Preparing an autistic child for hospitalization and surgery

Sam had his first visit to the Hospital this week. For most children their first experience of going to the hospital for any reason would be scary, unfamiliar, and a bit overstimulating. Now imagine how it would be for an autistic child whose receptive language skills are severely delayed. Simply talking to them about the upcoming visit or reading a generic book about going to the hospital is not enough. Children with special needs need a multi-faceted approach to preparing them for anything new. Especially something that will be assaulting their multi-sensory system and in the end will be a procedure that produces pain.

I spent quite a few hours searching the world wide web for as many resources as I could find. After 3 hours one day I realized if I was going to find something it was going to be because I created it and blogged about it. Well, then that is what I will do. My hope is that I can save parents like myself the countless hours of searching. After all, don't we all have enough to do already?

I started with a simple step-by-step story of how the visit would go by typing it up in Microsoft Word and then started adding pictures to go with the words. I do not have access to a Boardmaker program with PECS or this process would have been much faster. But, by using copyright-free images from the internet I was able to give Sam pictures of the real-life rooms and places he would be going, which in this case I think was the most important.

The little green fellow is supposed to me the bad tonsil monster
that has been making Sam feel sick.

I included a picture of Sam with his favorite toy, Slither.
The surgeon had told us Sam could bring a comfort item
with him into the operating room.

The real life photos of the operating room, anesthesia mask,
and IV were a HUGE help to Sam

I wish I could say the photo of the IV was so effective that Sam
did not attempt to touch it...he did. Often.

The End!

Here are some pictures for Sam's big day at the hospital. He was a real champ and healed amazingly fast. He was completely off the pain medication 4 days after the surgery and was back in school the following Monday. What a trooper!

Waiting patiently to go into the Operating Room

In the Recovery Room sleeping off all that wonky anesthesia. They put a sock over his hand with the IV so he wouldn't wake up and be afraid when he saw it.

I WANT my Popsicle!

You got that popsicle yet?

Things went much smoother once he got both a popsicle and Daddy's iPhone to watch learning shows on YouTube.

We were on our way back home 4 hours after arriving at the hospital.
WOW! When I was a kid you stayed the night!

Internet resources for creating your own social story:

Hospital Photos for Children
Medical Photos
There are dozens of pages of photos from various Children's Hospitals in the US and abroad. Very good images of operating rooms, inpatient care rooms, playrooms, and children having various tests done (x-ray, MRI, etc.).
To use a photo just right click on the photo with your mouse and choose "Save Image As" then you can place it anywhere on your computer for use in your social story. For beginners I recommend just saving it directly to your desktop since it is the first screen you see when you turn on your computer.

Other social stories for children related to hospital visits:
Visiting a loved one staying in the hospital

A large assortment of social stories for various situations:
Library of social stories
This library is quite extensive but some of the social stories can only be viewed with Power Point, Microsoft Word, or Boardmaker software pre-installed on your computer

Miscellaneous social stories
Great site with scripts for a number of social stories. Just copy, paste, and then add your own pictures.

Slow and Steady

I have been desperately wanting/ needing to get back on my treadmill and work off some stress as well as the 20 pounds I have packed on in the last 2 years. However, I know myself pretty darn well and in order to get something done I need to have an incentive.

Actually, we all do.

I don't know many kindergartners who would willingly lay down for a half hour if they did not know they were going to get a cookie at snack time immediately thereafter. Men and women put up with bratty co-workers and snooty bosses all for the glory of their 1-2 weeks of paid vacation every year. For me, my incentives are relatively small, but still effective.

You see, I have this little deal with myself. If I get on the treadmill and run my 3 miles I get to take a glorious shower complete with warm water, soap, shampoo and conditioner. If I don't then I kiss the glorious shower goodbye until the next day or whenever I get my lazy butt back on that treadmill. In addition I decided if I had a tangible goal that directly aligned with my goal to run daily then that would only further motivate me. So, I signed up for my very first 5K that was held on August 22nd at River Valley Ranch in Manchester, Maryland.

Striking a pose before the big race.

My only goal had been to make it across the finish line in the vertical position. As opposed to being carried over it horizontally on a stretcher. As it turns out, I did much better than I had expected. I ran the 3.22 miles in 34 minutes 03 seconds. That was over 4 minutes FASTER than my best time I had ever run on my treadmill at home. I was especially impressed with myself given the hot, muggy temperature that morning.

The covered bridge is only 50 yards from the finish line so I was all smiles by this time. Plus, I could see the time clock next to the finish line and I was psyched!

The race featured chip timing which is great because it gives each runner
their exact race time.

I had such a great time that I signed up for another 5k being held on September 26th at St. Joseph's Hospital in Towson. This race is in support of Prostate Cancer research. Given my dad's diagnosis of prostate cancer just last year I feel very happy to be contributing in some way. I figure after that race I may try to do one per month.

So, it seems that something that started as a goal to get some more exercise has turned into a fun , stress-relieving, butt-kicking good time. When I was recently in a local running store I was talking to one of the employees about my new-found love of running and she commented that she found running to be rather 'addictive'. It has to do with the endorphins that are released in your brain after a good, hard run. We all love endorphins. Endorphins are those feel-good warm fuzzies we get when we fall in love, eat chocolate, or make love. They have a way of making everything in your world seem pretty darn good. Even if only for an hour.

So, the way I figure it...I'm striving for a good, hard run everyday so I can be the best mom, fiancee, ex-wife, friend, daughter, and sister I can be.

One Happy Plant

For those of you who have been following my blog for a few months you may remember my little friend I snagged right after Christmas from my apartment complex dumpster. I wrote about my rescue mission here.

By late January our little tree was enjoying its leafy life here in the apartment where it spent most of its days living on top of the dinner table because of this little fellow...

Noah, it seems loved the tree to death...or pretty darn close to that. Noah wanted to touch the leaves, stroke the leaves, love the leaves, and then rip them out one by one in his adoration. Then came the overwhelming love for the stems themselves. By late February I had a poinsettia tree that looked more like a poinsettia stick so I sought out some advice online as to how to care for this little guy and it said that in the poinsettia's off season you should cut the stem back to grade and keep it in the dark until the spring when you bring it out and starting giving it water and a little fertilizer. Thankfully by then the weather is warmer and it could live its happy days outside free from the grip of Noah, the tree slayer.

Well, I am very pleased to report that Mr. Poinsettia is doing very fine. Very fine indeed.


Wouldn't you agree?

I am not sure what makes a poinsettia a tree-form or the typical Christmas bush we see at all the grocery stores. I am sure it has something to do with heavy pruning and training the main stem to grow tall and stem-less but for now I think I will leave him just the way it is.

I think he's happy that way.

A trip to the doctor

Sam and I made the trek to the Ear, Nose, and Throat doctor on Monday afternoon. Apparently when you have 6 strep throat infections within 7 months that equals 1 tonsillectomy. Sam enjoyed playing with the various toys in the waiting room and when we went back to the exam room he thought the exam chair was pretty darn cool.


We met with a very nice doctor who I swear was probably just out of medical school (at least he looked that young) and he did a great job with Sam and explaining the process of the outpatient procedure to me. He agreed that the surgery itself would not be made more difficult by the fact that Sam is autistic. He said they would give him a sedative to relax him prior to surgery and that when he is wheeled into the OR he would be pretty loosey goosey and then they would put the mask on to help him fall asleep and then after he is out they would put in the IV.

Sounds like a really good plan to me!

The most difficult part, to say the least, will be the post-op recuperation when Sam will not be able to eat his typical favorite foods: grilled cheese sandwiches and my homemade chocolate chip cookies. He will be on a very soft diet for at least a week and will need to take pain medications orally every few hours. As I have mentioned in a number of posts my kids do not take oral medications because of their strong flavor. No attempts in bribery, threats, or pleading will get them to swallow it. They will either throw it back up or just stop accepting all food and drink in retaliation.

Over this weekend I have spoken to a number of friends about my fears and I have received some very good questions to ask the doctor regarding pain management. One friend recommended I ask the Pediatrician about the use of pain patches that are placed on the skin and release the needed medication that way. I think this would be a great idea if its available for children given Sam's love for band-aids. Another good friend, who has a child with ADD, mentioned that after her son's tonsillectomy he did not want or seem to need any pain medications and was even riding his bike in the driveway the same day. She said the doctor had told her that because of her son's brain receptors working overtime as they do the pain messages in the brain are more muted and are not received as easily as they would for a typical person's brain. I think this is very promising news given Sam has always had an extremely high threshold for pain and often does not seem bothered by injuries that would have you or I screaming for morphine. So, all in all I am feeling more optimistic at the moment.

But, I have always preferred to hope for the best and prepare for the worst.

100 Things...

I enjoy reading a number of blogs. Recently I stumbled upon Lynette Kraft's blog titled 'Dancing Barefoot on Weathered Ground'. Lynette recently said she would like to get to know her readers better and asked that we mention 10 things about ourselves. Well, I thought 10 was too little so I expanded.
Just a bit.
So here are all sorts of humorous, silly, strange, lovely, and downright weird facts about me, the Domestic Superhero:

1. I was born in Bartlesville, Oklahoma on November 6, 1975. That makes me 29 years old...or rather, I wish it did.
   
2. Spiders give me the heebie jeebies.
3. I used to smoke 2 packs of cigarettes a day. I quit when I was 22.
   
4. I went to college for 2 months and then dropped out. I have never been back.
   
5. When I was 5 years old I got lost in Disneyland.
   
6. The smell of sauerkraut makes me physically ill....really.
7. I love the color black. My mom always called it my 'signature color'.
8. I learned to drive a stick shift very abruptly when I was 17 and my mom left me 35 miles from home and told me I'd figure it out eventually. I think I made it home within 3 hours.
9. I am a wine snob. I love red, hate whites, and will absolutely not drink blush. I can't help it that my palette is high maintenance!
10. If I smell food I gain weight.
11. I love to read and every time I finish I book I go through this mini grieving process trying to find a new book to read that is equally good.
12. I am afraid of the ocean and any body of water that has other organisms swimming in it. Especially ones that can bite or eat me!
13. I am the classic middle child. I am always running interference between my older and younger sister.
14. I would have loved to be 6 feet tall. I'm 5' 9"
15. I can't eat fried foods or very bad gastrointestinal things happen! Trust me.
16. I had a miscarriage when I was 17.
17. I am allergic to codeine and latex.
    
18. I was raised Roman Catholic. Left the church and called myself an atheist until I was 22 and then found the truth and accepted Christ in the summer of 2000. I am so thankful and utterly blessed.
19. I'd do just about anything for a foot rub.
20. I love to have my back tickled. My mother started this with my sisters and I when we were babies and we were fussy. She would very gently tickle our backs until we fell asleep. Problem is...we never outgrew it and to this day when two or more of us get together we always ask each other to do it.
21. I have 4 nieces and 1 nephew. My older sister Caryn has Caytie and Jackson and my little sister Molly has MollyAnne, Madison, and Millie.
22. I have always wanted to go to a resort with a swim-up bar.
    
23. I used to swim competitively from the age of 10 to 17. I was fair, but nothing to write home about.
24. I had developmental delays as a child and went to a special class for my year between Kindergarten and 1st Grade.
    
25. I cannot stand the feeling of dust on my feet. If I am barefoot outside I will come inside and immediately wash my feet in the bathtub.
26. I used to be horribly afraid of being outside with all the bugs and bees and creepy crawly things. Now I love it and would prefer to be outside all day.
27. I can cross my right leg over my left but absolutely cannot cross my left over my right. Do all ladies have that problem?
28. I had lasik surgery after my second son, Noah, was born. It was amazing!
29. My mom taught me the gift of hospitality and how to pluck my eyebrows. Thanks Mom!
30. I lived in Colorado for 7 years in the best house I have ever known. My room had casement windows I could open and hear the river run 10 feet outside my window. Sometimes when I have trouble sleeping I recall that sound and it calms me and brings me comfort.
31. I am one of the biggest klutz's that ever lived. I have sprained or hairline fractured both of my ankles twice.
    
32. I can type 92 words per minute. 88 error free. To think I flunked typing twice in high school.
33. I don't really like talking on the phone. I would rather hop in my car and go over and see the person I want to talk to.
34. I get lonely very easily.
35. I've always had a thing for guys with long hair.
36. I would like to give it a try as a plus-size model.
37. I didn't go to my senior prom.
    
38. I was driving with a learner's permit in 8th grade. Yep, I was pretty darn popular that year!
39. I didn't have my first kiss until I was 15. His name was Jamie Stapleton.
40. I've always struggled with patience and I'm not afraid to pray for it.
41. I love gross medical stuff like puss, blood, and gaping sores. I guess that's why I always wanted to be a paramedic.
42. I'm not really a very good driver.
43. I applied for a position as a Baltimore City Police Officer and passed the beginning tests and background checks but never pursued it further.
44. I've always had a thing for older guys.
45. I don't much care for cats.
46. I love dogs and have had many in my life.
47. My mom once gave my pet iguana mouth to mouth and attempted to do chest compressions when we found her dead in her terrarium. Yep, she was the original Domestic Superhero!
48. I love to sing and I wish I was better at it than I am.
49. I have great difficulty remembering my left from my right and most people just point when they are navigating for me.
50. I got a tattoo when I was 19 and passed out from the pain.
51. I have to lie down when I get my blood drawn. I don't mind other people's blood, but my own, that is another story!
52. If you cry...I cry.
53. I don't like anger. I am not good at it myself and it crushes me when someone else is angry with me.
54. I've only mowed a lawn once in my life.
55. I have no depth perception.
56. I have learned a very keen lesson. If you bake it....they will come!
57. I love buying things secondhand. Goodwill and yard sales are some of my favorite stores!
58. I'm a foodie.
59. People who don't use turn signals make me crazy.
60. My grandmother was killed by a drunk driver one month before I was born.
61. I don't like to fly and would just prefer to drive thank you very much.
62. I really dislike boats too, unless they are docked to a piece of land.
63. I floss about 3 or 4 times a day.
64. I can't stand mushy or slimy textures.
65. I'll eat anything if its cold.
    
66. I'm a neat freak.
67. I'm much happier now than I was prior to my 20s.
68. I have to make my bed at night before I get in it.
69. My favorite book of the bible is the Song of Solomon. There is nothing quite like some good ole God-ordained romance! Now THAT man knew how to treat a woman!
70. I played the bass fiddle when I was in 5th grade.
71. I've had pneumonia 3 times.
72. I can't burp.
73. I completely disagree with the decision to use chocolate and raspberries together in a dessert. I'm thinking of starting a petition!
74. I worry. A lot.
75. I'll try just about anything once. Twice if I like it.
76. I smoked pot four times as a teenager and every time it made me throw up.
77. I was a girl scout for 13 years.
78. The first thing I notice about the opposite sex is their hands.
79. I can't stand anything that touches my neck. That means, no turtlenecks, crew necks, tight necklaces, or someone holding me too tight.
80. I give great massages.
81. I love to watch documentaries, but NOT reality TV.
82. I love to fill out forms.
83. I once went sledding at night with a good friend of mine down a very steep street and I swear we must have been going well over 30 mph.
84. I've only been to 1 funeral in my life. It was for my mom.
85. I once broke up a knife fight.
86. If I don't use something at least once within 6 months I sell it, give it away, or throw it away.
    
87. I never thought I would be a divorced single mom.
88. I lived to watch Sesame Street and most other kids shows. Except Barney...that dinosaur is just wrong.
89. I started going gray in my early 20s.
90. I think alot about my future and that of my sons.
91. I'm afraid of the dark.
92. I'm a big kid at heart and I love to go to Toys R' Us.
93. I could max a credit card at Williams-Sonoma or Barnes and Noble.
94. I love to watch movies. I've seen just about everything.
95. My dad took my sister and I to see the movie Poltergeist when I was 8. I still have reoccurring nightmares from that fun flick.
96. I'm early to bed and early to rise.
97. I'm most happy when I have friends in my house.
98. I love surprises.
99. I don't wear any jewelry except my hoop earrings (which I never take out). I don't much like watches or bracelets.
100. I would love to find a way to get paid to write.

Mmmmm. Pancakes!

We love pancakes here at Casa Walker. Well, 2 out of 3 of us love pancakes. The 3rd person merely tolerates their existence as long as he doesn't have to eat them.

Golden pillows of cakey goodness!

I tend to eat my pancakes differently than most. I have never been much of a syrup lover. Rather, I do love Grade A real maple syrup....but I like it inside my pancakes, not on top of them. I think it has to do with my intense dislike of mushy-ness. Its the same reason I am grossed out when my friends want to pour milk on top of their brownies or birthday cake. Its just WRONG!

At least in my book.

Noah also loves pancakes and since I have always only given them to him the way I like them I have never had to cleanup after a syrupy mess.

But, that's not to say there aren't any other messes to tend to...

Case in point....random pancake stonehenges

Arranged by this little fellow here.

Let the messing begin!

The Pancake Noanado leaves destruction in his path.

All in all, I can deal with some pancake cleanup...especially after the tough couple weeks this poor kid has lived through. If constructing and destroying pancake towers on the floor brings him this much happiness (and he actually eats at least one whole pancake) I can live with my duty as cleanup crew with my good friend Mr. Hoover.

Because, sometimes... you just have to pick your battles.