Educational Versus Medical: Why You Need to Understand the Difference!

Photo Credit: www.samuelmerritt.edu

Medical Versus Educational Diagnosis

The word diagnosis is thrown around a lot when it comes to educational issues. This is VERY important: the school CANNOT make a MEDICAL diagnosis for your child! When the school says your child has autism and they will provide special education services to your child they are NOT medically diagnosing them with autism! What the school is saying is that your child fits the educational definition of autism as defined by your state.  

Under federal law (IDEA) there are only 13 categories that are recognized. These are autism, emotional disturbance, hearing impairment (including deafness), intellectual impairment, other health impairments, orthopedic impairment, specific learning disabilities, speech or language impairment, traumatic brain injury, and visual impairment (including blindness).  A school will only provide special education services IF your child falls into one of these categories.  Also, each state may have further refined how each category is defined making things more complicated.

A medical diagnosis is made when someone fits a medical definition for a condition.  This definition is found in the Diagnostic and Statistical Manual (DSM V).  We are currently on the fifth edition.  The medical diagnostic criteria for autism is:

Diagnostic Criteria for 299.00 Autism Spectrum Disorder

• Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):

1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understand relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

There is more to the definition but you get the idea.

You will often see a doctor use a ICD 10 billing code. Autism is F84.0. For medical billing you WANT SPECIFICALLY F84.0 versus F84.5 which is Asperger's syndrome. Why? Because your insurance company will probably reimburse you for F84.0 but not for F84.5! It is very important to pay attention to medical billing codes! Medical billing codes dictates what an insurance company will cover in the way of therapy and equipment. If you ever want to look at 

Related Services

These are the services you get from a school district like occupational, speech, and physical therapy.  These are the most common related services but there are many more that you can get in the educational setting.  I want to explain the difference between medical therapy and educational therapy.  This is VERY important for parents to understand since it is the source of many disagreements parents have with their local school district.

Medical versus Educational Model of Therapy

Educational Model
The Educational Model focuses on the skills impacting educational performance in all subject areas. Deficits are addressed through an Individual Education Plan (IEP) or 504 Plan that is agreed upon by the school-age child’s educational team. This model will focus solely on the outcome that enables a child to benefit from his/her educational program. Therefore, the school therapist(s) [Physical Therapist (PT), Occupational Therapist (OT), Speech Therapist (ST), or a combination thereof] will direct therapy so the child will gain skills to maximize his/her opportunities within the school environment. Therapy services are provided in school and most often within a group or classroom setting.

Eligibility: Eligibility for related services must be based on assessment, an educational need for service, and there must be approval of the IEP team.

Medical Model
The Medical Model generally focuses on the impairment regardless, of severity level to ensure that the child can successfully perform the basic activities of daily living (i.e., putting on their clothes, feeding themselves, speaking clearly their wants and needs, walking). Services are performed on a one-on-one basis in an outpatient clinic.

Eligibility: The physician or other certified practitioner along with a child’s parents/ guardian and licensed therapist determine the severity and impact on developmental areas or self-care skills and develop a Plan of Care (POC) for the therapist to follow.

Why is this Important?

Personally, I prefer medical therapy. Why?  The child gets direct one-on-one service with a therapist, there is no need to call a meeting to determine service, and the parent gets to help determine the goals of the therapy while educational therapy has the goals determined by others. I have rarely had my children in public school to take advantage of educational therapy.  We tends to stick with medical therapy. When they were small (4 years old) we got both educational therapy through the school and medical therapy from our insurance.  Yes, you can do both!  I HIGHLY urge you to do both if you have the opportunity! Why? Because it is practically impossible to get too much therapy!  Therapy is VITAL to resolve educational and sensory issues that impair learning! Even now, while we homeschool, therapy is the main goal for my children; not academics! They can learn better when their issues are addressed so it's worth spending the time on therapy.

I know this is a brief explanation but I hope this helps you understand the subtle but important differences in the medical versus educational model of therapy.  Please feel free to contact me if you have any questions.  You can also join my Facebook group at IEP Assistance and Special Needs Parenting Advice. 

Did you know 65% of the population are visual learners? Now, what do you do when you have a child that has vision loss in one eye, reduced peripheral vision in the other eye, BUT is STILL a visual learner?  Think about that for a minute.  Yes, Joseph, my son with only one "good" eye, is a visual learner. Joseph has problems with visual-spatial reasoning among other visual processing issues.  As it turns out, all my children have visual-spatial problems. They all score in the 5 to 18 percentile in visual-spatial reasoning.  So how does an issue with visual-spatial reasoning impact learning?  I hadn't a clue so I wrote this post to understand!  Hopefully you, dear reader, will find it helpful too!

In a paper by Franceschini et al., there is a strong correlation to visual-spatial attention and learning to read. The children who had the most difficulty with visual-spatial discrimination had most difficulty in learning to read and often went on to be diagnosed with dyslexia.  Mayer et al., found a correlation in visual-spatial reasoning, along with cognitive ability and problem-solving skills, were the deciding factors in determining the scientific reasoning skills of elementary school students. What I really found interesting was the paper by Tosto et al., which studied the visual-spatial abilities of several sets of 12 year old twins. By 12, a bit over half of your visual spatial skills you got from your parents (genetics) but the rest is learned (this was true for both boys and girls).  The part of the paper I found interesting is that the same pathways in the brain for visual-spatial reasoning is used for math and science. Who knew?  This explains a lot as to why children with developmental dyscalculia have issues with processing visual-spatial information.

What are the signs of Visual Processing Disorder?

There are EIGHT types of visual processing disorders. These are:
Visual Discrimination

• Can't match clothing, socks, or cutlery, especially when the differences are subtle
• Doesn't noticing the similarities and differences between certain colors, shapes and patterns
• Will not see differences between similar looking letters and words (eg b / d, b / p, 5 / S, won’t / want, car / cat)
• Will have a hard time reading maps

Visual Figure-Ground Discrimination

• Struggles to find information on a busy blackboard
• Finds it hard to copy work from the board as the child keeps losing his place when copying
• Loses his/her place on the page while reading
• Has poor dictionary skills
• Struggles with map work
• Struggles to find personal items in a cluttered place

Visual Sequencing

• Has difficulty using a separate answer sheet
• Cannot stay in the right place while reading a paragraph. Example: skipping lines, reading the same line over and over
• Problems reversing or misreading letters, numbers and words
• Has difficulty understanding math equations

Visual Motor Processing

• Has difficulty writing within lines or margins of a piece of paper
• Struggles to copy from a board or book
• When moving around often bumps into things
• Has problems participating in sports that require well-timed and precise movements in space

Visual Closure

• The inability to know what an object is when only parts of it are visible
• Not recognizing a picture of a familiar object from a partial image. Example: A truck without its wheels
• Misidentifying a word with a letter missing
• Not recognizing a face when one feature (such as the nose) is missing

Spatial Relationships

• Difficulty getting from one place to another
• Has a problem spacing letters and words on paper
• Cannot judge time
• Reading maps and giving directions are difficult
• Difficulty in math

Plus there are other vision processing disorders like Irlen Syndrome, visual dyslexia, and visual dyspraxia.

Who Diagnoses Visual Processing Disorders and How to Treat It?

This is hard to determine.  Visual Processing Disorder is NOT a learning disability be itself.  It is only a learning disability IF it interferes with the learning process.  Ah, the fun of public education! If you homeschool it is easier because you can implement the accommodations and modifications at home to see if academic function improves.

If you are looking to pursue a diagnosis look for an opthamologist, vision specialist, vision therapist, or a neuropsychologist. One of these professionals should be able to run the psychometric tests needed to make a diagnosis.

There are three kinds of therapies that are important to be aware of as you’re considering ways to help your child with visual processing issues.

Optometric vision therapy: It’s important to note that there is more than one kind of vision therapy. Optometric vision therapy has been proven to help with vision problems that involve eye movements or eye alignment. These eye coordination issues are different from visual processing issues. Visual processing issues involve the way the brain processes the information the eyes take in.

You may hear some kinds of optometric vision therapy referred to as “orthoptic vision therapy.” Both can help with eye muscle and eye alignment. These kinds of therapy can help with vision problems such as convergence insufficiency (when the eyes don’t work together properly when trying to focus on a nearby object).

Optometric vision therapy doesn’t “cure” learning and attention issues. But if your child has vision problems in addition to dyslexia and other issues, resolving vision problems can help him devote more energy to finding strategies that can help with the way his brain processes information.

Behavioral vision therapy: This is different from optometric vision therapy. Behavioral vision therapy involves eye exercises that are designed to improve visual perception. These eye exercises are also designed to improve visual processing skills. But there is no scientific research that shows this kind of therapy helps the brain process visual information. For that reason, behavioral vision therapy is considered a controversial treatment for learning and attention issues.

Anecdotal evidence suggests that it may help some children. But be wary of any treatment that claims to “cure” learning and attention issues. Learn more about how to know when a treatment is reputable.

Educational therapy: Children with visual processing issues may benefit from educational therapy. This type of therapy teaches kids strategies for working around their weaknesses. Learning how to approach problems can reduce frustration, increase self-confidence and lead to greater success in school.

What are appropriate accommodations or modifications? 

• Use books, worksheets and other materials with enlarged print
• Read written directions aloud. Varying teaching methods (written and spoken words; images and sounds) can help promote understanding
• Be aware of the weakness but don't overemphasize it. While helping a child work on the weakness is important; it is just as important to build other skills and function in any setting
• Break assignments and chores into clear, concise steps. Often multiple steps can be difficult to visualize and complete
• Give examples and point out the important details of visual information (the part of a picture that contains information for a particular question)
• Provide information about a task before starting to focus attention on the activity
• Allow student to write answers on the same sheet of paper as the questions or offer opportunities for student to explain answers orally
• Provide paper for writing and math work that has darker or raised lines to make the boundaries more distinct
• Organize assignments to be completed in smaller steps instead of one large finished product
• Use a ruler as a reading guide (to keep focus on one line at a time) and a highlighter (to immediately emphasize important information)
• Provide a tape recorder to supplement note-taking
• Color code important information
• Have a proof-reading buddy for all written materials
• Use a tape recorder when getting important information
• Before writing letters or essays, create an outline to simplify and organize ideas
• Have a proofreading buddy for notes and essays

I hope you found this post helpful.  I had initially started this post just to discuss visual-spatial processing but as I started to research the subject I found there was so much more to cover!  I think I did a decent job overall to cover everything in a broad way. If I missed anything please let me know!  I you have any questions you can contact me on the blog or though Facebook.

Christmas 2014

The Christmas holidays were a lot of fun. Santa was so good to the children this year. Santa's gifts were in special blue paper, with special tags, and had a jingle bell on them. Santa's gifts were awesome! Christmas was a group effort. With the presents John and I got along with money from my in-laws, my parents, a friend who brought over gifts, and the help of MOST (a group of high order multiple moms) the children had the best Christmas they have had in YEARS! Santa was very good and on target with the gifts he brought. One of the best gifts was an iPad mini. I am excited to get apps to help with therapy stuff for the children.

James was happy to get some great gifts including Snap Circuits and a furby. He is having fun with those. He is also enjoying the games he got from Santa like Life and Clue Jr. Margaret got several gifts that she loves including a furby, new bedspread, a pop-up playhouse, balance board and clothes. Joseph got several gifts he loves too. He got a piano that he is having a blast playing! He got a bubble timer. Visually Joseph is having a blast with it! He also loves his new backpack. It fits his little frame just right.



John and I did not get anything for ourselves. We figured we could get something later with tax refund money.  ALL money went to buying new toys and toys to be used for
therapy for the children. The poor kids were so starved for new toys and more age/developmental appropriate toys that the children kept forgetting to open their Christmas presents to open Christmas morning. It took us TWO hours for them to open all their gifts! They would open a gift and then they would get excited about the toy and would ask for us to open it. We would open the present and then they would start playing with it. I would have to remind them to come back to open another present. James and Margaret would literally say, "Oh yea, I forgot!" LOL It was VERY cute!




Christmas day and the next few days after that was nice because no one asked me for my phone. They were too busy to playing with their new toys. :)

Where did the last month go???

Photo Credit: Chasedumont.com

When it becomes a long time since I last made a journal entry it becomes harder to get started because I know there is a lot I want to say but I never seem to have time. I get up at 5am-ish and leave the house no later than 6am so I can be at work by 7am. I work until 4 or 5pm and drive an hour home. By the time I get home, feed the children and put them to bed the small window I have to myself I do not feel like typing on the computer. Though I HATE the hour commute each direction each day I LOVE my job. I can barely say how rewarding it is to be working in the career field I went to school for AND be good at what I do. I have had several people in the office in the last two weeks tell me what a great job I have been doing. That really makes me feel good!

So let me give a brief run down on what all has been happening.

February 12 - I took the kids to a pediatrician. He is new to us and we had a great visit. I am happy we went there. As I have gone around to other specialists they know the new pediatrician and say he is a great guy. How is that for giving you confidence in your primary care doctor!

February 15 - John came to Phoenix for the weekend. We are working hard at re-building our relationship. I am hoping it can happen (for our sake and the kids).

February 19 - Joseph went to the Melmed center to be evaluated. Dr. Melmed examined Joseph and said he may be labeled as autistic. He would need additional psychological testing. It really saddens me to hear this. Mostly because that is not what I think is wrong with Joseph. To me autism is a list of symptoms of a disease. I want to know the disease (root cause) on what is going on with my baby. I am glad of all the improvements Joseph has made in the last year and a half but I would say he is now, at least linguistally, where Margaret was two years ago. I am hoping he will continue to rapidly improve with his speech. I have contacted a psychologist to do the additional testing. I am waiting to hear back from their office.

February 28 - We finally got to see the ENT. I was FURIOUS at first with the doctor's office. I had gotten a call the day before and I asked them if they had received all the information for the Margaret and Joseph to be seen the next day. I was told yes. I had spent an hour in the office last time filling out paperwork and medical releases for them on Feb. 6. The day of the appointment I was called at about 10am. The nurse asked about Joseph's surgery. I said he did have surgery but I did not have the records handy. They were at the hospital and I did not remember any of the details because this surgery happened back before Joseph turned one. The nurse then tells me the doctor will have to have the records and Joseph would not be sent that day. I was LIVID! Here I was having the appointment cancelled on me at the last minute. I got snippy with the nurse but I ended the call very politely. It completely took her off guard because I KNOW that was NOT how she was expecting the phone call the end....LOL. About an hour later I had the ENT doctor call me. He said he wanted to discuss Joseph and would I please call him. He said he was out at the hospital on an emergency and gave me his PERSONAL cell phone number. I was shocked! Every bad thought I was having I lost at that moment. I called the ENT back and spoke to him. I explained about Joseph and why I wanted to bring him in. The ENT agreed with me and said he was looking forward to seeing Joseph this afternoon. I told him his office staff had cancelled Joseph's appointment. He said there was no need for that and to bring him in. He said he was going to call his staff and tell them to put Joseph back on the books. We went to the appointment. I took everyone with me. I had me, Bailey and Alexa along with all three children. In the waiting area James decided to misbehave so I had Alexa take him back to the van for a bit. I know he screamed like a banshee but he did finally calm down. He was able to rejoin us before we went back to the exam room. While there the James was having a fit. He wanted to see the doctor too. Plus Bailey had told him he would get shot if he had to see the doctor...you know what, James agreed. This is the danger to threatening James with something you can carry through. He takes things so literally and he would expect you to carry though with what you promise. He would NOT let it go! When the ENT came in James INSISTED he get a shot. The doctor tried really had to humor him. The fact he took the time to do that made me like the guy! He brought in suckers in the end and James was at least distracted for a bit. We started to talk about Joseph. I explained all that was going on with Joseph and the multiple health issues he was having. Bailey piped in and said I did not believe in vaccinating the children or giving them medication. I explain why to the doctor since he had asked about giving Joseph the flu shot vaccination. When I was done he turned to Bailey and said it was a good thing I was not giving the vaccinations or medication consider all that is going on with Joseph and there are still a lot of unanswered questions. So the ENT examined Joseph and Margaret while we discussed Margaret. Margaret was found to have enlarged adenoids and inflamed sinuses. We are going to treat her with medication at the minute since the only other real option is surgery. I have no interest in having her go through surgery at the moment. I had also given the ENT a list of all the specialists we had seen in Las Vegas. The doctor was nice enough to recommend local doctors for each of the specialties. That was SUPER nice! He is a really great man and I can tell he care a lot about the children. What more can you ask for in a doctor?

March 8th - I get a notice from my insurance about the visit from the Melmed Center for Joseph. I had checked and there was not a problem. The insurance comes back though and says that the Melmed Center is out-of-network and I about nearly panic! The bill is for $660! I cancelled my appointment for Margaret (since it was for the March 13th) because I panicked! I wanted to make sure the medical insurance was going to cover the bill. It took several days and several phone calls but we finally think we have it straightened out. At least the insurance admitted there was a billing error on their part.

March 12th - I called the Geneticist's office. OMG, I wait on the phone for someone to pick up for 40 minutes! I get through and give them information. I find out they are booking appointments into October at the moment. Not shocked but I was hoping for better. They would not schedule an appointment for me until I fill out all the new patient paperwork. I got the stack in a few days ago...WOW! So I will be working on this information so I can fax it in and set an appointment.

You can see the height difference in the boys. It's a lot!

March 15th - I took Margaret and Joseph to the endocrinologist. It was nice because Joseph I was able to talk to someone about all the hormone concerns I have for Joseph. Joseph does not produce growth hormone on his own. When injected with insulin he did produce the growth hormone. So he is CAPABLE of producing growth hormone so I want to know WHY is he not producing the hormone on his own. Normally you have to fight hard to get growth hormone therapy approved since it is expensive ($2k to $3K a month) plus you have to give it as an injection every day. I would like it if we can find the root cause of why he is not producing growth hormone on his own because we might be able to fix that earlier AND we could skip having to go through the expense and daily injections until he is in his late teens. We spent 50 minutes going over Joseph's medical information. The endocrinologist doctor said he had received 60 pages of information on Joseph and did not want to have to read through it all (sad yet kinda funny). I explain in he end my speculation that Joseph my have cerebral folate deficiency and/or mitochondrial disease. The endo. doctor agreed with me that there is a strong chance Joseph could have mito. John said he was the first doctor to agree. I think he was a bit shocked to hear that news too. I had been telling him my suspicions for sometime but I don't think he has been paying a lot of attention to me. I am just the mom who spends too much time on the internet reading and researching stuff but to hear it from a specialist was different.

March 18th - Finally got someone from the Long-term care people call me. They supply the funding for the services I could get the children (such as therapies (OT, PT and ect) along with anything else) through the DDD. I tried to do this before but I could not. I am hopefully I will be able to get it done this time. Got the ball rolling again at least.

Happy Birthday Bill!

March 19th - James had his appointment with the Melmed Center. Since we got the insurance issues worked out I felt safe in taking him. The doctor examined James. It was rather funny. James has become VERY outspoken lately (sometimes good but sometimes bad). In the waiting room James was talking to a little girl (about 8) and then went to her Dad and asked if he could kiss her. What?!?! LOL At least he was polite enough to ask first BEFORE actually trying to kiss her. So some social skills are kicking in! :) When we go back to the exam room the doctor hold his hands so he cannot move away but he would not really ever look the doctor in the eye but let me say the boy developed diarrhea of the mouth! He was saying EVERYTHING including my phone number and our address. I am glad he knows this information but he does not know when it is okay to share and when it is not. The doctor asked me if he has a social filter and I said not really. Then we tell him a story of when James was at the doctor's office with Bailey and he saw an African American. James pointed to him and said, "He is black. We are white. Why is he black?" Know I acknowledge we lead a sheltered life and we could expose him to more ethnic diversity but he has seen African American people before. Bailey apologize and the man was okay about it but it you saw that at the wrong time in the wrong place (especially in the south) you could get beaten up for that. In the end the doctor said he agreed that James is autistic and he is most likely Asperser's. He wrote on his evaluation for James that he is a bright, high-functioning kid. I have to say...I agree. We have another appointment to go back later.

That evening we celebrated Bill's birthday!  The kids were SO excited!  They LOVED eating cake and seeing the candle blown out.  I am glad they had fun!

My Baby lost her first tooth!

March 20th - Mark it on your calendars...Margaret lost her first baby tooth and she is the first of the babies to lose ANY baby tooth on their own (Joseph has his two top teeth pulled awhile ago). I cannot believe she lost her tooth. I am glad she did though. She had her permanent tooth emerging in the floor of her mouth. It looks HUGE compare to the baby teeth. I am hoping the tooth will move forward on its own but I am worried it may not. Will be making an appointment for her to go to the dentist. I got to help play tooth fairy. I had found a small Hello Kitty bag with a toothbrush, toothpaste and dental floss. I put that under her pillow along with a dollar bill. I also placed a dollar bill under the boy's pillows. I did not want them to get it into their head that they had to get a tooth out to get something from the tooth fairy too. In the end the money meant nothing to the children...everyone fought over the Hello Kitty stuff...LOL!




March 27th and 28th - James and Margaret have an appointment with the dentist. They will go first and the next day Joseph will go. It will be good to take them in and have them examined.

Now you are caught up on at least part of what has been going on. I have been SO busy with work and other things too. At least I have been able to get things squared away though. In getting all of this off my mind it leaves me free to think about other things and do write the stuff I need to for work.....Thank goodness! Got to get a paper researched for school and then one written for work. Back to work for me...

Am I A Fool?

Photo Credit: Hellobaby.deviantart.com

Am I a fool?  Maybe so.  I am hopeful and cautiously optimistic.  After MUCH and I do mean SO MUCH anger and animosity between PITA and myself I was SHOCKED when he called last night and said what he did...

PITA said he had come to the realization that if he was going to be the moral and spiritual compass of the family as God intended then he had to step up and work things out with me to get his family back.  He said, "I want you and the children to come home."  I cried.  This is what I had been waiting and wanting to hear.

Has a miracle happened?  Has God answered MY prayers so we can be a family again?  I am hopeful but cautiously optimistic.  I am wanting this to be real.  For PITA to be serious about wanting to be with children and I.  I cannot immediately return to PITA and Vegas because there are people here relying on me plus I have a lease.  I am not sure what to do about the lease issues.  It is all logistics but I want to go home.  Home to PITA, Vegas and being a mom.

News Bits

Courtesy of TimeAndDate.com

I love it when I have various news sources overflowing with information!  So on the autism front I have some interesting news.  The Autism Research Institute (ARI) is holding its Fall Conference in Garden Grove, CA in October 11 - 14.  The speaker line-up looks great with Dr. Emeran Mayer, Co-director of the CURE: Digestive Disease Research Center at UCLA, Dr. Robert Hendren of UC San Francisco, Drs. Nancy O'Hara, Elizabeth Mumper, Martha Herbert and others.

I know this is a MAJOR area of controversity but I wanted to post this here to let people hear all sides of the story.  Holly Riley discusses how her son with Autism was cured with biomedical intervention.

 
A Facebook friend, Jennifer Grayson, writes a wonderful blog about Autism, food allergies and other health related topics.  It is a great read.  She recently wrote and article about parasites.  We may live in the United State but if you think there is NO way you could have parasites you might be wrong and are suffering silently for it.  Conditions such as allergies (including food), eczema, asthma, migraine headache, nightmare, bedwetting, chronic fatigue, fibromyalgia, arthralgia, multiple sclerosis, irritable bowel syndrome, seizure, mental illness and even cancer could be caused by a parasite infestation.  The article is a great read so please stop by!

For those dealing with mitochondrial disease the options for treatments and therapies can be confusing.  United Mitochondrial Disease Foundation (UMDF) is an excellent website for many resources on mitochondrial disease.  They even have a page breaking down the various treatments and therapies to help point you in the right direction.  This is a wonderful site if you are trying to diagnose mito and need information on local doctors. They have been very helpful to me in finding Joseph a doctor.

Found a wonderful recipe of Zucchini Chips from the Naked Kitchen.  Yum!  They are both a green veggie and much better for you than potato chips.  What more can you ask for?  LOL   There were several FB friends that swore by this recipe and I am looking forward to trying it one day.

For those who cannot eat gluten and are looking for a easy add on to a meal that is flavorful and chalk full of fiber check out this recipe for Homemade Refried Beans.  I have made these at home and they are delicious!  I used it and mixed in some homemade salsa for some chip and dip action.  The children ate it up!

Yummy Recipes, Vaccines and Other Things

Today I went to the doctor and have him look at my hand.  The scar from the carpal tunnel surgery is VERY sensitive and there is a lot of scar tissue forming under the scar.  It hurts!  :(    In talking to the docotor he said he thought I was healing ok still but I find that debatable.  He recommended therapy to help  decrease the sensitivity of the scar and to break up the scar tissue.  I thought this was a great idea and make an appointment.  I just realized this evening that I could not pay for the therapy because each therapy session I to pay my $20 co-pay.  This SUCKS!  So I will just have to do what I can to increase the flexibility and strength in my hand.

Joseph's Medical Summary Letter

I went to the pediatrician today.  I had worked on a medical summary letter for each of the children as a rough draft for the doctor.  Took me about 2 hours for all three children. I think a medical summary letter is fantastic when you have a child with a long and complex medical history. You can pull the letter out and just hand it to another doctor to give them a quick run down on all the medical issues of your child.  Here is an example of Joseph's letter.  (if the type is too small hit CTRL and the + sign 3 or 4 times to enlarge the font).  When I got to the doctor's office I figured out I was an idiot and FORGOT to burn a disk with the letters to give the doctor's office.  Ugh!!!  I did remember to take the WIC forms to get Margaret and Joseph their Pedisure AND I got the right form filled out to get a handicap plate for my car.  It will make taking the kids out MUCH easier in some places.  The doctor was funny.  He said which child is this for since all of them could qualify.  LOL  That was both a funny and sad statement!  I got the permit for Joseph though.  I also got the information I needed sent off to to the medical supply company to get Joseph's wheelchair.  That will be SUPER helpful!  So I did pretty did pretty good today.

Just as a quick note to people in Nevada applying for a handicap plate or placard for their minor child here are the instructions on what to do.  I called the Nevada DMV twice and waited over 30 mintues on the phone for this information because I could not find it online...lol.  IF you call talk to the Special Plates Department.  Their number for the Las Vegas area is 702-486-4368 and them wait for the options and press 2, 1, and then 5.  That should get you to Special Plates.

Online you go to the Nevada DMV page for handicap plates.  Download form SP27 Applications for Disabled Persons License Plates/Placards. Once have the form you fill it out for the child you want the plate for by putting their name and address on the form. The Nevada Driver's License or Identification Number you leave blank.  For Signature of the Applicant the parent signs the form and puts in parentheses minor child.  This lets the DMV know the child will not be on the registration of the car nor have a driver's license number.   Just have the doctor fill out the medical portion and you are all done!  I just saved you at least 10 minutes on the phone.  : )

While I was at the doctor's office the doctor mentioned getting the kids vaccinated for the flu. I just brushed it off.  He is right though in one thing.  I LOVE the kids pediatrician and he is a VERY cool doctor but he is in a VERY busy practice and he mentioned that over the winter he sees a lot of super sick children.  Just taking them to the doctor's office  during the winter would be putting them at risk of catching something. It makes me worried.  I worry EVERY winter about the children and in particular Joseph.

Speaking of vaccines there is a great article by Marcella Piper-Terry saying vaccines do not cause autism.  At first I thought, "What?!?!" Then I read the article and it all made sense.  Basically the article states that vaccines do not cause autism but a host of other illnesses and conditions that are the underlying conditions of autism.  Really great read!  Then another great article by Moises Velasquez-Manoff was published in the New York Times Opinion Section called An Immune Disorder at the Root of Autism.  The article has some sad information talking about the immune system of the mother attacks the child in the womb.  Autoimmune disorders significantly increase the chances of having a child diagnosed with autism.

Blog to mention is the Naked Kitchen.  Like Jamie Oliver's Food Network show Naked Chef the blog is about keeping food whole and simple.  It is a great blog with LOTS of good and healthy recipes!  Speaking of recipes I came across a great little recipe for making pizza dough.  SUPER simple and I am looking forward to trying this!

Two Ingredient Pizza Dough

• 1 cup Self Rising Flour
• 1 cup of Greek or natural yogurt

In a bowl combine flour and yogurt.  Stir until it forms a ball (might be a good job for a heavy duty mixer). Remove dough and turn out onto FLOURED board.  Knead dough for at least 5 to 8 minutes until the dough is nice and pliable and stretchy.

Living in Flux and Eating Bon Bons

At the moment I think it would take me less time to tell you, my reader, the few things that are the same in my life but I am going to try and cover as many as I can in the post.  First is my living arrangement.  My husband, since he has dropped the divorce, is still out of the house the kids and I live in.  With the money I am getting from John along with the what little money I am getting from SSI I am not able to cover all my bills.  So I have been applying for jobs all over the country.  The way things are looking are: 1) move back in with John (which he does not want and really, neither do I)  (2) become homeless (not literally but I would be stuck in a cheap hotel) or (3) find a job.

For me getting a job would be great because I would LOVE to have a job and make my own money. This is especially true if I am able to land a job that is related to what I have been slaving over graduate school for the last two years. On that note, I have had two interviews.  One for the State and another for the Federal government.  I would LOVE to have either job!  They are both in my field and are RIGHT in line with the master's degree I have been working towards for the last two years.  I am hoping to hear something soon.

In the meantime I am trying to hang on to my house in Vegas.  Moving the children is hard on them.  I would like to just move once, for my job, than move several times.  On that note though I had an interesting development on Monday.  John had dropped off the children on Sunday and talked about how much they had loved attending church and what a great time everyone had.  I was happy for them all but I told John that  he could not take the children to church (an in return Sunday class) after school started.  He just looked at me.  I said he could not do that because of the risk of exposure to Joseph for respiratory diseases.  Then he said that I was asking him to give up church.  I said I was not.  I was just asking him not to go to church every other Sunday morning when he had the children.  Otherwise he was free to go to church as much as he liked.  He could go Sunday night, Wednesday night, Tuesday night for his group stuff and every other Sunday morning.  He was upset with me but I thought that was going to be the end of the story.

On Monday evening he comes by to see the children and to put them to bed.  When he comes in he says he has some good news.  I am think that sounds promising.  Then he says, "Well, I think it is good news but I am not sure you will think so."  At that moment I KNEW I was about to be PISSED off.  I did not even bother looking at him.  I just waited for him to say what he was going to say.  He tells me that he had called Joseph's pulmonologist without my knowledge and spoke to him over the phone.  He said he wanted to take Joseph to church and asked for clearance to do it.  The part of this story that boggles my mind the most is that the pulmonologist gave John the clearance without seeing Joseph!!!  So when I looked at John and said I would like to see some proof he smiled and pulled out a note on a prescription pad note that said Joseph could go to church.  To say I was angry would be a gross understatement!  I yelled at John.  He said he did not understand why I would not be happy that Joseph could go more places.  I asked him if he had even been aware of what was going on in the past year.  How could he really?  He spent most of his time away to avoid me and somewhat the children!  When he was home we rarely spoke.

I tried to calm down and explain it to John again.  Joseph has MANY medical issues and his hypotonia, narrow trachea, tracheomalacia and low weight make ANY respiratory illness for him dangerous.  Then John pointed out the 4 colds that Joseph has had in the last two years.  Yes, Joseph has had four colds and recovered from all of them well.  I told him that was not the point.  During the winter all sorts of nasty stuff floats around including the flu and RSV.  THAT is what I am concerned about.  John asked why I was getting so upset.  It was not like he was sick or something.  I told him not yet but in my opinion he was playing Russian roulette with our son's health.  I was SO angry that I had to leave.   I could not stay in my house any longer.

The next day I called the pulmonologist's office.  They want NOTHING more to do with me now because of this crap.  I called and told them that John and I were separated and he did this behind my back.  I wanted to know what was going on.  The nurse said John had called and left a message for clearance for Joseph on Monday.  His doctor gave it to him but did not know the entire story like John placed Joseph into a child care class with 4 or 5 other one to two year olds.  I said with John doing that I might as well just place Joseph in a daycare or school myself.  The nurse said John did not mention this.  The clearance for church was for Joseph to attend church and sit beside John in the auditorium and NOT for him to be in any sort of class with children.  The doctor's office was NOT happy to be informed that they were being used in this power play John was pulling and threatened not to see Joseph any more.  SO NOT PLEASED WITH JOHN!!!

The next day I told John I called up the pulmonologist's office to get clarification on what was going on.  I said he could take Joseph to church, which I did not agree with, but he would HAVE to keep Joseph with him.  Then John gets completely mad at me and says a lot of things but the one that hurt the most was telling me to leave.  I want to stay and work out things with him but with him going behind my back and putting Joseph's health at risk along with his attitude I am not sure I can.  He basically said I would not allow him to parent and he was basically just money and a babysitter to me so I should leave and go to California.

I did not know what to say really.  I did yell at him about saying he was babysitting for me.  I said he was taking his time with his children and NOT babysitting for me.  What a joke!  So we argued about that and I said he can give up his rights to see the children whenever he wanted and I would keep them.  I did not need him to "babysit" and I would just keep them.  Then he got defensive and said I could not keep him from seeing his children.  Yet, apparently, if he takes them, then he is babysitting for me.  WHATEVER!!!   So when I have the children am I babysitting for him???  How absurd!!!

So now our relationship is strained and he has told me to go.  I am not sure what I am going to do.  I guess this is just another problem I will have to wait and see how it plays out.  Then there is school.  I have my last class I am suppose to take.  I started the class August 6th but I dropped out on the 19th so I could get a 100% tuition refund.  I just found out that I will not be able to sign up for the class again until December.  In some ways this is good.  There is a REALLY good chance I will be moving (for work or to California), having to set up the kids services again, get settled into a job (hopefully), find someone to play wife for me (cleaning house and taking care of ALL of the children's activities), do research on my topic for my paper AND most importantly figure out HOW to collect data and write a research paper in the SHORT time frame of my class.   You know, I have nothing going on really.  I just sit around and eat bon bons.

Today it has RAINED, RAINED and RAINED!  I even had the feeding therapist tell me NOT to come to therapy session today because there were wide spread reports of flooding and their parking lot was flooded.  I have never had a therapist cancel my appointment!  The roof in the house has a leak and I have had to empty a large bowl three times.  The most water I had ever had in the bowl was 3/4 full.  I think the rain has finally died off.  It was a nice break though from all the heat and sunshine.

So that basically all going on in my life.  I guess I could talk about the lack of money (had to sell my sofa), lack of food in the house (I will be eating popcorn for dinner. Kids ALWAYS get feed!), the air conditioner in my van does not always work and the brakes need to be fixed, or that I have NO idea how I am going to get the money to move.  I shall not worry though.  Those problems can wait until tomorrow and I will go back now to eating my bon bons...lol.
















 

Last day of July....

And boy am I GLAD to see July come to an end!

Since John left I had to take care of the children by myself. After John telling me he was leaving it was an emotional weekend with no room to take a breathe and gather myself. On Monday, July 9th, Margaret had an appointment at the dentist. That was JUST the start of one of the WORST days of my ENTIRE LIFE!!! She had pointed out to me her front left tooth was loose (thanks to Yo Gabba Gabba...lol). With the recent abscess from Joseph's dead front teeth I was concerned. So poor Dr. Sina was the dentist we went to see. Margaret did pretty well for her during the exam part. She sat in the dental chair and cried VERY little! I was SO proud of her!

All was going well until the dental assistant went to take a couple of x-rays of her front teeth. Margaret gagged a little but not too bad. I thought I was in the clear. She got up from the dental chair and ran over to me. She had a pale pallor to her skin and I was concerned. I called to her but she detoured at the last minute and headed to a narrow hallway where the appointment setter works. She stops suddenly and projectile vomits. Two bad things about this. One is that I fed her 90 minutes earlier and she should not have been able to vomit so much. The second problem was the appointment setter gets ill easily and he RAN out of the reception area. I felt sorry for her. Luckily Margaret missed vomiting on her clothes and she only got a small amount on her shoes. That was perfect since it was easy to clean her up.

Then I left there and had appointments at two different attorneys to discuss my impending divorce. The first attorney I went to said I had an excellent case to gain sole custody of my children. I was pleased and I liked the attorney well enough. The second attorney was was heading across town to make the second appointment I called the office only to be told they could not see me. Sigh! So I turned the car around and headed home. I make it home at about 2pm after leaving the house at 9am. I arrived home and opened the front door using my key. I walk in and the children go in. They did not want to stay outside because it was SUPER hot that day. The next thing I know I hear James say the TV is gone. I was talking to my friend as I walked in the door and I walk over to where the TV sits and I see it is gone. My first though was that John came back and took the TV. Then I walk back to my bedroom and I see my jewelry box sitting out on my bed instead of being at the top of my closet. ALL the jewelry was gone! Including the jewelry that was in a baby wipe container that held my nicest jewelry. I easily lost $7,000 in jewelry that I had collected over 20 years AND the inheritance of my children. I called the police and at first I was mad. As I was filling out the missing property report I could not think. Most of the jewelry I had not worn in YEARS because of the babies. Then I started to cry. I was so stressed out that night and I was scared to sleep at home. Who ever did this has to either live close to my house or goes by it on a regular basis. That is how they knew I was gone but for someone just to hit my house for the jewelry and my TV they must have been in here before or know me. That was ALL that was taken. My laptop was left behind, my prescription pills and some other moderately valued electronic stuff that was small.

Then to round out the day my husband was trying to force (or at least I felt that way) me to agree to divorce stipulations that I was not happy with. I went to speak to his friend that evening with him and I had to start my car. It was not wanting to start. It was 114 degrees outside and the car was acting like it was fried. I tried to start it again and it did start but then the air conditioner did not work, the odometer (electric) did not work and neither did the speedometer. It was tough to drive 30 minutes across town with Margaret, Joseph and myself in a van with no A/C in 144 degree heat. When we got there I was lightly sunburned and we were all beet red due to the heat. By the time our discussion with John's friend ended thankfully my car had cooled and so had the weather so my car started right up and everything worked. I was grateful for that small miracle after such a tragic and awful day!

July 10th it was MY turn at the dentist. I have a MAJOR problem now with getting dental work because I seem not to be able to numb up with lidocaine. This makes ALL dental work at least kinda painful. I was able to convince John to take the children for part of the day for the first time since he left. I was a welcome relief from them but getting dental work cancelled that out...lol. The dentist knows of my problem and made sure he numbed me up SUPER well. I had enough lidocaine that my face was numb up to my eyes. It felt WEIRD! I had two cavities drilled and refilled. They were both large. They stated out as tiny pinprick cavities 20 years ago and now the tooth is all most gone. The next time I will have to get crowns on the teeth. :( I also had two teeth sealed. They will probably be the ONLY two teeth I have when I am old! LOL At the end of the drilling I was feeling the dentist drill. It was not too bad though. It took until the end of the day for all the lidocaine to wear off! When I got home the children were wondering what was wrong with me...lol.

On Wednesday July 11th I had feeding therapy for Joseph and while I was in the area I had an appointment with another divorce attorney. John was telling me I did not have a good case for the divorce and I thought I did. I went to another attorney to get another opinion. The last attorney told me the same thing. I had a good case. That made me relieved.

On the 12th I only had therapy for Margaret and Joseph. It was a nice break compared to the other days. July 13th John took the children for the weekend for the first time. It was nice. So Saturday I had an appointment with the Aveda school and got my hair done. It was SO nice. I needed that SO bad after all the stress of the divorce, the break-in of my home, and having the children for awhile without much of a break.

I got the children back Sunday evening and on Monday I had a WIC appointment but I could not make it to the recertification appointment. Tuesday the 17th I did not have any appointments. Thanks goodness! On the 18th Joseph had an appointment with Dr. Sina, the dentist, to clean the heavy tarter build-up on his back teeth. The tarter is so heavy because he does not chew food so the teeth do not have the tarter scraped off of them. So I took him in for his cleaning. He did SO good in sitting in the chair. When the dentist came in I sat Joseph in the dental chair, James in a small child's chair and Margaret in the stroller. I thought this was a good idea but I was horribly wrong! As the dentist started to clean Joseph's teeth Margaret became upset. I saw her stick her hands into her mouth and then the next thing I know she vomited EVERYWHERE! Vomit was in her hair, down her shirt, on her pants and she filled the bottom of the stroller with vomit so the back of her pants were soaked too. I was not prepared for that by ANY means! NEVER though she would get sick with Joseph having the dental appointment!

I had to go and leave Joseph alone while I took Margaret and James to the bathroom and try to clean up all the mess. I was able to get her shirt off without getting more barf in her hair. I rinsed out her hair and then I tried to tackle her clothes. I rinsed them off in the sink using soap and water. By the time I got everything clean her shirt and pants were completely soaked and there was no hand dryer in the bathroom not to mention that a hand dryer would have completely upset Margaret. So I did the only thing I could do. I dumped the barf in the stroller out and then tried to rinse the stroller in the sink but that was not going to happen...lol. Just would not fit. :/ I had to walk Margaret out of the dentist office with just her shoes and diaper on...LOL! The dentist was kind enough to offer me a gown for her but I said I was not worried about it. We only had a short way to walk to the car and then I was going to strap her in and take her to the house to get more clothes. I had JUST enough time to get home, grab clothes for her and then race across town to Joseph's feeding appointment. I just made it in time to walk through the door by the time I got Margaret into her change of clothes. What a wild day! By the time I got back out to my car the stroller I had rinsed out and her clothes were making my car reek of barf due to the warm weather. I was GLAD to get home! I got the clothes into the washing machine and the stroller I set up outside and then used the hose and some dish soap to get it clean. Then I left it in the sun for two days to make sure the smell would be gone.

That evening John came over and stayed so he could take me to watch the children because on July 19th I went to have carpal tunnel surgery done on my right hand. I have been having carpal tunnel issues for the last 20 years but it had gotten so bad that I could not drive, fill out a form, sew on a button or do anything that required me to grip something without my hand falling asleep. I had been tough! So I hoped surgery would solve my problem. I dove myself to the surgery center EARLY in the morning. I get there and I am nervous. I was able to settle my nerves until the nurses were trying to put an IV into the back of my hand. I just do not have good veins there especially on my left hand. So they stuck me once and it did not work so another nurse tried. She got blood but it would not flow. She was moving the needle around and I cried out in pain and starting crying. They think they were on a valve. I don't know besides it was SUPER painful so they stopped. All most the ENTIRE back of my hand was bruised for a week. The anesthesiologist came out and stuck me in my arm and got it at once. I was glad there was NO more torture!

I was wheeled in and got on the surgical bed. The anesthesiologist knocked me out. I work up later. The surgery was really short. My hand was wrapped up and I was woozy that first day but otherwise I felt fine. The next day I watched the children for a few hours while John took a nap. The children have been gone for the most part. I have had them over on Thursday and Sunday nights so that John can get up early and go workout with his trainer. Then I kept the children for 4 hours the day after my surgery, I kept them for another 4 hours one day after John got back from working out and Saturday (28th) I kept the children all most all day (10am to 7:30pm). By Saturday John was starting to beg for mercy from the children. I love the little munchkins so much but the can wear you out. I asked John if he understood why I could not do school work at night after taking care of the children all day and he said yes so I agreed to take the children on Saturday. :) I have an appointment with the hand doctor on August 1. Recovery for my carpal tunnel surgery has been difficult and I have had a lot of pain in my hand. Even now I have pain often when I move my thumb. It hurts. I am hoping he will say it is all normal and will heal great. I did have the surgeon tell me that my surgery went well and the carpal tunnel was under extreme compression. I am hoping I got the surgery done in time to keep permanent damage from happening to my nerves in my hand.

To wrap things up on the divorce end John and I are going to try and work things out so currently the divorce has been dropped. We will go the couples therapy and see if we can stay together because having disabled surviving quads we will probably ALWAYS have to deal with each other until we die. It would be easier to do that if we were able to stay together and work in unison for the children than work against one another.

Still grateful the month of July has ended! One of the worst months of my life!

It's a PITA!

I have not posted in awhile and I think part of it has to do with I am not sure what to say. Its not that I don't have a lot I could say but I feel like most of it is not good news.

On a personal note my marriage is hanging by a thread. I mean it literally. I am expecting John to file for divorce at any moment. If he does I am not sure what I will do. I am close to finishing my MS degree. I am in my last class now and then I have a two month break (June and July) before I can start my capstone project. I should finish that class at the end of December and should graduate then. I have been looking for a job but so far I have not been able to find anything.

John did say he would stick around longer if I went to therapy so I have tried calling a few therapists. So far I have called seven of them over the last two weeks. I have been doing research on the internet of the therapists in the area and no one yet had called me back. A couple of the instances were funny because I would call and one said, the therapist had a six week waiting list and the second one said they were closed for the next three weeks. Just today did one of them call back. I will have to cancel another appointment to make it but I plan to go. John thinks I have a lot of problems. I think I have some problems and the problems I think I have I am pretty sure is different than what he thinks I have.

This past week the homebound teacher for the school has been here. I got a bit upset with her because she was getting pretty cross with James. At one point she told him, "Do we need to get your mom in here?" What kind of threat is that to an autistic four-year-old and all I could think is what would she have done if she know I was not going to be there to witness what was going on. It scares me for my children.

We went to two appointments last week around all the homebound stuff. One day for me as to get the children up, clean the house some, have the homebound teacher arrive, have the OT person arrive, have them both leave, feed the kids lunch, put stuff away and gather what I need to leave, get shoes on everyone, pick up Joseph and herd the other two out the door and into the car, buckle everyone in and head out. I get to my destination and take everyone out. Joseph goes in a stroller while I keep and eye on Margaret and James making sure they do not run off, we go to the appointment and wait. We see the doctor and then get to leave. I take everyone out and make sure they do not wander off as we head to the car. I get everyone into the car and buckle them all back in and then collapse down the stroller and put it into the car. We drive back home and typically 3 to 4 hours have passed since we first left the house. So I arrive home about 4pm to 4:30pm. I have to feed the children again and get them settled. Then I have a bit of time, maybe, to make some phone calls before 5pm.

Alternate scenario is homebound teacher leaves at 11:30am. Then I feed the children lunch and we have maybe 90 minutes before the speech therapist arrives to work with the children. She works with the children for the next hour. She packs up and leaves and I take the children outside for about 30 minutes. By then it is 4pm-ish. I bring them inside and give them a bath. Then it is time for me to start dinner. I fix food for them and feed them again. By then it is about 6pm. That gives them 2 hours before bedtime to do as they wish. Overall we have pretty packed days.

My days often fly by. Lately I have been struggling with keeping up with school. I am towards the end of my last class. I will then be on a two month break and in August I will be starting my capstone project. Once that is completed in December then I will graduate. I will be SO excited!

Right now my life is a PITA (Pain In The Ass) but I think things will be getting better soon. I hope...lol.

It Looks Like a Clothes Bomb Went Off In My House....

It is nice to have a moment to breathe. Sunday night at 10pm my time was the last time I could enter any clothes into the consignment sale. I swear my house has looked like a clothes bomb went off in my living room. Clothes were EVERYWHERE! I got 130 items entered into the sell. Today I went to turn the items in so they could be placed on the sales floor. OMG, it was a mad house there!!! I was having to struggle with two large and one really large box of clothes along with Joseph in a stroller, Margaret without her backpack leash and James. This is after we went to therapy today.

So lets go in order. We went to therapy. We got to therapy where at 10ish Margaret and Joseph went back to get OT for Margaret and PT for Joseph. This left me James in the waiting room for an hour. Luckily he played on my phone and entertained himself with it even though my "nice" phone broke. That is a story I will get to in a minute. Then at 11am I got Margaret and James went back for ST and Joseph got OT. So Margaret and I went shopping at Trader Joe's since there is all most no food in the house. We shopped and got back to the therapy center where the therapist brought out James and Joseph.

We left the therapy center and came home. I fixed the children lunch and then put Margaret and Joseph down for bed. After therapy they always need a nap. So they were in their room from 1:30pm to 3:00pm while I worked on my school work I could not complete Sunday because the school's computers were down. James watched Toy Story. He has really come to like Toy Story 1 and 3 a LOT! He will watch the movies 2 or 3 times in a row. Anyways I got my work done. Got the children up and fed them again. Got them ready and we left the house. It took us about 30 minutes to get to the consignment sale location. There were a TON of cars and I could not find a space to park my car. You have to keep in mind I drive a Ford E-350 15 passenger van. It is huge! So I have to park FAR away from the door but I did swing the van back around and dropped off my three large boxes of clothes near the front door. After getting the children out and Joseph loaded into the stroller we went to the front door. I lucked out and got a clothing rack. I loaded the clothes into the clothing rack so I could leave the boxes behind. While I was doing that a TON of people walked by and cars were going slowly by. I was SO nervous Margaret would walk out in from of a car. James was entertaining himself by pushing Joseph around. Overall he was doing a good job but I was worried he would tip him over. I managed to get all the clothes loaded onto the rack and get the clothes and the children inside. After getting in I soon "lost" James. I knew he was in the store somewhere but I was not sure where.

Margaret was being good because she was staying fairly close. The women went through all my clothes. It took her about 15 minutes. She pulled out about 8 outfits. In the end she rejected four. Then I had to go and find James. I see him rounding the far corner where the toy are displayed and he is riding a pink bike...lol. I told him to get off and to put it back. He started to cry. Then I grabbed his hand, Margaret's hand and was trying to steer Joseph's stroller to go back out to the car. James is bawling all the way saying he wants a bike. Margaret is crying too and Joseph is crying because the other two were crying. It was sad really but in a perverse way funny. All these other people staring at me. Not one person offering to help going in or coming out of the consignment sale.

I got the children loaded into the car and I got to hear James cry for 30 minutes as I drove home. I got here in time to meet a woman who wanted to by the white toddler bed I had advertise on Craig's List for $20. At this point money is money because we have very little of it especially if I am going to the consignment sale to buy clothes and toys for the children.

So tomorrow is therapy day again and the consignment sale will begin at 2pm. I will be there with the children. I tried to find someone to watch them for me but that did not happen. :( Hopefully James will be able to find his bike tomorrow. I hope so!

One last thing I want to throw in about Margaret because it was rather funny. Sunday night Margaret was screaming upstairs in her room about an hour and a half after bed time. The sound of the scream I had a good idea that she had vomited. I get upstairs to check on her and I was right. She was paralyzed from her own vomit. It was ALL over her and her bed. John comes in to help. Margaret as you know is Autistic and she scrips a lot. Right now she is no a Wonder Pets kick and she likes to script them. So when John went and brought her out to the changing table Margaret started to whine and then sing, "stuck on the barf, stuck on the barf, this is serious, we've got to help her, Wonder Pets, Wonder Pets, we're on our way to help the baby Margaret and save the day," John and I cracked up....LOL. So John takes Margaret to the bathroom and gives her a bath while I change the bedding. I get done as he is finishing her bath. So he starts to dry her off and she sings, "Our work here is done. Time for celery." then as John finishes putting on her clothes and she walks into her bedroom she says, "to the flyboat, to the flyboat, Wonder Pets, Wonder Pets, were on our way, to help a friend and save the day, we're not too big, we're not too tough, but when we work togethr we've got the right stuff, go Wonder Pets, YEA!!!" LOL She is one funny, quirky little girl!