special needs parenting

Let’s Go Fly a Kite

I remember flying a kite as a kid. I also remember crying when inevitably the string would snap, or the kite would get stuck in a tree. So even though I don’t remember kite flying being the most fun I’ve ever had, it was something that all kids do.

 

Or so I thought.

 

So when Karin mentioned over breakfast that she had never flown a kite before, our plan for the day changed.

mom and liam

Karin and Liam were both going to fly a kite for the first time in their lives. I on the other hand, and without expecting to, was going to have more fun doing a basic childhood activity than I thought would be possible.

 

liam kite flying

And that’s just what we did. Getting these awesome photos was just an added bonus.

Family kite flying

Don’t worry. I’ll still get to the highlights of 2015 post.  Today was just too much fun NOT to post about.

A quick visit.

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It always happens so damn fast. After an amazing Saturday afternoon which included a visit from New Jersey by Liam’s grandparents, dinner out at one of Liam’s favorite restaurants (of the two he’s visited), and a visit to one of our favorite places in all the world, the Roger Williams Park Zoo. It was Sunday that started with Liam having a weird shivering motion we’d never seen before and a rising temperature. Some Tylenol and Motrin, and a quick call to his pulmonologist’s nurse practitioner just to give her a head’s up, things seemed to resolve using Liam’s sick plan (The sick plan is a series of ventilator changes and nebulizer treatments given at our preditermined increase when Liam isn’t feeling well, Waiting until an illness arrives is the wrong time to come up with a plan for how to treat it with a kid on a ventilator.). Reaching a high of only 101.3 in the afternoon, by the time we got Liam to bed at 9:30pm he was sitting at 98.8 and we thought we were out of the woods.

It was 11:18pm when we went in to check on Liam. Now, with his temperature rising, the shivering motion that resolved so quickly in the morning was present and stronger. His rate of breathing was about three times what it should be. By a quarter to 12am we were calling 911.

By my count 5 of the 6 EMT’s and firemen  who responded have been here before Sunday. The holdout looking barely old enough to drive. The blood rushing from his face as he walked in and took in the tubes and chords across a little boy’s bedroom. He watched as we changed Liam’s trach and looked for a chest rise and listened through our own stethescope, listening to see how well he was moving air just in case the respiratory problems were from an occluded trach. I would have laughed at him if I wasn’t busy rushing out of the room to get the Liam’s suction rig ready for an ambulance ride and making sure the med list saved in my phone was current, while Liam Karin got Liam, his ventilator, and his oxygen tank ready for his transfer to the stretcher.

It’s been a few years since we’ve had a sick visit to the children’s hospital. We’re out of practice. But back into our roles we all fell pretty easily. Put onto the Servo Ventilator ( a huge hospital-only piece of equipment) in the ER and for it only taking three tries in three different veins on three different parts of his body to get an IV access (it usually takes many more), Liam almost immediately looked to be breathing better. Against the doctor’s wishes (“that’s not the priority right now!” she yelled at the nurse) the impressive ER trauma room nurse caring for Liam, was able to get the blood needed for labs before taping the line onto Liam’s bicep. That line would miraculously stay flowing and give them a place to administer IV antibiotics, until we left yesterday afternoon, and while she tried to get it while getting yelled at by a Dr. I cheered her on the whole time as if she knew that Liam being such a hard stick, if she didn’t get the blood from a vein then, it would probably take an OR procedure later to do so and not blow the line for access.

By Monday afternoon Liam actually looked pretty comfortable. Sleepy for sure but his fever controlled again by tylenol and motrin, the new Nurse Practioner of the PICU who we had not yet met, seemed more than a little surprised and a bit put out that even though he was back on his home vent and his numbers seemed to be ok, I refused to let her ask Liam’s pulmonolgist and the PICU Attending Dr. to let us go home that afternoon.

“Parents don’t usually ask to stay here another day sir, his numbers have been very good.” It was clear her plan was to get us out of there as soon as possible. Karin and I gave her the reasons why we flat out refused to go.

“Even though he looks fine now, we haven’t gotten any answers as to what happened to cause him to get here. We made subtle changes to his vent settings only a few hours ago!  We don’t know yet if he’s going to tolerate them while he’s awake and breathing normally?! Lab cultures haven’t even come back yet, we don’t even know what his high white blood cell count in the ER was fighting off. No. We have gone home and then had to turn around and be re-admitted before, we aren’t doing that again. No. we are staying one more night to see if he really is doing better.” I said.

I’d be lying if I didn’t get just a bit of satisfaction when she had to come back only a few hours later and explain that his blood cultures grew out strep pneumo probably causing the fever and the pneumonio symptoms in his difficulty breathing the night before, and that while we wait to see what antibiotics this bug is most sensitive to, if we had gone home when she offered, she would have then had to call us back to be re-admitted through the ER for IV antibiotics. We were right. It was a good thing we hadn’t left.

The wait was kind of brutal. Liam really was doing much better. But that was because of the Cephtriaxone. If there were an oral ( or a non-IV administered version) of that antibiotic we would have been home on Tuesday. Instead, we were forced to wait until the lab got true drug sensitivities of this particular strain. Apparently different strep bugs all over the country are more or less sensitive to different antibiotics.

“Why haven’t we just tried good ol’ penicillin? We used to always treat strep with Penicillin.”  the attending Doc relayed at morning rounds on Tuesday. Having known Liam most of his life though (and spending one entire night a few years ago never leaving his room as she ruled out whether or not he had had a heart attack due to the sceptic shock just ravashing his blood pressure. Don’t worry. He didn’t) she added, “well I guess there’s no need to get cavalier about it though, this is Liam. Better wait on the Lab. One more day.”

By Wednesday morning’s bedside rounds, the lab sensitivities were in… We knew if we had an oral version of the antibiotics allowing us to bring Liam home.

It was penicillin.

Good Ol’ Penicillin.

It was time to go home.

We are all at home now, but It’s been a long week. A week of sleeplessness and worry. But also a week of bragging about the boy. Bragging and visiting with people who have spent time with Liam at his worst. People who have been there to help save Liam’s life multiple times, but don’t get to see him use his ipad. People that care for him for weeks post surgery but not for the weeks post Santa visit.

Like the proverbial pebble thrown into a lake, Liam has touched so many lives. Part of being Liam’s parent is knowing that every now and then Liam will decide it is time to teach a med school class to a rotation of new residents. To open the eyes of a brand new EMT.  To reach out to a nurse he may have taught something to in the past (one of his nurses this stay learned how to change a trach on him  a few years ago, the last time he was admitted, and under our supervision and permission.), or to teach a Nurse Practioner that maybe listening to the patient (or his parents) is just as important if not more important than what the numbers say.

We’re all at home now, and it has been a long week. A week of sleeplessness and worry. But I did so much bragging about Liam, and he visited with, so many people who have known him for as long as he has been alive, people who have helped him through his very worst times.On top of that, Liam met new friends. Friends who will go out into the world feeling the positive energy of meeting a charming boy like Liam and bringing that into their careers as nurses, and doctors and respiratory therapists.

We’re all at home now, and it’s been a long week. A week of sleeplessness and worry.

But on some weird level, and this is only because aside from the few hours in the ER Liam was basically comfortable the whole time,  I can’t say it hasn’t been a little bit worthwhile.

*****

Somewhere in the Swamps of Jersey

Ok, not the swamps, instead the rolling hills of northwest New Jersey but if you think I’m not going to quote The Boss when talking about our trip to Jersey well then you just don’t know me at all.

Yes the Olson’s packed it all up and headed south for adventure. When I say packed IT ALL up, I mean it. It makes little difference if we are going camping or visiting family in their home, the packing remains the same. 2 days or 2 weeks and there’s little difference to the list. A CVS, across the street from a Walgreens next to a Target a short walk from where we’re staying? Ha! find me syringes, feeding tube bags, ventilator circuits, or  nebulizer parts on any of their shelves and I’ll eat my hat. No, the whole kit and caboodle needs to make the trip when we travel.

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Actually, make that the whole kit and caboodle . . . times two. Because ventilators malfunction. Ventilator batteries lose their juice. Electrical chords and plastic oxygen tubing can all fail. At any time. We have to be ready.

Ready for anything. Twice over.

At all times.

And so we are.

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The trip was great! We visited with family we don’t see often enough, ate good food, and had a relaxing few days away. We even took Liam to another zoo.

 

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For his part, Liam was wonderful. He endured the ride as well as could be expected considering it was RT 95 through Connecticut. He was well-behaved, turned on the charm for his grandparents, and aside from one late night with an increased heart rate that worried us until we realized it was just gas, stayed spectacularly within his baseline sats and numbers. In a new environment in a mostly climate controlled (dry) facility and only recently making a full transition off of supplemental oxygen these are not small details. I’ll be the first to admit that I get a bit nervous travelling and being away from my bubble. It makes me so proud to see how well Liam travels.

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I hope he keeps it up. Because along with our wonderful trip out-of-town for a few days last week, at the end of my vacation from the day job I was approached by the nursing company that supplies Liam’s home nursing care. It seems they had representatives at the conference where I spoke last month and would like to send us all to Pennsylvania so that I can speak to their national meeting of all of their pediatric nursing directors (they have offices nationwide). Details still need to be worked out so I don’t want to say too much, but they want me to speak and I really want them to hear me, so it looks like our trip to New Jersey was just a dry run for a greater adventure.

We’ll be ready.

Ready for anything.

 

 

 

 

 

Sure Shot

The first three or four times I tried it, it wasn’t so bad. Environment can be everything. In a hospital room, on a hospital bed, IV’s and catheters, nurses and doctors, the med cart, nothing there is designed for comfort.  Learning how to do it was nnecessary for Liam’s discharge so those first four times of doing it myself just didn’t seem as difficult. Not until we got him home. Not until I tried it on our couch, in our living room, somewhere that Liam should feel safe from things like this.

No, it was that 5th time I tried doing it, in the comfort of our home, in front of our TV, stretched out on our own brown couch that brought tears to my eyes. That made me sick to my stomach. That made me hate, actually hate a medicine that I knew Liam needed in order to stay healthy. It’s been almost three weeks of doing this now and it hasn’t gotten any easier. Twice a day for the next 2 to 5 months and I’m sure I’ll never get used to this.

I will always have a hard time giving my son his shot.

It’s only a 27 gauge needle, just about as thin as they make them and barely as long as your thumbnail, but that doesn’t make it any easier. I hate the whole process. Drawing up .2ml dose, finding a bit of fat that hasn’t yet been pierced or bruised, wiping the area with alcohol. The build-up to the main event. To try to be gentle and gingerly about it will only backfire I have learned. You have to just stick that needle in there. A 45 degree angle to stay above the muscle but under the skin, we want fatty tissue for this. Thighs, a bit of the belly, those big beefy arms on my boy, a pinch of the flesh before the prick and a release just after the plunge, his eyes go wide for a second while his upper lip curls in a jolt of quick pain.

Pulling back it’s over as fast as it started and it obviously pains me more than it does him because almost every single time Liam will be back asleep only seconds after it’s over while I obsess over whether this one will bruise. This isn’t a knock-out drug at all, the return to sleep has nothing to do with narcotics. Sadly Liam is too accustomed to being poked and prodded. I’m just not at all accustomed to doing the prodding.

The blood clot begins below the knee and travels high enough into his abdomen and under his intestines to be hidden from the view of the ultrasound. It is a big one, the result of a major disruption to his clotting factor when Liam was in septic shock. His own blood basically poisoning him. The central line it grew around never even had a chance as it was only  in a couple of days before the clot took over and the line stopped giving a blood return for labs. The lovenox in these shots is what will help to break that clot up, hopefully preventing a pulmonary embolism in the process.

He needs this medicine and I know that. Hours before or after I have to give this medicine when the intensity of having to hurt my child in order to help him fades I feel a sense of pride that I am able to give him what he needs to get better. That pride gets forgotten when I take the syringes out though. That’s when the nerves, and frustration set in.

Like I said, it’s been three weeks of doing this and I haven’t gotten used to it yet.

I hope I never do.

 

Starting Again

Intimidated by the daunting task of summarizing the last 6 or 7 weeks, I’ve avoided the computer for almost two weeks. I haven’t been writing for this blog but worse yet was the fact that I haven’t been reading any of your blogs. I’d been twittering a bit and the occasional photo on instagram but those are both things that I can do on my phone. The pressure, the guilt, the usual fear of sounding like a fool, and probably most of all, that feeling of isolation that can surround a family with a child of special needs (especially during and after a long hospital stay) made even the idea of firing up the old blogging dashboard and sharing the whole stressful ordeal seem too insurmountable a job. I wanted to blog again, I swear.

I just got stuck figuring out where to start.

Until tonight. Until I finally scrounged up the courage to fire up the old laptop and make the rounds of my usual blog haunts to find that I had missed out on the release of something wonderful. Something beautiful.

Something to remind me that we are not alone at all, and that telling our story is a worthwhile endeavor.

Something to give me a place to start again.

Please, please, please take just a moment to watch Elizabeth’s wonderful movie and then link back to her blog here and share it with anyone and everyone you know who may be touched by a special needs parent in any way.

I know many of those faces in that movie even if we’ve never met. We have grown to know each other through writing these pages and posts as if to each other and sending them out there into the world to see who they find.

They always seem to find exactly who they need to somehow, which is exactly why I need to keep putting my own out there.

Thank you so much Elizabeth for taking the time and care to make such a wonderful thing, and for reminding me that we are not in this alone, that there will always be people who understand.

Thank you for giving me the kick in the pants to put things out there again.

A new place to start.

A Letter to a Home Care Nurse.

Against our better judgement Karin and I agreed to allow a precepting (training) nurse into our home to fulfill her 24 hour(3 x 8 hour days) trach and vent skills training and assessment with the agency preceptor who happens to be Liam’s daytime nurse. (4 days a week, 6 hours a day). We have had precepting nurses here before but it has never been a pleasant experience so we made this a no teaching household for about a year. The agency recently played the “but we have a family who needs their nursing hours waiting on this nurse” card which in light of past practice of their handling of MY OWN FAMILY’S nursing needs, is both manipulative and insulting. But at least we have SOME nursing, and if it’s true then we don’t want to be the only reason another family and child is going without the help it needs. Plus it also gives Liam’s nurse a nice little bump in pay for those hours and while that is hardly my concern or priority, he has been with us for almost 2 years so it’s nice to help him sometimes too. More importantly though, there is always the possibility that the new nurse in question could be capable and confident and we might find ourselves a quick fill-in nurse who would then have knowledge of Liam’s case and needs. We wouldn’t be allowing it if it didn’t benefit Liam in some way. He’s a little boy not a training tool.

So we gave in. The Liam Olson School of Nursing opened it’s doors for one more student.

She will be its last.

Here then is an open letter to our most recent attendee (I won’t exactly call her a graduate). I post this here not only in the hopes that any future home-care nurses out there may stumble across this and learn from her example, but mostly because it’s a more interesting way to tell this story than a straight chronological narrative.

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Dear new nurse,

I hope that you are able to give whatever family gets stuck with you the help that they need. I will not be allowing you to ever work in my home with my son ever again. You may have been able to show that you can perform the tasks involved to care for a child with a trach and vent (Once. With an experienced trainer standing behind you. Good for you.) but you’ve got a long way to go before you’ll instill confidence in any parent longing for the ability to not worry about their young child for enough time to take a shower or a nap, or a quick trip out to the store. If they need to assist you with the little things then you aren’t helping at all and isn’t that what you are there to do?

Anyway, this isn’t about your clinical performance since I’m sure that will be well covered by the report your preceptor will give to the agency. This is about the rest of your job.  Let’s call it your inter-personal skills assessment. I can only asses you on behavior that I have seen so this will be specific to my house. While I can’t speak for anyone else, based on my friendships and interactions with other families that have home nursing, I think that our approach is fairly normal and probably more easy-going than most so you can probably take much of what I write to any other case. (besides this is all just me trying to be too clever turning what happened with us into a blog post.  You’ll never even read this.)

Understand that when you work in this house caring for my wonderful son you are still a guest in my home. Karin and I are more than capable of taking care of Liam which makes you expendable. I refuse to be made uncomfortable by near strangers in my own home so please act in a manner that makes everyone in this working relationship comfortable, most of all Liam. We, for our part, will extend to you the same courtesy. I am not saying that we need to be best friends. I’m not saying we need to be friends at all, as long as Liam is being well cared for. If you are a quiet and private person — that’s fine. Loud and talkative? Heck, so am I. No one is asking you to change who you are, we just ask that you are courteous and respectful of the fact that while it may be your workplace, this is Liam’s home.

When you say that you are coming to work please do so. Calling in sick for the first TWO shifts (a week apart) that you were scheduled to be here for was not a helpful start. We do not feel comfortable enough bringing strangers along to appointments so we planned and adjusted our’s and Liam’s schedule around the days that you would be here. I know that things happen and if anyone understands missing work because of family emergencies it’s me but it is not the first impression you want to give. I can’t ever ask you to make my family’s needs your priority and I never will, but that start to me as a manager of dozens of employees in my day job is just plain professionalism and responsibility.

When you are given the privilege to work with Liam please show him the respect that he deserves as a person. You were here for three eight-hour shifts and you said more to my cats than you did to my son (not a joke). My adorable son, who you were supposed to be here to care for, training shift or not. He may not respond all the time. Hell, since you are a stranger he probably wasn’t ever going to respond to you in all three days but you didn’t exactly give him much to go on now did you? If you were working with a three-year old without developmental delays you would probably talk to them and let them know you were about to suction them or lift them right? Show Liam the same. He deserves it.

The unfortunate and unfair part of all this is that you never had a chance with me. I knew before you and I even met that if you were to make it through the three-day training with Liam’s daytime nurse that you would never be working here again. Kids like Liam and any other trach and vent kid you may get assigned to, they head in and out of the hospital all the time. During those times you may need another case you can fill in for here and there to keep your paycheck rolling in or maybe even make a little extra cash if another family needs some nursing hours. You lost the option to do that here with this amazing little boy within the first three minutes of meeting my wife.

Is that really fair? I’d say so…

You are lucky actually, that it was Karin’s morning to make the coffee since she was the first one downstairs. She is much more patient, and kind than I am, especially within minutes of waking up after only a few hours of sleep. Instead of pleasantries and maybe a minute or two of small talk with her, your boss for this 24 hours of training, you figured that questioning her parenting would make for a better first conversation.

“What time do you put him to bed for him to still be sleeping this late in the morning?” now you see, I’m exceptionally impressed with your ability to question our decisions while also implying that Karin and I are lazy, seeing as how if it’s too late in the morning for a child to be sleeping it’s probably to late in the morning for his parents to be rolling out of bed. I believe many people call that chutzpah. Or balls. Big brass ones.

As I mentioned Karin is a much nicer person than I am. So she explained my unorthodox work schedule and how if he didn’t stay up until eleven I would never even see Liam awake during the week. She didn’t explain about Liam’s med schedule which dictates when he is at his drowsiest. She did not mention that his night nurse schedule of only a few nights a week is jarring enough that trying to start a routine any earlier than eleven is pointless. Or that with his early afternoon school schedule he is more alert and productive at the time we need him to be if he sleeps until about 10am. She didn’t explain these things because she shouldn’t have had to explain herself at all.

“Oh, well I’m pretty sure that’s not very good to keep a kid up that late. I don’t think you should do that.”

That’s what you said to her. Think about that. That’s what you said to a complete stranger while in her home.

In her own home.

Did I mention that you were lucky that Karin came down first and alone? You see had I come down with her and heard that? You would have been told to leave my home immediately. How dare you question the parenting decisions that we make as a family while sitting in my own home. I don’t care if the initials after your name read RN, LPN, MD, PhD, NYPD, or POTUS you do not come into my wife’s home or anywhere else for that matter, and question her parenting decisions and ability as a mother ever. EVER. Not in your first conversation. Not in your 1,000th conversation. In the 2 years that our daytime nurse has worked for us he has never questioned our role as Liam’s parents and you would be better for it if you get that right as soon as possible. Other parents might not be as forgiving and compassionate as my wife is. Like I said. You got lucky.

Instead Karin just left. She came back upstairs and explained to me what happened. Then she told me that since she had already made a commitment to the agency and to your preceptor to allow your precepting here, she asked me to be nice. That’s the type of wonderful person that she is. And so I was.

Is it fair that I wrote you off before ever giving you a chance. Nah, guess what? Life’s not fair. Like I said, working with Liam is a privilege. One that you neither deserved or appreciated. Perhaps there is a family out there that will have a better chemistry and fit for your personality. This one isn’t it.

Home nursing is more than changing trach dressings and administering medicines. It’s about care. Care not only for the medical needs of the patient but to ease the burden on the parents stretched thin by stress and exhaustion. I don’t know about you but I get stressed when I have strangers I don’t like in my home. When you add to a family’s stress you are not helping. If you’re not helping then what are you doing there?  Just collecting a paycheck? Not on Liam’s dime you’re not.

Sincerely

Eric.

Membership Has its Privileges

Occasionally I’ll read a tweet or overhear a “typical” parent discussing a legitimate and “normal” worry or complaint. ( I hate both terms typical and normal since we’re all just parents and what in any of our lives is actually “normal” or “typical” but you catch my meaning more efficiently by using them so that’s what I’ll go with here) A worry or complaint that Karin and I have never had to worry about with Liam. It always gets me thinking of all the bright sides, all the silver linings in the clouds of special needs parenting.

At first I thought about how we never have to wait when we end up in the E.R. (it’s amazing how bringing in a kid hooked up to a ventilator can bump you to the front of the line) or the fact that the pulmonologist, neurologist, and pediatrician will write us a script based solely on a phone call since they know us so well we don’t have to come in to be seen first. But while both of those could in a weird way be considered benefits, what other parent would ever be jealous of things like that? Having the top pediatric surgeons in the state know you on sight isn’t all it’s cracked up to be.

No, instead I’m talking about benefits that will help me feel better when I hear other parents talking about “date nights” knowing that they probably don’t have to involve nursing agencies and insurance companies to get a babysitter. Benefits to think about and comfort my own jealousy over parents who get to sleep in the same bed together more than one or two nights a week.

So I  thought about all the good parts. All of the concerns I’ve heard mentioned that my family doesn’t have to give a second thought to (yet.)

The privileges. These are not worries that I am making fun of at all. Parents absolutely should be worrying about these things. Lucky for us, Karin and I just don’t need to.

1. Baby-proofing — This is the one I heard mention of today that got me thinking about this post in the first place. Liam was born so early we hadn’t even thought of baby-proofing our house yet. By the time we got home from the NICU we had a pretty good idea that we wouldn’t need to. Liam can’t crawl, he can’t grab, hell thanks to the trach he can’t even swallow and so the electrical outlets in my walls are free of little plastic covers to lose or be stepped on. My kitchen and bathroom cabinets, even the ones on the floor, open with a quick flick of the wrist. I can even keep the scotch right out on the counter. (just kidding, I keep that on top of the fridge where Karin can’t reach it. That whiskey is mine!)

2. Story Time. —  Look I love children’s books. The more of them I read the more I find new ones that are so clever or funny and who doesn’t love revisiting the classics of our own childhood’s but I’m willing to bet that I made my parents read Grover’s “Monster at the End of This Book” a million times.  Over, and over, and over again, the poor things. During the daytime and at school Liam hears his fair share of kids books and stories but at bedtime when I get to read him to sleep I get to read my own stuff. It’s all about tone of voice anyway so instead of more Seuss and Silverstein, Liam and I read aloud Vonnegut, and Gaiman, Cherie Priest, and Adam Christopher, Terry Pratchett and Harlan Ellison. And everything else that I find at the library. Liam is very well read for a three-year old.

3. Potty Mouth — I swear a lot. I always have and I always find it funny when we all censor ourselves and politely substitute benign words or start spelling things around our kids. My parents swore around me growing up but I definitely knew there were a bunch of words out there that I wasn’t allowed to say until I grew up. Let’s face it if or when Liam utters his first word if it happens to be shit or another of the four letter variety (it’s not an unheard of occurrence in my family) I would laugh and cry and celebrate that wonderful curse for the rest of my days.

4. The Back of the Milk Carton — I don’t mean to be insensitive about something so serious but kidnapping or abduction? It’s not really a concern of ours. Hard to steal a child securely attached to a 40 pound ventilator and 50 pound wheelchair.

5. So You Want to Go See a Show? — Sure Karin and I don’t get out for a date night very often but I’ll tell you where else we don’t end up. “Disney on Ice”, “Dora the Explorer Live!”, “The Spongebob Squarepants Live Screech-a-Long” or “Raffi’s Two Hour Children Screaming Extravaganza”. I’m sure that every kid in every one of those audiences is having a wonderful time waving their light-up novelty toys and yelling their adorable little heads off. Not so sure about the adults in those same rooms though. Luckily Liam’s not a very big fan of crowds or loud noises. So when he gets just a little older and bigger I’m sure we’ll take him to one of these shows just to say we have but I’ll bet you dollars to doughnuts that he shuts down and sleeps through the entire performance.

6. Open Up the Hanger Here Comes the Airplane — The tricks other parents must have to resort to in order to get a three-year old to choke down enough carrots and peas without spitting it all over themselves or their high chairs is beyond me. Instead I put exactly the amount of formula for the calories that Liam needs in a bag and set the rate on his feeding pump. Boom! consistent nutrition and growth at the press of a button. Can’t beat that with a rubber ended spoon of Gerber Beef and Gravy.

Well there’s a quick list of six and while there may be more I think I’ll end it there before I have all of my “typical” parent readers running out looking for their very own special needs child.  I don’t want to start having to worry about number 4 on the list anytime soon.