Nurse: Let's see how Collin's doing. This is his 18 month checkup, right?
I confirm as she pulls out his folder and looks at his developmental chart. Pauses.
Nurse: OK... (She puts her finger on where he was at our last appointment and seems to be processing.) Maybe I should start at 12 months this time.
Me: I wouldn't.
Nurse: Really? He's not talking yet?
Nurse: Okay. Hm. Not even 'mama' or 'dada'?
Nurse: Drinking from a cup?
Silence. She still has not looked at either me or Collin at this point.
Nurse: Well, how about 9 months?
Me: (Taking a breath first.) His First Steps evaluations have him more around the 3-6 months range.
Nurse: Hm. Well. Okay. Let's just forget about this.
She closes the folder and leaves.
This probably would have had me close to tears a few months ago, but this time, I mostly felt sorry for her. She just didn't know what to say and seemed to know on some level that it was going poorly but couldn't salvage it and I couldn't help her. At the end of our appointment with the pediatrician, I suggested that the nurses look at a child's chart before they start asking developmental questions and when they see a major delay, start off by saying, "So tell me what new things Collin is doing since your last visit." That allows me to brag on the fact that he laughs consistently and can hold his head up more reliably now rather than having to endure the whole rigamarole of finding the 'right' spot on that blasted chart for Collin. It also allows her to get the information she needs without floundering and being insensitive, however unintentionally.
Other than that, though, the visit was very smooth and positive. Our pediatrician is FANtastic, in case I haven't mentioned that before. He loves Collin and at one point, when he held Collin up in the air and put their foreheads together, I literally had to swallow down a little sob. He is very pleased with Collin's progress (which seems to be the theme these days) and said that he looks very happy and healthy. I'm going to email him some information on Collin's branched chain amino acid therapy so he can learn more about it (because that's the kind of doctor he is) and he is very supportive of the geneticist's suggestion to try growth hormone therapy. He ended the appointment by writing down my suggestion about the nurses and telling me that we're doing a wonderful job with Collin. It caught me off guard and I choked down some more tears as we left.
We got out earlier than I had expected and Collin fell asleep in the car, so I got an iced chai latte at a drive-thru and we just drove around for a while and listened to classical music. All in all, not bad for a Wednesday morning doctor's appointment.