All Done!

I'm using one of Judith's favorite phrases for the title of this post, because today was a big day for her.  We had a meeting with her service coordinator during speech because her coordinator wanted to touch base before her annual eval.  We discussed her progress, and decided that since she met and exceeded her goal, we would officially discharge her from services!  Speech was the last area she was showing delays in, so this means she is completely caught up, and the discharge is a total discharge from early intervention!

Of course we have the card and number for her service coordinator, and we can call at any time if we have a concern or want an evaluation for something, but unless she shows some serious regressions in an area we should be set and can close another chapter of her preemie story.

Switching Up Routines

It's always hard for us when we have a major change to our routine, especially a routine that has been in place for a year!  It was our first day without physical therapy services, and I'll be honest: I was nervous about how Judith would react, and I wasn't sure what to do with myself since I was missing out on one of the rare opportunities for face-to-face adult interaction that I get in any given week (pathetic, I know, but such is the way of life during RSV season, especially when you don't have Synagis to back you up).  By 2:30, I was trying to figure out why it felt like the day was dragging, and I remembered it was because we wouldn't have PT today.  To celebrate, Judith decided to take a nap during the time when she was so accustomed to working hard.

We're almost a week into the breathing treatments, and we've had a good stretch of cooperation!  It helps that I discovered the goodness of Mickey Mouse Clubhouse on Disney Jr. every morning - that show is like baby/toddler/preschooler crack, and Judith is hooked after 2 episodes.  As far as kids' shows go, this one is pretty good and doesn't drive me nuts like some of them (::cough cough Barney cough cough::).  It gets us through the majority of the treatment, and I'll take any special distraction we can!  She's also adjusting nicely to the mask.  I know that for many kids, the mask is a huge issue.  However, the more she's using it, the more she's adjusting to it.  I'm always amazed at how quickly she adapts to things, and I attribute a lot of that to everything she's been through in her short life thus far.  Plus it helps that she's used to using her spacer twice a day, every day - that has a mask on it, and Judith knows our key words for her treatment, so I can turn those around and use them during neb treatments!

Granted, I'm typing all of this and painting a glorious picture of this calm, cooperative toddler, and that's not exactly the case.  She has her moments, and today she was extra wiggly during treatment time.  Even so, I'm getting the bulk of the TOBI into her lungs, and that's the important thing.

I feel bad for Buster & Lady.  They're not terrified of the nebulizer, but they certainly don't like it.  The machine is loud, there's vapors in the air, and Judith looks like a little dragon breathing the mist through the mask.  For some odd reason, cords, tubes, and wires freak Buster out, and he's paranoid to jump up or go near an area that he perceives as "obstructed" (realistically, he can easily clear said cord, tube, or wire, but chooses not to unless we coax him... a lot).  Lady has taken to plastering herself against me while I give Judith her treatment - I love the dog, but it's mildly annoying when she does this and sinks into the crevice between cushions on the couch, making it hard for me to move if I need to readjust to Judith's squirming.  I know this is an adjustment for them too, and I'm hoping they adapt, otherwise I'm going to hate to see how they react once Judith can get The Vest.

Breathing Treatments and EI

No guarantees that I can keep this post short - sorry!  I'll break it into 2 parts though, because a lot has happened in the past couple of days!


Breathing Treatments
I gave Judith her first breathing treatment Wednesday night.  That was an epic fail: Judith screamed through the entire treatment, and it was the type of fit she normally reserves for the doctors' offices.  And since she had herself so worked up, she puked all over the place once the treatment was done.  So not only did I have to worry about remembering what I needed to clean on the nebulizer, I had to clean up the vomit in the PnP and the Step & Play piano, plus change her and supervise her to make sure she didn't get into the dog water bowls.  Fun times.

Thursday morning started the same way: she was refusing her treatment, was fighting me, and threw the mask with medicine cup attached on the floor... twice.  Finally I had her sit on the couch (I was right next to her with a hand on her in case she decided to bolt) and tried holding the mask at her face instead of trying to strap it to her head.  Throw in a little singing, and she was able to complete the rest of the treatment.  I felt much more confident about things after seeing what would get her to respond, and I filed it in my mind for the next daytime treatment.

Thursday night, she slept through the entire treatment, which was my goal (it was my goal for Wednesday too, but she decided to wake up).  Score!

This morning, she did well!  Yes, she still shoved the mask away and wanted to play with it more, but we got the bulk of the treatment into her lungs since she allowed me to hold the mask against her face for longer periods.

Now let's hope that she continues to do that well for the remainder of the treatments!



Early Intervention
Judith's annual eval was yesterday afternoon, and I am very pleased with the results!  Judith actually performed the majority of the tasks they were looking for, save for a couple things!

An hour and a half later, the paperwork was signed and we had the results.  I can't remember what all of the specific numbers were (we should get the report in the mail soon), but I do remember that she's at a 16 month level in gross and fine motor, which means we're discharged from PT services!  She's somewhere around 16-17 months for cognition, but is lacking in communication and speech - she scored around 11 months in those areas.  As a result, she qualifies for speech services, and we will get those moving within a few weeks once we set up a time with the therapist and whatnot.

If you are unfamiliar with how EI performs these evaluations, they score the baby/toddler based off of their actual/chronological age, so for a preemie, it often looks like there's a bigger delay than what there really is.  That's the case with Judith's speech and communication: if we adjust her age, she's actually within the normal range and would not qualify for services.  But because they base it off her actual age, she qualifies.  I'll do anything to help her get caught up to where she needs to be, and if speech services will be the final boost, so be it!

I was just thrilled to hear how well she's doing in so many areas, and to hear that she's almost completely caught up!  At this rate, she will be caught up by age 2, and that makes me happy to know how far she's come in such a short time!

EI, PT, and 2 BTs

Hah - a title full of acronyms.  Pretty clever for my brain not functioning well from lack of sleep in the heat last night.  I finally caved around 2 am and got up for an hour.  Judith was up for a feed anyway, then decided it would be appropriate to stay awake for an extra 45 minutes.  She went back to sleep, but was up at the butt crack of dawn.  Lovely.

She was actually fairly pleasant today, and that's a good thing because we had our first physical therapy session through early intervention this afternoon.  Her therapist is great - he explained how to do some easy stretches to help her torticollis (which is very mild, and should clear up in a couple weeks - yay!).  We'll get our full goal plan next week, and I already told John we're sticking with the program for the full course.  Some parents choose to end services early, but I think that's a little silly.  If she was getting therapy as a full term baby with torticollis, I would stop once it's cleared up.  But since we know she's already delayed, and could end up even more delayed in time, I say it can't hurt one bit to give her the services for as long as possible.

The dogs were awesome the entire time today!  I'm so proud of them!  I don't really like to gate them in a room when people are here, but right now it's the only way to keep the chaos to a minimum.  They stayed in our bedroom, where their blankets and collection of assorted rawhide bones are.  Neither one made a peep, and the most noise I heard was Buster jumping off the bed (he makes a nice, meaty thud on the floor whenever he does this).  Now the guilty part: we had some leftover hot dogs from dinner last night, and I actually bribed them to be good - I told them that, if they were good this afternoon and didn't bark like a bunch of crazed maniacs, I would cut up a hot dog in each of their food bowls for dinner.  So guess who got hot dogs in their dinner tonight?  :-)

It's probably a good thing that Lady remained upstairs.  The therapist brought his therapy ball in the house, and I could just picture Lady pushing the giant ball around, playing with it and trying to figure out how to get it in her mouth.  And don't think she wouldn't try either - John had a plastic pumpkin decoration out this past year, and Lady annihilated the thing in about 10 minutes.  All it took was my dad saying, "Oh look.  A pumpkin!" and that was it.

But I'm off track.  We're going to look at therapy balls so we have one here at the house to help Judith.  The therapist recommended getting a real one instead of using a beach ball because if a therapy ball is punctured, it'll merely deflate rather than bursting.  It shouldn't come to that point, but I'd rather be prepared!

We've been winding down from the craziness of the weekend.  Easter services went well, and Judith was good the entire time!  Next on the agenda: preparing for her baptism!

I'd also like to take a moment to mention that we watched the movie "Unstoppable" tonight.  Great movie - I highly recommend it if you haven't watched it already.  Awesome part?  John's best friend was one of the rail consultants/experts that helped keep the big Hollywood folks on track.  Neat, huh?  :-D