Now that he has the autism diagnosis though, I second-guess everything he does. Is he spinning because he's playing a fun game, or because he has autism and spinning is a repetitive stimmy thing? His therapists tell us we should try to stop him when he's doing a repetitive behavior and redirect him to something else, but I don't know what this behavior is! All little kids spin around, right? So is Lively's spinning a normal little kid thing, or an autistic thing?
2. Is autism the wrong diagnosis? In my last post I talked about Lively freaking out in the grocery store recently, crying, overwhelmed, terrified. And during that episode, all I could think was, this is it. My baby has autism. But all kids freak out in grocery stores once in awhile, right? So was it just a bad day, or was is autism?
A few days later, Pete and I took Annie and Lively to the mall. Our house is for sale, so when there is a showing, we have to leave for an hour or two. For this trip, Lively looked like this:
The next day, we took Lively to Lowe's, and he looked like this:
I can almost convince myself that there isn't a problem here.3. Is autism the right diagnosis? Lively has had a gastrointestinal bug the last few days and hasn't been able to hold down any food. He has a runny nose too, and seems not to feel well. Last night we walked over to our new house, and instead of happily frolicking in the back yard (which is a beautiful fenced-in yard, and I have been dreaming about seeing my kids chasing one another in it), he cried so hard when I picked him up that I eventually set him down in the grass and let him rock and do this finger-flicking thing he's just started to do. My heart broke into a thousand pieces.
4. I feel enormous self-imposed pressure to quit my job and devote myself full-time to doing therapeutic activities with Lively to help his development.
5. The problem with number 4? Therapy is incredibly expensive. My 21-month-old has around 10 words that he uses so irregularly that I'm not sure we should really even say he has 10 words. He needs speech therapy. But the fine print in our health insurance policy reads that although we are entitled to 60 visits of PT, OT, and speech per year, if Lively is eligible for free services, such as those in the public school system, insurance may decline to pay for additional services. Lively gets about 25 minutes of speech a week through Early On, but I haven't been impressed at all that it has made any difference for him. He needs more. A speech therapist who recently evaluated him recommended at least 2 hours of additional speech per week, and this, if we need to pay out-of-pocket, will cost around $1200 a month. And that's just speech. What if I want to take him to music therapy (which has been shown to be helpful with some autistic children)? Another $100 a month. The local pediatrician who specializes in autism and comes highly recommended, but doesn't take insurance? $300-$500 a month. The herbal supplements and millions of other products the internet recommends? $300 a month at least. So actually, instead of cutting back, perhaps I should pick up a second job.
6. When I do come home from work, I'm so exhausted both from work-related pressures as well as the underlying stress that comes from worrying about Lively 24/7, that my fuse is short and I'm not the positive, patient, therapeutic-play providing parent that I want to be. It takes all of our energy to get dinner on the table, to bathe a kid or two, give Lively his medicines and set up his tube feeds, read him a story, watch a Phineas and Ferb with Annie, read her a story, and get them both in bed. And then it's 9 o'clock. Which is when Pete and I crawl into bed and both fall asleep in the middle of a conversation about how I'm so worried about Lively.
Despite my neglect, the movie star seems to be taking things in stride.
7. The internet. I frequently tell my patients not to believe everything they read online. But there is so much conflicting information out there, I just don't know what to do. Do I experiment with a gluten free casein free diet? Am I the worst mother in the world if I don't try this? Do I vaccinate him when it comes time for his next round of shots? I have always believed whole-heartedly in vaccinations, and if I decided not to continue to vaccinate him, I think I might worry just as much about his risk of measles or rubella. Do I try the million-dollar vitamin supplements? Or the transdermal glutathione cream? I am actually thinking of a trial of the GFCG diet, although I'm not sure how to start because Lively requires about 750 ml of formula in his tube feeds every night, and finding a replacement for that seems almost impossible.
So far when it has come to Lively's health, we have had tons of questions his doctors can't answer. Pete and I have tried various methods to get him to take food by mouth based on things I've read in mom-blogs. And some of them have worked. But seriously, my son won't even eat non-pureed food, so how in the hell am I going to get 1400 calories a day in him if I can't even use his formula to make up the difference anymore?
8. Did I mention, um, the guilt?
9. The unknown. Lively is interactive, loving, happy, cuddly, and engaged. Will he continue to be this way, or will I wake up one morning and no longer see my sweet baby's personality in his eyes? Will he be able to have a job one day, or do we need to start thinking about providing for him forever? Should I hope for better treatments and therapies, or just accept that he will always struggle with this diagnosis?
10. I am neglecting the rest of my family. And myself. I need to go to the dentist. I need a haircut. I need to exercise. I need to cook a healthy meal for my family. I need to have a conversation with my husband about his day without being interrupted by kids or being too tired to listen. I need to be able to focus on Annie. I need to be able to provide a more therapeutic environment for Lively. I need a vacation (and for everything to be perfect when I get back).
Fortunately, for now, despite the suckiness of autism, I still come home to this guy every day. Seeing him and Annie and Pete when I walk in the door is the best moment of my day. You can probably understand why.




You know, this early on nothing is concrete. I've said this before, I think, but at 3 KayTar tested as autistic on one of the developmental assessments when she started school...it was wrong. I think the best policy is to look at Lively as Lively. Don't view him through the autism goggles and overanalyze things too much. Kids have bad days, with or without autism. Some kids have sensory issues, with or without autism. Same for speech delays and physical delays and feeding problems and everything. For now, I'd try to take it a day at a time, and see where things go. Having autism on the table doesn't necessarily mean things are going to go a certain direction...it might, but try not to get ahead of yourself. Anyway, that is my assvice. ;) It took me a long time to learn to live that way and sometimes it is still hard, having a totally undiagnosed kid, never knowing what will come next...but it is easier to deal with things as they come than to worry about what might be around the corner.
ReplyDeleteHang in there, and don't beat yourself up! It is legitimately tough. I did quit my job because of KayTar's needs, but here I am a few years later, back in school as a premed...something I never would have thought I'd have the time or freedom for a few years back.
Honey, I have been where you are -- minus the tremendous pressure that comes from being a working mom (much less a physician). Where you are right now is so incredibly hard and NOBODY truly understands unless they have lived it. Therapists all over the country succeed in making us feel guilty if we aren't engaging our children every single day-- which is an impossible task. I hate to give advice because I mostly feel like I am barely hanging on. But i will say this, the one thing I always wanted my husband to say was, "No matter what we will be OK because we will find a way to make things OK. No matter what we will go through this together. No matter what."
ReplyDeleteI didn't get that. I never said it, either (although I think I tried to get the message across in other ways.) And, wow, did my marriage crumble.
Nobody is going to be strong enough to say that every day, of course. But if you guys can take turns ... If you can wrap your arms around each other on occasion and take turns saying those words ....
That is the only advice I am even close to competent to give.
Hugs from Texas,
Leah
Hi Katie,
ReplyDeleteI have kept up with your blogs for quite some time now. Lively and Annie are both such dolls! They remind me of you and your brother so many years ago! I'd tell you to keep your job and that part of your life, because, as a stay at home Mom, it becomes easy to forget who you are. I did it for 5 years, and needed something that made me who I am, not just my children's mother. Ultimately it helped me gain patience with them as well. They actually will need you more in their presence as they grow into teen hood. I am not in your shoes, but my heart goes out to you in every way. Lively is such a miracle and Annie is so much like her mother. Mainstream that child so that he has the same life experiences as other children. Jake had a classmate who had autism, but the kids and teacher always allowed him to do the thing with his hands and fingers when he needed to, it was such a release for him. I am not happy with the advise of redirecting him. It is his calming mechanism and should be respected as such. (this is from hands on experience). Our friends name was Tyler and his parents felt he learned far more in the public setting instead of with kids that were much alike. Tyler withdrew both physically and emotionally in the setting of all autistic kids. Your kids are beautiful, enjoy any chance you get with them to laugh and smile. Lively will continue to be your miracle child, he will grow and grow, making huge strides with each year that passes. Look how far he has come......Wow!
Katie,
ReplyDeleteI follow your blog pretty regularly.You are doing such a great job with Lively! He is so adorable and he looks so big! Oh my gosh! Especially after his big boy haircut. And Annie, she is a spitting image of you. Especially in the picture you posted above. Just wanted you to know I was thinking of you guys.