Tuesday, January 27, 2015

Infertility: Balancing hope with reality

From our Winter Beach Trip this month
I'm so thankful for my first post without 'miscarriage' in the title. It will never be totally over, but thank goodness it's as over as it's going to get. I got my first negative pregnancy test on Jan 21st, cycle day 20, and for some reason expected to ovulate in the next few days. That hasn't happened, and it kind of makes sense. I think most people ovulate late after a miscarriage, if at all. I'm now on CD25 and I feel like my reproductive system has completely shut down. I feel absolutely nothing. No cramps, hardly any discharge, and not a twinge or anything. I'm hoping for a positive opk, but after my 12 week missed miscarriage I had a 44 day cycle. I think that's looking pretty likely.

Instead of being depressed about it, I'm seeing some positives. First, I'm doing great at the gym getting back into my pre-pregnancy fitness routine and really enjoying running. I was even able to do some sprints today. Secondly, I know it's a slim chance of getting preggo this cycle, but if I O late then we are getting awfully close to being able to have Halloween themed birthday parties! Halloween is my absolute favorite holiday of the year. We do a million community events and trick or treats the entire week beforehand. It would be so fun to throw a kid birthday party that week! I'd let the kids wear their costumes to it or maybe we'd get costumes just for the party and have a different theme each year. Would that be AWESOME?!

I know, I know, this isn't going to happen. I shouldn't get my hopes up, but it's tough to balance hope with the reality of infertility. With infertility, you learn that the perfect dates never happen. You play around with numbers so often and see anniversaries, holidays, and ideal age gaps between children up ahead and the potential for the perfect storm of numbers to strike with the next pee stick. But they don't. And yet, how do you do this without hope? How do you try and try for month after month without hope? The high's of ovulation and even BFP are nothing compared to the devastating lows of another month wasted, or another child lost. I don't know what else to do besides cheerfully plan for my Halloween baby, which would be the perfect time because it's my favorite holiday.  If that doesn't work out then I'll plan for my thanksgiving baby, which will be the perfect time because both my maternal grandparents have birthdays near thanksgiving. If that doesn't work out I'll have a Christmas baby, which will be the perfect time because I definitely need a reason to like that holiday more. When you're trying to conceive, then the perfect time to have a baby is NOW.

Thursday, January 8, 2015

The 1 Week Mark

Super Positive OPK indicating my HCG is probably still high
Tomorrow, Friday, makes one week since I started to miscarry.  Honestly I was hoping I'd be a little further along in this process, but, overall I'm happy with everything. The scan Monday showed that I'd passed the pregnancy, and the Dr estimated another two weeks of bleeding. I was OK with that news, but the ultrasound wand initiated some cramping and it really never stopped. From Monday until this morning I've been in varying amounts of pain and needed Advil and sampled the hydrocodone I thought for sure I'd never take.  Finally, this morning I passed a rather large piece of tissue that I suspect was causing all the problems. I felt great right afterwards and decided to take a chance by going to the gym. I had a great, easy, 3 mile run and haven't had any more issues. I guess I got too excited, but I took an OPK this afternoon since I was out of HPT's. It was ridiculously positive. I think I have a long way to go before my HCG is back to zero!

My plan is to continue healthy diet and exercise until we can start trying to conceive again. I've started running again and I'm happy that it doesn't seem like I lost any fitness during the pregnancy. I was only doing the stair stepper and elliptical during that time to keep things low impact and I thought my workouts didn't seem as tough. I'm glad I'm still pretty much where I was. I've looked into different trying to conceive herbs and supplements to speed up this miscarriage process, but I think the lesson learned from my last miscarriage is that I kind of need to just let this happen. Last time I spotted for months and kept taking black cohosh to stop the spotting. Looking back, I wonder if it was actually causing the all the spotting.  I've always been a big believer in red raspberry leaf tea as a uterine tonic so I will continue to drink that like I always have. I'm also taking extra vitamin C and folic acid, but otherwise I'm just leaving this alone.

Emotionally? I don't know what to say. I'm glad I'm running again to possibly define my feelings further, but I feel very emotionless right now. I only cried at the Dr's office when we initially found out. I haven't gotten upset since then and I'm not sure there are any more tears to cry. I guess I just truly feel like that baby was never supposed to be here. I still love him, but I feel relieved that he's finally where he's supposed to be. I'm looking forward to becoming pregnant with a baby I'll actually get to keep. I'm looking forward to keeping a pregnancy long enough to tell my 4yr old about it and see how excited he'll be. I'm looking forward to seeing my 2yr old be a big brother. I'm looking forward, and I think that's the real reason I'm not that upset.

Sunday, January 4, 2015

The Pregnancy That Wasn't. My 2nd Miscarriage.

If I don't share belly pics now I never will!
Well, this shouldn't take long, or maybe it will, but I wanted to cover all the details of this pregnancy from start to finish. Partially to catch up any readers I have since I didn't formally announce the pregnancy on the blog, but mostly for my own documentation. This is the story of another missed miscarriage discovered at 8 weeks 5 days and at that time the baby had no heartbeat and only measured 6 weeks 1 day.

CD1 was 10/29. I was on metformin, prenatals, vit D, red raspberry leaf tea and baby aspirin. I took soy isoflavones CD 4-7 and also some vit E early in my cycle.  I'd been off alcohol and caffeine for almost 3 months, and off sugar and gluten for about a month. It was the first month we were trying and I really felt good about our chances because my cycle was more regular than it'd every been. I was using the clear blue digital OPK's and got a positive on CD18 and 19. We got the job done both those days, and on CD19 I swear I felt ovulation. It was a small explosion of pain on my left side, and it got less painful but never completely went away. The pain slowly moved across my abdomen, and on 9DPO I felt a burning in my uterus. I think I felt the whole thing. Unfortunately, we were out of town on thanksgiving so I couldn't test. But, I got a bfp when we got back late on 11/27. Thanksgiving day! I thought I'd react by flipping out, but it was really a quiet disbelief. Like, a whispered, "wow. I'm really pregnant. We did it!" It killed me, but I waited til the next day so tell DH with a card. He was excited and said he always knew I'd get pregnant easy. LOL.

Egg sac, yolk sac, and teeny tiny baby is above the Yolk sac
I only got 1 beta, done at 18DPO and my HCG was 452. My numbers are always way above average, well within the normal range for twins, so, for me, this was unusually low. I explained that away by thinking maybe it was a girl, or every pregnancy is different. The usual things pregnant women tell themselves.  I had a scan at 6w3d and the baby measured about 1mm, although one of the measurements was 1.2mm. We saw a barely flickering heartbeat that was so tiny the technician had trouble measuring it, but she did eventually get 90bpm.  Again, this wasn't reassuring. I was completely sure of my dates so it should've measured further. When I got home and compared my scan to some of the others in my due date club, it just didn't measure up. Even the scans from some of the women in their 5th week looked better than mine. But, again, I made excuses. The Dr had said things might be fine and I was happy trying to believe that even though I knew things didn't look great.
I know just bloat at this stage, but it was big!

Before my 8 week scan I began to worry about my lack of symptoms. It seemed like the 5th week had been the hardest in terms of fatigue, but that 8th week I was able to stay up til midnight every night and functioned fine the next day. My nerves began to really get the best of me. I think women in my due date club were a little fatigued by it. My posts were daily descriptions of how anxious I was and how I handled my anxiety that day. Two days before the scan I decided to announce my pregnancy on twitter. I'm so glad I did! Without them, I wouldn't have gotten any condolences at all because we'd told so few people about it.

On the day of the 8 week scan I could tell right away there was a huge empty amniotic sac. The tech zoomed away from it as fast as she could to get the other pics she needed, but I knew right away it was bad news. She confirmed that there was still just a fetal pole and yolk sac. No heartbeat. Still measured 6w1d. No development since my last scan. I thought that I had completely steeled myself for this possibility, but I totally bawled. I'm glad my husband was there this time. I had to wait forever for the Dr and by then I just wanted to escape that place. I felt like I could stop crying if we could just get out of there. Luckily, the Dr was very focused on the technical instead of the emotional and kept the appointment moving. I managed to keep it together while he was in there. He was very fair about presenting my options and completely accepted my decision to induce miscarriage with mysoprostal (cytotec) instead of getting the more popular surgery.

I came home, took the doses, and started bleeding. There was much less pain, and much less tissue than last time although I guess there's a big difference between 8 weeks and 6 weeks. It was over in a few hours on Friday, January 2nd. Saturday was similar to a light period and today has just been spotting. I bet I could get away with just a liner tomorrow, but I've learned it's better to overestimate protection. Tomorrow I have a scan to determine if the miscarriage was successful, and if it was then I'll just have betas until my hcg is zero. It sounds like a simple plan, but I'm always vigilant for complications.

The Dr said we could try again ASAP, without waiting for a period! I'm really surprised, and eager, and afraid, and, honestly, not sure I want to try again so soon. This means we could theoretically be getting a positive opk and trying again this month!  Aside from the thought of reliving the emotions and the intense anxiety I've been feeling the last two months, the thought of physically enduring another first trimester is unappealing in the least. This morning was the first I felt like myself in a long time. I was full of energy and took the kids for a nice long walk. I can't wait to get back on my Paleo diet and to get back in the gym.  We probably will try again as soon as possible, but I'm definitely going to enjoy this time between pregnancies as well.

A final thought since this post is already running on. It was January 2nd, 2011 that I completed my first miscarriage. 3 years later I completed my second one on the same day. I really don't know what that means. There's only so many days in a year and I guess the same things have to happen on the same day at least some of the time, but it's still strange. I like it, though. It means I only have to relive the anniversary of two miscarriages once a year instead of twice, and even though both babies had passed long before they were born, I still consider that day their birthday. I like to think that they share a birthday in heaven, and it makes me happy to think of them together up there with that bond already made.

That's more than enough for one post. Today I wrote the final entry in my pregnancy journal for this pregnancy, and now I'm finished with the blog post. I hope tomorrow the Dr says I'm finished with the miscarriage. I'm so ready to close this chapter.

Wednesday, December 31, 2014

Pregnancy After Loss

Feels weird to still be having issues because my last pregnancy resulted in such a wonderful, easy and loving baby boy, but I'm realizing more and more as each year goes by that I took my 12 week miscarriage really hard. I think I took it harder than most. I don't know why that is, but now, 3yrs later, instead of trying to find a way 'to get over myself' I'm instead trying to accept myself.

I suffered my loss on New Year's day. Last year I was so determined to get over myself and be appreciative of what I had instead of mourning what I lost, I decided to go to my family's annual New Year's Eve party. I ended up getting ridiculously drunk in front of my whole family! It was so embarrassing and I guess they've all forgotten why this day is so difficult for me although almost none of them even acknowledged the loss in the beginning anyway so maybe they don't even care. 

These guys are the best distractions! 

This year I'm pregnant, and it's the first year I'm really acknowledging the anniversary of my loss and letting myself feel sad and have a difficult time. Ironically, letting myself have a hard time has made it the easiest year thus far. I've teared up a few times and felt a little shaky and out of control once, but I spent day on New Year's Eve taking my kids out to our neighboring city to run errands and the distraction helped a lot. I arranged to be home instead of away visiting family and I'm glad. It feels like I'm closer to my angel baby. It's been nice to just acknowledge the loss and now I realize that I was running away from it before.

It forever changed me, and I feel like I've had even more anxiety this pregnancy than I did last time. Some days I really 'feel pregnant' and feel very positive and confident, other days I wake up and just know that I'm going to get bad news. It's been quite a roller coaster. I'm so glad I'm 'out' on twitter and the blog now so I have a more supportive outlet than my pregnancy journal. I'm hoping to do weekly update posts just like I did last time and I'm looking forward to blogging that journey again. I really enjoyed it last time! I'm steeling myself for the worst news so I can handle it better than last time, but very much hoping for the best. Next scan is on Friday and I'll certainly update twitter immediately. I'll update the blog on my weekly update. Yay, for weekly updates!

Sunday, November 30, 2014

Trying to Conceive #3!


SELFIE REEL!
I hinted in one of my last posts that we're planning a 3rd child. The last three times I was trying to conceive (TTC) I updated this blog and twitter with every single false pregnancy symptom, ovulation test, and dreaded pregnancy test because this was an infertility blog and my twitter was pretty much solely about my fertility struggles. Now I feel like it's much more a mommy blog or even a special needs mommy blog and I'm not sure this is the right forum to detail every step of this journey. Also, a lot more of my family is reading this now and while I'm pretty open about my life when talking to people in person, posting certain things here feels more like making a big announcement rather than privately telling a few family and friends.

That said, I will share a little bit. Since my littlest has turned 12 months, there hasn't been a doubt in my mind that I wanted another child. Even on the worst days I am still completely sure. Adding a second child has brought us nothing but joy. I'm 100% sure I want another. I do worry that I will have a girl and she won't get along with her brothers or I won't know what to do with her, but if that's who I'm supposed to mother then I definitely want her. I'm not looking forward to the birth and I admit I don't adore the baby stage as much as some, but I can't wait til I have 3 kids over two!  Heck, J turns two in two months and I'm super excited to have TWO kids over two. I just love the family interactions, fixing two plates for dinner, talking with two kids in the backseat of the car, and keeping two little schedules straight in my Google calender. I love having more than one kid and I can't wait to have three!

What are we getting into?
This is our first month really trying although we've been 'letting things happen' all summer. I'm not surprised that nothing happened because I do have PCOS and I wasn't on any of my magic fertility supplements or following any of my tried and true fertility protocols at all.  I started all that stuff in August even though we weren't going to start timed intercourse until November and now here we are.  So far this cycle has been going really great! It's my best cycle since August by far. I'm in my 'two week wait' and should have the results by the end of the month. Will I post the results? I haven't decided yet. I probably will because I can't keep a secret, but we shall see.

Saturday, November 22, 2014

How to Potty Train an Older Child with or without Special Needs

 I am not kidding when I make the following suggestion. When you are potty training your older child, set out a jar or piggy bank and put in a dollar every time someone tells you to have your child pee on cheerios or any other ridiculous, ineffective, and unhelpful suggestion. Put in a dollar every time your voice cracks as you're telling a fellow mom about your potty training difficulties only for them to tell you they know exactly how you feel.  After all, their 18 month old is just not getting it.  If I'd done this I would've had enough to pay for Christmas presents this year! If you're looking for a magic bullet, keep searching, you won't find one here.  If you have been unable to toilet train your child after multiple years of attempts, there is no magic bullet. Realizing this, and settling in for the long haul actually reduced the stress for us.  It's already taken years, plan for it to take at least the next three months. 

About My Son, 'G'
Running away from the Potty Training Experience
     We do have a diagnosis for my son, but most don't consider him to have special needs. He's smart, funny, and very sociable if you get him one on one. He does have mild hypotonia (low muscle tone), some sensory processing issues, anxiety, and he's always been very uncertain of new things. Even as a little toddler he would take off running down the sidewalk behind his walker push toy, but refused to take even one step without holding on to something until he was 14 months old. He just doesn't like to do things unless he's sure he can do it perfectly. My little perfectionist is now fully potty trained at 4 and a half years old.


What Didn't Work
     Attempt #1 Occurred in August. It was a few months after G turned 3 years old and the first day of entering the 3 year old preschool class was fast approaching.  This attempt was comical. First, I tried spending hours camped out in the bathroom with him sitting on a potty seat on the toilet waiting for him to go. We had a portable DVD player, and I gave him unlimited sugary drinks in order to encourage him to go as much as possible. G had NO CLUE what was happening. Seriously, he would look down after he already started urinating and say, "IT'S HAPPENING!" It was a complete surprise to him, every time. We also tried the allegedly easy peasy potty train in 3 days method. HA! It can't work if the child is not feeling the urge to go, and doesn't even realize he's had an accident.  People talk about 'signs of readiness' as being interested in using the potty and being able to tell when they are about to go pee pee or poo. At 3 years old my son didn't display either of these signs. At times he can be a particularly oblivious child (possibly by choice?), and potty training just wasn't going to happen at that time. We nervously explained all this at our first teacher conference and thank goodness the teacher said to just send him to school in pull-ups. She promised he wouldn't be the only one, and assured us that 'boys take longer'.  We happily stopped all potty training efforts.

   Attempt #2 We still held out hope that our March baby would be potty trained by the time he turned 4 years old. After the excitement of the holidays ended we decided to switch to underwear cold turkey (except at night).  I talked to G a lot about it beforehand and told him when the new year started, the diapers weren't going to fit him anymore because he was such a big boy. We let him pick out his underwear and the morning of Jan 2nd we took off the diaper, put on underwear, and sent him to school. We did warn his teachers, and they were very supportive.  There were A LOT of accidents, but he did get a bit more practice in. During this time he also became used to using the potty at school. This attempt lasted about 30 days.  I don't want to discount all the progress we made during this time, but in hindsight I think the problem was that I was waiting for him to 'get it'. Everyone kept telling me one day he'd just get it and he'd train himself overnight. I kept trying different things to motivate him, and tried different strategies geared towards making that magic moment happen. I kept waiting and waiting for it to click and for him to wake up potty trained one day. This attitude of mine was stressing us both out. Instead of improving, he started to get worse and have more accidents. Ultimately we had to stop because G began holding in his BM's in until school and then would make a big mess for his teachers right as they were getting started. They put up with this for a full week before asking us to go back to sending him in pull-ups. I don't blame them! But, then we had no potty training support from his teachers.  He began to PANIC when wetting himself, and in general his anxiety was getting worse. We decided to stop.  This was a painful decision.

Have you ever had to quit potty training? If so, you'll be the only other mom in the world besides me. Maybe I'm being slightly over dramatic, but this time between quitting in February and starting again after school ended in June was tough. It was bad. I had breastfed, made all his baby food, taken him to library story times, and taught him letters, shapes, and numbers.  As a stay at home mom, mothering was pretty much my only job and I like to think I was pretty good at it. But I had failed at potty training.  I tried to hold back tears and share my frustrations with the other moms, but they would always respond by telling me to have him aim at cheerios or give him M&M's when he goes.  No one understood what we had been through. In my heart I knew he wouldn't be going to High School in pull-ups, but I was sure he'd start preK in them. I wasn't very hopeful about kindergarten, either.

This is what went up on the Bathroom door at first, but I added things later
How I Did It

First, I changed my attitude.  There wasn't going to be a magic moment where he just suddenly got it and trained himself.  I stopped googleing potty training methods because they were all for younger kids and we'd tried everything anyways. I also stopped posting about my struggle on facebook. The terrible advice I was getting and the condolences from mom's of little toddlers was...not helping. 

Second, I made a sticker chart. If this was going to take months then we needed to set up a simple, consistent system of rewards and expectations that were easy for he and I to follow.  My sticker chart was epic. It had over 100 spaces and had rewards about every 10 spaces.  In the beginning I had to draw in rewards more frequently because things were going so slowly.  I left it pretty blank in the beginning so I could add more presents and candy squares depending on how quickly he acquired stickers.

Almost to the top!
The day after 3yr old preschool ended, I put up the sticker chart and tried to be positive and excited about it.  I explained that he didn't have to use the potty if he didn't want to, but if he did he would get a sticker on the next available space. If that space had a lollipop or popsicle then he would get that treat. If the space had a present on it then he would get a wrapped present.  Usually the presents were between $3 and $5, but occasionally we'd spring for something he'd been asking for.  Whenever we were at home he would have a naked bottom, and he'd wear pull-ups when we went out. We had all summer, so there was no rush, and I admit I had lost all hope so there was no sense of urgency with this. I expected to be doing this for the next year, so why push him and stress us out? When we went on vacation I brought his potty seat, but he usually would wear pullups the entire time.  Everything was about keeping things low pressure and stress free.

The first 20 stickers took him 45 days to earn.  I cleaned up a lot of horrible poop messes off the carpet, the couch, and my child.  He urinated on the floor so often I stopped bothering to get out the carpet cleaner just for that.  But, he made slight progress all the time, and he was starting to show pride every time he earned a sticker. Looking back, I wish I'd put more presents on it in the beginning because I think it was getting close to that second present that started really motivating him to get stickers. By the end of July he was starting to get one sticker every day, sometimes two! I reserved August just for potty training. No vacations, and at least 4hrs of having a naked bottom at home every day.  I did send him to 3 weeks of morning summer camp at his preschool in August, but he wore pull-ups. I told him he didn't have to, but to tell me if he pee'd at school and it would still count for a sticker. On the 3rd day of camp he ran out to tell me, "I pee'd at school!!" From then on, he still wore pullups to camp, but came home dry because he was using the potty there.  We soon figured out the tightness of briefs was confusing for him, but he could wear knit boxers at home during potty training time and still be successful.

The Last Sticker! We were clapping and cheering.


He slowly got the hang of it as we approached the end of the chart, and I promised him that when he got to the end he could have a potty party with CAKE AND PRESENTS! This was highly motivating and he began having little to no accidents and earning 4 or 5 stickers a day. I hate to say it, but...one day he just got it.  After two nights waking up dry and asking to use the potty rather than his diaper in the mornings I decided to let him wear underwear at night. It's now November and he's only wet the bed 3 times since we switched.  After everything we'd been through on this journey I really wanted his potty party to be special so I admit I splurged on a nice pile of about 10 presents.  He got a pile of presents at his party and got a 'cake mountain with blue frosting' as requested. He ended up using the potty right before the party and earning the final sticker at the party (I admit to 'forgetting' to give stickers towards the end so it would work out just right).  He started Pre K in underwear and has only had a few accidents at school.

Potty training my son was a nightmare and the worst thing about parenting I've experienced thus far. But seeing him ultimately overcome and be victorious was amazing.  So, that's how we did it. I can't promise it will work for everyone, but patience and a giant sticker chart is what ultimately worked for us. Good luck!

Disclaimer: I'm not a doctor or a psychologist, just an inexperienced mom. Consult with a medical professional before making any changes to your routine. 

 

Sunday, November 9, 2014

The 'We Sort of got a Diagnosis' Update

Long time, no posts! My netbook died.  That's really no excuse because we have a desktop, but after that happened I stopped blogging and enjoyed the summer. A lot has happened with my 4yr old 'G.' We got the diagnosis of 'Other Specified Neurodevelopmental Disorder' for him which I was happy with at the time. At least it was something. The psychologist didn't give me any tips for potty training, but he did support my efforts. He agreed that there was not going to be a magic potty training method for him. It was going to take months of hard work. He said that G's diagnosis will probably change as he gets older.  He thought G definitely was not on the spectrum, but might develop generalized anxiety disorder or ADHD in the future (those disorders are not diagnosed at such a young age).

At first I was really happy with this because we could start occupational therapy and get health insurance to pay for pullups.
Those were two things that I really needed to happen, so any kind of a diagnosis was a victory. But, after we got into therapy it became apparent that G's sensory processing issues were more severe than I had previously considered. They seem to really contribute to how he handles situations that generally cause him anxiety. For example, trick or treating is something I wasn't sure he was going to be able to do this year, but with sensory therapy he did awesome.

The evaluation center I chose simply didn't seem to have the capability of diagnosing G. I still feel very strongly that he has hypotonia and so many professionals have agreed.  The evaluation center and the psychologist there agreed he probably had it, but that has to be diagnosed by an MD and they only had nurse practitioners and psychologists at the evaluation so it couldn't be diagnosed. They also couldn't diagnose sensory processing disorder because they only diagnose disorders classified in the DSM. So, while I know he has sensory issues, I don't know if he has Sensory Processing Disorder or not. They claimed that since he only completely bombed 2 out of the 5 tests for autism that he doesn't have it. It's great he totally passed 3 of the categories, but he totally failed the other 2. This didn't really mean a lot to me until I saw the pediatrician after the final report came out and the Ped said he was still very suspicious of autism and didn't think we should rule it out at all. Really, I just chose the wrong evaluation center. I was hoping to get a quicker result by avoiding our University Hospital with really long wait times and that was the wrong choice.

Our pediatrician really wants us to start over and get re-evaluated at the university, but I'm not sure what we have to gain by that.  We have decided not to send G to kindergarten in the public school system next year. It would be nearly impossible to get him an IEP without a more specific diagnosis, and his small private church school goes up to 2nd grade. We've decided he will stay there as long as we can afford it. It's expensive, but you just can't beat the class size of less than 10 kids in a class. This year the kindergarten and 1st grade have less than 10 kids combined!

He is doing occupational therapy and absolutely loves it! Our current diagnosis is good enough for insurance to pay for therapy so we don't need an evaluation to get that.  Other special needs moms have really pushed me to get the evaluation because knowledge is power and I could help him more if I know what he has, but the process is so stressful for us. I already have a great OT to ask questions and a multitude of facebook groups for special needs parents. I'm just not ready to drag us through another eval when it's not necessary. So we're happily watching his improvements and waiting to see if our situation changes.  I'm open to getting another evaluation done, just not right now.

G is doing really doing great. He's now fully potty trained. HOORAY! That definitely will be getting it's own post soon. He had a rough start to preK, but now he loves it and he has no accommodations at school this year. We started occupational therapy in September and it boosted his confidence immediately. He has really blossomed and life has gotten so much easier in the past few months. Perfect time to start trying for another baby ;)