Off The Beaten Path

I guess as I post this next sentence I am asking for it... Things have been fairly uneventful around here the past week or so. We have had the normal runny noses, poison ivy, and pink eye but nothing even requiring a Dr. visit. The poison ivy was the worst part and I feel very sorry for Carly because some of hers is on her face and 2 of the little 4 year old boys in her class were calling her Carly Krueger. I can't believe 4 year olds even know about Freddy Kreuger. That is nuts. I let her stay home from school after that because I didn't think it was necessary to subject her to that. I know that kids will be kids but come on, it's pre-K. My poison ivy on the other hand was totally deserved. We had a BBQ at the neighbor's house last weekend. I was rather inebriated and wandered home in the dark through the woods and got off the path. It was off of that path that I found the poison ivy. My stupid fault. We went to Germanfest on Saturday and had a great time. I actually got Carly on the tilt-a-whirl which was nothing short of a miracle. The weird part- she liked it. I was proud of her. The kids played outside this afternoon and they got nasty. Anna was not pleased about the picture, but Carly didn't mind.

Fair Warning

I am frustrated by the number of drug overdoses I see at work. If one comes into the ER as an overdose they have to come to ICU so I get to see them all. There are 2 universities in Denton so I do not know if that provides us with more than our share of overdoses but whatever the reason I am sick of providing care for them. It isn't because I have no heart because I have a large heart. It isn't because I don't realize some of them truly have psych problems that have got to be addressed for I know this full well. It is simply because they are by far the biggest group of selfish ungrateful beeotches I have ever met. They come into the hospital because of their own doings and then act crappy towards the nurses who have to wipe their assess after they get charcoaled. They believe that crapping in the bed is their right and that it must be a nurses duty to clean that up. Ladies and gentlemen, lets get one thing straight- if you are serious about dying then please do it right and if you are serious about living then please take medications as they are prescribed because I will no longer be wiping your overdose ass. I quit. I am seriously thinking of providing a manual on how to successfully kill yourself for all of our repeat offenders. Also, if you think suicide is the way out then please understand this- not everyone succeeds and sometimes the way you end up is far worse than the place you started. It is not all black and white, it is not that you will either just live or just die. There is a place in the middle where you live but you have a horrible brain injury that leaves you aware of what is going on but unable to respond to it. There is a horrible place that leaves you in renal failure which will make you die a slow death. There is liver failure which is also slow. When I say slow I do not mean months- I mean years of pain and suffering. God has a plan for your life but if you choose to alter that plan please know that you consequences may be far worse than the death you had planned.

Pretty Much Pissed

I am not sure if buzzed posting is a good idea but after a few Bud Lights here I am anyway. EI came out today and now I am just pretty much plain old country pissed off. OK, first off they were supposed to come out last month and simply "forgot" due to a scheduling mix up. I do not really get the scheduling mix up since they come on the 4th Tuesday of every month but I was willing to let that go. I received a call a few days after the missed appointment stating the OT was very sorry she forgot and she would see us April 14 for Anns's re-eval unless we needed her sooner. I did not schedule myself for work today so that I could be home for the eval. So EI shows up today and says the other lady who comes with her to do the eval couldn't make it so they will just do it next month. Uh, 'scuse me, didn't you already forget an appointment last month? Anyway, I just said ok and went on with the visit. We discussed Anna's progress and blah, blah, blah same old crap. We need to quit anticipating her needs so she'll talk more (as if we are the sole cause of her speech delay), we need to label objects for her as we speak to her, blah, blah, blah... Then, here is where I really got mad. OT asked us how many words Anna has and I said she has about 5 words she uses consistently and then Kenneth chimed in and said he really thinks she has more but she doesn't use them. OT then says, "Well, I have some mothers with kids all contracted in wheelchairs and the mothers keep telling me how smart the kids are but if the kids can't express it then are they really that smart?" OK heifer, my kid has a speech delay and can't say a lot of words and suddenly she is dumb? Perhaps you forgot the course in school about how CP kids have difficulty with their muscles and therefore difficulty with things like, um, speech. Then she proceeds to say, "There are just some things she is not going to be able to do and you are just going to have to accept that." The word can't will not exist in this house. Anna may not do things just like other kids- she may do them slower or not as well but by God she will do them. I will not accept that she will not do them because that, to me, is just not acceptable. If we tell her she can't then I can rest assured that she won't. She also said she would try to get the speech guy to come see Anna but "his contract has been cut back so I am not sure if he will be able to." So now I have a dumb kid with a parent who causes her speech problems who won't be able to do things and will not get the very services the state is required to provide which are apparently the services she needs to be able to express herself so she can prove she isn't dumb. Um, I thinking she didn't like being told I got another opinion...WTH

A New Twist On An Old Story

The girls with their "Pops"

There's nothing like sisterly love!!

The 2 Princesses

A treat from the Easter Bunny

The Original Princess

Happy Easter! I hope you had a great one and took some time to reflect on the fact that Jesus is risen and is truly the reason we celebrate Easter. The bunnies and chocolate are only a bonus! I just wanted to take a brief moment to fill you in a Bible story...from Carly's point of view:
Carly came home from school and was telling me how she had learned that day about how Jesus made a lame man walk and a blind man see. She explained in very intricate detail of how they cut a hole in the roof of the place where Jesus was staying and lowered the lame man down and Jesus prayed with him and healed him. I then asked her how he was able to make the blind man see and she quickly answered, "I think Jesus got him some glasses or something."

Where Do We Go From Here?

The DAFO (not the greatest pictures, I know)

Here is the evaluation:

Patient Name	Anna Watson
DX	764.0 IUGR, 343.9 Cerebral Palsy NOS, 348.0 Cerebral cyst, 160.10 Auditory tubes

Subjective	Anna Watson, DOB 12/03/2007, was evaluated on 04/01/2009 for occupational therapy services. Anna’s prior medical history, as reported by mom, includes intrauterine growth restriction, cerebral palsy/static encephalopathy, bilateral Eustachian tubes in Nov of 2008, speech delay and history of chronic ear infections, immature mylenation and small cyst after cerebral MRI. Mom reports that Anna does not appear to feel pain, has irregular sleep patterns, appear clumsy and uncoordinated and is on a modified diet. Anna has had Early Intervention therapy, however, parents feel that more can be done for Anna.
Objective	The following assessments were completed with Anna: The Peabody Developmental Motor Scales 2nd edition Anna’s age is 15 months. Her record of scores is: Reflexes Raw Score 11 Age Equivalence 7 months Stationary Raw Score 37 Age Equivalence 14 months Percentile 50 Locomotion Raw Score 78 Age Equivalence 15 months Percentile 50 Object Manipulation Raw Score 5 Age Equivalence 13 months Percentile 25 Grasping Raw Score 40 Age Equivalence 14 months Percentile 37 Visual- Motor Integration Raw Score 64 Age Equivalence 12 months Percentile 16 Gross Motor Quotient 96 Percentile 39 Fine Motor Quotient 88 Percentile 21 Total Motor Quotient 92 Percentile 30 The Infant and Toddler Sensory Profile was completed by Mom. Anna scores Definite Difference More that Others for Low Registration Quadrant and Probable Difference More that Others for Sensation Avoiding and Low Threshold. Anna scores Definite Difference More than Others for Sensory Processing Section of Vestibular Processing and Probable Difference More than Others for Auditory Processing.
Assessment	Anna is a pleasant 15 month old girl. She was a bit apprehensive but warmed up quickly and was very clear in what she was willing to participate in. She does not speak audibly. She grunted, pointed and garbled to let her needs and wants know. She demonstrated residual reflexes which are typically integrated by 6 months of age, specifically asymmetrical tonic neck reflex and she did not display protective extension backwards or sidewards. When tracking an item, Anna follows with her entire head and does not track sole with her eyes. Because of her decrease functional vision and lack of protective reactions, she is at a safety risk for bumping and falling. Anna presents with decreased visual motor integration skills (VMI) and auditory and vestibular processing issues. Her balance deficit was very apparent after completing a forward swing motion in that she walked 3 steps and fell down and required min assist to stand. Anna does not demonstrate a significant delay in any one area however when the VMI, auditory and vestibular differences are looked at as a group in functional skills the slight gap difference will only become wider if not addressed.
Plan	Anna would benefit from occupational therapy to address her balance, visual motor integration and her hypertonia so that Anna can complete age appropriate functional tasks. It is recommended that Anna participate in our intensive treatment of 12 consecutive days in our clinic followed by an 18 day home program. At the completion of the home program she will return for a follow up, it will be determined at that time further course of treatment.

Kenneth and I are trying to decide whether to do the intensive program or not. I have many reasons for and against it. We see Neuro on May 5 and I am hoping his input will help us decide one way or the other. She didn't do too badly but it is sad to not see her above the 50th percentile in anything. She is so bright and I fear that may someday be overshadowed by her body's inability to do some things. If I ever hear anyone refer to her as retarded I will lose my mind. She is smart and funny and I do not want her physical limitations to become what people see in her. I love her because she is Anna. I am having a rough time with all of this again. I am torn about what to do. I am so afraid I will miss something.