how would i ask a paediatrician nicely....................

[jenk1]

to be referred to a specialist to look at her ongoing bowel problems and incontinence issues.

cos im AS and dont want to offend him with my bluntness

but at the same time he has thrown dd,s toileting and medical problems onto the psychiatrist from CAMHS and she,s not a medical doctor.

TIA

the dead dead polite way of doing it would be - I want to find out whether it's a purely physical issue or whether there is any behavioural component to it - so would like DD to see an expert on the physical side as well.

hmm you see there is the consultant psychiatrist looking into if its a behavioural issue and the paed is supposedly looking into the physical side , but we,ve just found he,s wrote the gp a letter and he,s put the responsibility onto the psychiatrist.

now dd has been on movicol for 2 years with constipation problems, and he has always told us its cos of her hemi but surely he should be looking into if that is affecting her toileting?

he,s said he,s going to discharge her in july which we are not happy about either.

(he doesnt know we have got this letter, i told the GP i wanted a copy and he ummed and aahed but i said no i want a copy so he gave me one-sneaky i know!!!)

You could ask the GP.
My ds is under a community paed for the behavioural/ developmental side and a standard paed for his physical problems (constipation and exzema).
I tend to write to my gp prior to a visit so I can get my request or concerns across clearly.

Don't any of them know you have AS? Can't you "confide" in one or all of them that you feel awkward as you are worried about how to put your request across. They love it when you "confide".

jenk1 you are entitled to a copy of all the letters that get written from the hospital to your gp, ask the paed and they should get their secretary to copy you into all the letters in future. Tbh the only way we got one of dd3s referrals was to be totally blunt and say we would really like a referral to ...... because we would like to make doubley sure we have not missed anything important and that would really not be doing dd3 any favours in the long run. If you are not happy being signed off in July, maybe you could say that you'd really be happier if you could have one more appointment to put your mind at ease as you're really still very worried, and take it from there.

Your paed is definitely copping out. Has she ever been referred for even routine ultrasound or anything? I've got two that see the paed 3 monthly for continence issues (weirdly not the one with cp who has no continence issues at all ). If you can't ask the paed yourself, could you ask the CAMHS psych to send in a request that she is investigated to rule out physical issues prior to treating it as a behavioural problem?