Medical Specialist Appointment and You

By Amy Price PhD
You have been sent to a specialist…what next? First of all sort out what you expect to happen as a result of this visit. What are your goals? Make sure they are realistic. If this was easy your primary care doctor could probably fix it.

Before your visit explain what records you have and ask which of these they would like you to copy and pre-send. Usually you can get copies of MRIs or other diagnostic tests on CD. They are easier to carry with you or send than bulky films. If you choose to send your diagnostic results and films call and confirm they arrived. Get a cost for a cash price unless you have medical insurance which will cover your visit so that you will know your costs and if you can absorb them.

If you are making a distance appointment insist on a phone consultation so you will know if your expectations are viable. If the staff you speak with don’t have information about a certain area make arrangements to call back when it is available. This way all the preliminary material is out of the way and your appt can focus on what is most important. Explain you are travelling from out of town and are in pain and request the best time of day to be seen promptly. Emergencies or office back ups can still happen but this step minimizes the possibility.

Write down what you consider to be the most important things you want covered in your visit. The reason you may want to do this is because chronic pain and injury can cause us to be sidetracked by emotion. You may get a compassionate response but it may eat away at the time available.

This is the place to get your MRI and other diagnostic tests explained. The doctor that ordered the test is the one who needs to explain it. Get an advance copy of the report and ask about what you don’t understand. We get emails every day from people who want us to translate the MRI or other diagnostics. We cannot do this because the MRI is only part of the equipment needed for a diagnosis. It is your job to make sure you understand your diagnosis before you leave the doctor’s office.

It is helpful to plan a nice dinner out or a treat for yourself for afterwards and if you can, take someone with you who will remember what the Doctor says. The reason for this is it will be difficult for you to reconcile yourself to a 40 minute appt when the injury has taken over your life 24/7. Even though your appointment time may be quite generous, logic and rational thought cannot always be counted on, when you just want it fixed.

Now relax and trust the specialist you have chosen!

Dr and TBI

How you communicate with your doctor will often determine the quality of care you recieve and that your legal rights are protected. Here is a practical guide from Michael Kaplen a lawyer at BrainLaw. For other survival skills to help you through a doctor’s appointment this post is good reading

1. When you schedule your first appointment, tell your doctor that you will require extra time. Tell him that you need at least an additional 20 minutes (or more if you need it) for your appointment. The challenge here is to not feel rushed, as when you are stressed your cognition erodes.
2. If distractions bother you, arrange with the doctor’s office (when you make the appointment) for a quiet place to wait, such as a quiet exam room. If this is not possible, ask for somebody to come and get you in the foyer or your car.
3. Get to your appointment at least 15 minutes ahead of time, so you can collect your thoughts, become settled and unwind from the drive.
4. Write down everything you want to tell or ask your doctor. Cross each item off the list after you have covered it. Write down instructions that your doctor gives. Recap at the end of each issue, to make sure you understand.
5. Ask your doctor to write down your diagnosis. Ask for a written explanation in layman’s language. Ask for a written description of the preferred treatment and goals, with an estimate of the costs and the expected time frame.
6. Trust your instincts. If you don’t think that a diagnosis is valid, or if you think it minimizes your problems, remember this: YOU ARE PROBABLY RIGHT. Remember, you are the “expert” about you.
7. Always ask your doctor about the contraindications when he prescribes new medications. Additionally, have the doctor provide you with a written list. Take charge of knowing everything about the drugs you take.
8. Ask your doctor to make a notation in your file stating that you should receive a copy of all reports and tests as soon as they are received by the office.
9. Never sign a blank release form. Make sure all authorization forms are completely filled out. Read what you’re signing. Make sure the release has ONLY the names on it that YOU want. Get a copy of each and every release form/letter you sign.

Science bears this out. According to integrative neuroscientist Evian Gordon (2001, 2008) minimizing danger and maximizing reward is a significant principle in how the brain organizes and in so doing impacts our lives. If a situation leads to a reward response such as positive emotions, words, or activities the brain engages and approaches or engages. When a situation brings up negative emotions or punishment the brain sends out an avoid response and detaches.

Can you see where this principle would lead in marriages, the work place or learning? In one research study participants completed a paper maze that featured a mouse in the middle trying to reach a picture on the outside. Half of the group saw a piece of the cheese as the picture to reach while others saw a predator.

The effect on learning the maze was astounding those that had the cheese picture solved more problems more creatively than those with the predator picture. (Friedman and Foster, 2001). Other studies relate how people who specifically visualize and mentally practice winning have significant advantages over people who did not practice and in fact what they ‘thought” gave them a similar advantage to actually practicing (Logie and Denis ,1991)

Transferring this concept to the real we can ask these questions. How likely is someone who senses their credibility is undermined to be able to produce answers to complex problems or initiate creative solutions?

Performance reviews, constructive criticism, even unasked for advice can threaten status and cloud thinking. You can even threaten your own status by seeing yourself as hanging by your fingernails over a cliff or rehearsing failure. There are a series of steps you can take to change your mind and get it working for you from the inside out.

As an employer, parent, friend or marriage partner are you unknowingly causing threats to an individual’s status or is someone threatening yours? Watch this space for ways of enhancing status and changing your place in the workspace!

For ways to put these principles in action see this article http://empower2go.wordpress.com/

“…helicopter parents, moms and dads, who hover over their college-age children, chiming in on everything from housing assignments to homework.”

No, they’re not actually doing the homework for the “child,” but they’re still involved in the process.

Lately homework has become a big issue. In the past twenty years, the tendency has definitely been to pile more and more homework on younger and younger children. Alfie Kohn identifies five themes about homework complaints:
1) A burden on parents
2) Stress for children
3) Family conflict
4) Less time for other activities
5) Less interest in learning

Let’s take just one finding from the latest research:

“there is no evidence of any academic benefit from homework in elementary school.”

For more information, go to http://www.alfiekohn.org/books/hm.htm. or check out The Homework Myth: Why Our Kids Get Too Much of a Bad Thing.

The key is to rethink homework, says Kohn. Instead of schools and teachers automatically assigning homework on a regular basis because “it is the policy to do so,” he suggests that the regular condition should be no homework. Homework should be given only if it is beneficial to the student.

Another person re-thinking homework is Richard Lovoie, who agrees with Kohn on this point and also believes that as students move towards high school that “well planned, appropriate homework can have motivational and academic benefits.” Go to http://www.ricklavoie.com/motivationbreakthrough.html

In either case, we can now move on to a few homework tips.
1) Use trial and error to determine the best time and place for your child to do homework.
2) Prepare a homework toolbox or kit with all basic, essential tools and supplies.
3) Ask the teacher for an acceptable example of your child’s homework that has been corrected and is neat and legible. Use this as an example to show your child what to aim for. Consistency is important.
4) If your child is very disorganized, go to http://www.organizedstudent.com/ and read and implement suggestions from “The Disorganized Student.”
5) If your child is overwhelmed by too much homework, clear everything away except one assignment. When it is completed, give him another one.
6) Many parents and professionals believe that homework should be done where it is quiet, but the fact is that many students are more productive listening to music in the background – especially instrumental music.
7) If your child has attention, distractibility and impulsivity issues, read and implement strategies from “A Homework System That Works” at http://www.additudemag.com/adhd/article/1034.html If your child is very intense, sensitive and needy, go to http://difficultchild.com/ and learn how to apply the Nurtured Heart Approach to help your child.

We see a lot of students at Sparks of Genius (www.sparksofgenius.com), especially elementary school students, and I have to agree that homework is a major issue for all of them and their parents. And parents, by the way, means mothers. Right?

I know homework is an issue when the mother says “We have a lot of homework tonight.” So here’s another homework tip. When you check your child’s completed homework, look for neatness and completeness. Look over a few answers, but do not get caught up in going over every item.

Too many parents get overly involved in their elementary school student’s homework. Remember, you do not want to become a helicopter parent.

Recently I asked a mother of two, a dental hygienist, how she successfully got her son do complete his homework independently. She said “Look, I spent a lot of years teaching him how to have a positive attitude about homework, how to manage his time, how to complete his homework at the same time and place, how to use his homework toolbox, how to be organized and how to take responsibility for doing homework that is neat and complete and for handing it in.”

“When he entered seventh grade I told him he was on his own,” she continued. “What happened?” I asked. “Nothing,” she said. “He just started doing it.”

Remember, you do not want to become a helicopter parent. Or do you?

–Dr. Rohn Kessler

Let me tell you the story of this documentary.

The parents of three special needs young adults designed a “color guard” program for “developmentally disabled” young adults. Now if you are wondering what a color guard is, modern color guard is defined as “a combination of military drill, also called marching, and the use of flags, sabers, mock rifles, shields and other equipment, as well as dance and other interpretive movement.” It is typically seen in parades or halftime events. Until now it has never been part of the special needs world. Now, thanks to the vision of Jerry and Ellen Kleinert-Cohn, it is.

Anyway, the color guard, now called the Special Needs Color Guard of America, got invited to perform in the Macy’s Thanksgiving Day Parade and the documentary tells the story of that trip.

Ellen Kleinert-Cohn put together a program to train these adults to perform at many local events. She even got them a chance to perform at the Winter Guard International (WGI) Color Guard World Championships.

I was invited to speak at the screening of Bridging the Gap. Here are some excerpts from my speech.

“Martin Luther King had a dream of freedom. Ellen Kleinert-Cohn and Jerry Cohn have dream of inclusion, a dream that children and adults with special needs such as developmental disabilities will be fully included as belonging. They understood that we all have special needs.
Lawrence of Arabia said “All men dream, but not all equally. Those who dream by night, in the dusty recesses of their mind, wake to find it was all vanity. But the dreamers of the day are dangerous, for they may act their dreams with open eyes and make things happen”.

Dr. King dreamed with open eyes. So do Ellen and Jerry.

I too dream with open eyes. I dream of taking the best of neuroscience research and combining it with great computer technology to ignite people’s sparks of genius. I dream of brain fitness centers where people of all ages “work out” to improve cognitive and executive function skills.

Today people between the ages of six and eighty-three come to Boca Sparks of Genius. They exercise their minds playing computer “games” specifically designed to improve their mental strength, stamina, speed, flexibility and balance and, of course, to spark their genius. We use the term “brainworksbetter” exercises, and each member receives a customized set of exercises. They are assisted by friendly, highly-skilled personal trainers who are passionately dedicated to the success of each member of our fitness community. Many members of the fitness center also “work out” on home computer to maximize brain functioning and peak performance.

I dream of hearing the sounds of success, joy, confidence and discovery as more people around Florida, the country and the world discover, ignite and express their unique sparks of genius in a fun-filled, challenging, supportive, gym-like environment.

I see them all overcoming limitations, defying labels and breaking boundaries with their awesome accomplishments.”

–Dr. Rohn Kessler, Ed. D.

Tonight on NPR I heard an interview with Tim Page, a Pulitzer Prize winning music critic for the Washington Post with Aspergers. Robert Siegel was interviewing him because he had written a description of what it was like to grow up with Aspergers in the New Yorker Magazine. He called the article “Parallel Play”. He felt that the Aspergers led to a lifetime of “restless isolation” because he couldn’t connect with others in “normal” ways.

He said Aspergers was “a different way of processing information.” He was “obsessed with detail, with music and with old photographs. Throughout his life he has possessed an extraordinary memory for facts and data. However, he was oblivious to most social things and had to read Emily Post to learn how other people related to each other. Although he was praised for thinking outside of the box, he admitted that he often couldn’t even find the box.

“Aspergers is something that you never get over, but you learn to live with it.”

Tim Page has lived well and is an inspiration to others.

To hear a podcast of this story please go to:
http://www.npr.org/templates/story/story.php?storyId=12750745

Ninah Kessler, LCSW
Life Coach

One way this school has impressed me is the way that they handle academic goals as opposed to developing social skills. In my experience, parents will happily spend tens of thousands of dollars (if they can afford it) in order to remodel their kid’s report card, but the moment you tell them that this will help their child build social skills and make friends, the pocketbook goes under lock and key.

As students are processed for attendance at this school, the administration goes into detail with the parents about what the parents ultimately want for their child. Inevitably, the answer ends up revolving around independence, happiness and friends. This frees us up to work on those vital areas that ultimately decide the child’s fate.

If you are working with a challenged population of children, remember that a child can flunk out of high school and still become the founder and CEO of a major company. But even with straight A’s, a child with inadequate social skills won’t even be able to work as a janitor. Make sure you teach appropriately.

Good luck!
Allen Dobkin

How can we help reach out to children who are lacking friends?   Here is some helpful information reported by our friends at LiveScience.com.

When a person feels authentic pride, he or she was more likely to score high on extraversion, agreeableness, genuine self-esteem and conscientiousness. Hubristic pride was most often linked with narcissism and shame.

Read the article here.

We as teachers and parents can capitalize on this information in two ways.  First, we can help a child avoid a potentially embarrassing situation.  Socially awkward kids possess few and weak social skills.  When they are having a bad day, don’t shove them into difficult (for them) social situations or force them to participate in group activities or play dates.  Since this is a challenging area for them, we need to build a track record of success and set them up for success by controlling some of the circumstances under which they interact with peers.

The second way we can use this information to help them make and keep friends is to build them up prior to an encounter.  On the way to the neighborhood birthday party, remind the child of their successes and accomplishments, and have them help you remember the things they are proud of.  The achievements can be social, or they can be academic, sports-related, or anything that helps them feel genuinely good.   Your child will feel better and perform better under social situations when they are feeling good–just like anyone else would!

It’s Ellen again. As I muddle through my full, often exciting and stressful days, I think of  various subjects to write about that would have a positive impact on the lives of others. These subjects are usually ones which I personally have dealt with and I feel would be of significant value to discuss with all of you.

OK….here goes! Many of you are the parents of children or young adults that have a disability such as ADD or ADHD. They are really bright and intuitive, yet their disabilities make many tasks so very tough. Many in the general population believe that in order to have “a disability” one needs to have physical or facial attributes of such. We know that is not the case. But, this is what makes their lives so tough.

I know it hurts Wes, as well, he just doesn’t show his emotions–another characteristic of Asperger’s Syndrome.

My son has Asperger’s Syndrome and ADHD, as well. He is an extremely handsome, well built 26 year old young man. To look at him walking down the street one would have no notion that his Asperger’s Syndrome & ADHD make life so very difficult for him. Due to this fact, people expect “more” from him. They are not tolerant of the fact that when they drum up a conversation he cannot look you in the eye, does not understand social cues and finds it impossible to carry on a conversation without getting frustrated and ready to move on to something else, losing focus.  They wonder, “how can this be, he looks so normal, I don’t get it”. They cannot believe that he can have a disability because he “doesn’t look it”. They expect more from him and the lack of patience hurts me so very much. I know it hurts Wes, as well, he just doesn’t show his emotions–another characteristic of Asperger’s Syndrome.

A unique characteristic of AS and certain levels of autism on the spectrum, is the amazing ability to focus on one particular subject or art and truly excel in it.

Yet, also a unique characteristic of AS and certain levels of autism on the spectrum, is the amazing ability to focus on one particular subject or art and truly excel in it. Case in point, Wes reads sports statistics books daily. He is knowledgeable about just about every sport, such as, hockey, baseball, football, basketball, just to name a few. He knows information on every player, every team and if you were to carry on a conversation with him you would have no idea he has Asperger’s Syndrome (mild autism). In addition, many of the sports figures who live close by know Wes and respect him for the wonderful, kind person he is and enjoy carrying on conversations with him on his extensive knowledge of sports!

This is why we must educate society. A person can have a disability and not have to “look it”. Likewise, a person can have a disability, have physical and facial attributes of such, and society does not give that person a chance. Their IQ may be “off the charts” fabulous….but due to their “look”, the thought is “how can they achieve anything great if they have special needs.”

It is up to us to give our kids the positive reinforcement they need to continue being the creative, capable people we know they are!

I suppose you have to really get to know these people to experience what I live with on a daily basis. Not only with Wes, but with all the other exciting, phenomenal children and young adults I work with on a daily basis. How amazing, capable, talented, special and unique they are. I suppose the moral of this story would be, “Hey guys, Don’t judge a book by its cover!” Let’s take the time to advocate for our kids and teach society that they are worthwhile productive children and young adults that may very well be our future leaders. Everyone is important, they just need to be reminded of that. And, it is up to us to give our kids the positive reinforcement they need to continue being the creative, capable people we know they are!

Let’s shout it out….Let’s educate those that just don’t know what we know…..

THESE PEOPLE ARE PRODUCTIVE AND RESPECTED MEMBERS OF SOCIETY, THEY NEED TO BE GIVEN A CHANCE…..WHAT WINNERS YOU WILL SEE!

LET THOSE “SPARKS OF GENIUS” CONTINUE TO ENLIGHTEN US AS WE APPRECIATE AND MUDDLE THROUGH OUR BUSY LIVES. EVERYDAY IS A NEW EXPERIENCE, EVERYDAY IS A GIFT FROM “THE MAN UPSTAIRS.”

All the best & G—D Bless,

ELLEN

As a teacher, it can be tricky game of balance to give the challenged student everything he or she needs to be successful in the classroom without turning the student into a complete outsider. Here’s some tips to make life easier. Since you already have way too much to remember, these tips will all be about forgetting.

1. Forget labels. ADD, ADHD, Asperger’s, LD…they are a bunch of baloney. I’ll give 2-to-1 odds that any given student in your school has been misdiagnosed. Let’s be honest: the professionals in this field are likely to be compassionate, but not exactly rocket scientists. It just doesn’t pay enough!
2. Forget fair. There are two parts to this. First, only the kids who need glasses wear glasses. Nobody complains that it isn’t fair that only some kids get glasses. A learning disability of any kind is no different than needing glasses. The child with a learning disability needs corrective tools that others do not. Teachers: never deny or delay the challenged child’s accommodations because it seems unfair to the other students. It isn’t!The second part is that the teachers are supposed to be in charge of the classroom. When other students complain that they want extra time too and that it isn’t fair it is the teacher’s responsibility to lay down the law, “This is my decision and it is not up for discussion.”
3. Forget different. All students want the same things: they want to learn, and be respected, and feel a sense of accomplishment. They want to be recognized and valued as-is without having to become something worthy of appreciation. They want to have fun, live their lives and make friends.When I say all students, I mean ALL. You have a kid that isn’t interested in learning? Wrong! He IS interested, but something is getting in his way. Maybe his family life is rotten, or the only people who appreciate him are his fellow gang members and he’s dissing school to please them.
4. Forget lazy. If you’re thinking that this kid would do fine if he wasn’t so lazy, you’re on to something alright, but not the fact that he’s lazy! It is up to the professionals in a child’s life to (help him or her) figure out what the underlying causes are (of apparent laziness) and address them. That’s so important, I’m going to say it again and bigger.

It is up to the professionals in a child’s life to (help him or her) figure out what the underlying causes are (of apparent laziness) and address them.

Good luck!

Allen Dobkin