17 Months Old: Global Developmental Delay

My son at the local children's museum

I am tired.  And overwhelmed.

When your beautiful little boy is in a room being assessed by a clinician, and you see him yell and throw every object placed before him, a little piece of you shatters.  But he's angry, you want to say, because he wants to finish reading the book you took away.  But now you see your son as  the observer sees him, and the deficits are profound.  Please please please, you mentally beg your son, engage with the toys.  But your son is not interested right now; he wants out of the chair and out of the room.  He screams loudly.

The neurologist gave us a letter of referral.  Five months of intensive physical therapy, occupational therapy, and speech services, two to three times each week, with a followup neurology appointment scheduled in April to determine progress.  And next steps.  And then a diagnosis.  It's all a jumble of words.

Lots of phone calls.  A visit to the pediatrician for additional referrals.  More intake appointments.  The occupational therapist that tests our son says he has an immature grasp and delayed fine motor skills.  She wants to see him two times each week.  The physical therapist determines that he has "loose joints," and that his muscles are working twice as hard as is typically necessary to move.  She wants to see him three times each week.  When we outright ask the speech therapist where our son is with language development, she equates his language level to that of seven-month-old baby.  She will see him three times each week and wants his hearing tested.  Language and cognition are so intertwined at this early age that I am having difficulty proving to everyone that my little boy is cognitively fine.

None of the care providers will say for certain that our son will have a positive outcome with intensive therapy.

I was given instructions to begin "crawling boot camp" at home.  My son first needs to learn how to properly crawl.  The physical therapist showed me how to position him correctly when he is moving, and how to readjust his body into the correct position.  She showed me how to manipulate his surroundings to ensure that he has to lift himself up.  She does not yet know how stubborn my son can be.

It's a lot of work - the phone calls, the appointments, the therapies I do with both children at home, let alone the daily grind of just having twins!  Recently, I stopped attending play groups with other parents because it pains me to see my children with other children.  When I see other people's typically-developing toddlers I mostly see my own children's deficits.  Plus I have difficulty socializing with other parents because while their toddlers run around and play, mine need one-on-one support.  Admittedly, as the weeks and months pass, my son, while making small gains, seems to be falling further behind.

In my house, we celebrate every success.  Last week my son learned to clap, and Yay(!) we clap with him.  While my son cannot yet walk, he can now turn a corner while riding his little truck - yay for mobility!  My son loves books and is willing to read more than just his favorites over and over - yay for something new!  My son can now put blocks back in the bin -  yay for helping Mama clean up!  My son is willing to eat new things if I shove a piece in his mouth first and he accidentally tastes it while spitting it out - yay for fish!  My son is babbling da-da-da-da all the time now - yay for not screaming!  My son loves to be serenaded - yay for sitting on the exercise ball for core strength exercises while Mama sings to you!  My son is hyper-focused on musical toys - yay for happily pushing the button that plays the alphabet song fifteen times in a row so Mama can take a break.  My son suddenly has more facial expressions in his repertoire - yay for helping Mama and Mommy understand you!  Yay for your adorable sense of humor!

My son is gentle, and funny, and he laughs a lot.  He is easily excitable.  He is mostly happy, sometimes frustrated, very sweet, and comfortable with our daily routines.  He sometimes spaces out.   He sometimes cries uncontrollably for no apparent reason.  He clearly has significant motor and communication delays.  He does not yet stand, but he sits and makes eye contact.  He says "ah" and "da da da" and he closed his mouth and said, "Mmmm" for the first time yesterday.  He does not look where you point, and he does not often mimic, but he does respond to his name.  He belly-laughs when you repeat a word he thinks is funny.  He no longer ignores the short Baby Signing Time video we watch daily. With prompting, hand-over-hand support, and multiple scenarios in which to practice, one time this week he signed "more" appropriately and on his own.  My son thrives in quiet spaces.  He is easily overwhelmed in noisy restaurants or crowded events.  He splashes, flaps, and bounces so gleefully in the bathtub, and he snuggles so sweetly before bed.  He knows how to brush his teeth and loves to have his hair combed and scalp gently rubbed.  His crib is a peaceful, safe space, and he smiles contentedly at nap or bedtime.

Maybe my son will eventually catch up.  Maybe he won't.  But we will continue to celebrate the small successes because for him they are enormous.

Thanksgiving

I woke up the morning of November 9, 2016, to a world in which I did not want to raise my children.  I planned to rear them in a world where the first black man was elected president, followed by the first woman.  I anticipated more progressive thinking and reform in the United States.  I assumed that the adoption papers my wife and I carry for our own biological children would become antiquated.

I was wrong.

What happened to our country?  We elected a racist, narcissistic misogynist to run our country.  I say we because even though he clearly did not have my vote, 53% of white women voted for him.  What kind of respect do we as women have for ourselves if we elect as a leader who wants to take away our reproductive rights?  A man who disrespects us so much that he normalizes rape culture?

My black friends and colleagues like to tell me that I am black like them.  This is a false honor.  Unlike them, I was completely shocked by the election's outcome.  My friends and colleagues knew what was coming.  But in my naive white privilege, in which I do not experience daily social and institutional injustice, I believed that our society was getting better.  I was wrong.

Our President-elect is selecting his cabinet, and his "alt-right" choices are bringing back high school memories from the early 1990s.  I had completed a research project on neo-Nazi hate groups in the United States.  In my presentation to the class, I explained how Morris Dees, a lawyer from the Southern Poverty Law Center, was bankrupting hate groups by suing them successfully in the court of law.  After white supremacist members of the White Aryan Resistance (WAR) beat an Ethiopian man to death, Dees won a civil court case against their leader for $12.5 million.  The leader declared bankruptcy and WAR went out of business.

As part of my research I called neo-Nazi hotlines and recorded their hate-filled messages.  They were blatantly racist and anti-Semitic.  They threatened violence, torture, and genocide.  They were on a quest to reclaim their country from anyone "different."  They ended their tirades with, "This... is... WAR."  For weeks I had recurring nightmares about these skinheads coming to my school and sticking a loaded gun in my face, pulling the trigger when I was unable to recite the entire Lord's Prayer.  This is how, in my dreams, they discovered that I was Jewish.  During this time, in reality, we evacuated the school for a pulled fire alarm and returned to black swastikas spray-painted all over the stairwells.

Last year a friend tried to convince me that after so many white supremacist groups went bankrupt, they were quietly and slowly infiltrating government organizations, waiting for their time to come.  I laughed this off as another conspiracy theory.  She told me that they were rising in the ranks as police officers, FBI agents, and representatives in local and state governments.  I said something noncommittal, like "that's scary," and we left it at that.  Was I wrong again?

When David Duke celebrates Steve Bannon's appointment by Trump; when a KKK parade is planned in North Carolina; when a group of neo-Nazis raise their arm in the Nazi salute; when there are 700 hate crimes around the United States in one week post-election, the world becomes a much more frightening place.  On the other hand, these events are bringing together more than three million Americans who vow to not be complacent.  We have a community of three million who will stand up against bigotry, against racism, against misogyny, against anti-Semitism, against homophobia.  We are a community of people who in the past complacently believed it would all work out, but now we are ready for action.  We are a community of people who believe in goodness, diversity, and freedom.  We are ready to fight.

I still mourn the loss of the world in which I wanted to raise my children.  I didn't know how I could ever explain to them this turn of events in our nation's history.  But now, I also see that my children will have role models to teach them that one voice among many counts.  They will learn how to be an ally, how to speak up on behalf of others, and how to be part of a community.  They will learn how to be kind, loving, and accepting of all people.  On this Thanksgiving, while I am still anxious about the future, and depressed about the present state of affairs, I am also thankful for my friends, my colleagues, and my family.  May we do what is right by each other, and in doing so, be role models for all of our children.

Germs

I am somewhat of a germaphobe.  Not the excessive kind that wears gloves and walks around Lysol-ing doorknobs, but the kind that carries around hand sanitizer and goes to great lengths to avoid touching public door handles.  Riding a crowded bus has always been a balancing act, because I refuse to hold on to the poles.  I can't help but fixate on the germs I imagine crawling all over from everyone else's sweaty hands.

A sneeze or cough from someone makes me hold my breath and cringe.  Colds and runny noses are the worst - when I have a cold, I wash my hands so often and exhale so far away from others that I am the person from whom you will NOT catch a cold.  I often wish everyone would be so considerate.

And then I had kids.

Kids are germ-fests.  They can be sweet, loving, cute, funny, and sometimes annoying, but they are also disgusting.  While I expected diaper blowouts and food-filled faces, I never anticipated the depths to which my children are able to gross me out just by being themselves.

Case in point: my daughter has a penchant for pooping in water.  My wife protests this statement as false, but I disagree.  Once is an accident, twice is a pattern, three times is a habit.  The first time was when both of my children were splashing and giggling in our large, oval, jacuzzi-style tub.  I had just finished washing both children when I saw it.  Floating in between their smiling faces was an enormous, brown, banana-shaped turd.  OH MY GOD.  I threw a dry towel on the floor and hauled my children out of the bathtub.  In the eternity of the next second my brain realized five things:

1.  Due to the now poop-y water, my children needed another bath.
2.  This meant I had to drain the tub.
3.  Draining the tub meant STICKING MY HAND into the poop-y water to open the drain.
4.  I was going to have to lift that monstrous excrement out of the water to dispose of it,
5.  AND I had to act quickly because small bits of the load were disintegrating into the water.

Do I need to mention the gagging that took place as I completed these tasks?  Do I need to explain how I disinfected the tub and threw all of the bath toys in the dishwasher before running another bath?  Or how I scrubbed and scrubbed and scrubbed my hands with disinfectant soap?  Or how I detested being the responsible parent in this very moment?

The next time it happened, my wife was home with me.  This time it was floating rabbit turds.  My wife nearly dry-heaved and ran out of the bathroom, leaving clean-up duty to me.  Then she tried to explain that my daughter doesn't have a habit of pooping in the tub because she wears diapers and poops whenever she has to go, so it was normal.

Then it happened a third time.  In our condo swimming pool.   The swim diapers I had purchased were a size too large and completely ineffective.  We flew out of the pool so quickly both kids burst into tears!  To my horror, my wife sent ME back into the pool to clean up the feces.  My scalding shower upon arriving home was not hot enough to keep my skin from crawling.

But kids are grosser than just poop.  For instance, my daughter eats cat food daily out of the cat bowls.  I've given up trying to keep her away from the bowls in the kitchen, because it's a losing battle.  "Nom nom!" she exclaims, thinking it's fun to see Mama freak out and try to pull the kibble out of her mouth.  My son ate part of the canned cat food the other day while I was pulling kitty litter out of my daughter's mouth.  I didn't realize he ate the cats' leftovers until I picked him up and he breathed the incredible stench of fish in my face.  I almost dropped him.  He screamed while I washed his fishy hands with soap and water in the sink.

Going out to restaurants elicits my internal squirm, because my daughter likes to eat the table.  Open mouth on the edge of the table, sucking and drooling.  Granted, she is endlessly teething, but I don't trust the cleanliness of public tables and moist rags that wipe them down.  My stomach writhes in protest and I just can't look.  Whether it's tables, grocery cart handles, swing chains, or the arms on highchairs, stopping her is futile.  I swear the twins take turns needing my full attention so the other one can eat microorganisms.

It's no wonder that kids are sick for eight months out of the first two years of life  My wife read me this foreboding statistic and I still pray it isn't true.  Sick toddlers are the germ-iest, grossest little people on the planet.  From the yellow, white, and green stinky snot that hangs out of their noses no matter how much I wipe them, from the smelly liquid that splatters with each sneeze and cough, to the wet, slimy hands that insist on touching my face... these are the days my children snuggle and need the most love and nurturing.  These are also the days I am completely revolted by my children.  They cry because I incessantly wipe away their boogers.  They cry because I wash their hands and faces, then scour my own.  And my wife - she won't come near the bulb nose sucker or even worse, the Nose Frida - she calls me from across the house to tell me that our child's nose needs to be wiped.  She calls me from across the house to tell me that our child's diaper needs to be changed.  She reminds me that when we got pregnant she informed me that she couldn't handle body fluids because they make her vomit.  I didn't realize she was one hundred percent serious.  She often makes retching sounds on her way out of the room.  I also didn't realize how much my children would activate my own nausea daily.

To think that I was aghast the day my infant son peed into his own mouth while I was changing his diaper.  To think that I almost puked on my daughter the day she removed her poop-y diaper during nap time and played in it all over her crib.  To think I looked on in horror when all of the toddlers ate  the same drooled-on toys during playgroup.  To think all of that was just the beginning.

Don't get me wrong, I absolutely LOVE being a parent.  But I would truly enjoy it so much more without the disgustingness factor.

Air Conditioning

Our air conditioner broke.  In ninety degree Florida heat and humidity, it is not a good thing when the air conditioner stops working.  Unbeknownst to us, the coil was corroded and leaking.  The condo below ours was receiving all the water damage.

We paid a repairman to refill the freon as a short term fix while we battled with the warranty company to replace the 11-year-old unit.  Further damage to the home below ours was the impetus we needed to get the warranty service to send their contractor.  The air conditioner was to be replaced that Wednesday, and would obviously be turned off while the work was happening.  However, as soon as the rusted coil was removed, water poured out of the duct.   Our laundry room turned into a swimming pool.  Our downstairs neighbor's living room walls shed tears.

Our one-day air conditioner replacement ended up being a three-day job.  The contractors spent the rest of that long Wednesday removing the soggy fiberglass and flood of water from our home.  What did this mean? This meant that for three days I was stuck at home with the twins without the benefit of air conditioning.

I prefer to go on daily outings so I don't feel cooped up at home.  But I was not comfortable leaving the workers alone in the house, and the house was not tolerable.  Our home was scorching, and I mean HOT.  The thermostat said 87 degrees but the humidity was like walking out of the shower and being unable to dry off with towels. We shut the blinds, turned off all the lights, and turned on all the overhead fans.  My clothes continuously plastered themselves to my glistening skin, and my children lay motionless on the tiled floor in their diapers.  We spent much of an entire day playing in a cold bath.  The carpeting in the bedrooms became damp. When we couldn't stand it anymore we sat in the car in our garage with the air conditioning on full blast.  We went out to dinner just to breathe some cool, dry air.  My kids were so warm that I kept taking their temperature after naps to make sure they didn't have fever.  None of us slept well at night, because we were boiling even with the windows open. I finally abandoned the contractors and took the twins to the pool by myself.

This experience made me thankful to live in a first world country with air conditioning.  I thought about all of the people in the world who live in tropical climates without the luxury of cool air.  I thought about fellow Americans who cannot afford to have an air conditioner in their home.  My children were understandably whiny and lethargic, overheated and flushed.  I was too irritable to enjoy my own company, let alone anyone else's.  The only cheerful whistling in our house came from the contractors, busy at work in the laundry room.

That Friday, at 5:30 p.m., our new air conditioner was turned on.  Insta-cheer! Over the next two hours we literally cooled off, and our interactions with each other softened.  Energy and laughter returned to our home.  Normalcy relieved us all.

Every morning I wake up thankful for our brand new cooling system.  Air conditioning used to be a privilege that I took for granted.  Not anymore.

Swimming, Part 2

Swimming.  We purchased a cheap pair of inflatable water wings and put them on our son.  The package was for older children ages 3 and up, but we decided to try them anyway.  I was surprised that the water wings did not actually keep my son's head from going under.  However, they did offer him enough buoyancy to allow him to successfully float on his back without me holding him.  Not only was my son completely thrilled, but something clicked.  He discovered that his face went under water when he kicked his legs but remained above water when he relaxed and lay still.  So he relaxed, and floated around the pool, kicking and going under only when he could no longer contain his explosive joy.

He brought his excitement to the pool the next day, and shed no tears when the instructor pulled him gently into the water.  In fact, he laughed!  I watched my son put his face in the water, flip himself onto his back and float on the water all by himself!  The instructor needed to rescue him when he laughed so hard he nearly drank the pool.  My son wanted to practice over and over again, and I sat on the side of the pool with my daughter, cheering and clapping.

My daughter watched her brother carefully while I narrated what he was doing so well in the water.  "Look, he is putting his face in the water, he is turning around, he is taking a breath of air, and he is floating!  He is not kicking!  Yay!!"  She clapped for him with me, relaxed and smiling.  Usually she clings to me, all nerves.  But she settled into me and focused on her brother's successes.

Then it was her turn.  My daughter cried when brought into the pool, but without the usual intensity.  She cried louder when she was about to go under.  Then she suddenly stopped crying, stuck her face in the water, flipped onto her back, and came up for air, smiling.  She could not float on her back because she was exuberantly clapping for herself!
 
The instructor had promised me that my children would reach this point, but I had been so caught up in their endless tears that this moment caught me by surprise.  This is my rainbow after the storm.  My children no longer scream during lessons.  Swimming by themselves will be my pot of gold, and I now see it on the horizon.

Eating with Toddlers

my son after splashing in the cat water bowl

I was so relieved to have children who love to eat.  When we started them on solids at seven months old, they ate everything!  I proudly told other mothers that my children enjoyed tasting new foods - fruits, vegetables, grains, yogurt, proteins, legumes.  Everything that came in pureed form, my children devoured.  I heard horror stories from other mothers who felt compelled to force feed their children, and I was thankful for my easy eaters.

Then came finger foods.  We cut up the foods we ate into tiny pieces and the twins explored new tastes and textures.  My son loved to eat broccoli.  My daughter preferred spicy dishes.  They ate chicken, beans, rice, pasta, peas, Indian food takeout and Mexican meals.  Everything went in their mouths.  For my daughter, eating was a serious endeavor, requiring deep concentration.  My son thought mealtime was hysterical and giggled between bites.

Which leaves me stupefied.

What exactly happened to my children between infancy and toddlerdom?

My son gained a mouthful of teeth, which must correlate with the formation of the catapult.  He mastered the quick flick of his arm from the elbow, launching hand-held, bite-sized delicacies high in the air.  They oftentimes hit his mother or sister before dropping splat on the floor.  Sometimes he even puts the food in his mouth and chews it before taking it out and flinging it.  Mealtimes have become one way food fights.  And all foods are cast in equal measure.

I start by reprimanding my 15-month-old son.  "No, we don't throw food.  Food goes in your mouth."  Unfortunately, the barrage of flying food is followed by the let's-laugh-at mama-when-she-gets-mad-and-do-it-again strategy.  Which doesn't work.

So then I take his food away.  This usually causes some consternation followed by angry howling from the high chair.  Then comes my firm, "Food goes in your mouth, not on the floor.  Show me how you put food in your mouth," and the return of said food.  Which is promptly pitched over the side of the high chair once again.

Then I remove the child from the table, carry him silently into his bedroom, and plop him on the floor in the middle of the room.  Where he cries for all of two seconds, looks around him, and happily begins to play.  NOT the intended outcome.

Upon returning to the dining room, I see his sister drop all of her food onto the floor.  She is looking right at me, smiling.  She wants attention, too!  She is graceful and delicate and does not opt for the hurling launch.  Instead, she has perfected the open-handed discard, the ladylike free-fall that makes no sound.  Her food selections invariably bounce - onto the carpet, under the potted plant, under the furniture.

Again, the reprimand.  "No food on the floor.  Food goes in your mouth."  My daughter then pretends to put the food in her mouth, she pretends to chew, she says, "Nom nom," and she pretends that I'm not watching as she opens her hand over the floor and discards said food.

Thus the food is removed, the child is removed, and she cries loudly in the bedroom.  I sit down, take a deep breath, and decide to finish my own meal in peace and quiet at the now-empty table.

While I am eating, my daughter, followed by my son, crawls back into the dining room.  I'm still annoyed, so I ignore them.  They giggle.  They crawl under the table to the high chairs.  I continue eating.  I hear, "Nom nom" so I glance under the table to find my children eating their bite-sized food off the floor.  I close my eyes for a moment of sanity, trying to decide if the five-second rule is actually important or not.  My daughter is serious about her meal selection, finding shriveled peas from the day before under the potted plant.  My son thinks the whole thing is hysterical until I turn around to find him joyfully splashing in the giant puddle he created by upending the cats' water bowl.  How did he get there so fast?

Eating with toddlers is a blend of aggravation and humor.  I have tried different strategies.  Ignoring the problem makes it worse because my children think it's funny to make a mess.  Addressing the problem directly makes it worse because it provides desired attention.  So now I praise.  Every. Single. Bite.  It begins with my son's first catapulted splat.  I turn to my daughter and say, "I LOVE how you are putting your food in your mouth and chewing it!  YAY!"  I clap, she smiles, and she exaggerates her next bite to make sure I'm looking.  My son watches this exchange, and puts the next bite of food in HIS mouth.  I say to my son, "I LOVE how you are putting the food in your mouth!"  My daughter looks at him and claps, too.  When she looks away he lobs more food onto the floor, and we start over.

Today, my daughter requires a cheerleading squad to eat appropriately, and when one is not provided she pretends to discard her food to the floor, then quickly pops the food in her mouth and smiles sweetly at me.  She claps and cheers for herself every few bites and expects me to join in.  (If I fail to notice when she is finished, she will still deftly drop the rest of her meal overboard.)  My son continues to perfect his catapult, unless, of course, I have given him tiny bites of scrambled eggs, pancakes, waffles, or grilled cheese.  These are the only foods currently deemed edible by his tender palate.  All other nourishment I sweep up off the dining room floor after mealtimes, just in case my children decide to crawl back later for a snack.

Parenting with Migraine

I open my eyes to an icepick pulse reverberating through the right side of my skull.  I feel the ache deep in my shoulder blade, the stiffness in my neck.  Pound, pound, pound.  It is sharp; I can focus on little else.  My heart beats in my head, each beat sending ripples of agony behind my eye, through my forehead, the base of my skull.

Another migraine.  I slowly turn my head to the left, waves of nausea rising in my stomach and throat.  My wife has already left for work.  The sunlight in the window is blinding.  The children's morning babble through the baby monitor screams through my ears.  I turn my head slowly to the right, feeling the ache of cramps in my lower abdomen.  Where did I leave my medication?  It's not on the side of the bed.  It's in the bathroom.  The kids are safe in their cribs - they will have to wait.

I roll out of bed and gasp as I stand upright, looking through static.  Keeping one hand on the wall for stability, I shuffle to the bathroom, fight the seal off my pill cover, and swallow it.  I stumble blindly to the kitchen to grab the ice packs from the freezer, and collapse back in bed, icing both the back and front of my head.  Twenty minutes, I think, pound pound pound.  The medicine will kick in and I will be able to function in twenty minutes.  Just breathe.  Twenty minutes later, my head icy and numb, I crawl out of bed.  I can feel my heart beating in my head without the pain; the nausea has subsided.  I take a quick and necessary shower, and realize I will be reading no books to the children today.  The static aura makes focusing nearly impossible.  Has it been an hour?  No.  Cannot yet take the next medication.  The kids are still waiting for me and they are getting fussy.

I go into their room and act fake-cheerful, my soft voice way too loud in my head.   God,  I hope my children do not inherit these migraines.  I did read that migraines sometimes skip a generation, but I don't want my grandchildren to have this disease either.  No music this morning.  Mama's very tired.  In fact, Mama wants to go back to sleep.  I smelled that dirty diaper halfway down the hallway.  I gag and almost throw up while changing it.  Got to make breakfast.  Can you play for a few minutes by yourselves?

I manage to scramble two eggs and throw blueberries and cheerios on their plates.  My children are happy, energetic, loud.  I grab my computer and find children's songs on youtube.  They stare quietly at the screen while they eat.  There will be a lot of screen time today.  Guilt gnaws at me, remembering that I didn't want my children to watch TV at least until 2 years old.  I take my second medication and close my eyes.

I've had migraines since I was a child.  As I have gotten older they have gotten worse.  My new Florida neurologist diagnosed me with intractable migraine, a sort of chronic migraine that continues day after day.  Two or three glorious days each month I am migraine free.  The rest of the time I feel the migraine in my body one way or another.  The migraine pain overwhelms me one or two times each week - the sluggishness, nausea, aura, and headaches fluctuate in moments throughout the day.  Most days I sport a chronic headache that ranges on the pain scale from 0 to 10 somewhere between 1 and 3.  I'm so used to it by now that it's like background noise in my head.  On my severe migraine days, I beat myself up for being a "bad mother."  I put the kids down for longer naps.  They have way too much screen time.  I sit on the couch near them and stare off into space, leaving them to entertain themselves and crawl out of the room without my awareness.  My wife reassures me that I'm a great mother and this is completely acceptable, that I need to take care of myself first, and a little extra screen time won't hurt them.  I wonder if my children notice that some days Mama has entirely checked out?

Thank goodness for medications!  It took me ten years to discover this medication, which if I take it at the onset of a migraine stops the migraine completely in 20 minutes.  It's too late, however, for it to work if I wake up already in the midst of a migraine attack.  For those times my neurologist has provided me with a system: one hour after the first medication I take another, and, if necessary, two hours later I take two more.  By then I'm physically exhausted but functional, focused, and pain-free.  My emergency room visits have ceased completely with this system - the "migraine cocktail" of drugs given to me in the emergency room to treat severe migraine I can provide myself at home with a different set of medications.

Which brings me back to my guilt-ridden angst.  How will my migraines impact my children?  How can I prevent my illness from becoming a limiting force in their lives?  I already avoid perfumes and colognes, eat nothing with MSG (often labeled "natural flavors"), avoid all soy and soy products and vinegars and vinegar products, but I cannot control weather changes and hormone changes and other physiological changes in my body that also contribute to migraine.  Living my life means dealing with migraines.  Living with migraines means that sometimes, too many times, I am out of commission. Sometimes, too many times, I am unable to be the mother I want to be for my children.

Swim Lessons

My daughter has a healthy wariness for her own safety when in the pool.  She loves to float in a tube and splash, but she does not like to get her face wet.  Even in the bathtub we have to help her relax before she smiles and rolls around in two inches of water.  She is just as excited as her brother to put on a swimsuit but she needs a little encouragement to actually get in and enjoy herself.

My son comes alive in the water.  He laughs, kicks, and splashes, and has absolutely no fear.  His movements are awkward and joyous.  He does not want to be held, so he wriggles in my arms and face-plants into the water.  To my ongoing astonishment he comes up smiling while choking and coughing.  The more time we spend in the pool and in the bathtub, the more he is trying to move during the day.  I fully attribute my son's motivation to move and crawl now to his time in the pool, an unofficial water therapy.  I also believe that without our intense supervision he could easily drown.  Thus we decided to invest in swimming lessons for both of our children.

Infant Aquatic Safety came highly recommended.  An instructor meets us at our condo pool four mornings per week and spends ten minutes with each child in the pool.  The program promises that after 4-6 weeks the children will not panic if they fall into a body of water.  They will be able to flip onto their backs by themselves and swim to the stairs.  

The instructor and I spoke in depth on the phone before she accepted our enrollment.  She wanted me to understand that there would be tears.  Lots of tears.  I would not be permitted to hold or console my child for the full ten minute lesson.  She would keep my child from looking in my direction, and if necessary, I would have to hide.  She explained that she needed their full attention for the full ten minutes and that they would likely scream until they mastered the skills she was teaching them.  All children cry, I thought, how bad could it be?  I accepted those terms and we started the lessons.

I didn't realize how traumatic the lessons were going to be for my daughter.  She went from loving the pool to bawling going near it.  She screams hysterically for the entire ten minutes; yet after one week I see her independently put her head in the water, flip onto her back, and float with the instructor's support while she howls.  The lessons are clearly working!  But she is so upset...which fills me with angst.  I have to pry my daughter off my chest and hand her to the instructor, while she shrieks real tears and clutches me with all her strength.  Are we pushing our daughter too soon?  Are we damaging her by insisting she learn how to be safe in the water before she is emotionally ready?  I busy myself taking care of my son and playing with him out of the pool so my daughter in the pool does not see my face.  But I worry about her emotional health the entire time.

Our son cries, too, but they are angry cries.  He is angry because he cannot do what HE wants to do in the water during his lesson.  As soon as the lesson is over he is smiling and splashing again.

This past weekend my wife and I took the kids to the pool.  Our daughter sobbed and clung to us the entire 15 minutes we were in the water.  Our son repeatedly practiced putting both hands on the top step while keeping his head up above the water.  Then our son tried to crawl out of the pool!

Given this drastic change in our children's behavior in the water, my wife and I discussed whether to discontinue our daughter's swim lessons.  After some debate, we decided that it would be worse to stop while our daughter associates a negative (for her) experience with water, instead of continuing the lessons and having her master the skills necessary for both her safety and her confidence in the water.

Truthfully, we are counting on the accuracy of research which says children do not remember events before age three.  We decided that teaching our children how not to drown is more important than some tears in the long run; we are trusting that after four weeks the crying will stop as promised.  Our son is learning important skills so he can be safe in his favorite place.  Our daughter is unhappily mastering the same important life-long skills.  Why?  It is ultimately for her own benefit and our peace of mind.

Each morning, I wonder if we are doing the right thing.  Every day, I tell her how proud of her I am as I see her flip and float with the instructor.  Even so, her cries break my heart as I watch from the side of the pool.  

Status Quo

"How old are they?"

I hate this question. Everywhere we go, strangers walk up to us and ask if my children are twins, followed by the dreaded "How old are they?"  The only way to avoid this conversation is to never go outside.  Which is not reality.

"Fourteen months old," I say, and smile.  Inwardly I grimace, waiting for the inevitable.

"So they're walking now?"  There it is.

"No, not yet," I say.

"Aren't they supposed to be walking by now?"

At this point I want to wrap my children in my arms and disappear.  Other times I feel obligated to explain why they are not yet walking.  Why don't people understand that developmental milestones happen when a child is ready?  Many toddlers don't walk until 18 months and they are perfectly fine.  Our pediatrician told us that our kids will be caught up by age two, that it is normal for twins to develop a little later because they are smaller at birth.  It is for this reason that my children have received early intervention services since they were five months old.  My daughter has made so much progress that once she walks she will test out of the program entirely.  My son is making progress too, but more slowly.

To be truthful, my son has been labeled at-risk.

What does this mean?  At-risk is the label given to children when they are too young for a diagnosis but there are red-flags indicating differences in typical development.  My son IS reaching milestones - he learned to sit up by himself at 14 months.  He has been army-crawling, or creeping, for almost two weeks now.  He knows how to take turns in conversation; although, while his sister babbles and learns new words, his singular sound for months has been ah.  Our son has many intervention goals - to crawl using his knees, to stand, to walk, to develop more vowel and consonant sounds, to eventually say a few words.   Does it matter that he is developing more slowly than expected?  Well, no... and yes.

Our children have the early childhood equivalent of an IEP - individualized education plan - usually written for school-age children with disabilities.  Our son's paperwork identifies a communication disorder and motor delay.  As educators, my wife and I know that intensive early intervention is the best strategy for dealing with these developmental issues.  We are aware that our son may be 100% typical and may catch up naturally to his same-age peers by age 2 or 3, with or without intervention.  Given certain factors, we are also aware that he is likely to be diagnosed with autism or developmental delay.

I am drawing upon my skill set as a teacher, and using books such as The Activity Kit for Babies and Toddlers at Risk: How to Use Everyday Routines to Build Social and Communication Skills during our daily play.  My wife called numerous clinics and hospitals in different states and chose a hospital that performs a full evaluation and assessment at 15 months; all others assess children 18 months or older.  We decided to be proactive. This way we can know for sure.  If our child turns out to be on the autism spectrum, we will be able to get him services even sooner.

Nothing truly prepares you for hearing "at-risk."  Educators use this phrase regularly, almost clinically, when looking at student data.  But a parent doesn't want to hear these words.  My son is a smart, funny, sweet, cuddly, exuberant little boy.  He also has a unique set of needs for us to address.  My wife and I have been matter-of-fact about this, both of us operating in take-action mode.  My son's differences were most obvious to me the day we went to a parent group luncheon and I saw my child against the backdrop of other same-age toddlers.  That day I felt overwhelmed by the enormity of our situation and cried.  Yet it is also our status quo.  We have two wonderful, happy children, and all is well as long as we keep up the work and stop comparing our son to other children.  This is why I want to rage and scream when strangers ask innocuous yet judgmental questions.

"Shouldn't they be walking by now?"

Four Legs Kicking

Four legs kicking.  That's what I see when I glance down at the stroller I am pushing.  My children freely kick their feet while we walk, giggling as they watch each other kick.  While I am driving, they kick in their carseats and I see their legs in the rearview mirror.  In their cribs, they awaken and kick with excitement when I enter the room in the morning.  Whenever they are left to their own devices, they kick with their whole beings.  And when they kick, they smile.  More often than not, those smiles become giggles.

In the meantime, I have not quite recovered from our move to Florida.  We moved out of our beloved condo to a hotel in Massachusetts with two kids and four cats, then two weeks later we all flew to Florida.  Finally finally FINALLY our stuff came and we unpacked and unpacked and unpacked.  Then... limbo.

For the first time in my life, I'm not working.  So while my wife starts a new job in a new school district, I wake up every morning to a long day ahead with my two little ones, planning meals and household chores and errands and if I'm incredibly lucky a successful nap time.  It's too damn hot to go outside and I feel too cooped up staying indoors.  According to social media where I look for meet-up groups and things to do, I'm a SAHM.  A Stay-At-Home-Mom.

Sometime during my first week,  I found myself wandering aimlessly through Sam's Club, pushing my children in their double stroller, looking at huge quantities of many things we neither want nor need.  Is this my life now, I wondered, wallowing in homesickness.  Then I looked down.  There they were.  Four legs kicking.  Two little faces smiling up at me.

What did I do?  Well, I didn't get a Sam's Club Membership.  I marched us right back to the car and we went home.  I lay on my back beside my toddlers and all three of us kicked the bedroom wall with our legs high above our heads, thunk-thunk, thunk-thunk, thunk-thunk.  My children's laughter pulled me out of the mud.

Since then, every day has gotten better.  I have a new job now, I'm a SAHM.  It's intense, and exhausting, and wonderful, and funny all at the same time.  We spend a lot of time being silly, making goofy noises, dancing around the house, watching the overhead fans and turning on and off the light switches.  We play with educational toys, read tons of books, and go on daily outings.  Every day, my children kick with their whole bodies.  Every day, in my less-than-stellar moments, their joy reminds me to take a deep breath, smile, and kick a little more freely.