Last year at this time I experienced some of the longest seconds of my life as I watched Nani slip and fall down our deck stairs. It was one of those horrifying slow motion moments. I can still hear the sound of her head hitting the exposed aggregate concrete pad below.

Nani has made an almost 100% recovery. The long-term damage is minimal all things considered. (Minimal if you don’t care if you get any sleep…her post concussive syndrome has resulted in even more frequent “nocturnal awakenings”). But seriously, she is mostly back to her old self and I am delighted and so very grateful to God.

Emergency situations are surreal for everyone, but autism can make the experience take on the feeling of a Saturday Night Live skit. It’s not just an emergency, it’s an emergency involving a person with some very unusual behaviors and quirks, with the need for some very unusual accommodations for those quirks.

Right now several of my friends and relatives are thinking I am referring to myself. And…perhaps I should be because I seem to have a knack for adding to the bizarre aspects of these events. I’ve also come to enjoy watching the responses of people I call “the uninitiated”, the people who are about to be brought into the world of Nani. So even in the midst of trauma I have a tongue in cheek inner dialogue going on in my head.

The whole event started with Nani swinging outside and it beginning to rain. (Remember rain?)  I went out to walk her inside. Holding her hand and leading her up the stairs, she drops one of the many small items she carries at all times. This odd assortment of things are as precious as fingers to Nani, dropping one elicits an immediate search and recovery response from her. She pulls her hand away and turns quickly, the stairs are wet and slippery, before I can react she is slipping and tumbling down the stairs. Horrified by the sight, I am also very aware that autism is about to make this a very unorthodox  and more difficult emergency.

After the fall Amanda lay absolutely still, face down. I was kneeling beside her knowing not to move her, but wondering if I could leave her long enough to get a phone. After 15 seconds or so she turns over, slowly stands up and begins to try to walk around. Does she understand might have a neck or spinal injury? NO! 
(My inner dialogue says clearly we need to do some work on her giving some thought to long-term consequences.)

I’m supporting her while she wanders and trying to assess her at the same time. She’s disoriented, unsteady, un-cooperative. 
(NOT a new symptom)
But oddly, very calm. (NEW symptom!) 
For a few minutes we are wandering around the back yard, blood streaming down her face, and from her nose and mouth. It’s raining, we are soaked. Finally, she allows me to lead her into the house. Once inside, she wants to lead again but I need a phone! After a few minutes I manage to grab a phone on one of our passes through the kitchen.

We’re walking, I’m still supporting her, trying to brainstorm on how to get her off her feet, and talking to EMS. While I’m on the phone to EMS, I get the idea to put her in the car because she’d feel safe there, would be seated and strapped in, wouldn’t fall again if she blacked out again or went into a seizure. It would be a good environment for EMS to take a look at her. Nani loves the car. It was brilliant.

EMS dispatch thought this was a bad idea, wanted me to encourage her lay on her bed.  I explain there is no chance she is going to do that. Again the dispatcher stresses that I need to encourage her to lay down. I assure the dispatcher that no amount of encouragement is going to get Nani prone. (Note to self: remember to teach Amanda about emergency treatment protocols for shock).

Into the car she goes.

Fire and EMS arrive in a minute or so. I explain her disabling conditions. They wanted to know if I thought she was in an altered state.  I explain that the very fact that Nani is letting them anywhere near her is clearly a sign of an altered state.

It’s quickly clear that she needs transport. EMS want to know whether I think she’ll get on a gurney and go into the ambulance. (I refrain from looking around and saying, “Oh, I didn’t realize you brought the national guard with you!) Instead, I explain that due to Nani’s  high anxiety level regarding medical care, all her exams take place under general anesthesia, and an anesthesia team sedates her in the parking lot her just to get her into the hospital. So no… she is not going to get on a gurney and ride in the ambulance without major sedation, altered state or not.

We talk for a moment about what sedatives work for her, EMS goes back to the ambulance to get a sedative. It’s still raining, I’m standing outside the car with 3 firemen who turn and look at me, glance down at my clothes.  One says, “Ummm, do you want to go get ready to go to the hospital? Maybe change your clothes?”  They seem a little awkward, but there is no time to ponder that. It’s a good idea, I’m sopping wet head to toe.

Once I’m inside I realize it was a REALLY good idea. I had been wearing a light weight WHITE linen shirt and pants, nude bra and panties. But thanks to the rain, NOW I am wearing a very sexy number which, except for all the blood camouflage pattern that Nani provided me, looks like I might have just come from a wet t-shirt contest. This I feared could lead them to question my understanding of reality.

The awkwardness is now making sense. Judging from the looks on their faces there really is no chance that I will one day be referred to as a cougar. One more dream dashed!

It’s funny the things you can learn during times of crisis.

 

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