Wednesday, May 30, 2007

Well.

When last we parted, it had been confirmed that Huckle couldn't breathe, sleep, or hear.

Now, turns out he can't see. When his glasses get here in two weeks, they might be able to correct to 20/100. He needs a prescription for +8 and +8.5, but first we're making a stop at +6 and +6.5 to get him accustomed to the corrections.

"How many weeks premature was he?" asked the doc.

Still no clue.

Wednesday, May 16, 2007

Highlights of our new SW's first visit:

Huck's LOC is going to be changed from basic (none/none/none) to moderate.

He's being classified as a Special Needs adoption (even before we find out the extent of his heart problem).

Free college is not just 4 years. So long as Huckle passes ONE college class by the time he's 21, he has free tuition/books/fees (to a state-funded school) for LIFE, including graduate work, technical school, whatever. We'd thought it was four years max, undergraduate college or technical only. While it may be premature to start ordering embroidered labcoats for the Huckster, it wasn't too soon for me to inform the SW that the local community college offers Summer courses that give college credit to high school students for taking a 4 week class in art subjects. So, yup, we now know how Huck will be spending the Summer after 9th grade, just to make sure we lock that puppy in.
One of the best parts of the DTV is that I got to call my mother and tell her that The Good Therapist instructed me to use it.

Way back in November, back in the days when I couldn't be closer than a foot or further than five feet from Huck without neighborhood-alerting screams, back when I would lock myself in the bathroom and cry while he threw his whole body against the door and screamed, I used the DTV. And Huck didn't bond with me. He began bonding to The Hub, so maybe it was women. Then he adored my mother and my sisters, so maybe he liked blonds, so I took the purple and red and brown out of my hair in a marathon dye-lifting session. And the rejection kept on coming. Then at Thanksgiving, he took to my in-laws (this was such a knife in the gut for me, his ease with them when days before they'd walked out of the room instead of be in it with him [However, Huckle has always gone straight for the person in the room who is least-engaged with him and clamored for attention, whether someone is on the phone or attempting to ignore the facts of his existence. Only people he knows, though, not with strangers.]) and my grandparents. Somewhere around there, my mom admonished me for using the same tone with Huck as I use with the dogs and advised me to be "sweet, happy, and fun," with Huck, and somewhere around there the DTV was abandoned.

I wanted Huck to like me. I wanted to be fun and happy with him. I wanted (and still do want all these things, of course) to cuddle him up and sing songs and make him like me, make him trust me, make him take to me just like everyone else. Didn't quite work out that way, but it came from a desire to soothe and comfort, after all he's been through.

Anyhow, I feel kinda vindicated.

[We're big fans of The Dog Whisperer, by the way. It is totally about letting the dogs be dogs in safe ways, just like we have to let Huck be Huck. Our big dog used to freak out when people came into our house, but now a subtle hand cue tells her to calm down. Think it would be too much to teach Huck hand cues? And I don't feel too strange about applying dog training logic to this kind of remedial parenting -- at the basic levels they're similar. If we were talking about a well-parented, confident child, it might be a different story.]
I'm feeling better. I've stopped willing the ground to open up and swallow me whole. But, you know, it isn't as if I'm going to start researching heart defects now, embrace the horrible with gusto. I'll just wait and see, those medical texts will still exist after we get into the cardiologist and figure out what's the what.

Huckle's Good Therapist has me using my Dog Training Voice when asking Huck for compliance. She wants me to "teach him how to be parented properly." The last session made a lot of light bulbs go off -- even though I knew what we wanted to accomplish, the getting there, even the direction, was hard to figure out. So now, I am to be authoritative, clear, loud, firm, and kind. GT thinks that commanding respect will bond him to me more effectively -- he trusts Dog Training Voice, the DTV is consistent and dependable and might be worth believing in and handing over control to, whereas the Nice Mommy isn't trustworthy, can't be counted on, is easily manipulated, etc. (Not just me, though I do let him slide on some things because at times I may as well be begging him to be nice to me, but his mom fell into the same pattern of letting him run the show during their last reunification.) Dog Training Voice is good, so far. 36 hours into it, I'm going to consider putting this in the "breakthrough" category. Yay for observant GT, who also talked me through my fear of sounding mean while using DTV.

Tuesday, May 15, 2007

We've already got one surgery lined up. Sadly, the ear-tube-placing, tonsil-and-adenoid-removing procedure may be the least of our worries once this month is up. Most likely it will be put off, should they eyes or heart take precedence over the breathing or the hearing. That's okay, though.
Look where we're going, come hell or high water.

Monday, May 14, 2007

I don't have any references or papers on hand regarding the information I got from our developmental evaluation. Some of what she told us was prefaced with, "We've been seeing a lot of...", the "we" meaning her group of colleagues in our area that see mostly foster kids and many meth kids. For example, she said, "I'm going to listen to his heart for a while. I'm seeing heart murmurs and problems in meth kids as old as ten that have gone undiagnosed because no one is listening long enough." Even if she only had her personal observations from the last 10 years during the emergence of widespread mainland meth use, she was more accurate than I would have liked.

For the most part, she only mentioned things that worried her about Huck. After the first few biggies, I didn't retain much. She comes highly recommended because she's thorough and because she tells parents what she knows -- she takes the attitude that she may as well be as helpful as possible, even without the 15 years of data collection and a published study, on the off chance that what she sees in one meth-exposed kid out of ten/twenty/thirty might apply to the next kid she sees.

I'll try to get more information from her the next time we talk to her, after we figure out how bad the valve defect is, the level of blindness in his left eye, and once he can sleep and breathe at the same time, sans tonsils and adenoids.

Have you seen the article Atlasien linked? My First Lesson in Motherhood by Elizabeth Fitzsimons, from the NYT. One of the things I miss is being able to spend hours with the Sunday Times. I needed that article this weekend. That article, the zoo, and a couple Sapporos made mothers' day okay, made denial a sustainable worldview. I'll just stay there a bit longer.

PS: I'm not looking for cheering up, I'm not ready to look on any bright side, and I already know that things will work out the way they work out. Platitude free zone here, please.

Saturday, May 12, 2007

Dr. Google fails miserably with regards to trying to find out the current thinking on the effects of prenatal meth exposure. You get lots of studies about underweight rats and warnings about behavior and attention disorders and learning disabilities, but that's pretty much it.

Our developmental evaluation was yesterday. We were lucky enough to get in with one of the best in the state. I'm still fairly shellshocked from all that we were told, and I don't want to get into Huck's specifics, but I do want to tell y'all some of what we learned. (Edited to add: these things represent what we're dealing with now, and of course Yondalla's caveat applies.)

Even though meth hasn't been around long enough for there to be an accurate pathology for the meth-exposed child, there's still more known than "underweight and hyper."

The majority of exposed kids can either be characterized as either hummingbirds or snails.

Meth has more of an effect on the right brain as opposed to the left brain. This can result in subtle physical deformities on the left side of the body, such as reduced ear size, abnormal hair whorls on the head, reduced dexterity in the left hand, and a smaller left eye. In the case of a smaller left eye, the eyelid will appear to droop (think Paris Hilton), and the vision is often compromised. Often, the two eyes aren't weakened in the same way -- one is nearsighted and the other farsighted. With the smaller ear, it isn't just the visible ear, but all the working parts, too, and kids are much more prone to ear infections, effusions, and compromised hearing.

Heart defects, especially valve defects, are appearing more and more.

Sleep apnea is big. I also learned that sleep apnea causes brain damage to the tune of 1-2 IQ points per month. First step are meds like Singulair and Flonase. If those don't work, the tonsils and adenoids are the best next step.

Meth kids are about 3x more likely to have brain scans like those of kids with ADHD. (Did you know that ADHD meds can rebuild pathways in the brain?)

Pot-exposed kids have trouble, too. I can't recall the name of the stuff that gets blocked in their brains, and I'm just trying to get this out, but it results in not understanding (their own or others') personal space. There's other stuff, too, but that information is probably widely available.

And I'm probably the last person on earth to know this, but it turns out there's a really big staph infection problem going on. Because of that, we're supposed to keep Huck off Z-packs, just in case he gets one, and just in case he gets a resistant strain, lest he have to spend weeks in the hospital. Old school antibiotics are the new black.

In addition to all the stuff we learned above, Huck is now eligible for special ed. In the fall, he'll be going to the public school's pre-K (the state-sponsored early intervention program) five days a week, with at least an hour a day with one-on-one attention. (As testament to my "new normal," I am overjoyed that my baby qualifies for special ed...)

Huck's test scores weren't too bad at all, actually. He tested 7 months behind on his Leiter nonverbal and 6 months behind on the picture vocabulary. Unfortunately, he could have tested much higher, but 1/4 through each test he announced that he was done, and from then on just pointed at the same square over and over again (for the ppvt), and slid the blocks into the spaces in whatever order they were handed to him on the Leiter. I was so frustrated. On the verbal, one of the earlier words was "delivering," which he got right, but then he missed "fountain" toward the end. He knows what a fountain is. For both tests, he aced the first 3 minutes, then crashed and burned.

If I thought we had a lot of appointments when I wrote the last post, then I suppose we have an assload of appointments lined up now. Cardiologist, opthamologist, audiologist, ear-nose-thoat, psychiatrist, psychologist, school district, radiology, blahbedy blahbedy.

Something else we learned was that, if you're able to get medicaid after adoption, don't put the child on your health insurance at all. If doctors are working with two insurance companies, it is two sets of paperwork to fill out, and the extra $20 they'd get from your insurance costs them about $10 in wages or time, so very few docs (those that have their own practice and do the majority of paperwork themselves, that is) want to mess around with it. Doctors that are part of a medical group probably don't care as much.

In all, I'm feeling like someone worked me over with a bag of oranges, Grifters-style.

Wednesday, May 02, 2007

We had another therapy appointment yesterday. It went fine, involving mostly kicking Hub out of the room and the therapist watching how Huck and I interact. Nothing earth-shattering. Of course, he was sweeter and kinder than he is at home, so whatever. Only toward the end did he show a bit of his normal behavior. He exhibited about half of the "invitations to play" that she would expect from the average child. But these were new toys and games, so he did a lot of asking what things were for, then going to the other side of the room.

We've now got all sorts of appointments lined up. Developmental and psych evaluations, three months of therapist appointments.

I think Huck has pretty much broken me in. Except for while Hub is out of town for more than 4 days, or when we tried to explain adoption, the things he does don't hit me that much. It doesn't even suprise me anymore that such a little child can have so much anger and pain inside of him. When the local news runs stories about how judges and the public are outraged that children are sleeping in their SWs' offices, I get confused, because where else would they sleep if they can't find a foster home?

My new normal is ... well, it just is. It isn't bad, it just isn't always good.