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Start by reviewing what meds you're on.
We have no allergies besides the Thiomersal sensitivity.
Abilify is 5 milligrams right?
Correct.
We'll get the 4 off of there.
I think that confused.
I think that's when we first started out.
And the Clonidine, do you take two tablets at bedtime?
Yeah.
Okay and Ativan, a tablet at noon and then as needed if you get agitated right?
Right.
I know we just refilled that the other day.
Yes because I sent the bottle to school and I only take out enough pills
for the weekend and I completely forgot about Spring break so all of his meds were at school
and I'm like I'm not going to have enough to last now.
You're the second parent who has told me that this week so.
Spring break caught everybody by surprise.
It did it caught be off guard this year.
And then are you still taking Melatonin at bedtime?
Yeah.
6 mg? Okay.
Is there anything else I've forgotten?
Good. Alright well tell me how things have been going.
Everything's been going great.
How's school going?
It's awesome!
He's doing great.
What grade are you in school this year Andrew?
I'm a Junior in High school.
And your Junior year is going well?
Yeah!
What do you like about school
Well I like the drama class that's for sure.
Oh I can see.
Yeah you would be good at that.
Yes my little entertainer here.
What kind of plays have you put on?
Well um,
Tell her about your Improv!
My Improv, I'm about to do it when I come back from Spring break.
My Improv character is a Japanese game show host.
He's hilarious and he put it all together himself.
Cool!
It's hilarious.
Maybe at the end you'll do a little bit for me.
Okay.
At the end you can do it for me while I'll grab the blood pressure machine
and so while we're doing that you can do that Okay?
Okay, tell her about what you did last week when you went to Karaoke with mom.
Last week when I went to Karaoke, I sang the song "Turning Japanese" by the Vapors.
He was pitch perfect.
Quite the little entertainer.
He had the entire place rolling and clapping.
Wow good for you.
They had fun didn't they?
And school, behavior is good?
He's doing really well.
I mean he's had a few minor outbursts but he's been pretty good about
calming himself down and regulate himself.
How do you calm yourself down and get yourself under control again?
Usually I just take deep breaths and think of something positive instead of negative.
Okay. Good.
And how about at home, are you having any behavior concerns at home?
You know just the occasional outburst but he is so much better than he used to be
and can I brag a little bit?
Ordinarily when we want him to learn something or to get desensitized to something
we do the desensitization or we do the repetitive teaching.
This time I didn't try to desensitize him.
I tried reasoning with him as to why he should be, he's a grown man now,
and I have been shaving him with just a standard bladed razor
and his dad bought him an electric razor for his birthday
but he ever since he was very small has been afraid of the noises
and just very apprehensive about it.
So today, we decided he was going to use the electric razor for this appointment
and I did not have to use an enforcer.
We just reasoned through it.
He was very very apprehensive about it even resisting quite a bit at first
but then after we discussed it and he thought about it
he said "Okay let's try it" and then after he tried it what did you say?
It was awesome!
So now what can you do by yourself?
Shave my face.
Well that's great.
It looks good!
He did a good job.
Very good, very nice job.
So you didn't mind the noise?
It felt okay?
I did not mind the noise at all.
Good, that's great.
It was incredible to watch because you know all these years we've had to do
the positive reinforcement and the desensitizing.
This time it was okay we're having a conversation.
We're just going to reason this out.
He was really brave because I know those sounds are scary to him
because they are super loud and the vibration is like hyper from what I have
and he did awesome so I'm pretty proud.
Good Job!
The few outbursts and things that you see now what happens during those?
I don't how much of that is Autism and how much is a teenage boy.
When you have an 18 year old boy that wants his way and a mother that wants hers
and we're both pretty stubborn, usually he will yell.
He has been very good at not being physically aggressive.
It's just usually verbal.
If he gets too upset and he can't seem to calm himself down
or I can't convince him to go to his room and calm down,
he's really good about "Okay Andrew I think you're agitated let's take an Ativan"
and he'll say "Okay mom."
Okay, how often are you having to use it?
Oh that's really really rare.
I mean I've had to use it once, maybe twice since the last time we were here.
Okay, great, good.
He's been awesome haven't you?
And that dose at school?
He does need that daily dose yes.
It really helps him get through the second part of his day.
Okay.
Because he takes it at lunch time, and he tries so hard to keep himself together
and act appropriately at school that I think it helps him kind of keep it together.
And then when he gets home it's hilarious to watch him like let loose.
He's like "Okay I'm home!"
But you know you can be yourself at home right?
Right.
Good, and um academically?
He's doing well.
What grades are you getting?
A's and B's.
And this is regular curriculum.
This is not adapted for him.
He is completing 11th grade coursework on his own.
Smarter than his mother.
I can't help him with his homework anymore can I?
What do you want to do after you graduate from high school?
Well I was thinking of well, you know...
I was thinking of becoming a Youtuber like.
He really wants to be an entertainer but we have discussed maybe
learning some computer graphics.
Computer graphics to add to it.
That would help if you would learn how to use computers.
Yeah so maybe with computer technology and communications
I could get those degrees with what kind of college?
I'm just curious.
Well honey, we're working with your counselor on what we can do.
What courses we can take online.
What courses we may have to go to the community college for.
But you know you got to hangout with your mom for a few more years.
Right.
Well good, it sounds like you got some plans.
We're trying.
You've been thinking about that.
You mentioned that you are considering going for guardianship.
Yeah we actually are going through the process, my son-in-law is an attorney.
Oh that's right.
Which is really really really nice.
We did the paperwork, that's right.
We did the paperwork we just do not have the court date yet.
So we're kind of waiting for the court date.
Everybody signed off, even Dad.
So um, it's just a formality at this point going before the court.
And he has decided yes he knows that when it comes to money and taking care of himself
you need a little help right?
And that's why I have you Mom.
That's right that's why you have me, I'll keep you in line dude.
How do you think your medicine's working?
It's going great.
Okay good, two thumbs up huh?]
Right.
Mood seems to be pretty stable and level.
He's a little hyper.
But it's a positive mood and I can deal with the positive hyper Andrew.
That's always been, we're always kind of hyper at the house.
So for him being hyper it's kind of..
He paces a lot, he paces I mean.
He puts more miles on his feet at home.
Than a car would.
I'm serious. He puts in a lot of mileage.
Is that all day or just part?
Usually it's when he gets home from school and then he really is not able to just sit still.
Like if he's watching a show or playing, he'll get up and down and up and down.
Yeah I can multitask.
That's what he calls it, multitasking.
I call it exercising in between things.
Now at school do you have trouble staying in your seat for class?
No.
No and I think that's part of it is...
He's using that energy.
He's holding it together so well at school because he knows he has to
that when he's home, you know he's free to be himself
and if he needs to bounce around to calm down then let him bounce around
it's not hurting anything right?
Anxious, worried about things?
Um...
If you're worried about something you can tell her.
I'm fine most of the time but...
Usually if there is something very important in my life that I have to accomplish,
and I'm afraid I might not be able to, I eventually will and I have in the past.
The only thing is that he's a little anxious about and there isn't anything he can do
or I can do about it right now is I'm still unemployed so things are really really tight.
He's not used to that.
He's not used to "Hey mom can you take me to McDonalds
Hey mom can we go get this video game?"
He's not used to mom having to say "Can't do it."
So that stresses him because he has no control over that but he's handling it really well.
He's doing a really good job understanding, okay those are all
the chips you get until next paycheck.
Good.
Some people worry about weather or storms or insects, any of those kinds of things bother you?
No I'm not scared of anything anymore.
Spiders still gross me out but they don't scare me.
Storms, I'm not afraid of storms anymore but still I hate it when the power
goes out because of them.
I think we all do.
Okay, good.
And how are you sleeping at night?
Pretty well.
Good.
I'm a deep sleeper.
Falling asleep pretty quickly with your medicine?
Yeah.
Staying asleep well at night and not waking up and getting up and doing anything?
No, I mean every once in a great while he'll get up and go to the bathroom
but he usually just goes straight back to bed.
He's been doing really really well
And how about your appetite?
How's that?
It's good.
You're certainly growing.
Yeah.
Um, so any concerns about diet, about food choices or?
Well he's still an extremely selective eater but he does like I said
he does eat from each one of the food groups it's just a select number
of things from each food group.
I stopped obsessing about that a long time ago because as long as his
blood work comes back okay and he's healthy, if he wants only to eat apples...
you know as his fruits, apples and pears and he used to do grapes
but now "The skin gets in my teeth Mom."
And any problems going to the bathroom?
Any diarrhea, constipation, stomach aches?
Well he's had a flu bug recently but not on a normal basis when he's not sick
he's been doing pretty well.
And you're healthy now and you're all recovered?
Yeah.
A little bit of sinus still going on but I don't know how much of that is seasonal allergies.
Congestion, runny nose, that kind of stuff?
Yeah.
He's been pretty good.
Good.
Any usual movements?
Trembling, shaking, stiffness?
I haven't seen any of that not since a scary time.
Have a seat up there on the table for me.
Let's see how you're doing.
It's so cute to see the two of you next to each other.
My gosh, you can almost just stand there and sit down.
Let me grab my stethoscope, that would help.
I have to make him sit down so I can help him comb his hair.
I can see why, geesh.
It's great in the kitchen though.
Andrew can you reach up?
Yeah!
Big breath for me.
Again.
Excellent.
Alright sit back for me for just a second.
I'm going to look in your eyes and ears and just all the good stuff.
Alright stare over there at the computer.
Right there, there you go.
Try not to look at my light.
Perfect.
Try not to strangle you.
Very good.
Alright watch my finger with just your eyes.
Perfect.
Very good.
Now were you on Spring break this whole week or is it coming up for you?
I have been on Spring break all this week.
Some people are on Spring break next week that's why I asked.
Did you do anything fun?
Not very much.
Nope.
Well he did go to karaoke with Mom which we don't usually do because of school
and where we going tonight?
Karaoke, same place.
Hang on one second.
Don't stand up because I cant reach you then.
Say "Ahh" for me.
Very good.
And now before you stand up show me how steady your arms are.
Like that.
Very good, alright.
Sit down for me, perfect.
Well I think you are doing great.
This seems to be a great dose of the Abilify.
It is nice and low.
The Clonidine seems to be and Melatonin seem to be working pretty well.
I think you're doing really well.
Let me double check if you're due for any lab work.
It did not tell me that when I logged on but .
You know I don't think it was that long ago that we've done it but.
Yeah you've got another visit before it will.
Okay good.
We need a new prescription for Abilify.
It looks like that.
And the Clonidine it looks like we did a month or two ago so.
Right we just got a refill on that.
So we will do the Abilify and...
Let me see here.
Let me see if we've got your pharmacy, Kroger?
Yup alright.
I'll go ahead and put that in and I'll do this and I'll go grab the blood pressure cuff
and then you can do your Improv as I'm doing that set up how's that?
What are you going to sing for karaoke tonight do you know?
Turning Japanese by The Vapors.
And his second song is usually what?
Sugar Sugar by the Archies.
That's an oldie but goodie.
He does it so well too.
And if I ever get a third song "Ace in the Hole"
By George Strait
What's the other one you like to do Scott McCrerry "Trouble with Girls"
Yeah.
What was it "Burgers and Fries and Cherry Pies"
That one was by, who sang that song?
I don't remember who does that.
It was a country song.
It was an old one.
It's older than your mother.
Oh was it Charley Pride?
You're right it was Charley Pride thank you.
He has a better memory than his mother too.
Yeah.
Now if I could just teach you to count cards and take you to Vegas.
You could do some good calculations in his head.
Better than me.
And for his birthday where did we go?
We went to Dave..
Dave and Busters.
We went to Dave and Busters and I have to tell you a funny story
but parts of it I'll leave out because he's in the room but there was a game
where it's multi-player trivia.
Let's just say he really won.
I'll bet.
Big time.
Big time yeah, you're good at that huh?
Yeah.
And he proved a social point which I'll explain later.
Let's just say the other teenagers were not very accepting of the disability
and made some comments.
Oh really?
But he didn't hear them and my son-in-law is very very patient
and knew his ability so he just sat back and watched the humor unfold
and he really whipped their butts didn't you?
Right!
Good for you.
Yeah it worked out pretty good.
Alright let me go grab the blood pressure machine.
Are you going to do your Improv?
Hang on I'll go grab the blood pressure machine and then while I'm
getting it set up you can do that how's that?
Okay?
Okay.
Alright so hang tight for just a sec.
Alright.
Let me make sure that it will turn on for me.
Maybe.
There we go.
Alright.
Hold it right there for me.
Alright stop that, sorry.
There we go.
Now wait a minute it's not going down here for me.
The nurses usually do this but they're all off today so.
Of course they are this is good Friday.
Do you guys have plans for Easter?
Um, I plan to make a dinner.
Yeah okay well that's a good plan.
We plan to eat lots of candy huh?
You have a favorite Easter candy?
Smarties.
Smarties, you're not a chocolate Easter egg..?
I also like Hershey's chocolate bars.
But his big candy is Smarties, always has been.
Those are good.
When he was 3 and we started ABA, that was the.
That was his thing huh?
That was his primary reinforcer was Smarties and chips.
Okay and the Smarties have stayed huh?
Right and the chips.
What kind of chips do you like?
Ruffles.
Okay.
127/67
That's a good one.
Perfect.
You ought to write it down.
Great.
I like his Improv because he's really really funny doing it
but he has such a beautiful singing voice that I think he should sing.
Maybe I should do both at the same time.
Okay that might be hard, that might be hard.
Unless you do Turning Japanese and then do the Japanese game show host in between verses.
There you go.
I should do that act.
That would be hilarious.
So anything more, I appreciate you guys being a part of this, to help teach medical students.
Is there anything you would like them to know about healthcare for Andrew
or about anything?
Well of course each child is different but Andrew specifically
doesn't tell me he's sick until he's very sick.
Doesn't tell me he's in pain until it's excruciating
and a lot of times he doesn't even realize he's in pain
until it's gone on for a while
but I think one of the biggest challenges for me was when he was first diagnosed.
Everybody dismissing his symptoms as it's just Autism.
If he has diarrhea and his GI symptoms there's a medical cause.
Autistic children have medical problems, don't dismiss it as oh Autistic kids have that.
That and I realized that they're going through intensive training
but you have to listen to the parents.
You have to listen to the mother's gut instinct on what's going on
because there were a lot of times where I didn't know what it was
I just knew something wasn't right and you know before we met you
and going through that host of doctors, I can read parts of his chart
that say "It was the mother."
There's nothing wrong with this child but the mother.
She's too weak to say no but what they didn't understand was that I could say no
but he didn't understand what no meant.
You know and so if there's a concern, take it serious and look into it
and don't dismiss it as Autism.
Do you have anything to add?
What do you want them to know about taking care of you?
Well for anyone who wants to know more about taking care of Autistic guys
who are at the high end of the spectrum like me, I say never give up on your dreams
and always go for the golden goal.
Good job, great.
Well keep up the good work.
You are doing fantastic
Because we've gone up down up down up down with this boy
I know, we've had our ups and downs but this is a great place.
We're on the up
Well one of the things is every time he goes through a really bad down,
he comes out the other side better than he was before he went down.
So I often have hypothesized that it's like an electric wire or like neurons
that are trying to fuse and then they start short circuiting so it's really bad for a while
but then when it finally gets together you have a new pathway.
That's a great way to look at it.
And so I'm kind of wondering, you know, there's no way to prove that
but I've always kind of thought of it that way that okay the neurons are
just freaking out here try to bare with it and it can be tough.
It can be a tough tough challenge to get through those
but I think if other parents knew that that no matter how bad it gets,
when they come out the other side, they do seem to get better
and it's not just Andrew.
I've seen other children that do that.
If you can hang on to that thought because sometimes that's all you have
to get through it, well you know how desperate it got with us.
It was a tough time but look how awesome he is coming out the other side.
This is great.
If I show people, I took a video of him in Children's Hospital one time
when he had that huge relapse and if you compare that to this,
you wouldn't even believe it's the same child.
I know gosh.
If a doctor only knew Andrew from that incident, they would not recognize this child now.
Right, right.
I think this is the best I've ever seen you in here.
He is awesome!
Great, well thank you guys..
He's been maturing a lot.
He's really maturing and he's trying hard.
Thank you guys so much for coming and doing this.
I really appreciate it.
We had fun huh?
And you guys have a great weekend okay?
Okay.