CdLS Awareness Day 2014

So, here we are three and a half years after my last post, on CdLS Awareness Day.

Ben is now 8 years old.

We can hardly believe it ourselves.

He is doing remarkably well.   He still continues to enjoy exceptionally good health.  He is still a little guy, and weighs about 30 lbs.

He is eating all his daytime meals orally with a spoon (no more Nuk brush!), and he can drink liquids from a cup.  He is not close to being able to feed himself, however, and he sometimes plays games with the person attempting to feed him.    I have to say that he tends to eat beautifully for me.    What can I say?  He loves his Mom.  🙂    He still gets some supplemental formula tube feeds overnight.

He is still not walking, but he has learned how to get into a kneeling position and can pull himself up to furniture.

He still does not talk, but he hums and vocalizes a lot!  He has a very sunny disposition…most of the time.

It amazes me that he never seems to stop learning.

Life is good!

Intensive Feeding Therapy: Ben update October 2010.

It has been quite some time since my last post.

Ben is now almost 4 1/2 years old, and weighs just under 30 lbs.  He enjoys tremendously good health, and for that we are grateful.  He attends preschool three afternoons per week.  He does not walk, but is quite skilled at “army crawling”.  Over the last month, for the first time, he has been venturing from room to room in the house.  He now makes his way to the foyer, dining room and kitchen from the living room!  This means that we now have to be much more vigilant since he no longer stays in the room in which he is placed.  He is able to stand and lean onto furniture for support, but for some reason he doesn’t enjoy doing this.  He also has a gait trainer, but doesn’t seem motivated to walk yet.

Ben doesn’t talk or use sign language yet, but he does make lots of sounds.  At preschool his teachers are trying to get him to use devices with simple switches and buttons to make choices with the idea of perhaps eventually getting him to use a picture exchange system or a communication device one day, but it seems like he’s still a long way from being able to do that.

He still wears hearing aids, and he doesn’t really seem to mind them.

He wears glasses, and it is quite a struggle to get him to wear them consistently.  He can yank them off with lightning speed, and then he enjoys playing with them by swinging them back and forth with his fingers.

By far our biggest struggle with Ben since birth has been with feeding.  He is still 100% g-tube dependent, and has been extremely resistant to transitioning over to oral feeds.  Sometimes he seems to do really well for a time, but more commonly he fights, cries, arches, and wants nothing to do with spoons and “real food”.  We have been through outpatient OT at home through early intervention for Ben’s first 3 years of life, and we have been following up periodically with the feeding clinic at our local university hospital with only limited success.  Ben’s therapists at preschool are great for most things, but  frankly they have not been all that helpful for feeding therapy.  This is surprising to me since he attends a school for children with special needs.

So basically we have made very little progress with outpatient feeding therapy so far.

This summer we began the process of having Ben enrolled in the intensive day treatment program at the feeding clinic he has attended since he was a year old, and getting the required insurance approval for the program.  Several months later we received approval from Medicaid (but we were denied by our private insurance carrier.  I can’t understand why they denied it; tube feeding is very expensive.  So far they have paid out thousands of dollars for his feeding pump, formula and supplies over the last 4 years.  You’d think it would be in their best interests to pay for a treatment program to wean him off tube feeds, but I digress.)  So with Medicaid approval in hand, last Tuesday Ben began a 4-5 week program of intensive feeding therapy.

We were extremely anxious about how Ben would react to this program.  I took the day off work to go to his first day there.  They’ve got a great kid-friendly, relaxed atmosphere with two rooms full of toys, a room for naps, a big kitchen, and a TV/DVD player.   This is fantastic for us since two year old Nate also has to spend his days with Mark and Ben at the clinic.  Both Ben and Nate enjoy playing at clinic.  Even with their happy, laid-back approach, the director and therapists are all business when it comes to feeding sessions.

Ben arrives around 9 am after a 1 hour drive.  Over the course of the day, he has nine or ten fifteen minute feeding sessions with breaks for naps and lunch for Mark and the therapists.  They wrap up for the day somewhere between 4 and 5 pm, and drive an hour back home.  The program runs 5 days per week, and is therefore quite tiring for Mark, Ben and Nate.  While Ben is here, he is of course not attending preschool.  Logistically having Ben at feeding clinic every day has been challenging since I still must work full time, and we have two older sons in school.  Fortunately we have good friends who have been tremendously helpful and willing to help us pick them up from school when needed.

Right now our first goal is to get Ben to willingly open up his mouth to accept food without fighting.  The first thing they did was to switch him from a spoon to a Nuk brush, and for some reason, that really seemed to help.  Each session so far is about 15 minutes long, and Ben is given small amounts of food on the Nuk brush.  He is reinforced with a toy or music or something else he enjoys after he takes each bite.  They videotape each session, and weigh EVERYTHING in an attempt to quantify how much food he takes in with each feeding session.  We also have stopped Ben’s daytime tube feed boluses (we still give him water), but we are continuing his overnight continuous feeds.  Of course they will also be weighing Ben regularly at the clinic to make sure he doesn’t lose weight during this process.

After just the first day, Ben started opening his mouth for the Nuk brush where previously he’d just clench his jaws tight for me with the spoon.  He’s had 4 days of therapy so far, and although he is still not thrilled about feeding (especially at the start of each session), he’s doing SO MUCH better.  He’s starting to open his mouth up when the brush approaches now, and even smiles sometimes during his therapy sessions.  Also, with the Nuk we are able to place food a little further back on his tongue, and this makes it easier for him to swallow, and more difficult for him to spit out.  He is not doing as much tongue-thrusting or gagging either.

This weekend we have “homework”: we are responsible for carrying out the feeding sessions at home just like he has feeding sessions at the clinic.  We were given a detailed list of instructions for the weekend sessions, and even the home phone number of the clinic director in case we run into difficulties over the weekend.  Today we did six sessions with Ben and he did GREAT!  Maybe he has resigned himself to his fate.  I hope so!

We are still working him up to taking an ounce of food during a session so we can do a swallowing study on him.  We have been unable to do one so far because of his extremely limited oral intake, but perhaps we’ll be able to do that next week sometime, and go from there.

Overall we are very hopeful that Ben will continue to progress in this program, and will begin to take at least part of his daily feedings orally.  Maybe he’ll be able to enjoy some of our Thanksgiving dinner with us!

I’ve Got Wheels!

Ben doesn’t walk yet, and I suspect that it will be a few years before he does.  Because he is so small, we’ve gotten away with transporting him most places in an umbrella stroller.  After all, they’re lightweight, ultra-portable, and cheap.

Lately, however, we’re starting to realize that they aren’t such a great long-term option for Ben anymore.  He is getting bigger, and his posture isn’t the best in an umbrella stroller.  Also, they are sometimes hard to steer, and they force the adult pushing them to adopt a slightly stooped posture (which is hard on the lower back).  We did have a larger Jeep jogging stroller, however the seat back is broken, and it was rather bulky and cumbersome to use.  Ditto with the double stroller that we have – it’s just not practical to take most places, and Nate is just not interested in riding in a stroller anymore.

The physical therapists at Ben’s school suggested that we look into getting him a more durable wheelchair or stroller.  We went with one of the local medical supply companies, and they came out to Ben’s school one day, measured him, and gave us some options that would fit his body.  His therapists at school recommended the Convaid brand, so that’s what we got a Convaid Scout.   We placed the order several months ago, and it finally came in on Monday!

The representative from the medical supplier came out to help us adjust the straps, etc.  At first Ben wasn’t too sure…

…but then he decided that he definitely liked it!

He was proud to show off his new wheels at school on Tuesday.  Nate was happy to demonstrate how easy it is to push.

So far, we really like Ben’s new wheelchair/stroller.

It is lightweight, folds up quickly and easily, and fits in the trunk of either of our vans.  It rides higher than an umbrella stroller, so it’s easier on Mom’s and Dad’s backs.  And it steers wonderfully!  The big boys love to push him around in it.  It is also “transit ready”, which means that it can be strapped on to Ben’s bus for transportation to and from school (via the red rings visible in the photo above).  We think we will start sending Ben on the bus this summer, so we’ll see how it goes.  We got Ben’s pediatrician to fill out a handicap parking permit for him, but I have yet to mail it in.

We were fortunate that between our private insurance and Pennsylvania Medical Assistance, we had no out-of-pocket expense at all.  It also appears that because Ben is so little, we’ll be able to use this wheelchair for awhile.

Of course, I’m still hoping that Ben will walk someday.  I suppose time will tell, but for now I think we have a good solution.

Ear Gear!

A lot has been happening around here for Ben.   I think it will take a few posts to get everything updated.

Ben has worn hearing aids since he was 5 months old.  He often manages to pull them off (especially the one on the left).  For the last year or so we have used Critter Clips to attach them to his clothing to prevent them from getting lost.  However, the little elastic band on the Critter Clips became stretched, and wouldn’t reliably stay on the hearing aids anymore.

The last time we went to have new earmolds made for Ben, the audiologist mentioned Ear Gear to us.  Apparently they have been recommending these to more of their patients since they help to protect the hearing aids from humidity and sweat.  We decided to give them a try.

So far so good.  Ben seems to like them better, maybe because they’re a little softer against his skin.  He still pulls them off on occasion, but they stay safely attached to his clothing.  And I like the bright blue color we chose.

If only the Ear Gear people made something to convince him to keep his glasses on more!

Welcome, Spring!

This weekend was chilly, and today was rainy, but what gorgeous weather we had last weekend!  The temperatures got up into the 70’s and we were able to get out and enjoy the sunshine.  I had the day off last Friday, so while the big boys were at school, Mark and I took the little ones to the park.

Ben and Nate both went on swings and slides for the first time!  They had an awesome time.  We really should go to the park more often.  They both took good naps that day.

Nate’s an old pro with slides now.  His Sunday School class at church has a little slide in the room and he’s so thrilled that he doesn’t mind me leaving him there during services.

On Saturday morning, Isaac had a piano recital.  After the recital the boys were able to run and play outside for a bit.  Saturday evening we were invited to some friends’ house for dinner.  The beautiful weather continued, and the boys were able to play with their friends in their large fenced backyard until after dark.

Nate was given this balloon by someone during Isaac’s recital.  We hoped it would keep him quiet.  It didn’t.

Jonny thought he’d try his friend’s skateboard and found it was harder than it looked.  In any case, his friend told him that he shouldn’t be skateboarding in his “handsome clothes”.

Nate found the chip bowl:

I am SO glad that winter is over!

February 2010 Update

For a while I wondered if Iwas done with this blog altogether, but since it’s something I enjoy doing (and it helps keep my family in Trinidad up to date with what the kids are up to) I decided to start blogging again.  It has been so long since I last posted that I decided that I’d do another update.

Isaac is 9 and in 3rd grade.  He does GREAT academically, but if you ask him, he always says he hates school.  He loves video games, reading (especially manga and other graphic novels a.k.a. comic books), and playing the piano.  He doesn’t always enjoy the songs his piano teacher assigns, but often plays songs from the Legend of Zelda video game series just for fun.  Since I don’t play any instruments, I’m always impressed to hear him play the piano.  Isaac also plays soccer in the spring and fall because we make him.  He is a wonderful big brother to Ben and Nate (but just manages to fight and disagree with Jonathan on a daily basis!)

Jonathan is 6 and in the first grade.  He does fairly well in school, but is one of those kids who has trouble sitting quietly at a desk all day.  He does well with his schoolwork, however, and is an excellent reader.  He is an active kid who enjoys running around the house, playing video games, helping me cook desserts, and building with Legos and K’nex.  He is definitely a snuggler, and even now loves to sit on laps for hugs and kisses.  He talks non-stop at home (just like at school), and says such funny things sometimes.  I took the photo below after he asked me to give him a faux-hawk just like Ben’s.

Nate is 19 months old.  Wow.  I’d forgotten what it was like to have a “typical” toddler in the house.  Nate started walking at around 14 months, and since then we haven’t had a spare moment to ourselves it seems!   He is very sweet but manages to get into all sorts of mischief.  His favorite pastime lately is scattering things everywhere.

He enjoys emptying the contents of the dishwasher onto the floor.  He puts silverware into the trash.  He puts chalk into the bathtub.  He hurls toy cars and hard wooden blocks at our heads.  He sets the oven to self-clean.  He loves playing with DVD and video game cases, so we decided to get a cabinet that mounts on the wall.  Did that help?  Nope.

Thank goodness he has stopped splashing in the toilet for fun!

Nate says quite a few words as well, but still resorts to screaming when he’s frustrated or bored or tired or hungry.

Benji will be 4 at the end of April.  How time flies!  He still has a sweet, quiet, easygoing disposition and is such a joy to have around.  He loves playing with toys that spin, or anything long and skinny that he can hold in his “big” hand.  He weighs around 28 lbs and is in 2T clothing.  He has gained nicely in the last 6 months and is starting to look rather chubby!

Ben gets around by rolling or “army crawling”.  He can get from a lying to a sitting position by jamming his little feet under a heavy piece of furniture and sitting straight up with his strong abdominal muscles.   He can stand and use his arms for support on furniture, but he will throw himself backwards without warning, so he can’t be left in that position by himself yet.  He has been doing much better in his gait trainer, and finally seems to get the idea that he’s supposed to propel himself forward.  Nate also loves the gait trainer.

Ben still wears hearing aids and glasses, but is getting more opinionated about whether he wants to wear these or not.  I suspect that his glasses are a little uncomfortable these days because he’s grown so much in the past year and also because a certain little brother chewed the pieces that fit behind his ears.  In any case I think he’s due for a new pair even though his prescription hasn’t changed.

Ben is still g-tube fed, and is still very resistant to oral feeds.  Every so often, he changes his mind and willingly eats and tastes food that I’m feeding Nate, but that only happens once in blue moon.  We keep working with him, but it’s discouraging at times.

The biggest change that has happened with Ben over the past few months is that he has been attending preschool 3 afternoons a week!  We were so anxious about him going to school, but it has turned out to be wonderful for him.  He attends a local preschool for children with special needs.  The class is very small, and he has lots of one-on-one attention.  He loves going, and is full of giggles when Mark takes him in.  He has PT, OT, and ST at school, and they also work with oral feeds.  He also has circle time and playtime just as “typical” kids would in preschool.  He’s one of the smallest kids at school (if not the smallest), and everyone loves him!  I think I’ll have to do a post just about Ben’s preschool.

Ben continues to be wonderfully healthy, and we’re thankful for that.

Mark and I are doing very well, but we are tired all the time it seems.  I still work full time and Mark is home with the boys full time.  We still enjoy cooking together, and trying out new recipes.  “Santa” brought us a new TV and a PS3 this Christmas, and we’ve both been enjoying playing “Dragon Age Origins” after the kids go to bed.  We’d like to go to the CdLS conference in Dallas this year and are still working out the logistics of that.  We’re also planning a trip to Trinidad this summer…if we can get everyone’s passports organized!  We already struck out once; we got caught in a traffic jam on Friday afternoon and ended up not being able to get the boys’ done.  Maybe this week.

Hopefully I can keep this blog updated on a semi-regular basis.  We’ll see.

Where has the summer gone?

Good question, since today is the first day of fall.

Let’s see…we visited our family in Pittsburgh and went to a very cool museum…

We visited Washington DC for a day…

And the next morning visited Mount Vernon and learned all about George Washington…

We took a brief trip to the Jersey Shore (which the older kids LOVED even though the water was much too cold for my Caribbean sensibilities.  Ben agreed.)…

Meanwhile, Jonny turned six…

Isaac turned nine, and Natey turned one.  Isaac decided on hermit crabs for his birthday present…

Mark had a birthday this summer too, but I forget how old he is!  😉

Benji had his last home-based Early Intervention sessions with his awesome therapists, and got to visit his new preschool…

…we played too many video games, learned some new piano pieces and read a couple of Narnia stories and Charlotte’s Web and tons of books for the school reading list, cooked with lots of fresh veggies from our local CSA, and before I knew it fall was here, and I hadn’t updated my blog in months!

I hope everyone had as much fun this summer as we did!

Has it really been a month?!?

More like six weeks!  I haven’t posted at all for May – I don’t think I’ve ever missed an entire month since I started this blog.  Since this is my “journal”, I feel obligated to at least mention where some of the last month has gone…

Isaac has just completed second grade.  He has also finished his soccer season with lots of improvement in his soccer skills and attitude (for the most part).  He’s doing GREAT playing the piano, and genuinely enjoys playing.  Everyone but Mark (who was horribly sick with food poisoning) went to hear him play in his spring recital.  Even my dad was here at the time, which was a blessing since he was able to help with Ben during the recital.  Ben and Nate were big fans of  Isaac and his classmates; both enjoyed the music, but were a little loud and had to be escorted to the back of the concert hall!

Tonight we all went to see Jonathan in his kindergarten concert which was so cute and very entertaining.  Jonny turned six on Saturday, and we had a great birthday celebration at home, and one of his friends from school was able to spend the night.  He has come a long way since he started kindergarten – he is reading very well, and his behavior in class is much better than when he first started.  Jonny and I put together a time capsule of his kindergarten year as part of a class assignment, and I really enjoyed doing that with him.

Benjamin is doing great, still has healthy and happy as always. He turned three at the end of April, and we celebrated by going to the beautiful Hershey Gardens for a walk and some photos.  After that, we went out for dinner.  Ben had a great time being out with the family.

We still struggle from time to time with getting him to leave his MIC-KEY button alone, so these days we usually have him in overalls or an ace wrap over his belly.   We’re still working on oral feeds.  For about a month we took a break and didn’t really push the issue at all, partly because I felt it was turing into a power struggle of sorts. We restarted in the last week or two, and there have been good signs of progress.  Ben has actually started opening his mouth for the spoon, has been mouthing toys and objects more, and has been willing to take tastes of foods or drinks that other people are having.  I am cautiously optimistic, and hope that this new curiousity about food continues.  I hope he realizes what he’s been missing out on!

Nathaniel is 10 months old, and growing by leaps and bounds.  We had his baby dedication on Mother’s Day.  He definitely outweighs Ben, and this week he officially has surpassed Ben with his gross motor skills.  He now crawls forward (after a month of crawling backwards and getting stuck in tiny corners), and can now pull to stand.  He is such a social boy and isn’t happy unless someone is either holding him or helping him to stand.  He loves Ben’s therapy sessions and seems to think they’re for him…Mark is constantly having to corral him during therapy.  He now shuns baby food, and loves to eat whatever we’re eating.

Let’s see – what else…

My dad stayed with us for a few weeks in May.  The yard never looked so good, and he helped out immensely with the dishes and the boys.  I’m afraid he spoiled Nate terribly!  😉  My sister Aliyah graduated from college.  The ceremony was outdoors, and we all attended, and then all went out to eat afterwards.

Mark and I celebrated our 14th wedding anniversary at the end of May, and my awesome sister- and brother-in-law watched the kids for us so we could have a rare evening out (we went to a restaurant called “Eleven” in Pittsburgh.  The food was amazing!)  What an awesome gift.

Well, let’s hope I do better with blogging this month.

Snippets…

On Saturday, Isaac scored his very first goal since he started playing in the AYSO Under-10 division!   He really has been making a good effort, even though it has not been easy for him.  We were so proud, and so was he!

On Tuesday the weather finally cooperated and Jonathan actually got to play soccer!  He was so excited since his last two games were rained out.  He did great, had a blast, and scored a few goals.  When someone asked him if his team won, he replied, “There’s no winner.”  I’m glad that he enjoys the game at this stage without needing to keep score.  And we were thrilled that he was able to burn off some of that extra energy.

Ben has had a few trips to our friendly tertiary care center.  He has been picking and pulling at his MIC-KEY button, so last week we saw his g-tube nurse.  We have determined that the tube size is appropriate, but we think he has a mild yeast infection at the site.  We are treating him with some Mycolog ointment, but I’m not so sure it’s doing much good…he succeeded at PULLING OUT HIS MIC-KEY BUTTON for the very first time a couple days ago.  For now we’re continuing the ointment and keeping his belly bound with an ACE wrap.  Poor Ben.  I hope he stops messing with it so he doesn’t have to sweat all summer.

Today we went to  have Ben’s hearing aids adjusted.  He got new molds, and I told the tech about the severe feedback (whistling) we were getting.  She had a neat device which actually was able to cancel most of the feedback (I’m not exactly sure how it works), but Ben will finally be able to wear his hearing aids again.

Lately, Nate has been doing lots of new things.  He has begun teething, rolling over very well in both directions (finally catching up to big brother Ben with his motor skills), trying to crawl on hands and knees and really wants to learn how to pull to stand.  He has been learning how to feed himself and has been scarfing down those little Gerber fruit puffs like lightning.  But he has also been sooo needy these days and cries if you just stand up…before you even have a chance to leave the room!  He really loves Ben and enjoys playing with Ben’s face, hair, arms, feet, etc.  Ben usually tries to roll out of the way, but this week he really seems to be noticing Nate and interacting directly with him for the first time.

BTW, Mark found these neat shirts for the little boys at Toys ‘R’ Us to help everyone see that they are not twins.

Ben turns three tomorrow, and Nate is 9 months old.  Right now Nate officially outweighs Ben.

I suppose it won’t be long before they won’t seem like twins anymore.

Spring Soccer

I love watching the big boys play soccer!

Isaac is on one of our local AYSO Under-10 teams, and Mark is coaching.  They’ve had two games so far.   Jonny still plays on the Under-6 team but hasn’t had a game yet.  So far, the cold, rainy April weather hasn’t been cooperating too well with practice days or Jonny’ s soccer games.

However, the weather was gorgeous on Saturday, and it was nice to get everyone out for a little fresh air and sunshine.  I loaded Ben and Nate and all their paraphernalia into their double stroller.  Both little boys were fighting colds and Nate wasn’t in the happiest mood.  Ben, however, loves being outside.

Jonathan was all set with his Gameboy and a snack.

It was a little difficult watching three kids under 6 without help (since Mark was coaching), but it was still fun.  Nate got fed up sitting in the stroller and wanted to be held.   Jonny also wanted to sit on my lap along with the baby, and predictably had to go to the bathroom during the game, but he eventually found a friend to play with on the sidelines.  Ben, good little guy that he is,  fell asleep shortly after the game started and slept for hours.

To my surprise, all the kids (except for Ben who was sleeping with the stroller canopy up) got mild sunburns.  I never thought the sun would be strong enough for that!  I’ll be sure to take sunscreen to future soccer games.

I’m really ready for a whole week of warm sunny weather!