Saturday 25 August 2018

Epilepsy And Autism?

I said I would write about the 'episodes' that J has been experiencing, so here goes....

On a Sunday evening, back in July 2017, I was sat in the lounge, watching TV. Two of the boys were in bed, and J was wandering around upstairs (it was 9pm, so it wasn't his bedtime).
I heard a *bang* from upstairs, and as J is a fairly loud boy, with big feet, I presumed he had stamped his foot on the floor. I called up "stop banging", and went back to watching the TV. 
Within a minute or two, my ears tuned into a noise that did not 'fit' into the house. Gut instinct? Mother's instinct? It just didn't feel right.
I paused the TV, and listened intently. 
I jumped up after a few seconds, and announced with a panicked voice, "something isn't right!" and made my way to the staircase. I got half way up the stairs, and when I turned my head to the left, which meant I could see straight into the family bathroom, there on the floor was J,  making these horrendous noises (I still feel sick every time I think about those noises).
His head was wedged under the bottom of the radiator, with it digging into his brow. 
He was unconscious and he was making a gravelly, snorting, choking for breath noise. 

999 was called, and the operator could hear the noises J was making, and was asking all the questions about his heartbeat, breathing, any obstructions in his throat, any wounds etc.
A 'Rapid Response' man arrived within minutes, closely followed by a twin ambulance crew, and J was finally 'coming to'. 
We got him onto his bed, and he wanted to sit up. He allowed them to put a monitor on his finger, a blood pressure cuff on his arm, and use a stethoscope on his chest. 
He seemed fine, if not a little dazed. 
The decision was made, after around thirty minutes of them observing him, that it would be better for him to stay at home, as it would be too stressful for him to be in a bright and noisy A&E department for hours and hours. 
I was told to call 999 again if he went downhill or it happened again that night.

I checked on him every hour through the night, but somehow he managed to have another episode between these checks. 
I discovered him with blood caked over his face, and dazed. I had missed the actual episode, and had discovered him after it. He had a nasty wound to the side of his tongue, where he had chewed away at it (he still has dents in that side to this day, as it healed, but not entirely).

I chose to call the NHS helpline number, and ask for their advice as to whether I should take him to hospital, a GP, or call for an ambulance - I didn't want to waste a call to 999, and an ambulance, as I wasn't sure if he fitted the criteria. 
After going through some basic questions with me, the call handler said a doctor or nurse would call me back within an hour. The call back came within five minutes. 
After retelling what had happened the night before, and what I had just discovered, they sent an ambulance out for him, and I was told he would need to go straight to hospital.

As J was still very dazed and lethargic, the actual wait in the A&E department wasn't too stressful for him. He slept on and off, and didn't try to escape, or make any vocal distress noises. 
We were transferred to the children's wing of the hospital, and were lucky enough to see a specialist epilepsy doctor, who worked with children and adults who also have a learning disability. 
As J is so tall, the beds in the children's department were too short for him, and he had to lie curled up in the fetal position, or else have his lower legs dangle off the end!

I retold the story again, about each incident, and described in detail what happened. At no point did J 'jerk' or physically move his body. He was completely unconscious, and struggled to breath. 

When he was in the children's ward, they did an ECG on his heart, and he spent his time taking the probes stuck on to his chest and legs, off. It didn't help that they didn't know how to get the ECG machine to work, so he was getting bored with little square sticky pads peeling up at the sides, and decided to help them fall off completely. With my help, they finally got the machine to work ( amazing what switching it off and on can do!), and I tried to keep Joseph engaged with songs and away from the sticky squares. The ECG was fine.

An appointment was made to see the specialist in his clinic, and we were sent home.

During the next week he had another episode, and I filmed it. 
He was in his bed, it was around 1am, and I filmed what was happening. I did this to prove there was no physical movements and to show the way he was breathing and choking. I wanted to back up my claim that he was not just in a 'deep sleep' and snoring. 
I tickled his feet. I patted his back. I lay right next to him, and held him in the recovery position, and kept his jaw from grinding onto his tongue. If I were to even walk into his room when he's asleep, he stirs. If I managed to make it in there at all, and dared to touch his hair or his feet, he'd rapidly pull the covers over his head, or turn onto his other side. He was not just having a heavy sleep. He was experiencing something that made him lose consciousness, and become dangerously at risk of choking on his own blood or tongue.

The appointment with the specialist went okay. As okay as could be, as there was nothing he could say to reassure me, or confirm any diagnosis. It was a mystery what was happening.
He wanted J to have an EEG to monitor the electrical waves in his brain. 
The problem with an EEG is that the patient must lie very still for up to an hour, with probes stuck to their head. This would not work for J. Also, as the patient must be awake during this time, they cannot use any form of sedative or sleep inducer to keep the patient still. 
This meant that the EEG idea was abandoned.

An MRI scan was suggested, as this could be performed under a general anaesthetic. 
It took 11 months for this to happen. I had to chase it with my GP, as well as the specialist, as I kept on drawing a blank with my enquiries.

During those 11 months, he had many more of these episodes. I would wake to hear that familiar, and scary noise, and grab my phone (to  A) time the episode and record it, and B) to be able to call 999 if needed).
I had to lay with him each time, keeping him in the recovery position, and continually checking his mouth for choking or biting his tongue. I would talk to him, and stroke his hair. I don't know if he's aware or can hear me, and it is frustrating enough for him that he is unable to communicate verbally in his everyday life, so to be in this state, and potentially scared witless by his body behaving this way, I want to make sure he can hear my voice and my reassurances that I am there and he is safe. 

He finally had his MRI, and it was quite a stressful wait for him on the ward prior to the scan. 
We had to wait five hours in a hot and stuffy ward, before he could go down to the scanning room. 
I insisted he have a pre-med which would help him doze more, and the second dose worked within twenty minutes or so. It worked so well that he fell asleep on the ward, and wasn't awake for the actual administration of the general anaesthetic, or the long walk down the corridors to the MRI unit. 
He was wheeled down to the side room next to the scanner, where the anaesthetist began holding the mask over J's face. When he told me he was 'under', he said to give J a kiss goodbye, and it took all my strength not to break down there and then. I managed an arm rub and blew him a kiss, as if I had have reached down to kiss him, I think I would have dissolved. 

I have experienced a child having a G/A before, as W needed an MRI as well, when he was only a few months old, to rule out a brain tumour being the cause of his nystagmus. 
It doesn't get easier the second time. You have this feeling of losing control of being the carer and protector of your child, and couple that with the worry about the small risks of having a G/A and what they will find, you have to try and remain calm within yourself, and occupy your mind with a book or a walk. 

We are awaiting the full results of the MRI. Initial looks by the specialist, at a scheduled appointment recently, didn't show any obvious tumour, however the 126 images need to be looked at in depth by specialists. Our consultant has also referred us to another specialist in another hospital, as he wants a second opinion, and potentially this other specialist may have come across a case just like J's. 

For now, our specialist has said he doesn't believe it to be epilepsy. Despite this, he talked about the drug options available, but each one comes with some quite severe side effects. 
One drug has the high risk potential of making J angry and aggressive. 
Another drug causes insatiable feelings of hunger and wanting to eat non-stop. 
Both of these side effects would be detrimental to the measures I have in place at home. 
I have locks on the 'goodies' draws, and also have a separate fridge and freezer in the garage, which contain the foods J would eat raw. The kitchen fridge-freezer only holds foods which J won't touch.
I also cannot have J becoming violent or aggressive. He is so tall and well built, he would be a danger to myself and to his younger brothers, and it would make excursions out of the house a high risk.
Add to this, the specialist said that these drugs are not 100% in helping, and can take up to two years to start showing their positive effect. 
I cannot do that to J. I cannot medicate him with such high risks and low rewards. 

For now all I can do is monitor J every night. My ears feel like they have a radar in them now. They twitch at the slightest 'odd' sound in the house, and they get confused when one of the dogs snores (this dog has always been a loud snorer, but in his old age it has gotten worse), and I go into a mild, split second panic that it's J. 


I'm hoping that whatever it is, he grows out of it quickly. We've been lucky so far that they only happen when he's at home, but his school (and from September, his College ) is aware of the situation, just in case. 







Saturday 11 August 2018

The Full Moon Effect

I've written before about the full moon, and it's effects it has on J, and I feel it's time to write further about this, as it hasn't abated over the years, and it also affects my other two children as well.

I use a moon phase tracker on my phone app, and it's been really useful in solving the riddle of why my boys are acting up even more than usual. 
Let's be honest, children, no matter what age, are challenging. The challenges change through their childhood, but the full moon exacerbates these, and it can be stressful, noisy, and incredibly hard work.

Arguments, shouting, short tempers, door slamming, stomping up the stairs, selective hearing, demands, winding each other up, even just breathing in the vicinity of one another, are all the joys of raising siblings, and these go into full throttle when the moon is shining her glorious full sphere down on us. 



Something I'm keeping a track of is the full moon and J's 'episodes' of total unconsciousness, which last for up to 45 minutes at a time (they have increased in their duration the last couple of times). I'm interested to see if there is any link between the two. I've read that some people find their epileptic seizures increase at this time, so it's something to keep in mind, and hopefully I may see a clearer reason or pattern to what is happening to him. If you want to know more about these 'episodes', I've written about them here -  A Scary Night - and will endeavour to write a full post over the next few weeks, to explain in depth what has been happening to my Boy for the last year. At the moment they are not being classed as epilepsy, as he doesn't 'fit', but they are affecting him quite badly, and he is under the care of a specialist (the person who has said he doesn't feel these 'episodes' are true epilepsy).


As the words 'lunacy' and 'lunatic' are derived from Luna, the ancient Roman Goddess of the Moon, it seems the full moon and her effects have been noted for a very, very long time. Perhaps ancient Roman parents also had to endure little Maximus and Octavius stamping their feet, arguing over who gets to hold the broken stick, moaning about their supper, and complaining that Argentia has more chicken on her plate than they do. 


Luna, Roman Goddess of the Moon


Whilst the scientific jury disagrees with a lot of the beliefs surrounding the moon and her effects on humans and animals, there are a lot of people who disagree. There have been many studies carried out, and some conclude there are no significantly higher accident rates during this time ( emergency room intake statistics ), whereas other Doctors who work in psychiatric units have noted an increase in erratic behaviours amongst their in-patients at this time.
There have been sleep studies, where volunteers were not told the reason for their participation, and could not see, nor where made aware of a full moon, and their sleep pattern and sleep cycles were assessed before, during and after. One study (Current Biology) noted the participants (during the full moon) took longer to fall asleep, had 30% less NREM (non rapid eye movement - deep sleep), and overall had 20 minutes less sleep.


It is an interesting topic of discussion, and one that will not be conclusively decided for a long time. I am in the 'believers' camp, as I see what it does to my children, and other people around me - even my mood is altered, but that could be put down to having to play referee to warring children, and ensuring that each one has a turn holding the broken metal handle from the garden broom ( yes they really can argue about such absurd things!) 

It is interesting talking to other parents about this, as some see a pattern, and some don't. 
Whatever the truth is, the moon is a fascinating natural satellite for Earth, and humans have been intrigued by her beauty and mystique ever since we first looked up to the night sky. 

Thursday 9 August 2018

The Dentist Visit

The dentist has been something of an anomaly for J. 
During his primary school years, he regularly saw a dentist who specialised in treating patients who had learning difficulties, autism, ADD etcetera. 
Appointments were a stressful time for J, but she persevered, and was happy to attempt to look at his teeth whilst he stood up. She had some very clever tricks to persuade J to open his mouth, and with split second timing, she was able to view into his mouth every few seconds, and check his teeth. 

J has been very lucky with the strength and health of his teeth, despite the struggle to get him to brush them, or have them brushed by myself. 
He doesn't drink juice or cordials, sugary fizzy drinks, or milk. He doesn't eat any kind of sugary sweets, or even fruit (which can have a high natural sugar content) but he happily consumes pints of water a day, and eats a lot of vegetables, so this must have a positive effect on his oral health. 

When J began secondary school, the dentist appointments began to tail off, and were sporadic. There was never a real reason given as to why, but the likelihood was financial - the constant cuts to services for the special needs sector, for both children and adults, has been detrimental to so many. 

There was a gap of around 18 months with J not seeing a dentist (bad I know), but I then decided to take matters into my own hands and that he would be seen by my own dentist. This also meant that if J ever needed to have treatment, my dentist would be in the position to refer J to a specialist who would use a sedating gas to perform any procedures, and it would mean J would be still and calm, and the specialist dentist team would be able to get on and complete the necessary treatment with ease. 

I briefed my dentist about J ; warning him and the dental nurse that J is very tall (his height can intimidate some people, and coupled with his non verbal babbling, can be a shock for them), and would be scared, possibly noisy, and at worst, refuse to even open his mouth. 
J was seen straight away, with no waiting around (as I use a private dentist and not an NHS one - due to having no available NHS ones in my area -waiting times are not as long I have found), and he willingly sat back in the dentist's chair. 
He jolted a little as the chair lowered backwards, but still remained seated. 

The dentist showed him the little mirror tool, and allowed J to hold it and look at his face close up.

Dental Mirror



J followed his request to open his mouth, and even though he did close it and re-open a few times, he kept it open for a good amount of the time, and even allowed the dentist to use the dental explorer (otherwise known as a sickle probe), and feel over his teeth.

Sickle Probe / Dental Explorer

I was amazed at how well J coped with the new environment, new faces, a potentially stressful situation (not many people enjoy a visit to the dentist), and having to do something he doesn't like ( laying back and not being in control, having people touch him on his face, and the frightening feeling of not understanding what may happen). 

The relief of not having him freak out, and have to deal with the fall out, and the feeling of achieving another goal with relative ease, is quite an accomplishment for myself too. 
As this went so well, it bodes well for further dental check ups, that J will be compliant having his teeth checked over, and he'll build up a trust. I'm further relieved about the agreement that he will be referred for any treatment, no matter how minor, and that he'll be sedated, meaning there will be no stress for him or me. 



Another positive step forward




Wednesday 1 August 2018

Pupil Of The Year!

On J's last day of school, I found a certificate and gift voucher nestled amongst various wads of school work, accumulated over the last school year, which had been sent home for me to keep. 
His certificate was an award for 'Pupil of the Year'
As I congratulated him, with high praise, he looked at his photo on the certificate, and walked off, nonplussed. Whilst he may not be bothered by this accolade, or perhaps he doesn't understand what it means, I was over the moon. 



I am an advocate of boosting people's confidence, skills and values, and want my children to do their best, be their best, and believe in themselves and their abilities. 
If J didn't have his difficulties, and attended a mainstream school, I would hope he would be just as motivated and keen to try his hardest, and work with dedication towards gaining good grades and exam results.

The gift voucher he also received can be spent in a vast range of shops, and I'm certain his choice will be a food shop, where he can browse the chocolate and biscuit aisles, and joyfully fill a basket with his selection of goodies. As he isn't able to convey to me what shop he'd choose, as his cognitive impairment limits this, I am confident in making this choice for him, due to knowing him so well, and being able to judge his likes and dislikes. He is very food motivated, and he will be in glorious confectionery heaven. 

It was a wonderful end to his five years at that school, and I'm so proud that he worked hard, tried his best, and gained this acknowledgement from his teacher, support staff, and the Head Teacher, who chose him from all the other pupils.