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Category Archives: KennedyKrieger

Baltimore bound… again!

Living 3-5 hours from Baltimore, you’d think that I would have been there many times in my 28 years– they have an amazing aquarium and the inner harbor has shopping, museums, and quite a few activities for families. My first trip to Baltimore, however, was in 2009. I was a few months pregnant with Killian and Ben, his dad and I took the girls for a day trip. We went to the aquarium, rode on the dragon boats, and visited the Maryland Science Center.

The girls looking out of the aquarium into the harbor.

This year, I’ve been twice.

First in April when I took the kids on a road trip to Vermont. We stopped for an overnight in Baltimore on the way back after stopping in New Jersey to visit Carlo’s Bakery (Cake Boss). Before heading home the next morning, we went to the Inner Harbor and visited the American Visionary Art Museum¬†(this is a must see if you have kiddos!).

At the American Visionary Art Museum

Then last week when Marley, Killian, and I went to Kennedy Krieger to meet Dr. Tierney (&Alli!) to get Marley diagnosed. I didn’t get many pics (other than in the hotel room), but it was still an interesting trip even though we weren’t able to visit the Inner Harbor again. I did find it interesting though, that the cake I made that weekend for a friend’s son was a Baltimore Orioles Baseball cap! It brought back great memories from elementary school– Johnny Oates was my substitute gym teacher and on his last day, he brought us each a signed photo card. I realized that I still had it tucked away, and as much as Baltimore is beginning to be a part of our life, baseball isn’t… so I gifted it to the birthday boy with his cake. I’m not sure who was more excited– him or his dad!

 

 

 

I found out yesterday that we are scheduled for our third trip this year. As I was working to finish yesterday’s post, I received a call from Dr. Deepa Menon. We are scheduled to meet her on 11/21/11. I have decided to leave Killian home with Ben while Marley and I make the trip. It was a tough decision, but Killian has been doing much better lately (allowing Ben to put him to sleep and comfort him, etc.).

I’ve been looking back through Marley’s medical records, cursing myself for being such a ‘relaxed’ mom when it came to milestones– I’m still like that, of course, but I see the value in documenting them now even if you don’t keep track of if the kiddo is ‘early’/’on time’/’late’. I’ve been looking through her seizure videos and will likely end up posting them in an entry soon just to have them all in one place.

I honestly do not know what I have done to reap such blessings as I have lately– the doctors we are meeting and the evaluations we are having done are typically not without a considerable wait and great cost.

Ten days away from more answers….

“Well at least you know…” Part 2

“When can I get my blood shot?”

“Is it time for my blood shot yet?”

“Can we get my blood shot now?!”

Never in my life would I imagine that I would have a child who was so intent on having labwork done. I had been honest and upfront with Marley about what to expect at our evaluation appointment. I let her know that the doctor would be checking her blood for cholesterol. She needed to know exactly how that would happen, so I showed her some phlebotomy diagrams and instructional videos on YouTube. She was able to see the vacutainer, butterfly needle, cleaning procedure, etc. shown step by step. It seemed to calm her fear that the tech would hit her bone.

For days before we left she would ask if it was time for her ‘blood shot’ yet. Done with hearing “soon” or “tomorrow”, on the way to Fredericksburg to stop for dinner she asked if we were getting the ‘blood shot’ that night when we arrived in Baltimore. In an attempt to avoid a meltdown over this (again), I told her that it was really late but that I would call the hospital when we left and see if they were still open.

Yes, I lied to her. I had tried unsuccessfully to explain it to her, and I’d like to think that overall I do a pretty good job of keeping her in the loop and answering any questions she throws at me. At this point, though, I was exhausted and no matter how many times I told her when the blood draw would happen she is not the best with timelines.

As we got down the road, she would ask once more. I told her that I would call, but that it was late so they may be closed. She then surprised me. “If they are closed, do we get to go to the hotel first?”, she asked. I told her yes, and asked if that is what she wanted to do. She said yes, that she wanted to get to the hotel, but that I should still call the hospital first. I breathed a sigh of relief– it’s so much easier when she’s on board!

From the moment she woke up the next morning, she was again fixated on the blood draw. She kept repeating her phrases over and over, despite being told ‘later’ or ‘soon’ or just plain being tuned out as the first doctor spoke with me. When it was finally time to go to the lab, Alli walked us down. Marley was excited to take a ‘secret tunnel’ Alli showed us which was painted in an underwater themed mural. She ran slightly ahead and pointed out animals along the way.

Once in the lab area, Marley and Killian played for a bit before it was time for Marley to go in. She jumped right up on the stool and thrust her arm out. The tech was surprised and suggested that Mo sit on my lap to be a bit more comfortable. When the latex band went on, she was not impressed. Knowing that ‘tight’ frustrates her, I had prepared her for the fact that this would be tight on her arm but that it is not on for long. In retrospect, maybe I should have tried to show her by a quick visit to our pediatrician’s office for a ‘this is how the band will feel’ rehearsal. (Yes, Dr. Young is just that awesome!) Eh, hind sight & all that jazz… Anyway, she was not a fan of the band, which lowered her tolerance just enough for the needle to bring on the tears and complaints. She kept her arm perfectly still despite wanting to be finished. She didn’t move a muscle or attempt to pull away. We are all shocked at how well she did. After the blood draw was over, the tech wrapped Mo’s elbow in gauze tape. (That stretchy bandage material that sticks to itself.) Well, to get it to stick, you have to stretch it a bit– you know, tight. Pink and purple hearts be darned– Marley wanted this thing OFF. Alli and I both offered to take it off for her which would have been fine except for the fact that she was convinced that she was going to bleed out/fall off (or something) and wouldn’t let us near it.

I still had a good bit of paperwork to do and Marley was given a boxed lunch to eat. We sat in an exam room in the lab area and a few moments later Marley declared that she needed to pee. Since I was eyeball deep in paperwork, Alli asked Marley if she could walk her to the restroom. Marley was fine with that and let us know that she would need help with her pants with a worried “But my arm is BROKEN!!”. ūüėČ I nodded to Alli that it was ok, and the potty trip was uneventful. After a bit longer, Marley was done with what she could eat of the lunch (lettuce from the sandwich, pretzels, a cookie or two, and a Sprite), the room was beginning to get stuffy, and Killian was not happy to be in the stroller. Alli suggested that we could go back to their office building and set up in a room that was larger for me to finish while the kids could be less confined. That was perfect, and we headed over.

I worked my way through the pages of questions. At one point there was a sheet that listed symptoms/disorders and with check boxes under the headings of “Mother”/”Mother’s Mother”/”Mother’s Father”/”Father”/”Father’s Mother”/”Father’s Father”. Without going into too much detail, I think this would be an excellent checklist for at risk teens who want to get pregnant– it was enough to make ME reconsider having kids… and mine are already here! ūüôā Items like “has had trouble with the law”, “suicidal”, “depression”, etc. are listed and I must say, it makes you think about what you’re throwing into the gene pool!

It wasn’t long before Dr. Tierney came in. By this time, Killian was tired and so he was on my lap nursing. She offered to give us time to finish and I cracked my typical “You’ve got boobs/I’ve got boobs” reply and she assured me that she didn’t mind a bit, so we got down to business.

I have since realized that these¬†questionnaire’s are not only about how I¬†answer the questions, but also how they are expanded upon for¬†me. When the first doctor had asked me about Marley making up words, I said yes, but drew a blank– only thinking about the (many) nonsensical words she comes up with that have no basis in reality or phonetics (which means I don’t commit them to memory since she will only inform me that I’m saying them wrong anyway). When Dr. Tierney asked, she followed with “such as creating other words for¬†¬†things…”– THIS was what I needed. “Yep! ‘Zombie garden’ for¬†cemetery, ‘squirrel peanut’ for acorn, she does that for a lot of things!”

As we went through the many questions, she was patient and understanding when I couldn’t answer a straight “Yes” or “No”; I realized that I prompt Marley often (as I do with all the kids in an effort to teach manners and proper socialization) such as prompting for “Hello”/”Goodbye”/”Please”/”Thank you”/etc. This is all well and good until you have to recall the last time your child said this or gave a gesture (for hello/goodbye) of their own accord or in response to someone without a push. Questions like “Does Marley show you things?” “Does she point?” were hard for me to answer. Yes, Marley asks me to come see a drawing or brings it to me, but in the car or on a walk she’ll simply say, “I saw a cow/dog/airplane.” in more of a informative way than a ‘I’d like you to see, too’ way.

Thankfully, Dr. Tierney is much better at this than I am. After an hour or two of questions, observing and talking to Marley, she looked at me and said (and I won’t even claim this is verbatim; I think there was a preceding phrase¬†affirming¬†that I wasn’t nuts, and if not, it came just after)…

Marley has Autism. She’s a tough one– she can make eye contact and has an interest in being social even if it isn’t working, but she does have Autism.

At this point, I cried. I think this particular flow was tears of relief. Especially as earlier that very day, I had felt that my moments of denial and questioning myself seemed to gain the upper hand as a doctor told me that she “didn’t see ASD”. To have been so close to going home with that… and now I’m being told that I’m right. I’m not crazy. I am in tune to my child and no, this behavior isn’t typical.

She mentioned that since Marley didn’t qualify for her study, she would bring me information on another. A developmental pediatrician named Dr. Deepa Menon is doing a study on macrocephaly and Autism. I never thought that Marley having a head in the 98th percentile would be a good thing, but it seems that for now it is. (It also explains her disdain and sensitivity to ‘tight clothes’– neck holes are her #1 trigger in clothing fit.) Dr. Tierney also mentioned something that I’ve told our pediatrician and a few close people without me saying anything to her first– it’s almost too coincidental that Marley had the Myoclonic Seizures as a baby and now has another neurological issue.¬†¬†I hope to speak to Dr. Menon about a possible link as well; it’s nice not to feel like a conspiracy theorist. ¬†She then took us into her office and wrote up a letter for the school system. Since I had so much trouble with my GPS on the way in, she asked Alli to get me directions for the way home and even highlighted a map for me. She told me to take some time to process this and then send her an email or call with any questions. I thanked her and joked that I had already decided to limit myself to sending Alli one email each week with all my questions from the days prior so I don’t flood them. We said our goodbyes and were on our way.

The trip home nice, the kids both slept the entire time. I called Ben and briefly explained things to him. I sent a text to our pediatrician to give her an update as well. Traffic was typical, but decent for rush hour in DC. I woke Marley & Killian up a little over an hour from home to stop for dinner/snacks and to get a Cinnabon. I didn’t expect the Cinnabon signs to lead me to a truckstop, but they did. It was a huge one and quite the adventure for the kids (ok, and me, too!).

Chlo√ę and Ben were glad to have us back and the littles were glad to see them both.

I will say, I was blindsided by how right Dr. Tierney was. When she said to take time to process this, I didn’t ‘get’ it. Like the soda for the road that Mandi ordered me at Sammy T’s, I didn’t think I’d need it.

I was wrong.

 

 

“Well, at least you KNOW now….”

This seems to be the comment I have gotten most often since Marley’s official diagnosis was made at Kennedy Krieger.

“I know you’re glad to have an answer.” and things in that vein.

Heck, MY facebook status update after leaving KKI was : “There is so much more to our story/adventure, but the important thing is WE HAVE A DIAGNOSIS.”

I don’t expect anyone to know what to say– especially when they are commenting on my status and seeing how I phrased it… it makes sense I would read those responses.

When the doctor began our goodbyes from Krieger, she stated that I should, “take some time to process it and send (her) an email/be in touch” with any questions, etc.

Time to process it? Psh. I “knew” already. I “knew” when I made the appointment. I was relieved just to have someone tell me what I had thought all along…. to put it on paper so we could move forward.

Right?

I THOUGHT I knew but — and I know this is so cliche/Real World MTV— I had no clue.

…and in the tradition of the Real World opener that (some) of us know so well….

“This is the true story… of Marley, Mommy, and Killian… picked to roadtrip to Baltimore…work(ing) towards answers and blogging… to explain what happens… when the doctor looks at you… and says…Autism.”

If you’re new to Marley, stop… or didn’t know we were going to Baltimore, you can find that story here.

We left after picking Chlo√ę up from school on Tuesday, 11/1/11. She was going to stay with my grandma for a bit until my mom got off of work, then they would go to dinner, mom would take her to school Wednesday and Ben would pick her up at the bus stop that evening.

I ended up leaving the area around 5:30pm, about the same time as Mandi and her dad. We hoped to meet up in Fredricksburg for dinner. The kids slept until we got off of the interstate to find the restaurant. Dinner at Sammy T’s was yummy and dessert was delish. I took Marley to the restroom after handing over my debit card to Mandi so that we could get back on the road. I came back to her telling me that she had them fix me a soda to go. At that moment, I thought that was amazingly sweet of her but that I didn’t really need¬†it. I’ve seen her get ‘one for the road’ at various lunch or dinner dates we’ve done, but it’s not something I ever do. She and her dad walked the kids and I to the car and helped me navigate back to the interstate. They stopped to get gas a few blocks from the on ramp and I went ahead towards Baltimore.

As I’m driving, I keep hearing my phone say “GPS signal lost”… well, that sucks. We have a GPS, but I left it at home since I’ve used the one on my phone before (but only in Virginia) and it’s one less thing to keep up with. It wasn’t long before traffic was at a stand still. THIS was why she got me a soda to go– maybe this is why she usually gets herself one to go– she travels a lot and is probably highly aware that the one time you’ll want a soda and not have one is when you’re stuck in traffic. For so many reasons I’m glad we were Baltimore bound on the same night, but this was the tiniest sweetest thing that is so typical of her. She knew what I needed even before I did. A few minutes into the jam my phone buzzed with a text. “I see you.” It was Mandi– she and her dad were coming up on my left side as traffic was merging into one lane. I let them in front of me and was able to follow them right into the city while my GPS kept chirping about the lost signal every 10 minutes. Their hotel was less than a mile from the interstate and I followed them into the parking lot to say goodbye and thank you. I should have taken it as a sign that Ron offered me their GPS. My hotel was only 10 minutes away, I said, and I should be fine. Silly me.

Getting to the hotel wasn’t that bad– I did, however, decide that picking up breakfast from the 24 hour Dunkin’ Donuts a few minutes from the hotel before check in was NOT going to happen while I hoped that my hotel was,¬†in fact, in the ‘upscale shopping center’ the reviews claimed it was since I was obviously in the ghetto currently.

I pulled into the entrance to the shopping center and was greeted by a small building with a gate. The security guard asked my name and directed me to the hotel. I wound through the parking lots and was able to park close to the main doors of the Radisson Hotel at Cross Keys.

I woke up Marley and Killian, grabbed our suitcase and headed to check in. Once in the lobby, Marley was fascinated by the lounge area and the fire place. She wandered around scoping things out while I got our room keys. I asked the gentleman at the desk if it was possible to get a room with no guests on either side as Marley has Autism and can sometimes get quite loud– as can Killian. He easily accommodated my request and we were given a room on the top floor. As he handed me the room keys, he reassured me “don’t worry about the noise. Have a nice night.” I don’t think he’ll ever truly know just how loaded my “Thank you” was that night.

[As I type this, I feel like I need to pause and mention that yet again I stammered ‘She has autism’ to explain Marley to a stranger. It seems to be the easiest thing for me to say to quickly explain her behavior,¬†awkward comments, or sensitivities. Not only are ‘sensory processing disorder’ and ‘Aspergers’ nearly unknown in the community outside of families with loved ones who have either as a¬†diagnosis, but even if the person I’m speaking to doesn’t know exactly what Autism is, they’ve likely at least heard of it. Each time I’ve said it, though, I get this nagging feeling like I’m lying– but I don’t know what else to say.]

Anyway, by the time we got into the room, it was after 11:30pm. The room was nice, with a cathedral ceiling and two Sleep Number beds stacked with down pillows.

Marley immediately claimed her bed and snuggled down into the comforter.¬†Killian was checking out all the door handles and mirrors while I tried to find something kid friendly on tv at midnight. I found the room service menu and placed our breakfast order for 6:45am–this was a lifesaver since Marley wasn’t allowed to eat after 7am but we didn’t need to be at KKI until 8:30am. Since they had slept the entire drive up, I spent the next two hours trying to convince Marley and Killian to sleep before we all finally caught up with those elusive Zzzz’s.

Way too soon, there was a knock on our door and our breakfast had arrived. The huge tray was filled with danishes, pancakes, bacon, orange juice, fresh coffee, chocolate milk, and a large bowl of fresh fruit. (I will say– I was impressed– the total was under $30 and everything tasted great! If we end up needing an overnight again, I would definitely stay at the same hotel!).

After breakfast, Marley took a bath and then we all got dressed. She decided that the shower cap she used to keep water/soap out of her hair during the bath was the perfect accessory to her outfit and insisted on wearing it to KKI. I repacked our suitcase and we headed downstairs to check out. in the car, I set the GPS to get us to Kennedy Krieger and we were on our way. I seriously underestimated the traffic going into downtown at 8am. We sat in traffic as the minutes ticked by. The GPS signal kept dropping and my attempts to call Alli (the awesome research coordinator) were not going well– I kept getting sent to other voicemail boxes by the automated system. I finally looked up the intake email on my phone and scanned it for the cell number that I remembered it included.

“Elaine Tierney”, the voice answered.

“Hi, this is Carmen Briggs and I was trying to reach Alli Koch”, I said nervously– I had called the Doctor’s cell. I explained who I was and she immediately commented about reading Marley’s blog, asked me what I saw and on which side of me, then pulled up a map and talked me through the next 10(ish) blocks of driving. I apologized for being late and lost, and she reassured me that they expect this and build in a bit of a time cushion. Have I mentioned how amazing she and Alli have been thus far?

I made it to the building and pulled into the valet parking. I’ve never been so glad to see a valet in my whole life– and told the attendant as much… he probably thought I was crazy, but he was so helpful and sweet as I unloaded Marley, Killian, the double stroller, a big clunky toy for Killian and my diaper bag. I walked into the building, checked in, and headed to the 2nd floor.

After waiting a few moments, wandering around looking lost, and asking at a desk where it became obvious that I was not where I should be, my phone rang. It was Alli. I was in the wrong building. In my frenzy to find the valet and be finished driving, I had forgotten the part of the very detailed email (and instructions from Dr. Tierney just before I pulled in) that stated that their office was in the building across the street from the valet. At this point, I am half an hour late and feeling totally flustered– not at all like the capable road trippin’ momma I try to be (usually am?). ¬†Alli met us at the valet area and walked with us back to her building.

Once upstairs, we reviewed the 11 page consent form (which went quickly since I had already read it at least 3 times since Alli emailed it to me).

We were then introduced to the doctor who would be doing the evaluation. (When I changed the date of the appointment so that it would match up with Mandi’s, it turned out that we would be seeing a different doctor for the eval, but that Dr. Tierney would be in towards the end of our day.)

After so little sleep, a rushed breakfast, driving in circles on the way in, and being told that she’d have to wait to get her blood drawn (yes– she was actually EXCITED about getting that done), Marley was in no mood for a meeting. She wanted to go to the play room I had told her about, but it wasn’t open yet. Even on a good day she isn’t a fan of hearing me talk about her, so listening as I answered questions about her behavior was the final straw. She went into “Grr mode” and clenched into herself on the stroller while growling whenever the doctor spoke or asked a question. After a few questions the doctor looked at me and said “I don’t see ASD (autism spectrum disorder).” and then asked if Marley wanted to go to the playroom (so that she could observe her). It took a few tries before Marley would answer politely and we walked down to the playroom.

Once there, Marley was a happy camper and did really well picking out toys and putting them back when she was finished. The doctor wanted to see if Marley would share with the assistant while I tried to distract Killian and not hover. I did notice that each time the assistant would ask if she could have a turn, Marley would decline and give a list of things she needed to do before she would be finished. This changed when Marley brought out a toy register. While pressing buttons the drawer came out and surprised her; she immediately handed money to the assistant. The doctor sat down with them and Marley handed her money as well. The assistant tried to ‘buy’ a scarf in the room from Marley, asking how much it cost, etc. Marley agreed to sell it but wouldn’t take any money– she instead handed the woman more money from the till. ¬†The doctor then excused herself to take me back into the office for the rest of the meeting.

She stated that she didn’t know what to think, but that Marley can make eye contact and shares, so she doesn’t see ASD. (I had told her that Marley will give you something on HER terms, but doesn’t necessarily engage in¬†reciprocal sharing. Once she gives it, it’s yours. To Marley, money is given. Never has she been given money and asked for it back. I felt like this was well illustrated in how she played with the toy register in the playroom.)

After telling me a few times that she “doesn’t see ASD”, she finally said that she thinks it is ODD. My heart sank. I wanted to run. I wanted to cry. ODD is Oppositional Defiant Disorder.¬†In short, ODD is described as:

Signs and Symptoms

Some signs and symptoms that must be perpetuated for longer than 6 months and must be considered beyond normal child behavior to fit the diagnosis are:

  • Actively defies or refuses to comply with adults’ requests or rules
  • Deliberately doing things that will annoy other people
  • Angry and resentful of others
  • Argues with adults
  • Blames others for own mistakes
  • Has few or no friends or has lost friends
  • Is in constant trouble in school
  • Spiteful or seeks revenge
  • Touchy or easily annoyed

^That^ is NOT Marley. I read about ODD when we first began this search for answers about why Marley was constantly touching us/Chlo√ę and why she was so sensitive. My child who, on a good/low trigger day, gets commended by strangers for saying “Please/Thank you/Sir/Ma’am” and relates to adults better than anyone is NOT that child. My child who, on a day where her schedule has been completely thrown out of whack, is growly and unsettled is NOT defiant or¬†deliberately¬†annoying. ODD didn’t fit Marley at all, but one of the sites did link to information about Sensory Processing Disorder– which I brought up to our pediatrician and she agreed that Marley has.

To have a physician essentially tell me that my child has a behavioral issue and dismiss the rest of my concerns was the ultimate blow. I didn’t say much to her– I didn’t know what to say.

By now, it was time for bloodwork. There was much paperwork left to do and Alli came to walk us down to the lab. She asked how I was holding up and I got teary– “She says it’s ODD, but I know it’s not. I just…”. She was sympathetic and calming. At some point in the walk (or while we were in the lab– so much of this day has run together), Alli informed me that Dr. Tierney wanted to meet us personally and do a full ADI evaluation¬†herself.

…and that¬†is a whole other post…. ūüôā (along with the adventure in the lab– that was hilarious!)

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