All posts by Peter

Fracture

Comparative xrays reveal Jon's fracture

PeterIt was no muscle spasm. After a brief meeting with his doctor at Bloorview, we whisked Jon to Sick Kids’ Emergency, where X-rays have revealed a huge fracture.

Here’s the deal: remember his last operation? Well, the hardware they installed has drifted down as he grew, and the shock of that sudden leg bump has caused the blade plate, originally in the femoral neck, to fracture Jon’s femur.

They’ll be doing emergency surgery sometime tomorrow, and it sounds as if they are still deciding on the best option, given that he bears weight on it (some kids don’t, and I guess that changes the equation). We don’t know what we’re in for, except that it will be the rest of the summer convalescing. And that he’ll be in much discomfort.

Poor Jon. It must have been excrutiating, and here we were saying it should be improving.

How did Children’s in B.C. blow the diagnosis? Maybe the angle of the x-ray, maybe the fact that in some kids a fracture isn’t immediately apparent, maybe that they had nothing to compare it to. I don’t understand.

We’ll need to get a social network going. Please feel free to visit, ’cause we’ll be here!

Laura is in Emerg overnight with Jon, I returned the car home and will return in the morning. We’ll be in The Room tomorrow.

Late-breaking note: Why was Jon always pointing to his banged knee as the source of pain? Because hip pain often radiates to the knee! Now you know (well, now we know). Apparently this is common knowledge in medicine.

Moving On

Jon and his Grade 2 reader

PeterJon’s reading programme, as designed by Tami, works like this: each day Jon reads two stories, and on a day when he can read the first one comfortably with no meaningful errors (and/or corrects himself on anything significant without assistance), he “moves on” from the first story and he is introduced to the next story. Leapfrogging, basically, with one familiar story always there.

Tami has had a plan for Jon’s reading for the past three years, and Jon has been up to the challenge. But Tami hurt her ankle badly in March, and was away for about 8 weeks. Despite the best efforts of her assistants, there hadn’t been much reading at school, and we did what we could on the weekends. When Tami returned at the end of May, Jon was about 120 pages short of her target for the year.

We undertook to read with him in a second session daily, which was pretty intense: previously when we’ve tried it Jon just couldn’t see the page–his eyes were tuckered out for the day. But in May and June, Jon responded well, fighting exhaustion, humidity and hormones, and his first bout of academic pressure. Towards the end, he was so strong that he would move on in both stories at the same time. And last Monday, he completed the 120 pages, and finished the Grade 2 reading program, and started the Grade 3. With two days to spare. Yay, Jon!

(He’ll get a little break during the summer, but Tami has supplied us with lots of reading and spelling materials. No backsliding!)

A little too precocious…

Peter So Jon has been somewhat emotional these days. He’s had several tantrums of late: explosive, sometimes physical, and very intense.

The weird thing about them is that he was turning on a dime. After the Sunday one, he turned around and did 16 pages of tough reading homework; cheerfully, anger completely evaporated.

Now, Jon has had tantrums before, and even waves of tantrums, but that was years ago. And all through all of them, none of his teachers had ever seen anything; they could barely believe that such an angel would ever do this.

This included Tami—until Monday, when Jon decided to try his new attitude at school. To sum up: demanding and surly, then kind of weepy when challenged on what was going on and why he was doing this.

He has been under a heavy workload at school. And there was the humidity. And he’s going through a new social phase, so he may be testing the waters. But we suspect there’s something else too.

Tami mentioned that it seemed “almost hormonal”, and the EA’s have noticed some other things that lead us to a new fact. New to us anyway, and we like facts. So how is it that we never learned—and no one ever told us—that it’s common for kids with CP to hit puberty early?

When I heard this interesting fact, I nonchalantly googled “cerebral palsy early onset +puberty”, thinking maybe one scientist had a study or two. 42,100 returns. Oh crap.

It’s called precocious puberty. (Of course it is.) Common in kids with brain injury, including kids with autism and FAS. For the boys, it tends to start early and end at the usual time, and the likelihood is inversely proportional to the amount of body fat. Oh craaap.

Looks like the future is now. With more coming soon. Anyone got some raw meat and a chair?

Parent Trap

Peter From what I can see, one of the common pitfalls of parenting a special needs kid is despair. There’s no explaining how draining it can be at times. I can’t know for a fact, but I suspect that parents of regular, store-bought kids don’t have as many moments where you fall into a little mental “What is to become of us?” cell.

Autism’s Parent Trap is a thoughtful article by Cammie McGovern in the New York Times that was spawned from a truly tragic subject: Three recent cases of autistic children murdered by their parents. Essentially, they died in the wake of parental frustration borne of doing everything they could and not getting much progress despite their efforts.

The article hits some poignant beats for us. Jon’s isn’t autistic—his challenges stem from physiological damage and the resultant developmental delay—but some of his behaviours are not dissimilar. We see a lot of progress, but much of it is gradual: socialization is slow to root, some aspects of math, like simple addtion and subtraction, aren’t rooting much at all. Toileting for #1 is pretty close to fully ingrained; for #2 it just does not seem to register.

The physical aspect of the cerebral palsy reminded us from six months on that there’s no “cure”. We knew we were striving for Jon to be the best he could be, given what he could work with. (To quote Clarence, cradling the infant Jon, “We’ll make him the coolest little guy with cerebral palsy ever.”*) We’ve come very, very far. Still, there are days.

Since the Times won’t keep the full text up forever, I’m going to pull a quote or two from Cammie McGovern:

I don’t mean to sound pessimistic about the prospects for autistic children. On the contrary, I see greater optimism in delivering a more realistic message to families: Children are not cured, but they do get better.

And better can be remarkable… I remember thinking maybe we’d laugh someday at the lengths we went to when we were teaching him language — the flashcards, the drills, the repetitions. Now he’s 10 and talking at last in his own quirky ways, and we don’t laugh about the drills (though we laugh about plenty of other things). Language is a victory. So is connection and purposeful play. So are the simpler things: a full night’s sleep, a tantrum-free day.

Parents working toward these goals will one day be surprised and delighted by their children’s funny new obsessions, odd fixations, and tentative but extraordinary connections with other children. Being more realistic from the start might make it possible to enjoy the journey and to see it for what it is: helping a child who will always function differently to communicate better and feel less frustrated. To aim for full recovery — for the person your child might have been without autism — is to enter a dangerous emotional landscape.

Hear, hear. One thing we have learned from Jon is that the fancifiul “What If” is a painful crock. There is no point in considering what could have been. You’ll simply be consumed by grief rooted in a fiction.

Play the cards you are dealt. Work with what you’ve got. And take joy in the little things.

*Given his father, this wasn’t going to happen easily.

Digital Boy

To the envy of his cousins, Jon’s been typing for years now. Writing or drawing is very hard, and to get the required stability it has to be hand-over-hand, which means an adult has to be there, and the chances of spontaneity are pretty much crushed.

While doing reading homework on the deck yesterday afternoon, Jon and I had a following conversation, witnessed by Bachan:

Jon (pointing to an exclamation mark, knowing full well but teasing me): What is that? Is it a period?
Daddy: No, it’s an exclamation mark, goof!
Jon: It’s a period! How do we make it an exclamation mark?
Daddy: Easy, we just draw a line straight down over the period.
Jon (wrinkling his forehead, more serious): Nooo.
Daddy: Yes, just drawing a line down.
Jon: Nooo. By pushing shift and 1.
Daddy: ??? Ohhhhhh…..
Jon (seizing my weak moment): By pushing shift and 2!
Daddy (reaching to the very height of his knowledge): Noooo! That’s an @ symbol for email!
Jon (smiling): Ahhhh!
Daddy: Okay, Mr Smarty-drawers, what’s Shift and 3, if you’re so…
Jon: Number sign.
(Pause)
Daddy: Okay, let’s get back to reading…