An excursion of sorts…

This morning J and I made our way to the doctor’s office for his initial check-up with the new primary care physician.  Last night suspicion that today was not quite a holiday arose in J’s mind; I know this because, in spite of having looked at the PECS board all weekend and seeing that innocuous activities had been posted in lieu of the BUS and BACKPACK, J asked -no less than 29 times- if we were making COFFEE in the morning.  While already upstairs, he asked for a book.  After reading the book, he asked about COFFEE, MILK and HOME again.  I reassured him that we would be home, but I had to skip out of the room before he added more nouns to his line of questioning.

When I finally asked him, at exactly 8:10 a.m., to get dressed, J looked at me with an expression that said “I KNEW IT!!!!!!  You’ve TRICKED me!!!!!!!!!”  He gave in; he dressed for our outing and calmly walked to the clubhouse so we could wait for our cab.  The driver, when he saw J’s impressive dimensions, said he had to sit up front.  J realized that this man was not particularly thrilled to have him in his vehicle because the man flinched when J climbed on and the shock absorbers absorbed the shock.  Our son being as perceptive as we all know he is, the rest of the drive to the doctor’s office was peppered with “SAY AAAAAH!” spoken quite clearly while turning his head to the driver.  The man couldn’t lean farther out his window enough…for a moment I thought he’d end up driving with only one leg and one arm inside the cab.

The man wasn’t so much “mean” as horribly uncomfortable with the large, imposing, sweet-faced dude sitting next to him.  That we sat in traffic and he had to hear “SAY AAAAAH!” while watching cars slowly (painfully slowly) trickle past the green light didn’t help matters.  When we got out, J recognized this particular building as the one where he’s been to the dentist, so he wasn’t thrilled about getting out there, but he graciously said THANK YOU to the cab driver.  Me?  I got the stink-eye from the kid.  I had to make sure that I used the entrance farthest from the door to the dental surgery, and that I steered him directly towards the Family Medicine Practice.  Until we passed the portion of hallway shared by the Dental Clinic, the Dental Surgery and the entrance to Family Medicine, J was walking so fast that I thought he’d crash through the one set of doors that was closed rather than use the other set that was open.

The vastness of the waiting room and the complete absence of small children soothed him immediately.  Once we signed in and found a place to sit, he discreetly asked me if we were going to see the DENTIST.  I told him NO, this time we were here for the DOCTOR.  His fingers found the DOCTOR’S OFFICE folder in his Proloquo2Go, and he listed all the things he was going to have done: CHECK BLOOD PRESSURE, CHECK WEIGHT, CHECK TEMPERATURE, CHECK HEIGHT, LISTEN TO HEART, LISTEN TO LUNGS.  I pointed out that he was also getting his flu shot, and he took this in stride.  At least, he must’ve been thinking, the only child wailing and complaining will be me.  The nurses were very helpful and he behaved beautifully.  His blood pressure was better than I expect, but high nonetheless.  His body has to work very hard with all that weight on it, and that was part of the reason we were there today: his weight.

The psychiatrist had suggested we consult his doctor about putting J on Metformin to assist weight-loss.  We spent the past week reading about this, and we reached the same conclusion the doctor reached: if the blood work doesn’t indicate that J is diabetic (which she didn’t seem convinced of) then this particular med won’t do the trick.  We’ll know for sure after his lab work on Saturday morning (because what better time to run out of the house with a child that’s been fasting than a Saturday morning!!!) and the follow-up visit next Wednesday.  J, it seems, is as healthy as we think he is, but his body has the challenge of extra weight foisted upon it by using the Risperdal which, of course, comes into play because of the behavioral issues caused by the anxiety that stems from his Autism.  So J’s only health problem, in a nutshell, is his Autism.  Not bad, I’d say…not bad at all.  That is: it could be SO MUCH worse!!!

Look, I’ll be honest with you: J is “fat.”  J’s carrying around 285 pounds (about 130 kg) on his 5′ 10″ (1.7 meter) frame.  That’s a LOT!  Yes!  But…according to certain calculations (height and wrist circumference) and the fact that J is male, the frame that carries his body is LARGE.  J IS imposing, no doubt about that, but he’s also basically big no matter which angle you look at him from, and the bulk that worries doctors, cab drivers and parents alike is in his abdominal area.  The rest of J is absolutely and completely proportionate.  Yes, his BMI is off the charts, people, but it’s being measured based on height and weight, and the fact that he is male…and a good part of his weight comes from those large, heavy, solid bones of his.

I’m not trying to minimize the issue here.  J needs to lose weight, BUT…

I told the doctor today, and I meant this from the bottom of my heart, J will never have that lanky, lean, long, athletic frame that Michael Phelps has.  Not only has he not worked at being long and lean, he’s also not genetically coded for it.  If J loses weight, even if it’s a significant amount of weight loss achieved, he will still be a Big Guy.  The question here is not to reduce J’s size, but to reduce his health risks and his waistband…that’s not size, people; that’s volume.  J’s frame is meant to hold those big hands, impressive legs, stout body.  Unless there is a chronic medical condition requiring the use of the Metformin, well, it ain’t going to happen.  We held out on medicating him with the Risperdal until he ACTUALLY needed it, not because it benefited US.  We will hold out on medicating his weight…we can find other ways to do this, even if it requires a complete overhaul and re-education about food for an entire household.

We left the doctor’s office in a good mood, buffeted by the strong breezes that made us huddle together as we waited for the cab.  I’d brought with me Mouse Soup, and we stood under a pergola, me reading out loud (much to the amusement of passersby) and J smiling and filling in the parts of the story where I paused.  On the way back, our cab driver was much more comfortable around J.  He asked where we were going and, once we started moving in that direction, J -who sat next to him on the front- tapped him on the shoulder and motioned to the radio.  “You want music???”  The driver fiddled with the knobs and waited until J motioned for him to stop at one particular station.  “You like that one???”  It was a short drive home.  No traffic.  No anxiety.  No “SAY AAAAAH!”  Just HOME, HOME, HOME.  And THANK YOU when J stepped off the cab.

We’ll figure this out…one thing goes wrong, and another is bound to follow, and then another, but…something will go right…here or there or further down…we’ll figure this out.