Signs of Spring

 It has been a long, cold, snow filled winter here in the north east and I am ready for spring. Mostly I am ready for weather were Little E can play outside. March is always a tricky month around here. I always think we should have turned a corner in the weather department and ma always disappointed when it is still crappy. Some signs that the nice weather will return have been sighted. First the snow melted and we saw our lawn and the curbs for the first time in months! Then we had a few days above 40 degrees! Followed by seeing a flock of Robins singing out side of school! Unfortunately this was trailed closely by my allergies. Although I am not enjoying feeling stuffed up and loosing my voice. We have been taking advantage of the warm temperatures and getting outside. Last weekend we took E to Drumlin farm to walk around and see the animals. It was great., E loved it. She was entranced by the chickens and kept running back to see the pigs and cows. I think what she really enjoyed most though was being able to run free and splash in the puddles. We had a great time and I am so glad we have a membership so we can go back as much as we want this summer. I have a feeling E will be spending a lot of time with these animals this summer. I also figured out that my parenting might be a bit different than other parents. While most of the parents spent their time trying to steer their kids away from the puddles I was actively encouraging E to get right in and get muddy.  Spring in New England...Mud and Snow piles...with the hope that flowers will follow!

What a week!

Nothing big has happened but geez am I glad to have this week over.  The kids are taking a quiz right now so I have a minute to blog.  So what made this week crazy?

• Shazam is in the middle of mid term papers so is working her butt off at the library all the time.
• Shazam is sick and feels like poo.
• Ella is teething.
• Work for me is hell.
• Shazam had a very important interview for her 2nd year internship.
• Shazam hates interviews.
• I had no time this week to get anything done at work because as I mentioned above work is hell.

The good news is that Shazam is making some progress on the papers and she got the internship!!!  This is great news.  She really wanted a hospital placement and she got one at The Brigham.  Not only will this look great on the resume but the program seems really awesome and it seems she will get great experience and the support that seems to be lacking at her current placement.  There are some drawbacks to this placement like the fact that she will need to take public transportation and that I will most likely need to to daycare drop off really early before school and then get to school just as the day starts.  Not ideal but we will make it work and it will put Shazam in a good place for interviewing for a job next year.

On top of teaching a new grade level with curriculum I have never taught but our team this year is "special"  we have lots of special needs and the mean girls.  Our days have been filled with meetings with kids, with parents, with other teachers and counselors this week.  I swear this is the only time this week I have sat at my desk.  At night I have been trying to write quizzes and planning my days.  I just can't seem to catch up.  I was going to go to Maine and visit my cousin this weekend but the weather is going to suck and I really don't want to be trapped in a small non baby proofed house in the rain and sleet all weekend so I am rescheduling.  My mom may still go up.  If she doesn't I think I may be traveling to her house so I can have help with E since Shazam will be at the library all weekend.  As much as it will stink to be separated it will be nice for Shazam to have some peace away from E and her crazy activity.

As for E I hope some teeth pop up soon her hands are in her mouth all the time.  Other than that she is well healed from her lung issues and off all the meds.  Which is good since they made her a crazy person.  The only thing we are still dealing with on that front is that the radiologist who read E's chest x-ray noted that she was osteopenic.  What this means we are still trying to figure out.   When she was at the doctor last week we had lots of blood drawn she wanted to look at her Vitamin D, calcium, phosphate and some other things.  All tests came back normal which is a good sign.  The doctor spoke with a pediatric radiologist at Children's who thought this might be because it was not a pediatric radiologist reading the xray.  She has a call into the pediatric endocrinologist to see what our next steps are.  One probable cause is her prematurity.  It seems that bones calcify in the third trimester which E missed most of so it would make sense that her bones would be not as calcified and dense.  What this means we don't know yet.  It may be that her bones are typical of a 20 month old 30 weeker.  It may be that all she needs is some calcium and vitamin D supplements.  It may means she needs to see the endocrinologist to figure it out.  The doctor is on top of it so I am just waiting to see what the deal is and not freaking out (which I am not and I am very proud of!)  Oh prematurity you are a gift that seems to keep on giving!  So now I need to run and figure out if I can send one of my classes to another lunch period since we have a class split by lunch and a quiz which does not mix well.   It is always something.

Early Intervention Evaluation

The short story is that she doesn't qualify. She needed to be at a 14 month level in at least one category and her lowest score was 16 months. So yeah!

Here is the breakdown she is 19 months actual right now.  Her last evaluation was at 14 months actual I will
put last evaluation in (green)
Fine motor-20 months (13 months)
She did very well and they were impressed with her grasp with a crayon. Only did a 2 block tower vs a 3 block tower.

Cognition/problem solving- 18 months (14 months)
She still didn't do the bloody 9 cubes in a cup task but I still want to see them put 9 cubes in the cup. She put as many in the cup until it was filled then took some out and started again. I don't get it...but I digress. She also had a lot of trouble concentrating perhaps I shouldn't have given her a dose of pretnisone 30 minutes before the eval (whoops).

Expressive language- 18 months (15 months)
She still doesn't have a ton of words but it is up and seems to be increasing daily. She scored where she did because she was repeating sounds very well. The SP said that this skill was key to increasing her vocabulary and since she was doing such a great job with it she was not worried about her low vocab.

Receptive Language-16 months (15 months)
This was a surprise to me. She seems to understand everything we say (doesn't do what we say but she is 19 months). Anyway she didn't point to the pictures when the asked where is the ball ect. She also had trouble concentrating during this part of the eval. which the SP feels she would have done better at if she wasn't all hyped up on pretnisone.  This was also her area of least growth so I will be working on this with her.

Social Emotional-26 months (19 months)
All I have to say is that we are in trouble with this one. She is was a ham for the evaluators and was on their laps giving kisses the whole time.

Self care-19 months (14 months)
I always think this is funny what should she be doing be getting ready to move into her own apartment?

Gross Motor- 18 months (11 months)
The pt was impressed in her improvement since she had a huge leap since her eval in the fall. She was at 11 months last time so a 9 month jump in about 6 months. Go E!

I am very happy with her progress and glad she doesn't need therapy although I am sure it would help her catch up more quickly although I am sure she will.  When I looked back at her evaluation at 8 months she was delayed in all areas except social emotional.  Her lowest area was her receptive language where she scored only at 5 months so this area seems to where she struggles and where we should work with her.  So good news this week.   Up two pounds and developing well.  Yeah for good evaluations!

Sick Sunday

Well we made an all time record for health this winter with a nice 2 almost 3 week span of a healthy E.  Alas all good things must come to an end.  Two weeks ago I went to pick E up at daycare and a pack n play was drying out in the yard.  Not a good sign.  Well it turns out two kids had gone home because of vomiting.  Another two cam down with it the  next day.  So we were on puke watch last weekend.  I was really looking forward to puke fest for my vacation.  Thankfully we had no vomit but her gastro system didn't get out unscathed and E started having problems on the other end on Sunday...at my mil's.  She seemed fine on Monday in the am but the afternoon it was back.  I stepped up her probiotics and it was gone by Tuesday!  We had a nice week together but on Thursday afternoon her nose started to run.  So I knew we were back on the sick wagon.  Friday she was ok and Shazam and I went out to dinner for her birthday.  Yum.  Friday night E was pretty restless and woke many times which is unusual for her.  Saturday was busy with tutoring and errands in the morning.  By the time I got her home in the afternoon I could tell she was tired and didn't feel great.  I tried to put her down but she would sleep for 5 min and then wake up crying.  Finally after 45 min I gave up and go her up.  She was labored in her breathing so I kept a close eye on her.  When Shazam came home from lunch with a friend she was retracting a little and grunting when she breathed.  I was really hoping to avoid the ER on Shazam's birthday so we gave her a bath and lubed her up with some vics but by 10 with no sleep to be had by little E and very pronounced wheezing that we would be ER bound.  So into the night we went.  She was very unhappy when we got there and threw a hissy in triage.  Her O2 was satting at 90 and she had nasal flaring and definite retractions.  When you show up with a preemie who is having trouble breathing you get pretty fast service and we were in a room less than a half hour of checking in.  We started blow by oxygen while we waited for the doctor.  The nurse observed her breathing and let me know that a respiratory therapist would be over to give a breathing treatment.  The doctor came in and checked on her confirmed that she needed a breathing treatment.  She got one breathing treatment and was still wheezing and her oxygen sats were 92-94 so off to a chest x-ray we went.  I think triage and the x-ray were the worst part of the visit.  We had to pin her down for two xrays and poor little E was pretty upset by the end of it.  On top of feeling like crap, she had not napped all day and by that time it was about 12 am.  The x-ray was clear so she had another treatment and a dose of oral pretnisone which did the trick and we got to go home.  We are now the proud owners of our own nebulizer.  We have been doing treatments every 4-6 hours and other than some wheezing this morning around 10 she has been breathing really well.  Still a little short of breath but not in respiratory distress (no grunting, retractions or fast breathing).  She also is on an oral dose of pretnisone once a day.  We will check in with her doctor tomorrow to see when she wants to see us in the office and will continue the nebulizer every 6 hours for the next 4 days and the pretnisone for another 2 hopefully by then she will be all set and we can pack the nebulizer away for a long time.  Although it is a pain to do the treatments E has been a trooper and while some kids hate the treatments E actually seems to enjoy them.  At one point tonight she had the whole tube in her mouth.  I am not going to let her know that she is supposed to hate them.  Here she is huffing on her elephant trunk as I call it. 

18 month update at 19 months

Well it practically took until 19 months to get her 18 month appointment because of snow.  We had to change the appointment twice.  Argh.  Anyway I wouldn't say it was our most stellar appointment.  I knew it wasn't going to go great so at least I was prepared.  Generally E is doing ok.  She was healthy for the appointment which considering she has been pretty much sick almost the whole winter and fall is saying something.  My major concerns were her lack of growth and her slow language development. 

So Ella's weight. it went down which as you all know is not the direction a growing baby's weight should go.  She was about 22 lbs at 15 months.  She was 21 at her 18 month appointment which really was 18.5 months.  Obviously she should have gained weight.  She has been following a curve at about the 15th percentile for her actual age which is pretty amazing since she was well bellow the average for 30 weekers at birth.  That is until this visit.  She is now at bellow the 5th.  The fact that she dropped is the problem really not that she is in the 5th.  So the doctor put us on a high fat high calorie diet to pack the weight on.  So now we are putting cream in her milk (which she loves by the way) and butter in just about everything.  I think it is working and we go back in for a weight check in a few weeks.  How we will get her to drink regular milk after this I will never know.  I also have had to be very careful not to pack on the pounds along with Ella.  I think that has been limited in its success.

As for the speech E had about 6 words at the time of her visit.  Mama, Ma, Bye Bye, Uh Oh, namina (banana), didi (dog)and apple.  Our doctor wanted to see her using 15-20 words so back to early intervention we go.  We just had our intake interview yesterday and the team will come out and evaluate her on Monday.  In the couple of weeks since she saw the doctor she has pick up some more words which has been nice but still not where she needs to be.  I spoke with the speech pathologist at school and she said that she should be using 30 words by now at almost 20 months.  So we will see if she qualifies for services.  I think she is doing pretty well in her other areas.  When we last were evaluated at about 14 months she was not walking so she was at 11 months for gross motor.  Now she is walking up a storm so I am interested in what she should be doing now.  Her fine motor has come along so far and she is really into coloring and doing puzzles.  I do need to keep a good list this week for all her words.  In addition to the words like up and bun bun that she has pick up we also realized that she is also speaking spanish.  So some of the words we thought were babble are actually words.  They speak Spanish at daycare so it is not surprising that she has picked some of them up.  So now her additional vocabulary is more (with the sign) and mas, pero, manzana, kitty, meow and up.  She also howls like a wolf and whoos like an owl.  I will have the low down next week as well as if we qualify for services.  I hear great things about speech therapy so if we need it I am ready to get going.

Ten Things Tuesday

Sorry for the absence.  So much going on and not enough time to blog.  I think part of my problem is that I don't have a structure to my posts.  I keep trying to think of what to write and then never doing it.  So I am going to try some repeating posts to see if I can get back on track.  So here goes my 10 things Tuesday.

1.  We finally got to go visit the NICU yesterday it was nice to see our favorite nurses.  It is nice to see that they remember us and miss us.

2.  It is vacation week I am so happy.

3.  Little E seems to be gaining weight again which means our high fat high calorie is working. (more on that in another post).

4.  Early Intervention is coming today so that we can get Little E back in.  She is not doing well with language acquisition. (more on that in another post).

5.  E took two naps today...how nice.  She is actually still sleeping.

6.  I am going shopping tomorrow.  I am so excited.

7.  Now that we have set up the EI evaluation E seems to be talking more.  Still delayed but perhaps now that she is walking full time she has time to get some words.

8.  I am actually interested in seeing how E tests in all her areas.  I both hate and love EI evaluations.  I love seeing what she has progressed in.  I hate that it points out where she is still behind.

9.  I did out Federal taxes an Shazam got her refund today so I should get mine soon.  Now I have to do our state taxes.  It pisses me off that we have to do them twice.

10.  I hear the little lady so I guess it is a good thing that I am on ten.  See you tomorrow...hopefully.

Wordless Wednesday-Snow Day