Wednesday, October 28, 2009
Night routine live coverage (Dah-ben Dahben three, two oh two.... LUNA )
He's stopped for the moment now mimicking some scenes from an Arthur learning CD where there must've been a spelling bee: "pee i c t u r e." He's also doing the oral stimming again, bringing water into his mouth from the bath and letting it run out of his mouth. I noticed specifically that he didn't do any of that last night, so maybe the B12 makes him stimmier the night of the injection? Who knows. This oral stimming with water drives us batty at bathtime and in the pool...but part of dealing with this junk is picking your battles and trying to not let every little anomaly and non-productive thing they do drive you apesh*t.
The Adam's Dad mystery of last night has an explanation. Dad says he went out to dinner with someone for their birthday, and he said something else quick that implied a "she" was involved. And when asked directly, he claims to still be sober. He stayed home from work today which lent additional suspicion, but he claims he didn't feel like going, has more vacation than he knows what to do with, and is resting up for inventory here soon, where they keep him around for 12 hours or so. I asked him directly if he was bullshittin me and he said he wasn't, so, I'll take that as a better than half chance that it's all as he stated. I'm not aware that he's lied to me before, and has been if nothing else, pretty honest with me about his problems and where he's at. I didn't press for why he didn't respond to my phone message, because that too could have two explanations. He's never been a reliable responder to phone messages. End of day: who knows. He did appear sober and fine when he dropped Adam off, and for that, I'm thankful.
When Adam got home here tonight, he went into the toy room and was playing with the 3 year old's train setup appropriately. That was good to see... he and our son are really about at that same level functionally in a lot of ways. Any time Adam's playing with toys appropriately and it's not something that makes noises, has lights, or is attached to a CPU, I'll take it.
The wife had a pretty good "crazy busdriver" story from this morning. The busdriver, who's WAY more erratic than the god-send woman of last year, and who we know is coming because she's speeding through the neighborhood up to the turnaround yelled at the wife this morning. Adam got on the bus, and the bus driver motioned for my wife to come out. The woman says "You have to keep him home--he's sneezing!"
"He doesn't have a fever, he doesn't act sick--what do you want me to do?"
Crazy erratic woman, we come to learn just got over pneumonia, so we probably had more to fear from her than she had of a special needs kid who's allergic to everything. This also explains why we had a cavalcade of bizarre sub bus drivers the past few days. Nothing like a sub bus driver assigned to the special needs short bus.
Bat-sh*t crazy bus drivers aside, this got us thinking "why IS Adam stuffy in the morning--it's not a high allergen time of year?" Then it dawns on us that that nice puffy new coat his uncle bought him... yup, sure enough, goose down. Doh. This burned us once before when I unwittingly made his bed once and mistakenly put the down comforter (to which he's allergic) on his bed, and puzzled for two nights over his sudden onset stuffiness at bed time. Duh.
Okay, he's ready to come out of the bath. "Adam, open the drain." He struggles a few times. "Up and left" I remind him. He gets it. "Put away the toys." After about 5 seconds (that's how long it seems to take for him to register a response), he starts doing it, and it slowly putting them all away. This is pretty good, actually--better than average. He puts all of them away, and steps out. Starts to nearly shiver.
I throw the towel over his head and he says "I'm cold." I tell him to rub his head to dry it. He doesn't do this well, so I put his hands on top of the towel, and help his hands make this motion. Then I tell him to dry his chest which he does, then his arms, then his hum (his 2nd language's word for his crotch), his butt, and his legs which he now can do okay with me pantomiming to him to give him a visual.
Now, we stand on the 3 year old's stool and he asks me for the hair dryer. I fire it up on high fan, medium heat and hand it to him. We've been working up to that. He has it for about a minute and then tries to give it back. "Turn it off, Adam." He does it.
"Go to your bedroom, get some underwear." He makes a detour en route to the 3 year old's room, I redirect him pushing him toward his room/closet. "Underwear" I say pointing to his closet. "On the floor, in the basket." He's unfocussed, I finally point his head toward the goal and he takes a pair. He thumbs through the shirts to pick one but I give him the one he wore last night. I come out to the hall to type some more. He sits up on the bed, puts his underwear on (hey, he got em on the right way tonight...hrmm... this he seems to be doing better with this finally!), and puts on his shirt (which he's done very reliably now for several months) and his sweat pants. He asks for his light to be turned on, I keep typing... and... hey how bout that, he's figured out how to turn it on with that rolling thumb wheel switch that's in line with the cord. Score for fine motor skills.
"Adam, go brush your teeth."
Right now, he's in front of the mirror in the bathroom. I'm trying to take a hands off approach here and just tell him what to do. He lathered up his hands with soap, and he's looking at himself in the mirror, making exaggerated faces and making Capital One noises and being silly. Now after prodding, he's turned on the water to rinse his hands. For about a minute now. "What's in YOUR wallet?" he asks me.
"Turn off the water, goofy." He does.
"900 dollars a month! No hassle payments. 900 dollars a month!" he says, looking at himself talk in the mirror, thoroughly pleased with his own performance. I'm having an idea that maybe he access to someone's YouTube connected laptop at Grandma's tonight? Toothbrush now moving around his mouth, and he's biting it pretty hard--must feel good.
"Adam, is there toothpaste on that toothbrush in your mouth?" He rolls the soap dispenser around looking at it down on counter level, toothbrush now hanging out of his mouth.
"Did you put toothpaste on the toothbrush?"
"Yeah"
"Are you sure?"
"Yes I am sure," says Adam.
Wow, score one for Adam. Usually you get a contradictory "No I am sure" or "Yes, I am not sure." I had to take over the toothbrushing--he hadn't put any toothpaste on that brush. Rinse, and done. Wipes his mouth on the handtowel, and runs it up to his nose too (ick, but ... ). And off to bed.
He wanders out of his room into the 3 year old's room again looking through his toybox. I get up from the hall, turn the lights off in the 3 year old's room to make him lose interest, and redirect him to his room. He crawls into bed. He's smiling and verbalizing more random commercial stuff to himself. He crawls under the sheet and I kiss his right cheek good night (Uncle remembers just a year or so ago before we took over when that then-poorly-kept mouth of teeth smelled like morning breath on steroids because no one was willing to fight him to get them thoroughly brushed every day--old habits die hard), tell him to have a good night, and he had that big goofy grin like he often has when he's in a good moon. "Good night Adam." "Good night Uncle Tah."
He's quiet... and breathing sounds clear. Ahhhhh.
Goodnight.
sleep and diflucan
We are still letting him sleep with a low wattage light on in the room, and haven't tried turning that off.
Back when the diflucan was introduced to him, our normally rock solid sleeper got disturbed. We started having sleep problems, and then there was a trip we all went on that he slowly recovered from and wouldn't sleep by himself again for a time, but he's back to normal now, sleeping through the night, refreshed in the morning, and not bugging anyone to have to sleep with him. Before he got back into this good place with sleep, we'd fight a little to get him to bed, I'd have to sleep next to him (he sleeps with Dad or Grandma at the other house), and he'd frequently wake during the night and demand that I go back to sleep next to him. All that's gone now, thankfully, and it just occurred to me that it maybe deserved a note.
Tuesday, October 27, 2009
Appropriate play with toys / Dad mystery
Today, Adam was well behaved, and had an okay Speech Therapy session. Some progress, some stayin the same. Bedtime routine went well here and he poured the water over his own head for bathtime, and was willing to do some of the lathering of shampoo into his hair. He's getting modestly better at drying himself with a ton of verbal and visual prompting, but there's work to do here. Dunno if dad/grandma make him dry himself over at their house on the weekends, but I've mentioned it before.
Adam's sleeping in the next room here, and has been coughing a bit which makes me hope he's not catching something. He'll cough something that sounds productive, and then we cringe to see him kinda chew with his mouth, and not spit anything out... Ick. Swallowing all that mucous. Meh. But, I haven't heard a cough since I started typing, so maybe he'll get through the night just fine.
Tonight, we got some carryout food and went to Grandma's/Dad's after afternoon therapy tonight to celebrate Adam's Dad's 1 month-iversary of sobriety. It's something I wanted to do so that Adam's Dad would get some positive attention from his family and me, instead of the usual highlighting of when he screws up. He has been (comparatively) great this past month since his discharge from his 5 day hospital stay for pancreatitis (3rd time now, yay alcoholism!).
Unfortunately, he wasn't there.
Now there are two possible explanations: 1) his company actually is working hard toward a deadline and he's working overtime, which would mesh with things he's said recently as there is a production deadline they're working this week. Or... ironically, or 2) maybe he's taken to--as he has before--going to a buddy's to drink after work so it's out of sight at home. If it was #2, the congratulations card signed by his brother, sister, me, and his mom will generate a great degree of guilt when he gets home, but guilt has never helped anyone get sober, though. I have a nagging feeling he's not as sober as he claims to be because when I've asked if he's stayed sober, his answers have not had the conviction they did in weeks 1/2 about him not having the urge. I dearly wish he'd get help with his sobriety via 12-step, but getting Asian immigrants to do 12 step is like pulling teeth though. As the wife explains, it's just not in the culture to show up in public at a meeting that says "hey look, I have a really serious embarrassing for the family problem and I need y'all's help." No wonder AA skews heavily white, and heavily Christian.
As loved ones of an addict, we have to abide by the mantra too--we're powerless over his disease just as much as he is--and if he's gonna get well, it's not going to be because we want if for him, HE's gotta really want it. And even then, he may not realize it, but statistically, he's gonna need help each day to keep sober.
He's in a bit of an enablement cocoon over there with Mom and 2 brothers in the same household, where no matter what he does, he'll have a place to sleep, and Mom being under the same roof won't throw him out on the street, and with a special needs child who needs his continued employment/medical care, the bottom he'll ever be allowed to hit is a pretty high one.
So for now, I'm keeping the good sober weekend we all had in mind,remembering that 3 weeks ago I somehow got him out of the house to join us all in a trip to the arboretum with his son (essentially unprecedented)....and being cautiously optimistic that maybe he really was working overtime tonight.
Adam's supplement and drug regimen
From the pharma world, things that really seem to help him are Flovent, a long-acting inhaler for his asthma, and Singulair. We've tried to take him off Flovent a few times, and every time we do, we seem to quickly end up regretting it. I'll mention that these two alone weren't enough to keep him clear at night, and it was only with the addition of diet and to a lesser extent supplementation that we really started seeing him be totally clear at night and in the day with respect to stuffiness and the asthma cough. He's also on a daily anti-fungal to help deal with gut yeast overgrowth. This really did improve the poop situation, and rather than having a mushy mess that wasn't formed, after a month or so of being on this, we started seeing normal looking poop.
Note that unless you're in the autism community, it's normal to think "ewwwww..." But in autismland, we talk about poop a lot, because it is a universal issue it seems. Autism poop has its own delightful god awful smell...now ya know.
Final note: we didn't just start him on this wad of crap. This was carefully and methodically phased in one at a time over a period of a week, with doses tweaked based on blood testing all under the supervision of our DAN doc. Adam's an 8 year old, 60lb kid.
To be given in the morning (between 7am-8am)
Probiotic (capsule – in blue bottle) 1 caps. Give 30 minutes before breakfast. Keep in fridge! This is a 12-strain active probiotic. As the theory goes, autistic kids gut issues have to do with the imbalance of yeast and good bacteria. Oral antibiotics rape and pillage good gut flora (bacteria) and probiotics help restore that. If you've ever seen a Danon yogurt commercial, Acidophilus is just one probiotic strain. In Europe, apparently, they prescribe probiotics any time they have to Rx an oral antibiotic to help keep all this in balance.
Caprylic Acid 1 caps.
Cod liver oil (liquid – in blue bottle) 1 tsp. Brain function, goof omega-3's and stuff, apparently.
Super Nu-Thera (liquid multi vitamin heavy on B vitamins which autistic kids don't get enough of and/or absorb poorly) 1 tsp.
Magnesium (powder – in big white container) ¼ tsp.
Vitamin C (Buffered Ascorbic Acid-powder) ¼ tsp.
Diflucan (Fluconazole-anti-fungal Rx) tablet (give w/food) ½ tablet Diflucan is an anti-fungal that actively attacks fungus overgrowth in the bowel.
Grapefruit Seed Extract (with lots of white grape juice) 10 drops GSE is a natural enemy of fungus.
ActiFolate 1 tablet
P5P (yellowish tablet) 1 tablet
Super Vit. B Complex 1 caps.
To be given between 12pm-3pm
Zinc (capsule – in small white bottle),1 capsule every 3 days
Cod liver oil (liquid – in blue bottle) 1 tsp.
Grapefruit Seed Extract (with lots of juice) 10 drops
Magnesium (powder – in big white container) ¼ tsp.
Vitamin C (Buffered Ascorbic Acid-powder) ¼ tsp. Helps with the immune system, and all that jazz.
Vitamin D3 (1 drop add to cod liver #3) 1 drop
CoQ10 1 caps.
To be given in the evening – late PM (7:30pm-8pm)
methyl B12 shot (1250mcg/0.05mL) 1/2ML once every 3 days
Singulair (pink tablet, Rx for asthma and lung repair) 1 tablet He's been on this forever it seems.
Diflucan (Fluconazole) tablet (give w/dinner) ½ tablet
Flovent Inhaler (long acting asthma Rx) 44mcg 1 puff He's been on this for a long long time too.
Caprylic Acid 1 caps.
Probiotic (capsule – in blue bottle) 1 caps.
On a time available basis I'll fill in what each is supposed to be doin for him.
Cod liver oil update
The wife stumbled on this this article from Mercola's website.
http://articles.mercola.com/sites/articles/archive/2008/12/23/important-cod-liver-oil-update.aspx
Now, Mercola is a pretty heavy hitting name in natural health stuff... and I won't bore you of our HORRIBLE experience at his Hoffman Estates clinic with Adam when we tried to go there for want of a close DAN! doctor (summary: staff marginal at best, whole thing seems to be geared toward separating you from your money, and there are some things they espouse that broke our HokeyMeter--emotional freedom technique? EMF killing us in immeasurable ways?), but it is interesting to read this new info on the interaction of vitamins A and D.
Vitamin D has been shown to be a huge + in so many things and its deficiency seems to be a big deal in a lot of maladies. This was even mentioned by my ER doc friend when I was recently talking with him, so it's not stuff that's confined to the natural health nutjob sphere of medicine. When there's overlap between western and natural medicine, my ears always perk up. In other Vitamin D news, apparently 50,000 IU a day if you get the flu can be a very very good thing. There's a compounding pharmacy locally that's selling a "flu kit" by prescription that includes Vit D dosing and other goodies for battling off the flu.
At any rate, we'll be asking our DAN doc whether this new research suggests any change in his cod liver oil dose/brand/whatever.
Monday, October 26, 2009
Back to some old stims, but some progress to note too
Adam got his B12 shot last night, for whatever it's worth, and had a pretty good day. He is still pretty darned stimmy though. Today he rediscovered his "number cards" which are like Uno cards and he likes to arrange them on the floor and look at them. He used to be full on into this months back, and had abandoned em a while. He's back into them now, though for some reason. He wasn't too ridiculous with them, however, so it's not terribly concerning. He also dug out all his computer game CD's again, found a Nemo one, and as he loves to do, drills on down through the file system of the CD to the directory where the video clips are stored, and watches the video clips used in the game, watching them fast forward, then in reverse, watching Nemo swim backwards, and giggling like a drugged morphine addict. He didn't do it for too long though, and went to bed very easily tonight. He did ask for my cellphone once today, but didn't seem to be bothered when I told him "no." Hrmm.
Good news: Adam and his occupational therapist have been working hard on brushing his teeth, and by gum, that kid can nearly do it by himself now. With lots of redirection he'll put toothpaste on, and then slowly brush around his teeth. I prompt him to spit to keep him from being tempted to swallow the fluoride, and I had to prompt him to flip the brush up so he would brush his upper arch, but he's actually doing the motions and stuff...it's exciting. I clean up and make sure he gets all his teeth thoroughly covered though, as he's not gonna have that goofy dracula smile again that he had with baby teeth--at least not on my watch!
Another bit of "hrmm that's new" came today when the furnace repair guy was here and he was about to be taken to Grandma's by the wife. He goes into the garage and as usual says "take-a the van?" and instead of just going out there and blindly getting into the van as he always does (heading for the back seat--his favorite), he stopped and said "Ah Saen, ah Saen" in a fairly calm way. My wife got out there and realized furnace dude's van was behind our van. Adam had put together that taking the van was going to be a problem with where that other van was parked. He said then "Take-a the Outback?" and had the biggest grin on his face. Not sure why it was so amusing to him, but it was cool that he seemed to put together those concepts, and formulate a plan to get around the obstacle. With normal kids, we never think about this as a big deal, but with Adam, his progress is slowed to the point that you get to see every bit of development in slow motion. When it happens, it's definitely exciting.
Adam was also very sweet when I put him in bed tonight. He had a big smile on his face, happy that I agreed to put him into bed, after he requested that I specifically brush his teeth, and then when I gave him the usual good night hug, he looks me dead in the eye with a big smile and says "Thank you Uncle Tah." This isn't unprecedented, but you don't get it all the time, and it was just a really nice cap out to his day.
It seems that every day after a B12 shot is a really damned good day for him...I haven't seen a counter data point to that in recent memory.
Oh, in other news, speaking of shots, we're not vaccinating him against seasonal or H1N1 flus this year, following our gut, as well as the advice of his DAN! doctor. DAN practices are all pretty universally against these flu vaccines, since they all have thimerisol in the shot preparation, and the nasal preparations are live attenuated virus. Besides, I wouldn't be shocked that the long lingering awful chest congestion cough illness he and the wife had 3-4 weeks ago wasn't H1N1, or flu. With learning this year that Adam very very likely did have vaccine injury as part of his autistic progression, we are extremely cautious as his immune system is very clearly not as healthy as, say, our 3 year old who was breast fed for 2 years!
Also, my perfectly healthy friend who's an ER doc is also avoiding the H1N1 vaccine himself for now, indicating that for him, he really wants to see how many people stroll into his ER with Guillan Barre syndrome if any in reaction to the vaccine before he takes the plunge. I've heard several other anecdotes of vaccine researchers, and other physicians who are looking at this H1N1 thing with a lot of trepidation. There's no doubt it was a hurry up job, it's a relatively novel take on the seasonal flu vaccine, all the multidose preparations have the ethyl mercury and aluminum containing preservatives that we know autistic kids struggle with, and at the end of the day, h1n1 is often a pretty darned mild flu, although a lot more contagious than the regular flu. If any of us in the autism community trusted the CDC, it might be an easier decision. But, for us, we're all avoiding flu shots this year.
Sunday, October 25, 2009
Stimmy Saturday and Sunday / Improvements with his Dad
After we got back, he gulped down some water, and about an hour later, had a near tantrum toward the middle of the afternoon. He either wanted a phone to stim on, or something not good for him and wans't happy with No for an answer. He also got a little destructive, tearing up some paper and throwing it around, and he got into my wallet and threw its contents kinda everywhere in the dining room, with a credit card on the ground and wadding up some receipts in the main section and throwing them on the ground. I caught him in the act of this, told him "no," and he laid on the ground calling "Dah-dee, dah-dee...." like he'd do when he was at our place earlier this week and I correct him for something (he'd call for my wife then).
He is due for B12 tonight, so this would seem to be a data point in our "maybe he needs more B12" thoughts, but Adam's dad reported that he wasn't appreciably different yesterday with respect to stimminess and making messes on purpose.
All this happened over at the in-laws (Adam's Dad/Grandma's house) around the corner by the way... I went there today to take in some football with Adam's dad. I'm thrilled that he's now just one day shy of being 1 month sober, and if I can be someone he can spend some time with without drinking, fine by me--I do enjoy his company when he's sober, and the idea of a boys day watching football is good times too.
This development with his Dad's sobriety is huge for Adam, and for his Dad I think. Getting Adam's dad more engaged will only help both of their recoveries. Big changes I see in his dad is that HE initiated us all going outside to play when it was clear Adam was getting a bit stir crazy inside, and was more than happy to amble all the way to the park and back.
Finally, there were some really cute moments between Adam and his Dad--they were playing a new game Adam seemed to pick up somewhere, where he talks (usually parotting a TV commercial like Capital One), and holds his dad's chin, making his chin move along with words Adam's saying. His dad was trying to do it back to him, but Adam didn't get that in this reverse role, he wasn't supopsed to talk! I got a video of it on my phone... it was awfully cute. So great to see the growth in Adam's dad here as he remains sober. I remain cautiously optimistic that it'll continue. His dad needs to learn how to fill up his time without thoughts drifting back to the drink, and hopefully in Adam he sees some opportunity in doing things with him as ways to keep his mind and body busy rather than just hanging around the house. For my part, I'll just keep engaging him in fun stuff to do with the boys and hope he continues to show interest in participating and keeps his car free of any places to pick up beer on the way home from work.