Thursday, October 29, 2009

When Toddlers Name Things

I still have my first teddybear. My mother is amazed he's still in one piece, since he's stuffed with rapidly degrading foam and covered with paper-thin fleecey stuff that has almost completely peeled off. Actually all that's left is the foam, turning to dust, in a netting that is the only reason Argle is still a bear. Yes, I named him Argle. How articulate were YOU on your first or second Christmas? Argle is what I called him, and so Argle was his name.
Kittyboy has a bear in a nurse outfit from his hospital stay, named Apple. As in the fruit, presumably. We don't know why. The yellow cichlid in a tank in the kitchen is Peekoo because that is how he says peekaboo, and she plays peekaboo with him, or so he believes. So Peekoo makes sense, but the world will never know why the nurse bear is Apple.
Better than Apple, though, is the fish we bought today. We went and bought a pleco to eat our algae in the big fish tank, and after we recovered from the unbearable excitement of BUYING A FISHIE, and poor fishie had gotten over the terror of being carried by a toddler and come out of hiding in the tank, I asked Kittyboy what he wanted to name his fishie. "Gank oo."
"So fishie's name is Gankoo?"
"Gank oo Gah."
"Your fish? What are you naming your fish?" I can't have heard that right...
"Gank oo Gah. Fishie gank oo Gah." He's used to having to repeat himself and clarify; obviously Mommy just wasn't understanding him.
"Your fish is named 'Thank you God'."
"Fishie GankooGah!" Proud happy smile, he has made Mommy understand now! Sometimes mommies just don't catch on the first or third time, you know.
As sweet as that is, I suspect there is indeed logic behind it, besides the precious thought that he is grateful to God for having created fishies to be our pets. One of his favorite meals is fish sticks, and he knows where food comes from and that God's creatures taste good. As we left Petsmart, he said, "Eat fishie?" and I had said no, this is a pet fishie, not for eating.
"Thank you God" is the prayer we taught him to say before meals..............

Monday, October 19, 2009

"The Song Remains The Same" - i.e. therapy is continuing

Therapy continues. Both speech and OT.
Kind of annoyed, but okay with it - should there appear a problem beyond just slow development, it is easier to show and seek treatment for if Kittyboy's already being followed. I can see the logic in keeping after him Just In Case. We could say, "Oh, I'm sure he'll have his pronouns straightened out and be speaking in complete sentences by the time he's, oh, four" but then what happens when he IS four, and still not using a, an, the, is, are, etc? Better that he be already receiving services and have the problem documented over time than have to start again. We know he's very intelligent, and he spends the whole day being spoken to, interacting with people, he loves being read to, but his speech scores are very inconsistent, and they shouldn't be. He should, at coming up on three, be giving a yes or no answer, saying a COMPLETE sentence (as in "The airplane went up in the sky" not "Airplane up sky"), and understandable three-fourths of the time by strangers - without context. He's understandable about fifty percent of the time with no context. If WE don't have context, we often have to play the guessing game. So speech continues - he qualifies because of articulation, but it's a good idea for word order and everything else as well.
And OT - Bree has been mentioning that he trips a lot in Speech, and Ginny's been noticing it too. We are continuing OT primarily to improve body awareness. When he's paying attention, he's a mountain goat, when not, he bounces off of walls (then again, I shouldn't talk, as I attempted to close a car door on my leg this morning - and I wasn't in the car). OT is continuing for sensory issues, basically.
So... huh. Kind of a let down. But not really, just a continuation. Nothing's CHANGED. He's just not all straightened out yet. And hey, he's my kid, he'll be forgetting to eat and closing car doors on his leg when he's 28.

Friday, October 16, 2009

The New "It" Music; or, The Byzantine Toddler

The Pascha right after Kittyboy came home, we got a CD of Paschal hymns from Greece. "From Greece" meaning that not only was the chanting entirely in Greek, there was no English on the packaging or the CD itself. This was GREEK.
And while it was majestic, transporting, awe-inspiring, and made me so crave to attend the church where that man chants, I could NOT sing along. Mr. Frank, at church, is on a whole different level from me in chanting, I mean, he Is A Chanter. But compared to me, the chanter on this CD is from another PLANET. It wasn't that I didn't know the hymns, it was that the style and ornamentation were so very Byzantine that I just couldn't follow. I was proud of myself just for being able to sing the harmony for the Glory To The Father.
Kittyboy wanted to take his Mary music ("Mayee! Faytokos! Mama God!) in the car with us to run errands. I grabbed that CD and what I thought was one of our recordings of chant in English, and gave him the choice. He chose the second - and boy was I mistaken, that wasn't a fancy font on the disc, that was Greek. It was the ultra-Byzantine CD.
Kittyboy's only heard the more ornate chanting three times, Pascha when he was four months, a year and four months, and two years and four months, and that's from Mr. Frank. He'd never heard anything quite like THIS. I figured I'd give it a couple tracks and see if he changed his mind. Change his mind he did not. We got to the first store in our three-store trip, and he didn't want the music to stop playing. I turned off the car - "Jesus music?" "No, we have to go inside now." "Jesus music inside? Okay." Thankfully he accepts me as a substitute for The Greek Guy. Every time I turned off the car, if the CD wasn't coming inside in his moist little hand, I had to start singing. Now it's the new sleeping music.

Monday, October 12, 2009

And the Speech news is....

Kittyboy's delay six months ago was 28-34%, 30% being what is considered in need of therapy (hence he "qualified by four percent"). Delay today - 21%! Woohoo, not only holding fast in his own curve but gaining. Sweet. I didn't think he was losing, but the gain is a happy surprise. Bree says articulation is just borderline 50%, he still qualifies on that, but he's way more understandable than he was six months ago. Among the questions she asked was, "How does he get your attention?" By continuing to repeat the same phrase over and over and over and over and over and over until it's like the droning of bees. He doesn't raise his voice, which is nice, but if he didn't GET my attention to begin with initially, say I'm washing dishes or in the laundry room, for me it only registers as background noise. Which is why he's added the tactic of grabbing my clothes and getting right in front of me, or if he can reach, putting his hand on my shoulder, leaning in so our noses are practically touching, and repeating said garble directly eye-to-eye. SMART BOY. He's noticed Mommy doesn't necessarily "hear" him unless he makes contact. It doesn't mean I understand him per se, but hey, then I know it's not random babble, he's communicating something, and can then resort to "Why don't you just show me?"
OOH. Starting tomorrow, I'm going to teach him, "Mommy I need you." He should be able to repeat that, and I will tell him that's what he says when he needs me. Followed by, when he's got me, the request.
And, "How does he ask for help?" By bringing you the thing and waiting patiently until you decipher what is wrong, or crying if he can't bring it to you. If you prompt him, "How do you ask for help?" he will make a noise and sign it. Help is not a word I've ever heard.
The majority of the evaluation was with a large flip book of pictures, each of which came with an instruction - "Which of these do you eat with?" "Which baby is sleeping?" and progressing to my favorite, pictures of a broken bike, crayons and paper, a book in a chair, and the scenario, "Katie hurt her knee. What do you think she was doing?" YEAH RIGHT! I giggled silently, Bree nodded with an understanding smile, and Kittyboy stared blankly, then tried to turn the page. Bree said, "Well, I have to keep going until he misses seven in a row." Which he never DID. We would have been there all morning. She finally said his scores were just all over the place, there were low-level things he was missing (doesn't answer yes or no really), though he has most of that section, there was a chunk of middle stuff totally absent (for example, wouldn't point to the nest that had no eggs, the basket that had no apples, etc, and got all colors wrong except yellow), but then there's a scattering of upper-level stuff he does get. Overall it came to a 21% delay, which is acceptable, but she wants him to continue therapy, so as to fill in the blanks and start speaking more clearly. And get some basics like yes, no (he says no, but not as an answer, as imitating what I just told him when he does something wrong, or when I say he can't have something), asking for HELP, etc.
So the verdict is... whatever speech therapy the school district throws our way should be fine! I told Bree that being all over the place is what he does best - like last summer when Fe (the OT at the time) thought he was just a genius, and Terri the SLP said that verbally he had an 85% delay. And both were true, Kittyboy was doing things involving reasoning that he shouldn't have known how to do, AND six-month-olds I saw at church were using more open consonants than he was.
Predictable is boring. He wouldn't want to be boring.

Wednesday, October 7, 2009

Why I now wear a knee brace - A Cautionary Tale

I now have a knee brace, courtesy of my doctor. I am a size medium in knee braces, which will be useful to know in case someone decides to buy me medical accessories for Christmas. I don't know why they would, but anyhow.
When Kittyboy came home, he had to be held at a goofy angle for bottlefeeding, and so to keep him at the right angle, he got fed propped on my crossed legs, and I spent a lot of my day on the floor sitting crosslegged. Up and down and up and down. Not that great for knees. One day I bent down from the changing table, screamed, and thought I wasn't going to be able to get back up. My left knee was in agony. My first thought was "No, this is really bad, I just blew out my knee." I did get back up, and of course I kept going, because I had an infant and a husband at work and had no choice, and by the time Husband came home, I thought the worst was over. And my knee did slowly get better, though it was stiff while it healed. But when it still hurt a month later, I went to our public aid doctor, because we had only public aid for insurance, and explained that I'd damaged my knee a month before, and though it was moving well again, it still hurt along the sides like it wasn't healing up well. She said it was arthritis. I said no, it isn't, it felt as if I'd torn something, and Tylenol doesn't do jack squat. She said to try other over-the-counter stuff. I went to Walmart, bought one bottle of everything generic, tried them all one after the other, and went back later to say, "They don't work completely, and I still say it's not arthritis." She said again that it WAS arthritis, and prescribed me Tramadol. That is a very powerful don't-mess-with-it painkiller. It's an opiate. I took one - my knee didn't hurt, for the first time in over a month. I was happy, I was so happy. My gosh, I could sleep pain-free again. Then I started noticing some balance problems while taking it (at the minimum dose of one a day). Basically, I got more and more sensitive to it, until I bought a knee brace and decided I was only taking it if I really, really could not stand the pain. I told myself, I've got a high pain tolerance, this stuff is scary, I have to do this. Then one day I just had to, I couldn't even sit comfortably, and an hour after taking it, I had the feeling of bugs in my skin. I was shaking. I had the symptoms of a heroin addict. I couldn't sleep. It took 24 hours before the "bugs" went away, and that was scary enough to make me not take it ever again no matter what, because obviously it and I were not compatible. Mind you, my knee didn't just hurt when I was moving it, it hurt at night when it was still. Our friend Carel and his brother were over that night, so I asked THREE football players (Husband played in high school) what they thought of what had happened with my knee, and all three said yes, it's a sports injury, everything I described was consistent with that, the doctor was an idiot.
And then we got insurance (nine months after the injury), we changed doctors as fast as humanly possible, and Dr. B said I'd ruptured a bursa (yes! I was right!), and a week of anti-inflammatories made everything better. Problem solved.
Since then, every so often, I'll step wrong and put my knee out again - feels a little like the joint's going to bend in a way it shouldn't, hurts like the dickens, and then it continues to hurt for a couple days. After all that time that I kept using it until we got insurance, I figured there was no point in going back to the doctor, my knee is just as healed as it will ever get and I just have to put up with it.
So I put it out again Monday night, got up Tuesday morning, and thought it was better until I got out of bed and bent to pick up my jeans. THAT hurt. I went to our wonderful Dr. Hendricks at last, because I'm just tired of it and I can't keep up with a toddler this way. I was explaining the whole loooooong story to the nurse, said, "I went the first time, said I had a joint injury that didn't seem to be healing right, the doctor said it was arthritis and to try different OTC stuff, I went home and tried one of everything, went back and said nothing worked and 'by the way, I still say it's not arthritis,' and the doctor said, 'well I still think it is!' and gave me a prescription for Tramadol," and at that the nurse's eyebrows went up, and up, and up. I liked that expression. So writing a scrip for a powerful painkiller is indeed NOT typically the first thing you do when something hurts. I'm thinking you usually try to figure out WHY.
Dr. Hendricks' first question was whether ANYONE had thought to x-ray it, the answer to which is no. Dr. B diagnosed based on my description of what happened and the stiffness when it was healing, i.e. exactly what I told the first lady who swore it was arthritis, except the medicine he gave me worked, which is how we know he and I were right. But no, no one's x-rayed, so Dr. H ordered x-rays to see if there had been any skeletal damage. There hasn't been, which is really good to know - the knee's not growing any spurs or looking ground down, it really is JUST the bursa being re-aggravated.
And now we know that when this happens, I should wear a knee brace for a couple weeks, rest the joint as much as possible, elevate when possible, take anti-inflammatories, and let it heal again. With arthritis you do exactly the opposite, since there you want to keep the joint moving so it doesn't freeze up. This is why you should make very sure what the injury IS when a joint hurts, because if it's one and you treat for the other, you WILL make it worse, either way, guaranteed. Taking pain relievers to keep moving was the worst thing I could have done.
If I'd gone immediately and gotten treated for the right thing immediately, it could have healed completely and this wouldn't be an ongoing chronic thing. It also might not have - the initial damage felt pretty significant - but at least it would have had a chance. Yesterday I told Husband, who was REALLY upset with the first doctor, that it's truly both our faults, because I KNEW she was wrong, and I should have either kept harping until I got somewhere, OR said, "You know what, she may be clueless, but I do know what happened, I'll just ask around on my own and find out what to do for a sports-type injury." I didn't even do THAT, I just ignored it. I could also have tried to change doctors at the clinic. What I should NOT have done is sat down and shut up after the second appointment.
I now realize that telling myself "Well, as long as my knee doesn't hurt, whatever..." is the same thing as saying, "If I don't open the overdue bills, they'll just go away."
But my knee IS feeling better faster with the brace during the day and the Lodine, and a lesson has been learned!

Monday, October 5, 2009

The Next, and Last, IFSP

So, the next and last IFSP for Kittyboy is going to be two weeks from today. I don't know why therapists don't get more than two weeks notice, considering the paperwork involved in evals and reports, but there you have it.
As I've mentioned, we anticipate Kittyboy TOTALLY clearing OT. There's nothing going on sensory-wise that we can't handle. And I would have expected him to leave Speech behind as well, except... the older he gets, the higher they raise the bar. He MAY still qualify, because although he's attained two-year-old level verbal language (a stranger could understand probably 50% of what he says), a three-year-old is expected to be understood 75% of the time (again, by a stranger who is unfamiliar with his particular "dialect"). The equation is 25% per year of age. Yes, that does mean that you should be able to understand one hundred percent of what your four-year-old tells you. When Bree told me that this morning, I STARED at her, and then I said I'd known many kindergartners in SCOPE who REALLY, REALLY, REALLY qualified for speech therapy.
I once had a conversation with an absolutely precious five-year-old girl, who was getting anxious because her mommy was running later than normal. I asked her what her mommy's car looked like, and she said it was a "gavudabu". A what? "It's a gavudabu!" And that was the only description I could get. Clearly, that was supposed to tell me something very significant about her mother's vehicle. After some time, the light came on - CONVERTIBLE. "Is her car a convertible?" "Thas wha I said, a gavudabu!" Yup. (Should I ever have a convertible, my license plate will be GAVDBU).
We've got Kittyboy saying "potty" when he needs to go, because "toilet" (though he does say it) sounds like a fourth of his vocabulary. It has to be something we can understand. I guess a lot of his speech we do translate from context - tractor and chocolate, for example, are not much distinguished from each other.
And he'll be three on Christmas, so that's the standard they'll be using. Since what he will say far outranks what even WE actually understand, he may well still need Speech, I don't know. It's not vocab, his vocabulary is GREAT - it's enunciation. (Man, they're picky!) But yeah, I can see where enunciation would be almost as important as vocabulary - can't communicate if you're not understood.
Dilemma - if he still qualifies, it will be the school district which picks up his therapy. Good news, they do have to provide services whether or not he goes, and what they provide will be free - bad news, they do not provide as MUCH to children who aren't attending. A kid in Early Start or Headstart or whatever they call it might get half an hour twice a week - one who's not attending might get half an hour every other week, or even just once a month, in which case, what's the point. We can go to Childrite where he's been going, privately, though insurance would NOT pay for it (we already know this).
Off the top of my head, if he does still qualify, my ideas are as follows -
Discuss by what percentage he still qualifies, and find out how important they think it is that he does continue to receive services. If it's the same small percentage by which he qualified six months ago, then he's just continuing to progress at the same delayed rate, no big deal. If, on the other hand, he qualified by 4% six months ago, and now qualifies by much more because of the higher expectations of being 3 (i.e., he's not maintaining the same learning curve, but instead falling further behind others in his age group), eeehhh, we'll see how much the district WILL do if he doesn't attend preschool, and whether Bree thinks it's enough to be worth it.
IF the delay, relatively speaking, is something that warrants continued therapy, and IF Bree thinks the "out-patient" district services aren't going to be enough, we would have things to think about. One thought being, eeehhh, find out how many hours a day Headstart, Early Start, whatever it is, is, and how flexible they are on attendance, and go from there.
It's all academic though, until the evals are done. I just like to keep in mind, "Okay, worst case scenario, what would we do next?" Something I learned from my dad, WHO, by the way, has a blog now, I highly recommend it.

Thursday, October 1, 2009

Killed a Spider - Still Jumpy

I have so far managed to not raise a fellow arachnophobe, only because Kittyboy's not that observant. I took down a basket of stuff for him to play with, out crawled a white recluse. And since Young-And-Impressionable was at my side, I could NOT scream my head off and leave the room. Worse, my son sat down NEXT TO the basket, and started pulling things from it oblivious to the large white spider running around the rim of the basket. I managed somehow, I don't know how, to keep from actually making any sound whatsoever, I grabbed a book, knocked the spider off, and tried to smoosh it. Spiders are resilient. Since it was on carpet, the first THREE TIMES I picked up the book, it kept running around. I had to put ALL my weight on the book and move it around before I picked it up and spider was no more. Kittyboy sat happily playing the whole time completely ignoring me. So then I just sat there holding my knees and shaking for a few minutes. I. HATE. SPIDERS.
Half an hour later, I'm still twitching.
Give me a bull snake in the bathroom any day of the week.