Monthly Archive: April 2015

Argh…this restricted diet is getting to me

CB is 4 years old …

CB is handling his restricted diet beautifully. He eats most anything we put in front of him, and responds well in situations where he can’t eat something his friend is eating. The generic “I’m sorry honey but that will hurt your tummy” response seems to work fine, at least for now. I am very grateful for this; however, for the last week or so, I keep imagining our family eating out wherever and eating whatever. I find myself hoping that his progress is not connected to his restricted diet. I picture a fridge full of full fat milk yogurt, cheese sticks, cream cheese, and ice cream. OK, can you tell I am missing milk products? I make our coconut milk yogurt, coconut milk kefir, almond milk, and on occasion we have Dayla cream cheese. They suffice but I really miss animal-based milk. I also imagine a time where I am not making so much of our food and we have a clean kitchen most of the time. I seriously am not keeping up with all the cooking AND keeping the kitchen totally clean. Maybe I just need to order a supermom cape. Once I tie the cape around my neck, I will instantly be the SuperMom I would like to be. One can hope!

So, within the next week, CB will have more bloodwork done to see how his nutrition levels are. We hope this will help us to see if the diet is helping his body, to ensure he is not having any new vitamin deficiencies, and to look at a few more factors we haven’t tested for before.

CB’s OT & ST started including the ILS (Integrated Listening System) as part of his therapy. With his first OT session with the ILS headphones, he was able to ride his balance bike (a bike with no pedals) smoothly down the hall w/no headphones on. After his OT put headphones on him, he was super wobbly trying to ride the balance bike down the hall. Surprisingly by the 2nd session, he was functioning quite well with the headphones on. His ST is also providing mouth and tongue tactile input to help him be more aware of the different parts of his mouth. This should help him to be able to move his tongue, lips, and jaw more independently. CB has this issue with his entire body. He has a hard time moving various body parts independently. His OT also performed some vision exercises with him immediately following spinning exercises. It is so good to see auditory and vision therapy being incorporated in his OT and ST sessions.

Glowing Glances: CB is stringing more and more words and more and more syllables together. Before swim lessons, HB was crying b/c he didn’t want to stay in the dressing room. CB’s first impulse was to hit HB so I mentioned that CB should instead tell his brother he was sorry he was sad or ask how he could help.  CB hugged his brother and said “I sorry your sad”. It was such a beautiful sentence.

Progress: CB has been dry for the past 3 days! We changed his potty reward system to reflect a new system where he gets a car if he stays accident free for a day. We made this change about a week ago. It looks like we now get to update it to be something like he gets a car if he is accident free for 3 days in a row. The interesting thing is that the point of the rewards system is to serve as a motivator; however, CB asks for a car about every time he uses the potty. He cries about 1-2 times a day b/c he wants a car then. I am pretty  sure he doesn’t understand our current system and just waits for us to tell him he has earned a car. He doesn’t have much of an awareness of time, so it makes sense that this could be an issue for him. As I type this I am realizing, that our current chart system kind of blows and maybe our next one will be easier for him to understand.

Let’s start from the beginning

CB is 4 years old …

For this week, let’s start from the beginning.

CB’s dad and I had mutually decided that we wanted to add a new addition to our small family of 4 (Olem, our 2 dogs, and me). We started to try to conceive, but my body decided to get all out-of-whack. After a couple of months, my body situation returned to normal but Olem’s schedule was extremely hectic. We decided to stop trying and to wait till we were both in a better place. The next time we decided to try to have a baby, CB was conceived with 2 weeks of trying. The pregnancy was a happy and fulfilling one. It was one of the happiest times of my life. The pregnancy itself was a little noteworthy. I had two yeast infections and took a medicine prescribed by the south american OB we saw for our first ultrasound called Icaden. We were traveling extensively and on a work hiatus when I got pregnant. I had placenta previa for most of the pregnancy but the placenta moved out of the way by the time CB arrived. For the last several weeks for the pregnancy, I had polyhydramnios. At 42 weeks and 1 day, I had to be induced b/c CB was not coming out on his own. I was given a low level dose of pitocin and the Dr broke my water. Labor was on the short side, 6 hours, and my midwife and her assistance were there to help the whole time. I stayed mostly relaxed throughout labor. During child birth, the umbilical cord came out while CB was exiting my birth canal and the Dr decided to cut the cord at that time. CB was born and turned blue right after being placed in my arms. After a couple of minutes (and after Olem began talking to CB), CB cried out and his color returned to normal. He was then placed back in my arms and we just stared into each other’s eyes. I still remember the extreme joy and connectedness I felt at that moment. While in the hospital we hardly slept because Olem and I just wanted to watch CB. The only time he left my sight was when Olem went with him and the nurse to perform a couple of tests. We were so excited about our new beautiful boy. I had lost a lot of blood after CB’s birth because my placenta had to be manually extracted. We had to stay in the hospital an extra day because CB was no longer pooping. It turns out he was severely tongue-tied. At 6 days old, we had his frenulum clipped. I should note he never had problems latching on. He just had problems latching on properly initially since his tongue would only extend to the back of his teeth. I also received numerous sonograms since I had placenta previa and then polyhydramnios.

The first weeks were a bit of a blur. I would nurse while my husband fed me from the food my mom had prepared for us. Olem took care of all the diaper changes, putting CB in his napper, and picking him up. It took 2 weeks before I had the strength (due to the low iron from the blood loss) to carry CB around.

We enjoyed our new beautiful boy and learned to function on little sleep. CB was a good baby and a pretty easy baby, as far as babies go. He enjoyed laying on the playmate and watching the lights and spinning toys, swinging in his swing, going for strolls in his stroller, and riding in his car seat. By 2.5 months, he was sleeping through the night and we moved him to his crib in his own room. One mom had noted that CB made being a baby look easy. What CB did not like was being carried in a sling or carrier on me or belly time. I had a wrap, sling, and 2 baby wearers. It took until CB was 6-8 months old, before he would tolerate me carrying him in one of these for more than a few minutes. He has always loved the water. He was a very happy baby. Everyone always commented on this, as well.

Promising Progress: Olem and I feel even more certain that Global Dyspraxia is what CB has. The DSM V states it as DCD, Developmental Coordination Disorder, but that only accounts for the fine and gross motor planning issues. If we go with the DCD diagnosis, then you could say he has DCD with Apraxia, sensory issues, visual issues, and auditory issues. Global Dyspraxia seems to cover his verbal dyspraxia, motor, coordination, balance, sensory, visual, slow-processing, focus, attention, and low frustration tolerance levels. He also has overall hypotonia (low muscle tone), which is common in DCD and Dyspraxia but is not required. It is still nice to have a more concise unofficial diagnosis.

CB’s Evaluation, Therapy, and Treatment History

CB is 4 years old …

I touched on CB’s diet in an earlier blog, but I don’t think I have gone through CB’s evaluation, therapy, and treatment history.

CB was 10 months old when his daycare provider informed us that CB was developmentally behind and did not seem to catch on to things like his peers. This was extremely hard to digest.

CB’s first introduction into the therapy world was with a warm, yet challenging Physical Therapist. He was 15 months old. She helped CB learn to walk. He started walking (ability to walk across a room) at 17.5 months. His PT would push him further than I ever would but she knew just how much to push him to help him grow and move past some of his frustration. It was a good experience and we ended therapy shortly thereafter.

CB started gymnastics at around 19 months old. We thought it pretty much worked kind of like PT as it got him moving and trying new and different physical activities. He hated the big parachute for most of the year and needed a lot of herding to keep him somewhat engaged.

The month after CB turned 2, he was evaluated by a PROMPT speech therapist and given the diagnosis of a moderate receptive-expressive language disorder and a moderate-severe neuro-motor speech disorder.  He started PROMPT speech therapy the following week 1x a week. The next month, Early Childhood Intervention (ECI) evaluated CB and determined that he had a significant speech delay. They started their services within the month and came to our house 1x a week. The ECI interventionalist helped CB with speech and social skills (i.e., sharing, taking turns). After 3 months of private ST, it was determined that the PROMPT speech therapist, although nice, was not pushing CB enough. We decided to end private ST and continue with just ECI. About 2 months before CB turned 3, a licensed ST from ECI started coming to the house 1x a week, as well. CB progressed but at a pretty slow pace. ECI evaluated CB for OT help but he was not far enough behind to get help. Although, I think if I had replied more accurately, he would have qualified. As a parent new to the special needs processes, I responded to most things with the best case scenario response. I think I replied that he ate pretty well with a fork and spoon. He still doesn’t eat well with a fork and spoon. It is still challenging and he gets food all over himself 9 out of 10 times when eating. ECI was helpful in training us how to talk to CB and how to play in a more helpful manner. My husband and I are not huge talkers so it felt very unnatural to talk about what we were doing all the time and to repeat what CB was saying. I think this information helped us tremendously and helped CB’s confidence. When we started saying what we understood him to be saying and not phrasing it as a question, I think he started to feel that we really understood him.

At 2 years 11 months, the school district evaluated CB and determined that he qualified for the PPCD (Public Preschool for Children with Disabilities) program due to his delayed speech. For his school district evaluation, he mainly produced 2-3 sounds for everything. Most of his responses were bah, buh, or duh. When the evaluator asked if we thought the evaluation was representative of his skills, we responded proudly that we thought he tested well because he had tried to answer every question with a response. He normally didn’t do that. He many times wouldn’t even provide a response when you asked him to say a specific word or to repeat after you. CB received 2 private ST 15 minute sessions and 1 group ST session at PPCD. CB also started private ST at the same time 1x a week. 2 months later, CB started taking Nordic Naturals Fish Oil, Probiotics, and a multivitamin. AT 3.25 years old, CB’s pediatrician approved blood work due to CB’s chronic loose stools (sometimes with undigested food bits) and developmental delays.

During the summer, there was no PPCD so CB attended a language camp for a month. Then he took a month long break from therapy because we were out of the state traveling. He still continued to progress during the break. When the fall semester started up, CB moved to swim classes since he could not move up in gymnastics since he was not potty trained. I am so thrilled the switch was made. He absolutely loves his swim class and the class is only 2-4 kids total each class. He also started private OT services 1x a week and increased private ST to 2x a week. CB also started karate. It is a class for kids with special needs. At 3.75 years old, I determined from the blood work performed earlier that year that CB had a much higher than average chance of being celiac. The next day, our household went (GFCF) gluten-free and casein-free. Within 2 months, we saw improvements globally for CB from speech to gross motor to fine motor to sensory awareness (he could feel temperature changes outside). Our household also went soy-free within 1.5 months of going GFCF b/c CB started to present with a soy allergy. His ST sessions at PPCD remained the same. In March, we added Physical Therapy to his schedule to focus on integrating his retained primitive reflexes. He has a long list of unintegrated primitive reflexes. She also works on other gross motor skills, as well. I perform the developmental exercises at home anywhere from 2-6x a week. For most of the exercises, I have to do them in passive mode. Surprisingly, CB handles his schedule quite well and enjoys all of the activities.

Some things we have learned along the way 1) the PPCD structure has been extremely helpful for improving CB’s executive function, focus, attention, independence, social skills, speech and potty-training skills. 2) CB has visual, auditory, gross motor planning and execution, fine motor planning and execution, coordination and balance, food sensitivities, speech, and sensory issues 3) to listen to CB and to work within his limits and abilities 4) stop/change therapy if it isn’t working 5) seek answers and ask questions 6) even though we have heard it over and over again, we are our child’s biggest advocates.

Positive Progress: 1) CB is now completely in underwear except for diapers at night. He has been wearing underwear at school since the beginning of Dec but continued to have accidents on a regular basis. We let CB direct when he was ready to start wearing underwear at home and that is working out well. He also decided this week that he doesn’t want to wear diapers during naptime. He still needs quite a few reminders so that he pees in the toilet, and not accidentally in his clothes or on the floor. He even had 3 days accident free. Yay!!

2) We arranged to meet with an expert in the dyspraxia field in the upcoming weeks! We also have talked with a director of a motor planning and coordination lab. We are feeling very positive this week and feel we are moving in the right direction.

3) We upped CB’s fish oil earlier this week. He is now taking Nordic Naturals Omega Complete liquid form .He was CRAZY for about 2-3 days. However, his articulation, fluency, and the amount of language he used improved. He also climbed a new type of monkey bar about 6 -6.5 feet tall (4-5 times) to get on a playscape.  It seems like in the past, the days/weeks or so following an increase in fish oil, CB makes a big jump cognitively, physically, and verbally. We then see a little dip and then a leveling off at a higher level from where CB started.

Low: CB still has light shiners under his eyes, a rash on his bottom, and some digestive issues periodically. Arghh…we have made quite a few diet changes but we still need to keep tweaking and testing to see what is still ailing CB.

Weekly update

It looks like rotavirus reared its ugly head. Both kiddos caught the bug. Fingers crossed, the virus is moving on. Fortunately, CB has been his usual self and doesn’t seem too affected except for the bowel issues, snotty nose, and sneezing. HB is quite a bit more needy and is having more troubles getting to sleep and staying asleep.

Common CB phrases:

  • “Are you coming?”
  • “Helping me?” while making his modified help sign language sign
  • “I want ____, please”
  • “Yeeeeeeeeeees”