She hasn't had a strep infection since she was 2, so that's not it. She has an obsession with washing her hands, because they might have a singular speck of dirt on them, and she has trouble with being able to go out of the house without going through a ritual of checking to be sure her shoes are tied, usually about four time, and that her bear, Lanie, has her coat on her and that she is warm and now that she has her oxygen she has extended the ritual to making sure she has her inhaler, her aero-chamber, her oxygen pack and her other miscellaneous paraphernalia that she needs when we leave. And when we do actually make it out of the house to run errands or go to church or meet someone or anything like that, we have to do everything in the order that she was told we were doing them in or she has a breakdown. For example, if we need to go to the gas station, the pharmacy, and the grocery store; we have to go to the gas statin first, then the pharmacy, and the grocery store, otherwise she looses her composure and "pitches a fit." She is almost to the point that she can't leave home. She has panic attacks when things aren't the way she thinks they should be.

Its been very tough, but I'm hoping it will get better in time and with the right support and management.