So much has happened in the past two weeks, that it honestly feels like I haven’t given an update in months….
About ten days ago, the 2020-2021 school year was going to look a little like this- I would homeschool Roslynn for the first half of kindergarten, with guidance from the Penn Manor School District virtual school. Greyson was set to learn from home as well, with a teacher coming out to the house daily to see him, specialists and his classroom teacher doing weekly check-ins and he would receive his ABA services in-home too. This plan drastically changed ten days ago. On Friday, August 21st around 3 PM.
ABA services have been wacky recently, due to COVID-19 and changes with staffing, etc. so I received word that Greyson’s RBT (who had been spending 4 hours a day with us, providing essential services) was moved around to other clients, leaving majority of Greyson’s hours unstaffed. This meant that I was going to be teaching kindergarten from home WHILE watching/tending to Greyson, who really needs one-on-one care 24/7. Derek and I slept on it and after much debating, we decided it would be in Greyson’s best interest to send him back to school. It was such a difficult decision to make and I still wonder to myself if it is a good choice. I must say, Greyson riding the bus from 8:10 and not getting back until 11:50, is a much needed break for me, even if I’m teaching kindergarten at that time. Greyson now will have an opportunity to have his PT, OT, VB and speech in person/at school and will continue to have ABA services from 4-6 PM.
We informed his classroom teacher on Sunday, August 20th that Greyson would be returning to the classroom (after telling her for months that he would be home, telling the bus company that he didn’t need a ride and setting up weekly consultations with staff for his check-ins). Luckily, she understood the predicament we were in and after rushing to get papers signed, forms in from doctors, medicine clearances, etc., we were able to send G back to school on Wednesday, the 22nd. In a typical school, there is absolutely no way that would have been done in two days- just goes to show that the IU in Lancaster has great staff members, who don’t mess around! Excitingly enough, he will begin to ride the bus tomorrow. Fingers crossed for a safe, smooth and easy transition into that.
Roslynn had her first day of kindergarten today! It’s hard to believe that she has gotten so big and is already five years-old and in kindergarten. Due to the overwhelming demand for virtual schooling, the school district’s programs for kindergarten and several other grades were not equipped to manage so many online students. While we wait for her modules and kindergarten classwork to be added to her portal, I had to improvise activities for today and most of this week. Now, I DID at one point want to be a teacher, but after working in a kindergarten classroom for a year, I knew there would never ever be a day when you’d see me teaching a class full of kids. It certainly takes a village to raise one child, but boy does it take one hell of a person to teach 20-25 hyperactive children.
As we wait for the school district to get everything together, I will continue to improvise and go with the flow of activities she likes to do, particularly on ABC Mouse and other educational programs. Today for example, I taught her the different between capital and lower-case letters, had her practice writing them with and without composition lines, then got her accustomed to using a mouse and laptop. She only cried once when she had a really tough time clicking and dragging items on the laptop. Overall, I think its going to be a lot of work, but I am hopeful that this is the safest option and it also allows her to work at her own pace, which is always very good for her.
Gone are the days that I was able to do small home improvement projects, as I’ve been doing for the past two weeks. I’ve traded in my hammer and paintbrush for a computer and curriculum guide. I’m actually legit proud of myself for doing these improvement projects, mainly things that I’ve wanted to do, but didn’t have the time when I was working full-time.
I’m hoping that I can give Roslynn a positive kindergarten “environment”, even though she is home and that I can live up to the name that she has given me, “Teacher Mommy”. I’m also hoping that the computer system gets its act together soon- one can only make up pretend lesson plans for so long! Sending prayers and good vibes to all those who are homeschooling, or making the hard decision to send their kiddos back to school.
For the past year or so, Greyson has seen a local pediatric dentist, who works for a practice that isn’t the greatest with a non-verbal, autistic toddler. We began seeking a new dentist for him back in the fall of 2019 and were referred to the Penn Medicine Dental Program in Philadelphia. They do many “in home” procedures with laughing gas and they do sedated visits at CHOP, when needed. After the referral was placed, I was able to make sure they accepted his insurance (which had changed since his last appointment due to the loss of my benefits in April), which they did. Roslynn’s dentist (who Derek and I both see, along with the rest of my family) does not accept her new insurance, so I figured we would have her see someone at Penn Medicine too, since we were going to be there for Greyson. Today was the intake appointment for both children at the main campus in West Philadelphia.
The morning began as usual, with the exception that Greyson FINALLY slept in his own bed, for the first time in nearly two years! I was shocked. I woke up this morning, not knowing where we would find him, but I checked the clock at 7:30 AM and there he was, laying in his bed, snuggled under the covers, looking so cozy. I was hopeful that if he got a good night’s sleep, maybe he wouldn’t be a total grump at the dentist. Well, that hopeful thought lasted about an hour, because soon after waking up, he was not happy. Overall irritable, but energetic, so I was super confused. Alas, both kids were up, dressed and ready to go, so I felt like despite his attitude, maybe it would still be an okay trip.
After many visits for CHOP for MRIs, EEGs and miscellaneous appointments, I knew that leaving early would be best for the sake of traffic and I always prefer to be early for appointments, just in case. So, like I typically do, I google mapped the location (for the 5th time) and route, along with the nearest parking garages and meter parking availability. I felt pretty confident that I knew where we were going and where to park, so I actually did not feel anxious for a “mini-trip”, like I typically am. That should have been my first warning that the day was not going to go as planned so easily. Greyson, who was the first appointment of the two kids, was scheduled for 1:00 PM and Roslynn was scheduled immediately after, at 2:00 PM. We left the house around 11:00 AM, stopping for gas before hopping on the highway. Roslynn and Greyson both had virtual psychiatry visits this morning at 9:15, and Roslynn was also scheduled for her weekly (virtual) outpatient appointment with her therapist at 11:15 AM. Luckily her therapist was okay with us doing the appointment in the car as we were driving, so Roslynn had her session in the back seat while I drove, Derek navigated and Greyson watched “Trolls”.
At the conclusion of her visit, Roslynn was starting to feel car sick, as she typically does when in the car, so I was giving constant reminders for her to breathe and close her eyes, etc. The GPS was reading an arrival time of 12:53 PM, so I was getting a little nervous that we weren’t going to have much time to get situated before we had to go in for the appointment. We got onto the Schuylkill Expressway and I felt like we were making pretty good time, despite traffic being a little heavy. We soon pass the exit for the Philly Zoo, CHOP and the Philly Convention Center, and I realized that I had never seen signs for Independence Hall before on our trips. The thought then crossed my mind that I had never seen Independence Hall before at all, until it was sitting right in front of me. I still continued to follow the GPS, just assuming that it was taking us on a short cut around construction. I began to get even more nervous when the GPS stated that our “location was approaching on the right side”, and we were sitting in front of a spa, tucked away in a busy city block, far into Center City.
Panicked, I have Derek check the GPS address and he changed the GPS application we were using to good ol’ Google Maps. Turns out, the app we were using (which has never given me any issues before), took us to the other Penn Medicine Dental Program on the completely opposite side of the city. 12:53 PM came and went. I knew we would be really late, so Derek called and informed the receptionist that we were going to be late, to which she responded that we had “15 minutes past the appointment start time” as a grace period to get to the appointment. The GPS, with the correct location this time, was reading 1:10 PM arrival. Whew. I took a deep breath and got us across Philadelphia by 1:08 PM. We made it. I was so relieved. Traffic was getting heavy around the facility and there was no parking available out front of the building, so I dropped Derek and the kids off at the door and circled around the block to find a parking spot. About 20 minutes later, I finally got around the block and found a spot right in front of the building. I pay the $5.40 parking fee for two hours of parking and feel confident that maybe the trip wasn’t going to be a disaster afterall!
I quickly go through the security check-in, get my temperature taken and smother Purel all over my hands and arms and join Derek and the children in the waiting room in the pediatric wing of the building. Greyson and Derek went back first for the first appointment. I sat in the waiting room with Roslynn and heard the occasional scream/cry come from the exam room that Greyson was in, so naturally I assumed all was going well. Back story to why I really wanted to find a dentist that could manage an ASD child, was because Greyson injured his mouth/front two teeth back in early 2020, when he head butted the steps the entire way down from the top step, to the bottom (pre-helmet arrival). His front right tooth had been turning a gray-ish color after the injury, so we were really upset that Penn Medicine wasn’t accepting new patients (due to COVID) from March until August. About 30 minutes later, Derek and Greyson come out of the exam room and into the waiting area, and the same dentist took Roslynn and I back to the same exam room.
Before we began with Roslynn’s exam, the dentist debriefed Greyson’s visit with me. Shockingly, Greyson had zero cavities! He did however, have an extra tooth growing in between his front two teeth. The gray tooth is in fact a dying tooth, as we expected. The dentist did not feel like it was necessary to pull the dead tooth at this time, mainly because it isn’t causing him any pain or discomfort at this time, and the dentist doesn’t want to give him anesthesia unless seriously necessary, which we agreed with. I was able to see the x-rays from G’s visit and saw the very crowded front teeth, 3rd tooth and all. Roslynn’s exam was fast and informative. She did great for her x-rays, cleaning and fluoride treatment, giggling at the dentist and dental assistant’s funny jokes the entire time. I knew that Roslynn had a cavity on her lower left side of her mouth, which was visible whenever she opened her mouth wide enough, but I was not prepared to hear that she had 5 additional cavities.
Roslynn has always been a great brusher. Every morning she always brushes her teeth after she is dressed and her hair is done. Evenings, she does need reminders and help with motivation to go into the bathroom and brush well, which she tries to avoid frequently. I would be lying if I didn’t say that I felt like a horrible parent when I heard that she had so many cavities. The dentist assured me that most of the cavities are between her teeth, mainly due to the fact that she has very little enamel on her teeth, which is a common issue with children. Basically any small teeny tiny evidence of a cavity beginning to form, Roslynn gets a full-blown cavity, quickly. The dentist stressed to Roz that she needed to allow us to help with her brushing and flossing. She reluctantly agreed, received her fluoride treatment and we set up her follow-up appointment to come in and have her cavities filled. We made a pit-stop at the bathroom before we began our 1 1/2 hour journey home and made our way to the exit.
I was so excited to show Derek what a great parking spot I got. Since both kids were getting pretty antsy and wanted to go home, Derek was relieved to hear that we wouldn’t have a far walk to get back to the car. We exit the building and I immediately noticed a bright orange piece of paper in the rear windshield wiper blade of my car. I at first believed that someone placed a flyer of some sort on the car, but didn’t see any other cars with any papers on them. As we approached closer to the car, a homeless man walked closer towards us and stated that the Philadelphia parking authority had been by, ticketed my car and marked it for towing. WHAT???!!!! I literally paid for parking, so I was so confused when I pulled the ticket and the bright orange paper off of the car. Having seen the show, “Parking Wars” on A&E, I knew that getting towed in a big city was something that you did NOT want. I quickly tell Derek and Roslynn to hurry up and get in the car, while I skim the car, looking for a boot that would prevent us from leaving. No boot. I thank the homeless man for his information and we pull away before a tow truck could come and move the car. Derek pulls the ticket out of the envelope and the $55.00 fine was written due to parking in an AMBULANCE spot. I honestly checked the signs when I was parking and saw zero signs regarding anything except “two-hour parking” and a loading zone a few feet away. Sitting at the red light feet away from the parking spot, Derek saw an ambulance loading/drop off sign that was in a spot close by the “3-hour handicapped” parking sign that I was looking at when I parked the car. I wanted to get out of the city and be done with the day, so we paid the ticket online and were done with the disaster of a day we had so far.
Both kids were fairly hungry by 3:00 PM, so we stopped at an exit off the PA turnpike and got them some food. That held their crying over for about 20 minutes, until Greyson began to get fussy from sitting in the carseat. He was screaming and crying his high-pitched squealing cries that Derek and I just love so much. I was hitting some heavy traffic, so I was trying to calm Greyson down verbally, while paying attention the road and other drivers. Roslynn, who was complaining about motion sickness, was screaming for her raincoat, which we brought as a precaution. I asked her why she needed the raincoat, but of course, her anxiety and frustration of being in the car for so long, prevented her from answering me. She continued to scream “raincoat” the rest of the way home, which was about 45 minutes with the heavy traffic.
We got home finally around 5:00 PM, and were greeted happily by Mr. Duke. What a busy day. Both kids are out cold, just as I had hoped they would be. I love looking at them while they peacefully sleep, wondering what their little brains dream about at this age, (hopefully) not knowing the chaotic, challenging and uncertain times we are all facing as a nation. One thing I am certain of though, is I better not hear the word “raincoat” for awhile.
Evaluation day in Baltimore for a diagnosis of Sturge-Weber Syndrome…..or was it? Follow us on our mini-trip down I-83 to Baltimore, MD where we receive some interesting news about Greyson’s condition.
Just a quick reflection of this past celebratory weekend……
If you’ve read my previous posts, you know that Derek and I are somewhat decent at deciphering Greyson’s vocal stims. For example, “Uh-DUHHHHHH” means he’s really mad and you should leave him alone and “dig-dig” is typically something funny (it’s turned into more of a “tig-tig” for tickles now). The only stim that we have not figured out is “dig-a-lay-lay”. We did ask how he felt about his birthday on Saturday, which he replied “dig-a-lay-lay”, so hopefully it means something good? HA HA. He’s trying so so so hard to communicate, especially when he is extremely excited or passionate about something.
This past weekend, we celebrated Greyson’s 4 year-old birthday by having two separate family parties. We did it this way due to COVID-19 and not having a large group of family members together. Saturday, his actual birthday, was celebrated with my family, where Greyson had a “Toy Story” themed party. We had only immediate family members (again because of COVID) and it was small, but Greyson had a blast! Greyson woke up on Saturday and was extremely excited. I think he knew that something was up, especially since Roslynn was screaming “Happy Birthday, baby G!” all morning. Once I began decorating with the Toy Story decor, his face lit up immediately. It wasn’t as fun as the Bounce Kraze party we had last birthday, but it was more intimate and it was nice that everyone could talk and hang out.
Greyson’s favorite part of the day was the balloons. We had a few dozen balloons for him, and he was so excited once Derek brought them into the house. The next 8 hours basically consisted of him wrapping himself up in the balloons and playing with them rather than the toys he received as gifts.
Our birthday celebration continued into Sunday, with Derek’s immediate family, who planned a fun picnic outside for Greyson. Greyson was able to play on his swing set and run around outside, despite the heat and humidity. We had a blast playing and running around, which is his favorite activity. G’s seizures are typically triggered by heat/sun/humidity, but because we discovered this last summer, we were able to spot his warning signs (starting to foam at the mouth and slow down physically), preventing a seizure. I’m starting to think that maybe Greyson even realizes his limitations, because every time he gets overheated, he requests to be picked up and carried inside for water…which he would have never done last summer.
As of today, we are officially at 1,007 days since we began seeking a diagnosis and/or explanation into Greyson’s medical issues. This feels like a lifetime, and we aren’t even close to the finish line. I used to believe that we would have an answer after seeing a few specialists, but it seems like the more specialists we see, the more problems the doctors discover. My personal goal for this year is to stop obsessing over the idea that we will get an answer. This doesn’t mean I am giving up on finding one, but I am slowly coming to the realization that we may never really know all of the answers, and I can’t let it consume me. That’s just something I’m working on accepting.
Evaluation day in Baltimore for a diagnosis of Sturge-Weber Syndrome…..or was it? Follow us on our mini-trip down I-83 to Baltimore, MD where we receive some interesting news about Greyson’s condition.
In December 2017, Greyson had bilateral ear tubes put in for frequent ear infections. The tubes appeared to have been working for a few months, but by late 2019, we noticed that he was having frequent infections again. Turns out, Greyson’s tubes never fell out, like they were supposed to, falling into his inner ear canal. Because the body sees the tubes as a “foreign” object, his body began to send white blood cells to his ears to get rid of the tubes, which just resulted in more and more infections, drainage, hearing loss, etc. With both ear drums perforated and his infections becoming frequent in early 2020, we knew by February that he was going to need surgery to correct it. Because of COVID-19, everything with Greyson’s procedure stood still. We were unable to do anything about his ears since Pennsylvania was on an elective surgery restriction. By early May, Greyson’s ears had become so troublesome, that I made an office appointment with his ENT. Dr. Da Costa, the surgeon, agreed that Greyson needed to be sedated for a bilateral tube removal and ear drum patch, to replace the damaged ear drums.
Now, to schedule a surgery for a kiddo at the ENT center, we had to have a pre-surgery clearance appointment (within two weeks of the procedure) with his pediatrician and get the “OK” from her to proceed with the surgery. On Monday, July 27th, I was able to get in with our pediatrician for the pre-op appointment. This was going to be the first time that G was going to be under anesthesia without actively being on an anti-convulsion med for his epilepsy, and due to his most recent seizure, the pediatrician did not feel comfortable signing off on the procedure until she spoke with the neurologist. So, frustrated that we didn’t know what was going on, I was afraid that his procedure was going to be cancelled for August 3rd, which would require a longer wait for G’s much needed relief. By Wednesday morning, we received the clearance for Greyson’s surgery, but only if he could have the procedure done at a hospital, rather than the small outpatient center we typically go to for these types of day surgeries. I received a call from the surgery scheduler at the ENT office and she stated that she had one cancellation for August 5th at Lancaster General Hospital, but if we couldn’t make that work, we were looking into late October for the surgery. I refused to wait that long for Greyson. I knew that once fall comes, he is more prone to getting a cold, which almost always involves some sort of ear infection. We took the appointment for today and were able to get everything sorted out. Our pediatrician also recommended that both Derek and I could attend the day of surgery, since COVID has been restricting companions to 1 per patient. Greyson has been to LGH in the past for ER visits and an EEG in 2017, but never needed sedation for a procedure, so I was a little weary of the hospital, since it’s not necessarily a children’s hospital.
Like our other adventures involving sedation, Greyson almost always was scheduled first thing in the morning, due to his age and having to fast, etc. Today was no different- up at 4:30 am and out the door by 6:30 am. Now, I’ve been to LGH hundreds of times, but again, here I am the evening before, google mapping and street-viewing the parking, entrances, etc. I think my nerves always spark a fear of not knowing where I am going, which is a HUGE fear of mine. Fortunately, I found the parking garage with no issues and we checked in around 6:50 am. Each patient upon parking in the garage, is guided to the information desk for a COVID-19 screening, including a temperature check, symptom checker and questionnaire. LGH has quite the system when checking in for a procedure, so after we got our “screened” stickers, we made our way to the first stop, which was admissions. Being so early in the morning, there weren’t many people checking in, so Derek and Greyson stayed in the hallway, so G could spin and run up and down the halls. Mid way through check-in, I could hear Greyson’s sneakers running up and down the marble hallway, letting out the occasional squeal in excitement that he was out and running around. My faith in LGH was increased when the woman checking us in followed me to Greyson out in the hallway, to put a wrist band on him. She was an older woman, so I didn’t have much hope that she would understand Greyson and his needs, but she was great. She walked us to the elevator, was able to help us carry belongings, while Derek carried Greyson. Expecting her to leave us at the elevator, she accompanied us to the next floor for the pre-op waiting room and introduced us to the staff that would be helping G for the morning. HOLY CRAP a Lancaster County medical facility that had staff who saw our struggling and jumped right in to help. This has never happened for us at a non-children’s hospital.
The greeter assisted us to check-in and pickup our surgery pager and six-digit tracking number for us to check on Greyson’s progress throughout the morning. Though his job was to simply greet us and direct us to another desk, he took us back to a room immediately. HOLY CRAP. Another staff member who saw that we were struggling with an almost four year-old boy and jumped in to help us. I never would have expected this. We were brought back to Greyson’s pre-op room and begun the process of going over medical history, changing him into surgical attire and speaking with the anesthesiologist and eventually the surgeon. Due to Greyson’s allergy to Red Dye #40, we were unable to give him the sedative medication that the hospital carried, so a pharmacist made a special syringe of sedative that was dye-free. Once we administered the medication, Greyson started to feel pretty loopy after about 15 minutes. Because of the red dye hold up, we waited about 1.5 hours total in pre-op, missing Greyson’s surgery start time of 8:30 am by about an hour.
Waiting in the surgical waiting area was like waiting in a busy train station, while attempting to socially distance from other people. Pagers going off every few seconds, notifying family members that their loved ones were finished in the OR, or the lobby phone ringing repeatedly from doctors calling families to explain the outcome of the patient’s procedure. Greyson’s entire procedure lasted about an hour or so. His surgeon came out shortly after we were notified that he was finishing up in the OR and let us know that Greyson did great. We were relieved. Luckily, his ears weren’t too bad- some wax issues in the left ear, which was causing some hearing loss and both tubes just hanging out in the ears. Dr. Da Costa patched both ear drums and we were brought back to the recovery room shortly after speaking with him.
Now, I know this entire day sounds relatively normal and boring, but in the true Greyson style, the morning was about to get more…..difficult.
Derek and I predicted that the recovery area would be complicated because of his age and also because of the risk for seizures and self-injury. Our predictions were more than true, especially when recovery called up to the front desk and told the staff to make sure we had Greyson’s helmet. I put up my frizzy, untamed, curly hair and we made our way down to recovery. Precursor for this entire day would have been nice for me to tell you. Because Greyson, Derek, nor I had a COVID test before the surgery (which we were told wasn’t necessary), Greyson was treated as if he had COVID. That means full PPE- two masks, scrubs, dressing over the scrubs, a cloth/disposable covering over the dressing, goggles, a face shield, gloves and shoe coverings. It seriously was borderline the movie Outbreak with Dustin Hoffman. Every person who came in contact with us was required to have the full protective gear on. Once we got into the recovery room, Greyson was in a tiny pod, specifically for kiddos that have had procedures that may be scared or fussy. The pod still opened up to the other recovery beds, which is in an open room with curtains separating patients. Not really conducive for a screaming autistic child.
Greyson was still asleep when we got into the pod, which was just enough room for Derek, Myself and one other staff member. The staff member was in a hazmat suit, almost resembling an astronaut suit, complete with an enclosed helmet with a filtration system attached, so that she was breathing in purified oxygen. I thought it was a little excessive, but then I figured it was better to be safe than sorry. While the anesthesiologist came in to inform us that he did well and she wasn’t anticipating any issues, we received word that his COVID test (they did as a precaution when he was in the OR), was negative. I went over discharge paperwork with a nurse and we were discharged straight from the recovery room, rather than having to go back to the pre-op area due to him being extremely upset and having pulled out his own IV. As soon as we were done going over the information, I trekked down to the parking garage with all belongings in hand and pulled the car around to get Derek and G, who were waiting at the entrance in a wheelchair with three staff assisting. By the look on Derek’s face, I knew that Greyson probably freaked out once I left the room. Greyson was in the hospital pants, a t-shirt and helmet, and was hitting, kicking and headbanging Derek as the staff attempted to help get G under control. Once he was in the car, G began to hit himself, bite his legs/feet and scratch his body. We got him home, fed and put on “Tangled” for him, his latest Disney movie obsession.
The day was successful, stressful but also relieving to see that the staff at LGH were so accommodating and kind, despite being exhausted, working through a pandemic and having to use extra precaution for each patient. Again, my faith in the hospital system in Lancaster has been restored (for now) and I would highly recommend LGH for any pediatric procedure at this point. As for us, we will manage our still somewhat loopy toddler and torture ourselves by watching his favorite Disney movies this evening, just to keep him happy.
COVID-19 really messed up our ABA (Applied Behavior Analysis) services Greyson had been receiving for the past 2 1/2 years. Effective mid-March, the company we were using was told that they would be stopping all in-home services, including services provided by BCBA (Board Certified Behavior Analyst) and RBT (Registered Behavior Technician) providers. Greyson’s primary insurance (who was in-network with the ABA provider) was set to term on 3/31/2020 anyway, so we considered this a sign to find another provider that participated with his new insurance. We consulted with our family care coordinator at Greyson/Roslynn’s Psychiatric provider’s office, and she had recommended we submit a request to the insurance for a new provider. By mid-April, I was receiving notification that Greyson was going to start services with a new agency, Pennsylvania Comprehensive Behavioral Health (PCBH). I did the intake phone call with a Behavior Specialist Consultant (BSC) and had a few phone consultations with her until I requested clarification on the prescription that was sent over by Greyson’s psychiatrist. We had been under the assumption that G was recommended for ABA services, rather than IBHS (Intensive Behavioral Health Services), which was notated correctly on the prescription. Our family care coordinator contacted PCBH and we were set up with a BCBA almost immediately after the phone call was placed.
Through the months of May and June, all BCBA contact was being held via Zoom, which is helpful in some ways, but not if you are trying to provide one-on-one support for a highly anxious child, who has serious SIB (self-injury behaviors). Our BCBA (I will call her “J” for privacy reasons), finally was cleared to come out to the house last Friday, which was her first true interaction with Greyson. She informed Derek and I that our new RBT (I will call him “D” for privacy, too) would be starting services with Greyson effective (this past) Monday. This was a much needed sigh of relief, as I have been home alone with him for the past four, almost five months, with barely any behavioral support.
Greyson had been acting odd over the past week or two, so I wasn’t surprised when he didn’t really want to interact with J, or play with her. He did not show many behaviors during her one-hour meet & greet, but it was later in the afternoon, when he is typically calming down for a movie, while I cook dinner. I reassured J that she should not expect him to behave like this, because he typically has a lot of energy and a lot of needs.
Monday rolled around and I was nervous for the new RBT to start. I always am typically nervous when new people come out, only because I’m afraid of what they will think of our crazy, dysfunctional little family. Luckily, J was coming out with D for the first time, so she could introduce us and get us acquainted with each other. Greyson was asleep when they both arrived. He had a tough weekend of little sleep and a medication adjustment, which had thrown him off and provided a bumpy start to the week. Greyson slept almost the entire time that D and J were out at the house, only waking up the last 45-minutes of the session and visibly annoyed people were here talking about him. Thankfully, Derek had come home by that point and was here to help Greyson’s transition from sleep to being awake, which has been terrible over the past week or so. D was able to see Greyson semi-happy and semi-awake, with little whining, but still fairly lethargic. Again, I reassured D that this was not the typical Greyson and to definitely expect him to be different tomorrow. Tuesday D came out at his scheduled time and Greyson had woken up from his nap about 10-minutes before his arrival. I was hoping he was going to have a good session, but sadly I was wrong. Greyson was fussy, exhausted, not eating (not that this isn’t an ongoing issue) and was not feeling the urge to do much of anything except lay on the floor, groaning whenever we tried to interact with him. I thought this was a little odd, but didn’t think too much of it, maybe just because he had sleep to catch up on from the weekend.
Tuesday evening, Greyson had an even worse night. He was up frequently and was extremely aggressive, both physically and verbally, but felt the need to wake up the entire household and our very kind neighbors next door, with his loud shrieking and pounding on the walls with his fists. I felt like something was causing him to act this way, not because of denied access or demands being placed on him, the reasons for majority of his tantrums, but because of something more complex. Feeling horrible for Derek who had to be up for work in a matter of a few hours, I took Greyson down to the living room and told Derek to get some sleep. I was able to finally calm G down by 6 am, which was perfect for my favorite morning news show, Morning Joe which I can never watch peacefully while the children are awake. Both kids slept until about 10 am, which is seriously unheard of, but I soaked it all in while I could.
Weekly, Roslynn participates in a one-hour play therapy session via Zoom with a Licensed Clinical Social Worker, so she can work on appropriate turn taking, learning coping skills and just to chat with someone regarding how her brother’s disability impacts her and our family. I typically try to join in these sessions, so that I can help keep her on task and to connect with the therapist regarding how she has been progressing and any new concerns we have regarding her. This Wednesday was odd. I knew something didn’t feel right. We had grown accustomed to our typical routine over the past few months, always having G’s emergency medications on hand, but never really expecting to have to use them, since his last BIG seizure happened in September 2019. But of course, just when things become comfortable, that’s when the storm hits.
I noticed that Greyson was extremely lethargic, grumpy and was extremely sensitive to me being around, touching or evening talking to him. I did not want to push him and cause a tantrum during Roslynn’s session, so I put on Moana, which has been his favorite go-to movie over the past few months, and gave him some juice and grapes to keep him content. While I was adjusting the sofa pillows like the OCD maniac I am, I noticed Greyson’s hands and feet had a blue hue to them, similar to the shade of blue he turns when a tonic-clonic seizure is coming on. Greyson was laying down on his little Mickey Mouse cot, when I noticed his hands and feet. I went over to him to touch them, just to confirm that he wasn’t blue due to being cold. He was warm, even borderline hot.
I immediately called Derek and voiced my concerns. He was working from his Church office in Lancaster, about 15 minutes away (10 if you drive like Derek typically does). I have never been home alone with G when he had a tonic-clonic seizure, so I wanted to be sure Derek knew what was going on, in case I needed to call 911 and arrange someone to watch Roslynn. I was also extremely nervous and scared. Like clockwork, as soon as I hung up the phone, G began to have muscle tightness and minor spasms in between the episodes of muscle stiffness. He was coming in and out of consciousness and attempted to stand up and walk in between these spells. He appeared extremely dizzy, almost in a drunken state, falling over himself and walking in a manner that made it look like he had spent too much time on a merry-go-round. The spasms continued for over 30-minutes. I didn’t think it was necessary to give him his emergency medication because he was able to pull himself together between the episodes of muscle stiffness and attempting to walk. I was unsure if this was actually a seizure or if it was something else, but as soon as he was done, he fell asleep for four hours. He typically gets exhausted after a seizure, so his long slumber confirmed my fear.
Mr. Duke was by his side the entire afternoon. As Greyson slept comfortably on his Mickey Mouse cot in the living room, Duke climbed on and acted as a “big spoon”, in the popular big spoon/little spoon technique. D came out to the house in the midst of the craziness and had to leave 15-minutes into Greyson’s sleep (insurance and company policy reasons) and I knew that waking G up at this time was NOT going to go well. I allowed Greyson to rest comfortably, constantly monitoring him until Derek got home later in the afternoon. I became so comfortable with not having to “worry” about G having a seizure, since he had been (tonic-clonic) seizure-free for a few months, that I forgot the warning signs and the typical behaviors he (and Duke) show before a big one. The past two weeks were a giant build-up just leading up to the seizure. Increased aggression, hyperactivity, self-injury, crying, fussiness and no appetite should have alerted me that something was coming. Something big.
Flash forward to 5:30 pm last evening. Greyson woke up a COMPLETELY DIFFERENT CHILD.It was as if Greyson’s brain received an electric shock and completely recharged itself. He was happy, energetic, laughing again and actually ate 2 slices of pizza for dinner, the most food he had eaten all week so far. I was hopeful that the newly recharged Greyson would last, but I didn’t expect him to last all night. As we slept, Greyson went through a handful of Disney movies, ate two bags of regular M&M’s (and maybe another slice or two of pizza), and managed to keep himself occupied from 11 pm until 4 am, when he finally fell asleep. He was legitimately happy and content with everything and anything. It was not like the Greyson we have had for the past few months. Despite the limited sleep, it has been a much needed change to our daily routine, which typically consists of hours and hours of crying/headbanging day in and day out.
The seizure yesterday also reminded me that every single day is a new day and we should always treat it as such. We never know what will happen or when, but we always need to be on alert for a potential event such as yesterday. We are not naive. We know that this “freshly recharged” Greyson will not last. He may be here with us for a few more days, a week or so, maybe even only a few more hours, as we never know when another build-up will begin. We do know that he will most likely have another build-up over the next few weeks, but we will enjoy the “Happy Greyson” and very chatty (gibberish speaking) boy as long as it lasts.
It seems that Roslynn and Duke are enjoying “Happy Greyson”, as well.
In the spring of 2018, Greyson was written a prescription for a fitted medical-grade helmet, to keep his head safe from the headbanging he does. In 2018, his headbanging was minimal- typically only when he was mad or upset about something and it didn’t last very long. Fast forward to December 2019 and his minimal headbanging turned into severe headbanging, leaving marks on his forehead, even severe bruising. He began to headbang even when he was happy, which Derek and I assumed was a sensory output that we needed to get under control.
He began to really hurt himself in early 2020, which prompted our doctor to write another prescription for a second fitted helmet (his first helmet had bit the dust in summer 2019). Due to still being employed by WellSpan in January, I was encouraged to go through a WellSpan medical supply company to get his helmet. I contacted their office and had the pediatrician’s office fax over the prescription. We then waited for any correspondance from the supply office, which seemed to take abnormally long. Every time I would call, there were lots of different people I was transferred to, nobody knew the status of the helmet and couldn’t figure out what the hold up was. I had extra time on my hands in early March, after I was no longer employed, so I decided to get mean about the order. I contacted the higher ups from the medical supply company and spoke with the manager of the individual responsible for Greyson’s helmet order. I informed her that I had been calling for over 2 months, trying to get the helmet status and that we were in dire need of the helmet, due to an increase in self-injury. Within an hour, I had a return phone call from the staff responsible for the order. The staff member stated that he had attempted to contact me twice by phone in the past two weeks, which was not true, or else I would have taken his call and had Greyson’s helmet in hand. After voicing my concern and informing the staff that this was a long overdue order, I was taking measurements for Greyson’s new helmet.
Due to COVID19, the supply company was closed to the public. I had received the staff member’s personal cellphone number and had a detailed update when the helmet was ordered, shipped and received. Though I truly try to be level headed and kind, sometimes it does pay off to be nasty, I guess.
The helmet came in on a Tuesday and was picked up by my in-laws the same day (they lived closer to the supply company than we do). Back in 2018 when we were using the helmet for his minimal headbanging, any time we brought the helmet out, Greyson stopped hurting himself almost immediately. But as his self-injury increased, simply showing him the helmet no longer worked. We did not have Greyson wear his helmet at all hours of the day, as he was really only needing it when he was transitioning between activities and when he upset (which is when the headbanging was really happening).
June began with another change in our family’s schedule, I started to work again. Prior to working, I enjoyed three months of being a stay-at-home mom and had both Greyson and Roslynn on a consistent schedule. Greyson’s tantrums had decreased and he appeared to be happy and content with the schedule we had established. When I began working, even though it was part-time from home, Greyson’s schedule was completely thrown off. He no longer had a set breakfast/lunch time and no longer settled for a nap around 11:30am-12pm like he had done for the past 3 months.
Fast forward to this past Thursday. I was feeling really good about scheduling and the tasks of the new position, but I knew that they kids were both having a difficult time with the change. I finished working at 1 pm on Thursday and came downstairs to hang out with the kids and get them a snack. We had no furniture in our livingroom because we had a new sofa set ordered and pending arrival. The kids LOVED the extra space in the room, running around and taking advantage of the empty area. I thought Greyson was pretty low-key and mellow Thursday afternoon, even falling asleep around 3 pm, which wasn’t typical of him. I chalked this up to him being tired and not having a nap yet, so I let him lay down for awhile.
I woke Greyson up from his nap around 5 pm, before I made dinner and he was his typical “threenager” self, not wanting to wake up. Us trying to wake him continued well into dinner, then well into the nightly news. Around 6:45 pm, I told Derek that he (Greyson) had to get up and eat something, since he didn’t have snack for me earlier in the afternoon. Derek sat next to Greyson and began to rub his back, neck and head to wake him up. Startled, Derek jumped up and said that something was wrong with Greyson. I immediately thought that maybe he was having a seizure, so I was surprised that he was awake and walking when I looked up. Derek brought G over to me and told me to feel his head. I did. I was shocked. Greyson’s head felt like Jello. I couldn’t feel any sort of skull. Just softness.
Being the Queen of WebMD and Google, I looked up “Why is my child’s head soft”, which only returned articles and information about newborns and their soft spots. Having given up on the internet, I called the pediatrician’s office and was connected with the on-call nurse. After she consulted with the doctor on call, the nurse prompted us to take Greyson to the Emergency Room at LGH. An all too familiar feeling, Derek got G ready and I packed up his backpack with the essentials (meds, diapers, etc.). I decided I would stay home with Roslynn, who had already begun to fall asleep and because my immune system is not good and COVID is still lingering, I figured this would be the best option. The next bit of information is coming from Derek, so I’ll summarize what he had explained to me.
They got to the ED at about 7:30 pm and it was packed. Individuals who had symptoms or were suspected of having COVID, were placed in a separate area of the hospital, to avoid contamination with those who did not have a COVID concern. He checked in with the receptionist at the front desk, who knew that they were coming, per our pediatrician calling and informing them. He took Greyson to the section of the ED which was a little more secluded from the rest of the ED and it was easier for Derek to confine him in that spot, rather than letting him run wild among the injured and sick. When they were pulled back into triage, the staff member obtained as many vitals as he could and prompted Derek to bring G back into the lobby area until a room was ready. In the midst of being shuffled around, Derek observed a man getting agitated because his mother was suffering from a stroke and still had not been registered. The man became so incredibly irritated, he did not notice that his mother was taken back at first, and proceeded to take his temper outside to the street. Lime street in Lancaster near the ED is a cute little area, stuffed with different physician and specialist offices, most of whom are affiliated with LGH. In the time we live in, the man became so upset, that he was tackled by police who were called, in addition to the ED security staff. I guess it provided much entertainment for all in the ED, since the area is comprised of nothing but glass windows, facing the area where this man was having his fit.
Once Derek and Greyson were called back to the exam room, the doctor came in and felt Greyson’s skull. He too agreed that something was wrong and that his head should not be swollen and tender like it was. He ordered a CT scan immediately and Derek placed the helmet back on Greyson’s head for safety. Staff came in awhile later and attempted to sedate Greyson with a nasal spray (it worked really well for him at CHOP, so Derek had consented to attempting to try that again. This time however, it didn’t work. The staff placed Greyson in a papoose, similar to what he has at John’s Hopkins when he has laser treatments for his face, and got the images that they needed for the CT scan.
Turns out, due to severe headbanging earlier in the day, Greyson had a huge subdural hematoma between his skull and scalp and a likely concussion. The jello type feeling in his head was collected blood, just hanging out in there. Because his head was not actively bleeding and his brain was not impacted from what the doctors could see, he was sent home. After a follow up conversation with the doctor at the ED and the Neurologist, it was recommended that Greyson now wear his helmet at all hours of the day, whether he is happy or sad, just for extra safety of his head. In the meantime, we have to observe him closely until the hematoma is completely healed, to make sure that he doesn’t have any nausea, vomiting or other complications that accompany a brain injury.
The boys got home around 11:30 pm and I had already been weighing my options when it came to being sure that Greyson was getting the appropriate structure and supervision he needed during the day. I made the difficult decision to step down from my new job and be the stability that Greyson (and Roslynn to an extent) need. Upon submitting my resignation on Friday, the owner of the business I was working for, was completely understanding and as a mother to young children herself, could really empathize with my situation. She stated that due to the situation, I would be able to keep my job within the company, but I would be an “as needed fill-in” until the fall, when I could most likely do the company’s billing and other miscellaneous tasks in the evening, after Derek is home from work. I am so appreciative that I am able to stay on staff there, and hope that once Greyson is back in preschool and stabilized, I may be able to restart my tasks within the company.
I’ve also decided to come out of my “retirement” from teaching voice lessons, and really put my time and attention into that for the evenings. Its a flexible position where I am in control of my own schedule, teaching as many students that I want to. I revamped my marketing skills and reached out to some former students, to see if they would like to study again. Needless to say, I’m thinking I could potentially have a full studio again by the end of summer. I know that this is a good move for our family and will give the kids the attention they need during the day, and still allows me to get out of the house and do something on my own a few nights a week. Contemplating changing my LinkedIn account to “Full-time Mom, Fill in admin staff and optimistic musical entrepreneur” as my current job. Maybe I need to work on that job title a little bit.