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.
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.
Whether you agree or disagree with medical marijuana, don’t believe in it, swear by it or are not educated in it, I do not care. This post is therefore not a lecture, recommendation or meant to sway one’s opinion in either way. This is strictly our family’s experience with the controversial “drug” and the reasons why we have chosen to give it a try for Greyson.
So, I guess it’s best to begin with explaining the entire process of obtaining a medical marijuana ID, prescription and products.
First of all, obtaining the caregiver/medical marijuana ID is like going through Fort Knox. You have to fill out an application online and get your criminal background/FBI fingerprints done. Even if you’ve got all your clearances and have been fingerprinted for other reasons, you have to get a specific category for the fingerprints, so other prints don’t count. Once completed, you wait for the results. In the meantime, we looked up local doctors/offices that are in the state system to write prescriptions for marijuana. After sifting through all of the prescribers, we found an office in Lancaster that completed an evaluation to show medical necessity for the marijuana. After the evaluation, it took a few weeks to have the doctor send the evaluation report to the state for review.
Medical marijuana scripts are not like normal scripts- you don’t go to a pharmacy with a written prescription and pick up the medicine. Instead, you wait for the medical marijuana caregiver ID (caregiver ID’s are for individuals that are designated to obtain and administer marijuana to minors, consumers, clients, etc.) to come in the mail. To determine the dosage and combination of THC vs. Cannabis, you have to meet with a registered pharmacist to discuss specific medical history and information before the script is filled.
We began researching the option for medical marijuana in the fall last year, but let it go for a bit because of the holidays and work was getting busy. When the topic came up again earlier this year, I agreed to Greyson trying the drug, but I wanted Derek to take charge of obtaining the information, card, etc. since I have managed all other appointments/medications, etc. over the past few years. Derek obtained the prescription, did the consults, fingerprints and all. The entire process took about 6-8 weeks, but it moved fairly quickly.
We started Greyson on a specific regiment of marijuana, combining pure THC and Cannabis oil. He receives the medication via a dropper, three drops twice daily, with an optional third dose in the middle of the day, if needed. So far, he’s been on the medicine for 3 days and it has made a HUGE difference in his behaviors and aggression. This past week, there was no way I could take both kids outside by myself without Greyson trying to run off. By yesterday, Greyson not only allowed me to hold him for about 15 minutes, but he also stood in one place for about 20 minutes outside, with zero attempts to run off. In the 3 years, 8 months and 3 weeks that he has been alive, I have never seen him so calm and happy!
Today, we visited my in-laws, who have an awesome back yard/playset for the kiddos to run around and play on. I was nervous at first because Greyson was so excited and happy and immediately darted from the car as soon as the door opened. Luckily, he ran immediately to the swing set and sliding board. I haven’t seen him follow any sort of direction before, especially commands involving stopping and keeping close proximity to us. This kid followed almost every direction given to him. He stayed close by and had so much fun being outside for awhile. At one point, I even thought to myself, “wow, this is what it feels like to have a typical boy”.
I have read arguments and different opinions regarding medical marijuana. We have discussed the pros/cons with his medical providers and determined that it was worth trying, and I am so happy with the results thus far. There certainly are moments when Greyson appears to be really out of it, or “drugged”, mainly when he has his seizure meds/night time medicines that already make him drowsy.
Stay tuned, but for right now, we are hoping that we may have actually found something to help with his impulsiveness, irritability, aggression and self-injury.
Having fun outside at Grammy & Pappy’s house!
Roslynn has also started weekly outpatient therapy with a social worker, to address her anxiety and fears surrounding Greyson and his behaviors. She is still afraid of him when he is throwing a tantrum and is hypersensitive to loud noises. She’s been really afraid to do much of anything by herself recently, especially using the bathroom, going up or downstairs alone. Though she’s only had a few sessions, she has already learned that jokes help her focus on things other than her brother and that taking deep breaths help her when she feels sick or scared. Lots of uncertainties also surrounding the pandemic and whether mommy will be going back to work or not, have also made things a little bit more nerve wracking here, too.
I have been thinking a lot about the saying that most moms have heard: “the days are long, but the years are short.” And boy, do I really get what they’re saying. I feel like the stars are finally aligning and maybe, just maybe, we are getting somewhere.
So much has happened since my last post, I don’t even know where to begin!
For starters, I lost my job on March 2. I am not going to go into details about the breakup between me and my former employer, but at the time I was a wreck. After the initial shock and sadness, it turns out, I am quite relieved. I never realized how liberating it would be not being tied down to a “9-5 Job” and the best part of all, is that I’m spending time with my babies.
Finally was able to take her to a park
With the scary Coronavirus going around and schools all being cancelled, I’m certainly making up for lost time with the kids. After all, I went back to work after 8 weeks home with Roslynn at first, and only 6 weeks after Greyson was born. The first two weeks of my unemployment, Greyson and Roslynn were still in school, so I was running around, playing mom taxi and spent about 10 hours cleaning up the choir room at the church. I also had some time to organize different things in the house and work on tasks I had not been able to do for a long time.
Helped my sister paint her ugly red diningroom
Sadly, the virus has cancelled everything, so I have been stuck in home quarantine since mid-March. I’ve been a big “homebody” for awhile now, so staying home hasn’t bothered me much. I’ve used my time well, applying for jobs, cleaning/organizing, preparing items for consignment and best of all, learning more about Greyson and the extent of his needs.
Luckily I have been home for Greyson’s most recent break-through seizures. He has gone through a growth spurt over the past couple of weeks, but his med was never adjusted to keep up with the weight change, hence the seizures. Once increased, those seizures stopped….thank you Jesus! He also began Guanfacine a few weeks ago, which wasn’t showing much success with the small dosage prescribed, so that too was increased. He was displaying a lot of aggression and self-injury the first couple weeks, but Derek and I assumed it was from the change of schedule and his daily routine.
Bruises from his headbanging and punching himself
Late to the game, but I am now realizing things that absolutely need to happen to keep Greyson content, such as:
All lights on downstairs and in the hallway.
Absolutely NO baths unless daddy is home.
Pull ups are the only thing in stock at grocery stores, but he will ONLY wear the pull ups with buzz/woody on them.
Short sleeve tees and sweats are his preferred clothing, but his overalls are taken out for days he decides he wants to be a stripper.
He will only nap if the tv is on, volume on low and he is tucked tightly under my arm.
He is an avid snacker and refuses to eat breakfast or lunch.
The only movies/shows that are allowed on the tv are Pixar and Disney. Nothing else.
His juice, which can ONLY be honey crisp apple juice, should preferably be at room temperature with 3/4 juice and 1/4 nursery water with fluoride.
He likes to wear Roslynn’s nightgowns when he is upset. (I still have not figured this one out)
Proof, in case you don’t believe me
I’m not quite sure how I kept him alive for almost 3 full years before realizing these quirks he has, but better late than never, I guess. I am brainstorming my next home DIY project on a budget, but am content with my biggest task at hand right now: finding a grocery store with available pickup/delivery times.
The past 5 weeks have really taught me a lot, through all of the changes happening in my personal life, but also the changes to the world around me. The biggest lessons I will take away from this time, other than the fact that the US was clearly not prepared for a pandemic, is that I am worth so much more than I have settled for. I have an impressive skill set that I can offer a company and I can survive being a stay at home parent, a task I never thought I could try to take on.
While the future remains unknown for myself and many others around the world, I know my story still has a lot to be written.
When I was younger, I loved playing house. I would go outside and play in our log cabin playhouse (it was huge and made out of real wood by our neighbor) for hours. The playhouse was the place to be on our block, the entire backyard made into a kid’s playground dream. We were extremely fortunate that our parents were able to make us an awesome place to play, which we did during all seasons and types of weather. I always pretended that I had twin babies (I had the Baby Tumble Surprise Twins- super popular Christmas gift in 1997) and that I had the coolest house and cars, etc. I imagined I had the perfect life, perfect babies and perfect house.
Flash forward 23 years and I’m still playing house, except it’s real and it’s a lot harder than I ever anticipated. Also, instead of legit twin baby dolls, I have “Irish twins”, one of which is the equivalent of 2 1/2 kids. Now I don’t think think I could ever have that boring, plain life. I got my first taste of being a normal mom last night. Since Derek and Greyson were in Philadelphia at CHOP, Roslynn and I decided to go out to dinner with my good friend, Julia and her boyfriend. It was so odd leaving work and picking up one child to go to a restaurant to actually sit and eat. I felt like a normal person again. Afterwards, once we got home, the house was too quiet. Ironically, I got 5 hours of sleep (most I have in months) and I was more tired today than normal! Essentially what I have learned in the past 24 hours, is that I need to be a normal person sometimes and make time for normal things. I also really need the excitement of Greyson in my day. It was so lonely without his belly laugh and the sound of him staircase surfing at all random hours of the night.
Waiting for Julia to arrive for dinner
The next bit of information is per Derek, so I am simply relaying this.
Greyson and Derek checked into CHOP around 5:30pm. It took a good bit of time to get all the electrodes on his head, cap put on and wires stuffed into the backpack he carried around. The electrode placement is always extremely difficult for G, especially since the glue to hold the electrodes on, is super stinky and gross. After having the opportunity to eat dinner and relax, Greyson fell asleep. Unfortunately, he did not stay asleep through the night. After tossing and turning and a tough morning, he was finally discharged from CHOP around 1:00pm. Luckily, the staff was able to get the data they needed and even got the glue out of his hair before he was discharged.
After 5 different seizure medications and two years of finding a medicine regiment to control the epilepsy, we have finally received good news.
Greyson had zero instances of focal seizures while he slept and while awake. This essentially means that the Onfi is working! He has had minimal side effects with it and I’m really feeling good that we finally have found the right mix of meds. 835 days after his first diagnosis, we finally have a solution.
I’m waiting for a final report from the neurologist, but this is the best news we have heard in over two years. We needed this good news. We have been really struggling over the past couple of months, but all of those feelings are currently on mute. We are so excited. We still have a long ways to go, but this was the perfect push we needed to keep our chins up. Excuse me if I am giddy tomorrow, but TGIF and we have a successful medicine managing seizures that were once deemed uncontrollable.
2020 has been off to an interesting start. Interesting is the best word possible to describe the mixed emotions we have had since entering the new year.
Whenever I see people I know out in public (work, stores, church and other places I actually go), everyone always asks how Greyson is doing. I almost always respond “we are hanging in” or “he’s an interesting kiddo”. The truth resonating in my mind is always, “why do I try to play this off like it’s no big deal and that I am managing this fine”, when deep down it physically breaks my heart if I put too much thought into our situation. I thought that as G got older and we learned his routine, tics, compulsions and behaviors, things would get easier. Truth is, as we learn more about him and his condition and the bigger/stronger he gets, the worse things seem to be evolving.
I have found myself telling parents recently that “the world of Autism is an entirely different world. No books, research or degree is going to prepare you for it.” And it’s so true. The world of raising a child with ASD is an entirely different ball game. Even working as a TSS in the past with kiddos with similar disabilities as G, I never would have imagined that raising him would be the hardest job of my life. Working full-time and being a full-time mother of a child with special needs and a very busy sibling, is becoming quite the challenge.
I must say that my work has been keeping me grounded in actual reality. Talking to other parents, listening to their stories and putting their child’s faces with their name, has really given me solace that I am not alone in the world of Autism. WE are not alone in this world. We, as many other families, take our world day by day. Never assuming that one day will be the same as the next, because it never will be.
Medically, G has been grand-mal seizure free for a several weeks now, adjusting well to Onfi, which is is most recent anti-convulsant prescription. Things were going fairly well until January. Not sure what (if anything) had changed, but his impulsiveness became unmanageable. Everywhere we went, everything we did, always ended up in something broken, destroyed or someone injured. We were fed up. We met up with his child psychiatrist and started a dose of clonidine. Immediately we saw a difference in Greyson. We traded impulsiveness and hyperactivity for extremely fatigued and aggressive Greyson. On a positive note, despite the tiredness and negative behaviors, G has been doing extremely well on the clonidine. He is happy again, sweet and loving. He does not get really aggressive unless we deny him access to an item he wants, or if he is extremely tired.
Though there are many negative things that can be said about his destruction, aggression￼, lack of sleep and self-injury, he has been doing very well with school. He absolutely loves school and enjoys going to his class, even though they make him work. School has reported that he’s extremely fatigued and falls asleep during instructional time, most days. His ABA service comes out after lunch/naptime and he seems to be doing well with this as well, even enjoying his “roller coaster” toy for reinforcement.
Tomorrow, Greyson and Derek will be traveling to CHOP in a Philadelphia for another 24 hour EEG. This is overnight EEG #3 and his 5th EEG he’s had to date. We are hoping this new EEG will show if Greyson’s seizures are better managed during sleep, with the medication regiment he’s currently on. We are also hoping to see some more brain activity from the left side of his brain, which is his “lazy side”.
I used to have high hopes the night before a procedure, appointment or test, praying we would get answers or a cure. Now I have become so desensitized to how these appointments typically go, it just feels like another test and another appointment. If the Onfi is managing his seizures well, we could potentially discuss decreasing the medications all together, but depending on which neurologist you ask, we may or may not have much luck. Greyson’s specific type of focal epilepsy is very rare, specifically the seizures when he is asleep.
Electrical status epilepticus in slow wave sleep (ESES) is a rare, age-related, self-limited disorder characterized as epilepsy with different seizure types, neuropsychological impairment in the form of global or selective regression of cognitive functions, motor impairment, and typical electroencephalographic (EEG) findings of continuous epileptic activity occupying 85% of nonrapid eye movement sleep.
The neurologist and psychiatrist also have a theorythat Greyson is so aggressive and injuring himself over the past couple weeks, becausehe’stired and not sleeping well. He gets migraines when he’sextremely tired, so Ican only imagine how he must be feeling. He obviouslyisn’t aware that this EEG is taking place tomorrow, but please keep fingers crossed that we will see some improvement in his night time seizures.
Skimming through my posts from 2019, I realized it was a lot more eventful than I thought. No wonder I’m exhausted every single day!
Exactly one year ago, I was reminiscing about 2018, which was an awful year. Awful may actually be too nice. We lost several family members in 2018, and we continued to get more and more confused about Greyson’s behaviors/meds/condition/treatment.
When we started 2019, Greyson was refusing clothing and eating his own feces. We also began 2019 with absolutely zero visible seizures. Hard to believe that G only began having Grand-mal seizures in May of this year, it definitely feels a lot longer.
Along with the first grand-mal seizure, we had lots of “firsts” in 2019: first dentist appointment, first family vacation since being diagnosed, first day of preschool, first ER trip, first extended EEG and first set of stitches. Despite the chaotic day-to-day events in 2019, I am so relieved that we didn’t have a repeat of 2018.
We also learned a lot about Greyson’s condition over this past year. Along with the diagnosis of Autism, G has several different co-morbid conditions that seem to all be impacting his every day life, including Periventricular Leukomalacia (white matter brain disease caused by brain damage at birth) and the genetic mutation of the STAMBP gene. We still have a far way to go, but we have finally settled on the idea that Derek and I may never know what truly is going on with Greyson and what the future holds.
Since my last post, Greyson has begun new medicine for his (possible) Electrical Status Epilepticus in Sleep (ESES) diagnosis. We are currently on a trial medication named Onfi for this particular condition, which is essentially when an individual has continuous spiked waves in the brain while they are sleeping. The plan for this medicine is to continue the Onfi and the Vimpat (his daily anti-convulsion med). We will have another 48-hour EEG in February, this time with admission into CHOP’s pediatric neurology program in Philadelphia. We are also waiting for more diagnostic testing of G’s DNA/Genetic Samples. With the development in science and research on genetic conditions, we are hopeful that someday we will have more answers about the STAMBP gene and Mic-Cap Syndrome.
Roslynn had a tough second half to the year, with a lot of G’s aggression being taken out on her. Luckily, she has been playing and interacting much better with Greyson over the past two months, and I am definitely seeing more reciprocal play between them. She is enjoying her weekly dance class, preschool, playing with her cousins and walking my parent’s puppy, Charlie. She is set to begin kindergarten next year and though I am not ready for that, she certainly is. She loves to learn and has a fun, sweet and gentle personality and is the best behaved 4-year-old I know.
Derek has been extremely busy with his (not so) new job at T.W. Ponessa & Associates. He has been busy seeing clients, completing Functional Behavior Assessments (FBAs), making data charts, token systems and most importantly, enjoying having a job that he loves to wake up and go to. I am so proud of him and his accomplishments and look forward to what 2020 has in store for him.
Last but not least, I have been keeping myself busy with the typical: working full-time, managing two children and one grown man’s schedules and appointments and keeping my sanity (or the best I can fake it!). I am going into my 8th year at CADD and loving my new desk/tasks that the end of 2019 has brought my way. I’m looking forward to 2020 and the possible professional and personal endeavors that may come my way.
I always joke that once you hit 25, New Year’s Eve doesn’t matter anymore. I’m honestly impressed that I have enough energy to type this and that I’m not zonked on the couch right now. Kids should be in bed soon and I will be ringing 2020 with Derek, most likely by both of us passing out (from exhaustion) by 10 PM. I am more than okay with a quiet end to 2019 and hope that 2020 will bring peace, comfort and happiness to our family and all our friends, family, supporters, coworkers and all who support us on a daily basis.
Saying goodbye to 2019 by posting some of my favorite photos and cheers to 2020 with sparkling apple juice!
The past two weeks have been really tough. Greyson has barely slept, which means nobody in the Martin house is resting well, causing lots of grumpy kids. A new nightly ritual is that while we are eating dinner, G will impulsively throw his entire plate of food on the floor and scream bloody murder. He typically runs upstairs to the nursery and has a tantrum for about 1-2 hours until he’s completely worn out.
The lack of sleep is extremely hard on us, both mentally and physically, but I am hopeful that this is just a rough patch. G did see the neurologist last week and they switched when he takes his meds around, hoping to relieve some of his nausea, drowsiness and aggression. Unfortunately, this combination of meds has caused Greyson to become extremely aggressive. The aggression is typically taken out on the dog, then me and Roslynn. The PTSD and severe anxiety from previous attacks, has left Roz completely terrified of G. He utters a tiny whine, and she’s hiding and screaming that he’s “going to get me (her)”. This is really difficult too. It ends up being a vicious cycle: G freaks out, Roz freaks out, G freaks out because Roz is freaking out, causing G to become more aggressive and angry.
So out of it and sleepy
One of the many faces of G
Towards the end of last week, G had run out of 2 of his prescriptions, so we were out of luck. The insurance was holding off on refilling them due to the need of labs and information from the doc before they would approve anything. The few days that he was without any medicine were the best days that he has had in the past few months. Almost immediately after we started up the meds again, Greyson was back to his aggressive self. Every single night since restarting meds, G has been tired, grumpy, aggressive and overall miserable. Derek and I have both been in agreement with this, but we have decided to take our chances.
The thought that Greyson could have a seizure and have serious issues, is absolutely terrifying. As much as I want to feel confident and comfortable with our decisions, deep down I am so scared and worried. Since stopping the meds, he’s been so happy, energetic and sweet. He’s finally smiling, laughing and able to enjoy things like toys and playing with Roslynn.
My happy boy
I try really hard to put myself in Greyson’s shoes. I know that I would never want to be drugged up all day on several meds, crying and screaming because I am so tired and feel awful. The chances of G having a seizure are high without his meds, but having the risk of seizures is much better than the negative side effects from the meds.
Difficult decisions and discussions are expected in a marriage and family. I never expected that we would be making decisions that could impact our baby’s life forever. I certainly hope that we are taking the right chances and making the best decision for him.