Josiah was discharged from the hospital November 4th, almost 5 weeks ago.  What an exciting, joyful, emotional time it was to get our boy back home.  What a huge adjustment it was for him. And what a huge adjustment it continues to be for all of us.  Some of the changes we’ve experienced recently are these:

Josiah came home on 7 medications.  SEVEN!!  Some are prescribed 4 times a day.

He gained weight.  Quite a bit of weight.  Josiah continues to gain at an alarming rate; 1 – 1.5 lbs or more per week.

He sleeps now.  He sleeps really well.  Some days Josiah even takes 2 naps.

He no longer goes to Public School.  Josiah is currently being home schooled.

He has 3 caregivers who rotate throughout the week, with 2 more coming on board soon to fill in the gaps when Rick or I are not with him.  We all help Josiah with 3 basic goals:

Decreased dependence on others, safety and appropriate behaviors.

The aggression, self-injurious behaviors and destruction we observed before his hospitalization are all still very much a part of Josiah’s daily existence.  We track the number of incidences he engages in per day. We count how many times he scratches, pulls hair, bangs his head, hits himself in the head and/or is destructive. Sadly, it is much too frequent.

Josiah is healthier being home.  By this time most every year he’s had to miss quite a few days of school due to illness. Yesterday, was the first time we noticed the beginnings of a cough.

He is ridiculously close to being toilet trained.  Hallelujah!  Hallelujah! Hallelujah!  We take data in the bathroom to keep track of his successes.  This boy could EASILY be out of pull ups at any point in the very near future. We just need to get a few behaviors in check first.

The majority of time spent working with Josiah is to gain compliance.  He spent so much time in the hospital, with so few demands placed on him, he is now not interested or willing to comply with our requests.

Josiah would much rather sit at the kitchen table and do nothing.

He wakes up in the morning, stumbles out of bed and heads straight to his spot at the table. He likes it there.  He would sit there all day long if we let him.

Maybe the medication increased his appetite to the point he is always hungry.  Sitting at the table may be his way of ensuring someone will notice and hopefully feed him.  Who knows?

We often need to use a strong motivator to encourage Josiah to leave his coveted spot.  Presently that something is pudding.  That boy would do just about anything for pudding.

The first small taste is a freebie.  The rest he has to work for.  To get Josiah up and away from the table, we carry a snack pack of pudding and a plastic spoon with trace amounts of velvety goodness a few feet away from him. .  Magically, almost instantly sometimes, Josiah snaps to attention, willingly leaves his stool and follows the pudding.

It works to get him into the bathroom, to get him into the tub, to get him into his bedroom.  It works in public navigating through stores. It works just about anywhere, anytime.  The power of pudding is definitely not lost on Josiah and something in time we will gradually diminish.

Josiah’s excessive weight gain of over 42 lbs (and counting) in less than 3 months is the direct result of one of his medications.  I read it has been nicknamed ‘the obesity drug’ especially for teenagers due to the havoc it wreaks on metabolism and the way it alters body size rapidly.

We are weaning him off of it now and have been assured his weight should return to ‘normal’ once it is completely out of his system.  Hopefully by then we will have found another motivator to encourage Josiah with compliance.

I’m guessing all this pudding isn’t helping much either.