Sunday, May 20, 2012

Potty Training M

M has "Global Developmental Delays."  For those blissfully unfamiliar with the term, it means that every skill M acquires takes far more time that a typically developing child.  In our world, "inchstones" are celebrated because the "milestones" frequently elude M. Everything M has learned to do has been accomplished through the help of a devoted team of doctors, therapists, teachers and family.  The skills unfold ever so slowly and raising M is a wonderful lesson in patience and perseverance.

In infancy, M had to be taught how to eat.  M sat up at 21 months.  He four-point crawled at 2.5 years.  First steps happened at 3.5 years and M was able to walk independently shortly before age four.  At age five, M had but a handful of words and another handful of signs to communicate with.  He was six before he began putting words together to construct simple sentences. I beam with pride when I share this, for once upon a time we were cautioned M may never walk and may never talk.

Life with M has been a question of "Will he ever....."
When M was very young, one of the "Will he ever...." questions I'd ask myself is if he would have the ability to potty train.  M has very low muscle tone, neuromuscular dysfunction and significant kidney disease.  Physiologically speaking, I wondered if it were even a possibility.

I asked this of M's urologist as he was writing M's first prescription for diapers. M was three years old but was the size of an average seven year old and standard Pampers just didn't cut it any more.  The urologist explained that we could mail order larger sized diapers for M and that insurance would cover it because they  were a medical necessity.

He then answered my question and said he felt that M did have the ability to be toilet trained.  He guessed it would happen sometime between the ages of 6-8.

The summer before M turned four I decided that I would try to at least have M use the toilet in the morning when he awoke.  He'd been waking up dry for months and it seemed like a morning scheduled visit to the toilet just might work.(Afterall, I knew that his bladder was indeed full.) It was difficult for M to relax his muscles to go on command and it was several days of trying before we had a success.

What happened next I would call miraculous.  Within days, he was peeing on the toilet every morning.  Within two weeks, he was using the toilet full time and I felt comfortable moving M into underpants full time. He was 3 years, 10.5 months old and he was potty trained, day and night.

This was a shout-it-from-the-rooftops moment for me.  He was potty trained!  He wasn't even four years old! He wasn't that delayed on this one.  And he had achieved night time dryness before many of his same-aged peers....a fact I would manage to work into conversation whenever possible.  "Yes...M is potty and night!"

What made it all even more remarkable is that M had toilet trained within months of learning to walk.  He had trained at lightning speed despite the low tone, the coordination and balance difficulties, the kidney disease.  He had done it. (When every achievement has come through years of hard work, it was nice to have the potty gods smiling down on my and giving us an easy go of things)

M was toilet trained, but he was far from having total independence in the bathroom.  In those early years, he still needed my help to physically get on and off the toilet  (Being so tall, M did not having the benefit of using a toddler's potty chair or ring insert and had to train on an adult sized toilet) .  He needed me to work the buttons and snaps.  He did not have the strength nor the balance to bend over and pull down his pants without falling.  Even as M nears eight years old, he still lacks the fine motor skills required to button and zipper independently.


M's life is dictated by routine;  routine that begins from the moment he cracks open his eyes.  Each and every morning it begins in the same manner.  M will wake and immediately seeks me out so that I may walk him into the bathroom. (A routine so ingrained in me that more than once I believe I have actually slept-walked into the bathroom) I help, if needed, but my presence is more about the habit of me being there than an actual need for my help.

M has recently changed up this routine.  On his own.  Without prompting from me or anyone else.  This in itself is an "inchstone"  (insert choir of angels singing, "Halleluja!")

On morning, a few days ago, M was up earlier than usual.  As usual, he came to wake me.  Rather than inform me of our morning walk to the bathroom, he asked for a drink.  I suggested he use the bathroom first and he told me he already did.  Sure enough, he had, as evidenced in the toilet bowl.  (Typical to many seven year old boys, the art of flushing is lost on M)

M has continued to do this every morning since.

As I type this, I am laughing out loud at how ridiculous this may seem to some who read this write about my son's bathroom habits.  Perhaps to some it may seem insignificant that my soon-to-be-eight year old is using the bathroom alone.  It may not be a shout-it-from-the-rooftop kind of a big deal, but it is the kind of big deal that you do share with the grandparents and your closest friends who 'get it.'  I am grateful to have people in my life who will share my excitement on this one.

I keep a mental checklist of the things I worry about regarding M.  I feel good knowing I can cross off:
  •   Worry about when M will finally use the bathroom alone.  
(Yes, I've often pictured myself, old and gray with my walker, escorting M into the bathroom.)

It may seen small and insignificant and not worthy of much merit, but these are the thoughts that occupy my mind.  These are the things I think about enough to write about.

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