Thursday, September 19, 2013

Back to School!


Callie started her second year of special ed preschool at our home elementary school.  I really like the fact that she and Owen are in the same location and their classrooms are right down the hall from each other.  This year Callie is in an afternoon class five days a week.  A big yellow school bus picks her up and drops her off right in front our our home.  She loves it!  Of course the ride is only about 1 minute long because the school is right down the street from our place.  :)  She has one new teacher and all of the kids are new to her, but she has had no problems adjusting.  The teachers are making a good effort to use her talker in class and she seems to be jumping right back into her school-provided therapies.  Also, one of Callie's new classmates has PMG!  This is the first time we have ever met another child with the same diagnosis! Their symptoms present differently, but it is still neat to make a connection in person with another PMG family.  Overall, I think Callie is going to have a great year!  


(Can you believe how grown up she looks in this picture?!?)


Tuesday, August 27, 2013

AFOs and Walking


Callie continues to wear AFOs to help her walk properly.  We wear them as much as possible and always have them on when we leave the house.  The other day, however, we were at the airport about to board a flight, so I let her go without them for her comfort on the plane.  She happily walked through the airport independently sans braces and I took a little video to document her form.  She is doing great, but obviously will need her AFOs for quite some time.  But that's okay... Even if this is as good as her form ever gets, I am thrilled.  This is the girl who is not supposed to be walking!!  :)







Sunday, August 11, 2013

Ask and you shall receive!


She asked for it, she got it!  :)



Friday, July 12, 2013

Bittersweet Goodbye


Callie started receiving night nursing care when she returned home from the hospital a little over two years ago with a NG feeding tube.  At first it was essential... She had long night feeds through her tube and had to be watched throughout the night for safety.  If the tube came partially out while she was sleeping, formula could be pumped into her lungs and this was obviously very dangerous.  After 5 months, she was switched from a NG to G tube.  The G tube was so much better, but she is a very active sleeper and often became tangled in the cord, sometimes around her neck.  By this time Callie's nurses were already like family, so we were glad they could stay and continue to keep her safe at night.

The nurses became very attached to Callie and she loved them in return.  Miss Yolander joined us at the beginning of our feeding tube journey and over the course of two years watched Callie grow from 16 to 32 pounds.  She became very protective of Callie, often referring to her has her baby.  She was in charge of training any new nurses/subs for Callie's case and would give strict instructions for taking care of Callie, almost to the point of intimidating the new nurses I was told.  All of the staff at the agency knew about Yolander's baby.  :)  Miss Yolander also kept Callie stylish with super cute hairdos in the mornings.  Her teachers and therapists would comment on her cute updo's and I would have to confess that it was all Yolander.  

Miss Zeinab was with us on the weekends for nearly the whole two years.  She taught Callie her dance moves and spoiled Callie by letting her use her phone to play games and watch cartoons.  They were also known to party into the night on weekends.  We often heard giggles and laughter way later than we should have.  :)

Miss Christina was the newest addition to the team, but it quickly felt like she was there the whole time.  As a mother of four, she had a special touch with Callie and they were soon close.  They would read books together past bedtime and just seemed truly happy together.  This spring Miss Christina gave Callie a cute haircut and taught me how to do the same, although I have not been brave enough yet to give it a try.  

We were so fortunate to have such a great, caring nursing team.  At one point they picked up on her apnea symptoms and suggested having her checked out, which led to sleep studies and an apnea diagnosis, which lead to a tonsillectomy and adenoidectomy.  They also monitored Callie for seizures, although none happened on their watch.  Overall it was a huge blessing to have them be a part of Callie's team.  

It was bittersweet when we learned this part of Callie's care was ending.  At our last GI appointment, the doctor was thrilled with Callie's growth.  She is now firmly on the growth chart, holding steady at about 35% (up from 0%!).  Her most recent growth is definitely due to the introduction of a blendarized diet (which I wrote about here).  We had been slowly adding more calories during the day and cutting back on formula at night, and when I went over everything with the GI, he instructed me to move forward and cut the remaining night feed.  This was amazing news... After more than two years, Callie would no longer need to be fed by a tube at night.  No more hauling a pump, bags, formula and miscellaneous supplies while traveling. No more accidental bed feedings at home or on vacation (Hilton Parc Soleil… still so sorry about that!).  But sadly this also meant we had to say goodbye to Callie’s nurses. 

We miss you Yolander, Zeinab, and Christina.  Thank you for everything you did to care for Callie over the last two+ years.  We are very grateful for your service to our family and wish you the best.  <3 




Tuesday, May 14, 2013

Apraxia Awareness Day


Today is Apraxia Awareness Day!



Apraxia is among the most severe speech and communication problems in children.   Affected children have difficulty planning and producing the precise, highly refined and specific series of movements of the tongue, lips, jaw, and palate that are necessary to produce clear, intelligible speech.  Callie's case is considered severe.  While some days this gets me down, lately I have been filled with hope about the future.  

I recently joined a Facebook Group for parents of children with apraxia which has over 10,000 members!  We are clearly not alone on this journey.  Other parents are regularly posting videos of their children showing their progress.  The video below caught my attention.  Addison is an adorable 4 1/2 year old girl (one year older than Callie).  She has severe apraxia (like Callie).  She has speech therapy 3 times a week at school and 2 times a week privately (like Callie).  She had zero words until she was almost four (like Callie so far).  After seeing a SLP who specializes in apraxia, she made phenomenal progress in just 9 months (we are on a waitlist for a SLP who specializes in apraxia!).    


am so happy for Addison's family and will continue to hold out hope for ours!



Friday, May 10, 2013

Happy Nappy


Callie still takes an afternoon nap.  We wish her a "happy nappy" and often sing Happy Nappy to the tune of Happy Birthday when laying her down.  We have a web cam in her room and have noticed lately she prefers to play during half, sometimes all, of her nap time.  The other day my heart melted as I watched her hug and kiss her favorite little blue dog (affectionately known as "blue dog" because we are creative like that).  I know I am a little biased, but this girl is adorable.



Friday, May 3, 2013

Speak For Yourself


I am happy to finally post an AAC update!  In December I wrote about how we were entering the world of Augmentative and Alternative Communication and had chosen a DynaVox Maestro as Callie's first speech device.  I was very excited to receive the device and get started right away, but it unfortunately ended up being a bust.  I was going to write and tell you all about the issues I felt the device had as well as how we were not treated well by the rep, but instead I will keep this post positive and just say we moved on and found a far superior solution.  :)

I decided to convert my iPad into a speech device for Callie and focused my energy on researching various speech apps.  I had been following a special mom blog called Uncommon Sense and was intrigued by the app she chose for her daughter called Speak for Yourself.  While looking into other apps I kept going back to S4Y.  This app is different.  It was designed by two SLPs who have extensive knowledge of AAC devices and implementation.  They saw a need for a different type of speech app and created one with unique features.  The main screen of S4Y consists of 119 of the most common core vocabulary words.  Then each of these buttons links to a screen with additional related core words as well as personalized, programmable vocabulary.  The core words never change position.  This consistency is so much better for motor planning which can eventually increase the users rate of speech as they grow more familiar with where the words are located.  The app also has a no duplication feature.  Having only one way to get to each word is also much better for motor planning.  Finally, it takes no more than two touches to get to any word!   After programming the Maestro, I have a new appreciation for these features.  It really is an amazing app.  I "liked" the Speak For Yourself Facebook page and quickly realized the ladies who created this app are amazing too.  It didn't take long to figure out helping nonverbal children is their passion.  

About a month ago we downloaded the full version of S4Y (by the way, a free lite version is available and I love how it was possible to try it first before committing).  In only took me a day to program the app for Callie.  It was so, so easy.  I spoke to Callie's preschool teacher and SLP at school to let them know about our chosen app and ended up going in to give them a quick tutorial.  They were very open to using it and intrigued by its core word concept and unique features.  I started sending the iPad to school with Callie after only exposing it to her for a few days.  I was so incredibly happy to learn she did great with it the first day.  Her teacher let me know Callie was proud to be able to tell everyone her name and "I'm using an app called Speak For Yourself to help me talk."  She was also able to participate in circle time by saying it was sunny that day when they spoke about the weather.  A highlight was when she had the family screen open and after seeing Owen's picture, one of her therapists asked her who Owen was.  Callie pressed a button to say "I love Owen."  :)  Finally, during story time I guess she was pressing some of the buttons and they had to tell her to please be quiet.  LOL... Callie has never in her life been told to be quiet!!  Funny, but this made me so happy.  

So our AAC journey stalled out in the first couple of months, but we are rolling now thanks to our iPad and Speak For Yourself.  Callie is beginning to use her device intentionally.  The other night while eating dinner she motioned for her "talker".  I propped it up next to her and she pressed the Help button.  She had a piece of food stuck in her mouth and used her device to ask for help!  Today she was signing something, but I couldn't figure out what she was trying to request.  I asked her if she could tell me with her talker and she pressed the Bedroom button, meaning what she wanted was in her bedroom.  Then I figured out she was signing Bear... She wanted one of her teddy bears!  After that I quickly opened up and showed her the button for teddy bear and she is now using it instead of signing.  I just love seeing how she is catching on to this alternative form of communication.  

Here she is the first time we handed her the iPad with S4Y.  She was immediately interested:



FYI, for anyone who is interested I chose a protective Gumdrop (Drop Series) iPad case.  The case seems very protective and although it adds weight to the iPad, it is much lighter than the DynaVox and Callie is able to easily carry it around.  And we chose pink, of course!

Monday, April 15, 2013

IEP Success!



It is IEP season; time to negotiate Callie’s IEP for this fall, the start of her second year of preschool.  If you remember my update from last summer, you will know that the first time we went through this process was a nightmare.  The county assigned Callie to the wrong type of classroom in a school far from our home.  Then they mailed our IEP to the wrong address (privacy issue!) and therefore we did not receive a copy until hours before our first meeting.  The IEP itself was a mess, including many typos, referring to Callie as Joshua at one point (!), and it contained weak goals and laughable therapy minutes (just 20 minutes of PT despite the fact that she was hardly walking and only 30 minutes of speech when she had no words and limited sounds).  It was ridiculous and the process of working with the school teams was frustrating and stressful.  We muddled through the process as best we could and learned quite a bit.  While I felt more prepared with what to expect this year, I was also really dreading going through the process again.

But I am so incredibly relieved to report our experience was completely different this year.  I asked Callie’s teacher to please provide the first draft of the IEP as early as possible before our meeting so that this time I would have ample time to review it and better prepare.  Not only did she provide it weeks in advance, but it was a work of art compared to last time.  The information was accurate, neat, and organized, the PLOP (present level of performance) section was right on, and the goals were strong and appropriate for Callie.  We were starting in a much better place.  I went through it with a fine tooth comb and made a list of requested tweaks, and then met with the volunteer advocate I consulted with last summer.  I ran my ideas by her and she helped confirm what she felt was important to bring up with the team and what was worth letting go.  My main concern was Callie’s speech therapy minutes.  We were still at 60 per week, but now that her diagnosis is severe apraxia, this really was not enough.  Childhood apraxia of speech requires intense and frequent speech therapy.  3-5 sessions per week are recommended.  I decided to request 120 minutes, double what Callie was currently receiving.  While I felt this was truly what Callie needed, I dreaded bringing this to the IEP team because I had to beg, plead, and finally cry to get 60 last year.  What would it take to get to 120??  I did extensive research and put together a case like an attorney prepared for court.  Much to my shock, the team agreed to all 120 minutes of speech therapy in our very first meeting!  In addition, they agreed to increase her minutes from 60 to 120 immediately so that she would receive the addition therapy through the end of this school year.  They also doubled her OT minutes from 30 to 60.  I cannot tell you how pleased I am that a.) Callie finally has an appropriate and strong IEP, and b.) it only took one meeting to get to this point.  Last year the process dragged on through July.  This year we are settled in April!  What a relief.  I am so incredibly thankful the process went smoothly and am so happy for Callie.  It feels like a huge accomplishment to have successfully advocated for her.  I love this girl and would do anything for her! 

Sunday, March 31, 2013

Happy Easter!


Happy Easter from Owen & Callie! 




Monday, March 25, 2013

Walsh Lab, Boston



Over two years ago I learned about the Christopher A. Walsh Laboratory in Boston.  They research genetic mutations that can alter brain development and lead to malformations like polymicrogyria.  By studying individuals affected with these conditions and identifying the associated genes and their mutations, they learn about the proteins that are important for brain development and hope that this will lead to better options for diagnosis, management and treatment.

The Walsh Lab has a Brain Development and Genetics clinic that evaluates children with a wide range of brain development disorders, including PMG.  The clinic combines their specialties of neurology, genetics, genetic counseling and research to provide a comprehensive approach to working with families impacted by brain malformations.  Shortly after learning about the clinic I started the process of having Callie evaluated, but got side tracked with her weight gain issues and then feeding tube placement and never followed through.  A few months ago I reached out to the Walsh Lab again to set up an appointment, and a couple of weeks ago we finally made the trip.  It was worth it.

Their team was wonderful and met with us for about two hours.  We talked at length with Brenda Barry (genetic counselorand Dr. Anna Poduri (neurologist).  Dr. Chris Walsh then joined us to meet Callie and give us his opinion of her case.  The bottom line is her MRI shows fairly extensive changes with regard to her perisylvian PMG, but clinically she is on the better end of the spectrum with excellent development.  They mentioned the fact that her seizures were controlled immediately (her infantile spasms were controlled within one week with prednisolone) has no doubt contributed to her success.  Good signs include she does not have a drooling problem that is common with her type of PMG, she makes vocalizations, is socially aware, cognitively tuned in, motivated, and her body is not stiff.  These are all common symptoms that she seems to have avoided at this time and indicate she will continue to make progress.  We learned an interesting piece of new information... Callie's MRI imaging is unique in that there are deep 'folds' in the cortex or outer layer of the brain that seem to distort the shape of the ventricles and the corpus callosum.  These infoldings are not common in PMG cases.  They were intrigued by her and invited us to participate in their research studies.

We stayed after our appointment to sign consent forms and provide samples to officially enroll.  They are building a large collection of PMG patients with the goal of sequencing their genomes.  Their plan is to identify key genes that are associated with the condition by comparing genomes of patients and parents with hereditary PMG versus sporatic cases.  This seems like a great resource for our family.  To sequence Callie's genome means they will forever have a genetic profile of her condition.  If they find genes that are altered in Callie, there could be potential for treatment.  This would of course take years, but the pace of things in research is moving exponentially.  Who knows what they can accomplish in Callie's lifetime!  



Dr. Chris Walsh

 Dr. Ann Poduri

Thank you, Aunt Rhine! xoxo
 

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