Michelle

Jack has complex medical needs: Lennox-Gastaut syndrome (childhood epileptic encephalopathy), Arachhnoid Cyst, Chronic lung disease, Scoliosis, gastroesophageal reflux disease (GERD) and he is oxygen dependent. His parents have trained and do a lot of his therapies at home and are greatly supported by the community and hospital teams looking after Jack.

In 2014 Jack was seriously ill with influenza and spent three weeks in the Intensive Care Unit (ICU). Six months after the influenza episode things are still settling down; his liver function tests are still abnormal and his blood pressure continues to be lower than before the flu episode.

Jack, aged 11 has complex medical conditions. At the age of seven he was diagnosed with Lennox-Gastaut syndrome (childhood epileptic encephalopathy). Previous to that, when he was five months old he was diagnosed with West syndrome or infantile spams and Arachhnoid Cyst for which he had neurosurgery twice. His West syndrome is controlled with medication. For about seven years he was on the Ketogenic diet but developed gastroesophageal reflux disease (GERD). He also has chronic lung disease, Scoliosis and is O2 dependent.

By the age of ten he had his first chest infection and after that he had pneumonia and he was left oxygen-dependent. And for the next eighteen months he was in and out of the hospital with chest infections, rhinovirus infections and pseudomonas pneumonia. After the bout of infections, he was put on a jejunostomy feeding tube. He now has his gastrostomy for his medications and all his feeds are down his jejunostomy. Up to the age of five, Jack could eat orally and drink out of a bottle but all of a sudden, he lost his ability to swallow.

Jack has no speech and he is a non-walker but he can crawl and he sits up on his own. He has two sessions of chest physio every day, he has two hyperbolic nebs every day and he is on ALF overnight. Jack also has precocious puberty and for that he is on Zoladex implants.

Jack’s parents trained to do the chest physio, the nasal suction, oral suction and his feeds. So a lot of the interventions he needs are done at home instead of in the hospital but they have good support from the community chest physio and community matron. They were also taught how to listen to his chest and have their own stethoscope.

Two years ago, since his second chest infection, Jack was started on antibiotics as a prophylactic treatment – 7.5 ml of azythromycin daily. He sometimes has needed stronger antibiotics to cope with infections that have cleared after a couple of weeks. His mother finds that Bio-Kult has helped him overcome the side-effects of antibiotics; colitis that leaves him lactose intolerant.

In Christmas 2014, Jack became ill developing high temperature, sleepy and was not breathing well and struggling to cough. Michelle started him on dry antibiotics augmentin, which is the first line for at home treatment of bacterial infections. But the following day Michelle took him to A&E to get a second opinion because she knew that he wasn’t right’. The consultant admitted Jack straightaway and when the results from the sputum sample came back it showed it was influenza. Jack went on to developed life threatening complications and he was in ICU for three weeks. He was treated with Piptaz.

Jack’s parents have great support from the healthcare teams that have attended to Jack’s complex care needs over the years, including consultants, the GP surgery, the community team, hospital nurses, surgeons, physios, paramedics and even the hospital porters. But Michelle experience with the registrar in A&E and a young consultant in ICU that Christmas of 2014 was far from positive. Michelle felt that the registrar thought she was exaggerating Jack’s symptoms, but luckily the consultant intervened and Jack was admitted. In ICU she encountered a young consultant that was not interested in listening to what she, as a parent, had to say and treating Jack’s complex medical needs by the book’. Michelle says that the ICU consultant’s attitude was of speaking at her rather than to her.

Michelle explains that influenza affected Jack’s liver and his blood pressure and had to take medication for both and it also affected his oxygen requirements. Six months after having influenza things are still settling down; his liver function tests are still abnormal and his blood pressure continues to be lower than before the flu episode.

Michelle and her husband’s attitude have been to treat Jack like any other normal boy. They have another son and treat them both the same. Until he developed influenza, Michelle said that he was quite a healthy little boy considering all his medical issues.

Michelle knows that Jack’s condition is unusual but wishes doctors would use the right words to describe the features of his illness

Age at interview 40

Gender Female

Michelle really appreciated the support she got from nurses, who told her to go home for a few hours to see her other child, when her son was in hospital over Christmas.

Age at interview 40

Gender Female

Michelle took Jack to Accident and Emergency with a high temperature (he developed respiratory failure). The consultant and chest physiotherapist said she did the right thing.

Age at interview 40

Gender Female

Jack usually needs a stronger antibiotic to treat his infections. On one occasion when he was prescribed amoxicillin, his consultant said it was, as useful as a chocolate teapot.

Age at interview 40

Gender Female

Jack has complex medical needs and takes a low dose of antibiotics every day. His consultant reassured Michele that they were necessary.

Age at interview 40

Gender Female

Michelle thought flu was like having a cold until her son Jack became seriously ill.

Age at interview 40

Gender Female

When Jack had flu he became very poorly very quickly.

Age at interview 40

Gender Female

Jack was seriously ill with flu-like illness and spent three weeks in intensive care. Six months later his liver function tests are still abnormal and his blood pressure is lower than before the flu episode.

Age at interview 40

Gender Female

The A&E consultant trusted Michelle’s instinct that Jack was very poorly and told the registrar to listen to Michelle and observe Jack. He was admitted to hospital as an inpatient.

Age at interview 40

Gender Female