There were alot of changes made in week five. We started out the week with a change that caused a step back for Nathan. Before entering the program, Nathan hated having his teeth brushed, we literally had to hold him down to be able to brush his teeth for a few quick seconds. Since the first week of the program, they have slowly been working on getting him to accept having his teeth brushed. By the end of week four, they were able to brush his teeth with a wet tooth brush for 30 seconds, so his therapist decided that it was time to add in toothpaste. Apparently, toothpaste was the thing that Nathan hated most about brushing his teeth! Nathan really fought this change, by the end of the week the brushing started to look a little better, but not even close to how easy it was before the addition of toothpaste.
The negative behaviors that were brought on by the addition of the toothpaste actually slowed down my caregiver training. I was introduced into his mealtime first the first time on Wednesday. The introduction went much better than I thought it was going to go, Nathan actually was pretty excited to have me in the room with him. The first two meals, I was in charge of providing praise and reinforcement. The third meal, I was able to feed him his food, the fourth meal I did food and drink and the fifth meal I was able to do everything myself. His last meal of the day on Friday afternoon, I was in the room by myself, with the therapist watching from behind the mirror and providing guidance through an earpiece. After being in the room with Nathan for almost three full days of training, I now feel comfortable with his feeding protocol, but in the beginning it felt very unnatural.
The most exciting change of the week was the removal of his daytime tube feeds while he was at eating school! Because he was consistently meeting his goal volume for each of his meals, on Monday afternoon I was told not to bring anymore tube feeds to school with us. From that point forward, if Nathan had a bad meal, he would just need to wait until the next meal to eat again and hopefully start to feel hunger. So, with the exception of the weekend, for the first time in his life, Nathan consumed more of his required calories by mouth than he did by tube! We are so proud of him and amazed by the progress that he has made in only five weeks!
Thank you for continuing to keep our family in your thoughts and prayers! I have a feeling that there is going to be some HUGE changes coming for week six.....
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