Put Your Money Where Your Mouth Is

That sounds like exactly what I'll be doing a couple weeks from now. I visited my dentist this morning because I've been having a dull pain in my right front tooth. My tooth is extremely sensitive to cold drinks, but is not responsive to heat. The tooth in question tests "devital" (basically dead inside), and is non-responsive to repetitive pokes with an ice-cold substance called Endo Ice. This was first discovered during a routine cleaning last summer, and my dentist simply asked me to watch for increased discoloration of the tooth, pimpling of the gums, or tooth pain. The dull pain only started several days ago, so I thought I better have it checked out before it gets worse.

So two weeks from now I have an appointment with an Endodonist who specializes in root canal therapy. He will do further tests and x-rays, and depending on his findings, I may very well have a root canal done that morning. I've always heard that root canals are expensive - - even my mother-in-law in India always talked about her "Five Star Dentist" and his root canal fees. But wow--a whopping $800 for one tooth! Talk about putting your money where your mouth is. And that's just the start. My dentist suggested I return to him afterward so he can bleach my tooth from the inside out for a mere $200 (purely cosmetic, of course). Now for some reason that tooth is bleached beyond the color of the surrounding teeth, I can have the others bleached for $250 per bleach tray. If my tooth ends up obviously discolored from a root canal, I will do what is necessary to whiten it and match my other teeth. But if I don't notice any color change from what I have now, I will leave my teeth "as is".

With all the expenses involved in dentistry, it's no wonder Pankaj wants Samedh to be a dentist when he grows up.

Fun with Family

Getting older isn't so bad when you get to celebrate it with your family.

Therapy Session #2

Samedh had his second therapy session with Ms. Jenni today. She assessed his cheek muscles and lip strength and then had Samedh practice biting on his new chewy letters. He chose the Q today, and bit down well on both the right and left side. For snack, he brought his own alphabet cookies and Ms. Jenni provided a strawberry yogurt drink. Samedh ate on a "rotation" of one cookie followed by one sip of yogurt drink through a straw. He really liked the yogurt drink, so we'll be buying some for home. Jenni said Samedh chewed well on both the left and right, and would often use his tongue to shift the food from one side to the other. She encouraged us to keep offering foods on a rotation at home, often with a "reward" food at the end. Next week, she suggested we bring in chicken corn chowder, broccoli, etc. for Samedh to eat during his session. Practicing a rotation of foods in therapy will help encourage the same rotation at home.

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Jenni also mentioned that she forwarded her initial report to Samedh's pediatrician, along with a recommendation for a referral to the Developmental Pediatrician team at Devos Children's Hospital. Samedh is below the 3rd percentile in height and weight, and Jenni said in that case her next step would be to have him evaluated by the pediatric team in Grand Rapids. A typical assessment involves evaluating fine and gross motor skills, just to see what the child is capable of doing. Samedh obviously has no issues in those areas, but a dietitian may be able to offer ways for us to add calories to his meals. And then there's the social worker who offers feedback as well. Now we've had plenty of social worker experience with Samedh's adoption, but bringing a social worker into the mix now would be my biggest worry. I can just imagine an "outsider" evaluating Samedh on height and weight alone and making assumptions about his care and welfare without knowing any details about his background or genetic history. That's not likely to happen, but the thought is always at the back of my mind.

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Samedh's doctor is not concerned about his weight and growth, so he has not authorized the referral to Devos Children's Hospital at this time. Jenni suggested that Pankaj and I talk it over and contact Samedh's doctor if we want to pursue the evaluation. For now, I think we'll simply take Jenni's advice on adding extra calories to Samedh's meals. We'll be adding Carnation Instant Breakfast powder to his whole milk and give him Pediasure to drink at mealtime at least once a day. Adding extra butter to foods is something we've always done, but I'll now find ways to add sour cream or cream cheese too (now wouldn't that make a tasty mac & cheese!). Samedh did gain weight in the last two weeks, going from 23lb 13oz to 24lb 4oz. Jenni will continue to monitor his weight every week and submit periodic reports to Samedh's pediatrician. If we don't see an improvement in weight from week-to-week, we can always take the next step under the direction of both Jenni and Samedh's doctor.

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Jenni asked if there has been an improvement in drooling, and I was happy to report that there has. In just the last couple weeks or so, Samedh just hasn't been drooling as much. Maybe he's just more aware of it and is swallowing more instead. He doesn't seem to need his wristbands to wipe his chin as much lately...rather, he uses them simply for chewing.

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Finally, I want to report a very successful lunch time today! We tried a "rotation" as Jenni recommended, and Samedh took turns eating bites of mac & cheese, corn, and goldfish crackers, followed by a sip of milk. Since the goldfish crackers are his favorite, they served as his "reward" for eating the other foods first. He repeated the pattern until his plate was empty, and he enjoyed every minute of it. It was a very systematic process, and Samedh is fond of "systems" and organization. He was proud of himself for completing lunch, and I further rewarded him with chocolate pudding. I reminded him that if he continues to eat complete and healthy meals, more extra treats like pudding will follow.

Paper or Plastic? How About Canvas!

I've been using these canvas shopping bags for over 15 years, and they are still just as strong and sturdy as ever. We only have four bags, but I wish we had more. I used to use them primarily for grocery shopping, but have recently started toting them along to Michael's, Target, and even the post office! I get mixed reactions, especially at the local grocery store who happens to offer a "Save-a-sack" program for reusing your own bags. Service clerks (baggers) young and old often look at my bags like they can't figure out what to do with them. After all, the bags are neither paper nor plastic, so now what? Well, fill 'em up! A bag is a bag, whether it originally came from your store or not.

I actually prefer my old canvas bags to the ones many retailers offer today. Today's bags just seem so small, but they serve the same purpose. Everyone has them: Target, Walgreens, Spartan Stores, you name it. But all you really need is one good set for all your shopping (and hauling) needs. I recommend buying the largest bags out there, and using them wherever you go. The bags are especially handy for hauling 2-liter pop, which typically rips right through plastic or paper grocery bags.

So what prompted my to write about this today? Just a little comment I overheard in the check-out lane at our local Family Fare grocery store. The same service clerk has waited on us HUNDREDS of times before, so he is quite familiar with my canvas bags. In fact, he even tried to encourage me to purchase the Spartan Stores canvas bags about a year ago...going on and on about the importance of recycling. But today was different - - I heard him grumble quite a few times, "These bags are terrible!" I think he was upset because the sides of the bags kept collapsing as he was trying to fill them. Well in my opinion, he would have had a more difficult time trying to fill the smaller Spartan Stores recyclable bags if I had those instead. Maybe next time I should insist on bagging my own. Or better yet, I could simply take my $114 in purchases elsewhere. I could try Aldi or Save-A-Lot, where shoppers must supply their own grocery bags in the first place. Just my two cents...well actually, five cents per bag:)

Next Day Delivery

Now here's a surprise! When Samedh and I checked the mailbox this afternoon, there was a package inside. Somehow, Samedh knew instantly that this small package was for him, and he knew exactly what was inside. With a big grin he asked, "P & Q?" I could tell by the label that it was, but I just ordered his therapy toys yesterday. We opened the box immediately and he started chewing on his letters as soon as he could get his hands on them. I understood shipping would take approximately 8-10 days, and figured we'd receive our order within a week. But to receive it next day was such a pleasant surprise. Samedh has his second therapy session tomorrow morning, and plans to take his P & Q with him.

Therapy Toys

I found a great website for toys and activities to help Samedh with his therapy. Not only do they carry toys for oral-motor fun, they also have fun toys and tools to develop fine motor skills. Everything pictured above is on my current order, due to arrive within 8-10 days. Their prices are affordable too; the most expensive item on my order is the chewy P&Q set at $6.99. These chewy letters will offer Samedh something to chew on when he has the need (most often during our evening book time), and they can also attach to the safety necklace as shown in the second picture. The item Pankaj liked the best is the blue "blowing toy" with the floating eye ball. Not only will this toy promote lip closure, it will also help Samedh increase his lung capacity and blowing skills. It's just another alternative to blowing bubbles, I guess. The final two items on the order are primarily for fine motor skill enhancement. Samedh enjoys cutting with scissors, but still needs work operating them. The "bubble tongs" are great for pre-scissor skills, and you can use them to pick up cotton balls, small erasers, or use them in a sand or rice table. The small tongs can also be used to pick up marbles or other small objects during sorting games.

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Below is the link to The Therapy Shoppe, located in Grand Rapids. You can place orders online, via phone or fax. Unfortunately, they do not have a retail store, but you can request a free catalog through their website. I received my catalog within a couple of days.

http://www.therapyshoppe.com/therapy/index.php?main_page

One Day Closer to Spring

We are having beautiful weather today, and the three of us spent some time outside this afternoon. I raked leaves in the backyard while Pankaj and Samedh kicked a ball around. It felt really good to be doing yard work again after a long winter. Samedh even had his toy lawn mower out, as well as various diggers and front-end loaders. Those loaders are great for moving leaves!

Our lilac bush is full of buds, and there are hyacinths popping up here and there. My daffodils haven't yet emerged like they have at my parents' house, but they will soon enough. I just hope the snow is done for the season. Last year we had quite a bit of snow for Easter, so we'll just have to see. IF it does snow, I'll just make another snow-Easter bunny with Samedh and make the best of it.

Just a little something that came home today in Samedh's folder from school...
(Click on the picture to enlarge.)

Diagnosis: Dysphagia

Dysphasia Chewy Tubes

Today Samedh was evaluated by a Speech-Language Pathologist (SLP) through Holland Hospital's Dysphagia Program. Dysphagia is a feeding and/or swallowing disorder that can occur in adults and children. Ms. Jenni, Samedh's therapist, recommended his initial treatment be once a week for 12 weeks.

Today's evaluation included eating treats like goldfish crackers, pudding and mandarin oranges. Samedh enjoyed every bit of it...except for the mandarin oranges. Ms. Jenni took note of how Samedh ate with a spoon, chewed, swallowed and drank through a straw. She assessed his cheek muscles, both inside and out, and found the right side to be much weaker. Samedh's top lip function is weak as well, but drinking through a straw as well as other oral motor activities should help improve this.

Tomorrow we will begin keeping a food log, as well as making notes on Samedh's food likes and dislikes (including what foods he will TRY). At next week's therapy session, we'll learn about some new oral motor activities that we can try at home. In the meantime, we are going to continue what we've been doing over the past several weeks. I may also inquire online about some Dysphasia Chewy Tubes like shown in the picture above. Samedh used one today in therapy and they are supposed to be great for exercising the mouth muscles. They might be a bit pricey though, because I found one similar chew tube from another company that was priced at $30 each. However, it should be an expense we can turn in for reimbursement through our flexible spending account. The bottom line is, whatever we can do to help Samedh strengthen his oral motor function, is top priority at the moment. This is going to be a team effort, and we are all in it for the long haul.

CBA's and 321's

Ever since Samedh was introduced to the Leap Frog learning DVD's such as The Letter Factory and Talking Words Factory, he can't stop talking about letters, vowels, phonics...you name it. I can't tell you how many times he and I have discussed the difference between a "soft G" and "hard G" or "soft C" and "hard C" at the dinner table or while driving in the car. He even asked me to make him a letter G in the snow this year. Never mind making a snowman, he wanted a letter! It took me about 20 minutes to shovel out a giant letter G in more than a foot of snow, and then he asked for a letter H. I was so exhausted by creating the G, I told him if he wanted any other letters he'd have to make his own.

The one thing that surprised us most recently is that Samedh can recite the alphabet backwards from Z to A. He caught me off guard the other day when he asked if we could say "our Z to A's". I agreed, and let him lead the way. He breezed right through them in reverse order, and I couldn't keep from smiling the entire time. Nowhere in sight was posted the traditional A to Z order; it was all in his head. Then the next day he recited them for Pankaj, who was equally amazed.

Last weekend, we were having lunch at the Indian buffet and Samedh shocked us again. He had been drawing in a little notebook when suddenly he wrote out the word C-A-T. I knew he could write an H, O, C, and letter I, but writing the word CAT just seemed to come out of nowhere. I was so happy and amazed that I just about started crying right there in the restaurant! Now I have to admit that for quite some time now, Samedh has been spelling words like CAT and DOG and his own name with the large red "shiny letters" we bought in the school supply section at Staples. He just sounds out the words he wants and arranges the letters on the living room floor. Playing "shiny letters" has been one of his favorite daily activities for the past few months. We also have "shiny numbers" from 0-9 that we've been using to help Samedh learn his address and phone number. But actually wanting to write the letters and putting them together in small words is something very new and exciting.

I've had mixed reactions to Samedh's new love of learning letters and words. Most people (including a former 1st grade teacher) are positive and encourage me to continue working with him as long as he expresses an interest. However, I was warned by a Kindergarten teacher that if he learns too much now, he will be bored by the time he starts Kindergarten. In my opinion, if Samedh is interested in learning something now, I'm going to do what I can to teach him. Besides, it is very likely that by the time he starts Kindergarten in 2010, he will be going all day, every day. I'm sure there will be plenty of new things for him to learn in all day Kindergarten.

Finally, we purchased the Leap Frog Math Circus movie recently to help focus on numbers and basic math as well. Now occasionally I hear Samedh reciting, "One plus one equals two. Two plus two equals four. Four plus four equals eight. Five plus five equals ten. And ten plus ten equals twenty." I know he just memorized those facts, and really don't know if he truly understands what it all means yet. But just being aware of the numbers and basic concepts of addition and subtraction is not going to hurt a 3-year-old. However, Samedh got me thinking a little the other day when he blurted out, "A + B = C". At first I told him that you can't add letters, but then I remembered good old Algebra. I'm not about ready to introduce him to that yet, but we'll see...maybe when he's 5:)

I highly recommend all of these learning DVD's because they have cute stories, catchy songs, and make learning lots of fun for preschoolers.

Excessive Drooling in Toddlers

Playing the clarinet is one oral motor activity we are working on at home.

We recently searched online for information related to "excessive drooling in toddlers", based on what we have experienced with Samedh for most of the past year. There was little information to go on, but certainly enough to give us a head start in the right direction. My purpose for sharing our story is to let other families know that if you are seeing similar behaviors in your toddler or preschooler (who is obviously beyond teething), you are not alone.

Samedh is 3.5 years old, and has been drooling excessively for approximately the last eight months. The saliva just runs down his lower lip in a stream-like fashion, almost like he has no control over it. We first noticed the excessive drooling a year ago ONLY when he got excited or laughed at something funny, but now it doesn't seem to have a trigger. Additionally, within the past couple of months he has progressed to licking the back of his hand, chewing on his fingers, and even chewing on objects such as toys, DVD movie cases, his stocking cap, etc.

Based on feedback we received from an adoptive mom who teaches early childhood special education, we believe Samedh may have a delay in oral motor function. She suggested that Samedh is actually trying to build some of those muscles up by putting objects in his mouth. So what we thought was weird behavior, actually turns out to be something quite normal. Her recommendation was that we provide him with a "chew toy" at home and at preschool so that he only uses that toy to get those needs met. There are plastic tubes available that can be strung into a necklace or bracelet so that the child can chew on these when needed, but we decided to try sport wristbands instead. Samedh has been wearing the wristbands faithfully for the past several weeks, and they don't draw unwanted attention in school like a necklace or bracelet would on a boy. Samedh can use them to wipe his chin whenever he drools, and he also "chews" on them when feeling the need to exercise those muscles. Sometimes he likes to wear the wristbands to bed because late at night is when his urge to "chew" seems most powerful.

We have also been trying some activities for strengthening oral motor muscles, including drinking milk through a straw, blowing bubbles, and blowing cotton balls with a straw. One of Samedh's favorite activities is playing his clarinet, which he got for Christmas. I also recently bought him a harmonica, since he so enjoyed playing the one at Grandma and Grandpa's house. We plan to continue these various activities, but truly believe the next best course of action is to have him fully evaluated by a speech pathologist. We will be discussing these issues with his pediatrician this week, and hopefully will have a referral in the near future.