My Cute Little Monkeys: Therapy Schmerapy

On Tuesday we had another visit from Mike, Dylan's new PT. His first question to me was if Dylan's still standing up to everything to which I responded that she wasn't doing it any more than before, but yes. He asked me if I had still been corralling her and I admitted I hadn't been as great at that... he was forgiving, but he said we need to get right back on that again. It's what made a huge difference initially, I just need a pep talk every week or two to keep it up!

She has been in the stander, points for that? Though, not three times a day, I try to preserve Ian's fingers and toes and half the fun is her riding around in it while Duncan pushes! So, she has to be awake while Ian's sleeping for it to work out perfectly... excuses, excuses. She really does like the stander though!

I explained my frustration with the cruising, side-stepping, it was so hard for me to work with Dylan on this because she just does not get it. She doesn't get the shifting the weight... she's not all about it. It's reminding me of early feeding days when I gave up and Pat said she didn't blame me, we weren't getting anywhere and we needed to try a new strategy. Hard to work on something that's not rewarding when usually working with Dylan is VERY rewarding.

He said "What do you mean, she just went to walking?" As Dylan took like three steps along the kitchen chairs we had lined up. Well... no, that's not what I meant. Silly girl, showing off... She just does better facing forward, not side stepping so when she kind of turns, she kind of goes. She's been doing better with the walking when we hold her hands, but the motivation's the key here. (Hence why the corral is so important.)

He commented that she seemed better in 3 or 4 four different areas so even though I was hard on myself for not making her corral, whatever I was doing was working. (Big fat news though, it's not me!) I guess when you see her every day it's hard to see that she's progressing and that there's a big difference. He saw it though... at one point she was up on one knee, sitting there, and he was saying how much hip strength it takes to balance like that (try it... it does!!) and that was definitely an improvement too!

There was a TON of information covered in our time together, he went in to a lot of detail but said he normally doesn't but it seemed intuitive to me so he explained a lot of the science behind it. PT in my future perhaps? Not so sure about that... but I like the details and apparently he could tell.

He had me try the tapping thing he did last time. If you remember his hands were moving like mad, tapping and pushing and grabbing to get her to stand. They were really going. This time he had me try and I could totally do it. Which he pointed out I would have never been able to do last time because she's much more stable this time. She was... it was only a tap here or there and she would stand on her own.

My take away was to take one hand and help her shift her weight to the opposite leg as she walks toward me (a binki in my mouth is a great motivator for this... backwards of course!). He said not to relieve any weight, don't make it easy, she needs to learn to move her weight. If she loses balance on her weight bearing leg I am to grab it with my other hand to give her stability and assure her she was okay. Then, as she brought her other leg forward I switch hands, to shift the weight to the other leg. It's quite interesting... the goal was to keep her moving, and not relying on how much support I was going to give her. Use two hands and kids tend to drop their legs out from under them knowing you'll catch them! She did very well. When Matthew got home he asked me to show him and we did it and she took four steps toward me! He was very impressed!

Pretty good because she's not feeling very well and has been pretty crazy grumpy for about a week. We even had to bust out the magic pills Trina gave us to get her feeling better! Those things are amazing, I am telling you... I wish we all had pills that help us feel better quickly but I guess our bodies are supposed to do that for us where hers won't! Her poor little bowels have been completely whacked because of the last antibiotic too.

I inquired with Mike about a wheelchair because he had mentioned it last time we were in clinic and he looked pretty stunned. He said he was really on the fence with her about it and if he pushed it in clinic it was before he saw her in home and realized her full potential. He's really thinking she probably won't need one at all. He said giving her one at school will just let the teachers be lazy, since our goal is to not have her in wheel chair that would be the wrong way to go! He commented about it being a terrible alternative to a stroller but we could pursue it if we wanted. Uhmm... if you think she won't need one we will go with that! If we start leaning that direction he said he would find a loner for us to try out.

Speaking of school - He offered to go to her IEP, CURSES, it's over! I love that all of these people wanted to go to her IEP to advocate for her! Pat, Linda and Mike all offered! He talked about setting goals to make the time she receives longer... that way if she doesn't meet the goals it's on the school for not providing the services required. Not as big of a deal when she's three and going for a couple hours, twice a week, but when she goes more we really need to push for good goals. Interesting! So I told him I might take him up on his offer later.

Monica asked if this was the end of therapy or if she gets some through school which is a great question. It's the end of therapy here in the home that the government pays for or subsidizes (we had a small monthly fee through IE but it's on a tiered scale depending on income and number of kids). She will get some therapy in class but not a lot. She gets a half hour a month of each OT and PT and speech offered a half hour a week (I think...). Speech is going to focus on communication more than actually talking at this point. For most of it they will come into the classroom where there will be a couple of kids who need services but occasionally they will take them out. Apparently the structure that's set up in schools now is for the therapists to teach the teachers how to work with the kids and the teachers do most of the work. No pressure teachers... sheesh, this hardly seems fair doesn't it?

Hence why we are pursuing Mike outside of school and we will likely pursue speech and OT when the time comes. Mike said it's likely her gross motor will far exceed her speech and fine motor and we will probably have a problem getting her to sit and focus on learning to sign and other things because she'll be so good at being on the go. He said we will have to get chairs to strap her down to learn... I told him I would forgive him if he could get her walking.

Matthew's ready to have weekly PT regardless of the cost (anything for his baby girl) but Mike said with the progress she's made in the last two weeks it's fairly obvious that there's no need to break the bank with him and twice a month would be fine. FYI - in case you're curious, sessions cost $125 or so an hour with a discount of 15% or so if you buy four at a time. Because he's out of network Insurance will pay 70% of what the insurance company deems is an acceptable rate (possibly... probably... not $125 an hour). It's still not a HUGE expense for us, we will no longer be paying IE, and it will benefit her greatly... it's also not going to last forever. It really helps you feel blessed that it's not a great expense though there are in network therapists for those who can't pay out of pocket (Medicaid and such will pay for therapy for those that qualify).

Mike mentioned maybe a month of intense therapy next year if she's close to something, only then should we do once a week for four weeks, but other wise weekly is probably excessive.

11:00 is also a bad time for Dylan, but it's all he's had available so far. At 11 she's usually just winding down. (Though she did sleep like a baby after PT yesterday!) She's much better first thing in the morning. So he's offered to schedule her sessions early in the morning, on a day he doesn't normally do therapy for his business, he will come to our house at 9:00. It's not a time on his calendar but he said he would schedule it for us. We have the 10th and 17th set up for November and then she will be off for Thanksgiving, we will probably do the same thing in December.

I have to be honest and say that I have been totally overwhelmed with his kindness and flexibility. I have so many things up in the air with regards to insurance, how much they will pay, how to submit claims etc. but he's made me feel totally comfortable on how he will work with us in getting things done. Also his willingness to work on a day he normally doesn't and even come to our house, something he normally doesn't do. The offer to advocate for her at the IEP? Amazing. Whenever we get overwhelmed with someone going out of the way for us it makes me a little teary...

He asked if I was having withdrawals from IE since most people really have a problem with leaving it at this point. I mentioned how I would miss Pat but I know she will always be there... other than that, I wasn't fond of Sarah and was severely under-impressed with Group so I was okay with things. It's a new chapter, but I am not change averse at all so I think we will come out on top. We always do.

In other areas - We scheduled Dylan's bladder study for the 3rd of November. We plan to thoroughly abuse our sitters that week (*wink* *wink* Ami). Dylan has appointments at Primary the 1st, 2nd and 3rd. Matthew has the 2nd and 3rd appointments scheduled off from work, so we can divide and conquer those days if necessary but we tend to like to go together. Especially if the bladder appointment will result in a cathing lesson...

She's also eating like a champ. She ate for her dad the other day, and she'll eat for me as many feedings as I want to give her during the day. We always do breakfast but the other meals are a bit sketchy depending on what's going on. She's really been quite good about it. The gal loves her lemon pudding, what can I say!

As for the boys...

Ian's started crawling, just in time too! He's been cruising like mad and he's started planing, which is my new word I have learned. It means walking against a flat surface, such as a wall. (See, we learn so much!) He's the happiest little guy in the world and he rarely cries... so there's nothing else to report here. Thank goodness for easy little people!

And Duncan who is now my big boy (ask him, he'll tell you) is doing great with his potty training. We even went to both grandma's this weekend with big boy's on... this is great because as you probably know, boys get distracted when they are having fun and are busy. He did perfectly, we haven't had an accident in a while (knock on wood).He even takes naps with a dry diaper. Number two is still an issue... but he usually does it in the morning when he has a diaper on from over-night. He doesn't want to tell us when it's going to happen but if we catch him he will go on the pot.

He says everything now... and we realized fairly quickly that when he says bridge it sound much more like a certain curse word so daddy's been having a blast with it. "See ya later bridges!"

He also thinks he's quite big for being able to put his milk away in the fridge when he's done with it. And get it, and put it away, and get it, and put it away... it's a work in progress.

Another crazy long post!! I just like to remember almost everything and jot it down for future reference... and all four of my fans are just along for the novel!