Blink of an Eye

Thanksgiving 2018, began as a normal holiday in my home. Amazing food, company, and the promise of Xmas shopping plans. My in-laws came in to enjoy the fun with us. Reine had been acting slightly off. I thought it was just all the excitement of the holiday, my in-laws, and Xmas shopping.

On Black Friday, things went from fun to very serious in a “blink of an eye”. Literally.

4:00 pm
I walked in the door from shopping and noticed Reine was doing an odd heavy blinking movement. She was slightly out of it as well. This continued straight for 30 minutes.

4:30 pm
I began calling her specialists at Kennedy Krieger (KKI) and our insurance company to see if/where she needed to be seen. We were very new to all of this still. I did not want to make a big deal out of nothing or vice versa. It was deemed that we needed to be seen immediately in our local ER.

5:00 pm12 am
Reine was in the Pediatric Emergency Room (ER) of our local hospital. We began taking videos both at home and in the hospital. The ER was not knowledgeable or equipped to care for Reine. They immediately called KKI and John Hopkins (JH) neurologists for a treatment plan.

Videos were sent to KKI and JH’s neurologists. It was deemed that Reine was in fact having absence seizures with awareness. The ER began anti seizure medications while they, KKI, JH, and our insurance company decided where and how best to treat Reine.

Reine was given medications by the ER to try and stop the seizures. Understand that she already had her normal dose of anti seizure medication that morning as well.

The hard blinking and disorientation continued despite the medications. Then Reine began having hallucinations that would end up lasting for several hours. Unknown to the doctors on call in the ER, one of the medications causes those that are on the spectrum to have graphic, vivid, violent, absolutely horrifying hallucinations. My mother in law was with me during this time. We spent several hours calming Reine down. She was screaming because the walls were opening and closing, things were dropping out of the ceiling at her, we were distorted “monsters”, things were coming out of the walls, things were melting, and we were trying to kill her. Basically, it was like she was on a very bad acid trip.

At midnight, the decision was finally made to transfer Reine to JH because she was still seizing and her KKI specialists were affiliated with them. So any testing that needed to be done would be able to be seen immediately by her specialists and she could be better treated and monitored.

Between 12 am – 4 am
We began to notice a few dots in a line on her abdomen and armpit area. It was brought to the attention of the ER nurses and doctors but they completely blew us off. My oldest daughter, Tristen, switched with my mother in law when we knew for sure that Reine was being transferred by ambulance. Tristen would ride in the ambulance while I followed behind in my truck. This also allowed my mother in law to sleep for awhile. I was the only one that was going to be a constant in the hospital. My husband would serve as a taxi service for shuttling them back and forth as they came home to rest and shower.

4 am
Reine was transferred to John Hopkins Children’s ER via ambulance. Tristen rode in the ambulance with her while I followed behind in my truck. It was one of the most heart-wrenching/helpless things I have had to do as a parent.

5 am
They arrived at JH. Reine panicked when I was not there when she was taken out of the ambulance. Thankfully Tristen was able to calm her down after a few minutes.

5:30 am
Reine was given a 3rd dosing of the anti-seizure medication. The same one that created her hallucinations while in our local ER plus an entire days worth of her regular medication. The hallucinations began once again. The dots on her abdomen and armpits began to get larger and more circular.

6 am
Reine was admitted to JH.

6:30 am – 9 am
Neurologists came into our room to do intake. Reine had a blinking seizure while they were there. She was unable to answer basic questions like “What am I holding up?” (cell phone). “What is your name?” (Reine). “Who is this person” (Me). She was completely disoriented for quite a while after.

12 pm – 6 pm
Tristen and my mother in law switched out a 1 pm so that Nikk could go to work. Reine finally slept mid afternoon through most of the day. First time she had fallen asleep since the day before. Reine was given an EEG (which she slept through). Results showed a “normal” epileptic brain with blips here and there.

An MRI was ordered. They were able to do the MRI without sedation. This was incredible for us as they were trying to figure out if she would need to be sedated and whether or not she could even be sedated. The prelim results showed that she had experienced very recent minor seizure activity with reversible brain damage.

6:30 pm
Reine is given another double dose of her regular seizure medication.

Evening Rounds
It was decided that Reine would need a second EEG within 12 hrs of the first EEG.

Going on less than 2 hrs of sleep within 48 hours, I finally slept while my mother in law watched over Reine.

Second EEG was administered. The results were “normal” with “blurps”. No “active” seizures. This came as no surprise to any of us in the room. Because of the last EEG they could not put on the discharge papers that Reine had anything other than eye blinking ticks.

Reine had been pumped so full of anti seizure medication that her pupils were not dilating properly and she was not able to walk more than 3 steps without help.

Fastest Discharge In History
During our stay at JH, Reine’s spots “finished” developing. She was diagnosed with bed bug bites. The bites did in fact fit the timeline for our local ER according to John Hopkins. We were discharged within 20 minutes of this last diagnosis. Thankfully none of the little assholes thought us worthy enough to hitch a ride on. Everything from coats to bags where placed in our deep freezer for 3 weeks. All clothing was put on a sanitize cycle in my washer and dryer 2 times.

The total amount of medication that Reine received in a 24 hr time frame was as follows…
1 normal dose of Trileptal (home)
2 doses of Ativan (Local ER)
1 dose of Keppra (Local ER)
1 dose of Ativan (JH Children’s ER)
—–All within 10 hours on Friday—-
2 doses of Trileptal (JH Children’s ER)
2 doses of Trileptal (JH )
—–Saturday morning and early afternoon—-

I am not sure who felt more upset with the final diagnosis from the hospital…Us or the neurologists. Everyone agreed that the tests had been administered after the medication finally kicked in and stopped her seizures instead of before they took effect.

When Regression Means More Than You Realize

Something changed in Reine in August of 2018. It seemed to come out of nowhere. She just woke up one morning and became a completely different person.

Reine started to pee her bed at night and herself during the day. She became disoriented and “zoned out” a lot. Her ODD tendencies flared without provocation and she reverted back to where she was before behavioral therapy. She was unable to concentrate on anything homeschool related. Reine actually lost knowledge. Everything we had learned in the past year was just “gone”. She could no longer remember things like her letters, their sounds, simple addition like 1+1= 2. She was doing 4 digit addition and subtracting prior to August. Her address and phone number no longer were memorized. Her stuttering that had completely disappeared was now suddenly back with a vengeance, frustrating her even more. She began falling, running into things, and tripping over literally thin air.

Most days were spent soothing the “beast” that had seemingly possessed my Mermaid. I spent countless hours rocking out so.much.laundry. My nights were often spent with me in tears because of the long days. I was just in awe and completely thrown that this was all happening. There was no way to research what was happening to us. I know it was just as frustrating for Reine.

Then on Sept 19, 2018, Reine had had a particularly rough day. She could not sleep soundly no matter what we tried that night. I decided the best thing I could do was to just sleep with her. I told her I would stay in her bed with her until she kicked me out of her bed (she is known for literally kicking others out of her bed in her sleep). I told her that if I was not her room when she woke up that I would be in my bed. In the middle of the night, I woke up as she pushed me out of her bed. I went to the bathroom and was going to go crawl into my bed when something stopped me dead in my tracks. Call it intuition, mother’s sense, whatever you want to, but something told me to go back into your room immediately. I listened and went and laid back in her bed. Within seconds, she had a Clonic-Tonic seizure in my arms. I knew exactly what was happening because my biological mother is epileptic. I knew exactly what to do with/for Reine. I never panicked or anything like that.

I contacted our family doctor at the time, along with Reine’s ASD specialists and we began the process of having her neurologically tested. Because of an insurance switch, things were not as easy as we had hoped they would be to get the diagnosis and for treatment afterward.

Thankfully her developmental pediatrician¬† at Kennedy Krieger was also a neurologist and Kennedy Krieger required Reine to also see Christine (her behavioralist) immediately. We were able to get one session with Christine before the new insurance company told us that Reine’s behavioral through KKI would no longer be covered.

On October 10-11th, Reine and I were guests for an overnight EEG study through Kennedy Krieger. The testing almost did not happen because of the switching of insurance coverage. I had to get Reine fast-tracked through everything. We had to leave our family doctor of 13 years for a new doctor that had to request that Reine get the testing through KKI and continue with her developmental pediatrician for follow up. We were granted a 3-month window for this. With this granted, we were allowed to proceed with the EEG study. It was a long 2 days for us as Reine had to be sleep-deprived for 24 hours prior to the testing. That meant I was also sleep deprived.  Reine had several seizures during the testing, including with strobe lighting.

Reine was officially diagnosed with unprovoked focal epilepsy with photosensitivity seizures on October 18, 2019. An MRI was ordered along with more behavioral therapy to help us navigate everything. Medications were decided upon. Then the new insurance company stepped in and everything medical came to a screeching halt.