Handle With Care

I made an appointment for Monday with a hand therapist at a local sports medicine clinic. I had delayed for two weeks since my doctor referred me with excuses about not being able to find childcare. It turns out, the clinic is attached to one of our local YMCAs. (Not the one where Sprout has her swim lessons and soccer and where I take bellydance classes... this one is actually closer to home.) One of the advantages to this is that I can put Sprout in the nursery at the Y during my meeting. I'm not sure if it will be free (I'm a member and they do offer members free childcare for 2 hours a day while they're at the Y...) or if I'll have to pay (a dollar an hour, it's not going to break the bank) since I won't actually be using the Y itself...

What I realized, after I'd hung up, was that I knew a week ago that if I couldn't find any other way, the clinic is open early enough that I could schedule the appointments in such a way that I could leave Sprout with her daddy while I went to my hand therapy. With that acknowledgment fresh in my mind, I had to admit that I didn't make the appointment because I'm a little afraid.

As I said in my previous entry, I didn't have much time to process what was going on between the CTS diagnosis and my first surgery last time around. Any concerns that I might have had about surgery were completely overshadowed by the suggestion that the tendons in my thumbs were so bad that the muscles had atrophied, possibly beyond the point of recovery, and that I might not regain the full use of my thumbs. Opposable thumbs are good things, I like mine, I wouldn't want defective tendons to drag me backwards on the evolutionary ladder.

I've learned a lot since then and met people who've had less favorable outcomes from their CTS surgeries than I had. I also know that there are some different factors to consider with a repeat surgery. The questions that need to be addressed now are "Why am I having a recurrance of symptoms?" the surgery cut my carpal ligament, the nerve pressure should have been resolved. And, yet, I'm loosing sensation in my fingers and my motor control is suffering. What is the source of the pressure causing these problems? Is it scar tissue? was the ligament release incomplete? Is there some underlying medical concern that was mis attributed to CTS? How will these things be corrected? Surgery? Will therapy do the trick? If surgery, am I possibly looking at implants or vein wraps? I've never had any kind of graft procedure before and I'm a little worried about what might be involved...

And, to change the subject (or maybe not) there's the whole question of how this will effect our decision to have (or not) another baby. The last time around, I made the appointment with the specialist at about the same time that we'd planned on starting our family planning/expansion efforts. The surgeries, and the financial recovery after we saw how much the insurance wasn't covering, postponed our child-making plans by almost 3 years. I'll be 39 in 2 weeks. If we're going to have another baby, we need to start trying soon. We might get pregnant right away, but last time around (between PCOS and my miscarriage) it took us 3 years to have Sprout.

I'm feeling very adrift about all of this. Conflicted. I love being a mom and love having Sprout in my life. I know that she would enjoy having a sibling. She loves babies so much and is so excited by them. There would be an almost 4 year age difference between her and a sibling if we got pregnant right now. But if surgery is a possibility down the road rather than right now, how much harder would it be with an infant and a 4-5 year old? What if I don't need surgery now but I get pregnant and the CTS gets worse? (it's actually not uncommon for that to happen)

Well, I need to spend some quality time with my little girl. This stream of consciousness blogging is just taking me in circles and Sprout wants someone to play with her...

Image Note: An engraved illustration by Gérard de Lairesse from a 17th century Dutch anatomy text.

Review: The Bob Books from Scholastic

The information about this series came into my inbox at a particularly appropriate time. For some time, Sprout has exhibited many of the signs of reading readiness, including the ability to identify the letters of the alphabet in both upper and lower case, basic understanding of the primary sounds of individual letters, and (most importantly) a strong desire to move forward in her acquisition of language. She often asks what words are by spelling them, i.e. when we're driving and she sees a traffic sign she will read the letters off of the sign and ask what they spell. She also remembers many of the words that she's been exposed to previously. All of which is meant to say that, although Sprout is barely 3, I did not believe that it was too soon to try her on something like the Bob Books even though they are intended for an audience of 4-6 year olds.

When the box arrived, I was excited to open it and begin looking through the materials. I had already visited the Bob Books website and was a little disappointed that there was not more guidance from the site on how to get started. The support materials on the website were limited to a single PDF coloring page per 12 book box set. Unfortunately, the box and individual books didn't contain much further guidance.

Sprout did, indeed, read the first book with no problem. Unfortunately, the feeling of accomplishment didn't bring with it any desire to pick up the second book. I suggested that we read "Her Books" at least once every day for a week and she responded every time by saying that she wanted me to read to her and not the other way around. After several days, I tried another strategy, "We'll read the first two Bob Books together and then you can choose any 4 books off your bookshelf for me to read to you." She agreed, we breezed through the first book a second time and then made it through 8 of the 12 pages of the second book before she seemed bored with it and completely uninterested even in having me read the books she was supposed to choose from the shelves. It was beginning to seem as though the Bob Books were inspiring a lack of interest in reading.

I was a little uncertain of how to proceed. Surely I couldn't be the only parent who had ever gotten this reaction from the program. I could really have used more support materials from the website or the packaging inserts. I'd talked to a couple of the other moms on Sprout's soccer team and learned that one of them had tried the Bob series with great success. I asked a few probing questions and realized that she had a much more structured routine with her children than we've ever tried with Sprout. I tried to structure our "study" time a bit more but Sprout interpretted my efforts as a punishment and resisted even more strongly. I got similar responses to bribes ("let's read and then we can go to the park") and attempts to make it into a game by "Playing School."

To make matters worse, she had almost completely stopped many of her earlier reading readiness behaviors. She was no longer reading off the letters on traffic signs to ask what they said, no longer pointing to words that she knew when she saw them spelled out in the "real world." I abandoned the series mid-way through the 5th book for fear that maybe she just hadn't developed the attention span required to make it through the series and we'd be better off trying again in a year or so, once she had reached the target age for the books.

Sprout's soccer coach, "Miss B," has been homeschooling her older daughter for the last 2 years. Miss B's younger daughter, Em, is 4 and will be enrolling in a pre-k class in the very near future. I called Miss B and asked if she thought that she and Em might like to try the Bob Books. She was very interested in giving them a try. We talked very briefly after Saturday's soccer game and Miss B says that they've worked through the first couple of books in the series in the week that they've had them but indicated that she was having some similar problems getting Em to focus.

I've been trying to work out some games and activities that we can do to try to make the books more fun for Sprout. I've added to our collection of alphabet magnets and I'm thinking that we may be able to make the process of reading the books a little more interactive by using the letter magnets to act out the process of sounding out words. I may also try to encourage Sprout's impulse to build on the sentences in the books by composing additional lines of text using the magnets.

Lest you think that my feelings are entirely negative, they're not. I think that the Bob Books have a lot to offer. They're a great concept and the illustrations are simple enough that I'm thinking I can help Sprout write and illustrate new stories or build upon the ones we have. I don't know if my difficulties are a result of Sprout being so much younger than the target audience, or if perhaps our less structured lifestyle has left her ill-equipped to follow instructions and concentrate for a lesson. I'll be continuing to work with her some on the challenge of staying on task for a period of structured activity.

In short, I like the concept of the books, I like the approach and the execution. I'd like to see more support for parents from Scholastic via packaging inserts or web support. I also think that it would be quite simple to develop a series of related activities that built upon the books which could be delivered via the Bob Books website, something more than a single coloring page per boxed set of books.

The series has been around for something like 30 years and a great many people have enjoyed great success with it. If you're concerned that your child might have the same type of attention problems that Sprout has shown, it would be well worth checking to see if your local library has the books in their catalog. That said, the first set is not very expensive and I think that I would find it well worth the investment to have the flexibility to put the books away for a period of time and try again later.

This is the second of the sponsored reviews for Mother-Talk.com that I mentioned here. You can see the first review by following this link.

Give a girl a hand

I started having problems with my hands when I was in college. Pain... loss of sensation... loss of control... As a 22 year old, during a particularly bad period, I went to the campus health center and was told that I was most likely dealing with arthritis. I was a child and it never occurred to me to ask for a second opinion.

In the spring of 1999, after spending an intense period of time working on some hand-built porcelain vessels that I wanted to use for a grant proposal, the problems with my hands reached a new extreme. I felt as though I had lost all fine motor control. When I tried to hold something, my grip was so tight that the item would crush in my hands. A tiny vessel, which had taken hours to build and was nearly finished might be crushed to dust in my hands when I thought that I was gently holding it. At the same time, I would try to grip things tightly and they would slip from my grasp to the floor.

Within a month, I had the first of 6 hand surgeries which were spaced out over a period of 8 months. The diagnosis was Carpal Tunnel, Tendonitis and ancillary nerve damage. From diagnosis to the first surgery, I was so busy with blood tests and surgery prep that I didn't have time to think about what was happening.

Soon I will be seeing a hand specialist for a "pre-surgical consultation." I don't know if we will ultimately choose surgery, and I know that it is unlikely that we would have to repeat all of it, but I'm a little freaked out. I don't want to repeat any of it. I honestly don't know how I'd manage life with Sprout during my recovery. I can't manage life with an energetic, high-needs three-year-old as it is. I've had the number for the physical/occupational therapist for almost a week and haven't scheduled my first appointment because I just can't seem to find a childcare solution. We considered enrolling her in preschool. The problem is that preschool is 3 hours 3 mornings a week. I would spend 1/2 hour of that driving her daddy to work after we dropped her off, another 45 minutes driving to the physical therapist's office, it takes another 1/2 hour to get from the physical therapist's office to the preschool which means that if the appointment is an hour, I have exactly fifteen minutes margin for delayed appointments or traffic problems. I'm not sure it's possible but I am almost certain that the stress will drive me around the twist.

Of course, the way that today has been going, I'm probably going to run away from home. As an indigent living on the streets in the midwest, scheduling medical appointments will probably be the last of my worries. What is it about 3 year olds that inspires them to bite and hit when they don't get their way. It's not like ***We've*** ever modeled that behavior, although I will admit that I really, really wanted to hit her with a rolled up newspaper when she bit me the second time in less than a minute.

The good news is that tomorrow is my bellydance class. It's the thing that I look forward to all week and the thing that really gets me through right now. Between dance class and trying to find my way around Ravelry, I'm starting to remember that there's a world out there that has nothing to do with preschoolers.

Image: Georgia O'Keefe: Hands with Thimble photograph by Alfred Stieglitz