Ear, Nose and Throat Doctor (ENT). The ENT doc, who we were at a follow up visit with after Bennett's hospitalization and tracheal stenosis diagnosis in November. I had figured that we'd go to the follow up appointment, be given thumbs up and sent back home.
Instead, the ENT doc gave Bennett a good check up of his sinuses and determined he has the beginning stages of nasal polyps, a common symptom of Cystic Fibrosis. Nasal Polyps are small growths of inflammation inside the nose that are typically caused by irritation. In the case of Cystic Fibrosis, they are caused by the constant presence of mucus in the nose. This is why the ENT doc decided to prescribe Nasonex and the use of saline nasal spray twice daily.
"Twice daily? Oh boy - that's going to be interesting to force a three year old to do this" was my first thought. But, like everything with Bennett, we don't have time to think about how we're going to do it - we just have to.
Knowing that we might would have to fight Bennett to do his nasal sprays twice per day, I decided to offer up the chance for a toy. Bennett, who is highly motivated by new superhero toys, was more than excited to begin earning a toy for his patience and endurance of taking these medications.
But, not to be forgotten, we offered Oliver the same deal. If he could sleep through the entire night in his own bed (something he stopped doing about the time Bennett was born), he could also earn a toy.
We knew Bennett would be motivated by a toy. But would Oliver - who is rarely motivated by extrinsic rewards?
Now, we are 5 weeks out and we are estatic to say both boys are sticker champions!! Bennett hardly ever fights getting his nasal sprays. And Oliver has consistently slept in his own bed for more than a month for the first time in three years!! Whooo-hoo!!
It may look like Oliver has to get fewer stickers than Bennett but it's only because Oliver gets a sticker for sleeping in his bed (one per night). Bennett gets two stickers per day for each nasal spray (morning and night) and an additional sticker for staying on his g-tube pump at night (another situation we were having issues with but has since been resolved).
Up until this point, I have slowly added one day per new sticker chart. So, the first day, we started with 1 day's worth of empty squares to be fulfilled. The next day, we went to 2 day's worth of empty squares before a reward was given. In order not to overwhelm the boys with a sticker chart that they could not sustain the energy for, I increased the empty squares one per day. My goal was to go slowly until we could build a habit.
However, now that the boys have been successful sleeping in their beds and taking their medications for 24 days, we feel that we are now all in the habit. So, my plan is to begin to wean the boys away from having to use a sticker chart at all for this particular behavior.
But are we done with sticker charts? Are you kidding?! NO WAY!! Sticker charts are AMAZING!!! What is the next behavior I'd like to strengthen with the boys? Hmmm....
We meet with the ENT doc again in the next few weeks. I hope she will notice some improvement in his developing nasal polyps. We know quite a few CF children who have had to undergo surgery to remove them. We hope that won't be the case for Bennett for quite some time. However, if they begin to inhibit his breathing, we won't have much of a choice. We shall see. For now, we're just proud of our big boy for continuing to be so brave with the addition of new daily medications. We are equally proud of our biggest boy for being willing to sleep in his own bed by himself. It's a sure sign his internal anxiety is under control.