Showing posts with label communication. Show all posts
Showing posts with label communication. Show all posts

Monday, May 27, 2013

Normal

It's been well over a month since Wyatt's surgery.  I am starting to feel like my self again only now, after two sun-filled weekends at home.  According to the experts, this is a 'normal' reaction after an extended period of stress, after a perceived threat (in this case, to a loved one).  Despite my profession, I have to keep reminding myself that a low period after a time of intense stress is to be expected.   It's a natural reaction, especially when you consider that my [often precarious] work-life balance was tipped dramatically in one direction then quickly pushed back again. After the surgery, I was going along at a pretty good pace too, or so I thought... until I found myself in an empty room, unsure what to do, straining to hear anything over the silence and my own breathing.  The sudden absence of a presence, one that had haunted us for over two years, left a void that I had to fill.  Over time I did that.  I've made it my own.  After spending time with my family, after spending time in the garden, I feel better.  I feel more like myself; our family life has cautiously settled back into its own rhythm.  Wyatt's progress has been a big part of that:  his rapid healing, his adaptation, his overcoming of things like sore muscles and wired ribs that feel weird has helped us all maintain some clarity as we assume our 'new normal'.  Our post surgical normal.  Our brave new world.

The idea of "normal" seems to have became a theme in the time since my last post.  I swear, I'm running across examples and discussions about this all over the place.  This concept of normal vs broken seems to be a real thing in the DS community (if you can even call it a community any more).  When you think about it, it's no wonder really; after thousands of years of looking at those with Down syndrome and those with intellectual disabilities as "less than" or "broken", modern society is struggling to give these ideas up.  These concepts are familiar and comforting, like an old blanket.  However, it is time to evolve and "put away childish things", as it were.  People with intellectual disabilities are here, have value and worth.  Different.  Equal.  Not separate.

I will agree that the extra chromosome gives a lot of unknowns, a lot of variables.  My first, "typical" child was a "What to Expect..." baby.  Every month there would be a new list of goals, of things he "should be" doing, things he "might be" doing and things that would be coming up soon. Spoiler:  he didn't follow the lists.  Quinn was barely starting to walk at 18 months, but had the vocabulary of a child much older.  He didn't play with toys conventionally either, preferring to figure out how they worked and then make some kind of art statement out of them.  

What we've realized with Wyatt is that development is non-linear.  It is fluid.  He does not progress along a predictable path towards a readily recognizable outcome.  It may take him months to finally realize that tapping his spread palm to his chin means "mother", but in a short period of time can polish off a few skills that took his typical siblings months to reconcile. Instead of sitting still while he recovered from open heart surgery as he could no longer crawl, he instead adapted and learned to "scoot'.  Holy cow is that kid fast.

Even amongst children with DS, there are no set rules.  Not so long ago, pediatricians everywhere adopted a series of Down syndrome growth charts, which for chart/graph minded people like pediatricians, seemed to be a good thing.  It helped everyone to get over the idea that kids with DS were "poorly" due to their (generally) smaller stature when compared to their more typical peers.  These charts are now falling by the way side as not every kid, especially the ones with DS, adheres to a regular growth pattern.  None of my kids have, that's for sure.  Growth charts are a touchy subject with me anyway as I am the Mom of two preemies.  I've found myself shifting from foot to foot with irritation at a number of appointments, as I watch my two obviously thriving children not "measuring up" to what some chart has to say about "healthy growth".

Wyatt, even with his (previously) busted heart, is not broken or deficient.  He does look slightly different than other children I guess.  Most people that see him or his pictures want to nibble him, so I can only assume that he's a pretty good looking kid (which, as his mother I suspected all along).  None of my three look exactly the same...  Quinn is currently in a bag-of-antlers stage, with stunning blue eyes that make you want to fall in and drown. He's also in that stage where some of his teeth are loose, some are sticking out at odd angles and the new ones look like they belong to a horse.  Zoe has my olive complexion.  She has straight hair--which is a sharp contrast to both her brothers and their blonde curls--and soft brown eyes that can go from molten chocolate to granite in seconds. She can also do bridged lateral push ups between the couch and the coffee table.  Genetics are a wonderful thing.  However, due to some physiological differences, Wyatt is considered to have a "visual disability".  It is "visual", as you can see it and therefore--if you talk to a large (ignorant) percentage of the population--get to pass judgement instantly on his abilities by just looking at him.  A casual glance at his twin would not reveal that she has a lisp or delays in her speech or hand tremors that often occur with prematurity.  However, Wyatt, due to the shape of his eyes and his button nose, perhaps the way he holds his mouth or curls his toes, is immediately "recognizable".

There are no delusions about the future.  Wyatt may develop some behavioral problems, that is true.  Having been in Mental Health for years, the place where people with "outbursts" of all shapes and sizes end up, I've had my fair share of experience in this area.  I also know how many of these come about and how easily many instances can be both exacerbated or prevented.  He may not face this, either.  He may speak 'clearly' by conventional standards, or not.  Perhaps he will not speak at all.  Regardless, he will be able to communicate his wants, needs and desires quite well.  You will need to possess the willingness to listen.  It doesn't take much really, other than an attention span and patience that lasts more than a beat or two.  I also won't know until they are grown up whether any of them will have schizophrenia (as I have two cousins with this), will suffer from depression, have diabetes or cancer.  There are variables with all my kids, just like your genetic code will dictate whether your kids will develop the issues that occur in your family. 

I guess, in my mind, that's what really set the "This is Down syndrome" list of illnesses and disorders away for good.  Yes, my kid does go to a lot of doctors.  So do I, when you think about it... and I consider myself to be a reasonably healthy person.  To put it another way, here is a list of things that can "go wrong" if you happen to have Trisomy 21.  Here's a list of things that can "go wrong" if you are human:


It's a big list...


Homo sapiens are a diverse bunch, full of colours, shapes, sizes and bodies that ultimately break down, no matter how much we exercise or how organic our produce is.  Or how many chromosomes we may or may not have.  We are all broken, if that is the criteria you use to determine worth.

I think the sooner that we as a species, realize that all of us have equal value, the sooner we will stop hearing stories like this one, where a hotel in Spain refused to allow children with Down syndrome as they would be "disruptive".  We'll stop perpetuating myths that our kids with intellectual disabilities have an unholy attraction to water or wandering;  kids without DS can drown and bolt without warning just as easily.  I know this, I was that kid.  I would routinely wander off, especially in public.  My mother can tell you many stories about how I would hide in clothing racks or just get lost, period.  My mini-me daughter is shaping up to be the same too, which is going to mean a lot more grey hair in the future (assuming it doesn't just give up and fall out).  Everybody wanders and gets confused by their surroundings from time to time.  If you don't believe me, watch a security camera in a hospital for a length of time.  Trust me, I've seen some things...

Normal, as they say, is simply a setting on the washing machine.  When it comes to people, there really is no such thing.  We're all bags of quirks and "illness" and here for a very limited time.  That includes our members with developmental delays and intellectual disabilities.  There is no "less than".  There is no broken.

There is life:  messy, glorious and mostly mercurial.

Wednesday, May 1, 2013

In the News - April 2013

Every month I compile a list of the stories I post on Down Wit Dat's Facebook page. They are stories of activism, of inclusion, of advocacy, of education, of hope and awareness. April was a busy month, including the ongoing efforts of the Down syndrome community to demand justice for Robert Ethan Saylor and to illuminate an ongoing bias towards those with Trisomy 21. 


Legend:
AUDIOindicates an audio clip
APPEAL indicates an online petition or plea
BLOG indicates a blog post
EVENT indicates a scheduled event
LINKS indicates links or resource materials
PHOTOS indicates photos
STUDY indicates a study
THREAD indicates an online discussion thread
VIDEO indicates a video

BLOG
The weirdness of being told that the death alternative is the one I should consider.

Read more here: http://www.islandpacket.com/2012/12/01/2295922/beaufort-teen-with-down-syndrome.html#storylink=cpy
BLOG
Support flows for woman with Down syndrome mocked by radio DJ - See more at: http://www.dispatch.com/content/stories/local/2013/01/31/support-flows-for-woman-mocked-by-radio-dj.html#sthash.ZV10BbV0.dpuf
Attitudes about Disability Prove Almost Lethal
Support flows for woman with Down syndrome mocked by radio DJ - See more at: http://www.dispatch.com/content/stories/local/2013/01/31/support-flows-for-woman-mocked-by-radio-dj.html#sthash.ZV10BbV0.dpuf
Support flows for woman with Down syndrome mocked by radio DJ - See more at: http://www.dispatch.com/content/stories/local/2013/01/31/support-flows-for-woman-mocked-by-radio-dj.html#sthash.ZV10BbV0.dpuf
Support flows for woman with Down syndrome mocked by radio DJ - See more at: http://www.dispatch.com/content/stories/local/2013/01/31/support-flows-for-woman-mocked-by-radio-dj.html#sthash.ZV10BbV0.dpuf
BLOG
BLOG
VIDEO
BLOG
Cutting Our Teeth on a Paradigm Shift –
BLOG
Antidote
BLOG
Questionable Parenting (this post is funny) –
BLOG
Ask the FBI What is Going on in the Frederick County Sheriff (Day 2 of “8 Days for Ethan”)
BLOG
Public Awareness and a Redress of Grievances (Day 3 of “8 Days for Ethan”)
VIDEO
APPEAL
BLOG
EVENT
Annual Inclusion Awards


BLOG
BLOG
Let’s get some National Advocacy (Day 5 of “8 Days for Ethan”).

BLOG
BLOG
BLOG
Who will speak for Ethan Saylor?
EVENT
LINKS
Sunday Blogaround - 4.7.13
BLOG
LINKS
42 Great Down Syndrome Resources You Should Know About
BLOG
Mom, I Hate Having Down syndrome
BLOG
BLOG
BLOG
BLOG
BLOG



VIDEO
EVENT
BLOG
A Game-Changing Treatment for ADHD
I Married a Pygmy –
A Game-Changing Treatment for ADHD
BLOG
LINKS


BLOG
BLOG


BLOG

BLOG
BLOG
The special education that we really need…
BLOG
LINKS
BLOG
LINKS
DS Research 101: Part 2
BLOG

BLOG
BLOG
VIDEO
VIDEO


BLOG
BLOG
BLOG

APPEAL

EVENT
BLOG

BLOG
BLOG



VIDEO


BLOG

VIDEO

VIDEO
VIDEO

BLOG



This month:






Fairytales, a post from September 2012, tied for a "SWAN" for "Best International Post." 

This month also saw the creation of the Surgical Suite:


...And that's the news.  Keep the stories and information coming! 

Thursday, October 18, 2012

Therapy Thursday: Speech and Language, Part 1 (31 for 21, Day 18)

The development of speech and language is important for many reasons, including the formation of both cognitive and social skills.  To children with Down syndrome, early interventions in this area are very important.  Cognitively this is important as:

  • Increased vocabulary translates to increased understanding of the environment
  • Using language increases thinking and reasoning abilities

Whereas socially, language:

  • Gives the ability to navigate through world
  • Helps control behaviour (by being able to express thoughts, feelings and desires)

The delays with Down syndrome are not universal;  not only do they vary in severity between individuals, but they also occur only in certain developmental areas and not others.  In regards to both speech and language, this area is fragmented into some skills being strengths and others 'weaknesses'.


Strengths

  • Social development
  • Social Understanding
  • Communication (non-verbal, gesturing) 
  • Visual short term memory 
  • Visual-spacial processing
  • Perception
  • Socialization
  • Development of daily living skills

Weaknesses:

  • Development of spoken language (phonetics, syntax)
  • Problems with speech (planning, articulation, phonology)
  • Delayed acquisition of vocabulary (which is understood much before it is used) in early years.  (This becomes a strength however, by the teenage years)

'Receptive language', that is, the language that is understood, is much more developed than 'expressive language', or the language that is able to be spoken.

There are a variety of reasons that the development of speech and language are impacted by Trisomy 21.  They include:

  • Impairments of brain functioning which impact the phonological loop of working memory
  • Hearing deficits (including conductive, sensorineural)
  • Oral-motor difficulties (which will impact speech-sounds and word production), found with structural, muscular or innervation differences.
  • Vocabulary delays

[Next week:  Strategies for early intervention]



Buckley SJ, Le Prèvost P. Speech and language therapy for children with Down syndrome. Down Syndrome News and Update. 2002;2(2);70-76.

Martin, Gary E., Jessica Klusek, Bruno Estigarribia, and Joanne E. Roberts. "Language Characteristics of Individuals with Down Syndrome." Topics in Language Disorders 29.2 (2009): 112-32. Web.


Sunday, October 14, 2012

Care and Feeding of the 'Special Needs Parent' (31 for 21, Day 14)

It's only human nature to be weirded out sometimes.  We have a limited capacity for accepting new things it seems;  I see it on the faces of all the new people at work all the time.  I work in mental health, an area where I have seen some things in my day.  Lots of scary things, lots of very sad things.  It doesn't matter who it is either, could be a nurse from another department, could be a visitor, a doctor, it could be a new security guard... they all get that slightly fearful "I don't know what I am looking at or quite what to do right now" look.  Often there is a stunned silence that goes with it.  I watch this and I intervene when and where I can.  In the absence of experience, a little health teaching can go pretty far sometimes.

I ran into a lot of that with Wyatt's diagnosis too.  Down syndrome is not a scary or weird or sad thing as it turns out, but at the time... well, I thought it was.  I had a lack of knowledge, so I began teaching myself and then others about Down syndrome.  In the interim, the health teaching and increased knowledge gave me comfort where I did not have experience.  Now that I have some experience (at least almost 20 months worth) of this 'special needs' Mom gig, I feel much better, but I am continuing to learn.  I still see that look sometimes though, on friends, family, colleagues... strangers in the supermarket.  Sadly, the knowledge deficit that I had is peanuts compared to the rest of the world.  The last generation or so of people with DS have come so far and right now we are on the threshold of something fantastic.  The life expectancy has gone (in my lifetime) from 25 to 60+ and with each new discovery, is climbing higher and higher.  We have not yet completely tapped the cognitive potential of the Down syndrome brain either.  In the next few years we will see some serious advancements.  Sadly, most people will never hear or know about it, or even believe it once it happens.  It's too weird.  The stigma runs too deep.

As a parent of a little boy with Down syndrome (and of twins), I am aware of all these exciting things.  I am also aware of a lot of things that we 'in the community' have to put up with all the time that you may not know exist.  I'm not asking to be treated like a Fabergé egg, don't get me wrong.  However, if I am edgy or tired or tear up easily, there probably is a good reason for it.  I'm not clinically depressed, thanks.  I'm not sorry my son has an extra chromosome either.  I would however, like to point out a few things that you may be unaware of.

The R Word

Please don't ever use it in my presence.  I am speaking of the R word or "retarded".  It is the most offensive thing that you could say, ever.  I would rather you punched me in the face or dump a bucket of raw sewage over my head as both of those are easier to deal with.  That goes for any word with the suffix "-tard" at the end, no matter how 'cute' or edgy it may seem.  I have said, in detail, many times what that word represents.  Others have said similar.  It never seems to be enough.  When you describe your dog using this word as he's tracked in mud or use this word to describe your boss, the cop giving you a ticket... whatever small insignificant annoyance has troubled you... you completely and utterly demean everything that my son does and will ever do.  You demean my family.  You demean me.  It is a name of oppression, it is a word of hate.  Do. Not. Use. It.  Ever.

FYI:  Citing free speech or artistic freedom or some other thing to cover your bad behaviour only makes you look like more of an asshole. 


"I am tired"

Nowadays, it from shift work and two teething toddlers.  However, we 'special needs' parents lose a lot more sleep on average.  Lack of sleep will do a number on a person;  I swear that 80 percent of my patients just need a decent night's sleep.  Being tired not only interferes with mood and brain functioning, but it can also contribute to things like weight gain and lowered immunity.  If I have a nap on my break, don't assume I've been up all night partying.  I've probably been attending to one of my kids or the laundry monster in the basement.  Besides, I can't remember the last time that I was up all night partying.  If I do have a glass of wine, it will occur in the hour between the last kid going to bed and when I fall asleep in the chair/couch/drooling on the laptop.


"I am worried"

I worry about a lot of stuff, even if I don't show it all the time.  I worry about my son's heart and his upcoming surgery.  I worry that my eldest will be bullied as his younger brother has a learning disability.  I worry that I won't live to the point where my kids don't need me any more.  I worry that my daughter is going to end up with some narcissistic antisocial jerk that treats her like crap and she loses her amazon spark.  I worry that the lady behind me in the supermarket who is peering at my twins and wondering why the boy looks a bit different is going to say something stupid and I will get into a fight right there as I am trying to scan my fabric softener.

All parents worry, that is true.  We worry more.


"I don't want to talk about it" and "I want to talk about it"

I blog as a type of therapy, this is not a secret.  Most of the time I "get it all out" in this format, my page or my group.  As a result, I probably won't feel like talking much when you approach me looking for an update.  Honestly, I'm not trying to be difficult when I say "read the blog", it's just that I've said it all already.  I'm a better writer than I am a public speaker so you will probably get the best answers here anyway. 

Some days are different and in the course of a conversation you and I will stumble on some new research or nugget that I have discovered.  Just let me geek out a bit, ok?  I promise I will listen to your tales of knitting or how many squats you did or whatever it is in particular that you are interested in.  Down syndrome is more than just something my son has;  as I continue to learn more about it every day, it's become a hobby for me in a way.


"I want to hear about your kids" and "I don't want to hear about your kids"

I love my nieces and nephews.   I love all the little people that are in my life.  I love sharing in their triumphs and developments.  Please, share them with me, guilt free.  If, at some point, I suddenly excuse myself to use the washroom and come back with red eyes, just let it go ok?  I'm probably having a bad day.

What I won't do is get into a "pissing contest" with other parents, especially those whose kids have special needs.  It is not a contest.  No one wins if they prove they have the sickest kids and the most on their plate.  Stress is subjective, as is anxiety and grief.  I will help, support, validate, care and love you when and where I can.  I will not feed your ego.  With that;


Bullying is everywhere

I don't want to hear about people having to 'just toughen up', ever.  I have 'toughened up' more than most people will ever comprehend (sadly, that is not idle boasting).  Bullying is a real monster and I see it everywhere.  It is in the schoolyard, on the school bus.  It is at my work, in the form of lateral violence between my colleagues and between departments.  It is in every online chat room, in the comments of every page, in every forum and especially on Facebook.  Trolls are everywhere and sadly some people have so little in their lives to fill them up that they get off by being hateful in a semi-anonymous forum.  I am a target as I am "out there" being an advocate for a highly marginalized group of people that get made fun of an awful lot.  I also speak my mind and consistently call people on their bad behaviour; I don't care who they are.

What may be a surprise to some is that bullying exists in the special needs community too.  I've seen fans from one special needs page troll another special needs page for a difference of opinion.  There's a lot of passive-aggressiveness out there in "the community".  It's particularly sad as it diverts energy that could be making things better for everyone.  Things are very compartmentalized in the special needs world, based along diagnostic, political or religious lines.  It's kinda ironic that a bunch of folks that ask for inclusion can't practice it amongst themselves.  All are welcome at my table;  many of my readers don't know anyone with Down syndrome but recognize that the paths that we walk are similar.

Bullying is a trigger for me.  It is never a joke and never tolerated.


Coping is as Coping Does

Coping, like stress, anxiety and grief, is subjective.  What works for me may not work for you, just as what stresses you out might just 'roll off my back' like water off the proverbial duck.  As long as what we are employing as coping mechanisms isn't destructive and does not interfere with the rest of our lives, it's okay.  That may mean building a fort in the closet one afternoon.  It may mean a glass of wine or two (or three).  It may mean extra long runs in the rain.  It may mean recreating the Sistine chapel on your bathroom ceiling, it may mean simply approaching a problem from a different angle.  It may mean all of those things or none of them.  Whatever works, man.

I use an analogy that I share with my patients a lot.  I have, in my mind, a coping "toolbox" that I use to battle stress and anxiety.  It has a variety of specialized tools that I employ at specific times based on my stress levels.  If my stress is low, I may hang out on Facebook or read or blog.  If my stress is higher and I find myself unable to concentrate on those things, maybe I'll walk or pull weeds in the garden or sort out the toys.  I wouldn't use a wrench instead of a pencil, so I don't try to read when I am particularly anxious.  I have different techniques (or "tools") for different situations which allows me to be prepared most of the time.  My tools are as varied as I am and can range from wandering around the yard with a camera to helping out one of my Facebook friends with a problem.  None of it is wasted time.

On a related note, I finally found the answer to "I don't know how you have the time to do it all."  You know all the time you spend at the nail salon, doing your hair, painting your toenails, watching tv, playing sports, visiting friends, going to classes or building things?  Yeah... I don't do any of that.


Parents of 'special needs' children are special in their own right sometimes.  We still have the same hierarchy of needs that everyone else does (thank you Abraham Maslow), but in order to achieve happiness, we have a few more quirks than most.  We are, however, not fragile snowflakes or weird specimens.  We are people whose kids have a few more hurdles than the rest... and they aren't weird either.

I have a little joke that I share with new people in psychiatry, especially the students.  I tell them to "always know what side of the glass you are on".  It's not an 'us vs. them' thing, rather it is a matter of perspective as to who is on the 'inside' and who is on the 'outside'.  Both sides sees the other as bizarre, ill and often, ignorant.  The trick is to create a space where the glass is no longer necessary;  hopefully with a little education and understanding we can all be happy, fulfilled people.

In the meantime, don't get huffy when I am a bit off, or I forget to call or you encounter one of the things I've mentioned here.  On some days it is harder to choke down the extra helpings on my plate.  Instead, pull up a chair.  Offer up an understanding ear, or if you dare, dig in a spoon.  You'd be surprised what flavours will greet your senses.


Friday, May 4, 2012

What a Long, Strange Trip it's Been

The last little while has been a complete blur of appointments and late nights.  Copious amounts of carbs have been consumed (and cheese, most often together).  Much sleep has been lost or interrupted.  Tempers have been a bit short on all accounts, including both of us, the kids and the people that we have had to interact with.  At various points, this past week has seemed to never want to end.

It started the day after the birthday party (Monday, April 23rd).  We had an OT visit where several things were looked at in detail.  One, how well Wyatt's mobility has come along in the last few weeks.  Since the last update, he can make his way across the floor, half dragging, half commando crawling.  We have not seen him sit up (by himself) since the party, however he has come very close several times.  It's probably like the rolling thing;  we won't actually see him doing it for a while.  We'll just look over and assume he just teleported, or in this case, was magically repositioned while we weren't looking.  We are trying to get him to understand what his legs and feet are for (other than additional hands);  we have a variety of sitting/kneeling/bent over positions for him to practice and to get used to putting some weight on his legs.  So far, not much, but we are trying.  Point of interest number two:  how far his eating skills have come in the same amount of time.  We talked about finding a good time for another speech-language assessment before the OT left.  We should have an appointment by our next visit.

The following day (April 24th) meant an appointment with the pediatrician for both Wyatt and Zoe.  I don't know about you, but a snotty receptionist can really set me on edge.  This one in particular seems to have majored in Passive-Aggressive with a minor in Bitch.  The day before, she had telephoned to confirm our appointment.  During that call, no actual appointment time was mentioned when she spoke to my husband; I assumed I had the correct time listed in my phone.  You will imagine my surprise as I blustered into the office, 15 minutes early (for a change!) only to be met with cold silence.  Once I had dug out our health cards and settled my daughter (who had just had what could only be a harrowing stranger experience in the elevator with a kindly old man who told us all about his twins), I turned to face the receptionist.  She barely made eye contact, quickly scooped up the cards and said quietly "I just called your house."  "Oh?"  I answered, confused.  "What's wrong?"  "You're half an hour LATE!" she informed me in clipped tones, barely containing her hostility.  I whipped out my phone to check the times and surprise, there was no match.  For some reason, our appointment had been moved to 9:45.   My husband (to the receptionist's surprise) walked in a minute later and reminded her that she did not mention a time on the phone and therefore, did not confirm the appointment properly. Mistakes had been made all around.  There was another period of awkward silence, where I prepared to get comfortable in the waiting room as I figured she would now make us wait.  A few minutes later, she approached the babies with artificial sweetness and told us that it was time to come in.  We maneuvered our beast of a stroller through the narrow hallways into the exam room and began to get them undressed for their weigh in.

Aside from that little bump, the rest of the appointment went well.  There was no one else in the office at that time, so the doctor was able to see us.  Zoe now weighs 9.14 kg (20.1 lbs) while her now little brother Wyatt weighs 7.95kg (17.49 lbs).  They are both small for their age, at 70cm (27.6 inches) and 67cm (26.3 inches), respectfully.  Their big brother Quinn was 25 inches at birth, just to offer up a little comparison.  Both rank somewhere in the 5th percentile for height on their respective charts (although Zoe has crept up a bit in the weight department).  Numbers aside, both are happy, healthy infants who are doing well in their own way.  Wyatt attempted to sit up while we were there, which made the doc happy.  Zoe wasn't too keen on walking barefoot on a cold floor, so she did not get to show off her running prowess.  The doc made sure that we got an actual appointment card this time and we took our leave.

Wednesday (April 25th) was the ENT.  Sean took Wyatt by himself, as it was an early morning appointment and it interfered with Quinn's schoolbus time.  I was expecting the boys home shortly after 10 but they didn't arrive until 11:30 or so.  I was a bit confused at first, but Sean explained that our bad doctor karma from the day before had spilled over into this appointment as well.  Although they were on time, the ENT was not.  After sitting for almost an hour, the doc wandered in the front door, ignored what was now a packed waiting room, went straight to the back and had the first patient sent in. It was apparent that he was in a shitty mood by the time Wyatt's name was called;  he then proceeded to take it out on Sean.  We haven't been exactly diligent with remembering to put drops of mineral oil in Wyatt's ears (to keep the wax loosened) and the doc let Sean know a little more brusquely than necessary that this wasn't cool.  In fact, his tone suggested negligence.  He even went so far as to accuse Sean of using Q tips on him which, if you don't know, are a no-no with ears as they are self cleaning (Q tips just impact the wax).  Sean tried to explain how we never use Q tips and clean only the external ear and when that was completely ignored, he half-desperately threw in a "you know my wife is a nurse, right?"  for good measure.  This all had very little effect on Dr. Grumpypants who continued by demanding to know when Wyatt had a specific hearing test done.  We do keep on top of all his hearing appointments, but lets face it, we have no idea what exact tests are taking place, just what the results are at the end.  This was not an acceptable answer either and prompted him to place an angry call to the audiologist's office. After extracting the gunk from Wyatt's ears (which, wasn't too bad at all), the boys were then sent back to the waiting room to wait.  During that stay, Sean overheard the secretary talking to the audiologist's office and learned that the specific test that the ENT was peaking about was not done at the last appointment... as it had been done at the one before.  This fact would have been apparent if he had bothered to read Wyatt's chart. A more sheepish ENT called them both back in to let them know the results of the hearing test and that based on that information and the examination that he had just performed, Wy's ears are just fine, thanks.  See you in 6 months.

Flash forward through a whirlwind of my 6 year old's actual birthday (April 26th), one twelve and one 16 hour night shift (April 28th and 29th).  It was now Tuesday of the next week (May 1st) and time for Wyatt's sleep study at Sick Kids.  Prior to this, we had to fill out a sleeping/eating log for 10 days;  it was only through some miracle that I remembered to yell at someone at the last minute to grab it as we were going out the door.  Even for overnight, I had to take a lot of stuff for me and one baby.  Jammies, diapers, wipes, cream, pillows, emergency bottle, Tylenol, toys, 'whoosh whoosh bear', the stroller to push all our stuff around in... plus I brought the laptop "just in case".  Although it turns out that there is a complementary TV in the room (and free WiFi!), I wanted the ability to play a movie or write/fool around on the internet if I couldn't sleep.  I figured that, much like sex in the champagne room, there was no sleep in the sleep study.  I had no idea how right I was going to be. 

It was a good thing that we arrived early as it gave me a little extra time to get lost.  It's a pretty straightforward hospital in most respects, but you have to trust me, getting lost is a specialty of mine.  Sean claims that I have a compass in my head like everyone else, but unlike everyone else, mine is broken and just spins.  I do make up for this with my map skills...  To prove this point, seconds after I discovered a wall map, I found the Atrium and the elevators that I needed.. 

Sick Kids is a fabulous place... I have mentioned this before.  The main elevators are a sunny yellow and the whole place looks like it was designed by a toymaker.  However, if you have vertigo like me, it's a little unnerving getting from the central elevator hall to one of the quads. 

Sick Kids hospital atrium
You can see the yellow elevators on the left.  Photo courtesy of skate_simmo
We were greeted by our Tech who assured me that they do sleep studies on babies all the time. In fact, last week he had three babies there at the same time (the lab has four beds).  We were shown to our room and I set everything up while Wyatt got to play in his crib a bit and stretch out after the car ride.  I realized somewhere during my exploration of the room that psychiatry has ruined me:  the entire time I was setting up, all I could think of was how unsafe the room was.  Including the closet, which was just the right depth and had a bar in there that someone (small) could hang themselves with.

Our room fo the sleep study.  My day bed is in the back there.
Our room.  My daybed is in the back there

My bed.
My bed.  I've slept on a lot worse, trust me.  For my convenience, I'm right next to the hanging closet.

Baby logistics is another specialty of mine.  Knowing that I had to feed him for him to go to sleep and assuming that there was a tangle of wires in his future, I had to work out how we were going to do this.  Our Tech and I talked about it and he would come back to wire my son up when he started to look a little sleepy.  I tried to make Wy feel as comfortable as possible;  he had a few toys there, a few homey smells and I set up the laptop and streamed some music for him (they have a radio on all night for noise and company).  He started to look a little droopy and I called our dude in to (literally!) hook us up.

For those that don't know, during a sleep study you are monitored for quite a few things.  Your heart rate, your breathing and your oxygen/CO2 levels are important.  They also monitor brain waves so that they know how asleep you really are. Finally, they monitor movement, to see how restless you are.  Basically this translates to an ECG, an EEG and an oximeter.  There was also a camera in the room and an observation window if needed.

In total, there were about 20 'leads' or wires about his little person.  Two on each of his legs, four on his chest and the rest on his head.  There was also a O2 sat (oximeter) on his toe an a CO2 monitor on his chest (that was relocated to his back in the middle of the night).  He looked like a little Borg.

You will be assimilated
Resistince is futile.  (He's not crying BTW, just mid-babble)


He got a little Teletubby hat made out of some Surgifix (stretchy tube mesh that they put over IV's and lines and things) to keep the wires on his head.  The Tech put a towel over the lead box on the bed hoping that Wyatt would forget it was there and I was given the OK to feed him.  I set up shop beside the bed, gingerly pulling on the wires all the while hoping there was enough slack.

He wouldn't sleep for love nor money.

Usually he falls asleep during his bedtime "snack".  No dice.  I whipped out a bottle of homogenized and heated it up for him.  Nope.  At one point I  turned on the end of the hockey game, hoping he'd get tired (he watches a lot of hockey with Daddy if he can't sleep at night).  We called Daddy, we sang songs, we rocked, we burped, we got Tylenol.  Finally, about 10:30 he went to sleep in my arms.  I carefully tucked the towel underneath him so that he would not immediately roll on the wires (or catch them in his sleep), put up the side rail and tiptoed to my cot.  I didn't realize how tired I really was until my eyes closed while I was typing on the laptop.  I shut everything down, pulled the blanket over me and drifted off. 

At 2 am I woke to him stirring and was at his side a minute later when he started to cry.  Once he is down, Wyatt does not wake up in the middle of the night unless he is sick.  What I found when I got there was pretty much heart stopping:  all the wires were wrapped around his neck.  I sat my crying boy up and started to gently un-garrote him;  he looked like a kitten tangled in a ball of yarn.  At one point I had to go get the Tech for help as I was afraid of dislodging everything.  It took a bit, but we were able to free him from his wire-y prison. 

It's 2 am and I am tired and happy to be untangled!
I am sooo tired!  I also HATE this hat!
For his trouble, he also ended up with a nasal cannula, which he also hated.

Wyatt's (slightly dislodged) nasal cannula
This thing is 'teh suck'.

You can bet that he was wide awake after that, so I put the radio on over the phone and held and rocked him.  He kept trying to pull out the cannula and that one purple wire in the photo above, so the only thing I could do was to put him on my left shoulder, tuck his one hand into my armpit, hold him (under the wires) under his bum and hold his other arm down with my right arm as it held him over the wires.  And rock.  Which I did...  For a solid hour.  I thought he was asleep at one point and tried to put him down but it didn't work as he was crying and rolling and threatening to get tangled up all over again.  Finally, he was a sleeping rag doll again around 3:15 and I tiptoed back to my cot.  I had a hard time settling as well;  I think I got back to sleep around 4, although I woke up several times to unfamiliar hospital sounds.

My eyes opened again at 10 minutes to 6, so with a sigh, I started quietly packing up the room.  The test ended at 6 and our Tech was there promptly to unhook Wyatt from his torment.  We turned all the lights on and found my little lamb sound asleep.  I hated to wake him up but it was time to go.

Wakey wakey, Wyatt.
Wakey, wakey Wyatt.
The conductive jelly that was in his hair, despite the reassurance that it was water soluble, would NOT come out with warm water and a cloth.  I got him dressed, packed up the room, stripped the beds and was out by 6:30.  I managed to get lost a completely new way before (gratefully) finding the Whaaambulance and my family waiting for me outside the Elm St. entrance.  We rocketed home in the fog and by afternoon, all 5 of us went down for a nap.  After a nice bath, Wyatt also had 95% of the tape and goo out of his hair.

My week did not end there as I had a 12 hour night shift the next night (May 2nd).  I also start a new 4 day tour tomorrow (May 5th) but the kids have settled back into their routine.  I won't know the results of the study for a while.  In fact, I'm not sure how I will find out exactly;  we will probably hear from one of his doctors and/or get a phone call or a letter.  I do know that while I worked the night away, everyone slept very well at home, in their own bed. 

It's been a busy, crazy, cranky and tiring spell for Team Logan, but we have come out the other side of it.  I know I will be happy to see Wednesday morning (May 9th), when I start my next run of 5 days off. One of the good things about blitzing through a bunch of appointments is getting them all over with... which we have, until the next go around in a few months time.  In the meantime, we won't be idle waiting for results.  Instead, life will go on as it does for my raucous household.  Full of laughter, life and love.

Now that's worth the price of a few crappy nights sleep, isn't it?

Thursday, March 1, 2012

Better Living Through Peek-A-Boo

I haven't been feeling very brave.

I knew it was here somewhere...  It must be under the 19+ loads of laundry that I have dealt with (so far!) in the last 4 days.  Maybe I left it in my work bag?  Perhaps I kicked it under the couch by accident.  Whatever, where ever... the last couple of days I have been wandering around like the cowardly lion, looking for my courage.

Courage really isn't the right word for it either.  Neither is "special" or "blessed" or any other adjective that people use to describe "Special needs Moms". You know that thing that makes my magic helmet and the proverbial double edged sword less heavy?  That. 

The cause?  Nothing really.  Not any one thing and everything, all rolled up in puff pastry.  Probably a little bit of a crash too, as we are still coming down off the kids birthday's and Wyatt's new-found sitting prowess.  It happens.  No matter how hard you try, you do have days where you are worn down.

I came to a realization the other day as I stood downstairs at my bar, waiting for my morning cup of Tassimo.  I glanced over at a stack of books and saw our copy of "What to Expect the First Year".  As I stood there, waiting for the last few drops of coffee to fall, I smirked and half chuckled to myself.

There is no manual with a special needs child.  There is no manual for Down syndrome.

I used this book religiously with Quinn, our eldest.  Each month, I was delighted with each new thing that he had picked up.  Most of the time, I lauded him for being "ahead".  As parents, we dream and delude ourselves all the time.  We aren't supposed to compare our kids with others, but we do it without fail.  "See that?  With that fine motor control, he could be a surgeon or a dentist!"  "With those long fingers, he could be a concert pianist!"  "He's three months ahead with his speech!  Let's hope he stays out of public office..." and so on.  Constant comparison, constant validation.  As the title says, I knew what to expect with him.  There were very few surprises.

Zoe?  Pretty much the same thing.  She will always have the "six weeks corrected" with each of her milestones.  This makes it a little worse in a way, as "...she certainly isn't acting like a preemie!  Look at how far ahead she is!" 

Then, there is Wyatt.

With him I got a list of facial features, potential physical ailments and things he cannot do.  There is no set list for "can" or "will" or "when".  Information is partial at best.  There is no comparison, no handy yardstick. Instead of a book telling us "What to Expect..." we now have to embrace a whole new philosophy:  "In His Own Time".  There is no instant gratification with this one.  It takes a metric f☠ckton(ne) of patience and another still of sweat equity.  And time.  Lots and lots of time.

To me, everything happens for a reason.  As the fates would have it, I lost "What to Expect..." until a couple of weeks ago. I remember looking for it frantically at a few points, hoping to find an answer to some obscure question or another.  It's being lost until now has turned into a blessing in disguise, really.  For all our good intentions, month by month, week by week detailed comparisons between the twins would have been inevitable.  Contrasts would have been more obvious.  The differences at various points would have been heartbreaking.  Instead, this book remaining lost for so long kept everything a little more vague.  At least in this one instance, a little bit of ignorance was bliss.

I would not begrudge Wyatt a single thing.  Any dedicated parent will say that they would do anything for their kids.  I'm just putting my money where my mouth is.  Each and every thing has to be thought out; you constantly have to be aware of what skill you are trying to develop and what the ramifications are.  This morning for example, we had half an hour of controlled kneeling and quiet play therapy, followed by fun tambourine time.  I have learned that Zoe will be intrusive, no matter what you do;  while I am changing Wyatt's diaper, she is trying to step over him as she cruises around me and chatters.  Instead of pushing her away, I set her up on the double pillows too.  The babies got some face to face talking time as I gently held my sons hips and shoulders in alignment and his knees together.  They pulled a toy back and forth between the two of them, both of their chests on the pillow and when that became tiresome, Zoe rolled over and lay half propped on them, still chattering over her shoulder to her brother and I.  They each got a tambourine and after the usual back and forth trading between the two of them, I took a little time with each of them and explored the different sounds and actions.  Wyatt at first was sitting up, but he was obviously tired so he lay propped up on a nursing pillow and held his tambourine (and the maraca he was hitting it with) up over his head.  We patted, hit, shook and head butted our jingly noisemakers for a couple of minutes until Sean and Quinn returned and Zoe almost bowled me over as she ran for the gate, screeching for joy.  Sounds like a fun half hour, right?  The kneeling was to continue strengthening his core, getting his hips and legs ready to that unsupported and be able to get those knees under him so that he may learn to crawl.  Bringing his hands together and banging objects together are not milestones per se, but are important skills to refine as they lead to so many others.  Finally, connecting the dots between action and sound is an ongoing lesson, especially with kids with Down syndrome who are so visually oriented.

With Quinn, I tried to add certain skill enhancing activities, just like a lot of parents, simply because I could.  If I forgot or didn't have enough time, it wasn't that big of a deal.  He picked things up very easily.  With Wyatt, I have to.  Like Yoda says "...There is no try."

I found my "brave" last night.  Little did I know it was hiding under a blanket.  Wyatt would not sleep for love nor money and he was hanging out with us downstairs.  I had a fire going and a glass of wine in my hand and I was getting a little bit discouraged with him as he would not sleep, despite my best attempt at a Zen atmosphere.  I took another sip and started scrolling through my phone.  I heard a "YAH!" and looked over.  He grasped the edge of his blanket in both hands and pulled it up over his head.  Tired, (as we have been working on peek-a-boo games since they were very young) I gave a half-assed "Where's Wyatt?", only to have him quickly drop the blanket and grin at me.  I could not have been more surprised.  I gave him the "There he is!" and looked over at Sean.  He asked  "Where's Wyatt?  Where's he at?"

The blanket went up again.

Then it came down.  "THERE HE IS!!" we both yelled in unison. 

We did this for a good ten minutes.  Sometimes he would peek around the edge of the blanket and grin at me.  Sometimes he would get distracted by the TV and then yell at me and make different sounds at me to continue our game. He would go back and forth between both of us.  It was awesome.

I know... it's just peek-a-boo, right?  Not really.  See, much like our kneeling and tambourine time, it means a lot more.  It gave him an opportunity to communicate with us, one that he initiated himself.  We got to make eye contact and react to one another.  It also showed us that he is working on object permanence, that he has made the connection that when his vision is blocked by something (in this case the blanket), we and the world still exist.  As this is a visual task, it is not surprising that children with Down syndrome progress with it faster.  He showed us that cognitively, he is coming along.

For us, it was a much needed shot in the arm.  Physically, the evidence was there that he was progressing.  Now we have proof that everything else is too.  Each little step answers a few more questions and gives us a little boost that keeps us going.  Forget chemistry, we have better living through peek-a-boo.

Bravery?  Where are you?

Oh there you are!  I see you...



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