Wednesday, October 14, 2015

Medical Complexities and Changing Opinions

Over the past couple years I've been joking with Walter that I am going to become a dog trainer. And he has joked back that I'm not allowed until Stella is a "good dog" (see previous post). I looked up the requirements to attend The Academy for Dog Trainers and found the essay question each applicant must answer. At first it stumped me but it didn't take long before I knew exactly what I would write about if I were to complete the application process.

Below is the essay question and my response, which exceeds the 300-500 word limit, but for the sake of this post and my personal interest in the importance of this question, I am choosing to flesh this out in detail.

We’ve all had the experience of holding an entrenched or strong opinion and then changing it, sometimes as a result of gradual reflection, persuasive arguments made by others, epiphany or a combination of factors. Describe a time when you changed your view about something. How did it come about and how did it change you? Your experience can be about any subject (not necessarily dogs).

I grew up going to La Leche League (LLL) meetings with my mom. LLL is an international organization devoted to helping and supporting breastfeeding mothers. To say breastfeeding was a big part of my life is an understatement. I'm not even sure when I realized that another form of feeding for infants even existed, but I was significantly older that most. My mom was (actually still is) an LLL Leader, which meant she was devoted to counseling struggling mothers through the process of breastfeeding. This also meant our home phone rang off the hook with crying mothers on the other end of the line. I remember a little pepto bismal pink message pad at the ready by the telephone and my sister and I were given detailed lessons on how to properly answer the phone and take down messages. 

When I was pregnant with Isabella I didn't even consider an alternative to breastfeeding. My husband didn't consider an alternative either, we didn't see any necessity for formula and it was clearly written out in my birth plan that Isabella would not be given a pacifier or bottle, and would be put to the breast upon delivery. I'd even been attending LLL meetings in Kent, Ohio as an expectant mother and I couldn't wait to enjoy a magical breastfeeding experience with my daughter. 

Nursing Isabella was hard right off the bat. And I began to understand why people choose to replace the breast with a bottle. But I was determined and I stuck with it and got through the hard part. And nursing Isabella was magical. I loved nearly every minute and enjoyed lazy afternoons snuggling my infant and feeding her the world's perfect food. Not only that, I was enthralled with idea that my body was not only able to grow a baby, but it was more than capable of providing her with perfect nutrition for the first year of her life. As someone who struggled with an eating disorder and previously felt completely uncomfortable in my own skin, this was an incredible experience and extremely healing for my body and my soul. 

Fast forwarding a little bit, I went through the process of becoming an LLL Leader and within a year I was leading meetings and counseling other women. I felt strongly, actually, I was even hardheaded that breast is best and formula is evil. Isabella never had a bottle. We didn't even own a single bottle. 

Let's fast forward a little Isaac. 

Isaac was born and the dreams I had of recreating my experience with Isabella quickly dissolved, no actually, they were smashed, with a giant hammer and then shredded with a chain saw--how's that for imagery? 

Breastfeeding Isaac was miserable. He cried. No screamed...all hours of the day and night. There's this lovely moment after a satisfying feeding in which the baby unlatches and some breast milk dribbles from their mouth and they look completely drunk on love. Yeah, that never happened with Isaac. Nursing him was miserable, living with him was miserable, trying to get sleep while living with him was miserable. You get the idea. We blamed most of this on his need for the upcoming craniofacial surgery. I was convinced his head shape was giving him headaches and that after surgery and recovery we would be back on track. Surgery came and went and several months later Walter and I were having a meeting with the pediatrician about Isaac's lack of growth and weight gain. I was furious and I felt like a failure. The doctor (who has since apologized) blamed breastfeeding even though by that point I was on a stressful and exhausting quest to find out what was wrong with my baby. I knew in my heart it wasn't breastfeeding and I was determined to continue providing my son with what I felt was the very best nutrition. 

Nine long months later, Isaac got a g-tube. I angrily breastfed him until he was fifteen months. I say 'angrily' because it was never enjoyable and by this point he had a slew of doctors and was in feeding therapy slowing gaining one ounce after another. We went from not even owning a bottle to trying to get Isaac to take any number of bottles on the market. 

The puzzle pieces of his diagnosis gradually came together in a painful process and by this point I was stepping away as an LLL Leader. Going to meetings was hard and I usually went home feeling sad and frustrated with my own situation. Mothers at meetings were worried about how often they should nurse their baby and it seemed so trivial compared to what I was going through. All I wanted in the world was for my baby to be satisfied by breastfeeding. Not only that, but formula was on the horizon for us. And admitting that to those around me, to my entire community of friends so devoted to breastfeeding, was daunting. 

Unfortunately, g-tube = formula. That is beginning to change a little and I can share more in a different post but when your kid goes into surgery for a g-tube, they don't leave without a prescription for formula. Within a matter of days, I went from feeding my baby the most natural meal on earth, to the most artificial. But guess what, he literally wouldn't have survived without formula. Isaac had long been diagnosed as failure-to-thrive, which is a stab in any mother's heart, and he needed medical intervention in order to have any chance at reaching his greatest potential. By fifteen months old, my son wasn't walking, crawling, babbling (let alone talking), and the future looked grim. 

Isaac still has a g-tube and at this very moment I have three boxes of canned formula in my kitchen. And yes, I still blend real food meals for Isaac, and he does get the packaged Real Food Blends created by a brilliant mother on the quest to change what the standard of enteral feeding looks like, but pretty much every day Isaac has formula. And you'd better believe that every day I am thankful for that can of Organic PediaSmart. 

I am no longer an LLL Leader. I resigned shortly after Isaac got his g-tube because it was too hard emotionally for me to attend meetings. But I have an incredible group of friends that grew out of LLL and their support along this journey with Isaac has been unwavering. Walter and I still believe "the breast is best" but we also believe that formula has made our lives, and the life of our son, so much better. With sincerity, I now understand why some moms just don't want to breastfeed at all, why some babies need formula, and why some moms may want to breastfeed but due to medication or medical issues, they are unable to make that choice. Ultimately, formula exists for a reason. Those of us who are LLL or breastfeeding supporters, can hold strongly to the opinion that breast milk is the perfect nutrition, but we shouldn't bash the need for formula and a mother's choice to choose what is best for her, and her baby. 

Isaac is no longer diagnosed as failure-to-thrive. It has taken a very long time to remove that diagnosis and I am thankful that there are many ways we can provide nutrition to the medically complex child. I am also thankful for my many experiences and opportunities for growth that have come from raising a medically complex child. I have learned that it is okay for previously steadfast opinions to morph. As a result, I am more capable of supporting other mothers in a loving and thoughtful way. 

Tuesday, October 13, 2015

Good Dog

I've been thinking about what makes a dog a characteristically, good dog. Spoiler alert: I don't have an answer. So it's your choice if you waste your time reading this post.

Now that we are raising a puppy, it is quite obvious that dogs are very similar to children. For example, Charley (our five month old German Shepherd Dog), takes things without asking then tries to lie about it (conceals stolen item in his mouth until he is out of sight), gets far too excited about meals (have you ever seen how desperate a toddler gets at the thought of a cracker--it's mind boggling), rips up paper, invades personal space (every kid I've ever known--except Isaac) and likes to explore disgusting items, like trash (this is comparable to my kids trying to drink their bath water).

So what do we do with these disgusting and out of control creatures? Redirect. It's pretty simple. But it's time consuming.

There's a reason everyone is told to "baby proof" the house as the baby gets older. Those computer cords you think are boring and hidden from sight, are readily sought after by the curious toddler. Disappointingly, some parents choose to swat the curious toddler's hand every time they reach out to touch a cord or that important piece of paper left on the coffee table that you're too lazy to move. What does this teach that toddler? Fear, and exploration is a negative experience.

I'm still learning a lot about dogs, but I think it's pretty similar. Swat the dog on the mouth every time it gets mouthy, whack it on the hind quarters when it goes after something enticing, knee it in the chest when it jumps. What does this teach your dog? Fear, and exploration is a negative experience--and human hands are not to be trusted.

I didn't know much about dog training when we brought home our now ten year old rescue dog, Stella. It didn't take long before Stella was banned from my parents house for stealing an entire pork loin off the counter followed by an expensive apple tart from the local bakery. How could she possibly resist such a tasty meal? I'm pretty sure Stella's stomach is lined with diaper gel beads. If I could ask her what her favorite thing to steal is, I am one hundred percent certain she would say, "Duh, you human idiot, dirty diapers. It's so fun to toss them around and rip them apart and make a huge, smelly mess for you to clean up. After all, you've been ignoring me for years while you take care of these crying children!" And I'm pretty sure he arteries are nearly blocked from chowing down on sticks of butter. Is it her fault she find these things so enticing and can't resist them when we aren't looking? No! We left the diaper out or the trash uncovered, and we left the butter on the counter within reach. It's simple.

Unless told otherwise, our dogs and our children will continue to make mistakes and probably the same mistakes over and over again. We daily teach and redirect our children so they can become well functioning adults and part of society (though I do wonder if Isabella will still jump on the kitchen counter as an adult) and as dog owners, it is our responsibilities to do the same with our canine companions. You can't bring home a dog and expect it to know what you're thinking and instantly be aware of all the household rules and boundaries.

Imagine I had a lovely piece of cheesecake, with chocolate drizzled on top and lots of whipped cream. And I sat down at the table to enjoy this dessert and just then Isabella walked in the room:
"Oh, that looks so good! Where's my piece?"
"Sorry this is just for me."
"But you know I love cake, and chocolate, and whipped cream!"
"I know, but this is for me, sorry."
Beginning to get desperate, "That's not fair! Why can't I have some?"
At this point she quickly swipes her finger across the whipped cream for a taste.

Replace Isabella with a dog: The desperation is replaced with demand barking and the swipe of her fingers is paws on the counter or table and/or a tongue reaching out to the plate.

Now, obviously I would never do this. Any sane person should know they can't enjoy a dessert in front of child without offering some to them. This is why I save my dark chocolate for after bedtime. I would guess, this is how our dogs feel when we begin cooking dinner or sit down for a meal. Charley assumes he should have his paws on the counter while I'm cooking and demand barks at me while I'm chopping vegetables. I guess my point is, there is no point in yelling at him for this response, he hasn't been taught, or rather, he is in the process of being taught, that this is not appropriate behavior. Instead of yelling or kneeing him in chest for jumping up to the counter, he is redirected to something enticing of his own like a bully stick, or a his favorite toy, and for demand barking, he gets a time-out because this is a behavior we are really working on with him.

So what's a good dog? I think a good dog can be found with a good owner. And most bad owners don't realize that they have a good dog who just needs some help.

Let's set up our dogs for success in the same way we set up our kids for success. Our expectations have to be within reason. And just as you shouldn't be a lazy parent; don't be a lazy dog owner.

Saturday, October 3, 2015

School Days

Two weeks ago I dropped Isaac off at his first full day of preschool. Six, childless hours loomed ahead of me and I stood in my dining-room and cried. What the heck, I thought. I'm supposed to be experiencing pure joy right now. I've been waiting for this day, this exact moment when both kids are happily at school for eight years and yet, I'm crying?

As it turns out, I didn't actually miss my kids. I love them, but I also love handing them over to the proverbial village. I just had no idea what to do with my six hours--it was intimidating. I could be productive and prove that I worked hard during those hours, I could lie in bed and catch up on endless hours of TV, or rent one of the three hundred movies I've missed out on over the past eight years, I could walk the dogs, or read, or knit...I sent an iMessage to my family and said I was confused and didn't know what to do with myself. I was paralyzed in my freedom.

My dad said to take nap...or any of the other aforementioned ideas.

I took a hot bath. Have you ever taken a hot bath during the day? I'm not sure why, but it feels even more luxurious than at night. I think because it's so unusual. Although, I am quite easily entertained so this could all be in head but, I mean, who takes a bath during the day unless they have the flu? Or they're Isabella, who takes baths during the day for fun and literally talks to soap suds (no joke--she is amazing at talking to inanimate objects) for an hour.

I've had a few more days since then to get used to my new routine without the kids. It is heavenly and I feel so blessed by Isaac's preschool teachers. They excitedly offered to learn how to feed him with the g-tube and it has worked out beautifully. Knowing Isaac, we were a little concerned about how he would react with others performing the feeding routine, but he has taken it all in stride. He also uses the potty at school and even pulls up his own underwear and pants--so many accomplishments over the course of one summer!

I do spend a lot of time wondering what moms do all those hours their kids are at school. Half the time I don't even know I do. I'm certainly not going to spend all of those coveted hours cleaning. I usually try to have one cleaning goal to accomplish during those six hours and the rest can be done after school hours when the kids are playing or I want to pretend that I'm actually a productive person in front of them so I have witnesses. It's all about the witnesses, people. Don't squander away those hours on cleaning when no one actually sees you in the act! Thankfully Walter thinks I worked hard if I made the bed. He'll come home and say, "Wow, it looks like you did a lot of hard work today." "Why yes, yes I did. In fact, it takes many steps around the king size bed in order to arrange the blankets just so."

I should mention that Isabella is doing very well in public school. The transition from homeschooling to public school worked out better than we'd hoped. She does tell me that she works harder than anyone else in our family and last week she said that "third grade is less fun than second grade." While there are some things lacking from her education and most definitely things I would do differently, I can tell she is learning and above all else, she is happy. Except when we assign extra work for her and in that case, she falls in a puddle of tears and tells us how mean we are and how "nobody else at school has to do extra work!" Dude, when did I ever convey that we want to be like everyone else?

Back to the main to the main theme of this post. I have a list of what I'd like to accomplish around the house during my 'free' hours, and I also have some research goals and a very long list of books to read and projects to knit and dog training to get done. One step at a time, I tell myself. I know too well that too many goals just sends me into a paralysis otherwise known as, depression. Yes, the 'D' word. I know some of you are cringing--thinking of it as a shameful word not to be spoken, but it's called life, and it's called, chemical imbalance, but more on that another time.

As for right now, I enjoy hugging my kids in the morning (well, not Isaac, he doesn't like hugs, but I try to steal them every once in a while) before they happily run into their respective school buildings and trust me, they do run. Maybe they are just as excited to get way from me as I them. I come home and greet my dogs, who honestly believe I am the most amazing person in the world. And savor a day without doctor or therapy appointments for Isaac, a few less tantrums to deal with, one less g-tube feeding, and one meal without interruptions. Life is good.

Friday, October 2, 2015

The Family Meeting

When I was growing up my parents periodically announced the need for a "Family Meeting". My earliest memory of a family meeting was when my parents told us that our dog, Brandi, the dachshund, had died. I remember passing around rolls of toilet paper as we sat on the floor of our living-room. I was in kindergarten.

As we got older, the meetings were usually related to not putting our bikes away and hence they were left out in the rain, leaving books outside overnight, poor grades on report cards and the need for a tutor (this was in direct association with me--my sister is the one who is good at math and science), messy rooms and a new form of bribery related to actually putting one's shoes and coats away.

And now I'm a mom. And I get to call the Family Meetings.

-Walter, we need to have a Family Meeting tonight.
-Should I be the secretary and take down the minutes? Do you have a bullet-point agenda?
-Hardy-har-har. You are hilarious.

He makes me sound so 'Type A'. The state of my desk would quickly make you realize that I am not. I'm more of a messy, unstructured, creative, free-spirit, type A--if such a juxtaposition exists.

My mom couldn't stop laughing yesterday as I recounted our latest Kohn Family Meeting. Isabella has been suffering from a case of the 'mean grumps' and we needed to talk it out.

When I was taking classes to earn a Professional Writing Certificate, I learned that if you are writing a business letter in which negative information must be shared, you should begin with a positive and end with a positive. I implement this strategy during our Family Meetings. It starts out something like this:

-Isabella, we love you very much (but you're being a pain in the butt and we're looking into boarding schools--just kidding, we don't actually say that) and you've done so many wonderful things lately (insert example(s)). Right now we are concerned that you are feeling emotions you might need to talk about (this is where Walter looks at me like I'm a crazy person and gives me the eyes that say I just need to spit it out). We feel like you've been disrespectful with us lately and we want to help you make a change. (This is also the point where Isabella crashes her head into the pillow and starts sobbing: Why are you guys being so MEAN to me!? You just say everything that I do WRONG and you think I'm a HORRIBLE person!) 

Whoa! Back. It. Up. What just happened?

Rein it back in. Gently discuss the negative, finish with the positive, wrap it in a bow and give hugs all around. Wipe brow--roll eyes with husband and eat some chocolate.

Oh, and here's an example of a "meeting" between Walter and I:

-Sierra, you just need to understand that the dishwasher does not remove chunks of peanut butter from the knives.
-It will eventually.
-No, it won't.
-Well then, you just need to engineer up a dishwasher that has little scrubbers that are released inside, like minions, and then we won't have anything to worry about!
-Actually, I need to install sensors that send me a message every time you load something with chunks or put too much soap in the dispensers.
-Whatever. My idea is better.


What do Family Meetings look like at your house?