Monday

Today is Monday. And today I am exhausted. After a couple of weeks of feeling like we were winning the battle against epilepsy, we had an epic fail over the last few days. I can’t describe exactly how draining this journey is; every single day is an unknown and the Lennox-Gastaut syndrome demands every ounce of our energy in caring for B.  Up until now the most prevalent seizures B has had have been obvious. Big head or body drops, being flung backwards across the room, being unresponsive and vacant. Distressing to watch, and time-consuming to record, alongside the constant background decision making on what necessitates extra meds intervention versus what B can cope with. The seizures are so sneaky though. Once you think you have a handle on what’s going on, it all changes.

On Thursday B needed to be woken up- for a child who regularly wakes between 4.30 and 5.30 am bouncing off the walls and ready for the day this was highly unusual. More alarm bells started ringing when he couldn’t physically climb out of bed without support. He was shaking all over, clumsy, minimally responsive, uncoordinated, unable to feed himself breakfast, and most notable of all, unable to walk properly without someone helping him. I wrote in his home-school communication book* so school were aware of his presentation, and sent him on the bus. At around 11am I had a call from school, who were concerned that B hadn’t picked up, in fact he was progressively getting worse. It’s worth noting at this point that every time my phone flashes up with a call from school, my heart is in my mouth. It’s almost always a bad thing. In the early years it was usually due to a fall or bump (hyperactivity plus clumsiness does not a bruise-free child make), nowadays it tends to be around the seizure shit. Although I’ve never admitted this out loud, a tiny part of me always wonders if they’re ringing to tell me the unspeakable- whether that phone call is THE phonecall- the one where they tell me it’s all over. That we’ve lost him.

They phoned again a while later to tell me he had fallen asleep. I advised leaving him an hour and waking him then if he hadn’t woken independently. Cue another call an hour later to let me know they couldn’t wake him up. At this point we decided together to intervene with seizure meds to try and break up whatever the hell it was that was going on, which apparently didn’t really do much. B slept the rest of the school day, briefly woke up and ate something, and then promptly climbed on me and fell asleep again. This whole pattern continued until Saturday evening. On Sunday morning B was brighter, and continued to progress until by the afternoon he was back to his typical self. We did however begin to see some new odd movements which may be different seizures emerging. Watch this space.

Due to a combination of poor communication, logistics, inexperience (on both ours and the local hospital’s part), and the fact it was a weekend (I shit you not) we couldn’t get the required EEG that would have confirmed our concerns around B being in non-convulsive status epilepticus. So if any of you out there are thinking about going into status, make sure you don’t do it on a Friday in Dorset. Poole EEG department ain’t got time for that shit. (In fairness, a certain member of Poole EEG department didn’t have time for that shit; the other experiences we’ve had with those guys have been great.) Non-convulsive status epilepticus is effectively a constant seizure state- in literal terms, an actual headfuck. In NCES all of a person’s electrical signals to co-ordinate their movement, thought processes, and general function are completely scrambled; hence they appear dazed, confused, lethargic, vacant, unable to perform usual skills and just ‘not there.’ Although not imminently life threatening, leaving a person untreated in this state for prolonged periods of time will cause neuronal damage; in other words, permanent brain damage will start to happen. In a child like B we simply cannot afford for him to lose communication, skills and function that has taken years to consolidate.

So, after two incredible weeks of fairly good seizure control, the beast returned with a vengeance. It was hideous to watch, so I can only imagine what B was going through. Lessons have been learned. Next time we won’t wait to see how it pans out, we’ll act ASAP with the urgency that should be applied to any child showing unresponsiveness and complete polar opposite behaviour to their normal. Especially since this is a child with a multitude of diagnoses and difficulties. Today I have spent time debriefing with school and speaking to medical staff about protocol should this happen again. We’re all on the same journey aboard the Unknown Express to Who-The-Hell-Knows-Where. The ride is turbulent at best, soul-destroying at worst, we are all shattered, and we seem to be off road in a place where few have been before.

Today I want to get off.

*The home-school communication book is a vital piece of kit for children like B. Imagine sending your child to school with no ability to communicate how their morning had been, how they were feeling or what was happening to them at any given moment. Then imagine picking your child up from school, asking about their day, and them being incapable of answering you. This is where the home-school diary wins out. Every morning we write the things B can’t say, and every evening we check out the communication from school so we know how his day has been. A little extra piece of admin every day. Because the universe thought we didn’t already have enough.