I mentioned in a previous post that before the kids and I left Utah we had a chance to meet a family that has two kids with SMA. It was so great to talk with their mom. She had great advice as well as encouragement. It is so weird to suddenly have this devastating disease in our lives. Even weirder is the fact that it is something I had never even heard of. Spinal Muscular....what?! Learning all the to-dos and NOT to-dos has been really stressful. There is also a mantra that I keep hearing from other SMA families that you should be proactive rather than reactive. Get bipap early, get a Gtube early because they will lose strength quick and things can go downhill quick. It has been really stressful and hard trying to decide all the right things to do for Benson. Another thing that was made even more poignant to me, was just how variable this disease really is.
To have this make sense, you have to know a little SMA basics. The gene affected by SMA is the SMN1 gene. When Benson was tested he results came back positive for SMN1 deletion, meaning that gene is not there. Instead, there is "backup copy" called the SMN2 gene. There are multiple copies of this gene, I believe up to 8 but don't quote me on that. Doctors can use how many backup copies a person has to classify their type (Ie SMA type 1 typically has 1 copy, type 2 typically have 2-4 copies). Clear as mud?!
These two kids were both very strong. The three year old boy could crawl around somewhat and get the toys he wanted. The five year old girl has learned to crawl upstairs! That is literally amazing to me. Both these kids have three SMN2 copies, same as Benson. Then today on a facebook SMA support group, I learned of a boy who could crawl until about four years and only has two copies. Some of you may remember the blog Avery's bucketlist about a little girl that was diagnosed at 3 three months with type 1. She died at just six months. But their as another girl on facebook with type 1 who is in her twenties.
So that only makes things harder. You just can't look at what someone else has done or what their life is like and know what to expect. The uknown is scary.
I still have days where I can't help but get teary eyed over Benson's uknown future. Will he be teased? How am I going to potty train him? Will he be embarrassed if I have to help him to the bathroom or shower, if Jon isn't available? Is he going to feel left out of all the things he can't do? Will he cry when the kids play football at recess and he is left out, again? Should I do homeschool or will public school be okay? What extracurricular activities will he be able to do? Will he have to have a trach? Will he still be able to talk after said trach? Will he be able to pass the sacrament? Will he be able to serve a mission? Get married?
If I think about it too much, the stress and worry is almost unbearable. My form of coping has almost been to not cope. To push it out of my mind and just go with the ride. Try to do as much for him as I can, let his life be as normal as it can be, and keep on keeping on.
After much debate over whether or not to document this, I have decided that I will. I want to know exactly where his strength is at given points so I can know whether it is getting better or worse. As of August 6, 2010, Benson is able to:
Sit independently. He does tip over so we have to make sure there is nothing nearby that could cause head injury. We use the bumbo anytime he wants to sit on elevated surfaces. He is still able to feed himself independently. His sippy cups are getting heavy and he sometimes needs help getting them to his mouth. However, once there, he can hold them up long enough to drink. He mostly eats with his hands as the utensils are heavy with food on them. But honestly, what two year old doesn't prefer eating with their hands?! He is standing with assistance and bracing. His longest stretch of continual standing was about 30 seconds. He can roll both tummy to back and back to tummy. He no longer uses this as a means of transportation however. I think this is because it's easier for us to do it for him and because once he is on his back or tummy, he can't get back into sitting position. He is great with his manual chair. He goes slow, but it's an amazing possibility for independence. He doesn't however, love to be in it. I think this is because our residences have not been very wheelchair friendly. We are hoping to change that here in about six months. Once in his wheelchair, he can get where he wants to be, but there isn't much for him to do. He can't bend down and get a toy off the floor for example. This gets extremely frustrating for him. We are looking into getting a service dog for some of these things. He has learned when lifting things to his mouth, or placing a toy kind of high, to brace his arm with his other hand. He most often uses his right arm and braces with his left. He can throw rocks in the water with a sideways throw.
He can still eat and swallow. He is extremely picky and is spitting things out more and more but he still is able to chew and swallow. His diet is mostly milk and pediasure but we are able to get a few things down him now and then. A Gtube is possibly in his near future, as much as I dread the thought.
His respiratory health is amazing. He doesn't belly breathe, which is great. His oxygen saturation is usually around 96. He hasn't had a sleep test, but we put the pulse ox on for a few naps and a full night and sent that in to the pulmonologist. For the duration of the night, he sats were only below 90 for two minutes. Most of the time, they were about 94-95. If they did drop, it was for less than ten seconds, totaling two minutes. He had a runny nose about a month ago but he healed quickly and there were no problems. Other than that I was scared to death, haha. His cough is extremely weak and not productive. He isn't currently doing the cough assist but it is something I plan to do once we are settled into Missouri.
In Utah, we were doing physical therapy twice a week with a home nursing program. I am really hoping to get him doing water therapy in addition to that and maybe even some horseback riding therapy. I think he would love both of those. But we will see what is available to us in Missouri. In this weird between spot we are in, we are doing as much PT ourselves and playing in the pool often as well. As I am sure is common, he doesn't love doing PT with us. I try to get him all psyched to stand and he'll agree and then once we start, he bails. We also have a stander that should be here the end of the month. We are hoping to work up to standing for at least an hour a day in addition to his therapies.
That about sums it all up. I am hoping here in about a year I can write this post again and say that so many of these are improved and he is stronger. I am hoping that he will learn to adapt and not rely on us to do so much for him. I am also hoping that we will have been able to adapt our home to him so that it's all that much easier for him to have some independence.