Stomach virus

JF apparently has a stomach virus. From 7:30 PM until around midnight on Tuesday night, he was vomiting every half-hour or so. Then he had diarrhea at 2:00 AM yesterday morning. I woke up because I heard him say, "More water?" Then as I was getting up I heard, "More sit on the potty?" So he was thirsty (already dehydrated) and aware that he was sitting in poop (potty training progress). I cleaned him up again, changed his sheets again, and allowed him to have some water.

When he's thirsty, he gulps it down. When he's sick, it comes back up. So we have to dole out the water carefully. I hand him his sippy cup and take it away when he's had two or three gulps. Then we sing a song or two. Then we repeat until JF stops asking for more. Sometimes we misjudge how many gulps he can handle or how often to offer the cup, and he throws it all up. Sometimes we hold back too much and he ends up going to the ER for dehydration. It's a fine line, and sometimes there just is no happy medium.

He had diarrhea two or three more times and vomited two or three more times yesterday. (I lose count.) When he's losing fluids like this, we worry about dehydration. We've been to the ER with JF many times. In fact, he was admitted to the hospital the day before his second birthday because of a rotavirus and dehydration. Not a great way to spend a birthday. We've never had it as bad as Kyla and her family, so I tip my hat to them. But it's never a walk in the park. So we try to avoid ER visits when we can.

JF has long ago made clear to us that Pedialyte will not be tolerated. So when he's losing fluids, we try to get him to drink Gatorade. Sometimes, if I offer water even once, he will completely refuse Gatorade. So yesterday, I was pushing the Gatorade. I don't even frame it as a question any more. ("Do you want some Gatorade?" No, of course not.) I tell him it's time to drink, as if it were medicine. Each time, he might take one or two sips.

All day yesterday, JF had no appetite. I got him to nibble at an English muffin (which we call simply "English" to avoid painful misunderstandings about muffins) and a cracker. That's right, one cracker. All day.

He was also lethargic, lying on the floor most of the day. This is not like him. He usually runs, jumps, climbs like a monkey. I brought toys to him, and he played with them, but mostly from a prone position. In spite of his lethargy, throughout the day, he kept asking, "Ready for daycare?" or "Go to the playground?" or "Go to the mall?" It broke my heart to keep telling him, "No, not until you're all better. Maybe tomorrow."

After his nap, at 4:30, he was even worse. He was pale, staring off into space, not interested in playing, not laughing at any of Momma's silliness. He asked for water, and I was so worried I forgot about the Gatorade. I let him have three gulps of water, and he threw it all up. Then Daddy came home from work and we discussed his condition. We called the doctor.

Dr. Strahlman said if he's vomiting and having diarrhea, he probably has a stomach virus. Try to get him to drink juice, an ounce every hour. If he continues to refuse, he might go into ketosis. I asked whether he can send a prescription for an anti-nausea medicine. (I knew about this from an ER visit.) The doctor said he can't prescribe it without seeing him, to rule out appendicitis or any other obstruction. He said if you can't get an ounce or two into him by 7:00 PM (by now it was 5:30), take him to the ER.

I filled up two medicine cups (about one ounce each) with grape juice, and we pushed it on him, sip by sip. By 7:00 PM, he had finished both cups and was much more like himself. No ER trip.

While I was on the phone with the doctor, I asked about the dosage of his Pulmicort. When JF had been on two doses of Pulmicort per day, his frequency of getting sick had decreased. As soon as we dropped down to one dose per day, he got a fever that week, and he's sick again now, two weeks later. Dr. Strahlman said that we can go back to two doses of Pulmicort per day.

In spite of that, we skipped his Pulmicort and Zyrtec doses last night. AF didn't want to risk making JF throw up again. I hope skipping these doesn't make JF worse.

This morning, JF seems much better. He still doesn't want to eat or drink much, but he's nibbling and sipping a lot more than he did yesterday. (He has finished two whole crackers already!) He seems to have learned some restraint when it comes to drinking fluids. Or maybe he just isn't as thirsty. Knock on wood, but he hasn't had diarrhea or thrown up all morning. Maybe he has turned the corner. Maybe? Please?

Staying home from work all day yesterday and all morning today has given me the opportunity to catch up with a mountain of laundry. It has also given me the opportunity to work with JF on his language skills. (Perhaps it's a bad sign that I think of the laundry first. But a sick boy has to have clean sheets and clothing, doesn't he?)

This morning I realized that it has been a long time since I played the game of pointing to each thing in the room and asking JF, "What's this?" I could make the excuse that I'm a working mom, and when I come home from work, I'm just too tired to do anything except eat dinner and go to bed. (Perhaps I need a higher dose of Synthroid?) But that would be just an excuse. Where there is a will, there is a way.

I realized that I've been hesitating (for months, maybe even a couple of years) to try to teach JF things that are subtle. A couple of weeks ago, JF's PEP teacher told me that he needs to work on recognizing lowercase letters. My first thought was that the lowercase L looks like the number one. I remembered my own confusion as a child over the lowercase letters b and d.

I now realize that I was hesitating to try to teach JF the lowercase letters because of these subtle distinctions. I was afraid that he wouldn't get it. I was afraid that I might confuse him by trying to explain the differences. I was allowing my fears to limit his potential. Silly Momma.

So yesterday, I wrote each of the lowercase letters on a small piece of paper, and mixed them up in a big bowl. I tried to make a game of it, asking him to take out a letter and tell me what it was. He recognized the letters a and i. I gave him praise & clapping for each of those. The second success I also gave him a kiss because I was worried that praise & clapping weren't enough. There were about five or six letters that he guessed wrong or refused to guess at all. When he guessed wrong I said, "Good guess," and told him what it was. When he refused to guess, I told him what it was. After a while, he seemed to lose interest, and I decided not to push it.

This morning, I played the game of pointing to each thing in the room and asking JF, "What's this?" I tried to alternate between things that I know he knows (door, floor, table) and things that he might not know, to keep him from getting discouraged. I also tried to explain distinctions (wood floor, carpeted floor, linoleum floor) and things that have more than one name (Thomas toy train, rather than just Thomas).

I should try to keep doing this (teaching JF to recognize objects around the house and lowercase letters) every evening, every weekend, and whenever he's sick. I should try to avoid working late at least two or three days a week, so I will have more energy to do this. This is where I was at when I checked my blog for comments this morning.

I described in a previous post that I was worried about whether JF was getting enough therapy at PEP. He attends PEP (actually PEP-INC, but its easier to just say PEP) three hours a day, five days a week. I had recently read that the recommended amount of therapy for an autistic kid is 20-40 hours per week. A commenter (Mom to JBG) suggested that I could work with him after work or on the weekends to bring up JF's 15 hours of therapy to the recommended 20 hours. This comment cemented my resolve to try it.