Lucky #7

The past four months have been a complete blur. Truthfully, 2022 in general has been a giant blur. I’ll probably paraphrase much of my life in this post, due to the fact that I can barely remember much that has happened. I will acknowlege that I basically lose my memory when I am stressed, or am in a difficult situation. I definitely think 2022 knocks that one out of the park.

As I wrote about in my previous post, Greyson was recovering well from his VNS implant surgery, and all was going fairly well at first. We noticed he had a lot of vocal stims that almost always happened when the device was actively running. We also noticed that the device also makes him extremely aggressive about a minute or so before the device is on. The first few times we had to swipe the magnet over his VNS, he seemed to respond very well to the intervention. The VNS has appropriately reacted to the seizures, haulting many within one or two swipes. We did two or three in person updates/adjustments with the Neurologist, and the rest of the VNS increases were done remotely, while Greyson was at school.

After about his third or fourth VNS update, Greyson stopped responding to the magnet during seizures. We went from one or two swipes, to four or five and still needing to use rescue medication. One particular seizure at school required all of the above, plus another dose of diastat. When this happened, I made the decision to change either the VNS settings or his medications. Because we were so far along with the VNS settings, we opted to stop his Epidiolex (the CBD based medication) and restart another trial of Onfi. Since weening Greyson off the Epidiolex, he has made a huge improvement on his seizures, not having a grandmal in a few weeks! The only downside to stopping the Epidiolex, is now he doesn’t have much of an appetite. As always though, once he stops having seizures, he doesn’t eat anything. When he’s having daily seizures, he eats everything. We truly can’t win with this kiddo!

Greyson was finally assigned a Registered Behavior Technician (RBT) in mid-April, and we have been SO blessed with such a wonderful team of behavior specialists for him. Our team lead was able to change Greyson’s approved hours, so we have a LOT more coverage over the summer, including when he is at ESY (extended school year) in July. Right now, there are two ladies splitting Greyson’s hours, one main member and an intern. We are doing roughly about 25 hours of behavior interventions with him this summer, more in July once he starts the school program in the mornings.

Roslynn also begins her summer school program at the end of this month. She didn’t fail 1st grade or anything like that, but we had the option of doing a summer program for her, to maintain her skills she has learned over the school year. Luckily her program is virtual, so when Greyson is in person doing his program, I can take her to the local Library and other places to do activities together that we wouldn’t typically get to do.

The conclusion of 1st grade, went out with a bang for Roslynn. We ended up at our local Urgent Care, the evening before the last day of school. She and Greyson were playing in the basement, and Greyson knocked one of our framed photos off the wall. The frame broke and at the same time, Roslynn kneeled down onto the broken frame, slicing a nice hole in her right knee. It wasn’t a huge injury, but enough to require two stitches to close her up. I was making dinner at the time, so I didn’t see the injury actually happen, but she was fairly calm and collected, especially when I told her I was taking her for stitches. She did get fairly dramatic at the Urgent Care, telling the doctor that she was “going to die” in the exam room, and that the doctor was “going to chop her leg off”. At one point, she also stated she couldn’t walk and needed a wheelchair to get out to the car. The doctor stated we were most likely the last patient of the day, and that Roslynn was her favorite person she saw all week. Roslynn did great, taking the numbing agent as a boss, and even watching the doctor stitch up her own leg. I guess it made for a good story on the last day of school.

I am now officially an “as needed” staff at work, so I can focus much of my time this summer on the kids. I went from about 20-25 hours weekly, down to about 10. A big cut, but when you factor in what childcare costs now-a-days, plus hiring a private nurse for G, it really is well worth it. I will go back to part-time in September, and have a similar schedule to what I had previously been working up until now. The best of it all, is that I can sit out on the deck and work on stuff while the kids play in the yard or in the sandbox. I’m also using this time to prepare Greyson for our trip in August. Finding a good form of communication for him, will allow us to have a more successful vacation, hopefully without any injuries or broken items. I am an obsessive planner, so you KNOW I already have a pinterest board of ideas for traveling with a special needs child. Hoping the vacation is more relaxing than work, since we will have zero behavioral help for him during the trip.

Most recently, we celebrated Roslynn’s 7th birthday with friends and family. Sadly, the rain forced many people inside, when we were planning that most of the party would happen outside, but it was a great party regardless. We had a local ice cream truck rented out for our guests to enjoy, rather than doing the traditional cake and ice cream. We did an ice cream themed party, which was a nice theme to kick off summer with. After some spills and a potentially dangerous pinata, the party was a huge success. The ice cream truck was a hit with many guests enjoying the surprise, and we even had some of the neighbors join in on the truck, basically to make up for the fact that we blocked off the entire culdesac with cars and a huge truck. All is forgiven with ice cream in my opinion. My mom would have been so impressed with how far Roslynn has come in a year. She would’ve also loved the rainbow sherbert that the truck offered. I hope that as Roslynn continues to celebrate more birthdays, she will continue with her fun, loving and gentle personality, and will continue to make all of her family, present and passed, proud.

Vaguna Nerve Stimulation- yes, you read that correctly

Feels like it’s been weeks since my last update, but sadly it’s only been a few days.So much has happened over the course of 7 days, I feel like time stopped and just completely threw me for a loop. I believe Greyson had an ER visit when I made the last update, but that was just one of several seizures over the past week. Thursday and Friday were regular days, nothing too exciting except that I was swamped at work. Seriously, I thought my previous job was a lot of service requests, but at my current position, I feel like I have zero time to put down the phone and breathe! I love this job, I enjoy working from home and despite sitting in a basement in a dim-lit room, I feel as though I am making someone’s day better by chatting with them.

Saturday, I had an appointment to discuss the end of my lease for my 2019 Chevy Equinox, so I was gone for most of the morning. Greyson was very active and fairly irritable the entire time I was gone, so I took him up to lay down for a nap once I got home (not gonna lie- I wanted one too). It didn’t take very long until Greyson was out cold, snoring away, face down in the mattress. I was about to doze off myself, when I heard a clicking sound coming from the other side of the bed. I looked down and saw Greyson starting with his typical early seizure symptoms. I moved him down to the floor and started the timer, all typical protocol for his seizures.

When Greyson has tonic clonic seizures, he’s typically unconscious until his emergency medication takes over and he slowly comes out of the seizure. But this time was very different. After 5 minutes of seizing, I administered his meds and waited for the convulsions to stop, only this time, they weren’t. I kept looking at the clock and 30 seconds went by, then 60, once we were hitting 90 seconds, I was panicking inside. I was trying to catch my breath through the panic, that I didn’t notice Greyson was not breathing at all. His lips began to turn a blueish gray color, then I watched as his rosy cheeks went from a healthy shade of pink, to a gray, lifeless color. At this point, I had Derek call 911 and we could hear the ambulance coming from the EMS station, about a mile away. Our neighbor, who is a truck driver by day and EMS/Firefighter volunteer by night, was the first person to come rushing over. I had not met this neighbor yet, so this was quite an eventful way to introduce myself.

As the rest of the EMS crew arrive, several faces were very familiar. It only took about 5 seconds to realize that holy crap, these are the same EMS staff that were at Greyson’s school to transport him to the hospital on Wednesday! After an awkward “hello, remember us?”, Greyson was evaluated. His vitals and blood sugar was all normal and coincidentally, the ER doctor on call for emergency calls, was also the same doctor who evaluated Greyson in the ER earlier in the week. Greyson had not returned to baseline yet, though the seizure had stopped, so the staff was very concerned that he had not woken up or really even flinched when being poked at. The lead on the EMS team waited and suggested we call the on-call doctor at CHOP. While waiting for a return call, Greyson finally was able to come to and the EMS staff said they felt confident enough that he was back at baseline and that going to the ER was not really going to make a difference at that point.

After documenting the seizure and watching Greyson closely, CHOP finally called us back and the one-call doctor increased his new seizure medication, Briviact. If you read my last post, you know that when Greyson was prescribed this on Wednesday after the seizure at school, you know that we only got the medication approved by calling the insurance and pushing for an emergency authorization. That auth was approved for a five day supply of medicine. Now that the on call doc was increasing the medication, we were going to run out before the five days were over, so I immediately called the insurance to ask for more medication to be authorized. Guess that’s not a common request, so I was on the verge of tears, basically begging the customer service rep to speak to a higher up and get us an approval, which luckily worked. We began the higher dose that evening and things appeared to settle down.

Due to the increase in seizures and the new medication prescribed, the neurologist’s office reached out for us to move up Greyson’s appointment to today (Wednesday). I was swamped with phone calls in the basement office, so I had Derek do the appointment with Greyson. The neurologist seemed to be concerned about the increase in seizures and that Greyson was not responding to any medications. I’m now paraphrasing what Derek explained to me after the appointment, so I too am attempting to process and understand all of her suggestions and ideas.

The doctor explained to Derek that if Greyson continued having these breakthrough seizures, there is a third medication we could try to use to control them. Though pumping Greyson with seizure medications sounds like a temporary fix, she did recommend a more permanent treatment that could help control the epilepsy. She suggested that we consider a surgical approach to manage things. Now Greyson has not been formally diagnosed with the MIC-CAP syndrome associated with the genetic mutation he has, but more and more co-morbidities associated with the syndrome are beginning to manifest. The main signs/symptoms of the MIC-CAP syndrome are as follows:

  • Issues with brain development in-utero
  • Epilepsy that does not react to anti-seizure medications
  • Microcephaly
  • Developmental delay/Intellectual Disability
  • Capillary malformations appearing on the surface of the skin as a Port-Wine Stain birthmark
  • Abnormal nails and joints on the fingers and toes
  • Unusual hair growth patterns, such as multiple swirls
  • The affected child does not learn basic motor and developmental skills such as holding their head up independently or sitting in an upright position

Keeping up with me? If you are keeping track and read my previous post, “Isn’t that genetic?”, I explained how this genetic mutation was typically inherited by both parents and both parents are typically a carrier of the mutated gene. In Greyson’s case, he only inherited one mutated gene, so his condition does not directly look like a typical case of MIC-CAP syndrome. Truth be told, there are only a handful of studies about this condition, because it is so rare, so no one really knows if he could have a “partial” case or it’s just a big coincidence that Greyson has almost all of the symptoms, except for a small head. I do not have a PhD or any medical background other than IB biology, some psychology courses, chemistry and an anatomy class, so I am certainly not attempting to diagnose here. I just do my research, read a lot about medical stuff and always look into any sort of treatment options for Greyson before agreeing to them.

In reference to the intractable epilepsy, the neurologist is making a case to the neurosurgery team that Greyson would be a good candidate for VNS therapy. VNS stands for Vagus Nerve Stimulation therapy, which is a newer procedure, where an implant is placed in a patient’s chest (a lot like a pacemaker) with a wire leading up to the brain via the Vagus nerve in the back of the head. The implant (or generator) then sends electroshock pulses to the nerve and brain, to prevent the brain from slipping into an epileptic episode. This treatment has proven to be especially successful in patients with ASD, because it can help reduce the irritability that often comes with Autism. The only downside to this treatment is that the implant’s battery only lasts 5-10 years, so if it is working for Greyson, he would need frequent surgeries to replace the generator. He could have complications with said surgeries and that is always a huge risk.

So, our next step is to take the referral and set up an appointment with the neurosurgical team at CHOP to discuss our options. If Derek and I chose to do this and we proceed with the procedure, the potential benefits certainly outweigh the risks and we would both do everything and anything we can to improve Greyson’s quality of life. I have a lot more reading to do and questions to ask before we decide anything. For now, I will poke fun at the fact that Derek called the Vagus (pronounced like vay-gus) nerve the “Vaguna” nerve when explaining the therapy to his mom. Maybe we both should do some reading- lol.

As far as the car goes, I did turn in my little Equinox and upgraded to a mom mobile. No, I will never and won’t ever drive a mini van, so I was able to find a super nice Chevy Traverse for a very good deal. I’ve cut my lease ways and decided to buy finally. Guess we will need the bigger car, so we can fit two growing kids and a mini-sized pony (Mr Duke) in the back seat.

Greyson approves of the new family car

A Wish Come True

In the summer of 2020, we were nominated to have a wish granted from the Make-a-Wish foundation for Greyson. At first, we thought about maybe going on a trip, but with COVID and his seizures not being under control, we decided to askk for something that would last awhile. Greyson has a huge swingset at his Grammy and Pappy’s house, so we already knew that he loved to be outside and loved swingsets. SO naturally, his wish would be a playset of his own for our house.

It felt like forever from the time of initial contact until we were finally picking out a swingset for Greyson. Over the course of a few months and tons of emails/phone calls back and forth, we finally picked a set and had a delivery time frame. Flash forward about 4 months and Greyson’s wish has been granted!

The swingset arrived on Wednesday, April 21st and as soon as it was assembled, Greyson was practically crawling out the door to go play. He has been outside every single day to play on it. We knew he was going to love the swingset, so we are incredibly blessed that the Susquehanna Valley Make-a-Wish was able to grant him this wonderful gift.

Greyson and Roslynn were on the tire swing underneath the slide

Despite a swingset and spending time outside, Greyson has had a tough couple of weeks. He reached his ideal dose of Lamictal shortly after my last post and continued to have issues despite the medication. Due to his frequent seizures while asleep, Greyson began sleeping in bed with me again about 2 months ago. He woke me up on Tuesday last week, with violent convulsions and twitching. Luckily I am a light sleeper and woke up to the movement and was able to monitor him.

On Thursday, Roslynn had a benchmark test for school around 9 am. While she was taking her test, I received a phone call from Greyson’s school, stating that Greyson had fallen asleep after a lengthy seizure and was unresponsive. I jumped in the car and made it to his school within 15 minutes (tyically a 20-25 min drive). When the school staff brought him out to the car, he was accompanied by EMS, the school nurse, his teacher and his personal care assistant. The EMS staff informed me that he was stable and his pulse oxygen level was okay and he was in a deep post-seizure nap (which happens after any seizure of his). I got him into the car and took him home immediately. Derek was working from home that day, so he was able to stay with Roslynn, so that helped me in getting there quickly. Once he got home, I fed him lunch and laid low for the afternoon until his RBT arrived. He didn’t seem like anything was wrong once he woke up, so I was feeling pretty confident that he was not having any issues and was okay to go outside to play.

Little buddy and I after his post seizure nap

Greyson wasn’t the only person in the Martin family to have a wish come true this past week. Derek and I began looking for a new house in 2018, mainly due to the fact that we outgrew our house shortly after moving in. Because I lost my job last spring, we put our search on hold until we knew we would be ready to proceed with selling our house and purchasing a new home. We began viewing houses again in early March and by this past weekend, we saw a total of 9 houses and had an offer placed on one, which we lost to another couple who offered more money than we did. I did not feel very optimistic on many of the houses we saw, or the homes that we were finding on Zillow, Realtor.com or from our agent.

Wednesday last week, we were sent a listing for a home in New Holland, PA, which was our ideal location due to the school district of the area. We pulled into a quiet cul-de-sac, tucked in between main street and farmland and immediately were in love with the neighborhood. Expecting to fall in love with the house and to lose it to another bidder, we walked through and confirmed our fate. We peeked around another home in Stevens, PA that we liked as well, but couldn’t get the thought of the previous home out of our minds. We slept on it, and decided to place an offer on the New Holland house. A few hours later, we got a call from our agent and the sellers accepted our offer! It feels like a century since we began looking and now actually having a contract in hand, but we are so excited! We will have plenty of space inside AND outside for the kids, lots of storage and a huge fenced-in yard for the dog! We settle in mid-July and will physically move into the house in September. This gives us plenty of time to do minor things around our current home and get it on the market to sell, too. Guess this was the week for wishes to come true!

OUR NEW HOUSE!!!!!