Friday, May 29, 2009

How could we prevent this distortion?


'Born to bloom but fated to be nipped'
A flower in full bloom is beauty personified. Every bud appears with the potentiality to bloom to the fullest, to radiate all its beauty and fragrance. Yet so many get nipped at the bud, so many wither away. Have we ever stopped to ponder whether this loss, this wastage could be prevented? Wouldn't the world be so much more beautiful, had all the flowers blossomed?

Every time I look at a developmentally challenged child, this question keeps coming back to me. Can we just sit back and watch the bud get distorted and wither away?
For every 1000 otherwise healthy babies born, 3 are going to be spastic, with stiff limbs and difficulty in ambulation, 2-3 will develop autistic traits, mental developmental delay & retardation to some extent will be noted in 20-25 children, of whom 4% will have profound retardation, 7% will have moderate problem % rest 89% will have mild retardation. Another 30 children are expected to develop Hyperactivity Syndrome, which we call ADHD. Later, as they start going to school, 16-20 children will develop learning disability of some sort. So out of these 1000 delicate buds how many are going to bloom to their fullest? Quite a grim picture, isn't it?

Let us take a closer look at the problem and try to find out whether we have anything to improve the present scenario, and who is to shoulder the responsibility?
A developmentally challenged child may present in various ways, with various disabilities, of different degrees, associate with a wide spectrum of complicated neurological diseases, all arising from a multitude of aetiological (read causative) factors. Confusing, right? No, I'll not go into any further medical jargon. To put it simply, the gamut of the problem is immense, both in prevalence and severity. But the silver lining lies in the fact that severe problems and grave presentations, though difficult to diagnose and treat, are relatively much rarer. Conversely, the milder varieties of developmental delay and retardation are more commonly met with. They are caused, to an extent, by environmental factors, hence are somewhat remediable and reversible. Milder mental challenges are prevalent in the weaker section of society where nutrition, basic health care, environmental stimulation and education has a lot to do with their intellectual and cognitive stunting. These challenged kids create a greater burden to the already compromised living of these poor families. Developmental challenge;;; a torture for the child, a source of anxiety and burden to the family, a burden and negative resource to the society.

I'm sorry if I'm sounding too gloomy. No, the scenario should not be so grim if we take a little effort, for much of this problem is amenable to correction, provided we act EARLY! Detect early & intervene early to prevent the disability from becoming really disabling! Moreover, much of the challenges & disabilities can be overcome or circumvented to allow the child to function much more effectively and efficiently, utilizing all his potential.
This is exactly what we mean by the common medical term of 'Early Detection and Early Intervention.'

Now the question comes, how early and by whom? In other words, who is to shoulder the responsibility and when?
By early we mean as early as possible, preferably at birth. Why? A baby's brain develops most when he is in his mother's womb & the 1st few months of life. And coming out of that pleasant home called 'mothers womb' to this angry world & surviving here is a trial for the delicate baby. Any maladjustment here can have a bearing on the child's developing brain, giving rise in later life to a developmental challenge. These perinatal and early infancy assaults can leave tell-tale signs, which if identified in time, will give us a premonition that the child may develop a disability. Also, as the baby grows, he can show subtle signs of a developmental lag, which can be picked up by a searching eye. We tend to ignore these minor signs and put it off by saying," It'll be OK as he grows older"....only to admit the disaster when it stares back at us when he really grows older.And this 'we' includes the parents, grand-parents, care-givers, neighbours, even physicians!!! Blissful ignorance!

So, dear parents and grand parents, please consult a developmental pediatrician if your baby was born too early (preterm) on too small (LBW) or was very ill after birth, had to be kept in the NICU. Keep a vigilant watch on how he grows : does he smile, does he hold his head up, does he sit & stand, does he talk in time? Does he see & hear properly? Does he look into your eyes? Does he play the way other babies do? Any suspicion, don't wait, consult your doctor. Dear doctors, please acknowledge a delay or aberration when you note it and for Heaven's sake, do not pacify your client with a "Don't worry, it'll be OK" unless you're dead sure. If it's not your special domain, refer to a 'development' colleague.

Early detection calls for early Intervention. Some problem in the tiny brain cells is preventing the child from functioning normally. If these weaker areas of the brain can be given constant & proper stimulation, they will grow to the best of their potentiality. Moreover, neighbouring areas of the brain can lend a helping hand. Thus the child can learn to improve his skills to the best of his ability. He is also taught to circumvent his disabilities by using his other acumen to perform a particular act. Thus he adapts to life in a more effective & purposive way. All this takes time and patience, but the reward at the end of the day is really fulfilling. The wide smile on the mother's face and the confidence in the child's look will surely tell you that.

This early intervention is not a single dose therapy. It has to go on and on and on. It needs specialized team effort : a team of specialists including a developmental pediatrician, a developmental psychologist, psychiatrist, ophthalmologist, ENT Specialist, a physiotherapist, an occupational therapist, a speech therapist, who will work with the child at regular intervals, through play based interventions, but the pivot of the team remains the mother, who will effectively work with the child day in and day out. It is her perseverance, on which the final show depends! A confident and patient mother wins the race. We have many an example of such battle-winners.

Every challenged child who learns to live a purposeful life, who attains the best of his potentiality, is one more happy person on this earth, with one more happy and content family surrounding him. We thus lighten the burden of one family, the social burden by one unit.

What a divine pleasure to see that smile of fulfillment on the lips of that little 'different child' at the back!
So, though a deformed bud, it wont wither away. It will bloom and it's deviant beauty may surpass the normal flower!


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Wednesday, May 20, 2009

Mothers Day 2009

Two women, two professoinals--on a week-end road trip through the Rockies at Colorado....

"The magnificience of these sandstone rocks is captivating"...:"Hmm. you can feel the touch of the greatest sculptor, The Almighty. No wonder its called the Garden of the Gods', as the Native Indians considered it to be."

"Can I have one more scoop ple-e-ease?".. "Dont you think you have had enough ice-cream for today?"

"Could you please walk a bit faster?"..."Dont run, I cant keep pace with you."

"This place is spooky, Mama. Hold on to me tight"..."Dont worry dear, I'm right there."

Wonder what these are? Bits of conversation picked up on the way? No, these are a few tidbits that went on between these two ladies travelling together-- one in her twenties, the other in her fifties. Who else but the mother & daughter duo could delve into such varied moods of conversation!

So began our week-end trip from Denver, where my daughter came from Buffalo to pick me up, aftter a conference, I had come to attend there.

We drove down to Colorado Springs, late that Friday evening, only to bundle off to sleep in a cosy little hotel,wondering what beauty awaited us next morning.A quiet sleep with your 'baby' nestled in your arms is a pleasant treat for a mother residing 12,000 miles away from her kid!

Next morning the soft sunrays of dawn woke us up at 5:45 AM--an early and colourful dawn heralded a real bright day.We started off after a quick coffee, towards the Garden of the Gods.A wonderful drive through the plateau region took us to the Garden of the Gods Trading Post, from where we got a grand view of the mighty mountain range of the Pikes Peak.

This trading Post was built by the Indian trader, Charles Staussenburg, way back in 1900. Largely expanded today, yet maintaining its heritage, this place now hosts a classic art gallery. a unique gift shop and real good food at its Balanced Rock Cafe.

From there we went into the Garden of the Gods--strolling at ease on foot through the magnificient red sandstone rocks, formed at the fancy of nature; the touch of the magic hand of the Eternal Scuptor could be felt everywhere.We were awe-struck at the beauty and intricacy of these natural monuments-- the Balancd Rocks, the Kissing Camels, the Siamese Twins, to name a few. Sprawiling over 1350 acres stood numerous such structures, which had been built slowly, over 300 milliion years, as sand and salts deposited layer by layer, beneath flowing streams. As geologists speculate, in another few milliion years, these huge sturdy rocks will again crumble down, back to sand and gravel. Thus we all come, we grow and we perish and the Eternal Cycle continues.

Colourful chirpy birds broke the silence, as if to say, "Come on, come alive and be happy."

After an enchanting couple of hours up there, we came back, only to utter, "Truly, a Garden of Gods"

It was 11:30 and we were hungry--we drove on to Manitou Springs, looking for a good place for lunch. Suddenly a colourful stage-coach caught our eyes and we walked into the historic 'Stage-coach Inn'. The ambience took us back down memory lane to the log-house-stage-coach days and we had a sumptuous lunch. The food was delicious with a country-side flavour.

Outside the inn, I felt a sudden tug at my sleeve--turning my head I found two imploring eyes meeting mine.The tug, the look spoke a language I was used to 15 years back!! "Mama please....look at those bears!!"

Yes, it was a wayside shop with wood carved bears on display: bears of differnt sizes and in different moods.My daughter dragged me across the street and we treated our eyes to the wonderful wood carvings.They looked real alive, holding up 'Welcome', Good By' and other placards. Of-course the one my chimp-turned-young lady chose was a 'Go Away' sign!

There were lots more to see and only one afternoon in hand, so we had to choose from a list of 'to-go's. We chose to go for the Pikes Peak mountain. We would drive up to the 14,110 ft summit, a 19 mile drive to the top...that was thrilling! The roads were real scary, with surprisingly no guard rails on the narrow hilly roads and hairpin bends. All the way the view was magnificient with snow-clad peaks all around, pine trres and hiking trails through them, and reservoirs reflecting the white peaks enhancing the beauty all the more. It was a pity the over cautious driving effort kept my daughter from being able to enjoy the beauty. For once, I felt sorry that I couldn't drive. Anyhow, once at the top we felt we had achieved our goal. It was reassuring and real boosting to spot the peak we had reached as we descended back. Mountains always spoke of enormity and grandeur to me--reminding me of how tiny and insignificant we mortals are, compared to nature & the Eternal. The tiny efforts to reach the summit is all we have to hold on to.

After a three and half hour enchanting drive, we returned to the base and drove back towards Manitou Springs. On the way as we stopped at a coffee shop for coffee, a glance at the next shop attracted our attention. There stood a wooden reindeer with a scene painted on it. As I was trying to decipher the paintings, a motherly lady came forward saying "Thats the fire. Please see the otherside-- that shows our fight, our struggle." A look at the name of the shop, 'Born of the Flames' and her commentary brought back the story vividly-- the story of the devastating fires of 2002 in Colorado and the brave story of fighting back to life.This ever-positive effort to survive tragedy---to create out of destruction---the untiring effort of an evergreen lady of seventy overwhelmed me.With all the woods burnt out, they had recovered the wood from the core of the Aspen trees, from which beauties in the form of vases, coasters, trays, lamps and many more were carved out. Each was a piece of art with a story to tell. Fire had destroyed a lot for these fate-struck but courageous people, but it had kindled a new fire in them, a fire of inspiration to survive and create. My hats off to Ms Ginger Krabbenhoft and her team.

Having gathered enough treasure for our eyes and mind, we now returned to Manitou Springs downtown--for a leisurely stroll before returning to the hotel.

Little did we guess what this dainty little downtown had in store for us! This small downtown was a treasure house for local arts. We went from one shop to another to encounter a display of varied arts--from glass blowing to jewelry, from wood carving to metal work--it was all there.Seldom do we come across such a thriving art community now-a-days. And shopping with your daughter always means a tug at your sleeves, an imploring 'Mama..', a fond indulgence with a false frown---even if she is the tour guide and its her credit card! These are small gestures which, I guess, we both cherish a lot.

Thus our day long Colorado trip came to an end--a merry, satisfying trip, where we enjoyed every bit of it-- taking in the beauties of today soaked in the nectar of fond remembrances.

Two professionally busy women at two opposite ends of the world, but bound by the strongest of bonds of an invisible umbilical cord, are suddenly brought together after a year--very, very close---on a one day trip to the Rockies. So what could be more fulfilling to a mom on Mothers' Day?




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