Thursday, April 18, 2019

2019 in a nutshell

Hi blogland,

Well, there's a lot going on. 2019 has not started off well for me. The kids are okay; Vivian is starting to wean off one of her epilepsy meds, and E has been doing well as the year comes to an end.

I have some to report about E's last field trip (huge success! YAY FOR HANDICAP ACCESSIBLE SHOWERS!) and our plan to transition to high school.

I have lots to tell, I'm just too drained to do it right now. Love to you out there, for you all still reading.

Thursday, January 17, 2019

Winter Coat Project

If you're a crutch user, you know how cumbersome it can be trying to use them with a warm thick winter coat.

Elena has tried the half-cuff option for loftstrand crutches; she needs the full cuff to move her best. It's difficult for her to stuff a winter coat sleeve into the cuffs--most of the time, she just shoves her forearm into the cuff, so the coat stays scrunched up right around her elbow, leaving her arms cold and uncomfortable.

I've tried working around this for years. Typically, a grown-up would help E get her coat inside the cuffs. We are trying very hard to enable Elena to be as independent as possible, and this includes dressing with coats or other bulky pieces. I have a dozen or so sketches, some involving a spring loaded cuff (which I don't have the equipment to make) and others involving creative adaptations for clothing.

One thing I didn't have was a spare coat lying around in order to test out my model. I tried with some extra fabric, but it's just not the same as using an actual thick garment. I couldn't find one that would fit Elena at a thrift store, and I didn't want to buy a brand new coat, because I was going to cut it. I was looking for an inexpensive test option in case my idea failed. I couldn't find one.

I decided to write to one of our favorite retailers to ask for help. (Please keep in mind, I am not paid to advertise for a retailer. Occasionally I have been asked to write pieces and have received compensation, but this is rare and always disclosed.) I wrote to Boden, telling them about my plan, and wondering if they had any damaged/factory seconds that I could obtain at a discounted price. They asked to see my sketches, which I sent, and had some questions regarding Elena's color preferences and size.

Much to my surprise, a new coat was mailed to us a few weeks later, completely free of charge! It is BEAUTIFUL. They paid attention to the material--a bulky coat (like a puffer jacket) would be too much material for me to handle once cut; the coat is waterproof, versatile, warm and relatively thin. Elena even loves the color. She loved it so much, and didn't want me to "ruin it" by trying my adaptations.

But we did it.

The Coat:

"Cosy Waterproof Coat"

We had Elena wear it for a week. Here she is, wearing it (fits beautifully!) to swim practice on a rainy morning. She just stuffed her arm in the cuff, the sleeve is mushed up around her elbow.

Sleeve mushed up above cuff

We decided to try to leave enough sleeve so that it would bump up against the cuff just a little, with the idea of creating a detachable bottom portion of the sleeve to accommodate her crutch cuff. I wasn't exactly sure if I should try to make a long "crutch pocket" out of the rest of the sleeve, or have it attach to the cuff, or have it attach to the jacket. First I had to make the actual cut.

I went to a friend of mine, JW, who enjoys sewing and knows a LOT about some tricky stitches. I didn't have confidence in my sewing abilities--but after talking with her about the plan, she knew she could make it work!

Two "coat cuffs"
JW made a "hidden seam". She folded back both edges of the cut coat towards the inside, and then expertly sewed them together by expertly guiding the needle through the seam by touch so as not to puncture the outside of the coat. It sounds complicated--but the hardest part was getting the folds right among the inside padding of the coat (in my opinion).

Folding towards the inside
Pinned and ready to sew!
JW did this to each end of the coat cuffs and the coat sleeves. Here is a close-up of the seam, once sewn. I think I can do this type of seam, but it would take me MUCH longer than JW!

Look at that pretty seam!
All Seamed Up!

At present, I've been trying different methods of using the coat cuffs with E's jacket. In the end, they all look largely the same as she's moving around, so here is a current picture of the coat and separated cuffs. Elena is testing out what I'm calling "coat cuff tethers". She has acknowledged that if she has to snap on/off the coat cuffs to either the rest of the coat or the crutches, she'll probably just stuff them in a pocket instead and end up eventually losing one/more cuff/s. I'm trying to find a way to keep them attached to the coat, but easy to maneuver with the crutches.

Coat shown with tethers
Coat on with tethers (a bit too long)
The idea is E can put her coat on, then while sitting or standing, put on her crutch cuffs and (again, sitting or standing) then use one hand to help the other put on the coat cuff.

Side view. Coat cuff dangling
Putting on second coat cuff
Once the coat cuffs are on, the coat itself fits well, there are no bunchy elbows, and most (if not all) of Elena's arms are warm and cosy.

Completed look
Front view, coat cuffs on
The procedure of putting these on and off is still a work in progress. The tethers are a bit too long (I attached them with a thin double cord to each of the shoulders, not one long cord from one coat cuff to the other--like you've probably seen in a lot of toddler mittens) and sometimes they spin around the crutches. Elena complains that her hands get caught in them a little, so I can fix that by braiding or knotting the two-ply cord. She hasn't mastered the art of putting her coat on with dangling sleeves with a backpack (I recommend she hold the coat cuffs in her hands while putting on her backpack). It'll take some practice, no matter the final iteration of separated sleeves. I strongly believe that the coat cuffs have to be physically attached to the coat in some way, as to not lose them. This alteration also leaves Elena's hands cold, so she'll have to wear gloves or crutch pockets.
Thoughts? Suggestions?

HUGE thanks to Boden, for giving me the opportunity to try this with a coat that fits Elena exceptionally well, and that is perfect for the weather and the challenges associated with this project. Thank you to JW for her sewing expertise and her time to help make this coat a success!

Tuesday, January 1, 2019

Quick Recap: Breakthrough (sort of), End of 2018

Hi everyone,

First of all, thank you all for your comments--truly, you are extraordinarily helpful at times when I feel like no one understands our situation. I feel like the biggest issue I have is trying to combat/learn our way out of issues at home when I do not have permission to write about them in detail, or at all. (For any new readers, Elena and Vivian have to approve anything I write on this blog about them).

So I'll do my best.

First, the breakthrough.

We have been working on a lot of self-sufficiency/executive function tasks/sequencing/attitude things for YEARS with our educational and psychology team. The reality is, we really haven't made much progress. We are considering a psychiatrist; not immediately, but the possibility is looming of getting help that way. (I understand that there isn't a lot of detail behind this).

Essentially a lot of this boils down to Elena being able to do things, but just doesn't. (Basic things. That she can do. I swear, taking all your comments into account, I am not asking too much with my demands.)

So, we are trying to find ways for her to practice skills without increasing her isolation (ideally, if she isn't ready, we don't just leave her at home, for instance). This has been a near constant struggle.

What ended up working was using her upcoming Chorus competition field trip (to Nashville) as bait.

I simply told her I wasn't going (as chaperone, or as her helper).

Her mouth dropped.

And then I told her if she wanted to go, I would not let her delay the group; she would have to find a way to prepare herself, using methods we have been trying to teach her, and she would have to demonstrate she was capable of this by a certain date or she would not be able to go.

So, this worked for a few weeks (a record!) and then sunk back, but as she realizes I am dead serious, I think things are getting better.

End of 2018

December was a whirlwind of end-of-school performances, medical appointments, and lots of time dealing with health insurance. My in-laws came down for Christmas; we always love having them, and they were especially helpful this year! My family joined us the day after Christmas and it was wonderful having everyone here. Dad is doing okay, Jason was our chef and dinner was lovely, and we even managed to get a family picture!

I don't know about you all, but my 2018 was a few amazing highs peppered among a lot of lows. Among the high points was my trip to Africa, spending time with friends and family in a few select cities (DC, NY), and our trip to the beach. The lows are more of the struggles vaguely described above, of course, my Dad's diagnosis, Jason's traveling for work, and navigating Vivian's epilepsy--which took about 3/4 of this year. I've been trying to take care of myself and our family during this time by stressing healthy eating, regular exercise, and a regular sleep regimen.

I know that the New Year is just another day, but the idea of starting fresh is appealing. Here are a few lessons I've learned this year, in no particular order:

1. Keep the best notes possible regarding health expenses. You never know when someone will be hurt or sick, and it can save a ton of time and stress if this is organized. I thought I was good before, when I blew out my knee in 2015--but Viv's condition is pretty complex. My plan needs some tweaks, including better digital organization, but I'll get there.

2. Everyone says it, but it's true: take time for yourself. I enrolled myself in an adult beginner tap dance class; I'm not good at it, and I can't make it every week, but I try, even if it's been a terrible night at home. I'll even get a sitter. The physical and mental challenge of tap really gets me out of my negative headspace, I can't possibly focus on problem solving home challenges AND getting the dance combo right.

3. Make an exercise goal. I joined an instagram challenge (something I've never done before) and while it wasn't super difficult, it made me structure in exercise where I wouldn't have otherwise. Now I make monthly short-term goals, and I've been doing well on them for the past three months. My biggest achievement (I think) is I've biked 50 miles/week (on my decade-old fluid trainer in the cold garage, mostly) for the past three months. I have bigger fitness goals, but it all depends if I can jog again, which I'll be working on in 2019.

4. Get fresh air every day. I know when things are negative, or cold and grey outside, sometimes cave days are good--but getting out, even if for a short while, makes them better (I think).

Friday, December 7, 2018

Neuropsychology Evaluation: Vivian and Elena

In September, Vivian had a neuropsychological evaluation. Basically, Jason and I had seen some unexpected changes in Vivian since her epilepsy diagnosis in January.

The differences were slight, except for the obvious change in energy/tiredness. She stopped reading long novels, and wasn't working on independent projects like she used to--projects that could last over a few days. Sometimes they were construction projects, sometimes painting, sometimes stories. They just seemed to vanish.

We weren't sure if it was a lull, or a real change, or if it was or was not related to epilepsy. I found out her condition qualified her for a visit to the neuropsychologist.

Vivian was evaluated over the course of two days. The eval consisted of a few questionnaires for me on her behalf, and a series of IQ/problem solving tasks. In short, Vivian is very intelligent, a good problem solver, highly motivated and enjoys being challenged. What was surprising was sometimes she misses "the big picture" type of question. While we'll never know whether or not this was always how Vivian was, or was going to be, Jason and I believe our observations of Vivian (types of books, projects, etc.) are different than they used to be. We've also seen her reading comprehension scores slide, even though she's on the higher level of scores related to her peers.

The neuropsych eval strongly hinted that this has been seen in epileptic patients. Normally this is not a side effect of medication, and was my suspicion, but rather a function of seizure effect/brain damage. Vivian's MRI shows no abnormalities. The evaluation gave us strategies to help Vivian as she grows older with things like reading comprehension, should we need them. In essence, this is a "baseline" for us, in case Vivian starts behaving differently or starts having trouble in school.

I'm glad Vivian was evaluated. I was disappointed that this was never recommended for Elena, so I asked the doctor about it. We had a good, long talk; basically, I noticed that when filling out the questionnaires for Vivian, I would have essentially recorded the opposite for Elena (self-sufficiency, social behavior, responsibilities, etc.).

She told me that currently, if a baby is born and determined to have a brain injury (as Elena was), their record is immediately flagged for a neuropsychology evaluation during her elementary school years. This can help a child who struggles with independence, personal responsibility, executive function, and social interaction--basically, all fields Elena (and many other kids) require assistance/help. It can provide strategies for her, and our family, to help achieve goals, manage expectations, and improve self-sufficiency. I wish I had known about this sooner.

I had Elena evaluated in November.

Our main question for the neuropsychologist was regarding our expectations for Elena, and if they were reasonable. They are not outrageous. She is intelligent, even though she struggles with some concepts, and is verbally talented. There is more to her stubbornness and lack of progress (in self-care) than just "being a teenager". It's a mix of "other', teenage angst, learned helplessness, and unwillingness to change (she is happy how things are, doesn't want to do more for herself--other people doing things for her suits her just fine, etc.).

The biggest message we got from the evaluation was that Elena is exhausted. Mentally and physically--the day exhausts her. She feels overwhelmed. By everything. She does not get excited about learning something new, it does not motivate her to do more with it--it just exhausts her. (She is not depressed.)

I thought that was how someone feels if the subject matter isn't interesting to them. I get that; if you don't like what's being taught at school or at home, it's a drag. To me, this would indicate nothing at school interests her--which I know isn't the case. And even though it's exhausting to her, she is doing much less than your average teenager--she has to be able to handle more, if she's ever to be a functional adult. Or functional teenager, for that matter.

The psychologist and I were a bit at odds, mostly b/c she was talking about how to encourage Elena through constant praise, very Kazdin-method type of lifestyle. I am convinced this doesn't work on a smart teenager--she can see right through shallow praise, and it backfires on us.

So, in short, we've been trying to encourage good behavior and try to be more patient. It basically just gave us more responsibilities than ever, and didn't help our home life much.

But, we eventually had a breakthrough. And that's where we are now.

Friday, November 30, 2018

6 month recap: Summer to now, school edition

To put it mildly, Elena has been struggling; with/because of her, the family has been struggling too.

The summer recap, in a few sentences: swim team was good, Elena and Vivian (!) both participated. Elena got a legal breaststroke this year! Vivian went to some fun camps, and Elena went to sleep-away camp at a small community college. (We sent her because she did not want to make progress on being self-sufficient; this came to a disastrous head during a chorus field trip to Toronto April 2017.)  She ended up having a great time--we figured she would, but it was a rough transition. We went to the beach (you can see some cute pictures in the Instagram feed in the sidebar). We went to NYC, and had a lot of fun. We had a lot of Vivian stuff going on--she has had 5 EEGs this year and tons of appointments. She has some "jerks"--not seizures, according to EEG, but situations were she is not conscious and sometimes hurts herself, only when she is *just* asleep or *just* awake. Jerks including falling off beds, resulting in hitting herself, or hitting her head (again--caught on EEG and NOT seizures). I was in protection mode when she was asleep, so I wasn't getting much rest. We bought a SAMi camera for night monitoring (it is a motion activated monitor that you can customize to record video footage because of sound or movement). Best Purchase Ever. She is doing well right now; for whatever reason, the "jerks" have stopped, and we are weaning her off one medicine while preparing to increase her Oxtellar medicine (because she's grown some).

School started--Vivian in 4th grade, Elena in 8th. Vivian still struggles with staying awake some days, but in general she is doing well. Elena had a rough start to 8th grade, to put it mildly.

Elena does not have an aide this year. This is a huge change, and she's very happy about it. I was adamant about the weight of her backpack this year, since she won't have anyone to help carry. That took some convincing (no aide, no extra weight, end of discussion) but it's going well. I am happy that E can handle herself on her own now--she is still very small, but can advocate for herself (needs to leave early/late to avoid a packed hallway, change for gym class, etc.). What I didn't realize, but suspected, were other things the aide did in terms of Elena's supposed-to-be-personal responsibilities. As in, keeping track of Elena's assignments, making sure her homework was organized and turned in, planning assignments for the week, reminding her to clean up, finding her a place to sit (be included) at lunch/assemblies/etc., reporting to me her feelings regarding school work, inclusion, relationships with peers and teachers. I get nearly no feedback from Elena or her teachers regarding her school day--maybe that's normal, but this year it is an abrupt change. She seemed happy without the constant presence of an adult, but has zero experience with being an independently responsible middle-schooler, and it shows.

Another issue was her math class. Elena took a "bridge" course over the summer to see if she was ready for Algebra; her 7th grade teacher (who we love) acknowledged that she thought Elena would have difficulty but she was capable. The bridge teacher thought the same and E was placed in Algebra this year. Because of scheduling restraints with her other advanced classes, Algebra was her last class of the day. I knew this would be a problem, b/c E frequently needs extra time to finish tests and quizzes (per her IEP) and she is worn out, mentally and physically, by the end of the day. Her education team insisted we try the schedule and see if we could make it work.

Elena tanked Algebra. It didn't help that her teacher was new to the school, new to teaching the subject, frequently unavailable for discussion with me, and very rigid regarding how she wanted information on a page and how she wanted tests and quizzes completed--regardless of what was in Elena's IEP. Elena would tell me horrible things that would happen every day, b/c she couldn't finish, or couldn't see the board (even though she asked to move her seat), or the teacher wrote fast and erased everything, etc. I decided to take all these stories with a grain of salt, just in case Elena took liberties with what happened on a given day.

Elena was failing. Her anxiety related to math completely consumed her; she literally spent all her free time doing math, made it very difficult for us to help her, spent so much time melting down over homework--there was no time for anything else, nor a refuge for the rest of us. I tried going through her case manager, but nothing really changed; I tried talking to the teacher, which went nowhere. The school psychologist didn't answer my emails. We found a tutor, who was wonderful, but Elena couldn't keep up with the pace, her math grades stayed low, while her other subjects dropped. She was begging to get out of the course. I went to the principal to find options, and he gave one; switch Algebra teachers, and lose the rest of he classes she loves (go to standard other classes instead of honors classes, and with all different teachers). I was angry and disappointed and unsatisfied with this one choice.

Elena agreed to ANY change, as long as it would get her out of her current situation. She was MISERABLE. She hated school, kept calling herself stupid, sobbed every day at pickup. I kept trying to get appointments with people who might be able to help us, but could never get a meeting to make actual change. I have NEVER had an issue like this with Elena and school, EVER--it was a new, horrible experience for me in the public school system. I finally got a meeting with the principal and demanded that she get out of the class, for her psychological well-being; I requested a lower math class, which was something no one else considered. She ended up changing her long standing F to a C with a major project, and then we switched her to the 8th grade pre-Algebra class.

I have never seen her so happy this year.

Her confidence is up. She is able to spend more time on her other subjects, and those grades have recovered. Sure, I think she needs more of a math challenge right now; we are keeping her tutor, who will "slow-roll" algebra concepts so they will be familiar to her next year, while addressing other issues she has (transcription errors, word problems, organizing work, and fractions). She is working on organizing her schoolwork daily, weekly, on her own; before she was essentially paralyzed by Algebra anxiety/workload. She has time to play, exercise, and stretch, which she didn't before.

It was absolutely the right choice--and one that Elena helped make a reality. I had her make the final decision, so she could own it. We finally had some literal and figurative breathing room.

Thursday, November 29, 2018

And here we are

Hi blogland.

It's been a really, really terrible 6 months.

No joke. I wasn't sure if I could write about

Vivian's epilepsy, horrible complications peaking in August

Elena starting school, first time ever having issues with coping with grade level academics

desperately needing more psych services,

continuing issues at home.

For months.

Then my Dad was acting strangely

diagnosed suddenly with cancer.

I'm ready.

Recaps starting tomorrow.

For any of you still reading,

thank you for your support.