Choices and Understanding

For the past two years I have struggled with the decision whether or not to have a hysterectomy due to my endometriosis.  I came very close once, but ultimately didn't feel right about it.  I had a laparoscopy instead (my fourth) and for almost a year it did bring some relief.

Even with the combination of birth control, my pain started to creep back in.  Before I knew it I was uncomfortable all of the time.  Ninety five percent of the time I awoke already hurting.  The pain would come and go all day long, but always was at it's worst in the morning.  I think it was due to have a full bladder and that irritating the endometriosis that covered it.  I had no choice, but to push through and take care of my kids even though I just wanted to lay down in fetal position all day.  I'm thankful I had my children to teach me to endure despite set backs.  Not to mention, I never knew what pain was connected to endo and what was just normal.  It's hard to decipher what your suppose to feel like when you've always had issues.  To me it wasn't necessarily pain, because I never felt anything BUT uncomfortable.  For all I knew everyone felt like that.  I always wondered if I just ate something that hated me.

Early this year I had a cyst the size of an orange.  It had a possible cancerous spot and after some thought and prayer I decided to have my whole ovary removed.  I knew a hysterectomy was close in sight, so losing one ovary didn't scare me too bad.  Gregg was still in school and we were barely surviving so I knew it was not the time for a full hysterectomy.  I would need a huge incision in order to pull out the giant ovary and safely remove it without spreading possible cancer throughout my body.  I was mentally prepared and just wanted relief.

During my pre-op appointment the day before surgery my doctor did one last exam to make sure the cyst was still there and growing.  Sure enough it was so he went over everything I needed to know and then left the room.  I immediately felt more uncomfortable, but figured it what due to the exam irritating my insides.  I still had to go to the hospital to do my pre-op check in and get blood work done.  I didn't feel good, but the intensity was about the same I had had on and off so I pushed through.  The nurse asked my what my pain level and I said it was a five.  Which makes me laugh now.  After I was done I picked up dinner and went home to finish cleaning the house for the next day.  I didn't feel too different than normal so I decided not to waste an Ibuprofen and to just deal with it.

I awoke the next morning feeling back to normal and we continued on with surgery.  After I had been put to sleep, my doctor decided to do one last exam before cutting me open.  To his surprise the cyst was completely gone.  They did an ultra sound and found lots of fluid floating around my abdomen confirming that the cyst had burst recently.  I came out of anesthesia very confused and also very embarrassed.  How did I not know I had a cyst burst?  Doesn't that send people to the hospital because of the intensity of the pain?

It didn't take long for me to realize that the pain from my endometriosis caused way more pain that a cyst bursting.  It was the first time my doctor or I understood the intense misery I was really enduring every day.  It was time to have a serious conversation with myself about having a hysterectomy.

At first I cried a lot.  I knew the time was near, but I didn't know if I had the strength. My infertility was thrown in my face all over again.  Friends my age were announcing pregnancies and all I could think about was the fact that I should be able to relate to them more than I could to 50 year old woman.  I had always secretly hoped I would become pregnant by surprise and I would finally be able to take a breath of relief.  My burden would be gone and I wouldn't be infertile anymore.  Just like I always suspected.  I obviously hadn't come to terms with being grouped as such.  My mom had six kids for heaven sakes.  I should be freaking out about being pregnant AGAIN not coming to terms with the fact that I will never, NEVER know what it's like to birth a child.

It was sad and tragic and I let myself cry...alot.  I had to mourn the loss.

We set a tentative date for 5 months away when Gregg was done with school.  I knew if I was going to make such a permanent decision I had to have a concrete answer from up above before I could go through with it.  I prayed and prayed and prayed some more.  I weighed the pros and cons and went back and forth on what to do constantly.  After one such prayer a thought came to me saying, "your home will still be filled with children."  It was comforting that there was still an important plan for our family that didn't involve me birthing children, yet I still had reservations that having a hysterectomy at this time was the right thing to do.

The ONLY concrete answer I ever had was that of Free Agency.  Meaning, it was my choice.  If I was done I could be done.  If I needed more time I could have more time.

NOT the answer I wanted.  You see,  I am a rule follower for the most part. Not that I don't make mistakes or occasionally go against the teachings of the LDS church, let's not get into my weaknesses at the moment,  but when making big/huge/permanent choices I like to know the Big Guy is directing me on what to do.  I mean WHAT ON EARTH WAS HAPPENING?  Just tell me yes or no and let's get on with life.  I should not be trusted with such important decisions and yet, here I was.

In an email I received a couple weeks ago from the Church of Jesus Christ of Latter Day Saints they answered this perfectly.  Elder Richard G. Scott said in a general conference talk, "You may want to express thanks when that occurs, for it is evidence of His trust....God will not let you proceed too far without a warning impression if you have made the wrong decision."

I moved forward and actually made the call to schedule surgery.  During and after the phone call I was completely calm.  I took that as a good sign to move forward.  

Preparations were made, babysitters found, and before I knew it I was laying on a table with big scary lights above my head ready to be turned on to change my life forever.  My last memory is one of prayer.  I admitted I was scared and needed peace and comfort.  

Before I knew it, my name was being called and I immediately felt horrid pain.  Greater than that was the overwhelming peace covering me like a protective blanket.  I did it.  I made it through.  Despite feeling like...well... like something had been ripped out of me, I felt relief and quite possibly even joy.  

Never have I felt so watched over and comforted during a time that should be upsetting and bitter.  

I was kept in the maternity ward during my night at the hospital.  Twice I had random nurses burst into my room cheerfully asking us where our baby was.  My nurses were like Pit Bull's protecting their young and angrily sent them away.  I literally laughed it off.  The irony, I thought to myself.  During the night I heard newborn after newborn crying in their mother's room.  I was only thankful I could go back to sleep without worrying about feeding a baby.  The next morning as I was being wheeled to our car we shared the elevator with a dad holding gift bags and pastel pink balloons announcing the birth of their new baby girl.  The nurse kept me busy talking about my own two children, bringing memories of their unique and precious deliveries.  I thought, how lucky am I to have M?  She made a choice far harder and more important than I just did and she did it.  I recall during the few weeks before Emme was born, M using the word peace over and over.  Placing Emme was physically and mentally excruciatingly heart wrenching for her, yet she used the word peace several times.  She had complete agency to choose, but she was not left comfortless.  While riding in that hospital elevator I finally understood what it was like to have an army of angels sent to comfort and provide at the most critical moments in our life.  I like to imagine a room full of women calming and holding me during my hospital stay.  I felt them and know they were sent to carry me through.  

About a week after my surgery Gregg and I had a moment alone thanks to my mom coming to help.  I started to cry as I told him about my experience and the realization that the intensity of their warmth had left.  I told him I was ok and I would be ok.  He just needed to know that random tears would be shed here and there as I continued to seek healing from infertility.  

And so it goes...seven weeks post op and I have very minimal pain.  I can already see the benefit of having a hysterectomy.  The choice was mine and I am thankful I was trusted enough to make it.

--Then sings my soul, My Savior God to Thee.  How great Thou art, How great Thou art.  

Corrective Teaching

Find the first post to this series here.


Corrective Teaching

If you've started applying Preventative Teaching with your children, you're probably wondering, "what happens if my child still doesn't obey?"  Answer is...you go into Corrective Teaching.

There will be times where your child still misbehaves even if you've set them up for success.  There will also be many times where events happen in the moment and Preventative Teaching is not option.

Children are likely to test the waters ESPECIALLY when a new concept is being introduced.  It's healthy to test the limits to a point, but obviously there has to be some boundaries.  Expect major temper tantrums during the first few weeks.  They are called extinguish bursts.  Know this is normal and it will pass.  Push through.  Emme is no exception.  She has tried everything in her power to get us to revert back to our old ways.  There were many times I thought I was going to rip my hair out and run for the hills.  Most importantly when using these new tools STAY CALM and stick to the plan.


Steps

1.  Stop/Describe the problem behavior.
2.  Give a negative consequence.
3.  Describe the positive behavior. 



Simplified or How I Do It.

1.  "Emme, because you hit Corbin you get a consequence."
2.  "You need to sit by the wall for 4 min."
3.  "Good job doing your consequence.  I'm so proud that you did it right away."


I should explain that Emme is learning new skills as well.  She first learned some healthy coping skills, which I'll talk about another day, and second she learned to follow instructions.  When I ask her to do something she is supposed to follow the steps below.

I pretty much have to prompt her on every single one right now, but she is starting to say "OK, mom!"  If she fails to do what we've asked or doesn't follow through with the rules we've set up during Preventative Teaching then she gets a consequence.  

Consequences

Negative

Sarah wrote a bunch of different consequences on popsicle sticks.  The ones that have black tips are for more severe behaviors.  Pulling out a popsicle helps with the consequences being sporadic and less likely to predict.  If Emme knew that she had to go to time out every time she had a consequence it would most likely lose it's effectiveness.  

Only give one consequence at a time.  Building more and more consequences will make a kid feel defeated and then they will most likely give up completely.  They are only expected to do their consequence and whatever it is that you asked them to do before can play or do anything else.  

EXAMPLE

"Emme it's time to go potty!"  

"No mom, I'm not going!"

"Because you refuse to go potty you have to chosen to get a consequence."

Pull out a popsicle stick and read the consequence.

"It says to clean off the table.  Here is a wipe."

Wipes off table.

"The table looks so clean.  Good job!  Now it's time to go potty."

After she goes potty...

"I'm so proud of you for going potty!  You can go back to playing Barbies now."

**Note that it is not always this easy... especially in the beginning.

Positive

Positive consequences and praise are very important and in the long run, way more effective than negative.  Make sure that you are praising and reinforcing good behavior way more than you are giving negative consequences.  That doesn't mean you let bad behavior slide, just that you remember to praise the good behavior as well.  In the beginning it will be hard, and most likely they will be getting quite a few negative consequences as they test you, but it is especially important to praise praise praise the good behaviors.  It is more likely that they will follow direction if they have been getting positive feedback from you all day than it is if you've been nagging them.  If they have a day that they are especially pushing your buttons, work even harder to tell them the things they are doing right.  It can be as simple as thanking them for tying their own shoes, or sitting quietly for two seconds.  Praise doesn't always have to be after you've asked them to do something either.  It can be over something you just catch them doing already. 

Sarah also set up a pom pom jar for Emme.  Every time Emme earns four pom poms she get to put them in the jar and choose a prize from the prize box.  I went and bought a ton of dollar items I knew she would like.  I even mixed in a few pieces of candy.  

When she fills her jar up to one of the lines she gets a bigger prize.  So far she has earned two Barbies and she knows when she gets to the top she gets a big Barbie car.  I have to admit Emme hasn't been super thrilled with the whole pom pom thing, but she does love picking out the prizes.  I always make sure to tell her how proud I am that she EARNED her new prize.  Her face always lights up when I say it.  It's important to have small goals.  If it takes too long to get to a prize, your child may get bored of it really quick.  

Keep in mind prizes can be things like getting to play a game with you, or having time on the iPad.  Obviously a 16 year old will not care about a silly dollar toy.  Get creative.  

Never reward negative behavior.  This is tricky.  Things like "If you stop crying you can have a sucker," or "If you stop screaming you can play with the iPad," are not going to stop bad behavior long term.  

A more effective way would be, "Because you are crying you need to pull a consequence."  

Then only after they are calm and finished with their consequence can you reward them.  

"You earned a sucker because you calmed down and did your consequence."

Real Life Examples

If your child is more compliant they may feel bad and want to fulfill their consequence quickly to earn your affection once again.  If that is the case, then hooray for you! Give them poms poms for doing their consequences right away.   That was not the case with my super defiant/independent child. 

She was really excited about the consequences on the popsicle sticks at first and acted in ways that she knew would earn them.  Cleaning sounded really fun to her the first day, so she did everything in her power to get in trouble.  Even though I was freaking out inside I kept my cool because I was told this would happen and I finally had a plan.  

After about a day and a half Emme started to refuse to do her consequences.  Cue, extinguish bursts.  They were big and they weren't pretty.  When this happens you go into what is called Intensive Teaching.  That will be my next post, but to keep it a little more simple I'm going to stick with Corrective for today. 

So for now I will give real examples of when Emme has done her consequence right away.  This didn't happen until we had been implementing the program for about a week and a half.  So stick to your guns even if it feels like they'll never comply.  

EXAMPLE 1. 

Emme was spitting in Corbin's face which earned an immediate consequence.

"Because you are spitting in Corbin's face you have earned a consequence." 

Consequence was sitting in time out for 4 min.  

Emme said "OK mom, that was really bad that I spit in his face."  Shocking I know!  Is this my Emme?!

Emme walks to the wall and sits down. 

"You are doing such a good job doing your consequence."  "Thank you for doing it right away!"  

Usually I give her some more positive prompts while she sits there.  

After four minutes.

"I'm so proud that you finished your consequence."  "Let's give you a pom pom for sitting there the whole time."

EXAMPLE 2.

After doing Preventative Teaching before going to Sam's Club Emme still didn't behave.

"Emme, remember the rules.  I need you to keep a quiet voice."

Emme continued to scream.

"Because you are still screaming we need to go sit in the car while dad finishes the shopping and you don't get to earn your cookie on the way home."

Emme walked calmly to the car with me.  

"You are doing a really good job walking by mom."  

Then we went and sat in the car.  Eventually, she wanted to go back into the store and was upset she couldn't have a cookie, so I empathized with her.

"I know, it's so sad that you chose to scream instead of having a cookie."   

She whined some more about it, then found a nearby marker she had in her carseat and drew all over her pants.  

"Mom, I drew all over my pants because you wouldn't let me have my cookie."

"Uh, oh Emme.  Right when we get home you need to pull a consequence because writing on our pants is not okay.  You also chose not to have a cookie when you wouldn't stop screaming."

We were going straight home so I knew she'd still understand why she was getting a consequence.  If we were going anywhere else I would have made up a different more immediate consequence.  

We got home and she did her consequence right away.  I praised her and gave her some pom poms for completing her task then we moved on with our day.

Technically that was two consequences, but because she had already fulfilled the first one and she did a new separate act, I felt it was okay to give her another one.

Next Time...

Next topic will be Coping Skills and Intensive Teaching.  I will also talk about Baiting and If/Then statements.

You may want to pause on implementing Corrective Teaching until you learn Intensive Teaching.  If your child is anything like Emme there will be hell to pay when you consistently start using these new tools and you will need to know what to do when the tantrums hit.  Get ready to put your game face on friends!

This is a lot of info to take in and it's late at night that I'm writing this so please feel free to email me abarnowlsview@gmail.com or leave a comment below if you have questions.  

Preventative Teaching

As I have talked about before we are in a parenting program right now.  It has been insightful and needed, but also hard and sometimes even gut wrenching.  I've decided to write about the tools I'm learning because it has already changed the course of our lives as parents and I know it could help others.

For anyone who is wanting to look into the program first hand, it is through Utah Village and is called Families First.  The University of Utah does a study on it every year to make sure it is still effective.  In fact my niece works at a residential home for teenage girls and uses the exact same program.  Quite interesting if you ask me.  Sara* (name changed) our specialist works with ages up to 18 and uses all of the same tools.  My point being...it works for all ages and with some of the hardest behaviors.  Now I do want to point out that I do believe Emme needed to be in a place where she could actually slow down and focus on what's being taught.  Thanks to the right medication and hard work our therapist felt like Emme was in a place where she could learn and actually retain the information she was being given.   There was a time it was not so.  But, I digress...

The first skill I learned was Preventative Teaching and guys... it is life changing.  With this skill we noticed more of change right away whereas the other skills took some more work to see improvement.

 Note* most of this info is straight from their handbook and not my from my own genius mind.

Preventive Teaching

"An ounce of prevention is worth a pound of cure."
-Benjamin Franklin

When to use________

1. When your child needs to learn something new.
2. When your child has behaved inappropriately in the past.
3. Always at a neutral time. 

Steps________

1. Positive motivation statement
2. Introduce the skill and steps
3. Reason for using the skill
4. Demonstrate skill
5. Youth Practice (at least 3 times)
6. Praise and feedback
7. Positive consequence (reward)
8. Preventive prompts

Simplified_________

1. Tell them something positive.   ex. - "You are doing such a good job sitting quiet right now."
2. Talk to them about how you want them to act later.  ex. - "Later we are going out to eat and I want you to stay in your chair, keep your voice quiet, and ask mom or dad for their phone if you get bored."
3. Reason.  ex. - "because we enjoy our dinner more when everyone uses their quiet voice and stays seated."
4. Reward.  ex. - "if you do that we can stop for a cookie on the way home."
5. Practice.  ex. - "Let's play restaurant and show each other how we're going to act tonight at dinner."

**To be honest I don't always give a reason, because at Emme's age the least amount of words I say the better she can remember everything.  We also tend to skip practicing here and there and it still seems to work fine.  I usually just remind her of what I expect of her a few more times throughout the day.

Real Life Situations__________


We noticed an immediate difference after introducing Preventative Teaching.

Before... Emme was running away and refusing to go to class at school.  She would kick me and scream the second she saw me after school.  She was hitting and biting friends during school.  She was getting scores of 2s and 3s (five being the best) on her goals.  Church was hell (is that an oxymoron?) because she was escaping from primary and running through the halls.  She occasionally would throw a chair and scare the other kids.  She'd lay on the floor next to the person doing sharing time and roll around.  She'd come into my class while I was teaching and take apart my bag.  Once she even cut her dress.  Seriously guys....Church...!!   At restaurants she would refuse to stay in her seat and crawl all over the dirty floor under the table.  She'd scream and run around the table.  Getting her into the car at any time was like catching a squirrel while it's running up a tree.  The list goes on and on my friends.

After... Emme went right to class, treated her friends nicely, scored 5s every day, and walked straight to the car after school without screaming or hitting me. At church, she has stayed with her class every single week and hasn't disrupted the group once or run away.  Serious miracles.  She has improved immensely at restaurants, but still gets pretty wiggly.  She no longer spends it on the disgusting floor though and to that I call it a success.  85% of the time she gets into the car with no problems and I no longer have to catch her and physically put her in the car.


Things to Note_________

Praise is key and you can never use too much of it.  Find ways to uplift your child all the live long day.  Especially, when you feel like they are underserving of it.

Positive consequences, like giving rewards, changes the way the brains thinks and acts where as negative doesn't.  Don't freak out... I'm not saying you can't use negative consequences only that positive is what brings the long term change.  I'll talk about negative and positive consequences in another post.

Rewards can be anything.  Treats, reading a book together, getting to go to the park, getting to play their favorite toy, extra time on a device.  Whatever floats your kid's boat.


Questions?_______

Feel free to comment or email me abarnowlsview@gmail.com

I'll answer the best I can!

Last Day

Emme had her final day at her therapeutic school today.  She's been going there five days a week for a year and a half.  Boy, have we had our ups and downs while she's attended.  She is not the same girl she was when she started.  The program is amazing and I am so thankful we live close to it. I know our moving to where we live was not by chance.  We will still see her therapist and psychologist there until she's six so I'm thankful for that.  Let's just move on before I start to cry.

Here is a list of things I will miss.  Eeerrr....something like that.

---Walking Emme into school looking like I just crawled out of the gutter.  ---Ok bed, but it might as well be the gutter for how awesome I looked.  I could put those "only at Walmart people" to shame.  When she first started I would put a little cover up on my face and maybe some jeans.  Today I went with greasy hair, sticking up bangs, a brown hoodie, no bra or undershirt, black exercise pants, and gray Toms.  Most days I just threw boots on over my pajama pants and left.  My face alone is a force to be reckoned with right now.  Acne is the new black right? Ya'll I just don't care.  Emme got to school looking pretty darn cute most days, so kudos to me!

---The dude holding the sign for the oil changing car place.---  On a cold winter day I almost gave you my gloves.  You were holding the special of the day (which never actually changed) with gloveless hands and I just couldn't bare the thought of you going all winter like that.  I pulled up really close and right as I was rolling down my window you stomped out your cigarette and dragged your gloves out of your pocket.  If cars could do an awkward moon walk out of a parking lot, then I nailed it that day.  To be very serious though, you impressed me with your dedication and endurance.  No matter the weather, you were out doing your job.  We could all learn a lot from you.

---The back and forth drive.  I won't miss you.

---Sonic.  Thanks for being close by.  I think we all know how I feel about that place.

---Emme's teachers/angels.  You are rockstars. You truly love those kids.  Thanks for throwing Emme a Last Day party and going out of your way to buy her gifts.  I have a feeling there will be a meltdown come Monday morning when she finally understands she won't be seeing you anymore.

---The cop that sat at the same spot every day.  Dude, find a new trap already.

---Being able to shower.  Goodbye nice smelling Lacey.

Emme with her teachers.  For real, I love them.  The one on the left has been crying all week about Emme leaving.

Sanity

We are officially counting down the days until Gregg is done with school. If I could relate this to anything it would be like running a race. A really long hilly race. One that you don't really care to win, you just want to finish. We are in the part of the run where you can see the finish line, but every inch of your body wants to quit due to the 100s of miles behind you. Yes, 100s.   Point is, we are done. So freaking done. 3 months feel like 3 years. I'm tired of not being together as a family.  I hate that every moment is so busy and relationships have been put on hold. 

I admit that I have moments of panic of what's to come, but most of me wants/needs to believe that things will calm down and become a little simpler. Until then, I'm relying on my good ol' coping skills. 

Jimmy Johns. Thank you for being so fast and so close to my home. Your delivery service and lettuce wrapped sandwiches have become one of my best friends on these many lonely nights. 

Sonic, Straws, and Swig. Or S cubed...as I like to call you, thank you for your Dirty Diet Cokes, for not judging me when I pull up to the window to pay and realize I forgot my wallet, and your beautiful sugar cookies. You...complete....me. I hope we don't break up in three months, but I may be seeing less of you. Who am I kidding? I will still love you. 

Photography. You get me.  You've saved me. 

Understanding friends. Thanks for not judging my lack of social skills, but supporting me completely. I KNOW I've survived because of you. 

Instagram. I'm addicted. We should probably tone it down a bit. 

Professional geniuses who get our family. I heart you.  

Super Nanny 911

Several months ago Emme's therapist referred us to a program that would help us specifically in our home since we were still having some major issues at the time.

It's an eight week program that's essentially like the show Super Nanny.  A lady observes us for a week and then teaches us all new skills for the next 7 weeks.  She spends about 8-10 hours with us every week so it's pretty intense.

I forgot all about it until I got a phone call recently saying we could start the next day.  I was a bit nervous to have someone in our home for such an extensive amount of time.  I mean, who can keep their house clean for that long?!  Not to mention every weakness I have would be on display and scrutinized extensively.  For real...no one needs to know that I rarely cook dinner and drink 44oz Dirty Diet Cokes on the daily.  Did I say that out loud?

We started a few weeks ago and just got done with the observation stage.  I just learned my first new skill on Friday and Emme will start working on her's this coming week.  I was pretty skeptical at first, but now I can't say enough how grateful I am to be a part of this program.  Our helper was very complimentary of me and even started me a few steps ahead since I was somewhat doing what they teach already.  Let me just toot my own horn here...toot toot.

Everything they teach is written down in a binder and put in steps which is exactly how my brain works.  I love that we have somewhat of a plan and have someone right there to help us implement the new tools.  Will it fix Emme's ADHD?  Not necessarily, but it will help her to learn how to deal with frustrations and how to cope in situations that are difficult for her.  It will also give us as parents the keys to support her now and in the future.  

I'm so proud of Emme and the hard work she has done to get to where she is.  She has to overcome so much every day just to accomplish simple tasks that other kids her age just know naturally.  So many people mention how they don't know how we handle Emme's intensity every day, but Emme is the one with the disability.  She is the one that has to struggle and try to retrain her brain all day every day.  She is a fighter.

My Body Hates Me

This winter is getting the best of me.

Muggy air is stupid and makes me want to move far far away.

My body likes to remind me it hates me.

Having a cyst the size of an orange is unusual.

Having a cyst that is possibly a tumor, benign or cancerous, is annoying.

Going into surgery for a cyst that burst the night before is super annoying.

Realizing I would rather endure the pain of a cyst bursting 8 times than deal with my endometriosis any day is sad.

Still having pain after cyst is gone and finding out it's because my endo is attacking my colon and bowels is frustrating.

Having to make big life decisions is overwhelming and scary.

Not understanding why an angel can't come down from Heaven and tell me what to do is confusing.  I just don't feel like it is too much to ask.  I mean...who needs free agency at a time like this anyway? 

I think a tropical island would ease my troubles right about now...