I have been so swamped at night lately, and updating from KKI doesn't work. There is an update by e-mail feature I'm really going to have to try. But I digress...
So, Sarah DID try cake at her uncle's birthday party. She spit out the first bite, but swallowed the second and third. I prompted her to mash, and she got them down just fine. She said she was done after those bites, and I wasn't going to push it. I was super proud of her, though, and her therapists are all very happy to hear that she ate cake. Hopefully since we have two more birthdays (on the same day!) this weekend, she'll eat some cake there too.
Monday, we headed to the clinic, happy to report that the weekend feedings went very well. I think she refused one bite all weekend, and it was more her spacing out to the Elmo DVD than really refusing. We had a few issues of her not clearing the spoon, but nothing too bad. Overall, I'm pleased and so are they. Her breakfast was normal, and she said happy birthday to one of her foods. She's too funny sometimes.
At lunch, they started working on having Sarah chew her bites. They went with a preferred food to make it easier for her - the beloved Elmo pasta (for those who don't spend a ton of time with Sarah, it's Earth's Best Tomato Soup with Elmo shaped pasta). She had to chew just a small number of bites and swallow them within a decent time window. She did great with this. She loves Elmo pasta and doesn't have sensory issues with it, so it was no problem to chew it. She normally swallows this whole, so I was a little nervous she'd do it again, but she listened to her therapist and did it right. Go Sarah! After that, I was brought in to do her usual lunch stuff on her protocol, and that went fine.
Dinner was the same plan, except she had to chew cooked carrot slices. That went okay, I guess. She didn't get all five bites down within the time cap, but it seemed largely due to struggle on her part and just not knowing yet how to move food around in her mouth correctly to chew it. She spit out bites a lot, but some of it seemed kind of involuntary. She managed to get two bites down, I think, and then it was my turn to feed dinner as usual. That went fine.
Tuesday was more interesting. We got stuck in traffic on our way to the clinic due to road construction, and Sarah whined most of the way there that I wasn't going fast enough. I gave up explaining to her that I can't run over other cars after about the fifth iteration of that speech. Then she was annoyed that D (her main feeder) wasn't there for breakfast. She was around, just not feeding Sarah breakfast. She saw the carrot slices, and was already crying before the meal started. She asked for me because she obviously wasn't interested in this whole chewing idea. I get it, but I brought her there to learn this. It was tough to watch that and hear her crying, but I have dealt with a lot of that from her before. Besides, I knew part of it was her general agitation that morning, and there isn't a darn thing I can do about that. I think two bites went down again. Maybe three, but I'm pretty sure it was only two. She did fine at breakfast, and was introduced to cream of wheat. She made some interesting faces, but got it all down basically without incident.
She had speech and OT that day too. She did great at speech with a substitute therapist since her regular speech therapist was off. She was really compliant. I don't know if it was because it was somebody new or not, but I'll take it for whatever reason! I think out of all the bites she tried to get her to swallow, only one got spit out. The poor kid had a huge meltdown when I went to take her to school. The teacher was out sick and nobody told me that. There was a sign on the door, but I'd already explained to Sarah that it was time for school, and she didn't understand that it was cancelled. That was ugly, but I got her calmed down and distracted until it was time to go to the playroom. OT went well too. She has been dipping green beans in ranch dressing and eating them pretty well, so I'm impressed with that.
They changed foods for chewing at lunch to pancakes. They also changed things so the therapist places the food more appropriately to help Sarah learn how to chew the food correctly. That went a little better, but she still only got two bites down. That's assuming I remember correctly. At dinner, they did the same thing and I think she managed four bites.
Today was another busy day for Sarah. So much therapy. She had breakfast, and at least she didn't cry this time about being expected to chew. It still didn't go well, though. I think she got one or two bites down. I fed her breakfast again and dealt with my first gagging spell. I think a dry part of the cream of wheat went down funny. I ignored it like I'm supposed to and finished the bite when she was done gagging. The therapist was pleased with how well I handled it. I already warned her I'm not likely to handle any vomiting episodes nearly as well.
At lunch, the chewing session essentially looked like a standoff. She got one bite down and sat there stubbornly for the rest of the time. So frustrating! She did fine with me, though. It was kind of funny, though, she was tickling D's arm during the standoff. D said it was hard to keep a straight face during that. I don't know how she does it, but I'm so glad she does.
OT and speech went well today, although speech was a lot tougher. We may have figured a way to help get her to swallow her bites, though.
She did well at school today, too, according to the teacher. She also told me her next days off in case Sarah gets scheduled for school when she's not there.
At dinner, they changed their protocol for the chewing session, and it seems to have worked. She got all her bites down, and only really refused the first. She spit the second one once (I think, but may be remembering wrong at this point), and accepted the rest. They are really helping her place the food correctly throughout the session so she can learn to chew it correctly, and I'm hoping that is why she did better. Her therapists and I have felt a lot like her problems right now are just lack of understanding of what to do with food that requires chewing. Hopefully if she learns what to do, it won't be so scary and difficult and she'll get the hang of it sooner rather than later. She was within forty seconds of the time cap when she got the last bite down, but that suits me just fine.
We headed home briefly and then to dance class. Sean had a better week, so that's good. Sarah was fine, and that's even considering the person who usually helps her was out sick. Good for Sarah!
So far my attempts at getting to the gym have not gotten past the "I should go, oh never mind that's too difficult." I'm to the point where I've realized the free bus is WAY too much trouble. If I can get a day where Sarah doesn't have a ton of therapy, I can probably go there in my car and just park. I just hope the garage at the downtown location isn't terribly full. There's another city location that is just a bit further away. Maybe I'll hit that instead. It might be worth the extra drive to not deal with the stress.
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