diagnosis

I took Max to a developmental pediatrician today to have him evaluated. He is doing fantastic and is a completely different child than he was a year and a half ago, but I wanted to make sure he is ready for kindergarten. As much as I dislike labels, I knew he would need one in order to qualify for accommodations in the public school system. I didn't want to send him out into the jungle without help if he needed it.

I had been stewing over the pages and pages of paperwork and surveys, making J-P re-read everything I wrote to make sure I answered everything appropriately. I didn't sleep all night and had a huge stomach ache in anticipation of what they might tell me. And let me say that I was caught completely off-guard by what they diagnosed him with.

After two hours of intense examination, interviewing, testing, etc. the doctor looked at me and said, "I can tell you are worried about Asperger's. I will tell you right now that he doesn't have it. I don't even have to add everything up to tell you that he isn't even close to having it." She proceeded to tell me that he is nowhere close to having anything autism related. At least not anymore. And she explained why in great detail. Which I appreciated.

After calming my autism fears, she changed the subject. She mentioned that he was exhibiting lots of facial tics. She said upon first glance she could tell that he had them, and he continued to have them throughout the whole two hour exam. "Oh, you mean how he squints his right eye and grimaces? He only does that when he is nervous, anxious, or upset," I replied. She seemed very concerned and continued to grill me about different tics, and tried to uncover any vocal tics he might have. I told her that a lot of people in my family have facial tics, like my brother, aunt, grandma, great-grandma, etc. I had no idea it was a big deal. She quizzed me about every person's tic, and I did my best to mimic them while she recorded it furiously on her paper.

In the end, she diagnosed Max with a tic disorder. She explained that some people's brains are just wired that way. Unfortunately, people with tic disorders are especially prone to OCD and anxiety, which explains why Max had such a hard time with those things when he was little. Her recommended treatment was fish oil, magnesium, and B vitamins. She was very impressed that I was already giving him all of those things, and even more impressed that I knew about and was giving him inositol. Apparently it has proven very effective in treating OCD/anxiety. One thing I also learned is that tics are very common in people with ADD, which luckily Max does not have (knock on wood).

The pediatrician said that he is above average developmentally. His skills are on par with a five-and-a-half-year-old (he won't be five until the middle of June), so he is definitely ready for kindergarten. And that was even after he got docked several points for drawing a duck when the doctor instructed him to draw a person. He thought it was the funniest thing ever and couldn't stop giggling.

mud

I read a book last week about brain development that made me feel like a very good mom. Most of it went way over my head, but the part about activities that stimulate brain development in children made me feel great. Making messes-check. Exploring outdoors and digging in the dirt-check. Who knew making messes was essential to brain development? Let me tell you, there has been a lot of brain enrichment going on around these parts via mess making. In fact, if making messes stimulates brain development, I just might be growing the smartest children in the world.

I have finally resigned myself to the fact that this season of life involves messes. Lots of them. And even if said messes are pushing me over the edge, at least they are enriching the minds of my sweet little children. Today I left my post at the kitchen sink for a brief moment to see what the boys were throwing at the window. When I turned around to see Max's muddy artwork on the windows I had cleaned just a few short days ago, I took a deep breath. Ok, I took several deep breaths. And then I reminded myself that all these shenanigans are fostering brain development.

saturday hike

We woke up and decided to drive to the mountains a few minutes south of our house to do a little hiking. J-P has been mountain biking there, but it was the first time we have all been as a family. We always drive to "better" locations for our hikes, but we really should take advantage of the proximity of the San Tan's more often.

Ava threw a royal fit in her fancy backpack, and insisted on walking by herself without holding anyone's hand. Little miss independent wanted to hike solo while holding her water bottle, but after two falls on jagged rocks we forced her back in. She screamed the rest of the way while the boys explored and filled their hats with shiny rocks for their "collection". Ian fell a few times, and Max was bummed that we didn't see any horses despite all the clues he found like horse poo and horse tracks. The fresh air and dessert smells were exhilarating.

Sunday pictures

When we got home from church, I asked Ava if she wanted to take a picture. She ran out the back door, and searched high and low for her white chair. She was so excited that she said "cheee(se)!" before she had turned around to face the camera. Her excitement for pictures lasts about five seconds and then she runs off to play. She seems to be doing really well. I was scared to death to give both her and Max antibiotics, as they had never had them before and I was worried they would have a serious reaction. I have read way too many stories about children that get autism (among other things) after taking antibiotics, so I've been a tad paranoid. So far so good, knock on wood. I will continue forcing them to eat coconut yogurt, raw sauerkraut, and take probiotics. I'm just glad they are still too young to know how crazy I am. The love me no matter how much "sour white spaghetti" I put on their plate.

the poser

I ran outside with the camera today to capture something cute that Ava was doing. As soon as she saw me with the camera, she quit doing aforementioned cute thing and ran over to her chair. She said "siiiii!"(sit!). I helped her onto the chair and she immediately smiled and said "cheeee!" (cheese!). I hadn't even taken the lens cap off of the camera yet. I have a feeling I won't be able to get too many candid action shots from here on out. She only stayed on the chair for a few seconds, and then quickly resumed her previous activity. As soon as I lifted the camera up to take a picture, she dropped what she was doing and ran back to her chair where she smiled on cue and belted out the appropriate "cheeee!" again. I tried several times to get a candid shot, but every time she saw the camera she ran to her little chair and repeated the drill.

16 months

This my effort to document Ava at 16 months. I am still in a fog from that whole week of no sleep, but I forced myself to pull out the camera and take a few pictures yesterday. Getting a non-blurry shot is the hard part, as she does not sit still long enough for me to focus and get a good picture.

Ava is talking quite a bit. She picks up new words every day. While in the hospital, she screamed "Toe! Toe! Toe!" for the duration of our stay as she tried to pull the oxygen monitor off of her toe. I called J-P from the hospital and asked him if he taught her the word "toe". I knew I hadn't. His response- "yeah, we worked on a lot of things while you and Max were in the hospital".

In addition to her increase in vocabulary, she became VERY attached to J-P while I was away for three and a half days. J-P drove her to the hospital so I could run out and feed her three times a day. But that's all I saw her. She has a special place in her heart for the parent that didn't abandon her. Any time he appears, she squeals, jumps into his arms and wraps her arms around his neck. Oh how she loves her "da da".

She loves her brothers' toys the best. She fills up little dump trucks with dirt, and belts out the appropriate "vroom vroom" as she pushed them around. She takes buzz lightyear and flies him around the house while making space shuttle noises. She will play with her "babies" too, but prefers to play outside in the dirt like her brothers. She does, however, like to fill up her purse with treasures and carry it around the house.

Her favorite thing to do is read. If she had it her way, we would spend the entire day on the couch reading. She brings me books all day long and screams "Read! Read! Read!" One is never enough. Ten is never enough. She always wants more.

New phrases: "ah wa jink!" (I want a drink), "mo da da" (I want more da da), "beanie bean and max????" (where are Ian and Max?), "ah done!" (all done), jah (yeah), "nurch!" (nurse)...

She is also going through the "No!" phase. Full body exertion is observed with her head shaking and feet stomping tantrums. It's incredible that at such a young age she knows exactly what she wants. I only wish I were that decisive!

and...we're back. in the hospital.

Five minutes after I got home with Max, I took Ava to urgent care. She was coughing, had a low grade fever, and I just knew she had pneumonia too. She had the same funky smelling breath that Max did (from the bacteria?). The urgent care doctor told me she was perfectly fine, just a slight cold. Oxygen saturation was great. No reason for a chest x-ray.

The next night she was still coughing, low grade fever, and faster than normal respiration. Same as Max. Still convinced that something was wrong, I called our pediatrician's night line. They told me I needed to take her to the E.R.

At the hospital her lungs sounded "great", but they did a chest x-ray anyway and sure enough...bilateral pneumonia. Luckily she has a much milder version than Max. Because she was borderline they gave me the option of admitting her or taking her home and watching her myself. I told them I would watch her oxygen saturation for 20-30 minutes and if she didn't drop I would take her home. After she fell asleep I laid her down on the bed and her levels dropped too much (from 95 to 85) and they said "sorry, we're keeping her".

Turns out that Ava HATES the hospital. I have been wrestling her the whole time while she squirms, screams, and tries to take out her IV. She tugs at her cords and yells "No! Noooooo! I don't! Mama! Mama, Nooooooo!" I am surprised they haven't kicked us out. She is doing really well, so I convinced them to let me unplug her so she could run around and play. She is currently rearranging the contents of the room, thus allowing me to write this update. They told me I could take her home tonight after her next course of IV antibiotics. Feeling grateful that she is ok and that I get to sleep in my own bed tonight.

home

We got home from the hospital last night. Max and Ian had a very happy reunion this morning, and played their little hearts out all day. It's nice to be home. Max has to do some breathing therapy and finish his antibiotic, but we have definitely turned a corner. He is back to his normal antics, as evidenced by the above pictures. I heard him yelling-- "Mom!! I'm muuuuuddy!!" --and when I peeked outside I saw this. Luckily his dad was home to clean up the mess because I was way too exhausted to deal with it.

progress

Max is having a grand time in the hospital. He loves having everyone dote on him, and smiles and bats his eyelashes appropriately. He loves unplugging all of his cords so he can go to the bathroom, and especially loves to push the button to call the nurse when his IV starts beeping. The crazy thing is that he doesn't seem sick at all. No fever, his breathing is great, his lungs sound great, no runny nose or congestion. He is laughing, giggling, and cracking jokes. His oxygen saturation is just lower than normal, and he coughs every once in a while.

I still can't believe he has pneumonia. It happened so fast. Last Thursday he started to cough here and there. He hasn't had a cold since he was 18-months-old, so I was a little concerned. He wasn't acting sick and had no other symptoms. Thursday night I drove the kids to Palm Springs to spend time with J-P. He was working in one of our favorite hotels, so we went to spend the weekend with him. Max coughed the whole way. I figured he must be having an allergic reaction to some peanut dust or something in the air so I gave him benadryl. It didn't change a thing. The next day he was still coughing off and on, and had a low grade fever. His fever came and went, as did the coughing, over the next two days. Max's appetite was poor, and his energy level was lower than normal so I talked J-P into leaving a day early.

We got home Sunday night. After J-P put the boys to bed I went in to check on Max. He was slightly warm. His breathing wasn't labored at all, but it was a little faster than it should be (43 breaths a minute). I told J-P I wanted to take him to urgent care. He resisted rolling his eyes and said- "He has a cold. Maybe the flu. He's fine." I made him call his brother (who is a doctor) to ask him what we should do. After a little more convincing, he let me scoop him out of bed and go to urgent care.

They didn't seem too worried and gave me the "he has an upper respiratory infection" speech. I asked the doctor about pneumonia, and if he thought he needed a chest x-ray. He said no. They checked his oxygen saturation, to be on the safe side, and it was really low. The doctor ordered a breathing treatment. As the nurse was asking me the standard "is he allergic to any medications?" type questions, I got a feeling I should tell her about his peanut allergy. Her eyes got wide, and she immediately put the breathing treatment down and walked out of the room.

She and the doctor came in and said that particular breathing treatment cross-reacted with peanut allergy and could cause a serious reaction. Which, considering the state of his lungs, might have killed him. Luckily the nurse was a former allergy nurse and knew about the cross reaction. They gave him the traditional albuterol (with oxygen), and his levels still didn't go up enough. The doctor changed his mind and decided to do an x-ray.

Next thing I know the doctor rushes into the room, and amidst what I presume was a panic attack, emotionally tells me that Max has pneumonia quite badly in both lungs and that he called an ambulance because he needs to be admitted to the hospital immediately. The nurse calmed him down and said that it would be easier for me to drive him myself.

They didn't believe me at the hospital that he had pneumonia, because he didn't have a fever and his breathing was fine. His lungs sounded "good", they said. As soon as they got a copy of the x-ray they admitted him in a hurry, started an IV, stuck an oxygen tube up his nose, and started blood work.

He is doing great now. He has been off of oxygen for about 12 hours, and we just stopped the IV to see how it goes. Hopefully we will be able to go home in the next day or so. I will have to admit that I am enjoying my little vacation from cooking, cleaning, and toddler crowd control. And it's really nice to be able to spend some quality time with Max. I sure love him.