A New Job

I've been working a little bit here and there as a speech pathologist since my girls were born. I do early intervention evaluations and generally do about 3-4 per month. It's a nice way to keep my foot in the door without having to commit to too much at once. 

I love being home with my girls and am so grateful I don't have to work full time. A few months ago I picked up one early intervention kiddo for feeding therapy. We've been making slow progress and I see him once a week. 

In December I noticed one of the local hospitals placed an ad for a per diem weekend speech language pathologist position. The ad was for someone to work one weekend a month. I applied because I figured it couldn't hurt. Childcare wouldn't be an issue either since W is home on weekends. 

I interviewed right before Christmas. I have zero hospital experience professionally or from graduate school and was unsure how the interview went. I interviewed with two people and one was very nice and friendly and seemed to like me while the other wasn't impressed by my lack of experience in hospitals. While in graduate school I was so convinced I only wanted to work with kids so didn't get as broad of an experience as I could have. 

Well, I was offered the job and quickly accepted. I figured it was an opportunity I couldn't pass up. W could be with the girls on the weekends I worked and it might provide some nice "empathy training" for him as I called it.

I'm in the process of training/orienting now. The computer system is overwhelming as is the documentation. Let's not even mention the nature of the job. This hospital is a level 1 trauma center. They have a new and big head and neck cancer center. I'm not used to seeing people that are that sick for therapy. It's intense to say the least!

I've worked one weekend so far and am excited. Some moments I feel totally in over my head, but then I realize I still want to learn new skills and information. I'm not happy to continue to do the same thing forever as I still have a strong desire to learn. It means really going outside of my comfort zone to expand my knowledge and skills. While that is scary, it's also pretty exciting. 

Most of the job is doing bedside swallow evaluations. It's mainly determining the safest consistencies of food and drink for people who have been hospitalized for one reason or another (stroke, pneumonia, cancer, surgery, trauma, etc). I know I can do it and learn it, it will just take time. I'm excited to learn more and get a whole new level of experience. I work this weekend so am looking forward to being scared shitless again. Haha

Fluid

As you know, Stella has had fluid in her ears since birth. They call it "eustachian tube dysfunction" meaning the tube that drains your ear has a hard time doing so. Children have a much flatter tube than adults which is why children get ear infections so much more frequently. The ear is better able to drain in adults. When we grow the tube gets more vertical and is better able to drain. 

Clara started physical therapy about a month ago. As part of the evaluation process, they will do a hearing test if they feel it's necessary, or the parents desire it. I've known Clara had some issues with her balance and coordination, but I also noticed her speech was much more difficult to understand than her sisters. As part of the evaluation I requested a referral for a hearing test. 

Clara hadn't had any ear infections until this past winter when she had three very close together. She was on antibiotics and steroids for a few weeks in order to get it to finally go away. Since that time I noticed she had a more difficult time following directions and listening consistently. 

We went last Thursday. Within a few minutes I was told that Clara has fluid in her ears and that we needed another referral to an ENT. With bone conduction testing they were able to determine the nerve is functioning fine and that the mild-moderate hearing loss she's currently presenting with is conductive. 

I'm grateful I'm able to be home with my girls as this was so subtle. There was no huge red flag telling me this was going on. I'm grateful I know my children better than anyone else and can tell when something isn't right and I'm so glad I pushed for the hearing test! 

I'm hoping we can get in to see the ENT soon as I'm hoping we can resolve this issue ASAP. 

Early Intervention

Lucy was evaluated by early intervention this past week. I was concerned with both girls' physical development in the early parts of the summer. It seemed most children their age were crawling and they still weren't. I texted a physical therapist I worked with and she offered to come look at them, but said that they were probably fine. I didn't have her come because I wasn't hugely concerned. Then Lucy broke her leg. 

Within the first week or so of Lucy getting her cast Clara started crawling. Although she's still not advanced by any means, Clara is still doing fine. She's currently crawling everywhere, moving in and out of sitting, walking behind a walker independently, and pulling to stand on everything. I'm no longer worried about her. 

Lucy, on the other hand, spent 5 weeks in a cast. The first night she came home she was moving all over the place. Since then she's been reluctant to do much. She's really not even rolling over consistently. She'll pull to stand if she holds on to your fingers but prefers to sit and play. She doesn't tolerate a lot of tummy time now. When she stands she's shaky and can't last long. Also, she has horrible posture and doesn't sit up tall like her sister. She has started to pivot and turn around while sitting. Whenever she does to much she seems to have a lot of pain at night. The other day W did a lot of standing with her and then that night was awful. She cried so much and was inconsolable. I think she was in pain as she just couldn't get comfortable. 

I do early intervention evaluations so I know how they work. I know a child has to have a "significant delay" in one developmental area as one way to qualify for services. I had a feeling the sooner after getting the cast off that I had her evaluated, the more likely she would qualify. Considering I was concerned with her physical skills prior to the cast it's no surprise I was looking to physical therapy as a good thing. So, the day after the cast came off I made a referral to early intervention. 

Her evaluation was this past Wednesday. I honestly had no idea whether she would qualify or not because I don't evaluate kids when the concern is their physical development. I evaluate when the concern is their speech and language development. 

Lucy qualified for physical therapy due to her not consistently rolling, transitioning in and out of sitting, getting on her hands and knees, etc. The therapist also blamed her poor posture on her having a weak core. Within the next few weeks a physical therapist will start coming to the house to provide services. I'm not sure how frequently at this point but my guess is that it will be once a week. 

I'm hoping Lucy won't take long to catch up and be where she should be with her physical development. I'm sure she and her sister will be running in opposite directions before I know it.