Saturday, June 27, 2009

Augmentative Communication 2

Before I go out in the backyard to harvest the crop of weeds I'm growing, I thought I'd share something that Uncle Jeff shared with me: www.brainfingers.com. "Brain Fingers" is a hands-free device that enables severely disabled people access a computer. The "success stories" link on their website talks about a teacher who always wanted to be the next "Annie Sullivan," the woman who helped Helen Keller learn to communicate via sign language. "Well," I thought when I read that, "maybe she'd like to teach a little 6 year old girl named Annie Sullivan who needs to learn to communicate?" This teacher took a number of students who tested at a 12-18 month functional age, taught them to use this gadget, and then tested them after using the thing twice a week for 8 weeks. Many of the students then tested out a 5-6 year functional age. Pretty impressive, I think.

So take a look at that link when you have a minute--I'm going to talk to the school about it, and maybe even get it to use at home. It looks interesting. And, if any of you know of anyone who has used it, let me know.

Better go work on those weeds while Annie is napping.

Wednesday, June 24, 2009

Augmentative Communication Evaluation

This morning, Olivia & I packed up Annie and went to an Augmentative Communication Evaluation down at Children's. Marci gave us some good ideas to help get us out of the rut of doing all the initiating in communicating with Annie, and her being a passive recipient. She taught us how to wait until Annie looks at us before we talk, and wait until she reaches to turn the page of a book, before we help her turn it. She also recommended a device called "Go-talk" to help her make choices, such as what book to read. We also looked at a touch-screen computer game that I think would be very motivating for her.

It's interesting how in the first year after her brain injury, I decided to "narrarate" the day in an effort to drag her out of her fog, but now, my constant chit-chat actually de-motivates her from initiating any communication. In other words, I have made a habit of spoon-feeding her information, and now I have to retrain myself in order to retrain her!!

Marci noted that Annie has "yes" and "no" down pretty good, but needs practice in using those words immediately, accurately and appropriately. When she does, then I can add in more complicated questions such as, "Do you want to go to get a bath, read a story, or go to bed?" Then repeat, "Do you want to get a bath?" (yes, no), "...read a story?" (yes, no), "...or go to bed?" (yes, no). That way, we can eventually make her communication more sophisticated and purposeful.

I really appreciate Miss Claudia, Annie's regular speech therapist, who also came to the evaluation, so that we can work together every week to help put these things into practice. It seems that for the last few months, Annie's progress has been hindered by her seizures, and maybe now, if she is moving into a more "up" trajectory, we can actually implement some of these ideas. Unfortunately, she did have one seizure right before the evaluation, and then another in the middle of it. She's had four today total, so that's a bit disconcerting.

She actually only had 2 full days of no seizures this past week, and has been having one or two a day--and again, I really don't know what is causing them. But we go up again on the Banzel tonight, and down on the Zonisimide tonight, so we'll see. These seizures are a huge barrier to her progress, though, so I do wish God would simply heal her of them. And I'll keep asking Him to.

Sometimes I wish I had speech, OT, & PT therapists who lived in my house. Annie just has so many deficits--using her hands purposefully, walking, eating, talking, blah, blah, blah--it is overwhelming for me... When she is in a medical valley and all I do is manage her 15 medicines, and keep track of her seizures, it's almost easier. But when she starts going up, I am overwhelmed at the enormity of helping her relearn to walk, (or simply scoot!), talk, eat, and use her hands. Oh, and I forgot to mention--her teeth. I need an inhouse dentist to brush her teeth every morning, because again, I'm just not getting the job done. And I have to say it again--it's even more frustrating because I KNOW God can heal her.

Jean

Have mercy on me, O Lord, for I am weak; O Lord, heal me, for my bones are troubled; my soul also is greatly troubled; But You, O Lord, how long? Psalm 6:2-3

Friday, June 19, 2009

Last day of school

The kid's last day of school was today--so you know what that means. Yeah, all the structure and planning for summer needs to happen within the next 2 days, because I had no warning that the beginning of summer was almost here. You see, the first week of June I was totally absorbed with keeping food in Annie's body. The second week, I had to make sure David wore something besides basketball shoes to his high school graduation. Then the third week, Olivia graduated from eighth grade, which was another clothing/pedi-mani/flower/cookies-for-all-her-bffs extravaganza.

So now we've dropped off the cliff of all these scheduled events, and suddenly there's a vacuum of things-to-do. I'm thinking I need to find someone who is creative, fun, and organized, because my kids will tell you that I am none of those things and that our summers are consistently non-events. I think they just need to lower their expectations. To zero.

And speaking of zero--we had zero seizures today. That's right, no seizures. The Banzel is working to stop the drop seizures, and as we are weaning down on the Zonisimide, Annie is becoming so alert and chatty. Praise the Lord for answered prayer!

Well, I better get working on the summer game plan. Maybe you could just send me yours, and I'll act surprised when we see you at the zoo.

Jean

Wednesday, June 17, 2009

Hippotherapy

If you haven't noticed yet, this whole brain injury/chronic illness management is two steps forward, three back. My job is to sense when we're moving forward, (because there's no such thing as a BRAIN INJURY CASE MANAGER WHO CAN HELP ME figure this out) and then seize the moment with therapy so that she might be able to regain what she just lost from the three steps back.

The first week of June she was in the hospital with a downturn that had begun in May. When we got out of the hospital, she was still on the way down with vomiting that had not resolved. God revealed that her vomiting was a motility problem. We started on Reglan, and now she is 1,000% better. I cannot tell you how amazing it is to be able to give her a g-tube feeding, and actually be able to finish the thing without holding a bucket under her chin. To finish 3 feedings in a day without her sending it back up is miraculous.

So, it's not even a week after I begin Reglan that I sense that we're on an upswing. Maybe for a week, maybe for a month, maybe for longer--but we're no longer going down, we're going up. So it's time to seize the moment.

Well, I had had Annie on a waiting list for at least a year for Hippotherapy. Here's a link that tells you what it's all about: http://en.wikipedia.org/wiki/Hippotherapy. The evaluation was finally scheduled for last Monday, but because she was in the hospital, I rescheduled for yesterday. So we went. Of course, I left the video camera at home. David came with me to help--which was a good thing, because Annie is now awake, alert and has an attitude.

We arrived at Little Bit Hippotherapy and sat down to go over paperwork. David took Annie out for a stroll because she wasn't interested in paperwork, she wanted out of her wheelchair. After the paperwork was done, we went back into a therapy room. Annie didn't want to lay down, roll over on her tummy, get up on toy horses, or have a helmet put on her head. There was a lot of yelling and screaming. Then we went out into the arena. A therapist picked up a yelling Annie, put her on the horse, (with two therapists on either side holding her legs so that if she had a drop seizure, she wouldn't fall off) and suddenly--NO noise coming from Annie. She is totally mesmerized by this h.u.g.e. Norwegian Fjord horse named "Bjorn."

The first walk around the arena, Annie is silent. The second time around she smiles a little bit. (Where IS my video camera???) The third time around she is giggling. Then they bring her back, put her back in her wheelchair and she resumes yelling.

The therapist there said that she is very weak in her trunk, and the therapy at Little Bit will be a trial, because going around the corners in the arena was a tremendous challenge for her to stay upright.

Of course, now I know what my job is: Do whatever I can to help her regain the strength that she's lost in the last month or two. And your job is to pray that God help me!

Jean

Commit your way to the Lord, trust also in Him, and He shall bring it to pass. Psalm 37:5

Saturday, June 13, 2009

Graduation weekend

So the Dave-meister--number 4 son--graduated from high school today. Bill & I are feeling old, melancholy, and wistful all at the same time. Why is it that it seems like just last week we were in the hospital having this baby?? He has grown so fast, and so tall, and we are so proud of him. Funny, though, but all week long he's had a bit of the "deer in the headlights" look to him. Not sure if he's too keen on the leaving all his friends part.

Annie tolerated the ceremony--Bill and I just strolled her around and watched or listened via loudspeakers and TV monitors. There were other parents walking their little ones out in the lobbies too--kids don't have much patience for long-winded speeches or hearing the first and last names of 400+ graduates. But it was a good day--and any day with no barf is a good day.

So my last post was all about how 6 days in the hospital solved all of Annie's gastro problems. However, I have led you astray yet again, and I feel like a broken record. Or CD, or DVD. But just like people who tune in to watch Days of Our Lives, you have tuned in to read, yet again, that Annie, has indeed Thrown Up. In fact, she threw up 3 times on Wednesday, and twice on Friday.

But I think I have figured something out--or God has told me what her diagnosis is. Now, she is on high doses of Hydrocortisone for her Addison's, and she is pooping, so her throwing up isn't a result of being stopped up, or needing extra hydro. So last night I was trying to figure out why, why, why, WHY she keeps throwing up. Then I read an article about chronic intestinal pseudo-obstruction, and there on the page was a picture of Annie! No, not really--but the symptoms of vomiting, early satiety, constipation, etc., were an accurate picture of what is happening to her.

In a nutshell, chronic intestinal pseudo-obstruction is when the intestinal tract doesn't move food through because of either nerve problems or muscle problems--or both. And it may be caused by disease (or acquired brain injury) or drugs, or both.

One of the treatments for this chronic intestinal pseudo-obstruction is our old friend, Reglan. Reglan is a motility drug that we had used early on in Annie's illness, and honestly, I can't remember why we stopped it. But as of today, we're trying it again, because if we don't get this wagon turned around soon, it's going to be uber bad. The good news is, as of her first 2 doses of Reglan, she has not thrown up. She has threatened to, but we've been able to cut her off at the pass.

Well, I am hopeful. I really need her to keep her food down and her hydration up. She just needs to turn this corner. Anyway--again, thank you for your prayers--I do feel like you guys are holding the lamp up as I walk through this maze.
Jean

Your Word is a lamp to my feet and a light for my path. Psalm 119:105

Tuesday, June 9, 2009

Day Six and we're outta here!

Annie finally hit the jackpot last night--oddly enough, while Andy was watching her down at the hospital so Bill & I could attend a senior awards ceremony with David. (Yeah--David won a scholarship that will at least pay for his books next year!)

So, yeah, Annie cleared her gut, and was discharged today. What a relief to be home! I can't believe how happy I am to be home. I think Annie is, too, but might take a few days to be on top of her game again. She is one tired little girl.

I think this one is going to be short--we are all pretty worn out. Thank you again for praying for us--and believe me, we will do our best to make sure this situation is a one-time event, never to be repeated again!

Jean

Monday, June 8, 2009

Children's Hospital . . . Day 5

If you notice this post to be low on the "eloquence scale" it's because this is Bill writing - not Jean.

Jean's with Annie tonight, and without her computer, so she asked me to post an update. She also made me promise not to say anything gross - so this will be pretty short.

We're still waiting for something definitive from the doctors as to why Annie continues to be stopped up, gaggy, and just generally droopy (come to think of it, I guess I would also be droopy if I were stopped up and gaggy). They've taken another x-ray tonight to see how much of the blockage remains, and we should have some answer on that tomorrow. We've been assuming all along that her gaggy-ness and throwing up are directly related to her being stopped up. It will be interesting to see once they get her completely cleaned out if the gaggy-ness goes away on its own or if there is another issue going on that we haven't dealt with yet.

Bottom line, we'll probably still be in-patient (and impatient) for another day or two at least until this latest mystery can be figured out.

We appreciate your prayers, and I ask that you pray especially for Jean tonight that she is able to manage some sleep - I'll be taking my shift tomorrow night. Also of course pray for Annie - though she can't say it, we know this is just as frustrating and boring for her as it is for us (add to that the pain of being poked and prodded all day and all night). Through all this, she has also lost quite a bit of weight that she'll need to get back once we are past this latest crisis.

- Bill.

Saturday, June 6, 2009

Brown cows and other moooving subjects

Well, Annie's still on IV fluids and Golytely, and we are seeing some progress--she's not as gaggy as this morning when she threw up twice. She also seems to be slowly responding to the Golytely--slowly being the operative word. Of course, I don't think I'm up for an explosive situation, so slow is probably preferable to fast, especially when you take into account her Addison's, and the importance of keeping her electrolytes in a safe and happy range.

This afternoon when her doctor came in to discuss the Plan, I floated the molasses & milk enema idea, and she agreed that a "Brown Cow" might be in order. She wasn't sure, though, if the hospital would have the ingredients readily available, and suggested that I might need to make a trip to Safeway. (I did find some anecdotal information on Brown Cows--or M&M's--on allnurses.com. As my nurse friend, Terri, commented, you never know when you might need this inside scoop, so take a look after you close out of Annie's blog.) Anyway--if Annie hasn't made any great moves in the right direction by tomorrow am, I'll run down to Safeway to get some molasses & milk.

Other than that, she seems to be doing okay--she alternates between being alert and angry at the nurses when they want to check her blood pressure, take her temperature, listen to her heart or brush her teeth--and sleepy and snuggly when we're holding her.

The plan tonight is to keep the Golytely going in, the poop coming out, the IV fluids on, and her hydro dose doubled. Tomorrow--if things have gone well--they'll probably shut off the Golytely, and start her tube feeds again. Then if she is able to keep her food down without throwing up, she might get to come home on Monday.

Thank you again so much for your prayers--God is answering.

Jean

Friday, June 5, 2009

Down at Children's

Well, we exhausted our bag of tricks to get Annie's gastro system to clear, so yesterday we took her down to Children's to see if they had any good ideas. The x-rays show that she is still clogged up, but the first bag of Go-lytely that was supposed to clear a path has already come back up. So we'll be down there until we get this problem resolved. We do need your prayers.

Jean

Tuesday, June 2, 2009

Keeping focused

The 11th chapter of Hebrews is commonly called the "Hall of Faith," and lists some stories of people in the Bible who trusted God in trying times. Some people were were saved through miraculous deliverances and some of the people died martyr's deaths. But all of them kept their eyes focused on "Jesus, the Author and Finisher of their faith." Hebrews 12:2

I've been thinking about Hebrews 11 a lot lately. I think on one hand, of how Bill was healed miraculously of PSP through the prayers of many people, and yet on the other hand, Annie is still sick. I think often that sometimes you get the answer to your prayers here on earth, and sometimes you get it in heaven. But I've felt more this time around with Annie, that tangible reality that Jesus is enough--even if Annie is never healed, and we take care of her the rest of her life, Jesus is enough.

Sometimes I feel like His Spirit is like a comforting blanket around us in our house. Maybe that sounds like one of your prayers? God's Spirit really is here, and He gives us what we need moment by moment. I know that this is a direct answer to many of your prayers, and I need to thank you again for praying for us. God is real, His Spirit is present, He listens and He acts.

I know that every person reading this has burdens, and some of you are dealing with life-long situations that will not change here on earth. I want to encourage you to re-read Hebrews 11, and ask God for the supernatural strength you need to keep going, and finish well the race set before you.

Jean

Therefore we also, since we are surrounded by so great a cloud of witnesses, let us lay aside every weight, and the sin which so easily ensnares us, and let us run with endurance the race that is set before us, looking unto Jesus, the author and finisher of our faith, who for the joy that was set before Him endured the cross, despising the shame, and has sat down at the right hand of the throne of God. Hebrews 12:1-2