April 2009 Archives

Happy Birthday Josie!

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It's our beautiful little girl's 3rd birthday today. She's never really had a shell to come out of but her personality has blossomed this year. She's continued with her severe independence but has started to develop a bit of patience. She loves music and will sing, dance and play instruments like there's no one watching.  She has a flair for drama and talking about how "wonuful" everything is.

We think so too. Happy Birthday Josie Grace, we love you!


School Holiday

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The school system here is a quarterly set up.  It really reminds me of the year-round system we had in the states.  The kids go for a term then have about a 2 week break before heading back for the next term.  Sophie is currently on holiday, as they call it here, and Josie and I have really enjoyed having her home.  More Josie than me, and you may think I sound cold but hey, I can't compete with 41 four year olds.  I just don't have it in me.  Josie on the other hand is more than happy to try and keep her sisters attention all day long.  

Sophie has gained enough independence that she's fairly self entertained.  She's been trying to manage Josie into doing everything she wants her to do.  And also getting her to do it the way she wants her to.  What can I say, the girl knows what she wants.  Josie has been a good sport and is the perfect counter to Sophie's bossiness.  If Josie doesn't want to do it the way Sophie is instructing, she just won't.  Does it sound like a recipe for disaster?  Surprisingly, it works out 99% of the time.  The girls have really started playing well together.  Both coming up with ideas and having equal parts in the game.  It's amazing how long they can be entertained by seeing which things they can pull with a jump rope.  

I took the girls to a play last week as something to do.  It was really funny how Sophie was curled up on my lap during the parts with the villain while Josie joined the other kids and shouted at him.  The story was quite cute and at the end the cast came into the audience and asked the kids if they'd like to dance.  The king asked Josie and Snow White asked Sophie.  Their faces were priceless.  Josie looked like the happiest girl on earth and couldn't wait to come over and tell me about her dance.  All afternoon they reenacted different scenes from the play with each other.

It's been nice to have them with each other and give them a chance to reconnect.  I think Josie really misses Soph when she is at school.  Oh, today I caught them kissing for like 10 seconds.  Sophie was saying, "No Jose, let's kiss for a long time like this (press mouth to Josies face)".  It was pretty cute.



Josie Update

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My last visit to the pediatrician with Josie was frustrating. Mostly because I hoped that we could get some answers or make some progress. Josie had been very lethargic, not sleepy but would just want to sit and stare or watch tv.  I'd offer to let her play or paint or do playdough, anything but she wasn't able to focus.  So when the pediatrician asked how she was, I let him know that she wasn't very responsive etc, to which he replied "but other than that she's well?".  I wanted to strangle him.  What I wanted to say was "NO she's not effing well!  She shouldn't be like this!"  Instead, I just started bawling.

I choked through the tears to ask my questions for him to pass on to the neurologist since our two month check up with her turned out to be a six month wait.  There was no way I could wait six months without talking to her.  First off, Josie's new drug would be at the maximum dose two months before our appt and I had no plan B.  We needed to know what we would try next if the lamotrigine didn't work.  And I hate to say it but I feel like all the Pediatrician does is weigh Josie and then play messenger for the neurologist.  Anyhow, I left feeling deflated and like the visit was pointless.

About a week later, we received a call around 6:30 pm from the neurologist.  "Hi this is Lynette."  It was like the stress melted. Did I mention that I LOVE this woman? I rehashed my concerns and she took them as valid, asked us to reduce her epilim but warned us that we may see increased seizures but a clearer child.  Which is exactly what happened.  The day after we brought the epilim down, Josie's seizure count jumped from 7 to 23 (and those are just what we saw) but she was talkative and interested in playing and reading books.  The neurologist also let us know that our next step would be either to try a different drug or the ketogenic diet.  She recommended the diet as the probability of drugs being effective decreases significantly if the first three haven't worked.  Plus adding a fourth drug then tweaking and weaning and adding the diet would take lots of time and possibly a big toll on Josie.  The timing of the diet will depend on the hospital nutritionists' schedule but we'll cross that bridge when we get there.

The neurologist called a week later and gave me some more instructions on tweaking her first medication Clobazam.  We're trying to ramp that up every four days to see if it has any effect.  If not, we'll just ramp it back down.  So far, Josie just seems more aggravated with sporadic seizure counts.  She'll have 5 one day and then 20 the next.  Some days she has no issues with you touching her or giving her a bath and other days I am expecting Child Services to come busting through the door.  When she has these sensory issues she can't stand to have her hands or face wiped after eating.  Or if you have her in the tub and want to wash her hair she just keeps screaming "Don't do that to me!  Stop touching me!".  She won't wash herself either and it if it sounds like a painful cycle, it is!  It's not consistent enough to even know when it's going to happen either.  She'll be all excited to get in the tub and happy with the water but once it's time to touch her she freaks.

She's also starting to push her boundaries with us (and I can't blame her).  So far, she's been very good about not walking on the hard floors without asking us to help her.  Most of the time she stands at the edge of the floor on the carpeting and says "Mommy, I waiting for you!".  Lately, she sees how far out she can get before you will notice and reset the boundary.  We've been trying to give her a little more independence since her full drops have almost disappeared, however, we still aren't comfortable with her walking around in the kitchen.

Yesterday we took a walk over to the pharmacy and Josie got to ride her three wheeler while Sophie rode her scooter.  I think it was just what Josie needed.  She was independent, got to wear her helmet just like her big sister and had some great physical activity.  We did a repeat of the walk today and added a trip around the block for good measure.  She seems to be mentally developing at a normal rate from what we can tell.  Singing her ABC's, counting, picking out her letters when she sees them.

I guess what it boils down to is most of the time she seems like a normal almost 3 year old.  What we struggle with is the constant possibility of a drop seizure.  Boy, that was a little sentence compared to the fear and horrible potential it carries.

Coromandel Trip

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Saturday morning, less than 24 hours after they arrived (and nearly a year since we last boarded an airplane!), Mary & Joe returned to the airport with us for a short flight back up to Auckland followed by a 3hr drive up to Hahei Beach on the Coromandel Peninsula. We met our friends Chris & Joanna for a nice lunch in Auckland and still made it to the beach by 4pm. The weather more than cooperated and we had a gorgeous long weekend - hope you enjoy the pics!

Josie Update

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Just a quick update to let you know Josie is on her fourth week of Lamotrigine with no apparent reduction in her seizures yet (which was expected). She seems to be struggling more with absence seizures, which leave her unresponsive and quiet roughly a third of the time. Lately she has had an increase in drops again as well.

Also expected, the lamotrigine seems to bring out her frustrations more (not that she doesn't have a lot to be frustrated by!): she'll rage and pull her hair now following a seizure, where before she would have cried or just been upset. At the beach she will roar and throw sand endlessly, which hopefully is therapeutic for her.

Aside from these times of silence or rage she is a very happy little girl, prone to giggling and always up for making her sister (and us) laugh hysterically. The two of them together are definitely "trouble" in the best way: thank heaven for our little girls!