Flight GNA01

Today is Rare Disease Awareness day which seems like an appropriate time to share a bit more about the journey we’ve been on with Quinns these last five months. 

Big Sister and Quinns smile together looking up towards a tv above the hospital bed Quinns is sitting atop in his  comfy chair.

In September last year Quinns ended up in hospital experiencing a dystonic crisis. Dystonia or involuntary movements are common in Cerebral Palsy. He underwent a whole raft of tests in an attempt to establish the trigger for the crisis. The only way to control the movements, which were by this point causing him physical harm, was to heavily sedate him. With so many sedation drugs on board Quinns eventually needed help to breathe and was put on a ventilator. 

The initial cause of the crisis was never established but in the process we discovered that his initial diagnosis was wrong. Rather than Cerebral Palsy, one of the most common childhood disabilities, Quinns actually has a very rare genetic neurodevelopmental condition called GNA01. 

GNA01 was only discovered in 2013 and as such there are currently only about two to three hundred people with this particular genetic mutation in the world. It presents in one of two ways either as a movement disorder which looks very like cerebral palsy or as seizures. Sometimes people have both but in Quinns’ case it is simply the movement disorder. 

It is obviously a shock to have an entirely new diagnosis after seven years. There’s a lot for us to get our heads around but what does it really change?

Cerebral palsy and the movement disorder caused by GNA01 are very similar. They both result in a disability requiring Quinns to use a wheelchair to get around and an eye gaze computer to communicate. He would have needed all the same equipment and support regardless of the name of the condition. The only thing that really changes is the narrative around his birth. His condition isn’t caused by brain damage but by a change in his genetic coding. There was absolutely nothing we or anyone else could have done when he was born to make his condition any different. 

As in Quinns’ case the condition usually presents when a child has an extreme episode of dystonia or hyperkinetic movement which spirals out of control and leads to a long period in intensive care. This is known as a ‘Storm’. If we had known earlier that Quinns had GNA01 and that such a Storm was possible perhaps we could have been more prepared? But on reflection there is very little that I would have done differently for him in the years leading up to the Storm. His life was fun, social and fulfilling and we did everything possible to ensure that for his future.

Although cerebral palsy was the best explanation we were given for Quinns’ difficulties it never fully explained his condition. We now have a condition and a list of symptoms that describe Quinns’ difficulties with movement more exactly. Unfortunately we can’t rule out the possibility of future Storms but hopefully we will be better equipped to avoid them or at the very least deal with them when they arise. Our decisions moving forward can be based on knowing more about the condition we’re dealing with and hopefully more and more research will be carried out on this relatively new discovery. 

Although we’ve yet to connect with them, Quinns is now part of a new small community of people with GNA01. There is a tribe of people who present almost exactly the same as him. One thing that struck me when I watched a video about some of the other children with GNA01 was how often their smiles are mentioned. 

Quinns has been through a lot these last few months but he’s come out the other side the same smiley happy boy we all know and love. He attracts the attention of many passers by as he sits in his chair atop his hospital bed giggling away while he watches Thunderbirds for the 100th time. Big Sister is of course still his most favourite person.

I set up this blog a short while after Quinns was originally diagnosed with CP. The aim was to share our frustrations and struggles that we faced as a family simply because Quinns was a wheelchair user. Those frustrations and struggles remain the same. Accessibility and societal barriers are still a big problem for him. We still need access to Changing Places toilets to allow him to get out and about and accessible play parks are even more necessary now as he so deserves some fun after all he’s been through. 

Hopefully once he gets out of hospital we’ll get back to sharing our life experiences again. In the meantime we want to raise awareness of GNA01 for the two hundred or so people living with the condition as part of the 300 million people living in the Rare Disease Community. 

You can find out more about GNA01 from the Bow Foundation website and watch the video Who is GNA01?  

Thank you

Over the last few months we have experienced some of the very best of the NHS. While sadly other family members have not due to increasing pressure and broken systems.

I am looking at the camera while Quinns cuddles into my shoulder. He has an oxygen mask near his mouth, a blanket round his shoulders, shaved head and very long eye lashes.

Quinns has been very unwell since the end of September. I don’t think my brain has processed quite how unwell yet. Thankfully his care has been great and he is on his way to being home. I’m not quite ready to share the many complexities of what has been happening but hopefully as he continues to recover and rehabilitate my ability to articulate will return.

He has been helped and is continuing to be cared for by so many people it’s difficult to name them all but here goes.

This New Year we are very grateful to the doctors, nurses, physiotherapists, dieticians, speech & language therapists, occupational therapists, psychologists, radiographers, surgeons, anaesthetists, pharmacists, phlebotomists, play specialists, hospital teachers, cleaners, caterers, administrators, specialists, porters, blanket gifters, volunteers and entertainers at Forth Valley Royal Hospital in Larbert, the Royal Hospital for Children and Young People in Edinburgh and the Evelina Hospital in London.

Special thanks to the ScotSTAR retrieval team, paramedics and air ambulance paramedics who got us safely to where Quinns needed to be. I have some amazing stories to share of our journeys!

Also as a family we couldn’t have managed without Kindred, Ronald McDonald House, the Edinburgh Hospital Children’s Charity, the Evelina Hospital School, Beads of Courage and of course all the support, love and kindness from our family and friends.

And finally thanks to the listeners, the pyjama enthusiasts, the ones who were always there, the task givers, the shoulders to cry on, the banner maker, the card makers, the hamper givers, the jokers, the organisers, the sorters, the providers, the bead supplier, the chair deliverers, the video makers, the new friends, the creatives, the tea makers, the custom pillow makers, the custom support makers, the messagers, the massager, the visitors, the cake sender, the flower senders, the chocolate and sweet suppliers, the dinner providers, the Disney enthusiasts and the music providers.

Thank you.

I’m fine

 

I’m fine. Or at least that’s what my photographs from the last eight weeks show.

Photo of a frog stuck in a plant pot

In reality I’m not fine. I’m processing a major event along with the rest of the world. It’s hard to admit that life is difficult when you know that it’s tough for everyone. Everyone has circumstances that make this situation difficult whether it’s isolating alone or as a working parent; losing a job or doing a job that’s particularly demanding. Everyone is doing what they can and hopefully communities are rising to the challenge of supporting each other just as ours has.

For us the shutters came down around our family of four a week earlier than lockdown. My instinct was to protect Quinns as I felt he was particularly vulnerable. I questioned myself constantly for several weeks before we finally received his shielding letter. The letter brought a certain amount of relief. Knowing that my instinct was right and that professionals agree is comforting. It doesn’t however bring back the support that we are missing.

We’ve gone from a team that couldn’t fit in the school’s biggest meeting room to just the three of us looking after all of Quinns’ needs while Dad works full time at a stressful job from home and Big Sister is home schooled.

There’s no longer the same NHS input as those who support us have been redeployed to cover other areas. On a practical level I have been unable to get the bigger size in Quinns’ support shoes from orthotics and have no hope for the next few months.

At the beginning of lockdown Dad had to fix the headrest on Quinns’ chair while receiving instructions on the phone from the rep. Later that day the rep was furloughed. For a while now a bit of the chair falls off periodically. We simply stick it back in.

Quinns’ three Nursery days a week provided not only education and socialisation for him but also space for me. He had the benefit of 1-1 support in the classroom while personal care was provided 2-1. Now it’s me providing it all and my much needed space is non-existent. My one saving grace is his classmate, Big Sister who also covers as my teaching assistant and occasionally additional support for personal care.

We chose to stop the carers who came into our home a couple of times a week to help us out. The risk to us and others was too great and we felt we could manage. However with grandparents all isolating in their own homes there’s absolutely no hope of respite. My only relief is when Dad manages to take holiday from work.

Much as I have wanted to I have not had the time or energy to write. I have however tried my best to keep up with developments. There have been times when I’ve desperately wanted to shout about frailty guidelines, DNR letters and serious changes to legislation. It rang so true when I read recently that it’s difficult to write when you are afraid.

‘We are all safe and well and making the most of our time together’ is my cover story for a level of exhaustion and anxiety that is off the chart.

Knowing that we are shielding at home till at least mid July, the only thing we can do is keep on going. We plan to make the most of the opportunity to ‘home school’ making use of the skills and resources available to us (it will come as no surprise that our home school has it’s own name and brand!)

I can’t take on all the roles of Quinns’ team but I can still be an advocate for value over vulnerability by sharing our positive stories.

And one last thing if you’re needing a break in lockdown and haven’t watched the film Crip Camp yet I’d highly recommend it!

Stay home save lives

Photo of Quinns sitting on Big Sister's knee on a picnic mat with apple tree in the background.

Life is a bit full on for everyone at the moment. Round the clock caring responsibilities without a break as well as home schooling is keeping us busy. We are shielding at home for the next 12 weeks but we are happy, healthy and making the most of our time together.

 

Staying at home

Photo of Quinns and his Big Sister together on the sofa playing on the tablet Big Sister is holding.As everyone now comes to terms with being in lock down our family have been shielding for well over a week. Quinns’ respiratory issues make it too risky for him to be around others. My asthma means I too am classed as vulnerable and as his primary carer I can’t take any chances.

When Quinns was first diagnosed our world shrunk. There were barriers, both social and physical that closed in on us as many people and places became inaccessible to him. I’ve spent considerable time pushing back against those barriers trying to widen the scope for him (and others).

Now as the Covid-19 pandemic strikes that same thing has happened again.  Only this time it’s more extreme and everyone is in it together. You no longer have access to the people and places you had before and that is not easy.

While homeschooling Quinns & Big Sister last week I was finishing off an online course (I’ve given up attempting to do any work of my own!) about Inclusive Education. Now as the schools close and everyone stays home in exclusive bubbles, the entire situation is almost exactly the opposite of inclusion.

Our discussions about schooling for Quinns revolve around balancing his  learning with socialisation. We want Quinns to go to the same school as his friends because we rank peer relationships pretty highly. How many of our children are going to miss their friends because they are being home schooled and no longer able to participate in extracurricular activities?

I appreciate we all have considerable worries at the moment. We must pull together to get through it but during lock down I hope people will have a chance to reflect and learn from this experience what a lot of disabled people already know, the importance of access and socialisation.

We are very fortunate to be locked down in our ‘new’ house with amazing garden. It’s ideally set up for Quinns to access everything he needs including chats with family & friends online and of course he’s fully included in our little quartet. We plan to make the most of our time. Getting round to all the activities we never have time for normally all the while trying not to let the worry take over.

Stay at home and stay safe everyone.

Swimming facilities

Would you be willing to parade in public in your swimming costume? I am discovering a level of body confidence that I never knew I had because I am no longer willing to cover up and pretend that what is being provided is ok. I am no longer willing to make it work but I do want to make swimming happen for Quinns. So far that’s involved walking through a busy public area in our local leisure centre dressed only in my swimming costume.

Close up photo of Quinns eye gaze with the words 'They went to the swimming I want to go to the swimming'

Scottish Swimming recently released a video to launch their inclusion campaign #SeeMyAbility. I totally agree with the message “Don’t separate, segregate or keep me apart…make inclusion, integration and togetherness our task”. I also fully agree with their tagline ‘Everyone can swim’ but from my experience of finding pools with suitable changing facilities for Quinns I’m not so sure that the practicalities have even been considered. 

We are working up to a family visit to the home of Scottish Swimming (where there is currently a £20 million redevelopment underway). Why are we having to work up to it? The Changing Place, that we have been told is the provision for the sports centre, isn’t even in the same building as the swimming pool. In fact it’s not even in the sports centre building next door. 

It is situated in an arts centre that is a 5 minute walk away from the pool building. The walk currently takes you past a building site and down a hill on a busy University campus.

Here’s hoping my new found body confidence in order to make swimming happen for Quinns will allow me to enjoy the feel of the breeze as I stride it out on my way to the pool! 

Caution Wet floor

Even with very little control of his body out of the water Quinns is extremely comfortable and happy in the water.

Quinns is not the only keen swimmer in our family. Big Sister is an aspiring olympic swimmer. Swimming, therefore, is an obvious choice of activity for the four of us to enjoy together. You would like to think it would be easy but it’s not. 

Photo of a sign saying 'Caution Wet Floor' outside a Changing Place Toilet

One of the reasons we chose to live where we live is access to what we thought were really good swimming pools. However we now realise none of the pools close to us are ideal for Quinns. The nearest pool with everything he requires is 20 miles away. 

Since swimming has benefits for people no matter their ability you would think the facilities would be more accessible.

Our local leisure pool has recently put in a Changing Place. That in itself is great but it’s not poolside! I’m not sure how that’s going to work once Quinns is bigger and needs hoisted but for now we can make it work with waterproof mats and towels in the Bug.

Before and after our swim we have to walk right through the public reception area of a busy leisure centre!

I’m not sure who is more uncomfortable when our little family troupe walk soaking wet through a public place but I know for a fact that it is inconvenient for the staff.

Swimming the dream

Quinns recently graduated from his Water Babies swim class with an underwater photoshoot. 

Photo of Quinns swimming underwater smiling at the camera

When he was eight months old and as our concern grew for his development I started taking him to the class. The health benefits of swimming are well recognised and I felt sure that he would gain from the water. That same sentiment was echoed when we ended up in hydrotherapy pools as part of various groups. At times over the last few years we were getting changed for swimming up to three times a week.

What I hadn’t really considered when he started the class was how much Quinns would enjoy being in the water. The massive smile that he could barely contain every time he entered the water told me and everyone else around how much he loved it.

In the beginning taking him to his swimming class was easy. He was changed the same way all the other babies were changed and then carried to the pool. As the others advanced to toddling and finally walking we still had the same routine. 

When he outgrew the baby changing table we looked for alternatives and negotiated the use of a therapy room. The adjustable height bench made it work for us even though I had to carry Quinns through a corridor that went from the building entrance to the changing room. Although we didn’t have far to go it wasn’t pleasant underfoot. 

Despite the negotiation to have the room there were times when one was not available. Each time we refused to use the floor of the disabled toilet. One time however we made it work by changing him on a couch in the reception area. It was hardly dignified.

As he grew ever bigger it all became more of an effort. It was increasingly difficult to carry him the distance to the pool and tricky not having access to shower facilities in the therapy room. Eventually one day when we were turned away because all the therapy rooms were booked for treatments I realised I was tired of being the one who made it work.

Our options for alternative classes are distinctly limited because so few swimming pools have adequate facilities. However we have now managed to find a suitable class with a Changing Place style set up that will work longer term.

So while I may be tired of making it work in the Water Babies class, of course that smile together with the benefits of the water means that making swimming happen for Quinns will always be worthwhile.