Wednesday, February 25, 2009

Monday, February 16, 2009

ABR: First Satellite

We headed down to Plano, Texas this weekend for our first "satellite session" for ABR. The main ABR center we attend is in Montreal, but for ease of travel, those in the program only have to go to Canada for one out of the first four training sessions that are mandatory in the first year of the program. The other three training sessions (which do not include evaluations by Leonid Blyum) may be done at various satellite locations available across the US. We chose to go to the Plano location because Trevor's Dad, Aunt and Uncle live in the neighboring city of Double Oak.

We planned to fly down to DFW and rent a car for our stay, but because of passenger loads and timing (since Trevor is a pilot, we get to fly for cheap... but it is only standby, so we risk getting bumped) we ended up driving instead. Luckily Plano and Double Oak are both on the north side of Dallas, and my hubby has a lead foot, so the drive is under seven hours. We timed it so Fletcher took his nap during the drive (3.5 each way... he certainly loves to sleep in the car!), so everything actually worked out great.

I have to say, I couldn't be happier about the training. Due to a couple of last-minute cancellations, there were only four families attending this particular session, and with two session a day that meant only two families per session, which means lots and lots of undivided attention with the trainer, who just happened to be Gavin, the man who did the initial evaluation of Fletcher in Montreal. I have a huge thirst for knowledge, so you better believe I took advantage of that time and really feel like I have a good understanding of how ABR will help Fletcher. That said, I am not going to type it all out here, but for the most part my posts from Canada in October explain the concept.

Speaking of concept, since we learned about that and the technique in the fall, the main purpose of this satellite was to practice the technique, get answers for any questions or problems we are having implementing the program at home, and to learn a few new exercises. Fletcher's new exercises involve the posterior neck, lateral chest, shoulder edge, and top of the head. Gavin also made us foam pillows to use for each exercise in place of the towels. Apparently, once you get used to the technique the foam pillows are a more effective tool, but towels are more forgiving, so they are used for the initial training.

We also got some exercises for the ABR machine. According to the ABR Canada website:
The main purpose of ABR machine is to enhance the number of ABR hours the families are able to perform. Typically the maximum number of ABR hours the families are able to do manually is about 20 – 25 hours a week with the average performance being around 15 hours weekly. That number of hours is most often good enough to demonstrate the efficiency of ABR Method and to bring consistent developmental progress for a CP child. However, in order to speed up the rehabilitation process, ABR machine brings the possibility to find extra reserves for working ABR hours.

The use of the ABR machine permits to increase substantially the number of hours clocked in. The machine is able to act as the second and the third provider and to extend effective ABR hours by using the reserves of the child’s daily livings – delivering ABR impacts in parallel with other routines (feeding; TV watching, sleep etc.)

Using the Machine to Apply ABR Technique while Feeding a Bottle

I am excited about the increased hours we will be able to achieve using the machine. While I know the manual exercises are the most efficient, and are the only means of applying the technique to areas of the neck and head, I also know, because of the baby on the way, that reaching our target hours for ABR will be difficult this summer (we didn't even meet our target this winter, without a new baby around). We will still aim for our goal of three manual hours per day, but having the machine will definitely give us peace of mind that Fletcher will still benefit from ABR when we are just too busy to get in the manual hours.

One of the other families we spent some time with this session was Charlie, his mom Katy, and her sister-in-law. Katy did a better job of updating in real time about our session, so go check it out over at Bird's Blog. And I will reiterate a comment I made on her blog here. While traveling for therapy is obviously first and foremost about the therapy, the experience of meeting like-minded parents is a motivating factor in and of itself. As Barbara mentioned in her comment to the same post, the natural environment (or in-home) focus of many early intervention programs, while good in many respects, unfortunately can isolate parents from the natural support groups that pop up in center-based programs. As much as Fletcher is and will benefit from ABR, I feel like as a mom I am equally benefited through meeting great moms in similar situations such as Katy and the others I had met in Montreal.

National Dental Health Month

Did you know that February is National Dental Health Month? Neither did I until my weekly specials link to a major online child-product retailer filled me in. So I quickly made an appointment for Fletcher's first trip to see the dentist. I mean, not seeing the dentist in February, during National Dental Health Month, would be un-American, right?

Actually, I have wanted to take Fletcher to the dentist for months now (in general, but also because of a brown spot on one of his incisors), but we failed to add him to our dental insurance last January, and based on articles like this one which indicate that prematurity can lead to a number of dental problems, I was afraid once we went in for an appointment we would leave with thousands of dollars of dental work to do. So, in my warped reality, it is better not to know what bad shape your kids teeth are in until you can pay for the work to be done, rather than get the diagnosis and then have to wait for the insurance coverage.

So, Fletcher's dental insurance coverage kicked in on January 1st, and we made an appointment early this month with a pediatric dentist. After all, I want a dentist familiar with working with kids, and the one we scheduled also has experience with kids with special needs.

The morning did not start off well. Trevor had planned to be home in the morning and was leaving to catch a flight at noon. Unfortunately, due to weather and loads and other pilot-type stuff, he had to catch the 9 am flight, which meant that I was flying solo. Not a huge deal, I am used to Trevor being gone, only I forgot to bring the stroller and it is not fun trying to deal with new-patient paperwork one-handed. Also, because I didn't have the extra pair of hands, their are no cute "first-time-at-the-dentist" photos.

The string of bad luck continued as I sat in the waiting room and the receptionist informed me that I have a dental HMO and can only see my primary dentist. I had been so focused on choosing the right health insurance plan for our family, that I completely ignored the dental options and chose the cheapest. I didn't even know that there were dental HMOs. So, now the dentist I had been waiting nearly a year to see wasn't even covered by our insurance. Ugh. Luckily, a routine appointment was only $40, so I decided to just go through with it and brace for the worst, and if the worst came to be and Fletcher needed thousands of dollars of dental work, we could change plans in June (when the baby is born, which would be an adequate "life event" to warrant a change in coverage).

We are called back and the dentist has me sit on a stool with Fletcher sitting on my lap facing toward me, with his legs on either side of my hips. Then the dentist sat on a stool facing us and I just lowered Fletcher down so his head was in the dentists lap. This worked like a charm and Fletcher tolerated a good five minutes of probing and scratching. This guy really was a pro (if you live in KC and want a good pediatric dentist recommendation, let me know). He took the little hook tool and scratched the little spot on Fletcher's incisor and I was in shock as the stain lifted and his tooth was completely white (I have scrubbed and scratched on that spot countless times with no luck). He explained to me that what I was sure was a cavity or at least missing enamel was actually rough enamel that just holds on to particles and becomes discolored.

Then he told me to increase brushing his teeth from once to two times a day and that he'd see me in six months. What? I was sure that he had missing enamel or worse, and this dentist is just telling me to be extra diligent in brushing... wow! So, that is it. The rough enamel does have a higher propensity to hold food, and therefore decay, but otherwise we had an uneventful appointment. I was shocked. You maybe be thinking, what's the big deal, he went to the dentist and his teeth are okay. But, unless you are a mom to a special needs kids, you do not understand how exciting it is to go to an appointment (albeit dental vs. medical) and have the professional tell you your kid (or in this case, your kid's teeth) is typical. That you don't have another appointment, or procedure, or condition to worry about. Seriously, it is the best feeling!

Saturday, February 14, 2009

Happy Valentine's Day

Mommy's Valentine

Daddy's Valentine