generally don't place any of the blame for my children's brain function on the hearth of the CDC's suggested vaccination schedule. I worry more about persistent environmental chemicals, especially those to which the kids were exposed in utero or in their licensed-character jammies, than those dosed via wicked needle several times during my kids' infancy and young childhood.

The licensed-character flame retardant-packed jammies are in a trash bag, the vaccinations are up to date, and I think this news gives me some small comfort with my choices. I think it would be revealing, though, to do the study again in some neighborhoods like the ones in which many of us live, with children born in the past decade, the age of heightened autism fears. I'd bet the neurodevelopmental benefit from sticking to the vaccine schedule would be erased -- but it wouldn't mean much.

We all want a great healthcare provider for our littles, regardless of the kind of insurance we might have.  An urbanMama recently emailed, seeking your suggestions:

We are due in May and are looking for a pediatrician; my WONDERFUL obstetrician, Robin Barrett, unfortunately declined my request that she go into pediatrics :)  Due to being laid off in Feb. at 7 months pregnant and losing my insurance coverage (thanks, huge Fortune 500 company-hope you saved a lot of money there, nice move), I'm going to have to enroll in Washington's state insurance for myself and my son when he's born.  Are there any Vancouver mamas (downtown, Esther Short, Hough areas) who have a great pediatrician who takes state insurance? Having worked in healthcare before, I'm well aware that many clinics treat the state-insured patients a bit less thoroughly. I'd obviously like to find a doctor who won't treat a laid-off mama like a "welfare queen".

When we see that our child needs more specialized attention, we want to offer that access.  An urbanMama recently emailed, seeking suggestions for child psychologist:

I have a child who suffers from extreme shyness and overall anxiety about numerous things from thinking about death to stressing over doing the right thing to making an out in baseball to being afraid to ask a friend to play for fear of being told "no." He starts kindergarten next fall and was looking for advice from a recommended psychologist on ways in which I can help him succeed before he enters the public school system. Would love to see if anyone else has met someone they respect who has helped out their child.

While we have had previous threads with suggestions on where to get glasses for the little folk (here and here), we have yet to talk about ophthalmologists you would recommend.  An urbanMama recently emailed:

I have noticed my 7 year old squinting quite a lot recently and since my husband and I both wear glasses, we're thinking it's time for a real vision exam.  I received the advice that we should see an ophthalmologist rather than an optometrist, but I'm always afraid to just pick someone randomly from our provider list.  Anyone have a pediatric ophthalmologist they recommend?

While our pediatrician recommendation archive is stocked with suggestions all throughout the Portland-proper area, it seems we could use more suggestions in the outer areas.  An urbanMama recently emailed to request suggestions:

I am contemplating finding a new pediatrician for my daughters, as we've moved from SE Portland to Vancouver. Trouble is, I can not find any reviews or recommendations on peds in my area. I chose our current pediatrician based on Urban Mama reviews, and would appreciate to hear from anyone who recommends someone in my current area. We're located near the Fisher's Landing/Camas area.

I have vaccinated all my three boys more or less on schedule, but it is more inertia than science; when Everett was born, I wasn't in a community that questioned vaccinations (my husband's best man was a pharmaceutical sales rep, for one), and it wasn't until later that I started wondering if filling babies full of toxins was really the best approach. By then, it was almost time for public school, and I didn't want to face filling out forms stating my "religious" refusal for one child, but not another.

But I know lots of you urbanMamas don't vaccinate; parts of Oregon have some of the highest rates of vaccination avoiders in the country. And last night on Law & Order: Special Victims Unit, I felt as if I was seeing one of my friends on trial. After an 11-month-old died from measles -- and her mom, a distracted and turbulent Hillary Duff, buried her in a parking lot, thinking she'd killed her -- it was decided that the real "culprit" was a mom who'd decided not to vaccinate her son. The baby and the little boy had been at the same playground after he'd been infected by an Amish teen with measles. The city of New York put the non-vaccinating mom on trial for murder. Seriously?

Not only were non-vaccinators called out in scathing tones for their lack of medical degrees and their dispassioned uncaring for all others ("I don't make choices for those kids!" said the mom shrilly), but the way the writers portrayed the woman was unforgivable; on the stand, she goes on a rant claiming that the baby would have died anyway, because Hillary Duff's character was a "bad mom" (true, but really) and she was a "good mom" and thus she deserved to get off. She did, much to the disgust of most of the SVU crew, who kvetched about how she'd gotten away with murder. The ending was too complicated and horrifying to describe here.

I was shocked that such an extreme viewpoint, which took the "mommy wars" media invention and ran with it in the ugliest way, was firmly established by a TV show I've often loved as the moral right. Did you watch the show? What did you think? Will you be watching Law & Order again?

I'm still not savvy enough to figure out how to link through on these posts, but I recently posted a question about putting tubes in my happy baby's ears. Lots of you responded, thank you! At our first visit with the ENT a month ago, Henrik's ears definitely had fluid in them, and his hearing was down 10-15%...we knew this was not a problem we could ignore just because of his happy demeanor but I felt strongly we were not going to do tubes without trying other avenues first. So in the last month, we have had 3 visits with a chiropractor who specializes in treating babies and mamas (Dr. Amy Watson at Whole Mama, Whole Child) and we've visited with our naturopath friend (Dr. Michelle Sturm at Blue Sky Wellness) who has been checking his ears and giving us lots of other things to try like herbs, probiotics, massage and hydrotherapy to get that fluid moving. We just had our follow up visit with our ENT, and after literally months of fluid filled ears, we were thrilled to learn that Henrik's ears are now totally clear!

As a mama, I have an instinct to FIX things and when my kids are sick or in pain, I want to DO something and I believe that knowledge is power so when I dont have the answers, I go out and I LEARN something. I like our pediatrician, and I feel that she has given us sound advice on how to take care of our boys. When I wanted to take a conservative approach on administering antibiotics to Henrik, she was very supportive but she did not have anything else for us to try beyond the antibiotics and tubes surgery. When I left her office and the ENT's office, I felt pretty helpless--either wait and hope, or do the surgery. On the other hand, I left the naturopath's office with herbs, oils, lotions and some strategy and a much more empowered feeling that maybe we could DO something to give his body a little kick in the pants to heal itself. Not to mention the time that each of these doctors have spent with us...the pediatrician and ENT are pretty much 30 minute, "in-and-out" visits with talk about symptoms and medications. The chiropractor and naturopath on the other hand, both spent an hour+ with us, asking tons of questions about diet, home environment, personality, etc. and I cant help but feel that these doctors are taking a much more comprehensive approach, trying to get at the root of the matter rather than just treating the symptoms. And they bill our insurance a fraction of what our pediatrician does.

I'm convinced that it's the combination of our collective efforts that did the trick, but I'll also acknowledge that it's possible that it was simply a matter of time too. But my experiences with the naturopath and chiropractor have gotten me thinking...is it in my best interest to consult our naturopath prior to our pediatrician the next time we come down with a bug? Should I consider switching to the naturopath as our primary care physician all together? What are the benefits to staying with our pediatrician? Is it cheating if I try to maintain relationships with both?

So I'm curious, mamas...Who takes care of your family? Do you see a pediatrician? Do you see a family practice provider? Do you see a Naturopath? If you see a pediatrician, is he or she proactive about sharing alternative therapies in addition to conventional or pharmaceutical approaches? If you see a naturopath, is there anything they have not been able to help you with? We've chosen to vaccinate our kids, do naturopaths do vaccinations?

Anne writes:

I want to get my son's eyes checked out after a few comments he's made lately. Does anyone have any recommendations for an optometrist who is good with little kids? Someone downtown or in close-in SE Portland would be ideal.

I've been thinking, studying, and discussing a lot lately about one very important topic: parenting. Not just parenting in general, but how to parent, and how to parent right. But even more troubling than the realization that I haven't been parenting entirely perfectly is the growing conviction that no one knows what they're doing. And I'm not judging you guys, the parents: no, I'm judging the experts, the parenting authors, the pediatricians, the teachers.

Everett's temporarily in a special education program and we're finding that the teachers, "coaches," and other great staff are -- despite their commendable patience and amazing energy -- frequently guilty of inconsistence. Are they right when they ignore bad behavior, or right when they provide consequences? I was all ready to embrace Love & Logic without question when I discovered some of the more punitive examples proffered by its creators. I love my children's pediatrician unreservedly, but occasionally her behavioral advice seems half-cooked. Another mama was raving about Alfie Kohn's speech, but admitted she had trouble putting much of his advice into practice after she got home.

While it's somewhat comforting to conclude that no one knows what they're doing, it's also terrifying -- how can I get it right if I can't even decide what right, is? I wonder -- has anyone come across a philosophy you embrace whole-heartedly? And why is this parenting gig so darned hard?

A few weeks ago, a mama wrote to ask for your experiences with CAT scans for the urbanTots.  She emailed us with an update, and also seeks suggestions on ways they can show their gratitude to their doctor:

This is an update from the post a few weeks ago about my 7 month old getting a CAT Scan.  Everything went well and he has turned out to be completely fine but we did have to spend a couple of days in the hospital and had to go through a bit of an ordeal. But during the whole process, our pediatrician was absolutely wonderful and went above and beyond what I would ever have expected in a Dr.  I am so very thankful for her.  Now my question is, I want to get her a thank you present but have no clue what?  Any suggestions from urbanMamas?  Or any Dr's out there that have recieved great or awful gifts that can share their experience?  Thank you!

Lisa has a specific question and wonders if anyone has gone through a similar experience:

I just came from my daughter's 2-year check-up and the doctor recommended getting an 'adhesion' removed from my daughter's genital area. The doctor examined my daughter and we were told that this thin lining may open up by itself but it can cause leaking of urine as she grows older because the opening is not completely open. I was astounded. I've googled and asked friends and no one has heard of this before. Fellow urbanMamas, help! I'm reluctant to do anything about this and let nature take it's course, but don't know anything about this subject.

LeeAnn is having her first baby and she hasn't chosen a pediatrian yet.  Does she need to? 

I'm due November 7th and just had my 28 week check up with my doc at OHSU this morning.  On top of taking the icky Glucose test, and questioning my overall well being, she asked if I've looked into any pediatricians yet.  No I have not.  I have Blue Cross Blue Shield and being my little man will be born there at OHSU, I've just been assuming I'd pick one up there at Doernbechers - but I'd love to hear of other BC/BS pediatricians.  We live in the SW (near Multnomah Village) and like the location of OHSU, but are there others out there I should consider that are also close in proximity?  Also, is it customary to 'interview' the pediatrician before birth?  What do I ask?  What am I looking for?  What's typically accomplished in an 'interview/meet-n-greet' with a new pediatrician?

Erin is new to Portland and new to motherhood.  Does anyone have an experience with lactation classes or newborn care classes:

Could you point me in the direction of lactation classes and newborn care classes? I've been searching but can't find any. I'm looking for recommendations and opinions on how the hospital-offered classes compare with private organization offerings.

We've had many threads on pediatricians, but this one is certainly unique.  Any advice for Kristi?

I have a question about pediatricians.  I have a 6 month old son and I’m beginning to realize that my parenting style (Attachment Parenting) is not particularly supported by my pediatrician, especially when it comes to sleep habits and fostering a long-term breastfeeding relationship.  I like the features that the office offers such as evening and weekend hours and especially the advice line which will answer my questions in a flash.  My question is: are there pediatricians out there that support the Attachment Parenting style?  If so, will I be sacrificing some of the office features?  Or should I just fib to the pediatrician and do my own thing anyway?

Being a first time mama is overwhelming in many regards.  Your body is changing and your hormones are crazy.  You go into nesting mode and everything needs to be set and ready... even if the baby isn't expected to arrive for another ohhhh 4 months or so.  A very important, and personal, decision is with the pediatrician.  It may seem odd visiting a pediatrician when you don't even have a child yet, but how else will you know you've got the right one?  Here at urbanMamas, our readers have written the anthology on picking a pediatrician.  We've got a few vax-relaxed recommendations.  Some recommendations for moms who prefer not to dole out the medications.  Pediatricians by area, pediatricians for preemies, pediatricians by network, and last, but not least, a comprehensive discussion about pediatricians vs family doctors.  urbanMama Henriette is expecting, and delving into the realm of picking a pediatrician.

I am currently pregnant with my first child and in the process of finding a pediatrician.  Does anyone have any recommendations for doctors at either Metropolitan Pediatrics Northwest and/or Pediatric Associates of the Northwest?  It is important for my husband and I to find a doctor who is open to alternative treatments and lets us schedule vaccines.

Somewhat similar to the quest for a doctor who will offer the MMR vaccine in 3 separate shots, can someone recommennd a doctor who would respect a family's decision not to vaccinate?

We just got fired from our pediatrician for refusing to vaccinate our 2 year old.  Can anyone recommend a pediatrician in close-in SE or NE who wii be ok with our choice?

Karen's wondering if her decision to use a pediatrician for her child is the right choice.  Anyone want to offer up their experiences?

After switching from a lovely family doctor at Portland Family Practice to a pediatrician at Broadway Medical Clinic, I'm wondering if I made the right choice.  I had a bad experience with the doc at BMC at my daughter's 3 year appointment, plus it is so big and busy.  The two reasons I decided to switch from PFP in the first place was that our doc there only worked a couple of days and, secondly, all my friends had babies (after me) and all went to a pediatrician, so I thought this is what I should do too - more specific medical attention for children, etc.  I should let you know, I'm Irish and we always went to a general practitioner growing up - I'd never heard of a pediatrician until I moved here and had my first baby 3 years ago!  I'd love to hear from other people about why they chose a family doc over a pediatrician and vice versa.  I'd also take some recommendations, even if it means moving within the practice in BMC.  I just want to get it right this time for my childrens' sake. At this point, I'm a little tempted to see if my doc at PFP will take us back!

Keith posted a comment recently seeking recommendations from the urbanMamas community:

My wife and I (can I be an UrbanPapa?) (urbanMamas note: Keith, of course you are an urbanPapa!) have a 5 year old with SID, and are trying to navigate the process. Throughout, it can be very intense and we worry about getting the right supports for our son, we fret over the intensity of what we have to manage . . . we just want to get it right, and help him be happy.

He is in a Montessori school that has been a good fit for him, and since his referral from the ESD he is in program at Grout for kids with special needs. They're serving him for adaptive and social/emotional delays there.

We're doing OT at Therapy Solutions now for his SID. We have been happy there and are looking forward to working with Barbara Avila who does RDI (Relationship Development Intervention) training for parents. Challenge is that it's not covered by our insurance, and costly.

Questions:

1. Who is doing the best OT work for SID locally? Is there anyone who is an expert, as opposed to "Yeah, we do 'some of that'"?
2. Does anyone have any strategies to manage uber-tantrums? We feel our son's tantrums are anxiety driven, and when he goes there, he screams uncontrollably, kicks, hits, etc. Very little seems to work, short of restraining him, and just re-assuring him that we love him, we're there for him, etc. It's emotionally exhausting for all of us (including, we suspect, his 3 year old brother). Help. Any ideas?
3. Has anyone done any RDI work and found it helpful for SID?
4. Is there any support group going out there? We live in SE, Mt Tabor area.

Thank you so much, urbanMamas, for all your recent feedback on your recommended doctors or naturopaths. Aside from previous suggestions for Open-Minded Pediatricians, please help Sara:

The doctor who I interviewed for my son, and who I trust, is on maternity leave. The doctor who looked at my sick kid today said his ear canal is red and prescribed antibiotics. I have no idea what kind of tendencies this doctor has regarding reliance on antibiotics, so I can't trust her at all and I really need a trustworthy second opinion quickly. Can someone please oh please point me towards a doctor who doesn’t prescribe antibiotics willy-nilly?

Recommendations sought!  Allison writes:

I am an urbanMama-to-be (due March 30th) and my ob has set me the task of finding a pediatrician in the next few weeks.  Does anyone have any suggestions of a great pediatrician in Southwest Portland or Downtown?

There is something in the autumn air that makes us want to seek out trusted health care providers.  Sharon posted a question on a recent thread:

I am looking for a naturopath for kids. Does anyone have a good one?

... To which Tia promptly responded:

In response to Sharon's query, my beloved midwives (Nora Tallman and Catherine Schaefer) are NDs who also provide women's health care and pediatric services. See http://agentlebeginning.com/ for more info. I found both Nora and Catherine to be kind, flexible, and generous of spirit...

Does anyone else have suggestions?

Choosing a doctor or health professional can be so, so hard! All of your input is always so appreciated by the rest of our urbanMamas community. So, can you help Valerie with some suggestions?

I am currently looking for a new pediatrician for my 3 month old and 3 year old. Until now they have always seen a naturopath, however due to insurance changes I need to find a pediatrician who is flexible with immunizations. We are on a slow-track for immunizing and do not want to feel pressured to follow traditional recommendations. I am specifically looking for a Providence provider. Any information about doctors that mamas like in the Providence system would be so helpful.

We've had several recommendations for pediatricians before, but Kirsten has a specific questeion:

I was wondering if anyone might have recommendations for a pediatrician on the East side?  I prefer one who has experience working with "preemie" babies.

About the MMR, India is seeking your help in searching for the following:

I'm looking for a doctor/clinic where I can get my 21 month old the MMR vaccine in three separate shots. Does any have any leads?

Thank you for all your tips on pediatricians and mommy yoga! Molly has a related question:

We have Kaiser; does anyone have a really great pediatrician or n.p. within the Kaiser system? Or, for that matter, a good Kaiser OB/gyn?

I've got a feeling that the urbanMamas community can give this mama some pediatrician recommendations:

Any mamas out there know of any open-minded pediatricians who are good and thorough but don't push antibiotics at the first sniffle, pleeease let me know.  If the doctor is also a homeopath or naturopath, that's fine too.

Oh, and one other thing, does anyone know of any good yoga classes or mommy and me yoga classes? I'll be living fairly close in, so any classes not too way out (in the N, NE or SE) would be preferable.

Thanks a million,

L.A Mama