On unnecessary, ableist pressure

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I’m over reiterating this, and frustrated that it’s a conversation we have to have again and again. For some, the UK is opening up and returning to some form of normality. For people like us who are vulnerable or protecting the vulnerable, we watch with envy because the world is not safe for us. People who aren’t at risk and don’t get it don’t wear masks, they aren’t willing to get vaccinated. They broke lockdown to have raves, and they pressure our nurses to break shielding and safety rules.
It’s frustrating to have to remind ourselves and others: we don’t want to be in this position, we HAVE to be in this position. We’re strict with our bubble for good reason. If Mikaere were to catch covid, it’s likely to be FATAL for him. The last time he got a cold that turned into a chest infection we were fighting to keep him out of ICU. The resulting seizures were devastating. He suffered. The last time he went into ICU, we also ended up on END OF LIFE CARE in hospice. Mikaere catching Covid would be an unmitigated disaster for our family.
We’re not unreasonable people, you know? Everyone in our bubble lives by the same rules. We haven’t been out in the world for non medical reasons in I can’t remember how long. We haven’t seen our family, friends, the inside of stores, people on pavements in A YEAR AND A HALF. Sam desperately wants to run outside for the ultramarathon he’s training for, that’s he’s had to cancel twice. His sisters just had a baby that we can’t meet. I desperately want to see my friends but can’t. Kai is missing out on 90% of his therapies because extending our bubble is too dangerous, and has literally lost skills because of it.
We’re not draconian gatekeepers though. If someone genuinely wanted to join our bubble, it’s possible. They just need to isolate, get a negative test and agree to the same conditions we live with. A handful of close family/friends have isolated to see us, sometimes taking annual leave. We’re grateful our loved ones are understanding and happy to see us in a manner that doesn’t endanger Mikaere or put him at risk.
Going the other way though, we’re strict about keeping Mikaere safe. If a friend isn’t able to isolate we don’t see them. If we thought for a second one of our nurses was engaging in risky behaviour, putting Mikaere at risk, we’d immediately remove them from the package. That’s hard, because we rely on our nurses to get through every single day. We can’t be everything Mikaere needs and have to trust them implicitly to keep him safe.
We have to be that strict, that sure. The world is unsafe for the vulnerable like Mikaere. It’s even clear in the data: since relaxing the rules, accessibility has reduced, the daily positive test numbers are going up, and they’ve doubled in the last week. Mikaere can’t be vaccinated and the risk is high. So we stay in. We don’t go out (even though we desperately want to) but it’s WORTH IT to keep Kai safe.
Having to remind people over and over that our rules are there for a reason? That our rules are not to be “fought” against because of some minor insecurity or lack of patience? Blah. If you have never had to consider the actual death of a person you care about as a very real, very literal and likely consequence of your actions, you’re living in a world of privilege that not everyone has. And that’s not an exaggeration. That’s our life.
I mean, could you look at that beautiful wee face and decide to make his world a less safe place? I’m just so frustrated you guys. Why do people not get it?

On the days following our A&E visit

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Mikaere’s been a bit flat since our a&e visit. Many hours sleeping, but he has some active/awake time. As It’s so warm, we’re out on the balcony for portions of the day, when he’s up for it, willing the breeze to blow our way. Warm weather is always bitter sweet for us, it’s delicious but the risk of seizures increases.
So we pulled out the cool blanket, the magic mat that’s filled with gel, so it’s cool to the touch. It lasts for about 15 minutes, and then you move to a new spot. It’s worked wonders to keep Mikaere cool.
We’re still not comfortable going out into the world, and the pictures of everyone else enjoying their break at the beach or in crowds of just, out an about with a bit of normality has me feeling very green. But onwards we go, enjoying the balcony, a bit of water in a tray, paddling pool static nonsense.
Onwards we go. Managed to get some smiles, even 🙂
 

On visiting the A&E

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It’s not the first time we’ve had to call an ambulance this year. It doesn’t get easier. The counting of the seizures, timing them, logging the presentation. After we give the second buccal, we’re meant to call an ambulance, but I don’t want to. Not really. I don’t fancy spending hours in a&e, holding down my boy for bloods. (That’s not why, though. The why is that I don’t want this to be beginning of the end, I don’t want this to be a deterioration, but I don’t let myself think those things. Instead I think about the uncomfortable chair and the boredom and the endless waiting and the child with the disorder so rare people just ‘pop in’ to introduce themselves and say hi).
So instead I call our critical care nurse, and let her convince me. She clears the way. When they arrive, the ambulance service already has Mikaere’s directive. We’re ready and waiting, and so we head right out.
Thanks to our nurse, the paeds A&E knows to expect us, which means we go right into Majors (it’s busy. The other two bays are already full with a broken ankle and a concussion. Usually they’re empty).
Triage is quick. Seizure frequency is up and drastically different from his baseline. We’ve given emergency meds twice and the seizures are still breaking through. We’re here for a review, and to rule out any acute indications that would mean a symptom stay.
The physical review is clear. No red flags. The bloods come back clear. Infection markers are low (so no infection). Everything looks fine.
At this point we’ve been in the a&e almost seven hours. The last four have been seizure free, and as there are no acute concerns, they’ll send a message to his neurodisability consultant to follow up, and they wave us out.
Grateful to be home. Hate seizures. Hate that this is happening with more regular frequency.
Hey ho. Life with NKH, hey?
  

On a bit of elastic

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Mikaere’s at risk of hip subluxation or hip dysplasia. Subluxation is where the thigh bone is partially dislocated or fully dislocated from the hip socket, and hip dysplasia is when a hip socket that doesn’t fully cover the ball portion of the upper thighbone (which in turn allows subluxation).
The reason for this is quite simple: because Mikaere can’t weight bear independently, he’s not spending nearly enough time on his feet to allow his hip sockets to form like they should. Let’s be honest, he spends most his day lying down, or in supportive seating. Now that he’s so big, standing is typically a two person job, and as he grew out of his standing frame last year and our trial appointment for the next one isn’t till July… basically, there isn’t a lot of standing going on.
When lying on his back, Mikaere has a tendency to splay his legs wide. It’s called excessive hip abduction, it’s no big deal, except that because he has low tone and it causes his hip to rotate slightly, it can hasten the journey to subluxation.
So, on the advice of our physio we introduced a bit of elastic band to our set up. Don’t get me wrong, there are lots of fancy, therapy-esque things you can get (like hip helpers, or the happy strap, both which we’ve tried and he’s outgrown) but they are all VERY expensive. We had elastic at home, and tied it together in a loop (very technical, and free) which works in the same way.
Essentially, it stops the excessive hip abduction, gives his muscles a teeny bit of a stretch in a different position and it was affordable and accessible. Woo!
I wish all disability equipment was as affordable and accessible as bit of elastic, but hey ho. I’m glad we’ve made it work in this case 🙂
  

On celebrating the wins

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This guy. Despite a whole year of no therapy bar us, not seeing any professional therapists and despite some minor backsliding in regards to his truncal tone, he’s doing SO WELL! We recently reintroduced weekly physio sessions with a new physio (our previous and much loved physio @lauragates82 moved away!) and Mikaere has risen to the challenge. Just LOOK AT THIS HEAD HOLDING!
I remember sitting in a room, once, learning about laser therapy and practically crying as I disclosed my fear that my baby would never hold up his own head. I worried that without head holding his ability to interact with the world would be limited (my well meaning but very ableist fears were ripe back then, and I’d soon learn how to adapt so he could engage with the world, head holding or no).
Regardless of my hopes and fears for him, I want to share just how hard he’s worked to develop his head holding skills. It is not all the time, but YOU GUYS! Just look! Is he not just the *most beautiful*? (Obvs, his pretty face is not related to his head holding ability, though I’m chuffed for him for that, too).
My mama heart, I love him so much!

On visits during covid times

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After getting vaccinated, isolating, and having negative covid tests, Mikaeres grandparents came down for a visit. Mikaere loves his grandparents, when they walked through the door he got very vocal, and there were smiles.

He loved the cuddles, and oh! The IN PERSON stories instead of on the iPad! So good. It’s been sixteen months since we’ve seen them last, and we’re grateful that they were able to come and see us all.

The things we’ve missed, hey?

 

On staying in, still

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Things are opening up here in the UK, and as always, I’m anxious. The world doesn’t feel safe for Mikaere. I want to trust in the vaccine (please get vaccinated if you can!) and hope that it does drastically slow transmission… but from the (ridiculous amount of) research I’ve read, it looks like the vaccine only reduces the risk of transmission (by between 25%-35%) but doesn’t STOP transmission. What it does is prevent you, a vaccinated person from experiencing severe symptoms.
Which is great, genuinely. Except that Kai wont be vaccinated (his first set of vaccinations put him on end of life care. We were living in intensive care/hospice for MONTHS). So, if the vaccine doesn’t stop transmission, Kai’s still at risk.
With the world opening back up and the CDC gettin frivolous with mask advice… the world just seems like a less safe place. I don’t know. I’m hopeful with reduced transmission rates thanks to increased vaccinated (ignoring the Indian variant) and with summer coming… perhaps it will be okay?
Perhaps in a few months positive cases would have dropped off (rather than the increase we had last week) and perhaps it’ll mutate itself into a less scary version and just… go away.  Obviously, we’re as keen as anyone to get back to normality, but the risk for our little family is so much higher than everyone else. It’s really hard, hey.
So, we’re doing what we can. Sensory foam play, with ducks. That brought a good 15 minutes of joy, I’ll take that.

Messy Play: Beans + Lentils

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We needed a small win today, something easy and interactive and joyous, but easily implemented because #lockdownLife is still a thing. So messy play it was! Beans and lentils, things that feel lumpy under little fingers, on a tray that makes a good sound when you bang it, and beans that bounce and make a good noise when they’re flung to the floor. It’s the kind of thing Mikaere enjoys – it takes a little bit of effort for him, moving his arms, especially when he can’t necessarily *see* the things he’s flinging, but, I mean…. they went everywhere. He was so joyous about it, too. The sound they made hitting the floor. Satisfying, for him.

Also, I’ll deny him nothing – if a moment of happiness for him is making a massive mess? No big deal sweeping up beans, it’s fine.  Sure, it was a good half hour of sweeping and banging and laughing, so worth the tidying after. It’s the small things, hey?

This Faaace

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This is the face Mikaere makes when he realises he’s spending the day with his nurse, and not with Mama. I think that face says so much, because it’s clear: with her he can do more, there is more fun and there is more attention (which is fine, because, that’s the point of a 1-1, right?)

We have a really generous package which allows for a significant amount of day/night help. Which we’re grateful for, absolutely. But also… there is that little kernel of guilt and sadness that, unlike a neurotypical family, we aren’t enough. As his parents we can not provide the round the clock care he needs (and we know, because we tried in that first lockdown, and it was awful for everyone). We literally don’t have it in us to be everything he needs, and when we try, it literally comes down to “how do we get through the next five minutes” (or ten minutes, hour, day…) and all the fun, all the engagement, all the therapy is lost, and his skills backslid. Also, knowing he’s palliative, and his life is limited, the quality of his life is really really important to us. And there was a significant drop because, bluntly, we didn’t have the capacity, and were running in the at minimum “keep him safe’ mode.

With the support of our nurses, fun for Mikaere has returned. Play, and therapy and just, intense the 1-1 attention that he needs to engage with the world (and needs, to keep him safe) – all of that is possible in a way it wasn’t before.

We’re also grateful that because of the sacrifices our nurses have made, isolating like us, in the extreme, we’ve been able to have them join our bubble. Without their willingness to separate from their friends and family (and walks and shops and everything else) we wouldn’t be able to accept their support. We’re so so grateful for our team.

So yes. That face. Worth it, hey?

On Standing

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Mikaere has outgrown his stander. We have a walker, but it’s difficult to get him to weight bear in it, and still keep his body in alignment. It’s much easier to practice freestanding with gaiters (to keep his knees locked) and AFOs (to stop his weak-never-has-to-weight-bear ankles from collapsing). The downside is that it requires two people to support him upright in this way, so when Sam has a gap at work and Mikaere’s in a good place, we do a moment of therapy. We dance to some tunes, and wiggle our hips and raise our arms and move our bodies.

It’s not the hour in the stander the physio wants, but it’s fifteen minutes or so of actual standing, transferring weight and proper uprightness. I’ll take it. We do what we can.