First EEG

needs: Her first EEG.

I had a little nudge since my girl was 6 weeks old. She slept so much, but “you never wake a sleeping baby”, and she was so distracted but “she’s just dreamy” and then later, she was slow to roll, sit, walk but “they all get there in their own time”.  Every time she was out of step, I secretly yearned for the key that would unlock things for her. So, when her Marx brother’s paediatrician suggested she needed a brain scan, part of me was relieved. He gave me a bit of paper and said I would need it on the day and it fell into my mother-lawyer bag between a file and a bottle of bubbles. Dr Oddball said he would make the appointment and I would be contacted by the hospital. After hot chocolate, I took her to school and I went to work.

Busy family-work life distracted me for 3 weeks. We heard nothing, but that was back in the days where we believed no news was good news. I contacted the hospital. After some transferring and hanging up, I navigated my way to the right department. I learnt there was a long queue for an EEG and she wasn’t in the queue.  After googling EEG, I tried to call Dr. Groucho and was phone blocked by his gatekeeper. She adamantly insisted the request for EEG had been made 3 weeks before. I called the hospital again and they confirmed a request had not been made.  I called Dr Zeppo’s gatekeeper. She said to leave it with her. I thought I already had.  After I cooled off, I called the hospital to repeat the transferring and disconnections until it was confirmed the request had just been made. My gratitude swam down the phone. 2 hours of chasing and my girl was in the queue. With mission accomplished I was ready to hang up and barely caught the fact that there was a 3 month wait and even then, she could be bumped for emergent cases. For a second it seemed like I had spent a morning trying to get something, and once I got it, it moved out of reach.

Months passed, and the concerns that lead to an EEG request became more prominent because I couldn’t get her one. Finally, the day arrived. I grabbed her from school and drove to the hospital. I had 3 work calls to make before we got there so I was playing with her hands, driving and arguing about contracts. We slid into a park after my third lap of the car park. Pulling on her little hand while finding change, getting a ticket and bolting into the hospital was a means to an end. Until, she stopped at the door. I had overlooked that the test was in a hospital.  I realised I hadn’t told her what to expect. I tried to give her little facts while working out which lift, what corridor and following the pink floor lines. By the time we got to neurology, she was wary. The nurse beamed at my girl, who warmed up a little. I beamed back and was shut down pretty quick with a “You’re late, we were about to cancel.” I looked at my girl apologetically and she glared at me.

I handed in my crumpled bit of paper from Dr Harpo and after some waiting around a nurse showed us into a room with a hospital bed and we were told to wait.  We looked around the room. I was hungry for facts and she was scouring every corner. The walls were littered with stickers, mobiles, bears and movie posters.  There was nothing new. It was all old and sad and looked like the kind of things grandparents think kids will like and maybe they do, but not for not long enough to warrant sticking up. My problem-solving brain went into hyper drive. Why doesn’t a toy store or a movie distributor sponsor this place? I snapped back to the room, to her. Her eyes were shiny, and they skipped across her Disney friends, even the ones she had outgrown who were there waiting for her. 

A different nurse arrived and was organising things while asking a lot about her brother, school, pets (we should get one of those I thought) and my girl chatted back.  I could see she was not at ease but when the nurse explained the next step was sticking little metal buttons on to my girl’s scalp connecting her to wires that were connected to a machine, wonder spread accorss her face. It was confirmed that this would not hurt, and she ruffled with relived. My mind scattered to a dark place, an unwanted thought I was letting them to do this to her and I didn’t know what was coming.

That EEG went for a little over 60 minutes. She was exposed to strobe lights. She was asked to blow windmills to the point of hyperventilating. Her eyes darted to me, desperately as distress engulfed her. I didn’t know the aim was to create a perfect storm for seizures so they could be recorded. Suddenly, that part was done and without time to reflect the lights were turned out. Sleep readings were next and we were left alone to get her to sleep on command.  I let her suck her thumb and stroked her head. I whispered into the darkness until her little mouth gave way to her heavy exhale and her sleeping breathing wafted over the room. Once she was out, I twisted to put my head beside hers.  Tears flowed as I gazed at her, plugged into a machine, hopefully dreaming.

The lights were turned on. The buttons were efficiently removed and we could go. She was dazed and frayed at the edges. I was conscious they needed the room, and rushed to dress her uncooperative little body. She held my hand tightly and even though I hadn’t carried her in an age, I lifted her snug into my neck as we charged to the car. Tucked in, she fell asleep before I shifted into reverse and I had one of those silent driving cries. 

means: What I wish someone had told me about an EEG

Before the EEG

An EEG (electroencephalogram) is a medical test used to evaluate the electrical activity in the brain.

It is just a representation of the day the test was performed.

A single line in an EEG report can dictate a course medication, assessment or therapy. A single line in an EEG can produce a diagnosis, heaps of appointments, side effects, and questions. It can also give you peace, understanding and a plan.

In the public system, there is little opportunity to repeat an EEG, so make that day a priority. Private paediatric neuro testing is not as available as you would think. The best thing about the public system is that the children’s hospital is set up for kids.

Be brave and ask for a copy of the referral for the EEG so you can chase it up.

Follow up with your doctor’s gatekeeper straight after the appointment. She, it is always a she, will be the one to send it. Ask her when she usually sends it and offer to chase it up. This can prompt her to fax/email it while you wait. If it is a 3 month wait, let the time start.

Get to know the names and roles of the neurology team at the hospital. Collect snippets of direct lines, preferred emails and fax numbers to follow up the referral.

Diarise and follow up the request with kindness. There are lots of worried parents wanting EEG’s, and not all of them are kind.

Once you get a confirmed appointment or day:

Book a return appointment with the specialist to discuss the results. (Avoid waiting for the report, which is sitting at the referring doctor’s office who is yet to contact you with the results.)

Ask about the EEG process. Each hospital does it differently. Ask if there is anyone you could talk to prepare your child. Ask for time periods, room description, sleep requirements, snack requirements, and waiting periods on the day.  Questions like this often trigger contact with a play therapist. There are great departments in hospitals designed to assist kids through difficult experiences.

If they send you a handout, read it and call to fill the gaps. While you are calling, get the low down on parking, location, cost and distance.  This removes the avoidable mosquito bites stress of the day.

Week of:

Dial down the family calendar, get a yum dinner in and some family time.  It’s so good to put a big deposit in the nurturing bank before an EEG, for both the patient and the carer.

Pack a test bag. Snacks, treats, and distraction. Throw in a surprise. I always take a book because sometimes she wants to hear my voice and I am at a loss for what to say. Pack a familiar blanket and a beloved teddy for the sleep component. My girl’s pooh bear has had as many EEG’s as she has.

In the days before the test You Tube some videos of an EEG. Watch a few, as procedures change across hospitals.  There are lots of short videos made for and by kids.  This switched my girl from patient to expert.

The night before the instructions may require you keep them up really late and then wake them really early. For us, it was up until 11.00 and wake at 5.00pm. This is hard for everyone and the tiredness makes the aftermath more emotional.

On the day of the EEG

Clean hair, super squeaky, clean hair. Makes it easier for them to stick the bits on the scalp.

We wear our good luck clothes. Comfy light pyjama akin clothes.  I clear the whole day and arrange childcare. My beloved steps in as well. Its an all hands-on deck family day.

Take out or Frozen dinner is sorted.

Parking change and directions are ready to rock.

Get there super early, park, wander, take in the hospital and use the toilets.

Get to neurology early and check in with all the people you have called. Introduce your little one to them. These people could be helping you over the years.

In the room make sure you introduce everyone to your kid. Sometimes it is only one person. Sometimes it is more than one. They are busy but a name reminds them they are working with a little one and can slow the pace. Get your kid talking with the techs and nurses, repeating their names. If you establish communication quickly, your child may feel comfortable speaking up.

You won’t be able to hold, cuddle or tickle them during the test. For my tactile girl it is important I let her know and give her a good-bye cuddle. I assure her I will be in the room but leave pooh bear to do cuddles.

The dark side.  Our last one began with an easy round of eyes open-eyes close. Then your already sleep deprived kid, may have strobe lighting flashed close to their eyes, followed by using a happy windmill to foster hyperventilation before being asked to sleep on command before observation during waking up. As a parent this can be hard to watch.

When the test is over, ask about the process for the report.  There is another queue here and the report is the goal. Confirm how long it normally takes and request they send a copy to your GP and the referring specialist with a business card for each. Confirm when you are seeing your specialist, you know that appointment you made? The response is usually “they will have the report by then”.

You can ask for the report (because really you can ask for anything) and they can give it to you. Despite hospital policy, sometimes when you ask, you will get it.

Before you leave, thank thank thank these guys.  It is important to acknowledge their role. My girl went through a stage of making friendship bands. That is her way, leaving kindness everywhere.

After the EEG

Leave the test with purpose. You and your little one, have plans. Have a test day ritual. It doesn’t have to be Luna Park. It can be a song, a particular salted caramel éclair, a hot wheels car, a bunch of flowers. Have something that says “I’m sorry this happens to you, and you did a good job”. Have it ready. You can’t go shopping after, you are going home.

They will tell you an EEG has no side effects. Seriously, at the very least lack of sleep causes some gross side effects in a family.  We notice she can be hung over. The combination of nerves, strobe lighting and sleep deprivation takes its toll. We plan for doona island. All the doonas in the house, on the couch, all the family and Star Wars. Somewhere between Tatooine and the Daygobah System, sleeping breathing kicks in and it feels like us again.

tools:

at the point of referral:

  1. ask your doctor’s gatekeeper when she is sending the referral and for a copy
  2. follow up referral with the Hospital
  3. make note of the Department and direct line
  4. diarise to follow up weekly

once you have an appointment or confirmed day:

  1. book a return appointment with your specialist
  2. ask the Hospital about the arrival time and the process. If they don’t offer, ask for a handout

the week of your eeg:

  1. keep family calendar light
  2. pack a test bag with your dude: snacks, comfort, diversion.
  3. YouTube an eeg for kids

the day of your eeg – before:

  1. squeaky clean hair and good luck comfy clothes
  2. take-out or frozen family dinner
  3. parking and directions sorted
  4. early arrival to navigate the area and find the toilet
  5. introduce your dude to everyone involved

the day of your eeg – after:

  1. ask about the report process
  2. tell them when your specialist is seeing you and provide their business card
  3. ask for a copy of the report- just in case you get lucky
  4. be thankful, really really thankful

After your eeg:

  1. treat time, for you and your dude
  2. future proofed family night of rancho relaxo

First psych assessment

needs: Her first clinical psych assessment

Diagnosis was the beginning. What followed was a series of assessments to determine the best way forward.  For us it was blood work, an EEG, an MRI, clinical psychological testing, occupational therapy, auditory processing and speech therapy. It was expensive and time consuming. Much of our energy was spent on scheduling, traffic time and parking. It meant more school absences when she was already behind academically and socially, separation for her brother and pressure at work for her parents. 

For a period of about 5 months we were taking her to unfamiliar places, with strangers, who pushed her beyond her comfort zone. The assessments were – Repetitive. Targeted. Spotlights. Designed to test her until the point of failure. Some tests stop when there are consecutive wrong answers, making inability and weakness the goal.  With each appointment there was less of her, and more of a patient. Assessments are kryptonite to a family’s means and needs. So why do them?

We did them because we were told to.  That’s the rule follower I was then. We put her through multiple assessments because we were lost and the diagnosis came with a road map that led us there. The first clinical psych assessment embossed the part of me that connects my heart and brain. I trusted a professional with the care of my girl and he was deficient in a way that watermarked my mothering. Now I have my own roadmap.

Being sent to a clinical psych was a bit of a shock for me. I honestly didn’t know what they did and assumed that at 5 I had a little longer to completely mess her up before she needed therapy. I think a lot of people feel this way because the late book at school usually says “appointment” but if its braces it says “orthodontist”. We were told this clinical psych was good because “he could do the auditory stuff as well”.  Convenience really shouldn’t have been a concern for us. My beloved confessed the phone call didn’t give him a good feel but we didn’t act on that. We knew it would be around $600 and we would “get some back later”.  We had an address and knew it would take a whole day. This is where I wow you with the questions we asked and the research we did, but we didn’t.

She was pretty excited about having a day out of school and spending a day with her mum. We drove across town, singing and chatty. This is the part where I could wow you with the careful preparation I did with her but I didn’t. Traffic was shitty and we were in a part of town I never liked as a teenager so it made me gloomy to cross into territory melancholia. Parking was a freaking nightmare and by the time we got in there I was glowing with sweat stress, dragging my angel behind me.

We met the old gruff bastard.  Believe me, they are the kind words I use to describe him 7 years on. He showed us into his crappy room where he had obviously reserved the one without natural light and set it up with a range of old furniture for adults. He showed me to a seat outside his door reminiscent of the principal’s office that had the added bonus of being beside the toilet. He sat our 5-year-old girl on the wrong side of an adult desk with her legs hanging off an old chair, for 6 hours of testing. This is where I impress you with my advocacy and tell you how I didn’t let a stranger take my girl into a room and close the door, but I didn’t.

After 2 hours he opened the door and she came out.  She was smaller.  He muttered about a break.  We cracked the lunch box while he stood over me talking about his qualifications. One thing I have learnt is the specialists with super powers don’t need to tell you about it because a thousand other people have and you had to donate a kidney to get an appointment. My girl and I shared a cuddle and he took her back in.

Two hours later, the door opened. She was smaller still. I had begun texting my beloved crazy shit. I had alarm bells ringing but I was frozen. More muttering about a break for lunch. This is where I could tell you I took her to a nearby park and gave her some fresh air and got her legs moving with some climbing before we had cuddles on a blanket and found animals in puffy white clouds, but I didn’t.

We sat on the chairs outside his office and she moved through her lunch box. My girl was sad but didn’t want to offend him. She whispered without words, desperate sounds. I was only catching threads about ‘not getting things right’ and ‘he was grumpy’ and she ‘couldn’t reach the desk’. And yet the shit show went on, the break was over and she was back in there. It was 24 hours too late to google things like “how to find a good clinical psych” but I did.

After the last two-hour session, he invited me in.  I was braced for the bad news, because I couldn’t imagine this man saying anything good. As she buried herself under my arm, he sprayed words like “abnormal, unsatisfactory, out of range, serious concerns” with authority. I nodded and she soaked it all in. This is where I tell you how I cut him off and indicated I would wait until I read his report, but I didn’t. He referred to his forthcoming report and its many recommendations. I already knew there was nothing in it for us. He asked me for $600 and I gave it to him. This is where I pray she doesn’t remember the day I took her to a dickhead, who made her feel less than who she is, and paid him for the abuse.

We got to the front door and she made a run for it. For the first time, she ran on to the road. And do I blame her?  I scooped her up and we walked into a bakery. I bought her the largest gooiest piece of sugar that desperation can buy and she wolfed it.  Next door I bought her a blue and white striped dress that she would never wear. I peeled the parking ticket off my car and she fell asleep as I called my beloved and cried. 

means: What I wish someone had told me about a Psych Assessment

What is it?

Having graduated from the medical school of Grey’s Anatomy, I was really out of my depth with the Psych assessment. My beloved and I were surprised to think our 5-year-old needed to see a psych.

Straight facts:

Either a doctor or a teacher will ask for the assessment.

There are lots of Psych tests.

The point of inquiry, the thing your doctor or teacher wants to understand – intelligence, behaviour, learning blocks, memory, information acquisition, concentration will determine which test is used.

The Psych will refer to the test with letters.  Google later.

For a good overview from a reliable source: Women’s and Children’s Health Network. https://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=122&id=2942

For Grown-ups

Research your specialist.  It takes 5 minutes to google a name and see if a mum has reviewed the specialist. Ask your referring doctor if the Psych is good with kids. How an assessment is conducted can impact the result, the report and most importantly the child.

Have a pre-assessment call or email and ask the 5: 1. Where will it take place?  2. How long will it go for? 3. Are you set up for kids? 4. Is there parking? 5. What is the cost and the reference number for Medicare/Private health? A good specialist will shoot through a pre-prepared document.

Get on line and check Medicare and your private health cover if you have it. Being free to support your child, means that you are not under financial stress.

Confirm the assessment the day before. It can avoid a missed school day by making sure the assessment is going ahead and often confirming the appointment ensures that it does.

For Little ones

Have a bath time or bedtime chat about an upcoming assessment and explain that these tests are for all the people in the world, and there will be lots of questions lots of people can’t answer. Delve into the idea that mistakes and errors are where we find the diamonds, where learning begins. This is the same for any school test, that feeling of not knowing something, as uncomfortable as it is, we can learn to recognise it as the first feeling towards learning something.

Take sustaining snacks that help focus. Bananas, nuts if it won’t kill them and dried fruit. Water, water, water….and something from the treat box. This was a shit deal. They should get a reward.

Take UNO, because it’s the best, and if you can’t get out and have a walk during a break out time, a quick game of UNO can always take them to the familiar and safe.

If there is going to be a discussion about preliminary findings hook them up to a device. They don’t need to hear that they are out of range, it already follows them around at school. If you cannot secure distraction make a phone appointment for the next morning.

Later that day

Meltdown or dial it down. In all likelihood the assessment will fry them so expect some mental, physical and emotional responses. Decompress from the day with comfort food, long baths, cuddle time and lots of stories.

My beloved wanted to know every detail. I couldn’t talk about it.  So, have your treat lined up. I’m talking about distraction and comfort. I have a friend who retreats to Twilight and another who finds wine and Gossip Girl is her jam. Feed yourself in a way that refuels your ability to tackle this stuff head on. I stand in a hot shower, cry a little, lean against the tiles and I know when it is time to get out and get on. That’s my means.

Evaluate the specialist and the process so that when that report arrives, you see it in context. If you don’t think the report reflects your child, you don’t have to show that report to anyone. We didn’t.

Finally, 7 years on, we have our routine, an assessment isn’t the focus of a week, it’s just something that happens on a Wednesday before her brother has Taekwondo.

tools: Assessment checklist

  • Research specialist
  • Pre-assessment call to specialist: Could you please tell me a little about…
    • the assessment and your process?
    • how long will it take?
    • can you please confirm the cost and reference numbers for Medicare/Private Health?
    • what is your address (google directions)?
    • can you recommend parking?
  • Contact Medicare/Private Health
  • Confirm Assessment day before
  • Cover process with the child
  • Game day bag:
    • Paper and pen
    • Snacks
    • Games
    • Device
  • Dinner
  • Chillax plan