Monday, May 31, 2010

"Thumbs up!"

Today was my first full day of swallowing/feeding therapy. It was quite an experience! Caroline is so great and I feel like we are already learning so much. When we first got to Haven 1, Caroline introduced us to the babies that have feeding issues and gave us a brief history of each baby.

Me, Dennis, and Sidney. . . .2 members of our feeding group :)

me and little matt. im already in love with most of these babies! so precious.
Bennet ready for therapy in all his gear to keep him from scratching himself.

Many things such as a baby's fine motor skills, gross motor skills, language and of course feeding skills are assessed to qualify them for our swallowing/feeding therapy group. Of course not all the babies at the Havens have feeding difficulties so we try to target the ones who need it the most. Gross motor skills are tasks such as sitting on their own unassisted, pulling themselves up during "tummy time", and working on head support and stability. We also play attention to their fine motor skills such as if they can reach for objects, fisting (which shows if they are tense or relaxed), tracking (holding your finger up and seeing if they follow), if they bring objects to their mouth or not, etc. We then assess their language. We want to know if they are cooing, smiling, laughing, babbling, have eye contact or not, turn to sounds, respond to their name, etc. All of these things play a big role in how a baby is feeding. The feeding issues we have seen in some of the babies also qualify them for our group including: anterior liquid loss (milk coming out of the front of their mouths), weak- to no suck, shallow breathing, weak non-nutritive suck (i will explain later on), overactive gag, spitting up, tongue protrusion, aspiration and abnormal oral facial structures.

After learning about each babies histories, Caroline also went over what a typical therapy session will include and how to perform each task. (The order of the tasks depends on the baby and his or her needs) but usually the first thing we do when we get into therapy is change them and get them clean and happy. (This is a big deal and can really play a big role in a baby's feeding) Next, we have "tummy time" where we are trying to get the babies to pull their heads up and get their muscles working and stronger.
Tummy time with Miller and Lushomo! They did an AWESOME job! So proud!

Sometimes tummy time is really difficult for these little guys! :( but we try to encourage them and not give in to their sad little cries as much as possible. We want them to get better!

We then perform Beckman exercises, which are oral motor exercises that are used to stimulate the baby's muscles used for feeding. This was really new to me. She instructed us on how to massage their upper and lower lips, outer cheeks, and inner cheeks in a soothing pattern to stimulate their muscles. We also use a “z vibe”, which uses vibrations to stimulate their muscles as well. For some babies, it relaxes their muscles causing them to gain more control of their tongue for feeding. Some of the babies absolutely LOVE this, and some think it is the devil. I had the pleasure of working with Teagan this morning and she has a love hate relationship with the z vibe. She is okay with holding it on her own and putting it in her mouth when SHE wants it there, but if I tried to put it anywhere near her she cried and threw a fit! Towards the end of the session she got more used to it though. YAY.

angry Teagan

happy Teagan. haha :)

We also give the babies pacifiers to work on their non nutritive sucking. Non nutritive sucking is different in the fact that they are not actually feeding so this type of sucking is generally faster and has shorter pauses than normal nutritive sucking. Non nutritive sucking is really important because it can increase their oxygen levels in the blood, decrease heart rate, and increase weight gain. Which is a big deal! So we make sure to incorporate this into our sessions as well.
After all this is completed we sing to them, show encouragement, give them their bottles and document their progress and look for more things to work on…and if we notice any particular problems while feeding during the session. It is only day one of my week of feeding therapy and I can already see what a difference these exercises and the z vibe can make. Caroline said some SLPs don’t believe this type of therapy approach works, but I have seen it work already with the two babies I worked with today. After doing this on Sidney, (a child with TB and that is also HIV exposed) her tongue was way more relaxed and she was able to drink more controlled with less anterior liquid loss. I am so excited to be able to help these little guys!

After a busy morning at Havens 1 and 3, we headed to lunch. I wasn’t feeling too good by this time and was having some stomach trouble. (slightly caused by being spit up on so much…but I’m getting more used to it) After lunch, Kaylee, Rachel and I walked back to the house together. When we got there Rachel went to unlock the door. After a long struggle Kaylee took a try at it, and then I followed..... NO LUCK! The lock was broken and we were locked out of the house! AHHH. After everyone else got there we each took a turn trying to wiggle the key into the door….. Still no luck. Catherine’s “bobby pin idea” was a FAIL as well. Haha. We ended up going to get Ian to climb through the bars of the window (since he is the smallest of course)…. SUCCESS! After about 30 minutes of struggle, we were finally inside, this time through the back door! WHEWWW. What a “situation!” haha. Props to Ian for being able to fit through this tiny spot!

The weather was still kind of blah today. It rained a good bit yesterday so everything was still a little wet and the sun didn’t show it’s face hardly, thus taking it longer for our laundry to dry! (still havent gotten that back...Ha) It was around 65 degrees with a breeze, but not chilly enough for a jacket. It is so crazy to see the natives around here. Since this is their “winter”, they think it is “SOOO COLD”. When we got to Haven 1 this morning we all laughed to see how some of the children were dressed. You would have thought it was below freezing outside in their “Eskimo gear”.

Little Lisa the Eskimo

Tomorrow we will continue our feeding/swallowing sessions at Havens 1 and 3. Please continue to pray for all the babies!

Nighty Night!

Sunday, May 30, 2010

"God Bless the Rains Down in Africa...."

It rained today!! We were all so shocked because it is their "dry" season. However, after church Kaylee, Catherine and I laid out on the back porch and got some awesome sun and read our books for about 2 hours before the clouds rolled in. It was so nice and relaxing to get a day off from work! I read about 200 pages of my book and got to lay on the couch and do nothing. ahhh. it was AMAZINGGG.

During church this morning we got to go to "children's church" and help with the babies from the Havens. Their singing was awesome and they actually incorporated a "name game" into a song for us all to sing order to learn each other's names. I took tons of video of them singing their songs and dancing. I will have to show you the videos when I get home though bc we arent allowed to upload them on this server! but they are so precious!

this is the children's bible class teacher. she is amazing and as we like to say "she keeps the kids in check" and makes sure they participate

cute little boy reading his bible

they get out of their chairs a lot and do tons of singing and dancing to praise the Lord. . . I just LOVED it.

three little kiddos during church

At the end, their teacher asked if we had any songs we would like to sing.. so OF COURSE me, Kaylee, Jaimie, and Catherine darted to the front. We sang "deep and wide" "the hippo song" "I'm in the Lord's army" (we even sang the cowboy/Texas version. . . the kids laughed and laughed at that! haha) They LOVED our songs! We will def be going back next Sunday and helping with children's church again.

On the way to evening worship today, Kaylee and I were walking in the pitch dark down a muddy road with our flashlights. . . kind of freaking out about the mud and bugs and snakes situation and whatever else we could imagine popping out of the bushes in the pitch dark...haha (if you know us, then you know it is all in fun) meanwhile these three sweet younger girls from the school heard us walking talking about a "snake" and wanted to help us and walked with us the rest of the way to the chapel. haha We talked and learned their names and ages and all that jazz and did "the handshake" (special friend handshake they do here in Africa) and then they came and sat by us in church. They were all so nice! I knew most of the songs that were sang during church, but the songs I didn't know (the songs in Tonga) one of the girls translated for me. I love our new friends! and we are glad they saved us from the "dark and muddy road of death." hahaha

After church we got to witness 4 children get baptized on the mission! It was such an awesome experience. We walked down the road to a guest house to see about 5 gentleman filling a metal tub of water up. The water hose wasn't working so they were having to dump buckets into the tub one by one to fill it up. but it got the job done! :)

Tub they were baptized in.
One of the men led an AMAZING prayer and me and Dr. Weaver both agreed it was a "LEGIT" prayer. haha. :) We have been teaching Dr. Weaver all kinds of new lingo while we have been here.

So happy to have four new brothers and sisters in Christ! YAY! What a perfect end to a perfect day!

It seems that everyone is feeling better. So far so good on week two starting tomorrow with no sick team members! yay!
Tomorrow we switch groups and Catherine, Kaylee, and I will be working with Caroline on swallowing/feeding. We are sooo excited to begin and to be learning new stuff! WOO HOO!

Saturday, May 29, 2010

"A picture is worth a thousand words"

Today I decided to share a bunch of pics with you instead of writing about the sessions. I figured yall might like this a lot more! :) ENJOY!

I would however like to share a bible verse that Marja shared with our language enrichment group this morning before prayer. It's Exodus 4:11 . . .

The Lord said to him "Who gave man his mouth? Who makes him deaf or mute? Who gives him sight or makes him blind? Is it not I, the Lord? Now go; I will help you speak and will teach you what to say."

I thought this was a very encouraging verse for us before our therapy session. Sometimes it is hard to know what to say or do to help these children, but it is important to remember God is in control. He is our mouth, our ears and our eyes! Thanks for the awesome verse Marja!

me and court
Kaylee and I teaching language class
Blessing playing outside on the car

Me feeding Donna. . . Nita being curious as usual

precious little Rachel at Haven 3

Catherine, our model child

sweet little Jana

It is not unusual to have a kiddo hanging on your legs at all times here. haha :)

"Tummy time" with Meagan and Miller

One of the aunties at Haven 1. I admire them for all their hard work. Being a "mother" to twenty or more babies every day is a HUGE job!

Alfred, our NEWEST addition to Haven 1

Lisa is obsessed with the camera!

look at that smile!

Ross is always so happy! (ignore the blue jolly rancher tongue! ha)

language therapy with the boys
more language therapy and singing

Me and Jana
They start them early here! haha :)

Katie in the "vroom vroom"

Friday, May 28, 2010

"More, Please!"

Zumba was actually REALLY fun. I might not have done all the right dance moves, because there was a lot to learn. . . but on the parts I didn’t know I just made up my OWN super cool dance moves. Haha. Not. After Zumba we did a few minutes of Abs and I know I’m gonna be one sore old lady. Haha.

Anywho, today was a busy day. I am exhausted. Kayleee, Rach, Catherine, and I walked to the haven this morning. It is a good little 25 minute power walk to get you awake in the mornings and we always have fun and see something interesting on the way.. . . aka OX carts!

When we got to the Haven, Kaylee, Catherine, Marja, and I were assigned to Haven 2 for language enrichment. We started out our session outside on the merry-go-round and swings and incorporating language skills into their play.

Katie and Charlie on the swing

I paid special attention to Ethel today. She is the cutest thing ever and we have not gotten much talking out of her, mainly because she is still warming up to us and is kind of shy.
Ethel on the merry-go-round

In this pic we are working on signing/saying “more please"

After singing a bunch of songs and doing our lesson on jungle animals with the children at Haven 2, we quickly moved to Haven 1. We pulled them from their cribs, gave them bottles if needed, and did a language class with them as well. My heart goes out to these kids. They do not get much attention except when they are being changed or bathed. So, since they are in their cribs most of the day, they are not getting as many interactions as most babies would be getting, thus delaying their language skills. Also, another thing that is crazy to me is that they do not hold them while feeding them and are hardly EVER rocked to sleep. Because there are so many babies at the Havens and not enough aunties, the babies are used to laying on their backs with small pillows on their stomachs that are used to help prop their bottles up... to feed themselves. Also, because they are not getting out of their cribs and crawling around and moving as much, some of the babies muscles are not developed for even simple tasks like sitting up or pulling their head up during "tummy time". Without these gross motor skills, this also creates a problem with swallowing/feeding. That is why it is so important for us to be here! During the swallowing sessions, Caroline has stressed the importance of “tummy time”, which is having the babies lay on their tummies and allowing them to try to pull their heads up. Some of the babies just HATE this and cry and cry because it is such a HUGE task for them. But it is good for them and important to build their strength, which in turn helps with their swallowing/feeding. One other thing I have noticed is that they DO NOT burp babies here in Africa either. . . . this just blows my mind! I can only imagine the poor little tummy aches these precious babies have. But, they are used to it. However, I made the mistake of trying to burp one of the babies, out of habit, and let’s just say it didn’t go over too well. Hehe.

a few pics of the babies

Ross with his big smile. He is always wandering and getting into things! :)

Shawn aka "little usher"

Lee . . .excited about language therapy.

poor little Bennet has syphilis. During our language session with him, Marja and I decided to put socks on his hands so he cant scratch and spread it any more. He HATED this and cried and cried but we know it will be better for the little guy.

After lunch, we went back to the haven for a few more hours of work. (This time at Haven 3) We were so excited to see these babie’s eagerness to learn. They were REALLY responsive and clapped and sang along with us. They had more energy, produced more utterances, and paid way more attention than the toddlers at Haven 2, which was a shock to all of us because these are the more medically fragile babies. They were so thirsty for language enrichment and made us all feel so good about our session with them. We can’t wait to go back and work with them. Tomorrow we will have a longer session. We had to end it short because we were invited to tour the Mission’s radio station and it cut into our therapy time. We also missed working while we were in Livingstone so we are working all day tomorrow (Saturday)

When we arrived at the radio station, we were all greeted with a handshake and asked to come in. It is really simple compared to radio stations in America.

inside the radio station

They use old school tapes for their music and a regular ole computer. It was really neat and the building was actually made out of a container like you’d see on a semi-truck.

The radio station promotes Christian programs and they broadcast things from the mission throughout Zambia. Everyone on the mission has been so welcoming and glad to have us and made us feel like we are at home. I think we might get a debut on the station sometime soon!

After touring the radio station, Kaylee and I went running before dinner. This was quite a sight to see two girls running down these dirt roads I’m sure. Especially me! Hah. I plan on making this a normal thing and wanna exercise as much as possible while I am here and have a partner for it.

After dinner, we all decided it was Friday night, it should be declared “Movie Night”. so we all watched “Dirty Dancing” in the living room thanks to Dr. Tullos' projector. We all curled up on the couches and chairs and drank our sprite and cokes that Dr. Weaver went and bought us. So nice! (Just fyi, I have NEVER seen dirty dancing. I know. I know. It’s crazy! I’ve already heard it from everyone.) I really liked it. And it also gave us some ideas for new dance moves for Zumba, right girls? Hahaha. :)

The rest of the group has been eating lightly today... but have been back in action, which is good! We were worried yesterday when everyone was so sick. I think everyone is almost back to normal….but now Rachel isn’t feeling too hot so please pray she isn’t catching the after math of all of this! And that it doesn’t continue to spread!!

Thursday, May 27, 2010

"SPEED UP!!! "

Today has been quite a day! After finally getting everything packed on top of the truck, we drove 2 and a half hours back from Livingstone. Last night Ian, Jaimie, Sara, Marja, and Meagan all got sick with a stomach bug and have been throwing up. Not good. Please pray that they all get to feeling better and that it does not continue to spread to the rest of our team! EEEK! We are hoping it is just something they ate, but we are not sure.

On the way to the Havens after lunch, Dr. Weaver asked if we wanted to participate in a "new research study". . . we were all like "sure, what kind of research"? She said lets see how fast we can go over the speed bumps and how far your bottoms go off the seats! haha. This was hilarious. Kaylee, Catherine, Rachel, and I were in the back and we were def up for her challenge. Dr. Weaver made sure to speed up on every hole and speed bump. We caught air a few times, almost hitting our heads on the ceiling of the truck. We laughed so hard we were almost crying. Dr. Weaver is so fun and we are so lucky to have her!

Since the others were sick we had a lot smaller of a group at the Havens and I was able to get to do my first swallowing/feeding session with the babies at Haven 1 and Haven 3. Caroline supervised us on exercises to help the babies muscles get stronger for feeding. These exercises were a very new experience for me. We used a z vibe and also some Beckman exercises to stimulate their muscles. I can't wait to do it again and learn more about swallowing/feeding from Caroline. I can tell our work here with her is really going to make a difference in these babies lives. I only got spit up on a couple of times and overall it was an amazing experience.

the babies in Haven 1 with feeding issues

the sweetest little things ever

baby Hamilton needs your prayers. He is THE tiniest thing I have ever seen and has feeding/swallowing issues! our team is taking extra special care of him. So pray we get him healthy.

Tonight I have decided to do Zumba. Dr. Weaver is gonna do it with us too! So this should be tons of fun! haha. I will let you know how it goes.