Tickets

We have tried everything to get Jack to eat and eat well -- meaning to first just getting him to just take bites, then to eat all his food without the constant reminders. We've done eating therapy, nutritionists, food charts, stickers, rewards, giving him money, psychologist, etc. You name it, we've tried it. Some worked, but for only a small amount of time. 

I guess it was just a matter of finding his right trigger and I hope we finally have. Another mom from Jack's school told me that she gives her children tickets when they do chores, then they turn in the tickets for video games and computer time. Interesting.... however, I didn't want my kids to get tickets for things they are already expected to do - and do (cleaning up toys, clearing their plates, help with laundry, etc.). But I thought this ticket idea may help with eating, and curve his constant drive to play the wii. 

If Jack eats all his food during a meal, he gets a ticket. If he eats really well - meaning no reminders from us to take bites - he gets a 2nd ticket. Each ticket is worth 5 minutes of computer or wii time. 

In the beginning, as soon as he got a ticket, he'd turn it in. He has now learned to store up the tickets for longer play time. It also helps him learn to count by 5. If he wants to play for 30 minutes, he counts out 5, 10, 15, 20, 25, 30 to count out his 6 tickets. Or if he wants to know how much time he has with all his tickets, he counts them by 5 to see how long (how much time) he can go. 

And I believe that kids should limit their electronic exposure. With this ticket system, he manages his computer/video game time so it isn't me telling him he has been playing too long. And there is never any complaining when his time is up. 

I love this is... 
-helping his math
-stopping me from nagging him to turn off the wii
-stopping him from nagging me to play the wii
-not costing me anything
-teaching him time management
-getting him to eat!!!

Back to Square 1

Remember this post about Jack's endoscopy, where we weren't sure if we wanted to do it, but was told it was one of the last physical tests to do on Jack.... and then we were relieved to have found an ulcer - caused by acid reflux, which was hopefully "the" reason behind his lack of eating. Well......

We had a follow up visit with the surgeon yesterday. The tissue samples he took from Jack show no abnormalities. Good, right? That also means -- no ulcer. That weird looking thing that the doctor thought was a ulcer, didn't show up on the pathology reports as a ulcer. So there goes that reasoning.

And better yet, if we want, we could do another physical test on Jack to see if he really does have acid reflux. Because if he did have the ulcer, they could assume it was caused by acid reflux. Without an ulcer -- it is unknown if he has acid reflux.

So as the Dr. said, we're really back at square one as to why Jack doesn't want to eat. We discussed several options and theories of what to do. Two options are more physical procedures to do on Jack. But at this point, we're unwilling to try medical procedures just to see if he has acid reflux or just to see if his stomach muscles aren't working properly and therefore aren't totally emptying out his stomach (therefore making him feel full).

So we've decided to do the following:
- keep Jack on the acid reflux medicine for 5 more weeks (8 weeks total)
- reduce the acid reflux dosage down from 2x per day to 1x per day
- try to alter his diet slightly to avoid foods that can cause acid reflux, but not go over board with these food changes
- if his eating improves, we can guess he has acid reflux
- if his eating doesn't improve, we take him off the acid reflux medicine and potentially take him off his appetite enhancement medicine because he could just be a kid who doesn't eat much.

Dare I say... the perfect son?

I'm sure every parent thinks their child is the best, is perfect, the ideal child. I've always thought that we are so extremely lucky in having Jack as our son. He is happy, easy going, loveable. And now I have a doctors agreement that validates my opinion!

Jack met with our psychologist yesterday. She spent about 30 minutes playing and talking with him. She said that Jack was clearly competitive and had a very good attention span for his age. She told us that she looked for signs of a troubled child, a distant child, a defiant child, etc. And all she could find was one who was bright, confident, well-adjusted, good humored, outgoing. Well... YA!! That is what we've been telling her. She even topped it off by saying in all her years of being with kids, she rarely comes across a child as well ground and happy as Jack. (yes, my heart is beaming with pride!)

She said that she gave Jack a challenge, but wouldn't tell us what it was. She also said to be competitive with him about his eating, meaning saying things such as, "I bet I can finish my dinner first." The dinner after meeting with the doctor, Jack didn't go on and on with his stories like he usually does - he ate his dinner (all pasta first, then all bell peppers, then all green beans, then all the meat) and ate quickly in order to try to finish first. Whatever the challenge is, I'll take it!

Week 2 of Therapy

Our big adjustment at meal time this week was to incentivize Jack that if he eats well during a meal, he'll earn a quarter. Eating well means, less stories / more eating, eating the majority of his food in a reasonable time.

Week Two:
Day 1 / Wed - most breakfast, barely lunch, half dinner
Day 2 / Thur - most breakfast, most lunch, barely dinner
Day 3 / Fri - off day because Jack had surgery (no breakfast allowed, barely lunch, half dinner but with help)
Day 4 / Sat - barely breakfast, most lunch, most dinner (with help due to being at a party)
Day 5 / Sun - barely breakfast, all lunch (at a Pump It Party), barely dinner
Day 6 / Mon - barely breakfast, little lunch, most dinner
Day 7 / Tues - most breakfast, barely lunch, barely dinner

most = more than half, little = less than half, barely = only a few bites

It should also be noted that since day 3 / Friday, at most meals, Jack complains that his tummy hurts. Not sure if it is from the surgery or from hearing us talk about the fact that his ulcer was probably causing pain from eating but he just didn't notice it.

During our 3rd visit to the psychologist she explained kids work for approval and acceptance. She challenged us to hold back on Jack so that he seeks our approval at meal time by eating more. Hummm.... not sure how much I can hold back on Jack or Brooke. To which she asked why. I explained three reasons why I just love on my kids....1) I have working Mom's guilt, 2) we worked SO hard to have a family that I appreciate it and relish in it, and 3) I never want my kids to point back to a situation saying "you didn't love me here" or "you didn't want me" or anything that would make them think that because they were adopted, that they were "less".... because the truth is, they are so much "more".

The psychologist really zeroed in on the working Mom's guilt... stating having guilt can be projected on the children, making them feel like there is something wrong with them. And could I be overcompensating (doing more) because I feel guilty about working outside the home? Interesting concept..... have I ever purchased a toy for them because I feel guilty about working? Well, I have purchased a toy for them. But out of guilt? Or just because I love them and love seeing the happiness on their faces? Is that over-indulging them so they feel my working Mom's guilt or so they are no longer seeking my approval?

And I honestly don't think holding back on Jack, will get him to eat. Not praising the good deeds he does and pointing out where he could do better, isn't something that I think, would resonate with him. And I honestly don't think I could hold back on hugging, cuddling and telling him how much I love him or how I'm proud of him when he does something great. Maybe because I do better with positive reinforcement instead of having an eyebrow raised at the "but you could have done this better".

Scott and I have decided to maintain the no focus on eating/food strategy. We're also giving the acid reflux / ulcer medicine time to work and pray that as it does, Jack's eating will increase. And we'll take Jack back to psychologist in 2 weeks as a recheck for us and a check-in for Jack.

Psychologist

Anyone who has been around us during a meal, knows it is a challenge. I like to think we are a balanced family but when it comes to meal time, everything gets thrown out the door. Tensions get raised (very high), there been tears (by everyone), yelling, throwing up, anger. It isn't a pretty sight. And we've finally decided we need outside help by way of a psychologist.

Scott and I had our first session Tuesday Jan. 10. We both walked away from it feeling really good about it, which is... good. We both also walked away with new things to try to help the meal time environment. Basically what it boils down to is, everything we've been doing -- we can't. And we have to do everything opposite. And we have to take away all the focus on the food. Easy enough, right?! For the first week, no more helping the kids eat, no more timer, no more reminding them to eat, no more walking way from the table, no more yelling. And for me, I need to be okay with the kids not eating for meals and days at a time. This is HUGE for me, because I'm so scared of Jack (esp.) loosing weight. We're told day one - Wednesday - will be good, then Thursday will be bad, Friday will get worse, Saturday will be bad, Sunday will get better and maybe by Monday, they'll eat half of what they are served. Here is Jack's progress.....

Day 1 / Wed - all breakfast, most lunch, little dinner
Day 2 / Thur - most breakfast, half lunch, all dinner
Day 3 / Fri - all breakfast, all lunch, little dinner
Day 4 / Sat - barely breakfast, lunch and dinner
Day 5 / Sun - barely breakfast, half lunch, barely dinner
Day 6 / Mon - half breakfast (after saying repeatedly he was hungry), barely lunch, barely dinner
Day 7 / Tues - all breakfast (but with some reminders), maybe half lunch, good dinner (said the babysitter)
* most = more than half, little = less than half, barely = only a few bites

I will say this... this process has seemed to help Brooke. No pocketing / storing food in her cheeks. She doesn't always eat all her portions, but usually eats at least half, if not more.

After this week trial, we went back to the psychologist. Still a good session. We have followed all the rules and the tension during meal times has gone down dramatically. The psychologist seems to think Jack is improving.... I personally disagree. We are going to tweak a few things; no apples at bedtime, change our answers to their questions during meal time and reward Jack with a quarter for every well-eaten meal. Next post in a weeks time to track the progress and update.