Saturday, 2 March 2013

Diagnosis #4

Sometimes it really sucks being right all the time!!! Lol.... Okay so maybe I'm not right ALL the time but boy oh boy when it comes to that gnawing anxiety I get whenever Ryan is doing awesome - I just know the "bleep" is going to hit the fan and sure enough the day Jeff left for California for 1 week Ryan started having some serious teething issues thanks to that "bleeping" final 2 year molar!!! He was fairly miserable throughout the day but the real heavy screaming he saved for the night time (generally right around the time I found the sweet spot in bed and got all cozy).

Nothing I mean NOTHING gave him any relief unless of course I was holding and cuddling him. Didn't matter to him....if it was 10pm, 1am, 2:30am, get the picture. Advil and Tylenol just wouldn't cut it - Momma's cuddles on the other hand - well they must be magical! Hahaha... Wouldn't you just know it the first night Jeff was home he was pretty much back to normal and slept through the night for the first time in a week! *sigh*

As typical with Ryan once he was over his pain and trouble he was back to amazing us with his tricks! He can bum scoot so easily now – it’s SO amazing to watch! His pulling up to stand is off the charts!

What I love most about his developmental explosion in the past few weeks is watching his face and listening to his excited squeals! He knows darn well what he's doing and man is he ever proud of himself - that alone makes my heart so happy! Just listen to this:

And here he is again same day actually turning around in his crib – so awesome!

So that’s the fun and exciting news…here’s the bad news: Ryan has now been put on the autism spectrum. I don’t suppose its bad bad news…it’s certainly not unexpected. Since Ryan was a baby I had been asking his regular pediatrician about diagnosing him with autism. He’s theory was why add another diagnosis to his already long list – what will it change? While I can see his point (and believe me I have the utmost admiration and respect for this doctor)…I don’t agree. What it changes for Ryan is being entitled to additional therapy. This is good and bad. Good of course for Ryan…bad for Quin. I’m already drowning in guilt for the time, effort and energy that goes into Ryan. Quin definitely get’s her special time and is extremely loved and cared for but I just always feel that it’s never enough. I feel that for both of them…God if I could just clone myself or add a few extra days to the week or hours to the day that would be just perfect (I'm sure parents that have "typical" kids feel that too)! Let’s face it…that’s not going to happen.

So how did Ryan get put on the spectrum? Well, on Valentine’s Day (of all days to give me the news – geez) Ryan had an appointment with the developmental pediatrician (it’s the 3rd time he’s seen her). She feels that even though he is visually impaired (which comes with its own autistic like traits and characteristics) and developmentally delayed he doesn’t act like he’s “just” VI and DD. Any other child who is VI or DD will still respond to their name, be much more socially interactive, make more eye contact and smile more. Ryan also rocks…a LOT and has some repetitive type behaviours. Appointments like these ones are hard. The doctor observes the child in an environment that is unfamiliar to them for a minimal amount of time and feels they have a diagnosis. While I’m not disagreeing with the ASD thoughts I did feel the need to defend Ryan. I made sure she knew that he does at times respond to his name and things like “bottle” and “up” and “more”. I told her that he will lock on my face from time to time and even smile. I made sure she knew how well he played and explored things. How curious he has become with his surroundings. Perhaps I came off a little strong at times and had a “back off bi*ch” demeanor but hey…I’m his Mom – and as many of you know…you just don’t mess with a Momma! So what additional therapy does this entitle Ryan to? I’m still in the learning process of it all but there is ABA and IBI.


Here is what ABA is:

What is Applied Behavior Analysis?
Behavior analysis focuses on the principles that explain how learning takes place. Positive reinforcement is one such principle. When a behavior is followed by some sort of reward, the behavior is more likely to be repeated. Through decades of research, the field of behavior analysis has developed many techniques for increasing useful behaviors and reducing those that may cause harm or interfere with learning.

Applied behavior analysis (ABA) is the use of these techniques and principles to bring about meaningful and positive change in behavior.

As mentioned, behavior analysts began working with young children with autism and related disorders in the 1960s. Early techniques often involved adults directing most of the instruction. Some allowed the child to take the lead. Since that time, a wide variety of ABA techniques have been developed for building useful skills in learners with autism – from toddlers through adulthood.

These techniques can be used in structured situations such as a classroom lesson as well as in "everyday" situations such as family dinnertime or the neighborhood playground. Some ABA therapy sessions involve one-on-one interaction between the behavior analyst and the participant. Group instruction can likewise prove useful.

Here is an explanation of IBI Therapy:

What is Intensive Behavioural Intervention?
Children with autism face a number of challenges–poor social interaction skills, communication difficulties and developmental delays.

Intensive Behavioural Intervention (IBI) can help some children with autism. It's a structured approach to breaking down the barriers that isolate children with autism from the world around them.

What's involved?
IBI professionals work with children with autism– either one-on-one or in small groups. They use systematic methods derived from principles of Applied Behaviour Analysis to promote development and change behaviour. Research tells us that IBI should be commenced early because very young children can gain the most from this approach.
IBI is intensive. It typically involves between 20 and 40 hours of direct service per week. IBI is individual. Program goals are based on a thorough assessment of each child's unique strengths and needs. IBI is practical. The focus is on developing the skills each child needs for greater independence.

Who is eligible for IBI?
The program is designed for children with Autistic Disorder or a disorder considered to be towards the more severe end of the autistic spectrum. An assessment by an IBI program provider is required.
What role do parents play?
Parents are critical to the success of IBI. A parent training component helps parents assist their children in reaching their goals.


The tricky thing with IBI (from what I’ve been told by the developmental pediatrician) is that if they find Ryan not to be eligible (ie. Not on the spectrum) he will be taken off the wait list and never allowed back on. It’s all still very confusing and overwhelming and I’m not sure I fully understand what is going on or about to take place next.

So since we've got that new stress to deal with why not add a little more right! We will be starting Ryan's Vigabatrin wean this Sunday, March 3rd. February 27th was his 18 month anniversary of being on it...standard course of treatment is only 6 months. A typical wean is about 6 weeks. There is absolutely no way in heck that I would wean him that quickly! I have done up a wean schedule that will take just over 10 months (42 weeks) - he will be completely off Vigabatrin just before Christmas. His neuro thinks I'm a little nuts but he also understands and respects my intense need and desire for a record breaking slow wean! As I've mentioned before I am terrified of his horrific Infantile Spasms coming back I am also afraid of new seizures which will no doubt start up once he is off the med. It could be days, weeks or months once he's come off the drug we just don't know. Some who have come off are seizure free for years before something new starts up. Vigabatrin is really only used to treat IS but his neuro does feel that it is also keeping the additional activity at the back of his brain (the occipital lobes) at bay. What makes this new chapter in Ryan's life even more frightening is that both his epileptologist and neurologist want Ryan to go maintenance med free during and post wean. Not the norm when you have a child with symptomatic IS but they are also believers in not over medicating. So we wait and see what happens and then medicate accordingly. I'm so scared that Ryan is going to suffer and also that he may lose all the skills he has should the seizures start up. There is a big fear that if the IS starts up again or new ones start we may not be able to get control of the seizures. The good thing about the wean is that it's possible Ryan may come a little more "alive". Vigabatrin causes a bit of a fog on the brain and it also creates a bit of low muscle tone. His neurologist says not to expect any change in either department but there are lots of people I've spoken to who have weaned their little ones and seen great things. In a sense Ryan has been self weaning since he began the med. His dose has never been increased even though his size has - he is about 10-11 pounds heavier than when he started. This may explain how amazing he's been doing lately...some of the fog may have already begun lifting during his own slow, self wean. So yes, I am excited to see if he progresses more as he get's deeper into the wean but I of course have many more fears about seizure control etc...if bad things start happening.

I fear never seeing this gorgeous smiling face again:

Please pray!