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Jamie’s Sundays – 15th September

The bond between brother and sister - so strong.

The bond between brother and sister – so strong.

We have had a wonderful day with Jamie, he was just the sweetest and loveliest young man. When he is like this, his personality shines through and I see the beautiful person there is locked away inside his autistic brain. Life must be so very hard for him – he must have ideas and thoughts going around his head all the time – but he can never communicate them and possibly never understand them.

I didn’t write this blog last week – we had just started out on the 2 hour drive to see Jamie when I got the dreaded phone call. Jamie had a seizure, he was ok but it lasted 4 minutes and he was being helped to bed to sleep  as the manager phoned. When I get that call, I just feel dreadful. It’s hard to put your finger on how you feel – but helpless, certainly. So often I want to be with Jamie, to support him in his routines, cook for him, clean him up, play with him, give him what he wants, but it is not possible. I want to treat him like a child and he is not – he is an adult, Anyway we knew it was useless to carry on our journey – Jamie would sleep until the afternoon, but if he saw us he would want to go out and he was just not well enough. He is always pretty unsteady on his feet when he has had a seizure. Thank goodness we didn’t go, Jamie had another seizure as soon as he woke, went back to sleep and then had another one when he woke in the evening. It seems as if he can’t come out of the seizure fully if he just has one. His seizures are nearly always at the stage when the brain is changing from a sleeping state to a waking state – the neurologist told us this was quite common. Jamie seems to get stuck in this cycle sometimes, it must be very frightening and horrible for him. 9 minutes of fitting and being deprived of oxygen in one day is not good – not good at all. I wish we could do more to stop them.

Jamie recovered really well the next day though – he was happy, settled and not so anxious. Suddenly his life seems better and if he is happy, I’m happy! When I rang to see how he was on Tuesday, his carer told me he had spent to whole day laughing – in fact laughing so much he nearly fell over!!! It reminded me of when he was young; we had periods of time, sometimes lasting for weeks when he would laugh a lot, but also times when he would just cry and cry and cry – there was no reason for this that I could see.  No obvious pain or discomfort, no neglect or abuse, but just constant crying. It was awful, just horrible. But I have since learnt that other autistic children have done the same. Almost like getting stuck in an emotion and not being able to come out of that emotional state.

So this Sunday – Jamie was so good, even though at the pub a family with 2 young children arrived halfway through our lunch. Jamie finds the noise and unpredictability of young children really, really hard to deal with. He was immediately anxious and obviously unsettled. But he coped really well. We gave him the favourite parts of his lunch – the onion rings!!! and he did not finish his lasagne, but he had eaten pretty well. Andy and I calmly stood up and let Jamie let us know whether he wanted to go or not. He does this by standing up himself if he is ready. He did this and we left without any fuss – no headbanging or upset. I was so very proud of him for his control and trust in us to keep him safe. We tell him that all the time, I’m sure it makes a difference to him that he knows we understand how much he needs us to protect him.

We went straight back to his home today, we just wanted to avoid any upset and Jamie did not seem to be totally himself after lunch, perhaps his anxiety levels were taking time to come back to normal. But it was really interesting because when we got back to his flat Jamie was very happy that we had bought him some wax crayons and took them up to colour on his paper. After meals Jamie gets 3 pieces of paper to colour and tear. He gets these whatever, they are not a reward for behaviour, they are just part of his routine. When he was younger Jamie would tear paper – any paper and wherever he was he would tear paper. It was his way of shutting out the world, but it very quickly became an obsession and was out of control. So Andy and I would ban any paper from him. This sounds really harsh, but it was the only way to control it, otherwise his behaviour would just escalate into a frenzy and uncontrollable anxiety. At school he was allowed a ‘flappy’ – a laminated piece of paper that he could not tear – as a reward for doing his work, but this was limited to one minute. But Jamie accepted this and quickly started to hand it over himself after one minute had gone.  It was weird that these rigid and seemingly cruel restrictions actually brought him out and Jamie no longer craved paper to tear, he no longer was grabbing things when we were out, no longer getting upset when we had to stop him. He was not limited by his obsession and so we could start to do more things with him again.

There was one time when he was at the doctors, wanted to flap and tear all their leaflets, was stopped from doing so and so promptly stripped off all his clothes. Now that is not really a good thing to do in public when you are 19 years old. Instead of helping, the receptionist called the police. Their station was only just over the road – they sent 4 police cars to deal with him! Luckily his wonderful carer had managed to get him into the toilet and called for back up which arrived promptly and Jamie was helped out with suitable covering round him. But this situation would have been so different without the back-up of his support staff. If the police had been allowed near him, Jamie would have kicked off in a major way, he would have reacted totally understandably by screaming, headbanging and biting. If you don’t know how to handle him he could have hurt someone. Then he would be sectioned – and it would be just awful because we don’t have an awful lot of jurisdiction over his care now that he is an adult. Doesn’t bear thinking about really.

Anyway, those days are over now that he is settled and happy in his flat and has people to care for him who love him and want to make his life better. It certainly makes me feel hopeful for his future.

I love you Jamie, I still miss you every day, just as I miss my daughter, but if you are happy it makes it easier to cope with. Long may it last my beautiful son!

Jan Mather

Jamie’s Sundays – 7th July

Well, today was a total washout really, certainly as far as Jamie is concerned. We drove the 2 hour journey as usual, in fact it was lovely because it was so hot we had the roof down on my car, makes it sound very posh, but it is over 13 years old and has done more than 190,000 miles. Still goes amazingly though!

Anyway I am digressing. When we arrived the manager met us at the door to tell us poor Jamie had had a sezure that morning. He was doing his normal morning routine  and as usual really the seizure occurred as he was in the bath. This is often the pattern with his seizures. The staff are always really vigilant and carful at this time, and especially so on days like this when he has not slept at all well. Because Jamie adheres to his routines so strongly, if he sees us he wants us to take him out and nothing will stop him. After a seizure he is not well enough to move so we can’t even go to see him sleeping in case he wakes and sees us. It feels awful but we have to think of him. 

Jamie’s seizures are horrible to watch, and although I find it really upsetting I’ll describe them so you can get a picture of what it is like. He starts to become a bit agitated and turns his head round to the right. (apparently this is a sign of a focal seizure that starts in the frontal lobe of the brain). He moves his legs and becomes really vacant and unresponsive, he is virtually unconscious by this stage. He needs to be supported as he just drops like a stone sometimes, and if he is in the bath he can never be left because he would just slip under the water and he is a dead weight during a seizure. While he is having the seizure he gasps for air and often his lips turn very blue because he cannot get enough oxygen into his body. I have over the years fought very hard to get him some portable oxygen which would help him, not during the seizure but help to re-oxygenate him when he comes round. Unfortunately no-one wants to know and they say it won’t help, I think this may be a cop-out because they do not want the expense – am I cynical? Probably but I have learnt this from looking after Jamie for 21 years. 

Jamie’s seizures are termed tonic-clonic focal seizures (they used to be called grand-mal seizures). The focal bit comes from the fact that they begin somewhere in the frontal lobe. Of course if Jamie could tolerate a EEG (electroencephalogram), we could see more where activity in his brain was abnormal. They tried this in hospital after his first seizure. Jamie sat there very happily munching on crisps while they attached all the electrodes to his head. When they had finished and were just about to begin recording Jamie decided he had sat there long enough, ripped them all out and disappeared out of the room as fast as he could! I don’t think they’ll try that again very quickly!

Anyway, Jamie’s seizure lasts generally for an average of about 3-4 minutes, during which time he is jerking a lot and gasping for air. Quite a few have gone on longer – an ambulance is called if they last more than 5 minutes, although he generally comes out of it on his own. It is of course really distressing to watch and the only thing you can do is support him as best you can. When he comes out of it, Jamie is really fuzzy-headed, he is totally unfocused and can’t really function at all. He is often incontinent during a seizure and so he is cleaned up and changed before being helped to bed where he will sleep, sometimes for 6-7 hours.

So that is what it is like for Jamie when he has a seizure – not nice, not pleasant at all for him, and difficult for his loved ones and carers to cope with too. We know that seizures are dangerous, that a seizure could kill him. We have to live with this. I know personally of one lad who died from having a seizure during the night and I have fought very, very hard to make sure Jamie has the level of care he needs to make sure he is kept safe night and day. He has alarms and monitors, staff outside his flat at all times so he is probably as safe as can be.

Recently Jamie has started having clusters of seizures – he comes out of one, sleeps, wakes and goes straight into another. This leaves him absolutely washed out and drained of energy. He has sometimes had three big seizures in one day. Andy and I have often discussed why this should be like this. Although the seizures are still tonic-clonic, the first one is smaller than his usual ones. Does this mean that he doesn’t ‘discharge’ all the anormal electical activity in his brain? Does this leave traces of abnormal activity that trigger further seizures? I think I’ll research this further. 

Back to Sunday – Andy and I still discussed Jamie on our way home again. We talked about how, when we come to take him out, he always takes his carer’s hand as he leaves his flat. Now I thought he wanted the carer to come with us to lunch, but Andy reckons he wants them out of his flat  – it is his space and they have finished their job and don’t belong there anymore. I think I know who is right here (Andy)  – it is just such typical behaviour from Jamie – I also get pushed out of the flat when we return from lunch. we no longer belong in his flat and his day has moved on to another section where we have no part. It seems very cold and clinical, but it is the one place where Jamie has his world, why should we not respect how he wants it to be?

I have learnt over the years never to expect the things from Jamie that we often want from our children. He hates cuddles and although he will put his head forward for a kiss sometimes it is not something he understands or even wants. But he shows how he loves us in extremely subtle ways – a look, taking your hand, a smile  – that and having his head rubbed non-stop!!

So it was not a particularly good Sunday, but we are as philosophical as we can be – the bad comes with the good. Next week might be wonderful, who knows!

Jan Mather