oops...sorry

For not having posted in so long its been a crazy summer. About two days before her EEG I crashed my bike and tore up my shoulder. Typing was wee bit difficult there for a while. Also the summer was just insane.

Lets see ... updates in a nutshell.

24 Hour Video EEG: shows they have no idea what is going on. Current official diagnosis. Intractable Idiopathic Epilepsy. And she has not one, not two, not three....get ready for this...four! distinct seizure types. I was in the waiting room at Abigail's neurologist waiting for Melinda to show up with Abigail to discuss the video eeg and look at the finer points of 24 hours in a small room with a 4 year old who has 30+ wires super glued to her head and a 15 foot tether..did I mention my shoulder was separated? I over heard the consult between her doctor and another neurologist. They never mentioned her name but I am pretty sure they were talking about her. He kept asking questions like ..."how old is she?"...."did you try this"..."what did the MRI's show"..."Have you tried combining this med with this med"..."What did the video eeg show?"....I am paraphrasing a bit as I don't speak the necessary Latin to describe some of the things they were talking about. The last words he said to Abigail's Doctor were "I don't know". That makes 5 different Neurologists who have looked at Abigail's records only to get the same answer...I am thinking t-shirts with that printed on it are in order.

Abigail now takes Banzel a recently approved drug for lennox gastaut...she does not have lennox gastaut...but she has LG type seizures, that took several attempts for Abigails neurologist to explain to us as we are already freaked that she might develop that. Another mystery that can't seemed to be explained. With in two weeks of her starting the drug she started speaking more and engaging with the world more. We think the drug is helping with some of the back round seizures that we never see, which in turn is allowing her to speak and have more cognitive ability. There seems to be no side effects which is nice.

July 14th...impaction. Yep the dreaded constipation turned turd plug. We make the calls to the Keto Team and her regular doc...and get the advice to take her to the ER. 10 days of no poo...many caps of miralax...lots of milk of magnesia, and a mental scarring (Melinda and I) suppository later we had nothing. So Melinda and I clear our afternoon and head to the ER.
It would take a small book to detail our 6 hours of fun...here is the brief recap thru snippets of conversation with various nurses and doctors.

Arrival at ER: "Ketogenic Diet? the check in nurse asks? "Oh she must be Autistic" she says.

We explain her condition and explain the diet, including possible side effects of constipation and such, and hand them the piece of paper with everything we just said that the Keto Team at Standford gave us.

"Oh she must be constipated...the poor dear....she really needs fruit, vegetables, and lots of fiber" She says. This is not a good start...."yes" we acknowledge... "but she cannot have any of those things" and we smile nicely pushing the point that we are aware of what is going on and just really need her to poop.

Check in to our room: We make it into our room in fairly short order. Our nurse comes in.

She is very nice and gets Abigail to smile at her. She asks what is going on. We say Abigail has not pooed in 9+ days. "Oh my goodness" she exclaims, "That is not good!" and looks at us like we are ogres. "She really needs fruits and vegetables....and fiber!" she says. Melinda and I exchange looks and give the nurse our best...yes we know smiles. "Perchance you can get the doctor now...please" I ask? ( I don't really say Perchance )

We explain the condition and the diet ....again. And request sedation of some kind since Abigail is really cranky and pissed off that she can't poop. The nurse has never heard of west syndrome or intractable idiopathic epilepsy, but does her best to pretend she understands what is going on. She leaves to get the doctor.

Queue Jeopardy's sound track for 30 minutes.

Doctor arrives...alas we only have to describe the condition because thankfully he has heard of the diet. "Well lets get this little kiddo pooping he says" He orders up a nice oral sedation and a double enema. I ask about the suspension of the oral sedative having sugar? He says it is grape flavored...."oh crap" I think to myself. I ask to have them mix it with out the suspension. The nurse is not smiling anymore.

More Jeopardy sound track 30 minutes: The nurse arrives and in a slightly irritated voice says this is going to be very bitter and that Abigail will probably spit it out. I explain nicely that Abigail already takes about 14 oral syringe fulls of bitter medicine everyday and it won't be an issue. I take the oral syringe from the nurse and Abigail takes the medicine like the trooper she is. We ask how long it is going to take to work and she says 30 to 45 minutes...and that she would be back in 30 minutes and then leaves. Pretty sure the door slammed on her way out. Melinda and I exchange looks along the lines of "What is her problem?" 15 minutes later Abigail can't even sit up straight and is super goofy. The best description is that she was really drunk. It wears off 15 minutes later and she is back to her crabby self. The nurse shows up with a second nurse 25 minutes after that...55 minutes after we gave the dose to Abigail. She is holding two enema bottles and bucket....better to be prepared I guess. Abigail is no longer sedated...Melinda is firmly denying them access to letting them do the enema with out sedation and I am wavering. One look from Melinda and I am back on board...I feel bad for having strayed from the path. Both nurses are saying it will be OK...we are not agreeing with them. Nurse number 2 leaves in a huff muttering something about having a better use of her time. Nurse number 1 is turning red. We mention that the meds wore off 30 minutes ago. "Well why didn't you come get us!!!" she exclaims ...."Excuse me??" I ask. "You never said anything about coming to get you!" I say. Melinda is no longer speaking for fear of what might come out of her mouth as it might involve them summoning security. I force a smile at this point and ask for a moment alone with Melinda to discuss the situation. The nurse leaves...and I take a deep breath. Melinda makes it very clear that we are not doing the procedure with out sedation. I get the message.

Negotiations: I exit the room and quietly shut the door. There is security guard posted outside our room and the room next door...It takes a second to realize the security guard is there for the teenage run away in the next room who is clearly doing her best to piss off everyone in earshot. I smile and nod at the guard. He glowers in return. I make eye contact with the nurse and beckon her to a side hallway. She is doing her best to smile and all the other nurses at the station are staring at us. She stops smiling when I start talking and explain our position on wanting more sedation before the enema. "but they have to special mix the sedation with out the suspension...and...the pharmacy is all the way on the other side of the hospital...and I would have to walk all the way over there ....AGAIN!" Alas we have the reason for why she was cranky
before. "You and your wife need to compromise!" she adds. "You are right?" I say. She seems slightly taken a back by my agreeableness. "My understanding of a compromise is its takes both parties, so why don't you start first" She is puzzled by this. "Why don't you go ask the doctor to come see us so we can have another dose and someone will be back 15 minutes after we give it to her and then we will go from there" her arms cross and all traces of pleasantness have gone. She turn on her heel and stomps off, leaving me in alone in the hallway.
10 minutes later...a 30 second conversation with the doctor..and we have a new order for another dose of the sedative.

Take Two: We got a new nurse...a veritable sweet heart of a women who swoops in and doses Abigail with no problem. She chats nicely with us for a few minutes and promises to be back with the enemas after she warms them up ...and a bucket. 12 minutes later Abigail is singing the ABC's like a drunken sailor and moving her arms to her own internal sound track. The new nurse shows up with another new nurse and they proceed to double enema Abigail in less than 10 seconds. They pop a pull up on her and mention we might want to stand back. I won't gross you out with the details ....but you could have played golf with what came out as it was of equal size and hardness...lets just leave it at that. We cleaned Abigail up and vacate the now Toxic zone we had just created. They hand me a sheaf of papers on the way out and wish us luck.

Its not till later that evening when I am going through the paper work and drinking a nice cold beer that I read the line about how to avoid constipation..."Be sure to feed your child lots of Fruits, Vegetables, and Fiber to avoid constipation in the future!" in big bold letters. I add the document to the shred pile and reach for the second bottle of beer.