Worldless Wednesday: Feeding Therapy

Wordy Wednesday - Too Much To Say

So what's been going on this week... Not much, we are all kinda sick and not feeling so good, but its like the edge of sick where you still do stuff and work but you kinda feel like crap but not crappy enough to stay in bed all day. It started with Holly's runny noise and a bit of a cough. Then Joel felt nauseous and actually came home from work in the afternoon on Monday. Holly had a rough night the night before and she refused to go down for her nap. She finally fell asleep at Noon, so I canceled her therapy session with Katie so she could get some rest. Then Chloe was sick so our afternoon play date was canceled. Just when holly was waking up was when Joel came home, so we all stayed in and he slept for a few hours.

I have some blog updates that I will have to postpone, like a description of Baby loves Disco, which we went to over the weekend, but Alas my laptop is broken again. This time its the power Adapter or the Port that the power plugs into on the computer. One night I noticed the screen was really dark and I was at like 20% battery and I realized the laptop wasn't charging, so I wiggled it and messed with the wire and the power came back and it charged. Well the next day I was using it in the afternoon, and didn't notice the monitor wasn't bright until it was too late. My Battery was already down to 4% and no amount of giggle could help me it eventually died and now I can't charge it. So my pictures from the weekend are on the laptop.

Today I finally had a few minutes and I called Dell and they will be sending someone out in a few days but at this rate I think it won't be until next week, but maybe I will get lucky.

On Monday Holly also turned 14 months which is exciting and scary, I can't believe she is 14 months already, we are starting into her "Second Easter, Mother's Day, and soon Father's Day" it is weird she has been around long enough to have experienced some of these things once already.. Even if she was a squishy blob the first time around. I hate saying 14 months it makes her seem like such a grown up and I want it to slow down, it is going by so fast. I don't think I noticed the time as much when I was on "weeks" I think I stayed on weeks until she was 5 or 6 months old, before she seemed "old" enough to start counting months, and the thing is, I will blink my eye and start counting years instead of months before i realize it, it makes me want to cry, and yes, I have another birthday coming up, so I am feeling old. Especially when many of the mommies in my groups are in there 20's still.

More good news, we got the approval for speech therapy. I spoke with Leela earlier this week who said she already did the PO and the Speech Therapist, Stephanie and I are already playing phone tag trying to set up a date, but how biased am I, or well judgemental is probably the better term, but i don';t know if I like her because she sounds young, inexperienced, and I could barely understand her in her message. I guess I just had this stereo type of a speech therapist being so well spoken, but the message she left me was really hard to understand, I think she might have an accent, and then when I called her back and got her voicemail it was super casual, like you would expect a 20 year old's voice message to sound like. I am going to try and with hold judgement until I meet her and we start working together, but I really hope she is good and my first impression is off. Especially since I am so grateful to even have her.

I heard from Sally last week that she didn't think it would get approved because they are making so many cut backs and that there is a several month waiting list for in home therapy and if I do get it I might have to go into Herrick. But it turns out, in my case I guess I am lucky, because we already have someone a week after the approval, and they gave me permission to start 4 months ahead of protocol.I also spoke via email to Paula the feeding therapist who says she is interested in working with Holly and is just waiting for the Regional Center to give approval, But when I spoke with Leela she said they already had and were waiting on Paula, so who knows. I am thinking of revamping our entire schedule. Because we are going from 2 therapists and 3 sessions to 4 therapists and 5 sessions a week. And with Holly's sleeping schedule she never naps like she is supposed to, so I am contemplating having therapy with someone every morning at 9:00 Am. Except for Katie I am pretty sure the therapists are right at 1 hour sessions only, So I am thinking Katie Mon/Fri Sally Wed and then Speech and Feeding Tue/Thur.

I figure it is time for me to get off my A$$ and be more of a morning person and it would be better for us if we could get therapy over with early in the day. After we can go play, lots of play dates start at 10:30 so if Holly starts napping in the afternoon, we can still have some morning time, and if she continues to have a morning nap, she can nap at 10:30 after therapy and then by 12:30 we have the entire day ahead of us. I do think however she is starting to shift to a later single nap. The last two days she napped only once and was exhausted. I pushed her to stay up yesterday till 8:30 and tonight till about 9:00 and then she zonked out. Today I tried to lay down with her for a second nap at 6:30 but she was having none of it. I think she would have went to bed at 8:00 but the night before she woke up at 11:00 when we tried to transfer her, stirred at like 2:00 and then woke again at 4:00 for a bottle. So I think it was still a little early for her.Tonight we pushed her till after 9:00 and Joel put her to bed, she fell right asleep and stayed asleep when he transferred her at midnight. I heard her cough a few times but not enough to wake her up. The sleeping issues could also be the flem, she did "throw-up" twice, but it was the slimy flemy stuff not really digested food. She also was very hungry and had bottles both times that she woke last night, but today I made sure she ate enough to hopefully last her. I am pretty dehydrated myself, I am drinking 2 container's of tea a day, but when you are sick you need all that extra fluid.

I thought about taking Holly to the doctor, but I feel like it is a waste of time they always say there is nothing they can do. Gripe Water for Upset Stomach, Motrin for Fever (which she doesn't have) Saline Stuff and Humidifier for Stuffy Nose, and Nasal aspirator for runny nose. The bulb thing never works, so I do my best with the boogie wipes to keep her nose clean, but it is just draining down the back of her through like it is for me, I know how she feels. If she had a fever I would have taken her in I think. Also, I am not convinced it isn't allergies. I am sneezing and the "world" outside is covered with pollen, and we have been out a lot, I feel allergic, and the runny noise can easily cause post nasal drip, I mean I had it as a baby, so why wouldn't she too.

On Wednesday we had our session with Sally and we went outside to the park. Well first we went to the front of the house and Sally practiced with Holly walking up and down steps. She is pretty darn good at going up and when I hold her both hands she can go up them all with my help. If I don;t hold her both hands she tries to "climb / crawl" up them, which works fine but we want to teach her to lift her legs and use those muscles. She is definitely dominate on the right leg base don its strength and always leading with it.

Down was a little harder, she was scared and didn't want to do it, and tried to sit down, because she knows when she sits she can get down the step, so good girl for being safe, I am glad she didn't try to tumble down them, and Sally said these are pretty advanced skills and she will be two before she can go up 2-3 steps on her own, with help and 3 before she can do it alone.

But now is a good time to expose her and practice. After the steps we played on the sidewalk and she looked at the flowers and wanders back and forth in front of the house and then we walked across the street to the park and she practiced walking in the grass which she didn't like to much. Then she got to "climb" a tree and sit in the branches which was a lot of fun.

Then we went back home and played stacking the blocks some, which she tries to do but is not gentle enough when she places one block on another so it doesn't stay. Next week Sally is going to bring over bigger blocks that should be easier for her to stack so she can practice the concept.

After our session Holly took a nap and then we went to a playdate with our meet-up group at Studio Grow. We were both still kinda tired and worn out but had fun playing. Ack! I got side tracked reading facebook updates and blog posts and now it is getting to be past my bed time! I still have to get pictures off the camera, so I will write more updates later.

Random Parks

So on my way home from Pirate Cove we saw this huge park just around the corner and Holly was fussing in the car and not ready for a nap yet, so I decided to stop and check it out. This park was huge. the main play structure was themed like the old west with a "mine" and bridge and wagons and horses. Holly had fun riding in the wagon.

This structure was like a huge maze. Not super baby safe so I stood about 6 inches behind Holly and she crawled along and explored, but she had a blast as it seemed to go on for "miles" with many twist and turns. there were about 15 slides coming and going from various sections of the play area and two bridges and a third that turned into a sidewalk path.

This park was inland a little more so it wasn't quite as breezy as the other one. and The Sun wasn't as bright as we were surrounded by a grove of tree's so I was able to let her take her hat off.

Lets see the weekly update, Monday was therapy with katie and a Playdate a Chloe's this is the new day for those Playdates. Tuesday was when we went to these parks, and in the afternoon on Tuesday was when I headed to Tumble and tea for a late Lunch

On Wednesday we stayed in. Holly had PT with Sally and then we saw the feeding therapist for her evaluation. It was pretty interesting. She said I am doing a great job, but certainly I am working too hard and we can hopefully make things easier for both me and Holly.

She totally thinks the eating issues are related to sensory problems. One of the things she recommended with propriocepture games before mealtime.

That is basically things that consist of heavy muscle work. like the wheel barrow or squishing and burrito games, deep pressure. I guess activating those big mucles and using some of that energy helps her to self regulate and be ready for eating. She wasn;t very specific on why this works, but said that the various sensory systems are related and connected and working with one will trigger ease in another.

This is the Second Play structure at the park. It was a bit more baby friendly with a slide Holly could do on her own, although I went down three of the bigger slides with her in my lap on the pother side of the park. This has an under water theme and she had fun climbing up on the rock climbing wall and the lumpy slide.

Lets see... The other thing that the Feeding Specialist recommended was adding more flavor into Holly's food. She observed that there was not a lot of lateral tounge movement and although she did nibble and "chew" this was basically wit her front teeth and not much with her jaw.

The therapist feeling was that holly wasn't getting a good sence of the food in her mouth where it was, so wasn;t getting enough input to know what to do with it.. This also relates to the over stuffing, as she keeps adding more till she gets enough input in hopes of it triggering an appropriate responce like chewing or gnawing but then when she tries to swallow she gets in trouble because it is more then she can handle.

The idea is that if you make food more flavorful then it activates the tounge and sences to tell her where it is in her mouth and she will explore the food more. She sais to think outside the box away from just sweet and salty. So here are some of the recommendations; Sesame oil, lemon juice, soy sauce, pickle juice, cinnimon, vanilla, horseradish, ranch dressing, pepper, cajun spices, ginger, garlic, mint. All of these (seperately of course) can simply be added into her regular baby food jar purees. So take some green beans, or apple sauce and add in a little horse radish and there you go, you have added a punch of flavor. I am not sure how great those flavors go together or how good they taste, but it is about giving her a new strong flavor, so if youhave ideas on more let me know.

The other thing she want's her to do is chew on hard things, like teething buscuits. But here is the caviot. So today she was eating a barely teething buiscuit and a banana cookie. A peice was bitten off but she then didn;t chew it she basically swallowed it whole. It was sorta a ragged peice and it isn't something that just melts like a puff, so she was a bit concerned about that.

So it was with mixed feelings that she recommended I let her gnaw on a carrott stick. But basically she wants something that is long and thin and can get back to her molars and she can really work on. The issue is that I have to keep a close eye on her, because if she is able to bite a peice off, i have to be ready to swoop in and scoop it out, lest it me a choking hazard. So while a long thick pretzel stick might do the trick, she thought that might be too easy to bit, where as a carrott is much harder. She also said i could cook the carrot or for example a potatoe in a fry shape and then freeze it. So she can gnaw on it and then as it melts she might get little bits of it, until eventually I have to throw it away.

SO the ultimate goal is for her to be able to feed herself grown up food. But the short term goal is for her to tolerate more chunky foods that are fed to her without her gagging on them, also the therapist thought I needed to work on getting her to eat/drink more in one sitting less frequently. So 5 times a day totally 2 snacks 3 meals, rather then the now every 1.5-3 hours a feeding. It is some days still 5-7 bottles and 1-4 food feedings, and that is where the "working to hard" comes in. She observed that I am making a real effort to not turn feeding time into a battle, but I have to carefully balance that with giving her enough that she is full to go several hours between meals, so we both don't have to be chained to so many small feedings.

She will be writing up a report in the next 3-4 weeks and send it to Leela, who will forward it on for approval. The report will recommend therapy 1X a week and may or may not be done by her, just depending on the authorization and who the regional center chooses, although she said she would love to work with Holly.

I also asked her about the speech. She indicated that is she does start using her tongue more it might help with a few more sounds but that the work she would be doing is very different from that of a speech therapist and there is very little overlap in her mind, especially since she thinks we need to in part focus ont he sensory part of it. So she encouraged me to soilder on with my quest for Speech Therapy (SpT). She said that some SpT do work on feeding issues, but most feeding specialists that are OT's don't do speech.