Thursday, September 11, 2014

Fork and a Foon

This morning I got the best news, it looks like we are finally at the end of what has felt like an incredibly long process. Kellen had always reached all his milestones within the ‘normal’ timeframe and once he started talking he would chatter away like any toddler. While his vocabulary would grow and he would put together multiple words, and eventually sentences, it seemed he was hard to understand. Not long before he turned 3 I remember asking a friend when her son started to speak more clearly so that others could understand him and she thought it was around preschool time when mom wasn’t there anymore to translate. So we plugged along and Kellen started nursery school in England. At this point Jamie, Patrick, and I were really the only ones who could understand him. It would break my heart to see him trying to talk to someone else and unless they spent a lot of time with Kellen and were used to the way he would talk they really couldn’t understand what he was saying. It seemed like everything was mumbled and some of the sound substitutions he made were unusual. He would get a lot of blank stares and smiles while people waited for me to repeat what he had said more clearly. But I told myself that he was little and eventually it would click.

A couple of months after starting nursery the teachers said that they felt his language was impacting his ability to interact with the other kids and it was difficult for the teachers to understand him. It was also getting progressively more frustrating for Kellen to constantly be misunderstood. At times when we would be at home or in the car and he would use a new word I often couldn’t quite get what he was saying and he would continue to repeat it, to the point of yelling, not understanding why I couldn’t understand him. This started a series of tests and appointments to try and figure out what was wrong and how we help him move forward. We went through long waitlists to get his hearing tested and get assessments done on what the issue might be. As we went along I learned a lot about all the different things that can impact speech. I was also given information explaining how delay in language can be an early indicator of delays in literacy, etc. So as we went along I worried about every potential issue we could be dealing with and what this could mean for the long term.

The NHS is amazing for many reasons, braces being 100% covered for one, but it does have its downsides. We finally did see a speech therapist and were given a few things to work on at home and told that they would check in 6 months later to see how he was progressing. To be fair there are children and adults in much more serious situations then Kellen’s but it was extremely frustrating to be essentially pushed through from appointment to appointment with no real clarity on what we were working on or how to do it. Then we left England and never ended up having the follow up appointment. Once Kellen started preschool here in Australia it felt like starting all over again. He had progressed some as any child will between 3 to 4 but was still far off from speaking clearly. I asked the preschool director for her opinion as she has so much more experience with kids at that age and no surprise they were actually going to suggest we have Kellen assessed… The saddest example was the day he brought in things from the Australian Museum. The museum had a special dinosaur exhibit running and we went to go see it. The school encourages the kids to bring in pamphlets or ticket stubs when they do interesting things so they can share with the rest of the class. Kellen brought in his dinosaur ticket and stood in front of his class excited to tell everyone about his day at the museum. The teacher said he was up there confident and excited but the other kids really couldn’t understand him. We were referred to a speech pathologist for an assessment of Kellen and I expected the same result but hopefully we could actually start some speech therapy as we are on private healthcare now.

The woman who assessed Kellen was great and actually came to his preschool and did the assessment there so he hardly even knew what was happening and didn’t have to go to another doctor’s appointment where the adults talk about how poor his speech is. When I got the assessment report I was amazed, she actually pinpointed what she felt was the source of Kellen’s speech challenges, tongue tie! What?! I had never even been asked about tongue tie and had never discussed it with anyone up until then and he was 4 years old. The first thing I did was make an appointment with the ENT she recommended and then searched online. I don’t suggest doing that unless you want to see terrible pictures of recently separated tongues. What I did learn was that while tongue tie is fairly common it is normally caught as an infant and can be corrected right there in the paediatricians office without even an anaesthetic. When caught as an older child it is an operation that requires going under a general anaesthetic. We were torn between relief that it was finally something tangible we could work on and a little concerned about the thought of our 4 year old going under a general. We have been very fortunate health wise, while I know many families have had to deal with far more serious operations none of us have ever had to go under and general and it was scary.

We met with the ENT and he agreed that Kellen was tongue tied but it didn’t appear to be very severe so suggested we try speech therapy for 4 months, at the end of the 4 months based on his progress we would either move forward with the procedure or continue to address it through therapy. While it was tempting to want him to say “Oh I can fix this tomorrow” I did feel good that we weren’t just jumping into anything and were doing the work on our end first before putting Kellen through a procedure. So we started going to speech therapy every Friday morning. I was so proud of Kellen during is sessions and then with his homework, he really did work hard even when it wasn’t easy. We were encouraged as we went along because we did see progress. As the end of the 4 months drew closer it was clear that while he did make progress he was really having a hard time making the sounds appropriately, and when he did it would be very slow. So instead of Long Kellen would say Lll-ong, since he would have to work hard to get the L sounds right and then hold it before moving on to the rest of the word.

We met with the ENT again and he agreed we should move forward with the procedure and was able to get us in just a couple of weeks later. Kellen’s appointment was for a Monday and since it was a fairly minor surgery they were able to do it from their day surgery and luckily we didn’t have to go into a hospital as I imagine that would have been overwhelming for him. We talked about what was going to happen the Sunday before, we didn’t want to build it up so much that it became a big scary thing and instead the day before we just talked about seeing Dr Taplin again and what was going to happen. I think I was the most nervous the night before first because he was going to have to go under a general anaesthetic and second because I really didn’t know what to expect as far as recovery. The next day we were at the doctors early and they were so good with Kellen, trying to make him and I feel comfortable. Once we were called back it was all very fast. I was able to stay with him while he went under the anaesthetic then I was taken out of the room. It was only about 30 – 40 minutes later when I was called back because he was in the recovery area. As he woke up he was understandably groggy but we were lucky that he didn’t get sick. After waiting to make sure he was eating and drinking we were sent home. The first time Kellen stuck his tongue out I was amazed as he was easily able to stick it out further than I have ever seen. He was lethargic for most of the day but by that night he was running around the house. By Wednesday he was back at school.

I assumed the change in his speech would take time but only a few days later we were in the car and he said something with an L in it and the sounds was not only clear but his speech was fluid. I was so relieved. Our biggest concern was putting him through the procedure only to have it not make a difference. Over the next 2 weeks the change in his speech was remarkable. He is speaking more clearly and much more quickly, it has been noticeable at school and at home. We had our post-op appointment with the ENT and he said that Kellen has healed perfectly, no need to continue to see him. The day of the surgery we only spoke with the nurse after as the doctor was held up in the surgery after Kellen’s. So it was only during out post-op that he had a chance to tell me that once he was in Kellen’s mouth he was surprised by the severity of Kellen’s tongue tie, he said he would categorize it as severe. He had to separate 2 ½ cm of tissue and it is no wonder her movement was so restricted.

Now to the best news. This morning we had our first appointment back at speech and I was looking forward to her seeing how far Kellen has come in just 3 weeks. She ran him through all of the sounds we have been working on and she said that it is amazing but he is fine, totally age appropriate now. The work he did the previous 4 months taught him how to make the sounds, it was just physically hard for him to do it, now that he had the ability he was naturally speaking in the right way. Kellen just turned 5 and this is the age where the R sounds becomes clear. She said that when there is an earlier speech issue it can then cause a slight delay in the progress of the future sounds. She even ran him through his R sounds and while he isn’t doing the perfectly in his normal speech, he can make the sounds and is right on track with any other 5 year old. We are going to meet again in a month just to touch base but as of now there doesn’t appear to be a need to continue with speech sessions.

The relief I feel at hearing that news is unbelievable. At different points over the last 2 years we have been worried about long term learning disabilities, hearing, his ability to process, etc. There has been concern that the difficulty in speech could impact social interactions especially as primary school starts in January. I was really focused on doing everything we could before he starts primary school. Right now the kids are so little and half of them talk in their own funny ways that it hasn’t been something to be embarrassed about or something other kids would tease about. I know once primary school starts even small differences can become the target of teasing and the last thing I wanted for him was to be teased for talking like a baby. I also think about how frustrating it is that it has taken so long to find out the issue was so easily addressed. Why wasn’t this caught as a baby or in any other assessment? I vaguely remember talk of tongue tie when he was first born and we were still trying to master breastfeeding but I was in such a confused state of post C-section pain pills and all the hormones that come along with just having a baby that I really can’t remember what was identified or why nothing was done. I also have to sit back and recognize how lucky we are that the issue was something that could be addressed. Last week I met a mom whose son is 7 and completely non-verbal due to autism. That was a much needed dose of perspective.

So today has been a graduation of sorts for Kellen. No more assessments and regular speech appointments. No more doctors’ appointments where he has to for the 20th time open his mouth, stick his tongue out, let them take pictures. No more having to correct him and work with him as he is just trying to have a conversation. No more having others not fully understand what he is talking about. Now if I could just do something about the percentage of time what he is talking about is Scooby Doo…


Thursday, July 17, 2014

Whale Watching

Two posts in one week, this must be a record. We had an unexpected adventure today that turned out to be amazing. This morning I had planned on spending our day running little errands like getting a birthday present for a party Ella is invited to this Saturday. I happen to look at Facebook when I saw a post on a local mom’s group I am a part of, someone mentioned there was a pregnant whale off of Long Reef Beach very close to the shore. As I was getting ready I just kept thinking how much fun it would be for the kids to see a whale up close and how much I want to see a whale up close, not just off on the horizon. I decided to make a detour and see if we could find anything, we grabbed the camera and headed out the door.

I had never been to Long Reef beach so we had to find it and then we trekked down to the beach only to find it empty and no sign of anything. We walked up and down a bit but there was nothing to see but at this point I had been selling a whale sighting pretty hard to the kids and I was determined to find something. Maybe chanting “we’re whale explorers!” should have waited until I knew if we would actually see a whale. There was a headland at the end of the beach so we drove down further and before getting the kids out I jumped to see if there was any sign of a whale or a crowds and didn’t see anything. It’s amazing how helpful things like a community group could be, there must have been multiple people like me driving around looking because when I checked the mom’s group again someone had just posted that she was a Warriewood beach and the whale was right there. We quickly headed down and got to the beach as fast as we could.

It was unbelievable, there was a Southern Right Whale about 30 yards off the shore. There were people above the beach taking pictures and people on the beach watching but not huge crowds, the kids were able to run around on the beach and play while the adults took pictures. The first thing I noticed was a woman in an orange vest walking around handing out fact sheets on the southern right whale, she came up to us right away once she saw the kids. She immediately reassured us that the whale wasn’t beached and appeared to be perfectly healthy and happy. There were NPWS rangers there that were out in the water at a distance from the whale and on the shore, I assume they were there to assist should the whale become beached or to prevent people from getting too close. While we were there I didn’t see anyone trying to get close or in the water, everyone seemed happy to just sit back and watch. It sounds like later in the day they had some problems but while we were there it was one of those unique environments when everyone is just excited and happy to be seeing something so rare.

We happen to run into a mom I met through the mops group I joined so we just sat on the beach and chatted while the kids played. I found myself too slow to catch the more dramatic photo opportunities and reminding the kids to turn around and look at the whale. Turns out a 2 and 4 year old don’t quite appreciate how amazing the experience of seeing a whale up close is but they did get some good sightings in between running around with their new friend. The whale wasn’t doing huge jumps or putting on a show but instead it just seemed to be swimming around the area, rolling over, and poking its head out.

We ended up not accomplishing any errands today but it was a very good day.

Tuesday, July 15, 2014

Life Down Under

It’s been a long time since I’ve posted, at different times I’ve thought about writing something but really our life has been plugging along and I figured only two people would be interested in hearing about the ins and outs of Kellen’s day at preschool or Ella’s ballet lesson. Since I talk to my mom and Jamie everyday there didn’t seem to be a need for a post. Since we arrived I’ve really felt like Australia is nice, or more specifically Sydney, but it is so similar to the US that I’m not sure it is different enough to warrant the high cost of being so far from family. I was lucky to take a trip back to Seattle in May so I could be there for Elizabeth’s wedding and as people asked how Australia was I really felt somewhat indifferent to it, we like it but I don’t feel drawn to stay, there are good aspects and bad aspects, it’s just ok.

What I wasn’t expecting was the effect a trip back to Seattle would have. Once I got back to Sydney I was able to see a lot of the things that actually are quite different and unique here that we just won’t get anywhere else. It is currently the middle of winter and we were at the beach playing in the sand on Sunday, Jamie asked where else would we be able to have the combination of how beautiful, clean, air quality (a co-worker just moved to Beijing so this is a very real consideration), good public schools, and a city that is large enough to have good jobs. I think the initial reaction was because it is so much more like the States than England is, I just read Bill Bryson’s book Down Under and he had a good way of explaining the unique blend of British and American influence here in Australia.

I can’t tell you how exciting it was. Insofar as I had accumulated any expectations of Australia at all in the intervening years, I had thought of it as a kind of alternative southern California, a place of constant sunshine and the cheerful vapidity of a beach lifestyle, but with a slight British bent – a sort of Baywatch with cricket, as I thought it. But this was nothing like that.

What’s more, and here we come to the real crux of things, I like it, straight off, without quibble or doubt, in a way I had never expected to. Something about it just agreed with me. I suppose it helped that I had spent half my life in America and half in Britain because Australia was such a comfortable fusion of the two. It had a casualness and vivacity – a lack of reserve, a comfortableness with strangers – that felt distinctly American, but hung on a British framework. In their optimism and informality Australians could pass at a glance for Americans, but they drove on the left, drank tea, played cricket, adorned their public places with statues of Queen Victoria, dressed their children in the sort of school uniforms that only a Britannic people could wear without conspicuous regret.

I think where I’ve landed is that for a family this really is a utopia. When I compare it to the States I should really say Seattle, as so much of the difference centre around weather, and when I say Australia I should really say Sydney, or more specifically our area of Sydney. Where we live is an almost bizarrely ideal area. We have the beach on one side and the bay on the other. There is almost no crime, we are surrounded by parks and it is extremely child friendly. The flip side to that is that the cost of living is the 3rd highest in the world, I wanted to get an oil change only to find out they are $150. There is also almost no diversity around us. There is relative financial diversity but while I have met multiple people from South Africa and Western Europe that really makes up the extent of the diversity in our area. There are suburbs that are predominantly Asian but we make up most of the diversity at Kellen’s preschool here.

But day to day it is great for the kids. In the summer Patrick was meeting kids at the beach every day, now that it is winter he is meeting them for pick up rugby games. The Xbox playing time is a fraction of what it was before. Kellen is always outside, at school they do most of their group time and activities outside, every time I even open the side door to hang laundry he somehow manages to dash out to the backyard. Last week was school break and we went to the library, as soon as we got home his first instinct was to take his book outside into the sun to look at it. I love that keeping him busy over break didn’t involve indoor play centres or endless hours of too much TV. Ella is happy to run errands with me because most of the time they involve walking around town where she can stop and look at things, she usually scores a doughnut from the outdoor bakery counter and gets to pet a few dogs along the way. It doesn’t sounds all that ground breaking that kids should play outside but after Seattle and then England it is a huge difference to be able to spend time outside year round. I was a real challenge was to try and keep kids entertained when it was either raining or freezing temps for months at a time. Being able to just head down to the beach on Sunday morning for the kids to dig or collect shells and have the chance to spot whales or dolphins is amazing. We are also starting to actually social with adults and no kids along, which again sounds obvious but when you are new somewhere it takes a while. Through school, ballet, and soccer I have met more people in the area so don’t feel quite as isolated as I had earlier in the year.

I also came back with a reminder of how nice it is not to live in a climate of extreme politics whether it be over women’s rights or gun culture. The lack of vast expanses of new housing developments and strip malls. Or the thought of trying to fit in our English size house with Ella now being as active as Kellen is sounds overwhelming to say the least.

So I was trying to think, why the sudden change of heart from indifferent to liking it here? Then I realized that in 2 weeks it will be 1 year in Sydney. I remember when we hit that 1 year mark in England suddenly feeling much more settled and comfortable, in a way that makes you realize that you weren’t fully comfortable before. I think I’m going through the same process here. The physical settling in was faster here, it was easy to figure out where to live, where to shop, brands, etc. But I do think when you move to a different country it takes a year to fully settle. Basic things like what the weather is like each season or what to expect during the kids’ school year. We just renewed our lease on the house for another year and it is nice to know we aren’t moving anytime soon. Ella has her spot in preschool for next year and Kellen is enrolled at the local public school to start kindergarten next year.

This isn’t just an open love letter to Australia. There are drawbacks to being so geographically remote. The school year here is longer similar to England so the kids actually have quite a few breaks throughout the year. Living in Europe we took advantage of every break and there were so many places close enough to drive or a cheap flight away that we tried to go somewhere of every chance we got. Here even traveling within Australia is long distances and expensive flights so to go almost anywhere is a longer and expensive family vacation. We are also so far from family, we’ve priced what it would cost to visit for Christmas and we would be looking at something around $10k just in airfare to get there. It is also very expensive here so we try and do as much shopping as we can when Jamie goes back for work and just bring an additional suitcase back. Plus my kids are growing up resistant to wearing shoes or anything that resembles warm clothing.

While we would jump at the chance to move back to Western Europe in a heartbeat we are finally settled here. The thought of where our next location might be is exciting but I no longer feel like we are just waiting our time in Australia out and that is a nice change. When I look at the environment and lifestyle for the kids I can think of few places that are better for them to be right now. While I won’t be applying for citizenship anytime soon I’m starting to see how this place will eventually be hard to leave.