ACTION TREMOR

Ever heard of it? Neither had we. But we're learning more and more since CJ's pediatrician told us he thinks CJ may have one. It all started on Monday, April 11th. Actually, it started long before that, but let's go back to November when Paige's mom was visiting for Thanksgiving. She noticed something in CJ, a tic is what she called it, but it was something noticeable enough to Grandma Forsgren that she told Paige about it. Now Paige, who had noticed CJ wasn't the smoothest in his movements, was a little defensive and brushed it off, knowing very well that CJ could sit and be perfectly still while watching a movie or reading a book, so she knew he didn't have a tic. Fast forward to April 11th when one of CJ's preschool teachers stops Paige after class ("Oh no, what has CJ done now?" were Paige's thoughts...see earlier posts) and asks if she's ever noticed that CJ is shaky, like when he writes, almost as if he's shivering. Um, taken aback a little bit, Paige responds that she's noticed that he's not quite as coordinated as other kids his age, and that he's always been just a little behind physically (he crawled at 12 months, walked at 17 months), but she thought that was just his personality. But then, of course, she's reminded of her mom's comment months earlier. Ok, so now if not only Grandma noticed, but a professional who works with lots of kids CJ's age noticed it and it struck enough concern in her to talk to us about it, maybe there is something more going here with CJ than just being a little more cautious or timid than other kids.

And so Paige made a phone call to Dr. Jantzen (CJ's pediatrician) that day, and 3 days later CJ was in his office. After asking several questions and doing some physical tests, both reflexive and task-oriented, and after looking at some of CJ's school work and drawings, Dr. Jantzen assured us that CJ's cognition is perfectly fine. In fact, in one of his drawings he had drawn seven features (it was a drawing of Mattie that had her head, eyes, nose, mouth, legs, hair, and pigtails) when most kids his age only draw 5, so that was very reassuring. However, he did want to run a blood test just to rule out a metabolic issue, which he was pretty sure was not the case, and he also wanted to have CJ evaluated by an occupational therapist to see if his fine and gross motor skills are delayed. That's when he told us he thought CJ had an action tremor, which he told us was nothing really to be too concerned about. Dr. Jantzen even said he had one, and showed us by pointing to something with his index finger so we could see the slight shake in his hand. Anyway, he went on to say that CJ would never be an Olympic gymnast, but he could play baseball and tennis and whatever else and be just fine. After looking at CJ's writing, Dr. Jantzen also thought that CJ might have something called dysgraphia, which is a deficiency in the ability to write, but that at the same time, a lot of kids CJ's age have scribbly, shaking writing, so it's probably too early to tell. Overall, Dr. Jantzen was very positive about everything, telling us that he really didn't think that CJ's tremor was much to be concerned about, that he didn't think he'd need therapy, but that he wanted to get an evaluation just to be safe.

After leaving the pediatrician's office, we headed over to the lab across the street to have CJ's blood drawn. And let us tell you, CJ is a champ! First they went in one arm, and after meddling around for a bit with no blood, they had to switch and go into CJ's other arm. More needling around in there and they finally got some blood, but they weren't sure if it was enough, so they sent CJ, who had watched the whole thing without as much as a yelp or a tear, back out to the waiting area. Then they called his name again because, just our luck, it was not enough blood and CJ had to go though it all again, except this time, all the meddling in his arm came out fruitless (unless you count the wincing and small crying that began this time around -  poor guy!). Finally, they had to call in the head phlebotomist who found a vein in CJ's hand that they used to get the rest of the blood they needed. CJ walked out of there with pencils and stickers and more stickers, they felt so bad, and he was practically bandaged up like a burn patient. It was probably all worth it though because his labs all came back normal. Yes! Check - no metabolic issues here, thank goodness!

Now to get an evaluation done. Not as easy of a process as we thought it would be. We won't go into all the details about therapists no longer on staff, therapists no longer taking new clients, therapists not taking our insurance, year long wait lists, etc, etc. Instead we'll just say that after many, many phone calls we were thankfully able to get CJ into to be evaluated by an occupational therapist just 8 days after his teacher had first brought this up to us.

CJ's evaluation was held at an occupational therapist's house. Heather MacNeil, the therapist, has transformed her basement into a mini gym, with pads and swings and planks and ropes, as well as toys and games and all sorts of other things. CJ had no idea he was being evaluated, he just thought he was playing at a new friend's house and this friend had the coolest stuff to play with :). The initial evaluation took almost 2 hours and ranged from things like balancing on one foot and throwing balls, to drawing shapes and using scissors. After his evaluation was complete, Heather told us she'd get back to us in about two weeks. And sure enough, about two weeks later Heather gave us a call. She sent us the official evaluation, the same evaluation she sent to the doctor and the insurance company, but over the phone she summed it up for us. Heather said that she did notice a little shakiness in CJ, but nothing she felt was hindering his motor skills. Good news. Then she told us his ball skills are great (in fact, that part of the evaluation took a long time to complete because when they test the skills of the child they test until the child fails a portion of the test, and CJ kept passing all of the ball tests, so it took almost a quarter of the time :), his fine motor skills and grasping are borderline, and his gravitational security and motor planning are what she would want to work on (gravitational security/insecurity is what affects how CJ feels when he goes down the slide, rides the swing, jumps off a high surface, etc; not feeling secure in his own body is probably why he's reluctant at first and usually needs help. Motor planning is the ability to see or be told how to position oneself, like playing Simon Says). Overall, Heather said that CJ is borderline delayed. He has skills that are emerging, like using scissors, but others that therapy might be beneficial for, but again, because he is borderline, we could go with or without treatment. She set some goals and thought that CJ could get up to speed on all the goals in 24 session at the most. And the insurance company would cover it. All good news...really good news.

So after both going over the evaluation and the goals Heather set for CJ, Bryce and Paige both decided to go ahead and begin therapy. CJ has now had two sessions - he currently has a one hour session every other week - and we already see improvement. He is doing much better at the playground, going from needing assistance at first, to not needing any assistance the last couple of times we've gone. And his grasping skills have really improved as well. Instead of using all his fingers but his pinkies to hold a pencil, he now is getting much better at using the standard tripod approach (thumb, index, and middle fingers) when he holds his pencils and whatnot. And probably the best news is that CJ loves his therapist and loves his sessions!

We feel very blessed that the insurance we currently have completely covers CJ's therapy, otherwise it would not be possible for us to have CJ in occupational therapy. But most of all, we feel so blessed that of all the struggles that CJ could have, being a little delayed in his motor skills is something pretty minor, and it's something that can be taken care of. We know there are so many children out there who suffer from terminal illnesses, completely debilitating diseases, and irreversible mental and physical handicaps, and so we feel very humbled, very grateful, and very blessed to have such healthy children. Life is good!