Solutions

Nolan has recently started listening to videos and cartoons. He used to watch television without paying attention to the sound. I know this because he used to sit on the couch, happily watching the visual feast on the screen- the volume set at a point where he couldn't hear it at all, but where Matt could hear it just fine.

Recently, Nolan has taken to standing right in front of the screen, which infuriates his brother. This is a great sign, because it means Nolan now wants to hear what is going on. He wants to hear the dialog, the music... he wants to get the story behind the pictures. Unfortunately, Matt can hear the TV just fine from the couch and Nolan's head makes a better door than a window.

To head off the TV Wars, I brought Nolan's rocking chair downstairs and set it in front of the TV. Now he can hear Cars and his brother can see it. As Nolan gets older, we may have to think about getting some sort of a loop system for the television. For now, though, the front row seat works just fine.

First Day of School

Nolan had his first day of preschool today. The first day that I would give him a hug and say, "I'll be back soon!" and leave the classroom. I was worried about separation anxiety. I was worried about communication issues. I was worried about other children potentially pulling on his hearing aids.

For all my worries, the day went so smoothly, there isn't really anything to write about. The other kids weren't interested in his aids at all. Separation went like this:

Me: I'll see you later, Nolan!
Nolan: See later, Mom!

No tears, no angst, not even a pouty little lip. Just a happy little boy who was baking a pretend cake with his teacher.

His hearing in noise is questionable at best, but the teachers are so caring and do everything they can to minimize background noise. Nolan's articulation differences are apparent sometimes, as he tends to have some distorted vowels and strange consonants- the other kids shouted out "COW!" during story time and Nolan shouted out "Dah!" (his word for cow). For the most part, however, he fit right into the class.

When I picked him up, he was eating goldfish crackers and a pretzel. Mouth full of gummy food, he offered me one, "Here go, Mom."

Today was an absolute success. I am thrilled that he is not the youngest in the class, and that the staff (I think there were about 5 staff members in the room) was so caring and helpful with my little boy. I absolutely love this program and I can see Nolan growing in many ways through this next year!

Falling Into New Vocabulary

Autumn is my favorite time of year. With Nolan picking up new phrases left and right (newest: "can't catch me!" to his brother) we are really enjoying the new language opportunities the seasonal change is bringing. New words for this week include:

Crunch
Colorful
Pumpkin
Squash
Cinnamon
Crisp
Turkey (we get them in our backyard this time of year)
Scarecrow
Chilly
Acorn
Rake
Pile

We are going to collect leaves to send to Grandma's preschool class in California (which sadly, lacks the colorful leaf change we see in our region). We are taking walks and admiring the goldenrod and asters in bloom. We are watching spiders spin their webs and butterflies sunning themselves at noon. We're also baking apple pies and pumpkin bread, which isn't so good for my waistline!

Nolanisms

Our future soccer star

Like all two year olds, Nolan has several words that don't sound exactly "right." These toddler words are so darned cute, and I'm going to miss them when they're gone! My favorite Nolanisms:

• Bape (grapes)
  
• Bider (diaper)
  
• Boppy (coffee)
  
• Bet-bet (blanket)
• Tut (truck)
• Mittey Mout (Mickey Mouse)

I know that "Want bape, Mom!" and "Want bet-bet and rock, Mom" are not long for this world, with all the speech therapy he gets and the rate his language is exploding. We are also making headway in other language skills.

Nolan hasn't used the concept or word of "yes" yet. He hasn't even nodded to indicate he would like something. After some games with our speech therapist, he is now (with prompts) using the word yes. It goes something like this:

"Nolan, do you want more bubbles?"

Nolan: "Want more bubbles."

Speech therapist: Nods head vigorously.

Nolan: Also nods head vigorously.

Speech therapist (still nodding), "Yes, I want more bubbles!"

Nolan: "Want more bubbles- yes!"

The good news is that the nodding prompt is now working to elicit the "yes" response (though he doesn't use it spontaneously). The bad news is that we are all going to need dramamine from the motion sickness induced by all that nodding!


Since I'm in brag mode, other new Nolan phrases are:

"Be right back, Mom!"
"Come on!"
"Want watch moodie (movie)."
"Don't kiss my head!"

There seems to be another language explosion around the age of two, and it is a big one. We have heard a six word sentence recently (though the more typical length is 3-4 words). If he continues at this rate, he may be orating speeches by the end of this year!

Gearing Up for Preschool

I can't believe summer is over, my tiny newborn is two years old, and preschool starts this coming week. Many families agonize over the type of preschool their deaf or hard of hearing child will attend. We don't have that worry, because we don't have many options. In our area, there are no oral deaf schools, no cued speech schools, and no bilingual ASL/English schools. There are three mainstream preschools in our area, and only one has a program for two year olds.

So for two hours on Thursdays, Nolan will be attending First Covenant's "Two By Two" program. I did this program with Matthew, and it is a wonderful program specifically geared to two year olds. As a side benefit, the parents get to go upstairs and have a snack and coffee during the program time (adult conversation is a very big thing in my world).


While I have done this program with Matt, this time it is different. For one thing, Nolan is my baby. My sweet, cuddly, still-missing-eight-of-his-baby-teeth baby. He's also small. Those jeans falling off his waist in the photo above? Size 12 months. The ten month old at today's softball game was the same size as my two year old, so his size makes me a little more protective. Maybe it shouldn't, but it does- he gets knocked over easily and isn't as "sturdy" as a lot of the other two year olds in his class will be.

And then I worry about how well he will hear in his classroom, with 11 other children, tile floors, and poor acoustics. No TOD, no FM System, and no one trained in educating or working with a child who may not hear them well at all with all the background noise.

I worry that the other parents will judge the whole potty training issue, which we haven't started because of some physical issues related to Nolan's PUV's. I dread the talk of toilet training and how everyone else has a great method that works lickety-split.

I worry that he will spit out his food at snack time, or spit up. Or choke and gag, as he sometimes does. That he will start one of his crying jags, which we now know is caused by a reflux event. I worry that the other teachers won't "get" that his eating issues and behaviors are related to a medical problem.

Some people have told me that Nolan starting preschool is no different than when Matt started preschool. But it is entirely different. On-a-another-planet-different. I'm not worried about him learning his colors and shapes, as he already knows these. Hey, he even knows many of his letters and that his name starts with an "N." No, I am worried about him, as a person. Will he socialize well with the other kids? Will he separate from me easily, or has he been scarred from so many medical issues in the past few months? Will he panic? Being the smallest one in the class, will he be babied too much?

We have an "orientation day" and I am going to meet with the preschool director (who personally teaches the Two-By-Two class) to discuss all of my worries. To show her his audiogram and explain that yes, he talks very well. But he doesn't have the concept of "yes," he doesn't answer questions without help, and he might not be "getting" what you have told him, even if he follows along with the other kids.

That first day is going to be harder on Mommy than it is on Nolan. I know, deep down, that he'll be just fine. The first few weeks might be rough, but he'll find his wings, dip them in finger paint, and get messy and be happy with the other kids.

Earrings

Nolan has taken a keen interest in other people's ears lately. We were sitting on the floor during speech therapy, and he noticed our speech therapist's earrings.

"That Cyndi earring."

She acknowledged his statement and talked about her earrings a little.

"That Mommy earring!"

I told him that I was, indeed, wearing earrings.

"That Nolan's earring!"

And so our hearing aids have earned a new moniker. They are Nolan's earrings, and he's mighty proud of them!

Approved

The medical office for Dr. Wonderful called yesterday and delivered the great news that they had prevailed over the insurance company. I was surprised it had gone through so quickly and easily, and Dr. Wonderful's medical front office person chuckled and said she had found a lovely loophole. The medication was approved not because our doctor thought it was the best medication for Nolan, but because of some quick thinking on the part of our doctor's medical office personnel.

The story, as related to me, went something like this:

I dropped off the prescription, and our pharmacist called to get insurance approval. The insurance denied the claim, and forwarded the information to Dr. Wonderful's office. Dr. Wonderful's office then sent the information back that the medication was urgent and the child in question needed approval quickly due to the severity of the case. Again, a big red DENIAL. So Dr. Wonderful's office decided to save the big battle for Wednesday, when there would be no one around. Just in case things started to get a little "loud."

She called and restated the information, that this child needed this medication. And he needed it quickly. The insurance company's response?

"Absolutely not."

She lobbied again and again, to no avail. They insisted Nolan take the cheaper drug, even though it was not recommended by our doctor. They would not approve Nolan to take Nexium until he had tried Prilosec and it had failed to work.

Then Dr. Wonderful's office noticed something. The Prilosec the insurance was willing to pay for was not only less effective for our little guy, it was also a PILL. Giddy with her plan, the office called the insurance person back.

"The medication you will approve for this child is a pill. He can't take a pill."

"He can take a pill. We are approving the pill."

"He's two. He can't swallow a pill."

"Why can't he swallow a pill?"

"He's TWO. YEARS. OLD."

"And how does that make him unable to swallow a pill?"

"It's a choking hazard!"

Silence.

More silence.

"The Nexium is approved."

So, on the basis that Nolan might choke to death on the cheaper drug and therefore cost the insurance company even more money than the cost of the Nexium, we have approval.

The kicker is the phone call I received about 10 minutes after I hung up with Dr. Wonderful's office.

*ring*

"Hello?"

"This is XXX Insurance Company, and I'm happy to let you know your son's medication has been approved without delay!"

Yeah, right, buster! I know the whole story. And I also notice that you never call when you're denying things, only when you have finally succumbed to approving something after a fight.

At least we have Nolan's medication approved for the next year, no matter what hassles we have to go through to get it!

On Nexium and Symptoms of Silent Reflux

Nolan, tugging at his neck. Nexium: Day 2

We are in "round one" of our battle to get Nolan's insurance company to approve his Nexium medication. I dropped off the prescription yesterday, and the pharmacist does not have any in stock. He said he won't order it until he gets approval from the insurance company, which is likely to deny the medication.

Our GI doctor feels that due to the severity of Nolan's reflux, Nexium is the best medication for him. Our insurance company feels a cheaper drug is the best for Nolan. Because a stuffed shirt in an insurance building knows more about my son's health than his doctor. But I digress...

The Nexium is a powder, which is mixed into a tablespoon of water. Nolan can't eat before it is given, and can't eat or drink anything for 30 minutes after taking the medication. Oh, and it tastes TERRIBLE. Since I can't mix it into applesauce or give him a drink to wash the taste out of his mouth, giving him the medication is quite the experience. And by experience, I mean "sit on your child and force 20mL of nastiness into his sputtering self while he spits as much of it back onto your face as he can." I'm guessing he's only getting about half the required dose, since he blocks the medication with his tongue and spits much of it out again. Mommies who have to dose your kid with disgusting medication that can't be masked, what do you do? I know there has to be at least someone with good advice out there!

I also thought I'd post about the symptoms of silent reflux. Now that we know what Nolan has, a lot of the strange things he does make sense. So, a rundown of his symptoms:

• Occasional random coughing and watering eyes. This is due to acid coming all the way up and getting into his lungs.
• Tugging at his neck. He does this quite a lot. This is because it hurts.
• Refusing food. Again, because it hurts.
• Craving liquid. This is because his throat hurts AND he's hungry.
  
• Night waking. He refluxes, he wakes up. We thought it was just a random toddler thing.

Non-silent reflux (would that be LOUD reflux?) shows up by vomiting more than twice per week. Nolan, as a rule, hasn't been big on the vomiting. He did it every day for a week in April, and again a week ago. Other than that, no puke. He does spit up every once in a while (about 2x per month), but not enough to scream "reflux kid!"

I'm off to call the pharmacy to see what phone calls I need to make today. If I'm lucky, we'll get approval before my sample packets run out.