Tuesday, December 30, 2008
OY Vey, Another day!
The medication that was supposed to decrease his anxiety has increased it and turned it into paranoia instead of just plain ol anxiety.
I have a call into Dr. S and hopefully will hear back from him tomorrow.
Please stay tuned for updates.....
Tuesday, December 23, 2008
A very Merry Christmas to all!!!!!
We have had our challenges this year but it only takes a minute to sit back and think of how blessed we are!
We have a roof over our heads, food in our fridge, a job and 4 beautiful children! I am so grateful for my husband and the hard work he does. He is my rock!
I pray this next year is filled with healing for my sons and peace for our family. I pray this for all parents with special needs children! May God bless and keep you all! Merry Merry Christmas!!!
Thursday, December 11, 2008
If you don't laugh, you'll cry....and we did both!
We were on the road by 3:30 for his 5pm appt. I thought we were doing really well.
The traffic came to a standstill about 3 miles from our exit. Thankfully, Boo was asleep and didn't have to endure the 2 hour drive! That's right! It took us 2 hours to get there. We were 3o minutes late and I was a basket case!
I pulled up to the loading zone and ran in to let them know we were there but still had to park. When I walked in, the receptionist said "Don't worry....see all these people here....they are all waiting for Dr. S too!"
We parked the car and Boo informed us that he had an accident while he was sleeping. He was very upset and did not want anyone to see him nor did he want to wear wet pants! I assured him I must have something in the trunk (remembering I had put a box for Goodwill back there). Well, it turns out they were all my clothes! Then I had the brilliant idea to cut the lining out of his wet pants (They were double sided). All I had to use for a tool were Rich's keys. All I succeeded in doing was ripping the inside of the pants and making them more difficult to wear! I had to think quick and came up with the idea to have him put a pair of my pj bottoms on under his wet pants so he wouldn't feel the wet. He agreed to this and off we went to see Dr. S.
When we walked into the office, I could tell by the expressions on the other parent's faces that they had been waiting a long time! I asked one mother what time her appt was and she said it was at 3! A few other parents chimed in with their appt times and apparently there were 5 patients ahead of us. I quickly struck up a conversation with a mom who's son was trying to get Boo to play with him. Boo took to the corner and decided to hiss at all the other kids who came close to him. Ironically, all of these children were a lot like Boo. I can spot Autism and ADHD a mile away now!
As the mom of the little boy and I got to talking, another family joined the conversation. I had shared that we came from LB to see Dr. S. These families came from Lancaster and Valencia! We all agreed that even though we wait for hours to see Dr. S, it's worth it. The reason he is always late for his appts, is because he takes as much time with his patients as they need. He also works at the psychiatric hospital adjacent to his office so he is usually there when he is paged that he has patients to see.
We were the last people to see Dr. S. He called us back at 8pm. He spent an hour and a half with us discussing Boo. We discussed recent studies and findings on medication. We discussed the multiple diagnoses that Boo has. He believes that Boo is very distressed. Boo's little brain has so much damage from so many different things that it's nearly impossible to sort out what percentage of his challenges come from which diagnosis. He is truly a puzzle!
We were advised to get another pediatric neuro and also a ped. cardiologist. Boo had an enlarged heart as a baby and now that he is on some pretty strong meds, he needs to be followed. We need to see the Neuro to make sure he isn't having seizure activity. 10% of children with autism, have seizures.
The last thing Dr. S said to me as I was walking out was "I'm sorry we haven't been more successful at helping Boo so far". I just wanted to lay down on that floor and bawl like a baby.
I have one of the best pediatric psychiatrists around treating my son and even HE can't help him.
We were certain that we would see an improvement in Boo by now. I have an amazing little boy under all the layers of diagnoses that just wants to live and love but he can't. Children are supposed to be carefree! They are supposed to play and learn and make friends. My Boo spends his days in a rigid state. He is full of fear and anger. He is obsessive and impulsive and he hates himself for that.
So tonight we try a new medication. This one is supposed to help him sleep. It is a heart medication that lowers blood pressure but it is used as a sedative. All we can do is take it one moment at a time. Oh and by the way....we got home at 10pm last night.
(I have not forgotten my book promise. It's coming soon!)
Friday, December 5, 2008
Quick Update...
We've also had a busy week.
I'll be back at some point this weekend to give a proper update :)
(In the meantime, please check out my dear friend's blog raisingreid.blogspot.com This family needs prayer right now for their little guy, Reid, who has just undergone heart surgery and may be facing another one soon)
Monday, November 24, 2008
The Explosive Child
It has been recommended to me by several parents who are raising children with a variety of challenges. The premise of the book is that "Children do well if they can".
It focuses less on reward and punishment and more on communication and collaborative problem-solving (these are skills that are missing in children with ADHD, FASD, ASD and other diagnoses.). It is a different approach to parenting but when you think of your child as having organic brain damage or even just emotionally developmentally delayed then it makes sense that the conventional parenting techniques used in neurologically typical children wouldn't work for these children. You wouldn't expect a 2 year old to sit down and write their ABC's and then punish them if they couldn't perform that task , expecting that the punishment would, in time, teach them HOW to write their ABC's.
Here is a link to the Center for Collaborative Problem Solving
http://www.ccps.info/
This website has more info on understanding and implementing the Collaborative Problem Solving approach (also known as CPS).
I will be adding more posts as I continue to read this book and start on our journey of implementing this new parenting technique. Stay tuned for more info........
ETA: Here is the Caregiver handout for the CPS model. It really sums everything up!
Thursday, November 20, 2008
From the end of the earth I will cry to You, When my heart is overwhelmed; Lead me to the rock that is higher than I. Psalm 61:2
I am beaten down. I'm exhausted.
The truth is I can't do this alone. I need the type of help that can only come from the One who has all the answers; The One who loves Boo even more than I do.
Lord Jesus Christ, Good Shepherd of the sheep, you gather the lambs in your arms and carry them in your bosom: We commend to your loving care this child. Relieve her/his pain, guard her/him from all danger, restore to her/him your gifts of gladness and strength, and raise this child up to a life of service to you. Hear us, we pray, for you dear Name's sake. Amen.
Saturday, November 15, 2008
Homeschooling it is.....for now....
Boo learns best by example. He was extremely stressed in his class because all of the children were behaviorally challenged. Ironically he was the best behaved in his class but it was due mostly to fear and anxiety.
My job is to find Boo the best possible "program". He needs intense physical and occupational therapy. He also needs speech therapy. He needs extreme structure and lots of visual cues. He will benefit from Pecs cards and from one on one learning.
All of these things have been recommended by several professionals Boo has seen. The school district is aware of Boo's needs and of his Dr's recommendations. Unfortunately, they can only offer him what they have available. (We are not in a position to hire an attorney or an advocate to fight this battle).
Right now, we are going to homeschool him. We are also looking into a few research projects that Boo may be able to take part in. He is also on a waiting list for a special partial day program at UCLA.
I am always amazed by the different hats parents are required to wear when they are parenting a special needs child. So far I have had to be an advocate, diagnostician, nurse, researcher, therapist, secretary, teacher, etc. The list just continues to grow.
As a child, I had complete trust and faith in Dr's. I believed they could diagnose and heal just about anything. I believed this was true for any Dr. that was able to earn the label "MD". My faith has been shattered time and time again in the last several years.
The first several months after Boo started having his severe rages, I would tell his pediatrician over and over that we were really struggling with him. The Dr. kept giving me handouts on handling toddler tantrums. He told me I just needed to be more consistant with him. He never once mentioned the possibility of Fetal Alcohol Effects. (He was aware of Boo's prenatal drug and alcohol exposure) I was not describing typical tantrums. I was describing hours and hours of "raging". I was describing Boo throwing himself down on the hard cement because his clothes were bothering him. I was talking about Boo banging his head on the ground on purpose when he was mad and waking up screaming several times a night. I was a frazzled mom who was saying "Something is NOT right". Have you ever had one of those dreams where you try your hardest to scream and nothing comes out? That is exactly how I feel much of the time.
I just want to end this with one suggestion. The next time you're out in public and you see a child tantruming and a mother who looks like she's about to cry, instead of judging her, pray for her! It is not always "bad parenting" that causes a child to meltdown. I don't know how many times I've heard "What your child needs is a spanking". Yes, thank you. My child does need a spanking. Why didn't I think of that. If I spank him, then maybe his brain damage will just disappear...or maybe his autism will be cured....or he will all of a sudden be able to tell his colors apart....or not run in the street for no reason........
Parenting is a journey, but parenting a special needs child is an Indiana Jones adventure!
Sunday, November 9, 2008
So you suspect FASD, now what?
Have you ever heard of the term "organic brain damage"? It's something I'm becoming increasingly interested in learning about. Boo has "organic brain damage". This means he was born with it. His brain did not form in the same way an average person's brain forms.
"Individuals with FASD often have symptoms or behavior issues that are a direct result of damage to the prefrontal cortex, which is the part of the brain that controls “executive functions.”" from Fasstar.com
Executive functions include:
- inhibition
- problem solving
- sexual urges
- planning
- time perception
- internal ordering
- working memory
- self-monitoring
- verbal self-regulation
- motor control
- regulation of emotion
- motivation
- judgment
A child with FASD may be capable of making good choices one minute and then "forgetting the rules" the next minute. They may be able to "hold it together" for authority figures or in instances when they are fearful or nervous. This does not mean that they have the "capabilities" to hold it together when they "choose". This is a common misconception.
Children with FASD often do not make the connection between action and consequence (which is why traditional behavior mod doesnt always work well for them). They are impulsive by nature and remember, even though they may repond to a consequence one time does not mean they will retain that information or learn from their "mistake". Confused yet?
Ok, so HOW do we teach these children? What DOES work for them? Well, remember that no two children are the same. As a parent, you must get to know your child first and then adopt a plan. Here is something I found to be simple yet helpful.
8 Magic Keys:
Developing Successful Interventions for Students with FAS
by Deb Evensen and Jan Lutke1. Concrete
Students with FAS do well when parents and educators talk in concrete terms, don’t use words with double meanings, idioms, etc. Because their social-emotional understanding is far below their chronological age, it helps to "think younger" when providing assistance, giving instructions, etc.
2. Consistency
Because of the difficulty students with FAS experience trying to generalize learning from one situation to another, they do best in an environment with few changes. This includes language. Teachers and parents can coordinate with each other to use the same words for key phases and oral directions.
3. Repetition
Students with FAS have chronic short term memory problems; they forget things they want to remember as well as information that has been learned and retained for a period of time. In order for something to make it to long term memory, it may simply need to be re-taught and re-taught.
4. Routine
Stable routines that don’t change from day to day will make it easier for students with FAS to know what to expect next and decrease their anxiety, enabling them to learn.
5. Simplicity
Remember to Keep it Short and Sweet (KISS method). Students with FAS are easily over-stimulated, leading to "shutdown" at which point no more information can be assimilated. Therefore, a simple environment is the foundation for an effective school program.
6. Specific
Say exactly what you mean. Remember that students with FAS have difficulty with abstractions, generalization, and not being able to "fill in the blanks" when given a direction. Tell them step by step what to do, developing appropriate habit patterns.
7. Structure
Structure is the "glue" that makes the world make sense for a student with FAS. If this glue is taken away, the walls fall down! A student with FAS achieves and is successful because their world provides the appropriate structure as a permanent foundation.
8. Supervision
Because of their cognitive challenges, students with FAS bring a naivete to daily life situations. They need constant supervision, as with much younger children, to develop habit patterns of appropriate behavior.When a situation with a student with FAS is confusing and the intervention is not working, then:
- Stop Action!
- Observe.
- Listen carefully to find out where he/she is stuck.
- Ask: What is hard? What would help?
I don't have the answers. I'm just beginning this journey myself. Boo has seen so many professionals who have glossed over the fact that he was drug and alcohol exposed. They attributed his behavior and emotional challenges to genetics or our parenting. The sad fact is that there are no hard markers for Fetal Alcohol Effects or Alcohol Related Neurodevelopmental Delays. 80% of people affected by FASD have no physical features of the disease. It is their brain that is affected. It is estimated that 70-85% of inmates need substance abuse treatment. It is also estimated that 61% of adolescents with FASD have been in trouble with the law. These statistics are both shocking and terrifying. FASD is real. We need more education out there and we need more funding for research. Our prisons are full of men and women who started out as innocent children born to women who drank alcohol and did drugs. Who is going to stop this cycle?
Thursday, November 6, 2008
Fetal Alcohol Spectrum Disorders
"FASD is the leading known preventable cause of mental retardation and birth defects."
From the National Organization on Fetal Alcohol Syndrome.
~~Today I had the opportunity to speak to a leading researcher on FASD at the University of San Diego. This extremely busy man took time out of his day to return the call of an exhausted and frustrated mom. Dr. Ed Riley has done extensive research on FASD and it's effects on the brain. He is in the trenches, so to speak, with parents, educators, neurologists, and other psychologists like himself who are working tirelessly to educate people on the irreparable damage caused by prenatal drinking.
My story was no different than most. He listened intently while I told him all the diagnoses we've received so far with Boo. He assured me that everything I had told him about Boo was right in line with ARND (Alcohol Related Neurodevelopmental Disorder). It is something that is not easily diagnosed by professionals. It is not a clinical diagnosis (yet).
Boo's best hope right now is getting intervention services for his Autism and ADHD diagnosis. Unfortunately, ASD is where the money is right now. FASD, while it affects 1 in 100 births is not something that is very well known. Most children with FASD are not diagnosed properly. They are labeled as having ADHD or even Conduct Disorder and everything in between. 80% of children with FASD have little to no physical anomalies and yet their central nervous system has been forever damaged. Unlike other disorders, FASD cannot be cured. It is organic brain damage and will stay with a child for the rest of their lives impacting everything from their education to their relationships with others. Many people with FASD are unable to leave home when they are 18. They are unable to function as an adult. Their behavior and emotional immaturity often get them into trouble with the law.
There may not be a cure but there is a prevention. There is no known amount of alcohol that is safe during pregnancy. Drinking can cause lifelong brain damage and my son is walking proof of that fact!
More to come on treatment for FASD...........
Saturday, November 1, 2008
I found this poem today.....
Heaven’s Very Special Child
A meeting was held quite far from earth
It's time again for another birth
Said the angel to the Lord above
This special child will need much love
His progress may be very slow
Accomplishments he may not show
And he'll require extra care
from the folks he meets down there
He may not run or laugh or play
His thoughts may seem quite far away
In many ways he won't adapt
And he'll be known as handicapped
So let's be careful where he's sent
We want his life to be content
Please Lord, find the parents who
Will do a special job for you
They'll not realize right away
The leading role they're asked to play
But with this child sent from above
Comes stronger faith and richer love
And soon they'll know the privileges given
In caring for their gift from heaven
Their precious charge, so meek and mild
Is "HEAVEN'S VERY SPECIAL CHILD"
- Author Unknown
I have often been asked "Do you feel resentment towards Boo's bio-mother for her choices during her pregnancy ie: alcohol, drugs, etc?" My answer is always a simple "No". I remember leaving the hospital the night we got Boo. I cried the whole way home. The one thing that kept going through my head was how lucky I was to be bringing this beautiful baby home. This poor mama just gave birth to her son and will never feel the joy of taking him home. She will go home empty handed and empty hearted...back to the streets. She has no one waiting to shower her with baby clothes and diapers. She will return to her life that is filled with pain. She is a product of the failing system. She was a broken person with a mental illness and a terrible addiction. She was unable to provide for herself let alone her child. Was I angry with her? NO. My heart ached for her. I thank God every day that He picked us to be Boo's parents. I pray for Boo's bio mom often and am eternally grateful to her for bringing our son into the world.
Tuesday, October 28, 2008
Why I created this blog...
We didn't have health insurance and since I wasn't working, money was nearly non existent.
Several months passed and I was finally able to get to a Dr. I was diagnosed with anorexia, depression, anxiety and colitis.
I was prescribed antidepressants (that saved my life) and went to therapy.
It was then I realized how uneducated people were about mental health issues. My friends didn't understand why I couldn't leave the house. They didn't understand why I didn't just "get over it". I was unable. I was paralyzed with anxiety and depression.
I slowly began to heal and vowed to be the poster child for "healing from depression".
Fast forward to a year later. We were expecting our first child. I was elated. The only thing I ever wanted in life was to be a mommy! We were blessed with a perfect little angel. Four years later, we were blessed yet again with another perfect angel. We had our two little girls and all was right with the world. When our second daughter was just five months old, we got a BIG surprise. I was pregnant ....AGAIN....
The pregnancy was rough. I started having contractions when I was 18 weeks along. When I was 24 weeks, my water broke spontaneously.
I stayed in the hospital for 10 days but Bo couldn't wait any longer. He was delivered on Feb 23rd, 2000. He weighed 1 pound 14 ozs and was 13 inches long. He was a fighter. The night he was born, we had him baptized and given his last rites. The Dr. told us "We're working on him". It was the scariest night of our lives.
He spent 3 and a half long months in the NICU. Those three months consisted of us getting several phone calls that went something like this..."We need you to get down here right away....Bo may not make it through the night".
Bo was stricken with a preemie disease called Necrotizing Enterocolitis three time. Most preemies that get this disease ONCE, do not make it. He was truly a miracle.
When Bo was finally taken off of his respirator and able to breathe on his own, we were hit with the news that he had Retinopathy of Prematurity. He had an advanced stage in both eyes. They couldn't guarantee that he would have any sight. At this point, it looked like he would lose all vision in both eyes.
They performed laser surgery on both eyes. It was still too soon to tell the extent of the damage.
Meanwhile, he was still not feeding well. He had terrible reflux but my mommy instinct told me there was something more going on.
He was released from the hospital on June 13th! We took him home thinking the worst was behind us. Boy, were we in for a surprise...
Bo had a follow up eye appt. one week after coming home. We were told his retina in his left eye was detaching and the only hope for saving his sight was a specialist up at UCLA who was one of two Dr's in the US that performed this particular surgery called a Virtrectomy.
We were up at UCLA the next day prepping Bo for yet another surgery. He came through better than expected. His Dr. told us his surgery was "newsworthy". He still couldn't guarantee the sight that Bo would have but was optimistic.
We went home and began life with a special needs baby, a 15 month old toddler and a four year old preschooler.
The whole first year was a bit of a blur. Bo had physical and occupational therapy. He was developmentally delayed and we spent more time at the Dr's office than at home.
Bo had a rough time feeding from the beginning but since he had been home, it had gotten worse. He was gaining weight but he was also projectile vomiting after every feed. We had seen several GI dr's who assured us he did not have a narrowing from his earlier battle with NEC. I was not convinced. We were at the ER nearly once a month for the first year with Bo vomiting bile. I insisted something was wrong and finally found a GI dr. who believed me. He sent us to a specialist at CHOC hospital who, after taking one look at a recent upper GI, admitted Bo into the hospital for a small bowel resection. Bo did have a narrowing in his small intestine that was hard to see on the film. The surgeon spotted it right away and wouldn't let us leave. He said Bo's intestine could have "burst".
Bo went through a very long and painful surgery to repair his intestine. He was sent home 9 days later and recovered quickly!
Every day of Bo's life has been a blessing and a challenge for him and us. He is burdened with the fact that he has poor eyesight. He is legally blind. He has cortical visual impairment which is basically a "short" from his brain to his optic nerve. There are days when he sees better than others. He also has Sensory Processing Disorder. He has a difficult time being in crowds or filtering noise/lights/etc. He also suffers some residual effects of his bowel resection. His tummy is sensitive and has been hospitalized a few times with stomach viruses and suspected twisted intestines. He is in school and is learning braille (in case he needs it in the future). Bo has a 10x's greater chance than an average sighted person to suffer a detached retina. He cannot enjoy jerky rides and has to be careful not to get hit in the head with a ball at school. He has had a few bleeds in his eyes in the last year that have sent us running back to UCLA to make sure he's not losing his retina.
He doesn't complain. He is a loving little guy who always sees the bright side!
Now onto Boo! We were blessed with a very memorable call from a social worker on Jan 31st, 2004. We had been foster parents for nearly a year and already had 12 little ones come and go. My heart was aching for a baby that I knew was coming....I just didnt know when. This was our night. The social worker said "I have two babies....a girl and a boy...both newborns...which one do you want?" I said...."The boy is our son...when can I bring him home?" I drove down to the hospital the next afternoon to pick up Boo. He was the most beautiful baby in the NICU. He was perfect. He was ours!
I brought him home and our friends came by to bring us various things we needed for him. We were used to getting babies by this point....but this one was different. This one was my "Boo". I just knew he was our forever son.
The next year was uneventful. We didnt take any more foster children. We concentrated on the family we had. Boo had some early intervention but overall was doing well.
When he turned 15 months, we knew something was wrong. He began having EXTREME tantrums. He would bang his head on the ground. He would hit and throw anything and everything if things didnt go his way. The problem was, we didnt always know what "his way" was. He couldn't communicate when he was raging. He was in a whole different world. He started to show some signs of sensory integration disorder and self regulatory disorder. The month before we finalized his adoption, our suspicions were confirmed. He was given the SPD dx. The problem was it was getting worse each day.
Boo was impulsive. He would run out of our house and down the street for no reason. He would run and laugh. He would bolt in parking lots with no regards to traffic. When he was three, I had him evaluated by the school district. He was able to hold it together and was denied services. I told the psychologist who evaluated him that he can hold himself together for very short periods of times but then will lose it. Once he loses it, there is no coming back. He could tantrum for two hours straight. He would kick, scream, bite, throw things for hours on end. There was no comforting him. It killed me that he was so frustrated and angry. He began rocking to put himself to sleep (also called stimming). He still rocks to this day.
I took him to two neurologists. One said he had "pre-ADHD" based on his symptoms and also on his prenatal drug and alcohol exposure. The other Neuro, that we had waited 6 months to see, told me it was my parenting that was causing his behavior. By now, Boo was nearly 4. I was at my wits end. No one will help us. No one believes that he has a serious problem.
Once he hit four, his speech hit a lull. He began to have a harder time articulating his feelings. He became more withdrawn. He lined up his toys and began hyper-focusing on certain things or parts of toys. He started to lose interest in his favorite TV programs. He was unable to sit for any length of time. He became even more angry and started making perverse statements. He started having severe anxiety. He was afraid to go places because he was afraid he would melt down. He started having a hard time reading social cues. He doesnt understand tone of voice. He takes offense and is easily hurt or angered by a tone in a voice that he perceives as "mean".
Boo also has a hard time understanding "kidding" or abstract concepts.
We found a developmental ped down at UCI who specializes in children with severe behavioral challenges. We waited 4 months to see her. She started Boo on medication and told us he was "complicated". She referred us to a psychologist for a neuropsychological evaluation. We started an 8 session evaluation. During this time, we were encouraged to "hospitalize" Boo for some severe behaviors he was displaying. We decided against this.
He was then dx'd with ADHD, Mood Disorder-NOS, General Anxiety Disorder and possible PDD-nos.
We then had to find a psychiatrist to manage his meds because his developmental Ped was taking a leave.
We were nearing the end of our rope by this time. We still didnt feel like we had a good "grasp" on what was going on. Even with those dx's, I still had questions.
We stumbled upon an AWESOME psychiatrist up at UCLA who was one of the leading psychiatrists at the Childrens inpatient and outpatient clinic. He works closely with the Autistic Clinic and is one of the leading researchers in Autism up there.
He took one look at Boo and said he was definitely on the Autistic spectrum. He diagnosed him with ASD, GAD, severe ADHD and a rule out of bipolar and fetal alcohol effects. We are currently working with him to find the right medication combination for Boo.
I felt like I finally found someone who UNDERSTANDS Boo. I finally had some Ammo for the school district. I take my paper with Boo's dx back to the psychologist who evaluated him a year ago. She takes one look at Boo and tells me he is NOT autistic. I wanted to scream. How dare this person who has spent less than 5 minutes with my son tell me that Boo's psychiatrist (MD.), who is an Autism expert, was wrong and she was right? I was livid. The evaluation they did on Boo that day was scarring. They actually held him down for one part of it. He wasn't cooperating. He was on sensory overload and was in a big room full of toys. They wanted him to put a puzzle together and he wanted to look at the other toys in the room. They sat him down after I promised him they wouldnt touch him. Anyone knows that a child with SPD or ASD, has a hard time being touched with no warning!
I left that day with little hope. I had been waiting a year for Boo to get some intervention from the school district. I was praying he could be placed in the Autistic preschool. They didnt want to label him Developmentally Delayed....They wanted to label him Emotionally Disturbed. They told me he needs hardcore behavioral therapy. The problem is, behavioral therapy is not always appropriate for children like Boo. He needs more specialized care. He needs help on the underlying causes of his behavior. It is clear, I am not going to win this fight. Boo is currently in the preschool program the school district recommended. He is in an ED preschool. We are taking it one day at a time. Homeschooling may be in the not too distant future.......stay tuned......