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Wednesday, 5 October 2016

Free Gift

On August 3rd I went to my son's to take him to a nurses appointment. It was the summer holidays, but I must help care for him despite having both my daughters at home. As per usual I arrive several hours before we need to leave for appointments, this is because my son is often in a deep drug induced sleep, or if no drugs were taken he is often up until the morning so again in a deep sleep, and then once awake he is then anxious. I need to allow plenty of time to rouse him and then he needs plenty of time to prepare himself to go outside.

This day started off as any other. I told my daughters I would be gone for several hours and made sure they understood that they would need to let the dog out regularly, make themselves lunch or go and get some chips if they like (french fries for my American readers). I left them a few pounds and left expecting to return and then pack to go away for a few days with my daughters to the seaside. My son was not answering his phone, so I knew he was asleep and I would need to wake him up. Also as usual, I parked at his local Tesco's and stopped in for a few standard thing; doughnuts, bread, ham, cheese, tomatoes, bananas, so he could eat something before we left.

I got there and he was asleep as expected, in his chair with his computer keyboard still in his hands.. I tried to say hello, but knew I would not get a response. I went around his flat assessing the mess and work I needed to do on my next visit. I put the shopping away and went back to try to nudge him awake. His post arrived and it was a long red envelop with his address handwritten on it which looked very similar to his Granny's writing. I said to my son, "Oh, look, it looks like you got a card from Granny and Granddad, and it s a bit thick, perhaps they sent you some money to help you out." That evoked some interest and he even managed to ask if the Valium he had ordered had arrived. It had not and he was disappointed as he had no benzos at home for a few days now. He did start to move about in his chair. I thought I would open the "card" and if indeed there was any cash inside, that might help him to focus on waking up as he was broke. I opened it and sadly discovered it was not a greeting card from his grandparents but some drugs. It was not his Valium however. I told him and showed him as he began to come around now. Eventually when he was fully awake he told me that it was his free gift, his free sample, from the seller who he had purchased the Valium from. It was a small amount of Butyr-Fentanyl, but he wanted his Valium instead.    

                      "Butyr-fentanyl or butyrylfentanyl is a potent short-acting synthetic opioid analgesic drug. It is an                         analogue of fentanyl with around one quarter the potency of fentanyl. Wikipedia"

                        "Fentanyl (also known as fentanil) is a potent, synthetic opioid pain medication with a                            rapid onset and short duration of action.[6] It is a strong agonist at the μ-                                                  opioid receptors. Fentanyl is estimated to have about 80 times the                           
                         potency of morphine."  

He looked at it and was surprised how much he got and said, "shit that is more than I expected, that is even to kill a few people if they aren't careful!" So I asked him what it was and he told me and I even wrote it down for myself so I could research it later. Time was getting on though and my son needed to get ready. He was stressed and anxious and on edge because he did not have any benzos for a few days and was worried how he was going to manage going out to the nurse without it. I reminded him of the time and also told him that he has his first meeting with his new drug worker tomorrow and asked if I should come over early tomorrow to clean up , but leave before his worker arrived. These comments and questions were causing him some anxiety, I could see. He then received a phone call from a worker of his supported housing asking if they could meet up tomorrow morning to discuss any debts my son has. He was visibly agitated during the phone call and possibly even mildly aggressive, which I understood was a consequence of the uncomfortableness of the phone call. I also started to become stressed that this call was delaying us from leaving for his appointment.

My son's agitation grew with the minutes, the minutes that were quickly passing and I was worried we would miss another appointment which he could not afford to miss. The stress levels were rising and my son was pissed he had nothing to calm him, He resigned himself though to that fact that we would be late if he didn't start getting ready, so since he was just in a t shirt and pyjama bottoms, he asked me to go into the other room while he put his boxers and trousers on. I did and sat down. A minute later I heard the click of his lighter. I loudly said, "are you getting ready, or smoking your pipe?" I heard no answer so went in and saw my son slumped over in his chair, a familiar sight I have seen many times before, that is what I walked into earlier as a matter of fact. I started to walk over to him and could see something was different.

And before I go on, let me stress to you that the time that passed from me leaving the room to going back in and walking over to my son was no more than 5 minutes.

This is when my world changed and time stood still.

I went over to my son and he looked very pale, his lips were slightly blue, and he could not be roused. I shook him, slapped him, shouted at him, felt for a pulse....something was very wrong and my heart sank. Strangely enough I walked across the hall very calmly and asked the office to phone 999 because something was very wrong, I walked back to my son and punched him in the chest, over and over again crying. He could not die! He could not die! He was not allowed to die! No this isn't happening! I was crying and I dragged him off his chair unto the floor. By then the staff member was with me and talking to 999. I was not sure what to do, I was asking out loud, "should I do CPR, what do I do?" I was asking no one but I had to shout out my thoughts. I began CPR, the staff told me to put him in the recovery position, the 999 operator told her no, to continue with CPR. What was happening? This was not happening? My son looked like an angel, he looked dead, he looked helpless, he loved like a little boy, he looked like an overdose victim, he looked so sad. I looked at him, he was my world, like all my children are. NO! He CAN NOT DIE!!! NO! He WILL NOT DIE! I was shouting his name, I was crying I was counting my compression. His jaw was locked and it was hard to open it to breath in. Was that because he was already dead? Is that why? What am I doing? I don't know. As the staff member spoke on the phone, she excited said, "oh, he is making noise", as if that was a good thing because she probably naively though he was coming around. I knew different. It was the death gurgle and I knew I was very close to losing him FOREVER! NOOOOOOO, it can not happen. More compressions, more counting, more hoping, more crying. I was no on the phone with the 999 operator and she was counting compressions with me and assuring me I was doing a great job. I was loudly sobbing and saying "no, no, no" and "please, please, please" He can not go!!!! More gurgles, louder cries of desperation. Continue compressions, don't stop, keep repeating his name, let him know I am there he he must stay with me. Roughly 10 minutes later the paramedics came.

I stepped aside and let them work on my son. I informed him on his drug history and told them what he took and that he smoked it. They intubated him and started breathing for him. There were 2 paramedics, 2 staff members, myself all huddled around my son in his small and extremely messy room. Everyone was talking and I was telling him as much as I could to help and still shouting out my sons name from time to time. I heard that the air ambulance was called, and they were waiting for a second unit. One paramedic was trying desperately and failing to access a vein so that she could inject my son with naloxone.

Soon the next ambulance arrived and more paramedics were on the seen and I can remember one rummaging around my son's flat and came into the bedroom "Sharps box, he is a user",(meaning a heroin user) I interjected that he is not a heroin addict but does inject benzos irregularly. I kept saying that he smoked some butyr fentanly and that is what he overdosed on and he is no longer a regular opiate user. Finally they succeeded with injecting my son with the Naloxone but to no avail. Another injection was giving and still nothing. Now two doctors from the air ambulance arrived in their special suits and began working on my son and talking to him and I just stood there when all of a sudden I saw my son come around. I remember looking at the clock and thinking in fear that it had taken 45 minutes to bring my son around! Surprisingly I was very calm from the moment the first ambulance arrived, my tears stopped and I was very focused and I suppose I put all my faith in them that he will survive this!

When he came around I noticed they had already taken the air tube out of him, I hadn't even seen them do it! He was coughing and was groggy and confused and then immediately started to freak out. This is a common reaction to the drug they use to stop the opiate overdose, Naloxone. I have heard stories of how angry and aggressive many OD patients can be as a result of this drug. It is because of how the brain receptors work and because it blocks opiate receptors and endorphins. All pleasure receptors are shut down.

From here things are somewhat blurry because my son's anger made me very sad and the tears began again. Though I was so relieved that he was alive, he was being aggressive and shouting and swearing at me and blaming me. The paramedics were throwing things around in the room in order to create space to take my son out on the stretcher. The doctors were trying to get a needle in him for any further intravenous medication and this made my son freak out and start shouting at the doctors and they had to restrain him because he was refusing. I was crying and unsure what was happening. Would I come with him, will I stay here, what will I do with my daughters who were waiting for me and expecting to be going a a short caravan break that day? What do I do with the drugs in his flat? The mess? When will he come back. Will the staff speak to me and want to demand answers? Will the police be called? My son was shouting at me to stay in the flat because he was not going to prison? His thoughts were irrational and filled with fear. His main fear was that the doctors and or staff would phone the police that he had overdosed on a Class A drug and therefore was in possession of it and that would warrant the police coming to search his flat and arresting him for the drug he only consumed a very small portion of! It was chaos in every sense of the word!

As they boarded my son onto the ambulance and it was clear I was not going with him, one of the doctors took me to the side and rubbed my shoulder telling me that I did a great job and I kept him alive. She also said that she knows how upsetting it is because with an opiate overdose the person immediately looks dead. She wanted to make sure that I seek out some help or have someone to talk to because it is a traumatic experience and I need to make sure I am ok, but again told me that I did a great job!

They left and I was left there feeling numb. I was numb and on auto pilot all day, the reality did not hit me again until the following day. I am feeling all the emotions surge through me once again and it was indeed the most traumatic event of my life that I am still suffering from flashbacks and will randomly burst into tears. So bearing this in mind, I will write my next post on the after math.

My son finally did what I have always feared, overdosed. All that I have to say now is that I am so glad he did it while I was there and I was able to help him, otherwise I would have seen my son buried.  Gladly I have not had to bury him and he is ALIVE and I intnd to help him stay that way for a very long time!