Intellectual Disability

The cognitive evaluation showed Kiran to have an intellectual disability. He tested at the moderate level but due to his young age, the psychologist put mild intellectual disability as his official diagnosis at this time. His observations and our questionnaire assessment both matched really well, and he said Kiran is currently at about a 6-7 month old level cognitively.

6-7 month old.  This was not only incredibly hard to hear – when asked before we started, I guiltily placed Kiran at about a 1 year old level – but I don’t fully buy into it.  Kiran’s global delays definitely factor into the way these assessments are written.  He understands far more than a 6-7 month old.  But I also understand why the assessments would place him in that age range.

He wants to see him again in two years. He expected to see delays, given the MRI results, but he (and my screaming internal voice) was still asking the question why?  Why is his brain developing this way?  Why isn’t he learning more quickly?

Why, indeed.  All we can do is keep moving forward and hope to learn more.

I am currently in stoic mode around this.  The best part?  He is still Kiran.  I truly feel like I can take any diagnosis in stride, as long as he never receives a terminal one.

He’s not yet three.  He is learning and progressing in every area – slow and steady.  According to the summary report, this intelligence evaluation “indicates Kiran requires a lot more assistance with learning and daily life activities.”  Guys.  I didn’t need to go all the way to Iowa City to know this.

But.  This gives us more information as we approach the changes coming in just a couple short months.  And it gives us the official evaluation document we need once a spot opens up for Kiran on the intellectual disability waiver.  So it was a necessary step – and another piece to the puzzle that is Kiran.

It’s a long road ahead, but we journey together.

 

 

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Avoidance

I seem to be in deep denial about Kiran’s appointment tomorrow. I keep pushing it out of my mind – and even now, while lying in bed thinking about the week – I seem to glaze over the fact tomorrow will, in fact, be an Iowa City day.

Kiran is getting a cognitive evaluation done tomorrow at the Center for Disabilities and Development.

I have no idea what to expect.

How do you assess cognitive ability for a developmentally delayed not-yet-3-year-old?

I know enough to know the results will hurt this mama heart deeply.  I know it will bring the all-familiar grief cycle back to the beginning again.

I also know, in my heart of hearts, the results don’t matter. They don’t add or subtract from Kiran’s value in any way. Nor do they change who he is and what he brings, not only to my world but to all who know him.

But man, I dread and push off and deny tomorrow is here. I am not looking forward to it.

Groceries

I seem to be living on the verge of tears lately.  This week, the wheelchair, feeding, constipation, this life … has been overwhelming me.

I am currently sitting in a running car, Kiran chewing on his keys in the backseat, tears streaming down my face, in the library parking lot.

Why?  Because we need to go to Hy-Vee, and while I was lifting his wheelchair into the back, it occurred to me the random bruises on my arm are, indeed, due to the way I lift his chair.  And then I couldn’t stop crying.

This life is bruising me, and it is leaving me tender.

How do you tell someone who is reaching out to you – who wants to be a friend to you – that you have no idea how to even socialize anymore?  That most times, you feel so alone in this life, your throat physically hurts from the need to scream?  How do you help someone who knows nothing of this world understand what it is like on the daily?  Without sounding … like this?

Without making them feel pity for you or making them uncomfortable…. WITH finding common ground somewhere, somehow, when you can’t think of how anything could possibly be the same?

And yet.  A six year old, daughter of a classmate of mine, peppered me with questions about Kiran today.  It has kept me thinking all day.  Because I am in tears, constantly, thinking about whether or not Kiran will have friends when he goes to preschool.  What will that friendship look like?  How can I help him facilitate this important piece of his life?

Here is what I think the 3 and 4 year olds need to know: He has a special heart and a special brain.  He is different.  He gets around in his special chair (look at the cool light up wheels!), and he has different ways of talking to you.  But you know what?  He likes to clap – like you!  He likes to laugh – like you!  He likes music – do you?  And he likes friends, like you.

And that’s the best I can do for him.

Right now, for me?  I want what I can’t have.  I want someone to tell me this wheelchair transport business gets easier.  It will.  But as it does, other aspects of life will be getting harder.  I want someone to tell me Kiran will eventually not need the chair or an alternate way to communicate.  It’s possible.  But none of us can predict it with any certainty.

I want to feel normal.  I don’t lead a normal life.  But Kiran simply sees that that continues – I have never felt normal, so it’s not as if I’m missing something that once was.

I am just struggling.  Today.  This week.

But we will make it to Hy-Vee.

 

Dream Car

Three weeks was more than long enough to have to fold and unfold Kiran’s wheelchair every time we went somewhere.  The Mini Countryman is a small car.  It is also a leased car that has to go back in early October.  The seat to the wheelchair had to sit in the backseat next to Kiran, while the frame fit in the very back.  With all of that, plus Kiran, plus his diaper bag, car toy basket, etc in the car, we had to be very creative to fit things like, you know, groceries in there too!

For those who don’t know, my dad loves researching and looking at vehicles.  He had been doing so for several months, and we had had many conversations about what I would be looking for when the time came.  A couple weeks ago, after looking at a Honda Element in person – and figuring out the wheelchair does fit in the back, fully together and upright – I decided for sure that was the vehicle I wanted.

Interesting life twist.  During my senior year of college, the car I had bought at 15 was no longer proving reliable.  My parents encouraged me to buy a new car.  I LOVED the Honda Element.  A new one was waaaaay out of my price range.  I went with the next best thing: a Scion xB.  I don’t know what it is, but I love a boxy car.  So now, more years later than I want to admit, I have purchased my dream car.

I mean, maybe not exactly.  It’s black.  It’s not a fun color.  And it’s a 2011, so it’s not anywhere near new.  But it is a car I have always loved – AND it is working really well for Kiran and me.  I no longer have to bend down to put him in his carseat.  The back opens up like the back of a pickup, so it makes it easier to lift the wheelchair in and out.  And – from home to car to anywhere accessible and back to home – I DON’T HAVE TO TAKE APART AND FOLD THE WHEELCHAIR ANYMORE!!!

(An Aside: I just realized I never bragged on my dad for this.  We got the wheelchair on a Wednesday.  Two days later, that Friday, my dad took the day off and built a ramp up to the front door, so we could easily get in and out of the house.  Kiran and I are so, so loved, and we appreciate this more than I can say!)

It was a good decision.  I am definitely still getting used to its size (the Mini is tiny in comparison), and gas costs are going to increase a bit…but ultimately, this should prove to be a good, reliable around-town car for us.  Ultimately, I feel good about it.  It feels good to move forward in ways that make our reality just a little bit easier, and this vehicle certainly does that, on a daily basis.

All Good News

Appointment days like today are always tiring. But man, it is so worth it when all the news is good news.

We were hoping to say goodbye to one specialist today. Technically, we did, because she is leaving Iowa city. However, Kiran will still need to be followed by endocrinology to assess pituitary gland function. We watch this due to his optic nerve hypoplasia (small optic nerve). So far, all of his labs have come back normal, and we have no concerns. Hoping to hear the same in a few days about the labs he had drawn today.  We thought we might get to be done with this specialist because his brain MRI showed the pituitary gland is structurally normal, but we learned today that isn’t an accurate indicator of proper function.  So, we remain monitored – but we get to go to a year here, too, instead of every six months.

Kiran’s echo went really well, and we now know to always request Roger.  We have had him twice as our echo tech, with someone else in between.  Roger is a calming presence and has abundant patience.  It made a huge difference with how at ease Kiran was, and he was a rockstar throughout.  Roger also takes more time to explain what we are seeing than any other (save one) tech we have ever had.

Cardiology.  Not only did we get our year card, but Dr R feels with what he has seen, Kiran may be years away from surgery.  Like – when Arif said he was hoping for second or third grade, Dr R said he was hoping for even longer than that!  The initial age we were given as a possibility was five, so I will take third grade, hands down!  Of course, this isn’t set in stone by any means – things can and do change – but wow, what great news about the stability of Kiran’s heart function!

Getting labs drawn always breaks my heart, and today was no different.  We requested the j-tip, which is lidocaine administered without a needle. It is basically injected through the skin using a forceful puff of air – best explanation I can give. It’s fairly new at the hospital, but Kiran has had it one time before, when putting an IV in for his MRI.  It seems to work well for him, numbing the skin before having blood taken.  He still cried and sweat a bit – poor turkey – that continues to be the hardest thing.  Kiran is not a big crier, so it tugs hard at the heartstrings when he does.

Kiran’s feet looked really good, and we asked the orthopedic surgeon if he had any concerns about his hips.  Clinically, he felt his hips had good range of motion and flexibility, and he had no concerns.  This dates back to the developmental pediatrician at the CDD telling us three months ago that she had concerns about one of his hips possibly being out of socket or misaligned somehow.  Given both his physical therapists and now his orthopedist have checked him out and do not share this concern, we feel we do not need to follow up with a hip x-ray.  Always good to knock one concern off the list.

All in all, what an exciting day!  We have been so lucky to not have any medical concerns with Kiran for a good length of time now, and it seems that continues to be the trend. So we just keep trucking along, doing what we do.

We are back in Iowa city, at the Center for Disabilities and Development, later this month for Kiran’s cognitive evaluation. In September, we come twice: once for his regular feeding clinic follow-up and once for genetic counseling and testing.

In October, we meet with the neurologist. This will be our first appointment with one, due to the results of his brain MRI. A big reason we were hopeful to be done with one speciality (endocrinology), but no such luck. So, we just add another specialist onto his list of many.

In November, we follow up with genetics. This appointment may change due to the testing schedule. December is genetic eye doctor. And January is another visit to the CDD for the Neurodevelopmental Clinic.

It feels like a lot right now. May they all bring good news – and more knowledge – like today.

This. Is. Big.

WE GOT OUR YEAR CARD!!!!!

I will update more later, but the big news of this morning is we get to go one full year before seeing cardiology again. Kiran’s pressures and heart function all looked great, with little change from January.

Huge. I cannot believe how far we have come.  So thankful his surgery was so successful, and his heart function has been near-normal for almost two years now!