Matthew's urology appointment was this morning. So I was in a STATE while I prepared to leave this morning, and during the drive to Vancouver--I was trying to keep calm but I kept wigging out. Spontaneous spazzing, let's call it. We got Ayden to school on time and then drove directly there. The biggest focus of my worry, which was of course a smokescreen for my toilet-training-my-son-made-him-a-psychopath anxiety, was getting Riley through the appointment without screeching or climbing everything. I brought the stroller and a dozen toys and half a dozen snacks, and a last resort bag of chocolate chips. Man oh man, chocolate chips buy me time for ANYTHING. Why didn't I ever think of them before? I discovered them a few months ago as a distraction for my youngest child when I'm busy and he's whining.
When we were almost at the hospital my friend phoned me freaking out about her ex husband's latest malicious tricks, which got me so frazzled I thought I might have a heart attack...
We were early for the appointment, so that was excellent. Being late for things makes me extremely anxious. Doctor's appointments make me extremely anxious. Both in one day = one crazy lady.
The doctor was okay. Not supercalafragalisticexpealidoceous, but not terrible. He was very good with Matthew, which is the important thing, but not so much with the people skills with me. He did spend a good 40 minutes with us, and devote much time to talking about the problem and his solution, so it was quite clear to me what he feels is going on. But he kept asking me questions and then talking over me to Matthew while I was answering. Like, either listen or talk, dude. Don't do both. And he was a bit mean about the fact that I admitted to having occasionally lost my patience and put him in a time out for accidents. I mean, it happens a few times a YEAR, it's not like we're coming down harsh on him every DAY. I just want to stick my fingers all the way inside my eyeballs and swish them around a bit to distract me from my frustration over WET UNDERWEAR EVERY DAY FOR THREE YEARS.
Here is Matthew's diagnosis:
Lower urinary tract dysfunction.
Matthew has taught himself some methods to cope with a full bladder which help him to ride out the feeling of needing to pee until it goes away. He dances, squats, and lets off a squirt of pee without actually going to the bathroom to relieve himself. Life is too full and busy to go to the bathroom. He has done this so consistently that his brain no longer registers that initial urge to pee, and he doesn't feel the urge to go until it comes BACK after being ignored and going away. We all know that if we ignore an initial urge to pee, it goes away for a bit. Then when it comes back it's super strong. Matthew's brain ignores the initial urge and the second urge is so strong that sometimes he floods, and other times he RACES to the bathroom and can hardly contain himself.
He also may have an irritable bladder, which can be affected by diet. He is supposed to avoid caffiene, carbonated beverages, citrus, and chocolate [do you hear me, grandma? NO MORE CHOCOLATE].
The method of addressing this type of learned conditioning is this:
Adherence to a schedule for intake and output. So, we go to the store and let him pick out a notebook or journal of some kind, let him decorate it with stickers and drawings and totally take ownership of it, and use this as a logbook. The schedule is to have him drink 5 glasses of water per day [as many glasses as the age of the child in years] on a schedule, so the same time every day. When he gets up, at breakfast, at lunch, at dinner, and when he brushes his teeth at night, for example. And he pees on a schedule also. When he gets up, and every two hours thereafter. Increased fluid intake along with scheduled pee breaks should help him retrain his brain to register when he has that initial urge to pee. Of course, he can pee in between the scheduled pee breaks also.
At the end of the day, successfully following the daily intake/output schedule is rewarded with a sticker on a chart. The goal is successful adherence to the schedule, and not dry underwear [well, ultimately this is the goal, but as far as the reward system goes, we reward adherence rather than dryness]. Wet underwear is not punished by withholding stickers. A completed chart gains a bigger reward. This can take up to 4 months of focused work to retrain the brain, but it apparently is quite successful most of the time. If it is not, he may have a different diagnosis.
Many children with this problem also have difficulties with constipation, which Matthew does not have. In those cases, increased fiber intake as well as increased fluid intake is essential, as is focusing on relaxation during toileting. Girls are encouraged to open their knees during peeing to avoid obstructing flow, and boys are encouraged to pull underwear all the way to their knees to avoid underwear impeding the flow.
Here is how I feel: relieved that although this is a learned behaviour, it is something he learned by himself. It is not my fault, nor is it a result of incorrect toilet training technique or something. [Yes, I am a slave to the Guilt Master, mwahaha....] But I was pretty piqued by the Dr's snippy attitude about the time outs. It bothered me all day. In the end I concluded that I need to let go of this Freudian notion that toilet training your child incorrectly or with any kind of pressure or focus can turn them into a neurotic psychopathic individual. It can create a negative environment for your kid, or become a control issue between parent and child that the parent really cannot control, but in the end it doesn't set them up for a future with a psychotic break in it. Yes, this was my fear. I internalized it so completely that I didn't even know why it was such an issue for me. Today, I figured it out. And I think I'm going to oust Freud and his frankly weird theories, for once and for all. If I can let go of Freud, I don't feel so snippy or guilty about the time outs. Ah, Freud. Take your phallus and shove it up your ass.
I also had my friend's ex husband situation to stew about all day. I conveniently forgot that I can rely on GOD when it comes to this friend's situation--I tend to overburden myself with responsibility for things that aren't within my job description, and I worry for my friend's well being. Particularly today. Her ex is crazy. Like, psychotic break material, except it just keeps going and going and going. Obviously his parents used the wrong potty training technique when he was little.
This afternoon I was tired. So tired. So what did I do? I made handmade perogies from scratch for supper. Perogies are a LOT OF WORK! And I had never made them before!! I laugh at myself for choosing such ridiculous projects at such ridiculous times, but I think I am coming to realize that COOKING RELAXES ME!!!! The creative energy involved in focusing on making good food distracts and calms me, because I feel like I can control the elements that go into making the meal, and when I'm successful at a recipe, especially for the first time, I feel a huge sense of accomplishment which improves my mood. Plus it gets my mind off of everything I've been stewing about all day, and gives me some time and space to come up with things like Freud needs to take his phallus and shove it up his ass. And my friend's life is in God's hands so it is not my job to fix.
And the perogies took me a good two hours, but man they were GOOOOOOOOOOD. I filled them with mashed potatoes, bacon, and two types of cheese, and fried them up with onions, bacon and sausage. I thought about my Grandma Kadie the whole time, as homemade perogies were her German specialty. I sure wished she was here to make them with me, so I could learn from an expert instead of a recipe on a piece of paper. I sure do miss her, all the time. Another specialty of hers was saurkraut. I didn't feel like saurkraut so I made coleslaw instead, with sesame seeds in it just like White Spot coleslaw, which is to die for. I always wish they gave you two scoops instead of just one. My coleslaw wasn't quite White Spot style, but it was still delicious. Yum. I love food. If I didn't love my husband so much I think I just might run away and marry food. Especially curry. What is up with how delicious curry tastes? Indians have hands down THE best food on the planet, no question. And Russians have the worst. Blech.
I'm a good cook.
I don't say this with pride or self satisfaction, I say it with incredulity. When Ayden was three I was making dinner one night and he asked me what I was doing. I said making supper. He LAUGHED IN MY FACE and said, "Silly! You're not the supper maker!!!! Hahahahaha!!!" Because I literally NEVER cooked. His dad did ALL the cooking. I hated cooking. I didn't know how to cook anything more complicated than pasta and canned sauce. I considered cooking an affront to my feminist sensibilities. What a doofus. So for me, the fact that I like to cook and the fact that I'm good at it are in the realm of ridiculous.
Also, while I was cleaning up after supper Riley was sitting on the counter and I was loading the dishwasher, and Riley fell off the counter. He landed face down and smacked his head on the floor, and it BOUNCED. He has a bruise on his forehead and a red mark on his chin and I'm a TERRIBLE PERSON because I let my baby sit on the counter while I worked in the kitchen and he FELL OFF! And the worst part is probably the fact that I know I'll do it again. Maybe with more care, but he LOVES sitting up there and chattering to me while I cook and clean up and it makes my life easier. So I'm double terrible. Uck. That moment where I saw his head hit the ground sucked pretty bad. I swore and apologized a few times!!! Good thing El Boobie was there to save the day.
El Boobie is what my cousin Sara's little guy calls breastfeeding, and his speech is VERY clear, and he just got back from a family trip to Mexico so El Boobie is HILARIOUS!!!! I was talking to her on the phone this evening and I could hear him in the background, "El Boobie! El boobie! El boobie!" So darn CUTE!
To underline the cute theme, here is a photo of Sara's two and my three for a total of five boys in a tub last week at my house!