Video: A Day in the Life with CP & a G-Tube: SUMMER DAY

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Video: A Day in the Life with Cerebral Palsy (Feeding Tube/G-Tube Schedule)

Video: A Day in the Life with Cerebral Palsy (Feeding Tube/G-Tube Schedule)

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Video: How to Change a G-tube (AMT MINI Balloon Button)

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Video: How I Make a Real Food Blenderized Diet Mix for G-Tube Bolus Feeding

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Video: How I Bolus REAL FOOD Through a Feeding Tube

Although I’ve largely abandoned updating this blog in recent years, I still check in on it periodically and am amazed that people still visit. Seeking information, readers from all around the world find themselves at our humble little blog.

How do I start the blenderized diet? What are the early signs of cerebral palsy? What is the prognosis for a 28-weeker preemie? What are special needs-friendly toys? What does it mean if my preemie failed both NICU hearing tests? What’s the best pediatric wheelchair? What is g-tube surgery like? 

I’m sure none of us expected to one day be asking these questions. But here we are. I hope that readers are able to find the answers they seek. I keep this blog alive and still update periodically because years ago, I, too, once desperately searched for answers and depended heavily upon the stories of other families to guide me through the uncharted territory of parenting in the special needs world. I have a duty to pay it forward.

In that vein, I’ve created a video. This is for the many readers who come across our blog because they’re seeking information about how to bolus real food through a feeding tube. There are actually a few ways to do this. Here is how I do it.

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Review: Real Food Blends

I am a fan of the blenderized diet for tube-fed kids. HUGE FAN. The gist: it saved Andrew’s life. For the full journey, click here, here, and especially here.

When Andrew was two, we went on a week-long family vacation to Maine for my brother’s wedding. The wedding was held at a mansion on a private island off the coast of Maine;  it was  accessible only by boat and nary a commercial establishment in sight. All food and drink (with the exception of the lobster boats that would occasionally stop by with their bounty) had to be specially requested and boated in. In anticipation of the challenges preparing Andrew’s blends on the island, we shopped for and filled two large ice boxes full of food and liquids for Andrew’s blends, boxes of produce, and also brought along our trusty Vitamix blender. The island had electricity–hallelujah! We would be able to cook, refrigerate, and microwave Andrew’s blends.

And it was fine. We made Andrew a new blend every other day. We did not run out of food for Andrew. The wedding, the island, everything was beautiful.

But. I can’t tell you how many times I thought to myself, “Why is there no healthy, high-calorie, shelf-stable blenderized food option I can bring on trips like this???”

Apparently, I’m not the only person who has thought this. Fellow special needs mom Julie Bambocino had wondered this too. But she took it a step further by creating a company in 2012, Real Food Blends, to produce exactly that: a healthy, high-calorie, shelf-stable, blenderized food option. Her product is amazing.

Real Food Blends comes in three choices: Quinoa/Kale/Hemp, Orange Chicken/Carrots/Parsley, and Salmon/Oats/Squash.

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 Here’s a close look at the Nutrition Facts of each option. Impressive.

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 Here’s the ingredient list for the salmon, oats, and squash: water, kale, grape juice concentrate, hemp powder, extra virgin olive oil, quinoa, cinnamon.

Priced at $4.16 for a 9.4 oz pouch, it may become pricey for daily use. We use it for travel only. However, many insurance providers now appear to cover Real Food Blends as an option in lieu of formula. Remember Andrew used to consume–and then barf up–his Elecare? The Elecare was and still is 55% corn syrup, by the way. Ick!

Always on the lookout for low-volume, high-calorie ways to boost Andrew’s caloric intake, I also purchased Real Food Blends’ Organic Coconut Calorie Booster to mix into Andrew’s food. One scoop equals 28 calories. Although the instructions say to “stir, shake, or blend well until fully dissolved,” I found that blending the coconut powder in a mixer was the only successful method to prevent Andrew’s tube from clogging. Andrew tolerates this product beautifully.

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I am that Real Food Blends is now out there to make the lives of tubie families easier. And best of all, I will no longer have to ask myself: “Why is there no healthy, high-calorie, shelf-stable blenderized food option I can bring on trips like this???”

Disclaimer: I was not paid nor asked to write this review. I am writing this review as a very happy customer and special needs mom who desires to share the news about a quality product.

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Andrew’s Favorite Things Part II (Special Needs-friendly Toys)

Kids love toys and Andrew is no exception. Finding toys that work for him requires a bit more thought than the typical kid, but is well worth the extra effort. Below are a few items that bring Andrew joy each day.

Winfun Step To Play Giant Piano Mat

Winfun Step To Play Giant Piano Mat

The Winfun Step to Play Giant Piano Mat  is exactly what it looks and sounds like. But instead of stepping, Andrew rolls, moves and kicks. I like that it is sensitive to touch, readily rewarding movement with cheery notes and songs. The exact piano mat I purchased looks as if it has been discontinued. Perhaps this one or this one might work as an alternative.

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Andrew enjoys his iPad for many hours of the day. Mostly, he listens to music on it. But he also has a few (free!) apps he likes to play with. These apps are great because with slight touch, sound is produced, encouraging Andrew to move his arms and unclench his fist. The apps: Virtuoso (piano),  Bubbles, ILoveFireworks.

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There are a few things going on in this picture–all good. First up, the maracas  and the Velcro jingle bell anklet/bracelets. Delightfully noisy (are you noticing a theme with Andrew’s toys?), they encourage Andrew to move his arms and kick his legs. The Babiator brand sunglasses  are great because Andrew is extra sensitive to light. We notice when he goes outside, he always has his eyes closed. It isn’t because he’s tired; it’s because the outside is too bright and overstimulating for him! The sunglasses are made of a firm but flexible material and are supposedly unbreakable.

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Andrew is also a fan of the Fisher-Price Go Baby Go! Crawl Along Musical Ball. Again, slight touch is rewarded with sound, which encourages Andrew to move (kick).  Sound in this toy’s case comes in the form of a maniacal monkey laugh accompanied by upbeat nursery music.

That’s it for now! Hopefully, someone out there will find this post helpful.

Here are links to two similar posts I’ve done in the past: Andrew’s Favorite Things Part I and Christmas Gift Highlights.

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Long time, no see!

Hello, dear readers! Over a year and a half has passed since our last update. There are three primary reasons for this:

Reason 1) My work schedule has become more demanding.
Reason 2) I had another baby. Mikey is now almost eleven months old!

From L to R: Jane (age 2), Mikey (11 months), Andrew (age 4), Eleanor (age 4)

From L to R: Jane (age 2), Mikey (11 months), Andrew (age 4), Eleanor (age 4)

Reason 3) I now realize that I blogged as much as I did in Andrew’s earlier years as a means to cope and process. By sharing news with family and friends and connecting with other special needs parents online, blogging allowed me to document and process the overwhelming fears and grief I was experiencing at the time.

I am happy to share, however, that Andrew has been physically very stable since our last update. His overall temperament has chilled out considerably as well. In fact, he is probably the happiest of our four children. Amazing.

The grief and fear is still there but the rawness has dulled. Our days have become quiet, predictable, and pleasant. As a family, it appears we have tentatively arrived at a peaceful acceptance of our unique circumstances. What a relief.

Going forth, I hope to revive our little blog with more frequent updates. There is so much about our journey I’d like to still share with you.

Andrew and Eleanor turn four!

Andrew and Eleanor turn four!

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It takes a village

Andrew and Eleanor turn three!

Andrew and Eleanor turn three!

Ironically, a part-time job of mine in college was working for an agency that provided respite services for families caring for a disabled family member.  I helped care for people ranging from ages sixteen up to their sixties; none of whom would ever live independently. Most were older and ambulatory. Seizures and varying levels of intellectual disability were common. The youngest, at sixteen, was the outlier and most disabled; like Andrew, she would not be alive if not for the medical intervention and technology available today.

Working in the homes of different families allowed me a glimpse of what caring for a disabled family member, particularly for the very, very long-term might look like. As a young and naive college student, I came away from the experience with the following big ideas:

(1) Caring for a child with disabilities will significantly increase the odds of marital discord/divorce, incredible sibling dysfunction, social isolation, and chronic sorrow.

(2) If the child is not going to be institutionalized, families need to obtain help. A lot of help. They can’t do it alone or they will burn out and their family unit will fall apart.

Disclaimer: I know there are many exceptions and lots of marriages and families don’t fall apart. I also realize that obtaining any help, especially quality help, is a choice that many families simply don’t have.

But working at the agency left quite the impression on twenty-two-year-old me. More than teaching me about compassion, it left me fearful. And suffice to say, when I found myself in my very own disabled child situation, it felt like some kind of an awful punishment; my worst parenting nightmare had come true. And I freaked out.

But I’m doing much better now, thank you.

I am doing much better not because I am amazing, inspiring, a super mom, or hero. The crude truth is that if I do appear to resemble any of those things, it is because I am extremely fortunate to not have the entire scope of Andrew’s care fall squarely on my shoulders.

With the dramatic stabilization of Andrew’s health on the blenderized diet a year and a half ago, caring for him has been the the smoothest it’s ever been. But it’s all relative. Because, still, the best analogy I can come up with in terms of what day-to-day care for Andrew is like is that of a colicky newborn–but so much harder. Andrew doesn’t sleep through the night, is fed and burped every two hours when awake, spits up, has temperature regulation issues, cannot stool on his own, doesn’t like to be left alone for more than a few minutes or he cries and passes out, cannot tolerate sitting in a stroller without having it pushed or aggressively jostled, and is basically held/touched/jostled by somebody most of the day even though he is heavy and only getting heavier. Once all these details have been accounted for, Andrew is a happy guy.

And you know what? He’s a happy guy most of the time, thankfully! But it takes an extraordinary amount of work and patience to keep him that way because his baseline state is typically one of physical discomfort.

Going at it alone, with no end in sight, most of us would start to lose it.

I am doing much better because I am not going at it alone. I am fortunate to have–and often, buy–the support system and village to make that possible. This is why I appear reasonably sane and cheerful most days. I get a break from the day-to-day physical grind of constant care, which alleviates some of the emotional baggage accompanying it, which in turn, allows me to focus on the incredible sweetness and gifts of Andrew. I can continue to work but at a part-time capacity. I am also able to give my other two children plentiful one-on-one attention and they get to do the things that other kids get to do. And, equally important, the village allows me to have quality time with my husband.

I realize it isn’t considered good form to talk about the struggles. I know talking about the daily challenges and admitting that it can be hard makes people uncomfortable or might make those who pity us pity us even more. I know first-hand that it is preferable to hear about how amazing and life-changing the experience has been, how it’s made us so much stronger, how I wouldn’t change anything about our lives, how this experience has been such a blessing in disguise, and this and that. There is that, too, of course. But glossing over the struggles strikes me as disingenuous.

Caring for a severely disabled child, particularly over the long, long term can bring weariness. I am as optimistic as they come, seriously. But only three years into the journey, I find myself weary even with the help of my quaint little village. Caring for a child with disabilities has a way of challenging one’s marriage, one’s relationship with their other children, one’s faith, one’s sanity, and every original notion of what one once believed to be so essential for a life fulfilled. With all of this challenging going on, the results can be either really great or really terrible.

Looking back at my two harsh takeaways from my college days as a respite worker, I have much more perspective about what the families must have been struggling with for years and years. During a time when society pushed parents to institutionalize and forget about their disabled child, these parents went against the conventional wisdom of doctors and professionals by choosing to keep their child at home. Consequently, they were sent home with no support, no help, no respite. Most of these families did not have the choice nor privilege of having a village help them until, often, decades later of going at it alone. They also did not have the virtual support and amazing community that the Internet today provides. That’s where I came in, years later, to provide long overdue respite for families, only to freak myself out in the process about the pervasive sadness and dysfunction I felt in each home. But I see now in a way I didn’t see as clearly before that the families I worked with were ultimately acting out of unconditional love for their special needs child. Those parents were doing the best they could under near impossible circumstances and I salute them for it.

Despite my initial freak out about having one of my worst fears come true, things have been okay. In fact, they’ve been more than okay. Often, things are quite awesome. However, it is a challenging journey and not meant to be traveled alone. I am glad to have recognized this early on and to have the good fortune of going on this journey with a loving village at my side.

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Rethinking Therapy and School

This May, a three-year-old Andrew will age out of the Early Intervention (EI) program which has provided all of his therapies to date. The natural next step for most families with a child of significant physical disabilities is to then begin transitioning their child from a home-based therapy program to a special needs school where the child is pulled out of class through the day to receive various services.

At this point in our lives, it is difficult for me to imagine Andrew ever going to school. Based on travel logistics, the demands of Andrew’s feeding schedule, his overall temperament, and a bit of soul-searching as a family, we have made the decision to not send Andrew to school this fall. Instead, Andrew will stay at home and we will arrange for our local public school district to have therapists come to us, much like how it has been with EI. But, even then, we have been re-thinking much about Andrew’s rather intensive therapy life. When we first started with EI, this is what his weekly schedule looked like:

physical therapy 3x
occupational therapy 2x
vision therapy 1x
feeding therapy 2x
speech therapy 2x
special education 2x

In all, that meant that somebody was coming to our home twelve times a week to work with Andrew. On the one hand, it is wonderful we live in a county so generous with services. We also cannot discount how much Andrew enjoys the touch, sounds, and overall attention he receives during sessions with our dedicated team of therapists. But then add to the many therapy sessions: nurse visits, equipment vendor meetings and visits, the near-daily stream of Andrew-related paperwork and phone calls, doctor appointments, and the occasional night or two in the hospital. It is a lot to juggle and it can be hard on Andrew and our home life in general. Our therapists are wonderful and dedicated to their work, but I sometimes question what it is, exactly, that we are all working towards. And at what price?

In some ways, having a child who is as disabled as Andrew brings a certain level of clarity in terms of therapy expectations. Our personal goals for Andrew have shifted from questions such as “How can we get Andrew to walk, talk, and eat by mouth?” to “How can Andrew best experience love and life?”  The old and new goals are not mutually exclusive. But recognizing the futility of the older goals for Andrew, we’ve largely abandoned them and have chosen to, instead, accept and appreciate Andrew as he is. Therapy will always have a place in our lives (it is important that Andrew is continually stretched, bearing weight, and encouraged to move), but it will not be a centerpiece.

Such realizations could not have been made without much reading and contemplation. As Andrew Solomon so eloquently states in his epic tome, Far From the Tree:

You find beauty or hope in the existence, rather than the achievements, of such a child. Most parenthood entails some struggle to change, educate, and improve one’s children; people with multiple severe disabilities may not become anything else, and there is a compelling purity in parental engagement not with what might or should or will be, but with, simply, what is.

Author and speaker Jennifer Johanneson, on her son, Owen, as he once lay comatose in the hospital:

I lay beside him in his bed, in the dark, and contemplated some very uncomfortable thoughts. “What if he dies? How will I remember his childhood?” Then, “What if he lives? How will he remember his childhood..?” This second thought was more harrowing for me than the first.

With this realization, Jennifer withdraws Owen from school, puts together a youthful and eclectic caregiving team, and focuses on providing a more meaningful daily life for her son. She continues:

I made the change just in time; Owen passed away two years later, at the age of twelve. I am grateful to have few regrets. He had a good life, which included two wonderful years in which we didn’t try to achieve anything, and more importantly, I didn’t try to prove anything.

Life after EI for Andrew will consist of a dramatic reduction of official therapies, and involve more swimming, napping, cuddling, walks around the neighborhood, and tagging along with his sisters on afternoon trips where he can fully experience the sensuousness of the world. In short: we envision meaningful, sensory-rich days at a pace our family can handle and will hopefully all look back fondly on. There’s a good chance we will never enroll Andrew in school. But it won’t stop him from continuing to learn about the world in his own way, and for Andrew to teach the world a thing or two as well.

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