SAM...MORE THAN A CONQUEROR: Sleep Wars (3) : A changed strategy

Sam. Conqueror. Overcomer.

"IN ALL THINGS WE ARE MORE THAN CONQUERORS THROUGH HIM WHO LOVES US : Samuel was born on 15th May 2009, two months early and in respiratory distress. After an initial Apgar score of 1, he was taken to the NICU and placed on a ventilator, together with an undeterminable amount of tubes, IV’s and monitors which made it almost impossible to see the little Smurfie character lying within…slightly blue and only three apples high. Sam was diagnosed within 24 hours with Rubinstein-Taybi Syndrome, a scarce medical advantage as, due to the rare occurrence of the Syndrome and the limited medical literature on it, many individuals are only diagnosed well into adulthood and some never at all. The page-long list of medical/health issues related to the syndrome, while vital in providing a prognosis and compiling a care plan, took a backseat, however, as Sam’s struggle to breathe and swallow became the primary focus of our concerns and prayers, deepened only by the heartache of not being allowed to hold and comfort him for the first ten days of his already traumatic life. After seven weeks Sam was successfully weaned from the oxygen but was still dependent on a nasal gastric tube for feeding, with which he was eventually discharged. Once home, what should have been a precious time to recover from the stress of the NICU and enjoy a relaxed and cherished time together, instead became a seemingly-endless timeline of specialist appointments, therapies, illnesses and surgeries as that page-long list of medical complexities came into play, affecting every part of Sam…physically, neurologically, medically and emotionally. Yet, despite these challenges and an “ineducable” future being predicted when his prognosis was delivered, Sam showed a delightful potential and eagerness for learning. Unfortunately though, this learning potential seemed limited to his cognitive abilities as, physically, Sam’s development lagged significantly behind that of his RTS peers. A week before his 5th birthday a brain MRI confirmed that, in addition to the RTS, Sam also has Periventricular Leukomalacia and Static Leukoencephalopathy (included under the umbrella diagnosis of Cerebral Palsy), which would more than likely have occurred as a result of the oxygen deprivation experienced leading up to and/or during his birth. Thirteen years later and with a number of surgeries and medical procedures which appear to be in fierce competition for their own “page-long list” (which surgeries and their subsequent recoveries have left Sam to face his day-to-day life with a residue of unshakeable anxieties and phobias), the boy you meet face-to-face…with his cheeky sense of humour, unfathomable joy and fierce warrior spirit…make it almost impossible to believe that that disheartening brain MRI and poor medical prognosis are of the same kid. As we begin to navigate this journey with a newly aged differently-abled teenager, leaving behind the little smurf whose fears and discomforts could so easily be remedied with a cuddle on mom’s lap, the anxiety of more surgeries and medical challenges now compounded by the universal fear of every differently-abled child’s parent/s (who will take care of their child once their own time here is gone) threatens to become overwhelming. But then the excitement of a horseriding lesson, the sheer delight of spotting a balloon (especially a hot air balloon) or a super silly giggle caused by simply hearing someone sneeze provides a beautiful reminder of the profound joy and courage these children radiate, despite their overwhelming challenges, and it provides the perfect encouragement and inspiration for facing your own. #samtheconqueror

SAMUEL - COMPLETE IN GOD
Our world has crashed, been blown apart.
This can't be happening....why us? Why now?
Your fragile life shaken before it could barely start,
How do we get through this...please, Lord, tell us how?

Drowning in our sorrow, waiting for answers that just don't come.
Our baby "special needs"? It simply can't be true!
The heartache overwhelms us, we're left feeling cold and numb.
The diagnosis tells us little - these children are so few.

But then we finallyget to touch you, to see your precious face
And all the heartache and questions fade, replaced with love and pride.
It's obvious from the very start you're showered in God's grace,
And with His love and guidance, we'll take this challenge in stride.

When once we couldn't pronounce it, Rubinstein-Taybi's become our norm.
When once the future seemed dark, we now welcome the journey as having an RTS angel brings lessons in unexpected form.

Our world has crashed, been blown apart!
This IS happening....to us.....right now!
We've been blessed with a gift, so precious from the very start. How do we get through this? Here's how.....
By believing in a God, so merciful and great,
By trusting that He's right beside us as we journey through the narrow gate.
By believing His love for us is not determined by a human frame,
By trusting that we draw Him near by merely calling His name. This precious baby we asked God for,
Prayed he'd be perfect and complete.
And, as Samuel means "God hears", He's laid His answer at our feet.

(Nicky de Beer : 27/05/2010)

Tuesday, November 27, 2012

Sleep Wars (3) : A changed strategy

NO WAYS!

I cannot believe it's been so long since I updated the blog. Life, as always at this time of the year, is a nerve-wracking whirlwind of various concert rehearsals, studying for exams, tears and sulking associated with studying for exams, more concert rehearsals...trying desperately to think of cost-effective but excitement-yielding gifts (Yes, Disillusioned *is* in fact my second name)...the actual exams...the actual concerts...as they say, time flies when you're having fun? ("Disillusioned" seems to be a popular second name).

So, taking everyone's chaotic schedules into consideration, here is a condensed yet thoroughly comprehensive summary of the Sleep Wars Saga over the past few weeks :

First we didn't sleep, then we did, now we don't.

The End

And now for the more detailed version...

On the 14th Nov Sam and I went off to see Doc Paul, after sending him a brief e-mailed explanation of what had been going on with Sam's rocking-and-rolling nighttime jiving. I find this a hugely beneficial exercise for both the doc and us (the pre-consult information, not the rocking-and-rolling) as it gives them time to research the scenario completely and come up with a workable solution in less than the few minutes assigned to each consultation. The sad thing is that I am quite often disappointed to find that the doctor has not read the e-mail or, as was the case with a recent new specialist's appointment, was asked by the receptionist when requesting the doctor's email address, to not send her an e-mail as she would not have the time to read it. Thankfully Doc Paul had taken the time (major smurfy kudos to him) and had obviously given Sam's situation enough thought. Ultimately Doc Paul shared Sam's OT's view that Sam's sensory and high-anxiety levels have reached a point where basic occupational therapy exercises like brushing, swinging, etc are not as equally intense as the symptoms themself. While he agreed that it was time to resort to medication, he explained carefully why meds like Vallergan, Urbanol, Aterax, etc are not the most efficient treatment and that if Sam has had a bad reaction to just one of those, he would more than likely react the same to the rest of that "group" of meds as well.

So instead he prescribed a very low dose of Faverin for Sam which effectively is an anti-depressant when used for adults, but has been found to be extremely successful in treating children with high anxiety and/or OCD/repetitive behaviour issues...in other words...Samuel. It takes approximately 2 to 4 weeks for the medication to start working at its full potential and we are only on Day 12. The first few days and nights there was no remarkable improvement, then Wed-Fri nights we had absolute, pure BLISS with Sam sleeping straight through from 8pm-ish to after 7am without any rocking-and-rolling or practically any movement at all going on. And all was well with the world...well, other than that Sam was not in the least bit amused at waking up in his own bed as opposed to snuggled comfortably between Mom and Dad. And this is where the inspiration to change his strategy was born.

On Saturday night, or rather Sunday morning, somewhere round the unearthly-wee-hours our littlest dude woke up. He didn't rock-and-roll in his sleep. He plain and simply woke up. And decided it was as good a time as any to play a little peek-a-boo with the duvet, search excitedly for imaginery Po's and La-La's lurking within the blankety darkness and practice his most awesomely adorable smiles and giggles. Ai Ai! What is a mom to do when confronted by such ruthless and unleashed cuteness? Well I tell you what she simply CANNOT do....ignore it. So my giggle-stifled, mock-scolding commands that Sam lies down and goes to sleep were most certainly not obeyed by the little smurf. Unlike Chris (and probably most other dads) I've yet to master the art of ignoring such antics, no matter how desperate I am for sleep. Sunday night was pretty much a repeat of the previous and last night we did about a half-hour of playing and about an hour of rocking-and-rolling before Sam eventually went off to sleep again.

While our sleeping issues at night are still very much a work in progress, there has definitely been a huge improvement with Sam's behaviour during the day. The snowballing lack of sleep was making him quite heartbreakingly difficult to cope with during the day with more meltdowns than I'd like to remember. There are still tantrums and frustrations aplenty, but nothing in comparison to our pre-Faverin journey. And, while there are still occasional nap-starved days, the norm over the past few days is hovering around an hour to two hours napping in the afternoon - YeeHaa! One out of two is quite satisfying for the time being ;)