I Love You

rezanewestIf you know Reza in person or have followed my blog at all, you’ll know he loves to climb and can scale just about anything.  He enjoys climbing in our garage and we usually let him roam in there with the interconnecting door open so we can check on him every few minutes.

Yesterday while he was playing in there we suddenly heard panicked cries.  My husband ran in to see what was wrong, but, at first, couldn’t see Reza anywhere.  He followed the sound of the cries to the window, where Reza was hanging by his fingertips from the lower ledge on the outside of the garage!  Apparently the window had been open, and he pushed the screen out and tried to climb down but got scared and stuck.  When we got close enough to help, we realized Reza was crying “I love you, I love you, I love you!”

We reflected afterwards that Reza probably associates those words with being hugged, being held, and feeling safe.  We say it to him over and over in that context of physically enveloping him in our arms and our safety and security.  So when he was hanging there, terrified and needing to be hugged, held, and safe, he cried out “I love you!” as his plea.

I cried a little.  I wonder if he’s internalized the meaning of “I love you” at once especially literally in that Autistic way, and yet also somehow more truly than our other children ever did at that age.

I freaking love this kid so much.

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Falls

I use a wheelchair part-time right now.  Which basically means if we are going to be somewhere where I have to stay on my feet for more than 10 minutes I use the wheelchair.  I sometimes feel embarrassed knowing people have seen me walk, but have also seen me in my wheelchair.  I wonder if they think I’m a fraud or something.  Part of the reason I use the wheelchair is because I don’t have the stamina or muscle strength to walk for very long.  But another big part of the reason is falls.

For a lot of people with ALS (hereafter I’ll use the acronym PALS), falls are the first symptom of this disease.  The majority of PALS are limb-onset, and of those, it is more common to start in the legs/feet.  I am bulbar onset, meaning it started in my speech/swallow region.  When I was first diagnosed my legs were totally fine to walk and run.  As the disease has progressed it has slowly been making it’s way down to my legs.  Over the past few months I’ve started having falls.  The problem with falls for PALS is that we have weakness in many parts of our body and that often means that we are unable to maneuver ourselves mid-fall.  It’s more of a rag-doll fall, zero control.  This is so hard to describe to someone who hasn’t experienced it.  Suffice to say, you have no idea how skilled you are at falling until that skill is removed.

I had a fall the other afternoon.  My head smacked against something and opened a small wound that bled like crazy and scared my husband!  Luckily, despite all the blood, it did not need stitches so I am recovering in the comfort of my own home.  Falling is dangerous for PALS, and it’s a big reason to start using the wheelchair, or another mobility aide if one is deemed more appropriate.  Not only are falls dangerous in terms of potential for acute injury, but, for reasons not entirely clear, falls seem to speed up disease progression in PALS.  And that is the absolute worst thing for us.

So the next time you see someone in and out of a wheelchair keep in mind there are many people with all different disabilities who legitimately need a wheelchair but can also sometimes walk.

But in this moment..

A few weeks ago I wrote a post that I titled Everything is Not Okay.  I wrote about my deep fears and anxieties about what is happening to me, and about death.  I wrote about my kids and how this affects them.  I wrote about the day-to-day struggles.  I wrote about choking and laryngospasm episodes where I feel like I’m suffocating to death.  Those moments of thinking “I’m really going to die right here at the dinner table in front of my children,” and the trauma that leaves on my psyche afterward.  I got a lot off my chest, which was good, but I couldn’t bring myself to publish the post.  It sits in my draft pile and it will maybe get deleted, or maybe just sit there unpublished like a private diary entry.

So no, everything is not ok.  Even though when asked I always say “we’re ok,” “we’re fine.”  In general I’m objectively not okay.  I have a degenerative terminal disease.  So no, everything is not okay.  BUT.  But..  But in this moment, I am okay.  Okay enough to be here writing to all of you.  Okay enough to share some things, and keep others to myself.  Okay enough to smile at the birds outside my window.

My experience with the unpublished post made me realize I need to share more.  Not everything- I want to keep my darkest most vulnerable stuff to myself.  But I think if I explained some of the things I experience on a regular basis it would both inform others and help me feel less isolated.  So stay tuned.  I’m going to dedicate the next several posts to these topics.

Dear autism parent…

Okay.  I’m going to vent here a little.  And I’m sorry/not sorry if I am, in this post, seated on my proverbial high horse.  A Facebook discussion really got this topic back on my mind.  It drives me nuts when people share videos/blogs about how hard it is to be the parent of an Autistic child.

So much ‘autism parent grief’ is preventable if said parents could just let go of what they thought parenting would be like, and create something new that fits their child and their family.  This phenomenon is not restricted to parents of Autistic kids.  I’m sure every parent recalls those moments with their NT child where they envisioned this wonderful parent-child experience, but instead the child hated it and it was a disaster.  I think the meme below, created by and for parents of NTs, illustrates it beautifully.

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The difference is, it happens a lot more often and more dramatically to parents of Autistic kids.  And while I understand parents’ disappointment of lost expectations, there is a point at which you’ve gotta put on your big girl panties, accept your child, and stop setting yourself up for more disappointment.  …and setting your child up for more misery (!!!).

I can’t count how many times I’ve read an autism parent blog lamenting the tragedy of another birthday during which their child covered his/her ears and screamed at the Happy Birthday song, then proceeded to have a meltdown at the sensory overload and social overwhelm of the whole event.  In these parents’ narrative it is not the child who is the victim of the story, it’s mom and dad.  Poor mom and dad, who can’t even experience a proper birthday with their child.  These parents will go on to repeat the whole fiasco next year.  And they will grieve it.  Again.  And their child will suffer.  Again.  Folks, this is completely preventable.  It’s not your day, it’s your child’s day!  Stop singing Happy Birthday if your child hates it.  Stop inviting all these people over.  Figure out what works for your child to make it a special day and do that.

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My son does not recognize gifts. But he LOVES Target, so for one of his birthdays, we pasted Target logos all over his gifts to make them attractive to him. This is one tiny way we were able to adjust to make his day special.

I see it with other stuff too.  Trips to places the child is “supposed to” enjoy but doesn’t.  Child doesn’t want to sit on Santa’s lap.  He or she is screaming, self-injuring, melting down.  Mom is moaning to the internet about how hard it is, how terribly sad, how all the nice little neurotypicals waited happily in line, smiled big for Santa.  But your child didn’t.  Guess what mom?  Stop taking your child places he/she cannot tolerate and this won’t happen.  It’s that simple.  There was a family in an autism documentary I watched where the little boy’s favorite thing was to ride the city buses.  Every day after work his Dad took him to ride his favorite bus lines for a few hours.  That is what he loved, and so that is what they did together to connect and bond.  In the end, shouldn’t it be about our kids?  Stop making it all about you.  Yes, it’s hard sometimes.  You know what, parenting is hard.  Take care of yourself, seek out supports, but when it’s you and your child, structure your family in a way that accounts for your child’s individual needs, challenges, interests, and joys.

When I talk to parents of a newly diagnosed child, one of the first things I always try to impress upon them is this: adjust your expectations.  When you do, it has the power to change your entire outlook from a grief-centered perspective to a contented “this is our awesome family” perspective.  I suppose that is the basic message of the famous “Welcome to Holland” poem which is oft shared with parents of newly diagnosed kiddos.  And it really makes all the difference.  Don’t set yourself up for more grief, more disappointment.  Don’t make your child suffer for your own rigidity (hah- do you see the irony?).  Find a way to be flexible, to grow your parenting into something that fits with your kiddo.  Welcome to Holland.  It’s not Italy, but it can absolutely be great, if you would only give it a chance.

Identity and Learning How to Be [Sick?]

Our identities are not fixed entities.  They are living, changing, faceted.  I visualize my identity as a word cloud (if you’re not sure what that is see some examples here).  More prominent aspects of my identity would be in large bold print, with smaller facets in smaller print.  What’s more or less prominent changes throughout my life.  Some facets of my identity are lost or discarded altogether, while new ones come into play.

I remember when “mother” became the most prominent aspect of my identity.  And alongside “mother” would have been slightly smaller but still prominent labels such as “breastfeeding” and “attachment parenting.”  Then one day “autism” became one of the biggest words on my imaginary identity cloud.  For the first two years after R was diagnosed, autism ruled so much of my thoughts and daily life.  Our schedule revolved around therapies and doctors and specialists.  Our son barely slept which meant we barely slept.  A lot of things in our household changed to accommodate his needs.  But gradually we got into a good rhythm.  We learned how to make our house child-proofed and autism-friendly.  Our son got the right blend of meds to sleep a six hour block.  He started school and had a great routine.  Suddenly, I had 3 kids in school all day.  Stay-at-home-mom no longer seemed like a prominent component of my identity.  While autism will always be a big part of our lives, it no longer seemed like this huge deal.  It was just our family’s normal, just life, and so it faded smaller in my identity cloud.

Around this time I remember feeling like I wasn’t sure who I was supposed to be anymore.  I’d had given so much to motherhood, but now my kids were growing, needing less from me in some ways.  It wasn’t a huge identity crisis, just this realization that I now had 6 hours per day to myself with no mouths to feed, diapers to change, or shoes to tie.  I decided to go back to school.  I realized with mounting excitement that I could actually build a career, one that I enjoy and find fulfilling.  I saw myself in the future doing part time work in a field I was passionate about.

So I went back to school full time to study social work with an emphasis on disability.  Suddenly, “student” was back on my identity cloud.  It wasn’t easy fitting school into my life as the parent who acted as primary caregiver while my husband worked and had a lengthy daily commute.  We ordered a lot of takeout, and the housework, normally more my responsibility, took a bit of a dive.  But I loved it, and I finished all my classes the first semester with a 4.0.  I was in the middle of my 2nd semester, with an acceptance letter and scholarship offer for the social work program I had wanted, when my ALS symptoms became troubling enough to start sending me from doctor to doctor.  A few weeks later I was diagnosed with ALS.  It changed everything.

When someone tells you that you may only have a few years left to live you have to decide how you want to spend the time you have left.  As much as I was enjoying school I realized this was no longer the path for me.  For one, things like typing had grown much more difficult due to my weak hands.  Then there were other logistics to consider- I would be driving 30-40 minutes to campus, but how much longer would I be able to drive independently?  As an aside, at this present time I no longer drive unless it’s an emergency and a very short distance.  I also thought about how working wouldn’t be possible.  And even if it was- even if school and work were all possible with the right supports- was that how I wanted to spend the time I have?  I decided I would rather focus on spending time with my family and doing things I enjoy while I can still do them.  So I withdrew from school and we booked a trip to Yellowstone.

It’s been almost a year since I was diagnosed.  My ALS progression has been quite slow so far, compared to a lot of PALS (people with ALS).  But I’ve still lost a lot compared to the old me.  I cannot write legibly, zip up my jacket, button my jeans.  I can’t clip my nails, pluck my eyebrows, or shave my legs.  I have trouble brushing my teeth without stabbing myself with the toothbrush because my fine motor control sucks.  As previously noted I don’t drive anymore.  My speech is altered, my gait is altered.  I have a feeding tube, and while I can still eat by mouth I have given up some foods and must be vigilant to avoid choking.  I drool at times while eating, and food gets stuck in the sides of my mouth because my tongue is too weak to push it back to where I could chew/swallow it.  I was never a tidy eater, but I in the past I considered my slightly messy, overly-exuberant eating style to be endearing, cute even (that’s what I told myself anyway).  But there is no longer anything endearing about how I eat.  It’s just embarrassing now.

In the wake of these changes I find myself sinking into a depression that centers around a feeling of identity crisis.  I’m not a student anymore.  And while I’m obviously still a mother and spouse, so much of what I considered to make up those parts of my identity have been stripped away.  I can no longer drive my children to activities, appointments, or simply to the park.  There is not a lot of housework or food preparation I can do.  And most painful of all, I can no longer even be home alone with my Autistic child because that would jeopardize his safety.  I am not strong enough to pick him up or lead him by the hand.  If he climbs somewhere unsafe I couldn’t get him down.  If he managed to bolt out the door I couldn’t catch him to bring him safely home.  I’m not strong enough to change his diapers because at 5 years old, his legs and bottom are too heavy for me to lift during a diaper change.  Nor am I strong enough to hold him in place when he resists being changed.  He needs an able-bodied adult with him at all times and that’s not me anymore.

My husband works from home as much as he can, and when he can’t, he still makes it home early enough to be there when R gets home at 4pm.  He waits to leave for work until R’s bus has picked him up (at 8:55am), even though this will result in a worse commute for him and less time at work to do work.  He makes all our meals, does most of the housework, does all the shopping.  He takes the kids to their appointments and activities.  Everything that I once did, now he does.  Sometimes I can see and hear how stressed he is.  Afternoons when R is struggling behaviorally, and the older two are bickering, and there’s dinner to be prepared and messes to be dealt with.  And I feel so guilty.  I feel so lazy and useless.  I sometimes try to help and end up making it worse.  For example trying to load the dishwasher but dropping the first glass I pick up because it’s too heavy.  It shatters all over the floor and now my husband has to sweep up glass on top of everything else.

I realized the other day that I don’t know who to be or how to be anymore.  How to be a sick person?  Or just how to be this version of me.  The disabled me.  Maybe it’s about that qualifier, disabled.  I used to be a mother, but now I’m a disabled mother.  And that’s something new I have to learn how to be.  A disabled mother, a disabled spouse, a disabled bibliophile, a disabled hiker and nature enthusiast.  I haven’t figured it out yet.  How to glue the pieces of my identity back together, or reshape them into something I can be inside this failing body.

I don’t even know what kind of sick person to be.  A brave one? (I’m terrified.)  A defiant one?  A fighter?  An angry sick person, or a sweet, gracious, compliant sick person?  None of them feel authentic.  I see other PALS blog pictures of themselves skiing mount such and such with adaptive equipment captioning something like “ALS can’t stop me!”  And here I am feeling like I’ve already let ALS stop me from…everything.  I’m too tired to be inspiring.  I’m not brave.  I just do what I am forced to do because of my situation and that is not the same thing as being brave.

I wish I had a deeply wise ending for this post that would pull it all together with some kind of personal epiphany.  I don’t.  It ends here.  Because I haven’t figured any of this out yet.  But I’m trying.

Love

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All three kiddos

Sometimes I try to look inward and analyze my feelings for R.  My love for him is so intense it is almost painful at times- the kind of pain that is an echo of the fear of losing him, knowing it would rend me completely. This intensity of feeling is ever present when I think about R, but it’s not that way when I think of my other two children.  This has bothered me every time I get to that point in the inward analysis.  I try to dissect it, to understand it.  I think about my feelings for each of my children very carefully, and, I hope, objectively.  I always come to the conclusion that I love them each the same amount, I just love them each differently. but never less.  So why the difference in that sense of intensity when I think of R compared to my other two children?

When I sit down and really think of that overwhelming, intense feeling my love has for R, I realize I have felt it about my other children, during discrete periods of high stress when they were in some type of danger or distress.  I felt it for weeks when Mohammad was a newborn.  He had pyloric stenosis and was so sick, literally starving and shrinking before my eyes for his first weeks of life.  He was initially misdiagnosed and by the time they finally hospitalized him and figured out what was wrong he was so sick and dehydrated that they delayed surgery for 3 days to stabilize him because he wouldn’t have survived the stress of surgery otherwise.

For those tumultuous first two months of my older son’s life, my feelings of love had that same painful, overwhelming intensity that I associate with R.  In fact, when my second child, my daughter, was born 18 months after her older brother, I had a hard time bonding with her.  When I got pregnant with R a few years later I opened up to my midwife about the trouble I had bonding with my daughter when she was first born.  I remember telling her that I didn’t understand it- everything was so easy with my daughter compared to what happened with her older brother.  She was perfectly healthy, never even lost an ounce of her birth weight.  Everything went perfectly.  So why had it taken 6 weeks for me to bond with her?  Why had I felt so confused and apathetic?  My midwife suggested that that was just it.  My only association with a new baby was one of extremely high stress and intense emotion.  My normal meter for what it was like to have a newborn was very off, and it probably impacted me when I had my daughter.

I think the midwife was right.  And while it took a few weeks, one day, just overnight, something clicked and that solid mama bond formed with my daughter.

I’ve had those intense love feelings with my daughter too- times when she was in the ER after a bad fall or after having been very sick with one thing or another.  The same goes for my oldest son over the years.  But that intense-emotion thing is not my day-to-day feeling for them.   But it is for me with R.  And I am realizing that for years we’ve existed in that high-stakes, high stress, intense, overwhelming please-don’t let-him-be-hurt-please-don’t-take-him-from-us place with R.  He is vulnerable in so many ways that my other children aren’t.  I am constantly, yet often subconsciously, on alert for him.  He’s four and a half and I still wake in the middle of the night in that irrational half-asleep panic where I have to check his breathing to make sure he didn’t somehow stop breathing in his sleep.  This is something I did with all my kids when they were newborn babies.  One of those weird irrational new mom panic things.  But with R it never went away.  And it still hasn’t.

And I think it all just reflects where we are at with R.  That primal “mama bear” protective emotion is always going full throttle.  My feelings are so intense for him, so much I’m bursting at times and it hurts.  But I don’t love him more than my other children.  It’s just that place, that parent “mode” we go to to protect our young when we feel that they are threatened.  Only with most kids that mode is temporary, like using the 4 wheel drive to get out of the mud or drive through snow.  It’s not a mode you use all the time for most parents or with most kids.  But with R we are always there.

That’s how I see it anyway.  I wonder if it will lessen as he gets older and I don’t know.  I do know that I don’t see it as a bad thing.  It’s intense, but it also makes the good moments of each day (of which there are many!) shine so much brighter.  I hope as my other children grow up they see it for what it is and know without doubts that we love them just as much as their brother.  I think they do understand it right now, and I often see the same fierce, protective love in their own interactions with their brother.  Isn’t it funny how small children can understand effortlessly things that become a lot harder to understand when you’re older?  I hope this is an understanding they are able to hold on to.  I love them so much.  I am so proud of them.  Every single day.  Even when I’m grumpy and snappy.  Maybe especially then.  I don’t know if I would have been as gracious and sweet and thoughtful if I were in their shoes.  They amaze me, and maybe one day they will read this, in fact I hope they do.  I love you guys!

Functional Speech

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You might think hearing your nonverbal four year old use a word to request something he wants or needs would be wonderful, exciting, fantastic, or any other number of positive adjectives.  But for me it is almost always heartbreaking and agonizing.  This is because R generally only manages to push the word out for what he needs when he has reached a level of utter agony and desperation. You can see on his face in those moments that he has employed every possible tortured, screaming brain cell in the task of forcing out a single word in a last-ditch effort to make us understand.  Most of the time this happens with the word “cookie,” which may not seem like a desperate situation, but it is.

Reza has a very important night waking ritual, and that is that when he wakes in the middle of the night he eats chocolate chip cookies and drinks some water, and then he goes back to sleep.  He repeats this in the morning when he wakes for the day.  He does this every day, and in the absence of this ritual he essentially has what amounts to a panic attack.  It is extremely mentally painful for him.  We always know what he needs (his cookies), but occasionally we have run out without realizing and it’s 3am and there are no cookies anywhere and he is screaming in pain and terror because the cookies need to be there and they’re not.  He tries every way he knows to tell us what he needs.  He leads me by the hand to the cabinet over and over.  He leads his Dad to the cabinet.  He screams and sobs and violently throws anything we try to offer in place of the missing cookies.  And sometimes, sometimes, in that moment of extreme distress he manages to push the word “cookie” desperately out of his mouth, spending the last of his strength to do so, hoping this might finally cause us to understand his need and to provide it for him.  It tears my heart to pieces because there is nothing I can do and I know his having produced that word at all is a measure of his agony.

Once, something like this happened during the afternoon while his after school therapist and a new BCBA were present.  Later that week we had his annual IEP meeting and the new home BCBA came with.  While we were discussing R’s communication needs she piped up and recounted how she heard him say “cookie” when he was extremely distressed and desperate.  She suggested to the team that we withhold highly preferred items until he gets desperate enough to say the word to request.  My mouth was open to object but R’s special education teacher beat me to it.  “No,” she said, “we’ve learned from working with R that while he can sometimes say a word, he often later loses the word(s) and genuinely cannot produce the word anymore.”  She went on to reiterate the focus on PECS and other nonverbal communication strategies for R.  Have I mentioned how much I love this teacher?  No kid should be tortured into producing speech, let alone when they often legitimately cannot produce that speech no matter how desperate they are.

But of course there ARE times when R occasionally says a word and it fills me with awe, excitement, and pride.  These are times when he echoes a word out of the blue with no apparent intent- usually a word from hid iPad program such as “giraffe” or “strawberry.”  He will say the word to himself over and over in a happy, sing-song cadence with a sweet little grin on his face and it fills up my heart.  When I sing his word back to him his whole face lights up with pleasure and I feel there is nothing more right than this moment.

The take home message from this post?  So-called “functional” speech is clearly not all it’s cracked up to be. 😉