Wednesday, June 18, 2014

I'm Sick

Since Monday afternoon Kit has been up and down with a fever.

Yesterday, we were hanging out on the bed together. She was playing on my phone, and without looking up, she said very matter-of-factly:

"I'm sick again."

"Where in your body are you sick again?"

"My eyes."

When I asked to see her eyes, sure enough they were teary, red-rimmed, glassy, feverish eyes. They were indeed sick again. Her fever and crept back up.

"I'm so glad you told me where you were sick! I'll get you some medicine."

While I'm never glad for my babies to be sick, this was a humongous breakthrough for Kit. To be able to tell me that she didn't feel well.

While she's never been completely unresponsive to pain or discomfort, she has been seemingly under-responsive. Often even seeming to enjoy what many others would consider painful or unpleasant, such as having an ice cube put down her shirt, by laughing and shouting "again!"

For a long time it seemed like it was not the shots that made her cry during vaccinations, but rather the being held down, because she would stop crying immediately when she was released. She'll just stand in an ant pile watching the angry insects biting her tiny toes. Nor did she register that what she felt when she put weight on her sprained ankle two months ago was pain. She would say no, when I asked her if it hurt, even though she would cry.

And we haven't started potty training because she hasn't shown signs of being able to identify the feeling of a full bladder or an impending bm. The handful of times she has actually peed in the potty have been circumstantial and she always looks thoroughly surprised.

A year ago, she couldn't point to a scrape as a source of discomfort, though she does finally do this. Almost obsessively in fact, asking repeatedly for bandaids, then pulling them off to look at it then crying for a bandaid again. But even this, I think is driven by her idea that it is supposed to be covered, though I think the pulling off part might be a response to feeling discomfort from the scrape.

I honestly believe that very often she doesn't register pain as pain. She is confused as to what she is feeling. Though she is finally begining to sort out pain from pleasure. And I think it has everything to do with her sensory issues.

She still requires much deeper tactile input than the average person. She still bites on her own hands and fingers as a seeking mechanism. She actually sticks her fingers into the cat's mouth trying to get him to bite them. We have to supervise constantly the two of them, because she will not only bite him and lay on him trying to get deep pressure input, but it often takes several bites from him before she registers that it is hurting and unpleasant. She litteraly used to laugh and giggle when he would bite her, she enjoyed the sensation, and would get mad at us for taking him away.

I believe that this underresponsive reaction to pain is the same inside her body as out. She still doesn't tell us she is hungry, but she does more often ask for specific foods (mostly candy) rather than just collapsing into a crying heap of hot mess!

She has never complained of a tummy ache! I learned her about-to-puke look after having caught it with my shirt several times without any other warning. She wouldn't even cry.

With this bout of fever, and likely the sore throat and cough that her siblings have been complaining about, she just wants to nurse and be held all the time. Until the medicine kicks in, and then she wants to repeatedly watch YouTube videos about playdough...and nurse. And she's a collapsing mess every time I won't let her nurse or we take the phone or tablet away. In fact, had her eyes not been tearing due to her fever and tiredness, I'm not even sure she would have said she was sick at all. The tears were making it hard for her to watch her videos.

But she did have some kind of recognition of the connection, and I'm so glad. When I began to notice her apparent lack of ability to recognize pain, I started deliberately using specific related language over and over. When she bumps her head, gets a scrape, or other injury,  I name it and say "that hurts" over and over.

I also say where it hurts first, then ask her where it hurts. "You have an ant bite on your toe. Where does it hurt?"   The idea being to help her recognize what that sensation is and to provide her the language to label and identify when she gets hurt. And she is doing better with external injuries.

This is important not only for her to recognize when she is sick or hurt, but also to discern when others are, especially if she has been the one who hurt them. She so rarely displays any understanding of how her actions have hurt someone else that it is difficult to dicipline or guide her behavior. She doesn't seem to make any connection at all, except that sometimes she can elicit a scream from her sister with a pinch or fistfull of hair and tries to repeat it.

She is truly lacking in an understanding of what "hurt" feels like and means for herself, so she is all the more ignorant of what it means for someone else to be hurt.

This is definitely a skill we will continue working hard to help her aquire. And yesterday was a welcome step in the right direction. But I hope she doesn't have to tell me "I'm sick again" for quite a while.

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