OT Preschool teachers

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Val,

Wow, all that from a Preschool teacher. I guess I must not be doing my job

LOL. Sounds like they need to stop being so formal and learn to have a

little fun. Don't get me wrong, Preschool is important, but there is a way

to teach them and still have lots of fun doing it.

We do assessments, but we don't put so much stress on this or that. Heck,

right now, I would be happy if I could get them all to write their name. At

least they can recognize it. I have had so many moms come to me and tell me

how far their kids have come in the last 9 weeks, and I don't get into all

that " goal " stuff she was talking about. Our goal is to get through the

alphabet, teach them manners and how to sit still in chair, do fun crafts,

learn our numbers from 1 to 10, learn our phone number, learn how to get

along with our friends, learn some rules (or choices as I put them), learn

how to interact on the playground and in the classroom, learn how to clean

up after ourselves, etc. The simple basic things (and usually a lot more)

to prepare them for kindergarten. I have had several kindergarten teachers

in our school district come to me and tell me they wished all their kids

came to my class, so I feel pretty good.

Anyway, it sounds to me like she doesn't enjoy her job very well. Just my

humble opinion, for whatever it's worth.

Angie,

Nacogdoches, TX

Re: overstating symptoms, parent teacher conf & med s

>Hi guys! I was thinking about the same thing - wondering if we

over-react/over-report symptoms. Since on the steriods Rob has been

" choking " a lot - just out of the blue - on apparently his own saliva. I

was real concerned - and the rheumy was too - and then when the ENT folks

stuck a tube down the poor little guys' nose to check his larynyx - I

thought - maybe I over-reacted to this. But, I guess not really - he still

does it and I am still concerned - he had such a rough time with that

experience that I haven't had the heart to schedule the barium swallow just

yet.

>

>Georgina - I am so sad to hear that Josh's symptoms seem to be returning.

I hope that things improve soon - and that the steriods don't have to be

raised back up.

>

>Rob's doc emailed me yesterday - his labs are doing so well that they are

prepared to start trying to decrease his steriods - so we are going from

27mg a day to 25.5 mg a day. So, I am pleased and anxious at the same time.

Rob seems to have more pain in the last couple of days - and we only started

to taper today. I keep saying I am going to keep a log or something - to

keep track of how much pain he really has....

>Also, I had the parent teacher conference yesterday - (now I know why Rob

adds " and all that " at the end of so many of his sentences - sorry I guess I

am being picky - my grammer isn't always the best either) Overall I felt it

was a waste of time. They have this formula with a book, and use a chart

they fill in - identifying " goals (weaknesses?) " in different areas, such as

" affective, social, creative, physical, etc " - and then pick from lists

under each category the " areas to work on " (aka goals). I am thinking that

in an effort to not list where the child is doing well, and where the child

is not doing well that they have chosen this method to identify goals (which

I can't help but think means areas that need improvement) - that they have

removed all clarity. She then said about more than one goal that "

has improved much in this area, but I had to put something, so I chose

this. " Ridiculous. Then she showed me this card (they apparently have to

do one each week on each child that shows how they are developing in that

area) - and the one she showed me from that week recounted how he went to

her when a child took something from him & she said what do you want now -

and he said I want him to give it back & she asked why and he said because

he had it first. That only happens about three times a day - yet it was

supposed to illustrate something about how he is learning to interact - and

yes I know that it may be a perfect illustration on he interacts - but it

doesn't illustrate growth when he has been doing this for six months. When

we finished with the chart she asked me if I would add anything from their

lists as goals in these categories and I told her that looking at the big

picture that all of them are areas that need developing because he is only

4, " a work in progress " and learning in all of these areas, but that for his

age he is bright, articulate and compassionate & he does frustrate easily

when he can't get something to work the way he wants, doesn't always want to

share - and isn't part

>cularly social the first couple of hours in the day - but that nothing in

the chart was going to identify Rob and his current needs. I then brought

up specifics that Rob was having trouble with and then brought up the

pumpkin incident and expressed my concern that Rob not be made to feel inept

when he is having problems with what appear to be simple tasks. I let her

know that Rob was very hurt and distressed - and that he may appear to be

having a good day because he doesn't want to appear different from the other

children. She said that they would take that in to account - but i really

had the feeling that after the " required " chart was complete she was already

on her way out - she stood up to end the meeting while I was still talking.

>

>Ok - enough rambling for now. Take care all

>Val

>Rob's Mom (4,systemic)

>

>In a message dated Thu, 25 Oct 2001 3:44:44 PM Eastern Daylight Time,

Georgina <gmckin@...> writes:

>

>> Hi Becki,

>>

>> Most of us, I think, have had this same thing happen. Not quite knowing

>> if we're over-reacting or over-reporting some of our children's

>> symptoms. I think it's still a good idea to report most things though,

>> even if you decide to call back later to clarify. The doctor will be

>> able to get a better picture of what's going on.

>>

>> Hmmmm ... As I type this, I'm thinking about how much things have

>> changed for me regarding this kind of situation. My son Josh has had JRA

>> for 6 years and 5 months now. I haven't phoned his pediatrician or his

>> rheumatologist this week, even though I've had some concerns. We'll be

>> seeing his rheumatologist on Friday morning though so I think it can

>> wait till then. Plus, I think I'm still a little fearful/cautious of the

>> outcome. Believe me, if it was 5 or so years ago, I would have already

>> brought Josh in for an office visit.

>>

>> Josh has been having some pain and inflammation in both of his feet and

>> in his left wrist. Why left, I'm not sure, as he's right-handed. It's

>> been recurring ever since we made the last 1mg taper in his prednisone.

>> Those used to be problem areas for . Those few joints had such a

>> major impact on his daily living. He used to not even hardly be able to

>> bear any weight on his feet. His pediatrician even took xrays at one

>> point, believing that he had a fracture there because it was causing

>> Josh so much pain. His little ankles used to get so swollen and have

>> those darned bumpy nodules on them. His fingers and wrists hurt so bad

>> at times that he found it hard to hold a crayon or pencil.

>>

>> His wrists and feet hadn't been bothering him for so long that I really

>> was hoping that they would no longer be affected by arthritis. Ever

>> again. At all ... but even after all this time, it seems like the

>> steroids may have just been masking the problems. His blood work from

>> last month showed a higher SED rate. Back up into the 30's again. Which,

>> compared to the much higher SED rates he used to have (in the 130's!),

>> still seems really good but compared to the more recent lower numbers

>> (like an 11) it has me somewhat worried about a setback.

>>

>> Josh is handling it okay but he's not happily telling me, anymore, that

>> his arthritis is gone He's been waking up a little stiff and sore

>> again. He's had no qualms about taking his meds. He even has begun

>> taking the evening dose a little earlier I've noticed, as his feet hurt

>> so much by the end of the day. I had hoped that he was feeling a little

>> under the weather just because he was sick with sinusitis and that once

>> he was finished with the antibiotics, his arthritis symptoms would

>> disappear. Well, not quite yet.

>>

>> Oh .... but getting back to your questions about MTX injections .... I

>> may very well be biased but I'd opt for an increased dose of MTX over

>> corticosteroids, any day. My son started MTX orally immediately and we

>> didn't switch to injectable for almost 5 years. I wish we had done it

>> sooner because he responded so much better to injections than to the

>> pills. I think we may have had a much easier time reducing his steroids

>> if we had gone that route.

>>

>> I know you must be so happy that the doc has agreed to just a milligram

>> increase in steroids. For us, we always had to raise it much higher to

>> have the same effect that we had on a lower dose. If we were tapering

>> down from 10 to 9mgs and the JRA started to flare, going back up just to

>> 10 wouldn't help. We'd usually need to double up the dose and start over

>> from there, as soon as things quieted down again and we could begin

>> reducing once more. That's just how it was for us, though. Everybody is

>> different. The lowest dose that causes a positive response would be the

>> better way to go, I'm sure. So I do wish you all the best, as you and

>> the doctor try to figure out the best solution for . You will both

>> be in our thoughts.

>>

>> Take care,

>> Georgina

>>

>> Allan Larson wrote:

>> >

>> > Hi,its Becki,talked to rheumy this morning about .I get really

nervous

>> > sometimes and I dont say everything I want to or it comes out

wrong,anyway I

>> > think I made Dave sound worse than what he really was,s symptoms

tend to

>> > follow a 2week pattern then change.He wanted to bring up from 9mg

>> > prednisilone to 21 mg.He also moved his appointment up 1.5weeks to show

me how

>> > to do MTX injections.Well after about an hour of thinking things over I

called

>> > him back.See had 2 really good weeks prior to his last

appointment,rheumy

>> > said MTX was starting to work(barely)he should do even better over next

>> > 8weeks,This was on a monday,everyday he got a little worse more joint

>> > involvement that would come and go all day long.Before it was only in

the

>> > morning then hed be fine all day after taking pred then he would have

problems

>> > at night.the bad lasted 2weeks what I didnt tell rheumy is that this

week things

>> > have calmed down again,only has problems first thing in morning then

again at

>> > night.No problems duiring the day.this morning he didnt even want to

take it

>> > because he wasnt in any pain it is 10:45 and still no problems.Called

Rheumy

>> > back really conserned that I might have overexaggerated and that hes

doing

>> > better this week,rheumy agreed that since he is coming in to see him

this

>> > monday,he would be willing to comprimise.We are only going to raise him

up to

>> > 12mg.What a huge differance.He still has to take his MTX orally this

fri. but

>> > hopefully when he starts injections he will respond better.

Becki and

>> >

>> >

>> > wrote:

>> >

>> > > Hi Becky

>> > >

>> > > My daughter is 9 and we switched to injections just about 2 years ago

after

>> > > nearly 5 years on pills. The switch was tough to make-- just the

thought of

>> > > sticking my baby every week was awful! But once the decision was made

it

>> > > went well. We use emla to numb 's arm before the injection,

though I

>> > > would suggest using an ice cube first. The ice numbs the skin quickly

and

>> > > then you can just get it done. The emla takes time, so the kids have

time to

>> > > think about what's going to happen. I've tried to get to try

the ice,

>> > > but she doesn't want to change things. Anyway, 's response to

the

>> > > injections has been good. She was on 20mg orally, but we've been able

to

>> > > maintain things at 15 by injection. She also is able to enjoy her

weekends

>> > > now, rather than throwing up every weekend. If the rheumy is in

agreement, I

>> > > would definitely try the injections, maybe even at a higher dose,

before

>> > > going back up on the pred. Methotrexate, while having some risk of

side

>> > > effects, certainly is far better for the kids than long term steroid

use. As

>> > > many of the moms will tell you, the goal with steroids is to use as

little

>> > > as possible for as little time as possible.

>> > >

>> > > Let us know what you and the rheumy decide to do.

>> > >

>> > > Liz

>> > > MTX injections

>> > >

>> > > > Hi,its Becki.Dont feel like rambling,but have feeling once i start

i

>> > > > wont be able to stop. is 3yrs old 39in 44lbs and he has been

on

>> > > > 9mg prednisilone for 32 days,he is also on 15mg MTX orally he can

go

>> > > > up to 20mg then have to add something else.About 1month ago Dave

did

>> > > > alot better,Rheumy said MTX was starting to work but it would take

>> > > > about 8weeks for maximum affect.He has been going down hill ever

>> > > > since.Alot more joint involvement that lasts for longer periods of

>> > > > time.The other day he went to bathroom and he couldnt turn the

>> > > > doorknob to get himself out.Found him screaming and crying at the

>> > > > other end of the house.He was a wreck,it really scared him.Anyway

>> > > > rheumy mentioned a couple of months ago that may have to go

to

>> > > > MTX injections,they are supposed to work better.Well I have found

>> > > > myself in a place where I dont know what to do.All I think about is

>> > > > and what we need to do to make him feel better.He has lost

2lbs

>> > > > since he was dropped from 12mg pred do we raise it back up or raise

>> > > > his MTX again?I feel like a mean mommy because I think I want to go

>> > > > ahead and try the injections,before rheumy says to.Anything to make

>> > > > him feel better(and no I dont mean I will just start doing it).How

did

>> > > > your kids respond when they were switched from oral to

>> > > > injections,Iwould really like to hear anything you have to say.

>> > > > Becki and 3systemic

>>

>>

>> For links to websites about arthritis and JRA, visit:

>> http://www.geocities.com/Heartland/Village/8414/Links.html

>>

>>