Rolling Dice

 Life is a roll of the dice. As far as I can tell, there are very few guaranteed outcomes. You wake up each day (hopefully), and see where things take you. I've considered myself lucky that even when life has taken me to awful places I never wanted to go, I've had the practical, physical, mental, and emotional resources to deal with it.

Procreation is also a roll of the dice. Will it work? If it does, what will be the status of any offspring produced? Who will they be and what will they be capable of? A’s story is his to share, but as I’ve mentioned here, being his parent, and trying to be a good parent, has challenged me. I’m not sure I have the right resources to deal with the challenge. And I don’t know where to go next.

I’ve searched for and found professionals. The first play therapist we found was a bad fit. She decided that the root of A’s behavior issues was the sleep training that we did at age 1. She also told A that the play therapy room was a safe space and “you can do anything you want to do in here.” Then she got quite upset when A filled a play tea kettle with sand from the sand table and poured it into a bin of musical instruments. She got even more upset when he did it again after she told him not to. I’m not sure how someone with 30 years of play therapy experience was surprised by a 3 year old pouring sand into containers after first being told that he can do anything he wants to, and then being told that he can’t do THAT, but she was. We mutually agreed to stop seeing each other after a few months.

The second play therapist uses PCIT, and that seems a better fit. He’s a licensed psychologist with 25+ years in the school systems before moving to private practice. He spent the first ~5 months working on how DH and I interact with A, essentially making sure we weren’t the root of the issues. That’s good, because for all I knew, we were the root of the issues! Therapist seems to be satisfied now that our interactions should be facilitating desired behavior, and yet, no improvements are happening. 

A month or two ago, A got frustrated during a session and threw the game the therapist was trying to play with him across the room. A threw it after repeatedly telling the therapist that he didn’t want to play any more, so he was clearly verbalizing his wants. Throwing was a normal reaction for A when forced to do something he doesn’t want to do. I think the moment a dozen ‘fishing for feelings’ game pieces went flying across the room was the moment when the therapist really understood that the behaviors I’ve been describing are beyond normal 4 year old boy behaviors. 

I expressed my concern to the therapist that it’s been months of sessions and months of me implementing the ‘homework’ and yet no improvement in behavior. Therapist acknowledged my frustration. He also acknowledged that usually he doesn’t have such a hard time connecting with kids as he’s having with A. Great. My kid is extra broken. 

We’ve also done months of OT, but OT, while extremely helpful, has taken us as far as we can go. You can equip a child and their family with endless tools, but until the child and family use them, there’s not much more you can do. 

So I rolled the dice and this awesome kid came up, but he’s hard. He snuggles, and cuddles, and giggles, and he’s curious, and amazing, and funny. He loves his dad and his stuffed puppy and sloth. I think he loves me and his sisters most of the time. He’s creative and he’s got so much potential it’s unbelievable. But he’s hard and I don’t have the right resources yet to help him with that hard, and I’m not sure where else to go to find the right resources.

Reminder: Check Yourself

 The amazing Mel from Stirrup Queens gives a priceless reminder each week: don't forget to do your backups. In this digital age, that's true, and I'm always grateful for the nudge.

I'll add a different reminder for this week: don't forget to do your skin checks.

Eight or so years ago, my dad's super fancy, doesn't-take-insurance, concierge doctor was doing an exam and noticed a small spot behind his ear. It was a location he'd never have seen on a self check, because even with a mirror, you can't really see the top, back, outside of your ear. He was in his 60's at the time. She told him she didn't really think it was anything, but she was going to biopsy it just to be safe. The biopsy came back as melanoma. 

I had always been skeptical of the ideal of concierge medicine. That said, no provider operating under insurance guidelines that compensate for approximately 32.5 seconds per patient would have spent the time to catch and biopsy that spot. I strongly believe my dad is still here today, albeit with slightly less of his ear, because his doctor was so thorough. 

Anyhow, that diagnosis, combined with my own pale, mole and freckle covered skin, earned me annual derm visits to check my skin for any concerning areas. I went in for this year's visit, 6 months late because my original appointment was booked for the day I had norovirus, then my rescheduled appointment was the day I had COVID. I had a spot of minor concern to me on my forehead. Turned out to be pre-cancerous. I now have a very ugly freezer-burn mark on my forehead, but hopefully won't find myself with squamous cell carcinoma in a few years. 

If you are a category at risk, schedule your skin check, it's worth the time and cost. If you're not sure if you're a category at risk, ask your doctor.

4.5 and 2 - Long overdue updates

 It's been a long time and a challenging one, but it's interesting to see how the kids have grown. 

T is fiercely independent in some ways, but absolutely wants to have all the attention in others. She doesn't like to do things for herself, she wants you to do things for her. It seems to be her way of confirming that you care about her. She's the one who tires easily and doesn't want to walk/run/ride as far, so sometimes it's just a lack of energy meaning that she doesn't want to do something herself, but she still wants it to be done. We've been working for months with her on how to ask politely and be patient when asking. These things are still not her strong suites.

T is smart, she has an amazing memory. If something is lost, you can count on T being the one to find it for you. If T tells you a story about what happened or what she saw, there's a good chance it's true. At home, she displays very little empathy. She can be silly if prompted, but at age 4, she'll be the one to remind me that "No, mom, he's a stuffed frog" if I ask her if her stuffed frog Mr Jumpy did something silly like eat the last cookie. In other words, she's a bit more serious than I tend to be! That doesn't mean that she doesn't giggle and have fun, but that she trends serious, not silly.

T is creative and usually wants to be the leader when playing at home. At school, her teachers tell us that she's always looking out for her brother, making sure he's safe. She even tries to help keep him out of trouble there, which is funny because she's the very first to try to get him into trouble at home! She also doesn't talk up or engage with others at school, unlike at home. We are putting T and A into separate classrooms in September with the hope that she'll be able to make her own friends and come out of her shell if she doesn't feel she needs to be A's caregiver at school. We've noticed at summer camps that she'll be the one to remember the names of friends, and to point out friends who are in the same camps together. I hope she can make friends this school year.

T's misbehavior is usually clearly driven by a desire to get more attention, or because she's tired. She's pretty good about going to her room to take a nap when she needs it. She can be trusted to play alone and she's a great helper. One on one, she's absolutely delightful. I think the experience I would have had raising her if she'd been an only child would have been vastly different than the one I have had with her as a twin and now an older sister. She spent most of age 2.5-4.25 having really spectacular tantrums. The worst one was last summer and was a full 90 minutes of top of her lungs screaming. Despite what any of the books say, no amount of acknowledging feelings helped them. No calming techniques helped. Any intervention just enrages her more. We've found that she just needs time alone with her stuffed frog to calm down. 

T is also gorgeous. I genuinely think she's beautiful. Everyone in our family is average, at best, so I have no idea where she gets it from, but I'm happy for her. She has stunning hazel eyes and beautiful curly hair. I grew up basically being told I was ugly by my parents, so I hope she knows how pretty and how smart she is.

A is still pure energy and an ear-to-ear grin. He never stops talking, or singing, or yelling. He has a beloved stuffed puppy and stuffed sloth and the stories he will tell you about their adventures show his joy and all the things he's learned. He loves helping his dad in the garage or his grandma in the garden and yard.

A has boundless curiosity, and for the most part, it's because he really wants to know and understand. He loves to cuddle and hug and climb you like a tree. He can't sit still. The only time I've ever seen him still was the first day that he had COVID. We knew he was going to be sick before the fever started because he laid down on the sofa with his grandma and didn't move for about 20 minutes. That has never happened before. A wants to be outside, playing and digging in the dirt, tearing things apart, or running around the house. Even sitting on your lap, he's a tornado, constantly shifting position from top to bottom.

A can be so amazingly sweet to his sisters, especially to E. He'll help her get her stuffed animals, he'll push her around in boxes, which she loves. He'll offer to feed her food and give her big hugs and play wit her. Unfortunately, at his worst, he'll also physically lash out and hurt her, kicking, hitting, and scratching. Sometimes it's because she's going after a toy he wants. Sometimes it's just because she happens to walk close enough to his legs that he can reach her to kick. His worst behaviors seem to stem from being told 'no'. We've done a lot of PCIT work. It seems that attention isn't what he wants, and he's actually great at telling you what he's feeling. After six months of work, our therapist told us in not so many words that, as parents, we were doing all the things we needed to be doing, so the issues weren't caused solely by our parenting styles. On one hand, it was good to hear that we hadn't "broken" our kid. On the other hand, that leaves us without a "fix" that we can implement ourselves. At the room, A just can't modulate his frustration from being told 'no' into behavior other than aggression. That aggression might be physically hurting a person, an object that a person cares about, or it might be screaming loudly because he knows that no one likes it. 

A absolutely does not follow directions. We're 9 months into OT and PT and we've made progress on hurting other people, but no progress on following directions. If he doesn't want to do something, you mostly have to physically redirect him. And once you have to get into physical redirection, then you're running into behaviors that stem from being told 'no', as described above. A is off the charts high on sensory seeking, so he's always looking for loud noises, making loud noises, and looking for tactile stimulation.

A likes to break things. Every toilet paper roll holder has been broken off the wall, all of our window screens that he can reach have been destroyed. Basically any object in our house that he can reach, he's broken. The psychologist we've been seeing since Jan said back then that he doesn't diagnose kids with ADHD until age 6 or 7, but by June he commented that we should plan to have A evaluated soon because his behaviors are consistent.

A tests high normal on intelligence and receptive language, and just barely scrapes into low normal on expressive language, specifically articulation. His speech is garbled and most people struggle to understand him. I really, really hope that time and therapy, and maybe the right medications, can help him because he is such an amazing kid. I worry that some of the amazing is going to get lost under the problem behaviors.  

E is the too-good-to-be-true kid I didn't dare dream of. She's all cuddles and smiles. She potty trained herself at 20 months. Legit, she said: "pee, potty! Diaper off!" and a week later, she was 100% done with daytime diapers. She's been using 10+ word sentences at 23 months, and 5 word sentences since 21. She is the kid with the sense of humor, joking with us on a fairly regular basis, albeit in 22 month old fashion. She shows empathy, worrying about both siblings if she hears crying or sees them upset. She adores her big brother, asking for him and always wanting to play with him.

E has a tenacity that I'm envious of. When she decides to do something, she'll keep working at it until she succeeds, typically without whining or crying. The downside of this is that we've had to move her out of her high chair already, because she decided to figure out how to unbuckle herself (and she did), and we've had to get rid of the baby gate, because she decided to figure out how to unlock it (and she did). The upside is that so far she mostly listens to directions and can get herself safely to and from the places that she needs to go. This includes climbing on and off the potty herself. Although she looks like a drunken Olympian mounting the pommel horse when it comes to getting on the potty, she can indeed succeed when she says, "Me do it!"

E is a picky eater who would happily subsist on milk only, or milk, cheese and pizza.