Saturday, September 19, 2015

Caleb struggles

If you know Caleb very well, you know that saying he is a picky eater is putting it lightly.  Caleb is a horrid eater.  He wasn't always as bad of an eater as he is now.  Sure, there were a few things he wouldn't eat, and he was never as great of an eater as the two older kids, but he still ate.  The last year though, we've had a serious struggle.  What Caleb will and will not eat has gotten narrower and narrower.  For the last nine months Travis and I have talked to him about what happens to calves when they don't suck (figure relate it to something he's going to understand) - they get a tube up their nose and their milk goes up their nose to their stomache so they get the nutrition that they need.  I've talked to my pediatrician about these concerns multiple times over the last few years.  He's always assured me that Caleb will eat when he gets hungry and I have kept that as my mantra.

The first ADD medicine that we had Caleb on (Vyvanse) was a stimulant which means it could also act as an appetite suppresant.  Nash had this problem but after some discussuion he realized it was improtant for him to still eat something even if he wasn't hungry.  Nash also didn't want to be taken off his meds if he didn't gain weight which is what would have happened.  This summer we switched Caleb to a non stimulant ADD medication (Metadate).  This medication should not affect his appetite at all.

Knowing how picky Caleb is about his food, I hate having him eat school lunch because I can't keep tabs on how much he's eating.  So, since the beginning of the school year I've been sending him a home lunch.  This is not an easy task.  Caleb will not eat peanut butter sandwhiches.  He will not eat ham sandwhiches.  He will not eat spaghetti-o's or lunchables.  In fact, he will not eat meat...period.  He does not like sauce of any kind.  He will not eat the majority of fruits and generally won't eat any veggies.  He will eat: Pancakes, waffles, french toast, bacon, eggs, cheese quesadillas and go gurt.  Tell me how to pack that into a lunch.  He can't open the go gurts without help and won't ask anyone in the lunch room for help opening it.  If I put any kind of chips or cheetos in there he'll eat those but nothing else.  If I put a drink in he will drink a it and if there are fruit snacks, he'll eat those.  The first week of school I packed him a half of a ham sandwhich, cheetos, a fruit snack and a drink.  He would eat the fruit snacks and the drink and maybe one or two cheetos.

Mind you, the whole lunch thing doesn't sound too awful, right?  I mean, they do eat lunch early at school.  However, take into consideration the following:  Caleb will take 45 minutes after he gets out of bed to get his pants and shirt on.  This leaves him time to eat what he can in the car on the way to school.  That means he either eats a piece of toast or some dry cereal (he refuses to have milk on cereal anyway) or a go gurt.  Not exactly the most nurishing of what should be the best breakfast of the day.  Combine this breakfast with the lunch he just ate.

Now, dinner, well, that's a whole nother problem.  It use to be that I would dish a little bit of everything onto Caleb's plate and I would tell him "You have to eat all of something.  At the very least half of two somethings."  He would fight it for awhile but eventually (when he got tired of sitting there and watching everyone else get up and go) he would eat something.  If he complained I would tell him that I am not a restuarant.  He could either eat what was there or wait until breakfast.  This too, would convince him to eat something.  Now, remember how my pediatrician said he'd start eating when he was hungry.  Well, as of late when I give him his plate he will start complaining about everything on said plate.  When I tell him his options are to eat what's in front of him or wait until breakfast 9 times out of 10, he will choose to wait for breakfast!  Even though he has just said not 5 minutes prior that he was hungry.  Now don't get me wrong, if I make a big breakfast for dinner, he's all over that.  But really, how much nutrition is there in pancakes or waffles or french toast?  He can't eat eggs for every single meal!  If I feed him bacon all the time he's going to have a heart attack at 15!

And that brings us to today.

Last night I went to bed at 11 pm and he was in bed asleep by then as well.  This was early for him - he generally stays awake reading until midnight.  I woke him up at 8 am so he had had 9 hours of sleep.  Should have been plenty, right?  He told me his stomach hurt so I told him to use the bathroom and then get dressed so he would have time to eat some food (he literally only ate 1/2 of a serving spoon of rice for dinner last night).  Caleb proceeded to sit on the bathroom floor for the next 35 minutes.  I walked back into the bathroom for about the 15th time and repeated what I'd already been saying "If you don't get dressed you aren't going to have time to eat before school so your stomach is going to keep hurting.  Hurry and get dressed so you can have plenty of time to eat!"  He just sort of started at me.  At this point I knew we weren't going to get anywhere.  We have to leave home by 8:40 to get to school on time so Nash doesn't end up with all his morning work as homework.  I just looked at him and said, "Caleb.  I don't know how to help you any more.  You won't get dressed so you can eat.  You don't eat and you don't feel well.  You don't feel well and you won't eat.  Just go lay on my bed.  I'm taking you to the dr. today to talk to him about how you eat."  Normally this would elicit a blood curdling scream and a quick response to action.  He sort of looked at me and shrugged like whatever.  I felt defeated at this point.  I got Nash to school and came home so I could teach preschool.  I had moved all my pm kids to the am class so I could haul him into the dr. this afternoon and still make it to work at the grocery store on time.  By the time I was done teaching and could go check on Caleb it was 1:00 pm.  The kid was STILL sound asleep.  He had fallen back to sleep after I went to take Nash to school and apparently didn't move.  I woke him up because by this point he had been asleep for 14 hours which is unheard of - even for him & he's my late sleeper.  We got him dressed and he said he was hungry.  I asked what he wanted to eat and he said toast with cinnamon and sugar.  I went and made said toast.  I did not cut the crust off.  I don't always cut the crust off - they've gotten use to that and will just pull it off if they don't want to eat it.  He finally came in and sat up to the counter.  He pulled half the crust off of one side of the toast and then laid his head n the counter in an attempt to go back to sleep!  He never ate his toast.  He did tell me he had thrown up earlier.  It wasn't true throw up - he's got his croup back and I think he was mostly choking on drainage that was stuck in the back of his throat.

We made it to the pediatrican's office at 4:20 and went in.  When the nurse came and got us they weighed him and checked his height (he's actually up to 40 lbs now and he's 3' 9").  The nurse asked what we were there for and I sort of gave her the run down.  She went out and eventually Dr. Clarke came in.  Dr. Clakre checked him over good and then pulled up his chart.  He showed me his growth chart and miracle of miracles the kid is actually gaining weight.  He's in the very lowest percentile on the growth chart but his numbers are slowly going up on the line.  That was a bonus I hadn't expected.  Dr. Clarke said he wanted to run some labs to check his mono status, his thyroid, his iron levels and his liver.  He said that if all the labs come back normal he wants to try an appetite stimulant.  It was at this point that I pointed out that Caleb is not eating when he's hungry.  That really threw the dr. for a loop - I could see the confusion written all over his face.  He sort of debated what to do at that point and then said, "I don't want to be hasty in getting a feeding tube in him.  Let's check to be sure that there's nothing else physical going on and try the appetite stimulant first.  If that will push him forward and get him out of that I'd rather do that than a feeding tube."  I told him that was fine with me.  He said that if the appetite stimulant doesn't work after a few weeks I will need to call him and there's a pediatric GI down at Primary Children's Hospital that runs a failure to thrive clinic.  I explained to Dr. Clarke that the failure to thrive is my biggest concern.  The number of foods Caleb's willing to eat is shrinking by the day.  Not only that, but the condition in which he's willing to eat those few foods is also changing.  There isn't a single food I can say that without a doubt he'll eat every time.  There are numerous other foods I can promise you that my other children will eat every time you put it in front of them.  I cna't say the same thing for Caleb.  My concern is that eventually he's going to start showing symptoms of someone with anorexia and those are things that are not easily fixed.  I am thinking this because he's starting to show some of the coping mechanisims that people with anorexia use - pushing food around their plate and flattening it out to make it look like they ate more - he does this all the time lately.

I love my pediatrician because he really does listen to me when I tell him what I'm concerned about with my kids.  He doesn't just brush me off.  And, I could tell by the look on his face that when I said he's choosing to wait until the next meal even though he said he's hungry concerns him.  But, we are eliminating the simple things first.  We did the blood draw this afternoon and lab results should be back by Monday or Tuesday.  If they come back normal (I'm assuming they will) I would think that he'll be able to start the appetite stimulant by Wednesday next week.  If we try it for two week sand there's no improvement, then I guess we'll head down to Primary Children's to meet the pediatric GI and get his input.  So for now, we wait....and hope Caleb disliked the blood draw enough today that he'll actually start to eat something!

Friday, September 18, 2015

Fall is upon us...

Well, the last few weeks of summer zoomed right by - as is to be expected!  Once the kids were in school I had my preschool open house and got a few loose ends wrapped up.  I've got 3 classes this year: a 4 yo am class with 8 kids, a 4 yo pm class with 7 kids and a 3 yo class with 6 kids.  Brookelyn goes to both 4 yo classes (she likes her friends just a little).  I originally hadn't intended to teach a PM class but ended up with 14 kids on the roster and was like, yeah, not teaching 14 4 yo's at one time!  We started preschool after Labor Day.  It's been a bit insane to say the least.  I canceled one day this week because the storm was so horrendous that I was worried we would lose power during the day and I didn't want 8 4 yo kids there with the thunder shaking the house and the power off.  I knew if they were anything like Brooke that it could be completely traumatic for them.  Fortunatley the power never went out so now I know that even when it seems super ugly outside we should still be fine to carry on in the lights inside!

Brookelyn started back to speech the first full week of school for the school district.  She goes on Tuesdays from 12:30-1 and on Fridays from 9-10:30.  She is loving it - just like last year.  Teacher Angie is great with her and she is progressing so quickly!  Hopefully she won't need services through her entire elementary school career!

Nash & Caleb are both in robotics at school this year.  Caleb also BEGGED to sign up for choir.  Choir is BEFORE school once a week.  This means he has to be at the school no later than 8:05 am on Tuesdays.  He is LOVING it.  Both boys are working with the school counselor this year.  Last year I just had Caleb working with her on some anger issues but after a few bullying incidents with Nash last year I wanted him to work with her as well.  I worry that somone is eventually going to push Nash too far and he's going to knock their lights out (which they will have coming and fully deserve), however, I know it will also land him in a heap of trouble - so, we are trying to prevent it.  Normally Robotics Club is just for the 4th and 5th graders.  However, seeing how completely anti social Caleb is (another skill he is working on with the school counselor) I wanted to see if it would help him integrate into the school setting a little better.  Mr. Hawkes (Nash's teacher & the Robotics Club advisor) was more than willing to let us give it a chance.  And, so far, so good.

Samantha hasn't been involved in much at school - just keeping in touch with friends.  But, that's ok.  She's dancing about 7 hours a week.  She has a ballet class for an hour and a half on Mondays.  She dances for 4 hours straight on Wednesdays (her competitive class, a leaps and turns class & a tap class), and an hour and a half on Thursdays for her pre pointe ballet class & her hip hop class.  She's staying busy enough with all of that!  She has a dance convention on the 25-26 of September down in Provo that she's looking forward to as well.  Should be interesting as I get to take all three of the other kids and we tag along.  I believe that Friday afternoon the kids will get to swim at the hotel pool until they are completely water logged!

All three kids are still taking piano lessons.  We had to find a new teacher since Austin left for college.  The kids started with Rowena on Sept. 1.  I asked Nash how he liked it after his first lesson and his comment was, "It was good.  Except...she's really, REALLY particular about timing."  Ha!  The kid has always struggled with keeping a steady beat so I'm not surprised that this is what stood out to him.  I conpared it to being the lead drummer in marching band (or any band) and how if he's off the whole rest of the band is off.  I told him that when you are in marching band the judges know you're music and they are listening to all aspects of it so if the lead drummer is off and gets the whole band off then the judges will dock points.  I asked how he would feel if he was responsible for getting the entire band docked points.  It was at this point that the purpose of timing sunk into his head!  He's getting there!  He's got a metronone app on my phone and he's started counting his beats out loud while he plays so I am starting to see steady improvement.  They will be having a Halloween recital on Oct. 30th.  Sam's learning Addams Family theme song for this.  I told her if she nails it I'll record it to use with the preschoolers for our Days of the Week song!

Travis said they are expecting snow in Alaska now.  Could be a long cold season for the guy seeing how much he loves the cold weather!  He's headed off shore next week to do a job.  I think that makes him happy - he likes the helicopter rides and he hasn't been off shore in quite awhile.  He's getting ready to go hunting when he comes home as well.  The boys are hoping to be able to go with him on this trip but I don't know if that's going to happen this year or not.  We'll see when it's a bit closer!

The weather has gotten quite a bit colder here so Fall is for sure right around the corner.  I've been working on Halloween costumes and have Brooke's all done.  I've got mine started and have the costume for Travis cut out.  Sam's will be last this year as it's going to be my most challenging one to complete.  Nash & Caleb don't need me to make anything but we've got to gather lots of pieces!  Hope we can find them all before it's too late!

Hope you are all having a great day!