Handling medical situations

[Before you can make things better, you have to stop making them worse...]

SD12 has to get braces, during the consultation they noticed that her tonsils/adnoids were enlarged and that they should be removed. She also has a strange growht on her uvula that needs to be taken care of. DH and his uBPDx were at the appointment when the ENT suggested the surgery to fix all of these things prior to braces. DH and his ex made a snap decision in the office that day to have her surgrey on 12/3. The doctor mentioned should would miss for sure W-Th-F from school and possibly the following Monday. After talking to SD she told dad and I that 1. she wants to spend her recovery time with us at our house and 2. wants to miss the least amount of school, having to make up school work. Here is the email exchange... what could he have done differently in communicating with SD's mom?

from DH to EX -

SD has expressed concern about missing school for her tonsils procedure, so I checked with the dr's office and they said they may be able to switch it to the week of thanksgiving and that way she wouldn't miss that much school. Your thoughts?

EX to DH

My opinion has not changed since we discussed it at the Drs office and agreed on Dec 3.

Having the surgery the day before Thanksgiving will not only ruin SD's holiday, but also everyone else's. She will not be able to enjoy Thanksgiving dinner or time with family as she would  be recovering Thanksgiving day. It is not as though she has already missed a lot of school this year. Like we discussed in the Drs office, we can plan ahead and ask for her work to be sent home

DH to EX

I understand that others may miss her at thanksgiving but that time frame as the dr stated would give her the best chance to rest( as she will need 6-7 days) with missing the least amount of school. We shouldn't have made such a quick decision in the office without considering all options and considering SD's input. Based on this and the discussion I had with her, I will be changing her appointment to 11/26/14 as I have consulted with the dr's office and that date is available for the procedure, I have to call back by 4:30 to change the appointment unless you have another option that affords her the greatest rest/healing time without missing school.

EX to DH

I spoke to the doctors office.  They are not going to change the appointment unless we both agree to the date.  That said, I still have no reservations whatsoever about dong it on Dec. 3rd. Like I said before, attendance is not an issue with SD.  She has not missed any other days of school and is doing very well.  However, if you insist that it be done over a Holiday, the nurse told me that 12/31/14 is available.  New Years is the least celebrated holiday of the season, and does not typically involve traveling to see extended family, so if you would like to compromise on that date, I would be agreeable to that.

DH to EX

Given all the circumstances I am fine with the New Year's Eve procedure if we can agree that the kids would be here after the procedure (weds-sun) and in return so that you have equal time with the kids over winter break, you could have them Friday 19 - Monday 22 10am. I feel that this affords SD the greatest time to rest and heal afterwards without flip-flopping between households. If at anytime you would like to come and spend time with her that would be fine as well.

EX to DH

I would not feel comfortable not seeing or being able to care for her after her surgery.  Our homes are 15 minutes apart. I am certain that she would be fine making the short ride.  As much as I would like to have the kids prior to the Holiday, it is best that we stick to the agreement and "local rule" as you have stated previously. 

DH to EX

The dec 31st date seems like it would work the best, so we'll go with that then

EX to DH

Dr's office just called and said that they cannot do the surgery on Dec 31 st as the Surgery Center will be closed that day. The nurse said they just made the decision to close today. So we have to pick a different day. They have the 10th or the 17th available in December.  She didn't mention what was available in January.

DH to EX

After talking with SD and weighing all options the 17th would work the best and she would miss the least amount of school. I will call Monday morning to schedule it with the Dr's office if I don't hear otherwise. Thanks

EX to DH

My concerns with the 17th are these:

Who will be caring for her on Thursday and Friday?

I am not comfortable with not seeing her for 6 days after a surgery.

It is still close to the Holidays and I am concerned that she will not be well enough to enjoy them.

SS's Christmas concert is the 17th.  Will you be able to get him where he needs to go?

I spoke to the Dr's office. January 14th is also available. She is off on Mon Jan 19th for MLK day. She would miss the same amount if school (wed, thurs, fri) and still have Mon to recover.  We would also both get to see her during her recovery. It is also after the busy Holiday season.

DH to EX

Ok then you mentioned the 10th as well, that would work well also and she wouldn't miss any activities. also I was going to be taking off a couple days along with Swiggle and you are more than welcome to come spend the day with SD while we are at work. And if she was to wait until January as you proposed she would have the same amount of recovery time as he December 17 date.

EX to DH

I cannot do the 10th I have a training that I am conducting in (City 4 hours away) on that date which has been scheduled for some time. Yes, she would have the same recovery time in January as she would in December and would miss the same amount if school. It would also afford both of us time to aid in her recovery and ensure that she enjoys the Holidays.

DH to EX

She will have a week before Xmas to recover and you will have opportunity to see her, and spend time with her a well. I see no point in prolonging this back and forth as any option I bring up you shoot down. I have discussed this with her and she wants to miss the least amount of school and like I stated before, recovery time is the same in December as it is in January , so I see no need on delaying this process

EX to DH

I do not think it is reasonable to expect me to "visit" my child at your home.  Unless you want to make arrangements for her to stay with me for some of the time during her recovery, this will not be acceptable. You seem to forget that we had agreed on a mutually acceptable appointment at the Dr office.  YOU were the one who (as usual) had to change the plans. Had you left the appointment alone, none of this would have been an issue. So please do not imply that these scheduling conflicts are entirely my cause. This surgery is a serious situation and not something that I am going to simply not see her through or "visit" her. As her parents, providing care for her is important for both of us

DH to EX

we both made a hasty decision without thinking it through first and where you are wrong is this is not about us this is about SD and SD alone and I am not implying that you don't spend time with her, but staying in one place and not being bounced around is what is in her best interest, not yours or mine

EX to DH

Both of her parents caring for her is exactly what is best for HER. You make "bounced around" sound like she would be traveling for hours. We live less than 15 minutes apart. That really is not an issue.

The parenting agreement has typical legal language about this type of thing that both parents shall agree blah blah blah. Now the office won't make any appointment without both parents consent so we can't even call and just make it. We try to do the right thing and inform her since that is wehat the agreement states for non emergency issues. We want to make sure that SD is as comfortable after her surgery as possible, for her this means being at our house. She is afraid to be with mom during revoery, she doesn't trust that mom will take care of her and respond to her needs. Mom does not do well in situations like these.She is to scared to tell mom this so we explained that we can only do so much in accomplishing that untill she is ready to have a voice with her mom about what she needs. We also know that getting the surgery done the week before christmas, she won't have much work to make up since they do end of the year activities and such, without much homework. The surgery has to be done on a Wednesday and we don't want to wait until January for this.  Their agreement does state that if the one or both of the kids are sick it is up to the parents t decide if they should go for parenting time and that if the don't go for the parenting time it must be made up. we would like to schedule the surgery for the 17th of december and offer trading the weekend after the surgery to mom for the following weekend, even though we don't think SD should be bounced around in the cold winter weather. Plus after surgery who really feels like even getting out of bed and into a car, if only for a 15 minute ride?

Our thougts are to play it by ear and if SD wakes up the friday after surgery and feels great then she can go to mom's, if she wakes up and feels crappy we decide we won't make her get out of bed to go? Not sure what the ex would do should that happen? Maybe show up and make a scene, call the cops, call her attorney... .I don't know. But I feel like this is our only option to the ___ty situation.

Swiggle

[Swiggle]

SD12 has to get braces, during the consultation they noticed that her tonsils/adnoids were enlarged and that they should be removed. She also has a strange growht on her uvula that needs to be taken care of. DH and his uBPDx were at the appointment when the ENT suggested the surgery to fix all of these things prior to braces. DH and his ex made a snap decision in the office that day to have her surgrey on 12/3. The doctor mentioned should would miss for sure W-Th-F from school and possibly the following Monday. After talking to SD she told dad and I that 1. she wants to spend her recovery time with us at our house and 2. wants to miss the least amount of school, having to make up school work. Here is the email exchange... what could he have done differently in communicating with SD's mom?

from DH to EX -

SD has expressed concern about missing school for her tonsils procedure, so I checked with the dr's office and they said they may be able to switch it to the week of thanksgiving and that way she wouldn't miss that much school. Your thoughts?

EX to DH

My opinion has not changed since we discussed it at the Drs office and agreed on Dec 3.

Having the surgery the day before Thanksgiving will not only ruin SD's holiday, but also everyone else's. She will not be able to enjoy Thanksgiving dinner or time with family as she would  be recovering Thanksgiving day. It is not as though she has already missed a lot of school this year. Like we discussed in the Drs office, we can plan ahead and ask for her work to be sent home

DH to EX

I understand that others may miss her at thanksgiving but that time frame as the dr stated would give her the best chance to rest( as she will need 6-7 days) with missing the least amount of school. We shouldn't have made such a quick decision in the office without considering all options and considering SD's input. Based on this and the discussion I had with her, I will be changing her appointment to 11/26/14 as I have consulted with the dr's office and that date is available for the procedure, I have to call back by 4:30 to change the appointment unless you have another option that affords her the greatest rest/healing time without missing school.

EX to DH

I spoke to the doctors office.  They are not going to change the appointment unless we both agree to the date.  That said, I still have no reservations whatsoever about dong it on Dec. 3rd. Like I said before, attendance is not an issue with SD.  She has not missed any other days of school and is doing very well.  However, if you insist that it be done over a Holiday, the nurse told me that 12/31/14 is available.  New Years is the least celebrated holiday of the season, and does not typically involve traveling to see extended family, so if you would like to compromise on that date, I would be agreeable to that.

DH to EX

Given all the circumstances I am fine with the New Year's Eve procedure if we can agree that the kids would be here after the procedure (weds-sun) and in return so that you have equal time with the kids over winter break, you could have them Friday 19 - Monday 22 10am. I feel that this affords SD the greatest time to rest and heal afterwards without flip-flopping between households. If at anytime you would like to come and spend time with her that would be fine as well.

EX to DH

I would not feel comfortable not seeing or being able to care for her after her surgery.  Our homes are 15 minutes apart. I am certain that she would be fine making the short ride.  As much as I would like to have the kids prior to the Holiday, it is best that we stick to the agreement and "local rule" as you have stated previously. 

DH to EX

The dec 31st date seems like it would work the best, so we'll go with that then

EX to DH

Dr's office just called and said that they cannot do the surgery on Dec 31 st as the Surgery Center will be closed that day. The nurse said they just made the decision to close today. So we have to pick a different day. They have the 10th or the 17th available in December.  She didn't mention what was available in January.

DH to EX

After talking with SD and weighing all options the 17th would work the best and she would miss the least amount of school. I will call Monday morning to schedule it with the Dr's office if I don't hear otherwise. Thanks

EX to DH

My concerns with the 17th are these:

Who will be caring for her on Thursday and Friday?

I am not comfortable with not seeing her for 6 days after a surgery.

It is still close to the Holidays and I am concerned that she will not be well enough to enjoy them.

SS's Christmas concert is the 17th.  Will you be able to get him where he needs to go?

I spoke to the Dr's office. January 14th is also available. She is off on Mon Jan 19th for MLK day. She would miss the same amount if school (wed, thurs, fri) and still have Mon to recover.  We would also both get to see her during her recovery. It is also after the busy Holiday season.

DH to EX

Ok then you mentioned the 10th as well, that would work well also and she wouldn't miss any activities. also I was going to be taking off a couple days along with Swiggle and you are more than welcome to come spend the day with SD while we are at work. And if she was to wait until January as you proposed she would have the same amount of recovery time as he December 17 date.

EX to DH

I cannot do the 10th I have a training that I am conducting in (City 4 hours away) on that date which has been scheduled for some time. Yes, she would have the same recovery time in January as she would in December and would miss the same amount if school. It would also afford both of us time to aid in her recovery and ensure that she enjoys the Holidays.

DH to EX

She will have a week before Xmas to recover and you will have opportunity to see her, and spend time with her a well. I see no point in prolonging this back and forth as any option I bring up you shoot down. I have discussed this with her and she wants to miss the least amount of school and like I stated before, recovery time is the same in December as it is in January , so I see no need on delaying this process

EX to DH

I do not think it is reasonable to expect me to "visit" my child at your home.  Unless you want to make arrangements for her to stay with me for some of the time during her recovery, this will not be acceptable. You seem to forget that we had agreed on a mutually acceptable appointment at the Dr office.  YOU were the one who (as usual) had to change the plans. Had you left the appointment alone, none of this would have been an issue. So please do not imply that these scheduling conflicts are entirely my cause. This surgery is a serious situation and not something that I am going to simply not see her through or "visit" her. As her parents, providing care for her is important for both of us

DH to EX

we both made a hasty decision without thinking it through first and where you are wrong is this is not about us this is about SD and SD alone and I am not implying that you don't spend time with her, but staying in one place and not being bounced around is what is in her best interest, not yours or mine

EX to DH

Both of her parents caring for her is exactly what is best for HER. You make "bounced around" sound like she would be traveling for hours. We live less than 15 minutes apart. That really is not an issue.

The parenting agreement has typical legal language about this type of thing that both parents shall agree blah blah blah. Now the office won't make any appointment without both parents consent so we can't even call and just make it. We try to do the right thing and inform her since that is wehat the agreement states for non emergency issues. We want to make sure that SD is as comfortable after her surgery as possible, for her this means being at our house. She is afraid to be with mom during revoery, she doesn't trust that mom will take care of her and respond to her needs. Mom does not do well in situations like these.She is to scared to tell mom this so we explained that we can only do so much in accomplishing that untill she is ready to have a voice with her mom about what she needs. We also know that getting the surgery done the week before christmas, she won't have much work to make up since they do end of the year activities and such, without much homework. The surgery has to be done on a Wednesday and we don't want to wait until January for this.  Their agreement does state that if the one or both of the kids are sick it is up to the parents t decide if they should go for parenting time and that if the don't go for the parenting time it must be made up. we would like to schedule the surgery for the 17th of december and offer trading the weekend after the surgery to mom for the following weekend, even though we don't think SD should be bounced around in the cold winter weather. Plus after surgery who really feels like even getting out of bed and into a car, if only for a 15 minute ride?

Our thougts are to play it by ear and if SD wakes up the friday after surgery and feels great then she can go to mom's, if she wakes up and feels crappy we decide we won't make her get out of bed to go? Not sure what the ex would do should that happen? Maybe show up and make a scene, call the cops, call her attorney... .I don't know. But I feel like this is our only option to the ___ty situation.

Swiggle

[ForeverDad]

Long term, try to get Decision Making or Tie Breaker status.

Short term, it is clear ex won't agree to anything that leaves her out of recovery.  However, some have referred to an old adage that may apply here regarding court consequences... .It is easier to ask for forgiveness than for permission.  Also, The poorly behaving parent gets few consequences and the well behaving parent seldom gets credit.  Those two truisms mean you don't have to always cave in.

On the other hand, dance the parenting line carefully, SD is just about old enough to express her wishes and have them impactful with the court but dad can't appear to be a parent who lets the child call the shots.  In other words, be balanced in all you say and do and don't paint yourselves into the wrong corners.

Get the recovery to start on your time, at least that way the immediate aftermath of the surgery is with dad.  Then when the weekend comes, as you're thinking, see how SD feels.  If she doesn't want to go, inform ex and offer to let her have the following weekend as a trade.  If it goes so far as the police being called, let the officer speak with SD, likely she may be brave enough to express her wishes to the officer - ":)on't tell my mother but... ."  The police will most likely not force an exchange.  My police always ended such standoffs with, "We are here to resolve the immediate incident, nothing more will be done here, I will file my report, if there are any issues left please resolve them in court."

If it does go to court, you will have the documentation that you did offer compensatory time.

Last year my ex filed for my son, then 11, to have an "in camera" interview with the magistrate and his Guardian ad Litem.  I don't think it was an accident that the interview was scheduled on my time.   In the subsequent decision no reference was made to any specific comments during the interview, it just stated he was careful not to offer preference for either parent (not wanting to have to take sides) but the court saw he was more relaxed when speaking about dad than about mother.  That meant a lot to the professionals.

[Swiggle]

Thank you Foreverdad.

This is exactly what i was thinking, it is easier to ask forgiveness than permission. We def do not to let SD dictate decisions, we do take into consideration what her thoughts/feelings are since she is 12. We also always talk to biomom in a way that is "in SD best interest, based on the circumstances and everyone's thoughts/feelings". Proposing the surgery be done during a holiday break was actually the ENT's suggestion. He mentioned that is usually when he does these things so kids don't miss a lot of school and can have more time to heal. 

How do we go about getting Decision Making or Tie Breaker status? She tried that when we recently went back to court saying, the if this can't be agreed upon mom gets final say. We def don't want that but I know she wouldn't give that up either so how do you work for that?

As a side note... .I get being a mom and wanting to be with your daughter during this time, but what strikes me is that never once has she suggested she has her the entire duration of the recovery or to change her plans to make things work. All of the exchanges below were to mom's benefits with timing, her plans, her holidays or working around her schedule. Not once was it ever about what is best for SD or what other's opinions might be.

[ForeverDad]

Well, someone would have to take it to court... .either ex files Contempt of Court or one of the parents seeks custody, decision making or tie breaker.  Neither parent will back down, so the court will have to decide.

• Custody - one parent decides and informs the other - harsh ruling for the loser



• Decision making - one parent decides and informs the other - keeps joint custody for public image



• Tie breaker - attempt to work it out but then T-B parent settles the issue

The difference is that with the first two the parent in charge can decide and then later inform, with T-B you reverse the order, ask first then proceed.  A lawyer could explain which options are more likely to be used or chosen in your local court.

In my court I had to seek Change of Circumstances and get that acknowledged first before proceeding with seeking custody.  In all it was near a year and a half and son got a GAL, his own lawyer, during the process.

[david]

I haven't figured a way to work with ex yet on medical situations. My ex is a nurse so that makes it even more difficult because I am not a "medical professional".

[Swiggle]

I haven't figured a way to work with ex yet on medical situations. My ex is a nurse so that makes it even more difficult because I am not a "medical professional".

I can only imagine how that must be, dealing with them is hard enough!

We would love to seek custody, SD has told us she doesn't want to live with mom anymore. I think that will only get worse too, since we found out yesterday that mom got engaged to the BF she moved in with recently. BF was the man uBPDex was having an affair with when DH said enough. They've remained a couple SD is asking questions, she can't understand how mom would have a bf and bring him around the kids only 1 month after dad originally moved out.  SD actaully said to me the other day "I think my mom was seeing BF while she and my dad were still married. I said "well the only people who know all the details are you mom and dad and it is really only their business" She said "I know whenever I ask my dad why they aren't together, he tells me that it is adult mom/dad stuff and that there were things thye couldn't work out, had nothing to do with my brother and I and it was better if they weren't married."

When she has asked DH specific questions about mom, he always says "those are conversations you should have with your mom" She told me that she would never ask mom, becausae she would just lie to her... .sad.

[ForeverDad]

SD actually said to me the other day "I think my mom was seeing BF while she and my dad were still married." I said "well the only people who know all the details are you mom and dad and it is really only their business".

Validation can be accomplished in a balanced way.  It might be okay to assist her just a little by confirming that she must be very observant and encourage her to base her conclusions on objective factors, that the learning experience and skills building will help her to have healthy relationships in future years.  I only say this because if there is a void left by being overly cautious you don't want the disordered ex to distort that void.

She said "I know whenever I ask my dad why they aren't together, he tells me that it is adult mom/dad stuff and that there were things they couldn't work out, had nothing to do with my brother and I and it was better if they weren't married."

It is good not to involve the children or pressure/manipulate them to take sides.  However, that does not mean they can't or shouldn't form their own valid conclusions based on their observations.  And some guidance is not improper.

[Swiggle]

SD actually said to me the other day "I think my mom was seeing BF while she and my dad were still married." I said "well the only people who know all the details are you mom and dad and it is really only their business".

Validation can be accomplished in a balanced way.  It might be okay to assist her just a little by confirming that she must be very observant and encourage her to base her conclusions on objective factors, that the learning experience and skills building will help her to have healthy relationships in future years.  I only say this because if there is a void left by being overly cautious you don't want the disordered ex to distort that void.

She said "I know whenever I ask my dad why they aren't together, he tells me that it is adult mom/dad stuff and that there were things they couldn't work out, had nothing to do with my brother and I and it was better if they weren't married."

With my kids and DH's kids I always talk to them about trusting their gutt, especially the girls as they are a little older. I validate what they are feeling and really want them to trust what they know without needing someone to slap them in the face with it... .does that make sense? As humans I think when we suspect something it is such a relief to know the truth but I think it is even more important to trust what you instinctly know.

We encourage the kids to look at patterns of behavior, what makes them feel good, what doesn't make them feel good and that actions speak louder than words. SD has learned by attempting to talk to her mom about some things that are important to her (but not to mom or they make mom look at her own actions) and mom freaks out, cries, plays the victim, makes it all SD's fault and will sometimes start blaming DH and I that we are putting her up to these things, it's all our fault... .After a couple of these episodes SD is soo reluctant to talk to mom about anything. We encourage her to talk about and ask for what she needs but mom has taught SD, by the way she responds, that it is all about mom and what SD feels or thinks doesn't matter.

actually reading what you have written and typing the above, made me think about something. Whenever SS7 gets into trouble when he is with us and we punish or give a consequence he constantly accuses us of not loving him. We say if we didn't love you we wouldn't care or sometimes we just say sorry you feel that way but we disagree. We know his mom tells him that we don't love him. At her house he is allowed to do pretty much whatever he wants. No bedtime, eats whatever, watches whatever you know no boundaries whatsoever, mom shows him her love in this way. Then when he is with us we do the opposite and bam in his mind we don't love him, to him it makes sense and is real becasue mom tells him we don't love him and follows that up with if they loved you they wouldn't make you do xyz or punish you for xyz. This has been a   moment for me.  

It is good not to involve the children or pressure/manipulate them to take sides.  However, that does not mean they can't or shouldn't form their own valid conclusions based on their observations.  And some guidance is not improper.

[david]

Conversations with the children do change as they get older. At 14 I think your conversations are proper. Our S16 asked lots of questions when ex first left. He was 9 at the time. Many of them I simply answered similar to your answers. He doesn't ask about things from back then anymore except when his mom tells him something he doesn't believe to be true. Usually I listen and ask him what he thinks. His answers do show that he remembers things from back then in pretty good detail. I usually say something to that validates his perceptions.

Both our boys (16 and 11) come to me with medical questions. I used to suggest they talk to their mom since she is a nurse. However, they both have indicated they do not trust her judgements and ask me instead. Our youngest (he was 9 at the time) had a wart on the bottom of his foot. I picked him up at school and hadn't seen him for 5 days. He immediately told me his foot was hurting for several days. I looked at it right away. I asked him what his mom said. He told me he didn't tell her because he was afraid she would do something wrong. I took him to a doc that day. I emailed ex to let her know I took him to the doc that day. I said nothing about the length of time S9 had the wart since that would have led to conflict for me and S9 with ex.

[Swiggle]

I get so frustrated sometimes, usually when there is a big blow up about something simple that mom has to make into a war. She undermines us and talks poorly about us in front of the kids, shares adult info with them that really they have no business hearing. She tries to get them on her side, my T always reminds me that our actions will outweigh mom's words. I see it with SD I just hope soon we will see it with SS. Sadly I think SS is more like his mom and has taken on her unhealthy stuff. She is UBPD and it wasn't until after SS was born that all hell broke loose. SD was raised with some amount normal and I think bonded with dad, he was always more the caretaker for both the kids. When SS came along there were questions in DH's mind about paternity since they had tried for so long to get pregnant and it wasn't happening, then all of the sudden it happend. He found out after SS was born that the affair uBPDx had started right around the time she got pregnant. DH says the ex was way differnt during and after pregnancy with SS than she was with SD, he said it was like someon flipped a switch. I don't think SS experienced the attachment with mom early on and not as strong with DH as SD did, we attribute it to the nagging feeling in DH's mind about if he was really his or not. I would have to imagine that would mess anyone up, not to mention dealig with her at the time coming unraveled and him handling two kids, fulltime job while mom spend loads of money, drank a lot and didn't come home some nights. I can only hope that with T, our healthy realationship, our actions and time SS will not turn out to have the same character as his mother.

[livednlearned]

Here is the email exchange... what could he have done differently in communicating with SD's mom?

from DH to EX -

SD has expressed concern about missing school for her tonsils procedure, so I checked with the dr's office and they said they may be able to switch it to the week of thanksgiving and that way she wouldn't miss that much school. Your thoughts?

I tried to make sure my emails had closed loops, so nothing open-ended like "Your thoughts?" Because the truth is, I didn't want his thoughts.    It takes more upfront work to really nail down a watertight email, but that usually means you'll have less back and forth. If you need information from her, that can be a separate email. "Please let me know by day/date what your plans will be for the holidays."

Then use that information to beef up your main concern, which is to help your SD deal with her surgery in a way that is best for her. Just brainstorming, but something like:

"There are two other dates that D can have her surgery, Day/Date and Day/Date. Please let me know by tomorrow if you have a preference, otherwise I will confirm a date that works best for D and reschedule. I realized after we discussed this in the doctor's office that 12/3 won't work, and these are two other dates that the doctor has available. Let's focus on making this as easy and comfortable for D as possible."

I know this is a tidier version of what you have going on in your situation, but just wanted to deconstruct ways to minimize the back and forth (and giving her control or power). The are three things going on here:

1. figuring out everything in advance takes her out of the loop (ie. get the info you need directly from the doctor, not through biomom)

2. giving biomom two choices, both that you approve of, involves her without giving her too much responsibility or final say

3. having a consequence for non-compliance allows you to do something even if she does not respond.

She's not necessarily going to be agreeable, but you at least have set the parameters for the conversation.

There's also this:

4. avoid giving her too much filler information, otherwise she will start using those points to bend and twist.

5. a good solid sentence about this being about D

The last part of the sentence, "Let's focus on making this as easy and comfortable for D as possible" gives you a moral anchor that you can keep repeating whenever the conversation veers back to biomom's focus on HER needs, which should be secondary.