Granite School District – Patrick Hoopes

Potty training and post-traumatic stress

“Scripture says, ‘Search diligently, pray always, and be believing, and all things shall work together for your good.’ This doesn’t mean all things are good, but for the meek and faithful, things—both positive and negative—work together for good, and the timing is the Lord’s.” – Neall F. Marriott, Yielding Our Hearts to God

I thought that having Patrick back in school would open up much more free time for things like blogging than it has. However, life is just as busy now as it was before. If not more.

At first it wasn’t. At first, I kind of wandered aimlessly through the days that Patrick was away. I didn’t recognize at first what was happening. I was watching an awful lot of Netflix and I was trying to catch up on things around the house. But I was pretty darn tired and pretty darn disorganized and wasn’t getting through nearly as much as I hoped I would each day. Looking back, I realize that I needed a chance to just reclaim my life a little bit after being a full-time caregiver for a year. I also had to trust that I had enough control over my own life to dare try to do more than these things.

Looking back, it took a lot to teach myself to slow down after transplant. To be ok with days spent sitting in a hospital room or in the Ronald McDonald House just taking care of Patrick. And now that I have the ability to do more, it took a lot to teach myself again that it was ok to NOT just pass the day with as little on my personal to-do list as possible.

That isn’t to say that I’m back to working on my personal to-do list. No, Patrick still commands my schedule right now.

A couple of weeks ago, we went to Parent Teacher Conferences at the school. Patrick is doing great with school overall. I’ve never seen him so well-behaved and engaged in a class. He is making friends. He sits in his seat and he raises his hand. He is making progress in reading, in math (where it turns out that going back and teaching the fundamentals is helping him to be less frustrated), and even in writing despite his severely limited fine motor skills.

However, his qualms about the school bathroom were just getting worse. He went from holding it all day to having accidents. Every day. And then to beginning to have accidents on the weekend at home because he forgot that he was wearing underwear and supposed to make it to the potty.

So, at parent teacher conference, I told the teacher I’d like to take away his pull-ups. However, the district has made the very sucky decision to save money by making special education class sizes almost as big as regular classes. There are 16 kids now in the class that was 9 students when Patrick joined it. Only instead of 16 typical kids, these are 16 kids with learning disabilities and behavioral and medical needs that have to be attended to. I can’t even imagine trying to manage 16 IEP’s. Thanks Granite School District.

And the message I was getting about potty training was: we’d love to help, but what can we do? We can’t afford to send adults out of the classroom.

And so, if I was going to ask to take pull-ups away, I also needed to offer help. Ok. You’re right. I’m under no legal obligation to help. But if I want to do this the right way, to have Patrick succeed, etc.. then I do.

So, for the past 2 weeks I have been meeting Patrick and his class immediately following their lunch recess to help to take Patrick to the potty. At first it went great. Patrick tried when I helped him and, even though it took a lot for him to get the courage, even went with his aide in the room (and me holding his hand.) I set up a super awesome “potty steps” reward system where I put pictures of each of the steps of going to the bathroom on a pill box and put rewards inside for him to earn.

Meanwhile, I helped in the classroom a little. I assisted at recess so lunches could happen on a field trip day. I organized a bookshelf. I helped some kids who stayed in from recess to finish up homework.

The second week, though, I think he figured out that I’d end up staying longer if I was still waiting to help take him to the bathroom. And so he waits longer to go. He waits until a moment where his aide is either gone or busy so I end up taking him alone. And so now we’re reinventing things again. It’s very frustrating. There was one particular day where I kind of just sat in the corner and waited for him for several hours. Finally recess rolled around and he still wouldn’t go so I didn’t go with him. I went and sat at the office and waited. And tears started to come and I had to step outside to calm down. He didn’t go at school that day at all. I ended up putting him back in a pull-up and leaving.

But as I sat in my car reading my scriptures, I ended up reading about patience in weakness. And I realized that that is what this is. Just weakness. Just a human struggle. Just and example of the purpose of mortality. And a temporary one at that. And the Savior’s love kind of healed my heart and gave me a great big dose of long-suffering to go along with this struggle. And we’re still at it.

There are some good things about this plan. It’s snapped me out of my Netflix daze. I only have 3 hours in the morning to get things done before I have to eat lunch and get to the school. So I’m actually working in my time at home instead of puttering around. Also, because I’m trying to leave the school by 2:30 most days even though school isn’t over till 3:30, it has given me a dedicated hour for scripture study and for a daily walk. Both of these goals are easier when I know what time of day I’m doing them. Sure, once weather gets bad, it won’t be as pleasant to leave the school and go find a spot to walk and read.. But we’ll cross that bridge when we get to it.

Seeing this is going to be a long-term process, I asked and asked if I could be more useful at the school. And starting next week, I’m going to start helping with a reading group in a different classroom. This frees me up so I’m not hovering over Patrick but keeps me nearby for the daily “do you need to go yet?” standoff.

I hope someday that Patrick will forgive me for blogging about it.

I’ve mentioned before that I have started to go to therapy. And we’ve been talking a lot lately about PTSD. Our whole family struggles with this to some degree.

The thing about living with a trauma is that words can’t capture it for anyone else. But it becomes a part of who you are on a very deep level. I know that there are some people who don’t like to hear me say that Patrick’s transplant was traumatic. How can a miracle be traumatic? But in a very real way, it was.

One little phone call. We left home. We left friends and family. We left work and school. We left everything routine in our lives. We lived for months under constant threat, never knowing what new life-threatening medical issue might arise. Patrick suffered intense ongoing pain. For a child, that is impossible to comprehend. As a parent, that is one of the worst experiences you can live through. It was temporary.. but that doesn’t diminish how hard it was.

And transplant was only the worst of it. We’ve been living with a miniaturized version of it for years.

Facebook has launched a new “memories” feature that shows me, daily, my previous posts from the past 6 years. For two weeks in September, my daily “memories” were of Patrick in the hospital recovering from surgeries or fighting off infections or praying we’d get one more central line in. No wonder I was an anxious, depressed basket case at the start of September. My body has been taught to brace for a fight when that month rolls around.

I’ve also been working this past few weeks on Patrick’s annual birthday video. I sift through a year’s worth of photos and try to pick the ones that tell the story of his last year best.

Last year, I was 6 months late completing this project as I couldn’t stand to look at pictures of the life that we had left behind when we went for transplant. I had to wait till we were starting to see hints of that life coming back.

But this time around. Oh golly. Looking at these pictures has brought back a flood of memories that I had, quite literally, blocked from my memory. Your mind does that. It compartmentalizes the hard stuff so you only pull it out and look at it when you need it.

I have found myself for the past 2 weeks waking up in the middle of the night with vivid memories of the months following transplant. At first, just our hotel room. The carpet. The sink. Then I could remember the ICU. It really shook me. To remember how afraid I was. How much pain Patrick was in. But as I’ve worked, I have also remembered the amazing support we received from friends and family and strangers alike. The feelings of love. And the sweet comfort from the Holy Ghost telling us this was all in God’s plan and would be ok. And it’s brought me peace again.

I’ll apologize now. When I publish this video. It’s long because I didn’t know what parts of the story to leave out. And it makes me cry every time I look at it.

Anyway – all of this. Where am I going with it? Well, it’s much easier to be patient with Patrick when I look back and realize what he’s come through this year. Not just offering it as an excuse as I started out doing.. but genuinely seeing what he’s been through.

In just one year, he’s learned to walk again. He has learned to eat for the first time. He has learned to go to the potty. He has learned to read. He has learned to do basic math. He has learned to speak in clear sentences. He has learned how to strike up a conversation with an adult (usually about their car). He has learned to not be afraid in the water. He has learned to live without a line. How to drink enough water in the day. He is learning how to be safe while being independent, how to play with other children in the front yard, how to play in a different room than me. He has learned how to wash his own hair and get out of the tub when he is done bathing. If he’s a little bit shy and a little bit afraid doing only one of those new things without his mommy (who he was with 24/7 for most of the past year).. that’s really pretty darn good. And he is really pretty darn amazing.

One other thing. Patrick had a doctor cancel an appointment a month ago when she had to go for an emergency appendectomy. It hadn’t occurred to him before that grown-ups might have had surgeries too. In fact, he’s discovering that many grown-ups have been through surgeries. So if he strikes up a conversation by asking you where you had your surgery, know that he is trying to put his experience into context with other people. Trying to find some common ground with his very uncommon experience.

The conversation usually goes like this: “Where you have your surgery?” You answer with whatever general body part and little more explanation required. He might ask “Did it hurt? Did you cry?” You probably will say it hurt. Then he might tell you, “Mommy have hers in her belly button.” I had a laproscopy to diagnose and treat my endometriosis. You give some affirmation. Eventually he’ll say. “I have my surgery on my WHOLE body.” I usually answer with something like, “Yes you did. You were brave and it helped to make you strong.” Something like that.

In another variant, he might tell you it’s ok to be different. To be mad. To be sad. To talk about your feelings. To be missing teeth. (He’s got two missing and a third wiggy right now.) To be a different color. To be bald. To be “indopted.” And he might tell you it’s ok to eat mac and cheese in the bathtub. That’s all a reference to a book by Todd Parr that he’s been reading about why it’s ok to be different. Just laugh along. It’s also ok to have a pet worm.

Transplant Day 290 and the Back to School Meeting

Today was insane. Brian and I woke up before Patrick, a rare occasion, and were lying in bed talking (we’ve missed each other) when the power went out. And then, a few minutes later we heard sirens. And, well, we hoped it wasn’t but we suspected that a car accident had knocked out the power. We live in a quiet neighborhood, but it’s near some busy streets. And this morning, somehow a traffic accident took down two power poles. Across the street form each other. The power was out all day.

Not the smoothest start, but we pushed on. It was a big and busy day and I needed to make the most of it. So, after sending Daddy off to work, Patrick and I got ready to go do a little more shopping. We still needed some things for school to start. And then we hurried home to meet my sister.

i ended up with 3 big things scheduled today. An allergist appointment, a school meeting, and a speech evaluation. My sister Marcy agreed to tag along for the day to help keep Patrick happy while I did the talking that needed to be done. Patrick doesn’t like us to talk about him.

Well, we got to the allergist and went to check in and they couldn’t find the appointment. Finally they looked it up and told me that it wasn’t until the following day. I explained that I had come at the time told to me and that I couldn’t come the next day because Patrick was in school. They tried to find a way to fit us in.. but with other meetings we couldn’t swing it.

I was disappointed because i really want help sorting out these new allergy test results. They revealed new allergies. They also hint that Patrick might be outgrowing his milk allergy. And I don’t know what comes next. But it had to wait for another day.

We went and grabbed lunch and then headed to a park. Patrick was seeming restless. But we sat down to eat only to discover that Arby’s had put cheese on Patrick’s roast beef sandwich. And with no answers from the allergist, I had to pick out the pieces he could eat. Frustrating.

Anyway – Patrick made a friend and the time at the park was fun enough. And then we went off to meet with the school.

I can’t really describe what school meetings for Patrick look like. This one was packed. We had the teacher, OT, PT, principal, nurse, district special education liason, and two other very big district big wigs over special accommodations in the school. Plus Patrick, me and Marcy.

As I mentioned before, I had talked to Patrick’s teacher and nurse the week before. The teacher and I talked at length about medical accommodations. She was very worried because Patrick needs extra supervision at recess, lunch, and especially with the potty and she just doesn’t have enough adults in her classroom to help with that. Especially since they added 5 kids to the class since last I’d heard. I told her I’d been promised extra help and she asked me how far I was willing to go to make that happen. I started writing e-mails that day. And I got promises that the district would send help to the meeting. (Enter the district big wigs.)

When I talked to the nurse, again, when we started talking about medical needs he said that it sounded like we didn’t have enough support. I told him that we had been promised extra help from an aide and I didn’t know how to make that happen. I gave him some names that I had of people who had made decision and promises. And he said he’d make some calls.

Yesterday morning, I got a call from the district nurse who was helping with Patrick’s school transition. She explained to met that, in fact, she had helped request an aide for Patrick and told me the language to use to make sure that one was provided. And she promised to call around and find specifics.

And so today we sat down and i started to go over Patrick’s needs and I brought up the concern that there wasn’t enough support in the classroom… and the district special resources person told the principal that they had 22 extra aide hours per week for Patrick. Her response was a mix of frustration and relief. Glad for the resources but not so much for needing to produce this extra employee for school to start the next morning. I can’t blame her for being upset. I’m upset that it took a meeting when I’ve been asking about it for a month. But I’m also partly to blame for taking so long to choose a school.

We went over medical needs. The nurse was really outspoken and trying his best to help. We talked about where Patrick should sit and lunch. (End of the table with friends with safe lunches next to him.) We decided we needed to set a time to train the classroom staff. Only with school starting, he didn’t think we could fit that in right away. We decided to let Patrick come 10 minutes late to school and miss breakfast. I explained that hands have to be washed with soap and water, not just hand sanitizer which created a fuss about the bathrooms always being out of soap. I offered to provide soap for the classroom. And the district rep jumped in and said I couldn’t do that and promised to remedy the situation.

We talked about potty training. That was one of the teacher’s biggest worries. I don’t blame her. It’s a huge time commitment. Especially with Patrick. I guess there are two kids potty training which makes things even more complicated. Also, the private bathroom I was excited about turns out to be in the school’s “sick room.” I was SO grateful when someone else spoke up and said that wouldn’t work. Not sure that we actually ended up with a resolution, though. They talked about making the school move the sick room. They talked about offering to install a changing table in the bathrooms that are being remodeled, too. We decided to let Patrick wear pull-ups to school while we work it out.

We planned to hold a new IEP meeting in October, once they’ve had a month to get to know Patrick. And we talked about including or re-including some new things at that time like restarting physical therapy and calling in the augmentative team to look at some assistive technology for writing.

And then, after we talked about everything that needs to be done.. the idea was thrown out that Patrick maybe would be better off if he didn’t start school tomorrow. I didn’t know if i was relieved or crushed by that idea. Really, they aren’t ready. Really, I’m not ready. I have felt like I have been only halfway there this year. Not put together. Not giving him time to transition after all the craziness of travel. And so a few more days will let me make his backpack and his lunchbox cute and medical friendly. It will let me train the staff. It will let them try to hire help. It might give me time to figure out this new allergy questions. And to get Patrick back into a routine with eating and potty. It will let Patrick and I have a few more days at home to say goodbye to each other. And to really get him ready for the idea of school.

But I’m kind of sad. It feels kind of like when you’re on a road trip and you finally make it to a rest stop only to find out that the bathroom is closed and you’re gonna have to cross the street to the gas station. It’s only a little further, but it’s the longest, hardest part of the wait. I look around and see so many things that have just been waiting for me to get to them. And they will need to keep waiting.

I feel really bad for Patrick, too. On Sunday, all the other kids will be talking about starting school. And he will have been left a home. Again. He will miss the craziness of the first day of school. But he’ll have missed the specialness of it, too. He’ll be the different kid. The one who came late. The new kid. Again.

They asked if I’d like to come teach the kids about his allergies and immune suppression. I told them about the presentation I gave last year at the start of kindergarten. And I could see they liked the idea. So on Friday afternoon, I’ll be going in to introduce Patrick to his class. And then afterwards, we’ll meet and go over a behavior plan and schedule.

And then Monday morning, he’ll start school. I’ll stay and help the nurse train the teachers. And I’ll maybe stay to help a little more than that if they don’t have another aide by then.

And I know it’ll be good.

I think I’m just a little bit mourning normal. I want back to school to be exciting and happy. This just feels complicated.

But maybe having a few more days to regroup will accomplish that. And meanwhile, we have one last week with the girl who’s been doing Patrick’s respite. And we have a few sweet days where all the kids are in school and we might be able to sneak off and do something awesome without a crowd.

Summer school and still planning for first grade

Well, as I mentioned in my last post, Patrick has started the extended school year program. Extended school year is a funny thing in our neck of the woods. I don’t know if it works like this everywhere, but Utah has such large families and our school district is one of the most established and biggest in the state so they are very efficient in what they do.. that, well, here you don’t get extended school year in your IEP unless you have a really darn good reason for it. I’ve tried in years past and was told that it really is reserved for children whose disabilities are so severe that they wouldn’t make much progress elsewhere.

I didn’t even imagine what that meant until this last week when I dropped Patrick off in his class. Patrick was placed in the amazing medical school in our district for the summer because he is still so newly post-transplant. Unlike the school that he’s been attending which serves children with medical needs but also the local community, Hartvigsen is a dedicated medical school for the district’s most severely disabled students. What an undertaking!

There are at least a dozen buses that bring students to this school. Their teachers and aides meet them and bring them to class. There may be fewer than a dozen crazy parents like me dropping their children off at school. (I prefer to do this anyway, but really had no choice if transplant medications were going to be given exactly as ordered and on time.) I was instructed to walk Patrick into his classroom. His teacher was excitedly waiting.

It’s possible he was the only student added to that class for the summer. He was also the only student who was verbal and not in a wheelchair.

I took a deep breath, a leap of faith, and kissed him goodbye.

Meanwhile, I headed over to the office for a meeting I’d scheduled with the district representative to talk about my concerns for his placement in 1st grade. The buses were late, so my meeting was late. And I got to sit and watch the students and teachers some into the school. And I saw Patrick come meet the office staff. He was very happy.

Now, about the meeting.. I know in my heart that he’s too behind right now to be comfortable just starting in a 1st grade class. But I also have just felt unsettled about the class they proposed putting him into.

So – we talked about it. She was amazing to listen to my concerns and express solutions. I told her that I am incredibly worried about him not being challenged if he’s only taught the goals that we come up with for an IEP. That he often surprises us by mastering things beyond the skills we think he’s stuck on. Sure, he’s struggling writing his name, for example, but I discovered that he can write about 60% of the rest of the alphabet with reasonable approximation.

I’m also very worried about him socially. I know that he behaves best, learns best, participates best and is happiest when he has friends. And so I’m worried that placing him in a class where he doesn’t have typical peers to socialize with.

And as I expressed these concerns, the woman I was meeting with mentioned that she wondered if he’d do better in a different self-contained classroom. They’d suggested that he be placed in a lower functioning classroom because of low IQ test scores. However, she said, there was another class where the students were closer to normal functioning, the class followed more of a typical class schedule, etc. She tried to describe the difference to me, and then offered to take me to tour the schools and classrooms (albeit without teachers or students) in a couple of days.

Tuesday, I had a much delayed appointment with the oral surgeon who helps keep me from grinding my teeth to bits and causing crippling migraines. So Wednesday was the next day I could. Meanwhile, Tuesday I happened into a couple of conversations that proved good reconnaissance on this issue.

For one thing, Patrick’s home hospital teacher, who he has clicked so well with and learned so well from, called to check in. When I mentioned the choice of classrooms, she didn’t falter. She said that hands down, the first placement we had been offered was too low-functioning for Patrick’s abilities. She offered to call around to some of her contacts in the district and then get back to me. And she did.. giving me some names and some specific behavioral strategies that she thought I should have put into Patrick’s IEP to help him. She hinted that she thought he should get into a typical classroom as quickly as possible, too, which made me falter a bit in my thinking.

Then, that evening, I had the chance to talk to a friend of mine whose son with autism is just finishing his 6th grade year in the higher of the two programs we had talked about. She only had good things to say about his experience at the school and we had a really good conversation about transitions and self-contained classrooms. It helped a ton.

I went into Wednesday morning pretty confident about what I wanted. We toured the lower classrooms first. The school was beautiful. I loved the layout of the classrooms. It’s only 5 minutes from home. And as we stood there, I told her that I was hearing from the teacher who has had the best results with Patrick that she didn’t think he belonged there.

Then we drove out to the other school. The one that sounded like the best fit. It was a long drive and kind of hidden in the middle of a windy-road subdivision. I didn’t love the classroom. At the second school, the self-contained classrooms are in portable classrooms, a.k.a. relocatables. The room seemed run down and bare. I could imagine Patrick cowering at the sound of rain on the roof. The classroom had steep aluminum steps and the nearest bathroom is inside the school building and I could just imagine Patrick having to go up and down them in the snow to go to the bathroom every couple of hours. The custodian was very helpful, answering questions about where the kids line up, where the buses arrive, and even the morning routine. He pointed out that they have a breakfast program where all the kids eat a district-provided lunch at their desks. Most parents would be thrilled. With food allergies and oral aversion and new transplant, I’ve been worried sick about lunch. Two meals at school, and one in the classroom, really bothered me.

I’d mention concerns, and my guide would do her best to offer accommodations they could offer to make things work. And I found myself saying, well, we’ll have to do this or that and make it work.

Still as we were leaving, my district representative asked me if I wanted to just start planning for Patrick to attend the more advanced classroom in the second school.. and I told her I needed to talk to my husband and Patrick’s therapist and get back to her.

I think I know that Patrick needs a higher functioning classroom. But I so wish that I could have him closer to home in a beautiful classroom in a school that used to be the medical hub so they are wonderful at medical inclusion. And I don’t know for sure what to do about these worries. Or if I can really do anything in the middle of summer.

They tell me we can move him if we pick one school and it doesn’t work. I hate the idea of him being continually bounced around.

Meanwhile, after a week in his extended school year classroom at Hartvigsen, the principal called my helpful district representative and asked me if I’d consider moving him into a higher functioning classroom. And when I picked Patrick up Wednesday, they brought me all of his school medical supplies again. He’ll be moving to a new classroom at the school immediately next door to Hartvigsen called Plymouth Elementary. They have one class there. It has 7 students of all grades. But I’ve seen them. (They were waiting for a late bus while I was waiting for my meeting Monday) and he will fit in better there. And learn better there. He keeps asking me if his new friends will have wheelchairs. And he’ll still get to swim on Wednesdays.

Transplant day 215 and the School Placement Meeting

I find I procrastinate blogging when I am having a hard time processing something emotionally. I’m finding this subject hard to write about. This past week hard to write about. And I was kind of relieved by a brief outage in the blog that made it so I couldn’t write. But if I don’t get this down soon, then I won’t get past it to the things you want to know about. So here goes.

I’m behind in blogging and, given how much has happened, have decided to do some belated day-by-day catch-up. So in this post, you’ll be travelling back with me to June 3. The day of Patrick’s school transition meeting.

Actually, let’s back up to the day before it. On June 2, I took Patrick for his end-of-year kindergarten assessment. We got delayed leaving because it was also lab day and so we arrived with breakfast still in hand because we’d just made it. That’s ok. Patrick tests better when he’s eating.

I sat in the corner and read scriptures on my phone and half-listened. I actually feel like the test was pretty representative and that he did pretty well. It also pointed out to me how much he still struggles. He aced letters and letter sounds, starting sounds of words, and read a few sight words. When asked to write words, well, first he is only identifying parts of words. Second, writing is one of those things that his brain injury makes hard. His teacher pushed him to write starting sounds, which I was pleased with. And he showed her that he still knows pretty well. He struggled a bit with sounding out words, too. His speech delays get in the way there sometimes. But I thought he did pretty well, for him. He counted to 26, though he almost forgot 16. He counted 20 objects. And then he avoided the other math questions.

It felt like a pretty good representation of his abilities as I listened. And when it was done, his teacher kind of talked through the results with me. As expected, he’s better with literacy than math and writing is a big obstacle. She told me that she was worried that he was not going to do well in a writing-focused first grade classroom and I started to fear that I might need to think differently about what I was going to ask for in the placement meeting the next day.

Like I wrote before, the week before the nurse had given me a heads up that Patrick no longer qualifies for medical hub services and so he’d need a special exception to attend Whittier. That was my preference, though I wondered if there might be other better options I didn’t know about. I knew I didn’t think he wouldn’t do well in a typical first grade classroom in a school without support. He is so far behind the rest of the kids in his kindergarten class after this year.

So, Wednesday morning rolled around. We were combining getting ready for our trip to Nebraska that evening with getting ready for this meeting. Brian tried to sneak in a work call and it seemed that we were going to be quite late. How we managed to find time to still go pick up Dunkin’ Donuts I don’t know. But I do know that I was on the brink of a panic attack when I’d imagined doing that and then didn’t think we could. I’m not so good with change.

Anyway, we dropped Patrick with my mom and then met with the team. At first, we went over Patrick’s current abilities. Strengths and weaknesses. Learning style. Kind of went around the table and his teachers and therapists talked about what he’d accomplished in the past month and where he still needs to go.

And then it was time to let the district representative go over placement options. She offered 3: 1) Repeating kindergarten, 2) A regular first-grade classroom with an aide, and 3) a self-contained classroom called a functional academic classroom.

We’ve talked about repeating kindergarten for quite some time now. When we got home from Nebraska, it seemed inevitable. But Patrick has made a lot of progress and he’s already one of the oldest in his class and this just didn’t seem like the right choice for him.

Then the principal explained why she didn’t think a regular classroom with an aide was a good placement choice. (Please note: the principal at Whittier is one of the kindest, most concerned administrators I’ve ever met. So when she shared this, it was full of empathy and a sincere thought in Patrick’s best interest.) She expressed concern that Patrick would get frustrated with being so far behind his peers. That he’d need a lot of pull-out time. And that having an aide hovering would feel limiting and restrictive to him. Patrick’s teacher had pointed out to me that he often stopped and tried to get her to give him answers or help in his test because he is so used to it.

Then they told us about the functional academic classroom. How it provided a smaller class size and lots more adult support so they can accommodate different learning styles. How the school is closer to our home. How it used to be a medical hub, too, so the environment there is accepting and inclusive. How amazing the teacher is. How they have often sent students there to see them thrive. How some of the IEP team also works there so we would have some familiar faces willing to advocate for him.

We also talked about placement at the school by our house. They gave me lots of pros to that, as well, but I knew it wasn’t right. That he’s not ready for that.

I knew as they talked about the other classroom that they were describing what will probably be the best place for him to learn. They reassured me that being pulled out in a self-contained classroom doesn’t have to be a long-term thing. That he might only need a couple of years to make up for what he’s missed.

But then, I started to imagine Patrick and the little friends in his classroom who have loved him so sincerely. How their faces light up when they see him. How they hold hands on the playground. And I started to cry. I HATE that I cry. But, as much as I know that academically this classroom will help him, I don’t want to see him lose that acceptance and friendship. And it is a total leap of faith. (One I am having a hard time making.) to believe that starting all over again in a new school isn’t going to set him back socially. Especially if he isn’t in a regular classroom. All the inclusive activities in the world aren’t the same as being in the same class.

And besides – it means giving up the amazing people at the school Patrick’s been attending. The familiar faces. The rockstar IEP team. The sensory room and PT gym. And my little oasis next door where I’ve been walking and studying and praying while he’s in school.

So – the meeting ran a bit longer because once I had tears on my face, they were trying to comfort and reassure me. Which made me feel stupid because I know my reaction is emotional. The logical part of my brain knows what’s best here. I’m already thinking of that as his new school. But I’ve got to find a way to make sure that all the i’s are dotted and the t’s crossed to send him there. And make sure that my fears don’t rub off on him.

And once the meeting was over, we sent Brian off to a meeting at work and I went and finished packing for Nebraska. And I was completely distracted all afternoon. And we were up till 2 a.m. for reasons I’ll describe in the next post.

And I’ve stalled writing this blog post because I still feel conflicted and unresolved. And a bit guilty that I didn’t pull off more of a miracle keeping him up with his class. But here it is. And I’m gonna post this and start another right away.

Kindergarten Take 2

Yesterday, Patrick went back to school. As I said before, to help protect him and ease the transition, he’s only going to attend school part-time for the rest of this school year.

So, yesterday we headed out about 10 a.m. We stopped at the grocery store on our way to get snacks for the classroom. (Since they are instructed not to feed him anything not parent-provided or approved.) Then, since we’d had a little mishap with Patrick’s g-tube coming disconnected during the night and feeding his stuffed animals instead of him, we swung by McDonalds to get him some french fries to tide him over.

Finally, it was time to go into school. We checked in at the office. Because he’ll arrive late every day, we will check in every day. And then we headed over to the resource classroom.

His special education teacher had a little Patrick height banner in the door welcoming him back to school. It was fairly adorable and made him feel really special. While he worked with her, I sat down with his new aide to give her a little crash course on his needs.

Then, we headed over to the classroom. As we walked down the hall, a little voice shouted out, “That’s Patrick!” Followed by a little chorus of excited friends announcing “Patrick’s back!’

We were a touch earlier to Patrick’s class than he’d been expected and so we waited at the door while they cleaned up centers. All the while, little friends would sneak away to come hug him and welcome him back. Patrick was dying to go help clean up, but was obedient and waited.

Finally, they gathered at the rug and I sat down to tell them about where Patrick had been. I explained that the doctors had found a new belly for Patrick. That he’d had a transplant, which means that they took the old belly out and put in a new one. One voice chimed in, “I bet that hurt!” And I answered honestly that it did hurt. A lot! Then, I explained that Patrick doesn’t need his IV tubes anymore and is learning to eat and he told them how excited he is to be back at school with them.

We talked about washing hands and being careful about germs. Patrick’s best friend asked if having a cough meant they couldn’t sit together. So we talked about catching your coughs in your elbow.

The feeling in the room was pure excitement. I am so glad that Patrick was able to go back to this class that has so willingly accepted him and embraced him for who he is.

I left Patrick and went to talk to the school nurses and to clean out the supplies that Patrick doesn’t need anymore. And then, before I knew it, it was time to go. And hour is going to go very quickly.

Patrick’s first preschool teacher was waiting to greet him as he came out of school.

This is going to be a different phase for us. Patrick was so excited when he got home that it took a long time to get him settled to nap. When he got up, there was barely time to get dinner made. And then, because he napped late and because he was excited, he didn’t sleep again until almost midnight last night.

Short school days at a school far from home means that it doesn’t make sense for me to come home while he’s in class. I’m planning to use that time to start walking and hopefully get myself in shape a little bit.

But, it also means a minimum of an hour and a half of what used to be my most productive time of day that I don’t have anymore. And it’s going to take some adjustment for all of us to learn to get things done with this new schedule.

Tuesday especially are going to be difficult. My own version of Monday. Because they start with a nurse visit, then school, the Patrick’s home hospital teacher will still come in the afternoon.

But we’ll get there. It’s only a month of school and I can tell you, by the joy in Patrick’s face when he got up this morning, that it is worth trying to make it work. At least, if we can keep him healthy enough.

Transplant Day 180 and School

This picture was taken 6 months ago at Pumpkin and Mustache Day in Patrick’s kindergarten class. I didn’t know it then, but the Halloween parade and party the next day would also be his last day of school.

6 months ago, I tucked him into bed and then I went and wrapped up his birthday presents and I went to bed, but before I fell asleep my phone rang and our lives changed forever.

I dare say, at least as far as I can judge right now, for the better.

Today, I had an IEP meeting with Patrick’s school. Can I tell you what an amazing school he is in? They were completely behind me asking for a slow transition back into regular school. In fact, they were good with just about everything I asked them to consider. This meeting was amazing!

Here’s the gist of things. There is a month left of school and Patrick’s immune suppression goals have been adjusted down because it’s been long enough since transplant to try. And the transplant team said that about this time we ought to consider starting to ease him back into the normal life that they did the transplant to hopefully give to him.

So, after a very thorough discussion today, the decision was made to start letting Patrick attend school for an hour each school day. He’ll attend the last hour of every day. He’ll spend the first half of that time working with a special education teacher to help him to make up as much ground as possible. And then he’ll spend the last half of the day with his kindergarten class so that he can work on relearning the classroom routine and social skills. Also, once a week, I’ll bring him in a little early so that he can spend time in occupational therapy as well rebuilding his strength, working on writing and other fine motor skills, practicing eating, and so forth.

Because he’ll only be in school part time, he’ll also still qualify to work with his in-home teacher.

And, when the school year is done, he’ll take a short break, and then get to participate in the extended school year (or summer school) program this year at another medical school that is actually even a bit closer to our home.

The mood in this meeting was so positive. I genuinely believe that this team is happy that Patrick gets to come back to school and eager to help him succeed in every way that they can. How many people come out of an IEP meeting saying that?

That doesn’t mean that his IEP meetings aren’t still intense. There is a lot to coordinate and I am constantly amazed at the efficiency with which they run these meetings. (Also, with their stamina to do so many back to back to back at this time of year. They had already done several that morning with several more to go.) We made plans for how to drop Patrick off and what to do if classmates are sick and an aide to be with him in the classroom and what physical activities he can participate in and what to do when he needs to stay home and how to make sure that he gets the absolute most bang for the buck out of his hour a day at school.

For the rest of this school year, they’ll be reimplementing the amazing IEP that they wrote for him the week of his transplant. Then we will reconvene in a month to figure out where he is on his goals and what the best plan for school next fall will be.

The most amazing part? I thought we’d be waiting a week or two more for medication changes but the team in Nebraska says that because he kept swinging too high, they brought his dose down and he’s already there. That doesn’t mean he’s not immunocompromised. But this is about the best it’s gonna get for a while and so we might as well let him live.

We are taking the next few days as a family to celebrate Patrick’s 6 month transplantiversary and half-birthday (because, face it, transplant is an awesome birthday gift but a sucky birthday party.)

And then on Monday, Patrick starts school.

I’m trying to wrap my mind around gathering all of the supplies, emergency plans, paperwork and other little details I need to have ready by Monday at 10:45 a.m. I’m hoping this is as good of an idea as it sounds. That he has the strength. That he can stay healthy.

It’s strange to think that a month ago, I answered a phone call and our lives stopped and reset.

And now, 6 months later..to the day.. we’re trying to kickstart life again.

Patrick is bouncing off the walls excited.

Kindergarten – untraditionally

It’s a quiet snowy afternoon and seems like time for an update. This is a busy week comparatively for us. With spring break over, Patrick’s back to a regular schedule with his home hospital school. In this district, they have assigned him a teacher for 2 hours a week. She comes one day a week on Tuesday afternoon and stays and works for 2 hours.

When I heard that schedule I was actually really upset. We had 3 hours a week scheduled as 3 one-hour sessions when we were in Nebraska. Patrick rarely stayed on task for the whole hour. We often didn’t get all 3 sessions in. And I really wondered if this schedule could possibly work.

I would never have expected how well this would work. Ms. Emily is a special education teacher in a “behavioral” classroom in another elementary school in the district. That means that it’s no longer just me with strategies to keep Patrick on task. His teacher is really good at finding a balance between pushing him to do hard things and finding ways to turn breaks into educational opportunities or “teaching play.” It’s teaching Patrick to ask for a break when he feels overwhelmed or frustrated and that is a skill that will go a long way for him.

I really worried about the long sessions, but she’s good at keeping a variety. Patrick earns the chance to play educational games on her iPad when when he completes more challenging work and that seems to make the time pass. (And gives us moments where she stops and teaches me ways to work on the same skills at home.)

I think the best thing, though, is that she is bringing me tools that actually are helping me to make good use of the time I spend teaching Patrick. Not that I wasn’t doing my best before. Thank goodness for the resources of the internet or Patrick would have been much further behind. But there is something to be said for materials prepared by a professional educator for your child’s needs.

For example, she brought me a stack of sight word flashcards. They are printed on goldenrod yellow paper which she says is the color our minds learn best reading from. Patrick was pretty resistant to these when she first used them to try to test his knowledge. But she started to plant the idea of sounding out words to him and pointed out a few sight words that he could use that skill on. Patrick and I sat down that week to run through the cards and before I knew it, Patrick was figuring out words by sounding them out, and asking me for more cards to work with.

He is practicing with about 20 sight words cards right now, most of which he’s mastered at a glance. As he gets good at these, we just add a few more in at a time and soon he’ll have that whole stack memorized. She added to that showing me how to use some touch prompts on his arm to help him sound out and blend words together and he’s really starting to be good at reading most any CVC word, new or not.

In the same session, she gave me a stack of worksheets that she’d cut out of a handwriting notebook. And two plastic page protectors. I really doubted this one… but as it turns out, Patrick is totally in love with this particular workbook. I looked online to just get a copy of it and it’s about $100 off the shelf. Basically, it’s pages where he practices tracing numbers. But it has just the right mix of activities that catches his interest. Trace a number 6 times and then practice drawing that many pictures of a totally simple object for a kid to draw, for example. Who knew Patrick would love drawing suns and balloons and candy canes? And on the other side? We practice counting and patterning. I really need to make it to a teaching supply store and get some tanagrams and counters to match the workbook.. But he doesn’t seem notice they’re missing so far.

This work has been reinforced by another little bonus this school district threw in. To honor Patrick’s IEP, they send an occupational therapist out to work with him for 20 minutes a week. 20 minute, again, sounds like nothing. I feel bad for the therapist who devotes 2 times as much driving as she spends teaching. But her support in handwriting and other fine motor activities has taught us a few helpful things like labeling the lines on Patrick’s page with sky, flowers and grass that help him fit his writing within the lines. And because the therapist comes from the school he used to attend, she brings along familiar things that he worked with before that really make him happy and willing to work.

The grand sum total of this is that instead of spending time hunting for curriculum for Patrick, I’m given tools to work with and all the time that I can fit in for school work is spent working and Patrick’s making good gains.

The more I see how things are being done right here, the more convinced I am that things were done very, very wrongly by Omaha Public Schools. Patrick’s teacher was a sweetheart who really meant well. But I’m certain that several of the rules governing special education were broken. I can tell you I certainly will do things differently if I ever have to work with that school district again.

The upside is that things are good here. It’s still a struggle. Patrick is a little bit TV addicted right now and he isn’t always happy when I pull him away to work. But only at first. He’s always happy once we get started.

And we especially struggle on the days that Patrick doesn’t feel as well. We finally finished the 2 week course of antibiotics. It is so nice to only have to get up to refill formula, not to wake up and stay awake to try to give antibiotics. It took a few days to get Patrick past the insomnia that giving him Benadryl every time he woke up was causing. But finally, the family is getting a little better sleep and that helps all of us do better.

Sadly, though, allergy season hit just as Patrick came off of the Benadryl. He had some hayfever symptoms those first couple of days. Or at least, that’s what we thought was going on. Two evenings ago, Patrick started to sound stuffy, too. By yesterday morning, he was sounding pretty congested. Of course, there was also this massive wind-storm that came through and I thought that was to blame. Then, overnight, it snowed. 6 inches. It has snowed all day today. And Patrick isn’t breathing better with the air cleared out.

We had an appointment with his GI and an intro appointment with the liver transplant clinic today, too. I took him, masked. And his doctor thinks this is likely a virus.. so far, he doesn’t think it’s anything overly concerning. (Though I guess we are watching in case his immune suppression causes a latent virus in his body to get worse. But they don’t think that’s it. It’s more likely he caught something over the weekend when we splurged a bit to spend time with family.) Anyway – so far, we are just supposed to keep a watchful eye. Patrick isn’t horribly sick or getting worse. He’s not running fevers. His oxygenation isn’t the best while he sleeps, but humidifiers seem to help with that. And he sounds pretty cute when his little voice gets croaky and cuts out.

Otherwise, it was a productive appointment. It is actually kind of comforting to know that Patrick’s been assigned a transplant nurse coordinator here in town who can get us a doctor quickly is Patrick needed things. They’ll also be watching Patrick’s weekly labs and making phone calls to doctors, the Nebraska transplant team, and us if anything looks off.

Dr. Jackson and I talked about getting orders in place for Patrick to be able to go back to school part-time. He needs to write a letter summarizing what Patrick’s medical and nursing needs will be as he goes back to school. So we talked about my goals and how what he wrote could help with those. He said would recommend for nursing support for Patrick because, as he put it, a multivisceral transplant makes him “one of the most complex patients in the valley.” I wonder how the district will interpret this. I’ve been trying to get an appointment to talk about and plan for Patrick to transition back to school and need this doctor’s letter first because the district trying to figure out what services he needs to attend school and where he’ll go that those can be offered.

Anyway – in brief summary, this is what the school year is looking at right now at our house.

With a lot of Bob the Builder in the background. Patrick rediscovered Bob the Builder this week. He is thrilled to find that he already owns Bob the Builder toys. He doesn’t remember this was his favorite show when he was 2.

I’m trying to figure out how to make Bob the Builder do math. Surely that would increase the incentive and willingness to work at it. Patrick hates math because counting is boring. (And hard in the midst of his ADHD and brain injury.)

Oh, P.S. As I cleaned off my car this morning, I was pretty sure that that much snow overnight would have shut down Nebraska school. Kudos to Utahns for being hard-core in all sorts of weather.