Sep 23, 2013 0 Share

Growing Pains


Close-up of doctor taking man's blood pressure.
Thinkstock

I came downstairs to find Cameron eating his breakfast. As we greeted each other with the traditional good mornings, Cameron said, "What medicine can I take for a headache?" 

My initial reaction was, "Uh oh. He never complains of little aches and pains. I hope he's not coming down with something." 

I gave him an ibuprofen, and prompted for water consumption. As I began my morning routine, I started to think about all the over the counter medications we have available to us ... and then I started to realize how infrequently Cameron feels poorly. Aside from the allergy pill and the inhaler he manages himself, he's had little experience with determining what medication to take and when to take it. Yet another independent living skill to develop. 

As if on cue, Cameron returned from school that day, and said, "I have an important question to ask. How often can you take those headache pills?" Good of him to ask! He took another pill, and at bedtime I suggested he take another. "Are you sure? It hasn't been quite six hours." Maybe this skill development won't be as difficult as I thought. 

Guardianship is just one of the many questions I'm dealing with since Cameron has reached the age of 18. Specifically, with regards to medical care. While I'm a bit concerned with Cameron's ability to sign for himself in all things legal, the thought of him being able to deny medical care, for whatever reason, and the healthcare providers being required to abide by his wishes has left me a bit nervous. Cameron has an extreme aversion to needles. I worry that something causes a visit to an emergency room, a nurse comes at him with an IV needle, and Cameron protests, "No! No! No!" What's a hospital to do in that case? 

I decided to graduate Cameron from the pediatric practice he had been going to, and scheduled his annual physical with the internist I see myself. I really like my doctor's approach, as he is very reluctant to get out his prescription pad. He supports reasonable alternative approaches. At my last visit, I had explained a bit about Cameron, and floated a question about guardianship. I was worried that the doctor would not even allow me in the exam room, based on HIPPA regulations. While the doctor seemed to encourage medical guardianship, my own research proved that HIPPA isn't as restrictive as I had thought. Healthcare providers are allowed to provide information to family members, without written consent from the patient. While providers may have their own requirements in this regard, it is not a HIPPA requirement. 

How is this going to help me, however in the ER scenario where I'm not there, and Cameron is screaming "No!" at the needle coming towards him? 

As part of the initial physical, our doctor does extensive screening. So much so that the lab I took Cameron to for the blood draw was concerned they would be taking too much. But after consulting their matrices, it was determined it was safe to fill up all those tubes with Cameron's blood. I warned Cameron on the way to the lab that they'd probably need about seven tubes. He was a bit miffed that the tube count was closer to 12. As the nurse was preparing for the jab, I coached Cameron on deep breathing and relaxing. I told him to close his eyes and visualize a place he'd like to be. My visualization would always be a beach, but I'm sure this would not be the case with Cameron. I just had to ask Cameron what he was visualizing. "The sausage sandwich I'm getting after this." Of course! It had to be food! 

Cameron did great during the draw, and reported to the family at the dinner table that evening that it wasn't that bad. I think he'll be fine if he's on his own with medical care decisions. But I'm going to make sure he understands what it means if he says no when I'm not around.