I have been putting off this update partly because I knew it would be long, but also because I would actually have to sit down and put everything going on with him into words. And that is what I am not doing so well with.
So, I will just jump right in.
Josh was seen at Primary's two weeks ago for a Feeding Clinic appt. All in all it was a good appointment. He is exactly where they want him for height and weight. We did some med adjustments to include his weight gain since last appt (in July... sad!). But Josh has been having some major tummy issues again. Very constipated is putting it lightly. I started running water through his G-tube during the night, and it seemed to take the edge off the problem, but didn't solve it. After talking to Dr. O'Gorman about what is going on, we came a to a couple conclusions. He is not getting enough water for his weight. I didn't even think about that. I have just been doing the same amount as always. Also... he has a major motility problem. And she suspected that if we ran a small amount of water through his g-tube almost 24/7, it might just push things along for him. So.... we started that. I hate having to have him hooked up to his pump so much again, but guess what? It worked! I am doing a smaller amount per hour than before because his doctor thought we were putting too much for his body to absorb it where it needed to. And for whatever reason....Josh's GI system just does not function properly and will need a constant push. So.... as far as future goes for him, it looks like the tube is here to stay for awhile. I get alot of questions on when does he get to have it removed. Well.... there is your answer. Not anytime in the near future. So once we got that problem under control he is doing well from a GI stand point.
But of course it wouldn't be life with Josh if that was all we were dealing with. Ha ha. Jokes on me. About 2 months ago I noticed he seemed 'off' for a couple days. Slowly since then he has had more and more bad days. His balance is bad, he is falling and getting hurt so much. He has fallen off our barstools probably 3 times a week now. He hadn't fallen off in months. He has bad bruises on his legs and arms from falling, and even some on his chest and back. He endurance isn't what it used to be. He gets tired doing things he did fine before. He seems to run stiff legged alot. He seems uncomfortable alot. He complains of his legs and arms hurting. I don't know if it is a tone issue or what. He is genuinely not himself. Even his preschool teacher has noticed and was concerned. I called his Neurologist to get an appt and of course they are booked out until September now. I can't wait that long. So I am going to take him into the pediatrician and see if he has any better suggestions or can get the ball rolling with neurology faster. We'll see. It has just been heartbreaking to see him struggle so much. He did good for so long that I kind of 'forgot' about how things can go with him.
And then to top all of this off we had his IEP meeting on monday. I have a love/hate relationship with IEP meetings. They are great because it is the only time you have the whole team of people that work with your child together in one place. But... I always leave these a little sad because it is a stark reminder of how far he has to go.
This time the big focus was on speech. Meaning it was the one thing we talked about in depth and there was an additional speech pathologist there from the district that gave good input too. Basically I learned that his diagnosis of Speech Apraxia is the hardest speech disorder to overcome. Awesome. I leaned the tiny little progression steps of speech and realized that he has a really long way to go. He has to learn the basics... like the most common sounds... pah, bah, mah, kah, lah to even begin to learn words. That is what they are working on. He is doing the PECS (Picture Exchange Communication System) very well. He is signing very well as has has been for over a year. The goal is to get him ready for a communication device by mid year next year and be very proficient at it by the start of Kindergarten.
So Basically I was told it is likely going to be years until he can speak intelligibly for people to understand. They don't know yet if he has developmental Apraxia... meaning as the years go by and he learns to speak he will retain everything... or if he has regular Apraxia. That means he will lose words and gain words his whole life and having a normal conversation will always be a problem. He has already lost some words that he could say before. So they don't know. This next year will be crucial in that regard. We might get a better long term prognosis next school year.
So... that is what is going on with Josh. He just need some extra love and support right now. Things are difficult for him right now, but he is a trooper and pushing on through.
I will update as I get more information.
4 days ago