We are going through a particularly taxing stretch with Anthony. Part of it is with him directly, and part of it involves him but is indirect.

The latter has to do with his daily service provider who, as I have mentioned before, is the only choice we have now because of Anthony's propensity to occasionally hurt people. Due, I suppose, to what appears to be a high rate of employee turnover (which I can't fault because it's not a job I would do myself), there are some aspects of the quality of attention given to Anthony that affect us here at home. One is that it is unusual to see him come home without a change of clothes due to wetting himself--sometimes twice in one day. It's quite rare for Anthony to wet himself here at home, and we have told the service provider what we do to get him to go to the bathroom, but we're to the point of giving up on hoping for a change.

The other issue affecting us is having some of Anthony's clothing not return home with him. Some of it is underwear; we have been baffled as to why we never seem to have underwear for him to wear and have to keep buying it. Worse than that was a coat he recently wore. We would have thought that there was a designated place for a person's coat to be hung upon arriving, but perhaps not because it didn't come back. We were grateful a couple of weeks later (after considerable badgering from us) that someone finally found it. As with many of his clothing items, we bought it at a thrift store, but I had felt lucky to find a coat there that I thought met Anthony's needs well and wasn't looking forward to trying to replace it (or spending more money to do so.)

The problems directly related to Anthony are even more difficult for us. I have written before that he takes pleasure in ripping things, and lately that has come around again to clothing, but now it's at night when he is in bed. He'll rip off his undershirt (from under his pajama top), undershorts, and pajama pants. Sometimes it's his pajama top as well, so there is almost always at least part of him bare. As it takes me a while to go to sleep, the ripping sound jolts me if I am not quite asleep, or wakes me up if I am; either way, I get up to attend to him. I had a couple of days recently where it was quite difficult to function at work due to being awakened by him in the middle of the night.

Anthony currently goes after his service provider hours with a terrific lady and her family because our work schedules are such that neither I nor my wife are available to watch him for another couple of hours. But I am suspecting that the length of time each day without being at home and a regular routine has something to do with his issues. As such, we are trying to shorten the time he is out, and we try to get him on the treadmill here at home to give him the sufficient exercise that he might not be getting otherwise.

I have also been wondering with the increasing severity of his problems if something were changing in his brain or if he were no longer responding to his current medication mix, and one or both of those appears to have been confirmed in the last few days with the report that he had a seizure at his service provider. It's been three-and-a-half years since the previous occurrence, and one of his medications was specifically designed to prevent them from happening. With this new development, we're going to try to schedule a visit to the neurologist as quickly as we can.

But I keep coming back to the idea that things would be better for him (and us) if we could keep him home. Of course, if that were easily done, I might not be writing this post at all.

A constant issue for us with Anthony is the need to monitor him virtually all the time.  If there is food he wants to eat (that he knows he shouldn't), he will eat it. If there is something he can rip, he will rip it. If there is something that can be broken or snapped, he will break or snap it. Unfortunately, that last obsession has recently come to include razor cartridges.

For Anthony, I have gotten a handle-and-cartridge kit from Walmart. He snapped so many purely disposable razors that I had to go upmarket a bit with him. Now when he snaps the cartridge off, it doesn't actually break, and I can snap it back on. But the problem is worse for my razors.

I have settled on Harry's® razors as the best balance of price and effectiveness for myself. But Anthony has gotten increasingly aggressive recently about going after razors, including mine, and when he snaps off the cartridge, the design is such that he actually breaks it and renders it unusable. I have thought about contacting Harry's to try to persuade them to change the design, but I can't imagine the demographic of parents with autistic kids breaking their products being worth the likely-sizable investment necessary to re-tool the razor cartridge molds.

Gratefully, Harry's are now sold in some physical stores in addition to the mail subscription I have, so I can go buy more before the next scheduled shipment. But, beyond the aggravation and extra cost is of course the extreme worry that Anthony is going to badly cut himself--I'm amazed it hasn't yet happened.

I believe I have mentioned that we don't usually stay with him while he's in the bathroom; if he needs to have a bowel movement it's rather unlikely to happen without leaving him alone. But we do leave the door open so we can hear what he's doing. Generally the worst is that he will get into the trash to pull out a toilet paper core to rip. However, it has also usually been at those times that he gets up and grabs razors from the shower shelf.

Recently, though, he surprised my wife by suddenly heading to the bathroom and grabbing the razors before she could get to him. He's uncharacteristically fast when he wants to be.

So, my wife has hidden my razor behind her shampoos and conditioners. I fear it's a temporary solution and that he will figure out in short order its location.

That is, unless he's already aware and is again biding his time to bolt into action when he thinks he can't be stopped.

Anthony recently "aged out" of the public school system (he had to leave at the end of the calendar year rather than stay until the school year was over), so we have had to find a service provider for him during the day when both my wife and I are working. That's something of a tall order for us, as we've had a number of places refuse him because of his ability to hurt people when he's upset. And already with this new provider--less than a month with them--it took three people to restrain Anthony after he head-butted a fourth member of the staff there. When I heard about it, I suspected that he needed to have a bowel movement, and that turned out to be the case at home.

He has certainly had a number of these incidents at his previous school; most of what Anthony does goes unwritten here because this blog isn't meant as a comprehensive "web log" as much as it is about highlighting new issues without being redundant. But the school staff knew him well and had a general idea of what to expect. We have found that, even though we are specific from the start about the danger with Anthony, it seems each organization has to see it first hand to truly appreciate what we have told them.

In that sense, this is a re-hashing of something I wrote a few years ago after he sent a staffer to the hospital and we were then told they could no longer take him, though they had initially assured us they could handle him even with our cautioning. The difference now is that we are quickly running out of options.

Another recent issue is a morphing of an intermittent problem. We have more than enough of most kinds of clothes for him thanks to the past generosity of people at church, but lately he has started ripping his coats. I am sure that some of this is due to the change in his routine, not being at school, and being with two different service providers (one until 2:00pm and another after that into late afternoon) each day; I believe he has lost the sense of obligation to forbear doing something that provides stimulus to him. Whatever the reason, it's more serious for us than ripping shirts or pants (which he still does); it isn't as common for people to have spare coats hanging around at home as it is for other clothes that have fallen into disuse.

He had a new coat to replace a medium-weight jacket that had lost the use of its zipper. He ripped that in fairly short order, so I went to the thrift store and got him another. That lasted one day. He went back to wearing the one without the working zipper, but then ripped that as well recently. Not wanting to take a chance with his heavy winter coat, I went again to the thrift store and thought myself quite lucky to find a surprisingly decent leather jacket for $10.

As he has been destroying his coats while in the car with his second service provider in the afternoon, I informed her of this new jacket (that I hoped would be much more difficult to rip) and asked her to take it off him and put it somewhere he couldn't easily reach it. But it turned out that he tore apart this new one, sturdy leather and all, at his first service provider, the same day he head-butted one of the staff there.

Ultimately, I know that both problems would be solved if we could keep him home. It seems like a simple thing, but I'm pretty certain that Anthony prefers to be with us. Likely because we understand him better, his behavior is better with us whether it is at home or taking him outside to run errands. And I do like taking him with me to go places as long as he isn't in a questionable mood. Because he doesn't speak and it's difficult to tell exactly how he feels, my relationship with him isn't the same as what I have with my other two kids, but there's still something of a quiet joy to it that I would be happy to have more often.

On another note, I have felt for several years that I needed to write a book about Anthony once he was out of childhood, and that time is now here. This has been the plan while acknowledging the unlikelihood of such a book finding an audience of any particular size. If, however, the planets somehow align and it ends up on a book club reading list or two, that just might be enough to give me the freedom to venture into another line of work that allows me to keep Anthony home. Here, then, is to inexplicable celestial phenomena!