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ā€˜I donā€™t do the wee danceā€™

A last minute loss of guest prompts chats about change and medical matters.

When parking-related overwhelm means their guest canā€™t take part, Robyn and Jamie discuss how they manage sudden change.

A cafe closure complicates Jamieā€™s daily life. Robyn rethinks her living situation to get more help. And the conversation turns to how some autistic people struggle with knowing whatā€™s wrong when theyā€™re unwell.

With Robyn Steward and support bat Henry, Jamie Knight and Lion.

Produced by Emma Tracey

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Email stim@bbc.co.uk

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33 minutes

Transcript

This is a full transcript of the 1800 Seconds on Autism podcast as released on 7 May 2020 and presented by Robyn Steward and JAMIE Knight.
[JINGLE - Ā鶹¹ŁĶųŹ×Ņ³ČėæŚ Sounds: music, radio, podcasts. 1800 Seconds on Autism with Robyn Steward and Jamie Knight.
JAMIE - I donā€™t do a wee dance, I just go, ā€œI need a wee!ā€ with no warning whatsoever.Ā 
EMMA - Right, so you donā€™t get that, I mean thereā€™s a really obvious wee feeling?
ROBYN - Hello, this is 1800 Seconds on Autism, a podcast about autistic life. Iā€™m Robyn Steward.
JAMIE - And Iā€™m Jamie Knight. This show went a bit wrong due to a very legitimate autism matter: our guest couldnā€™t take part. In fact it was so last minute that Robyn and I were already in front of our microphones when it all changed.
ROBYN - Youā€™re probably thinking Iā€™ve heard autistic people hate change. Well, me and Jamie arenā€™t always big fans of change, but we came up with a plan and it worked. And later in the episode we will be talking about whether we can tell if weā€™re ill, and what not to do to Jamie in a hospital ā€“ thatā€™s a bit about getting poked by a doctor. Letā€™s begin with our producer, Emma, telling us the bad news about the programme changes.
EMMA - Okay, Robyn, Jamie, weā€™ve had a change of plan: the guest we were going to have weā€™re now not going to have, so things have kind of gone out the window. What should we do now?
JAMIE - We think we should do a podcast about change, and we will do an impromptu podcast about situations that cause lots of change, and weā€™ll make it up as we go along.Ā 
EMMA - I mean, this has thrown me this change.Ā 
JAMIE - Oh, weā€™re chilled. When I come for a podcast Iā€™m expecting to sit in a chair for a few hours and talk. Iā€™m going to still sit in a chair for a few hours and talk. Shall we do one of those traditional hello and welcome to the show bits?Ā 
ROBYN - Oh yeah.Ā 
JAMIE - I can see the producers twitching.Ā 
ROBYN - Okay. Hi everybody, this is the changed edition of 1800 Seconds on Autism. Iā€™m Robyn.Ā 
JAMIE - And Iā€™m Jamie.
ROBYN - And weā€™ve got Lion.
JAMIE - Roar.
ROBYN - And Henry, the bat. Heā€™s a bit shy.
JAMIE - And we also have Ollie andā€¦
ROBYN - Louisa.
JAMIE - Louisa. We found out that the person wasnā€™t coming and we have started talking about topics that we know about that we donā€™t need to prepare for. And then we picked four topics; we then drew them out in boxes and we put little icons on them to communicate what they are. And thatā€™s basically the structure of our show. Thatā€™s kind of what weā€™ve got instead of a script.Ā 
EMMA - And do we want to talk about why our guest isnā€™t coming?Ā 
JAMIE - Because parking is terrible, and when you run out of spoons in the middle of a car park itā€™s terrible. So, sheā€™s going to get herself home safely, which is the most important thing.
ROBYN - Yeah, thatā€™s the most important thing. Also maybe a learning point for the Ā鶹¹ŁĶųŹ×Ņ³ČėæŚ is maybe they should have a photo journey.
JAMIE - Maybe a photo journey, a visual diagram of where the parking is. Actually weirdly me and Ollie have parked in the same car park and the first time we went there we got thrown by the fact that the map doesnā€™t take you down the road thatā€™s got the car park on it. It takes you down the road to get to the front door, which is nowhere near the car park, so whoops.Ā 
EMMA - Okay, on with your show.JAMIE - You sound stressed, Emma.
ROBYN - Itā€™s okay Emma, weā€™ve got this, we know about how to do change because our lives involve lots of change and youā€™re going to beā€¦
EMMA - But what if I donā€™t have a show, though? I was expecting a guest. I donā€™t have a guest.
ROBYN - You will have a show. Donā€™t worry. Weā€™re going to do 1800 Seconds on Autism and we know how to do it, donā€™t we, Jamie?
JAMIE - We do. Letā€™s get started.Ā 
ROBYN - Okay. To start on each episode we do a checklist.Ā 
JAMIE - Ooh, hello.
ROBYN - And the first thing on the checklist is spoons. How many spoons do you have?Ā 
JAMIE - I have five spoons and I started the day with eight spoons. Iā€™m a little bit lower on spoons because of change and making things up as we go along, but actually Iā€™m pretty good. Yesterday was a complete mess but Iā€™ll come on to that in a bit because weā€™re talking about change. But you know what, right now Iā€™m pretty damn good. How about you, Robyn?
ROBYN - Iā€™ve got six spoons.Ā 
JAMIE - Six? Nice.Ā 
ROBYN - Spoons is something that came from the disability movement and itā€™s a way of measuring energy. Each person will wake up with a certain amount of spoons and some things will help you get more spoons and some things will cost spoons.Ā 
JAMIE - And when you run out of spoons thatā€™s the end of your day; youā€™re really going to struggle.Ā 
ROBYN - Yeah.Ā JAMIE - So, for example if I wake up with only four spoons I canā€™t do a five spoon activity, no matter how much I want to, because it will cause a meltdown or a shutdown or just a really bad thing. But Iā€™ve had support to get here today. The ride here was lovely so it only took a couple of spoons. So, of the eight spoons I started with this morning Iā€™ve still got five, which is pretty awesome.Ā 
ROBYN - And weā€™ve had Twixes.Ā JAMIE - We love Twixes.Ā ROBYN - Other chocolates are available.Ā 
JAMIE - Oh, other chocolates are available; this is not the opinion of the Ā鶹¹ŁĶųŹ×Ņ³ČėæŚ.Ā 
EMMA - What does five spoons look like?Ā 
JAMIE - What does five spoons look like?Ā 
EMMA - Okay, what does it feel like?
JAMIE - Bubbly, bouncy and, letā€™s see, whatā€™s a good five spoon activity, about three and a half to four hours of coding takes five spoons; reading about two or three chapters of a reasonably complex book takes about five spoons; a shower, a shave, going to the loo takes about two spoons, so I could have two showers, shave twice and go to the loo twice.
EMMA - Okay. So, two spoons is your morning getting ready for the day?
JAMIE - Yeah. Well, what I do is I do the shower and shave the night before so it comes out of the day beforeā€™s spoons, and thatā€™s how I make sure Iā€™ve got enough spoons for the podcast, as I try to move as much as possible to the day before and the day after.Ā 
EMMA - Can you regain spoons?Ā 
JAMIE - Sort of. If I stop and hug lion or have a nap or do what I did yesterday, which was to mostly curl up in a ball and hide for several hours, that can really help me regain spoons. The other thing that can help me regain spoons is doing things that are really super, duper structured. So, I have audio books that Iā€™ve listened to 100 times before. If I go and hide and listen to A Short History of Nearly Everything by Bill Bryson I can pick it up anywhere in the book, I know it word for word, thatā€™s really structured. It takes an hour and it really helps me recharge, get back on balance and then be ready to do more things.Ā ROBYN - So, now I need to ask you, Jamie, have you got any new stims or are they just the same as last time?Ā 
JAMIE - I have got a new stim and itā€™s kind of a really good one. Ollie, whoā€™s one of my support folks, whoā€™s actually sat in the room next door, he brought me a corduroy dinosaur for Christmas, and itā€™s actually a door stop, not a toy, and itā€™s really heavy and it sits in my bed. Heā€™s made of corduroy and corduroy is like this lumpy ripped fabric, and now when Iā€™m really bored I run my fingers down the end, right on my fingernails, and it goes f-dump, f-dump, f-dump between all the gaps. And I do it as slowly and carefully as I can, getting slower and slower and slower and slower and slower, and then suddenly I find that Iā€™ve been doing it for 20 minutes and Iā€™ve completely missed the phone call I was supposed to have. So, itā€™s good, itā€™s really relaxing and consumes my whole brain in quite a nice way; but not the most useful stim I guess.
ROBYN - What is your dinosaur called?Ā 
JAMIE - Heā€™s called Roy because heā€™s corduroy.Ā 
ROBYN - Oh.
EMMA - Ah.
JAMIE - So, his name is Roy.
ROBYN - Stim is when you do something that is repetitive like clicking the top of your pen or flicking your hair or playing with your beard, if you have one, or rocking or flapping.Ā 
JAMIE - And Iā€™m sitting in the corner doing about half of those things right now, which is funny.Ā 
ROBYN - You havenā€™t got a beard though so you canā€™t do that.Ā 
JAMIE - Iā€™ve got stubble. I love my stubble. Actually I hate my stubble but I like it, and then I go okay, done with stubble now, and shave it all off.Ā Ā 
EMMA - Why do you stim?
JAMIE - Itā€™s kind of soothing. Itā€™s kind of nice. My body just does it anyway; I donā€™t choose to. And ironically I canā€™t do any of my stims on purpose. So, the other day somebody asked me to show them an example of flapping, and they just started laughing because apparently if you had somebody pretending to be me pretending to flap thatā€™s what it would look like. And sometimes theyā€™re good, sometimes theyā€™re not so good, but mostly theyā€™re a useful thing.Ā 
ROBYN - I asked 100 autistic people about why they stimmed and for the most part it was a coping mechanism for a lot of people.Ā 
JAMIE - Do you ever wonder if, so for me my stims happen and then I have to think of a reason of what caused them? Itā€™s not like I go, Iā€™d like to cope 9% more in this situation.Ā 
ROBYN - Oh yeah, most people say itā€™s unconscious.Ā 
JAMIE - Yeah, we are trying to think of a reason to explain it rather than it being a choice, which I think is one of the things that the teachers used to get wrong when I was younger: they would assume that I was choosing to rock or choosing to flick my fingers. I wasnā€™t; my body was just doing it. And they used to go things like, ā€œStop that!ā€ and Iā€™d go, ā€œStop what? I genuinely donā€™t know what youā€™re referring to because Iā€™m not conscious Iā€™m doing itā€. So, we had to teach them to go, ā€œPlease stop rockingā€ or, ā€œPlease stop flicking your fingers, youā€™re distracting other studentsā€, that sort of thing.Ā 
ROBYN - Though you shouldnā€™t have to stop rocking.Ā 
JAMIE - I agree. Stims that donā€™t hurt people are kind of fine. There are some stims that end up then affecting other peopleā€™s environments. And we need to have that weird balance between respecting the environment that other people need whilst also not limiting peopleā€™s freedom to be themselves too much.Ā 
ROBYN - I think also itā€™s important to find out why a person is stimming, because it might be, say, their lighting is wrong and actually just reducing the lighting or giving them a hat with a brim or sunglasses or something would actually solve the problem.Ā 
JAMIE - Can I segue into a topic from there?Ā 
ROBYN - Well, weā€™ve got one more thing on the checklist.Ā 
JAMIE - Oh okay. Whatā€™s that thing?Ā 
ROBYN - Intense interests, have you got any new ones?Ā 
JAMIE - Well, Iā€™m still doing mountain bike stuff. Iā€™ve just actually started building another mountain bike, and Iā€™m writing a small book about how to build mountain bikes for autistic people. Iā€™ll probably never publish it but Iā€™m enjoying writing it. But the other intense interest is Bill Bryson has released a new book all about the human body, and I kind of really like cadavers and cadaveric science and how bodies work and what happens when people die and stuff like that.Ā 
ROBYN - What is a cadaver?Ā 
JAMIE - A cadaver is the name for a body when somebody has died. So, for example a medical cadaver is when somebody has died and they donate their body to science or to medicine they stop being a person, theyā€™re removed of their identity, theyā€™re given a number and they become a cadaver.Ā 
ROBYN - Oh.Ā JAMIE - Itā€™s the flesh of a human but none of the person apparently. Depending on your religious perspective that may or may not be true, but at least from the cadaveric sense thatā€™s what they mean.Ā 
ROBYN - Well, thatā€™s very interesting, Jamie.
JAMIE - I am being a good boy and Iā€™m not talking about autopsies, so I am being good and Iā€™m probably going to stop there.Ā 
ROBYN - Well, Iā€™d quite like to talk about autopsies but Iā€™m not sure how our producers would feel about that.Ā 
JAMIE - She looks a little queasy already.
ROBYN - But you really want to talk about a topic so go on then.
JAMIE - I do. There was a segue to it earlier about change, unexpected change and sensory stuff. Ah, I remember now: the cafĆ© that Iā€™ve been going to every day for five years pretty much has bloody closed and now Iā€™m stuffed. More about that on the 10 Oā€™clock News.Ā 
[Jingle - Email stim@bbc.co.uk]
JAMIE - Okay, so one of the biggest things that I find hard is being home alone, because when Iā€™m home alone there are a million things that are drawing my attention, but I also need to stay safe. And I tend to have lots of little accidents or make lots of little mistakes that are just really silly. So, leaving doors open, leaving windows open, leaving the cupboard doors open and then banging my head on the cupboard doors, leaving the fridge open, leaving taps on ā€“ I forget these things. So, when Iā€™m home alone I am being exceptionally careful and aware of my environment and being on top of it. But that means I get really tired really quick. So, rather than having support people around all the time, which is very expensive, and to be honest if theyā€™re just sat on the sofa doing nothing itā€™s a bit of a waste of their time, Iā€™ve been escaping my flat, crossing the road and going to a cafĆ© which was in the middle of Mothercare. Now, of course Mothercare recently went bankrupt and theyā€™ve closed all the Mothercare stores, and with it the cafĆ© that I use. So, now Iā€™ve suddenly lost that ability to escape the environment. I have turned up at the local cafĆ© in my pyjamas not wearing shoes, and they were literally just like, ā€œYouā€™re not wearing shoes, Jamie, should you be wearing shoes?ā€ And itā€™s in that bubble, all of my friends are nearby, so I can go to someone, ā€œIā€™ve walked to cafĆ© without shoes, can you come and pick me up or could you drop me a set of shoes over?ā€ If I turned up looking a little bit dishevelled or spaced out it was only a short road crossing, so I was very unlikely to get hit by a car. It had a zebra crossing, no traffic lights; even if I had very few spoons I could get myself there safely. With the cafĆ© in town I have to take buses, I have to take the right buses, I then have to walk from the bus stop across a busy shopping centre to where the cafĆ© is, go upstairs in the book shop to find the cafĆ©, then order food and find a seat, and itā€™s really busy. Thatā€™s all taking lots and lots and lots of spoons and planning. But what I need to is I need to leave enough spoons so that I can also get home safely. Now, I donā€™t know if itā€™s going to be two spoons or four spoons to get home, depending on how busy the buses are. If I leave and Iā€™ve only got two spoons I quite often get on the wrong bus, and then by the time I go, hang on a minute, I donā€™t recognise where I am, I should be home by now, I have no idea where I am. So, then I need to get someone to come and rescue me or find me a way home. So, when Iā€™m at home if I wake up, like yesterday when Iā€™ve only got four or five spoons for the day, I canā€™t make it to the end of the day; I need to find ways to preserve my spoons as much as possible and just try and make it work. So, what I want to do is I want to find something which is equivalent to what the cafĆ© was, which is a small space with people that I know, where I can be somewhat anonymous, and itā€™s kind of self-contained. Do you want me to run through some of our ideas?Ā Ā 
ROBYN - Yeah.Ā 
JAMIE - Okay. So, the two big ones, one of them is to get a flat share that I donā€™t live in. So, weā€™ve got friends who are looking to live in the same area where I live, so I put a couple of hundred quid a month in towards the rent, and in return I get the smallest bedroom. And all it has in it is a desk, and I go and hide there and go and work there. Because itā€™s not my home at least Iā€™m getting out and about, and then I can walk to and from work, even if work is just a flat over the road. Another option is various friends of mine build vehicles and want things like workshops, so maybe we can find like a large workshop where the friends that Iā€™ve got who want workshops could rent the workshop area and then I could go and hide in the office there and hear everybody else rummaging around.Ā 
[Jingle - Send any questions or thoughts to stim@bbc.co.uk]
ROBYN - Iā€™ve been doing decluttering now for about six months because my landlord said that I have a lot of stuff in my flat and that he wants my bedroom to look like a hotel bedroom.Ā 
JAMIE - Thatā€™s strange. Itā€™s a little bit invasive, isnā€™t it? We want our homes to look like our homes. Because I actually get it the other way round which is I get told off by friends for my flat looking more like a monastery, when Iā€™m like ooh, I donā€™t want anything else in here, I quite like it looking almost empty. So, itā€™s almost like thereā€™s an expected amount of untidiness, and if youā€™re more untidy or less untidy you get flak for it.Ā 
ROBYN - I always thought that living with other people wouldnā€™t be a very good idea because in the past Iā€™ve found it very stressful. However, Iā€™ll come back to that. The biggest room, the slash living room, slash kitchen, slash dining room, thatā€™s all now tidy. And it feels a bit lonely and huge. Now Iā€™m thinking that now that I have learnt to be tidy and Iā€™m relatively effective at being tidy in the spaces that Iā€™ve learnt how to do it in, maybe it would be better toā€¦so one of the big problems that I have is that there are a lot of small things that I canā€™t do, like my flat is in a house and the outside house light bulb went a few months ago, and I donā€™t have the dexterity to be able to take the light out. But I could go to the shop and buy a new light if somebody else could do the taking it out and putting it in.Ā 
JAMIE - Would be that something that your landlord could arrange?Ā 
ROBYN - Well, yeah, he probably could, but thereā€™s a guy that lives downstairs and heā€™sā€¦
JAMIE - Is he nice and helpful?Ā 
ROBYN - Well, heā€™s quite capable of being able to do that. Heā€™s taken the light out, but he has left it in his car, because he was going to go to B&Q.
JAMIE - And he didnā€™t get around to that bit?
ROBYN - And he hasnā€™t got round to it.Ā 
JAMIE - So, if you gave him one and was like, ā€˜Iā€™m being helpfulā€?
ROBYN - Yeah, but the thing is I donā€™t know what kind of light it is, because I asked him and he couldnā€™t tell me. My point to this story is there are a lot of little things like that that really become big problems. Or like the fact that the post in the communal doorway when it comes through the letterbox it just goes on the floor and thereā€™s a lot of post for random people.Ā JAMIE - That donā€™t live there anymore?Ā 
ROBYN - That donā€™t live there anymore or that own the upstairs flat but donā€™t live there or whatever. And I find it really difficult because of my visual processing problems to be able to sort the post out. Often the writing is small and you have to have a lot of short-term memory and it costs me basically a lot of spoons to be able to do that.Ā 
JAMIE - So, some support with sorting. All of my post goes to my friendā€™s house; none of it goes to my house.Ā 
ROBYN - My post is fine, I can manage that, but there could be a thing on the wall for sorting the post. And I have talked about it. And there are other little things that come up from time to time.Ā 
JAMIE - No, what I mean is rather than you doing it maybe thereā€™s some support you can access.Ā 
ROBYN - Yes, but Iā€™m coming to that.Ā 
JAMIE - Oh okay.Ā 
ROBYN - A friend of mine lives in a housing co-op. A housing co-op is when a group of people own a house, or in this case a street and all the houses on it, and they each have an equal share in whether it be a charity or a limited company that owns it. Thereā€™s no profit made. All the money thatā€™s collected goes into a pot, and there are subcommittees that choose how that money is spent. So, for example a certain amount of it goes to maintenance, and then some of it goes to the gardens, and theyā€™ve got ponds and fish and things.Ā JAMIE - Thatā€™s cool.Ā ROBYN - So, you have your own room with a lock on the door, but you have a shared kitchen, and there are three bathrooms per house of 10 people.Ā 
JAMIE - Gosh, itā€™s like youā€™re describing where I lived in supported living.Ā 
ROBYN - I guess it is like supportive housing howeverā€¦
JAMIE - Just without the support.Ā 
ROBYN - Well, yeah, but everybody has an equal say.Ā 
JAMIE - In theory in supported living that was the set up; it wasnā€™t in reality. Yeah, thereā€™s the financial side which is a bit different, but like pragmatically it sounds very similar. I loved supported living; it worked really well for me. I had a bedroom and a lounge, a shared bathroom, and a little kitchen space that I never used in my room, and then a big communal kitchen. I say cook, but I used to make things in the communal kitchen, and I liked it because there were always other people around doing their own thing. So, if something caught fire or if I really screwed up and chopped my finger off, there would be somebody to go, ā€œUh, I just chopped my finger off, what do I do now?ā€ However if Iā€™m at home completely on my own I screw up so badly using the kitchen, leaving doors open and leaving things on, losing things, leaving the milk out, that itā€™s just too many spoons and stress. So, do you think youā€™re going to go and move to the co-op?
ROBYN - Well, Iā€™m going to go and visit it with Henry on Sunday.Ā 
JAMIE - That sounds really cool.Ā 
ROBYN - Because also it saves a lot of money. It means that you are a part of a community where people value you. I doubt the person below me knows enough about me to value me or not value me, but Iā€™m pretty isolated where I live. I have loads of friends, none of them live in the borough I live in, but where Iā€™m going toā€¦
JAMIE - Youā€™re almost exactly describing why I moved to where I live now. Iā€™m on one road, the next road over, other side of the road, is where three of my friends live. My friendā€™s mum lives six doors up from them on the end. We know the neighbours both sides of my friendā€™s house; theyā€™re lovely. So, thereā€™s like a little community there. And the cafĆ© was just over the road. The cafĆ© was part of that community, so I didnā€™t have to leave that little bubble of people that I know and trust in order to go to the cafĆ©. Now the nearest place for me to go is a bus ride away, and that may as well on the bloody moon for how actually efficiently I can get there. So, I totally understand the urge to go and live near people who care. So, one of the things that I did I started accessing paid support. And the trouble with that is often the paid support was actually worse than just being left to my own devices. It was only when we had a structure, and letā€™s say a friend was doing something and we found a way that worked really well, weā€™d then get paid support to take over what the friend was doing. So, they were kind of duplicating things that were working, rather than turning up and going, ā€œHello, Mr Knight, what do you need help with today?ā€ because I have no idea how to answer that. But if one of my friends says, ā€œYeah, we walk through the door, check his fridge, check heā€™s not on fireā€ if we can give that to the carer then they can turn up and do the same things and theyā€™re not asking me constantly for direction on what they should be doing, because I donā€™t know, I canā€™t remember.Ā 
ROBYN - Iā€™ve had paid support and what Iā€™ve found with it is you constantly have to interact with them all the time, and you have to have it in certain chunks, and you have to fit around their schedule. And actually the kind of help I need is often very small things like Iā€™ve broken a glass on the floor and I need someone to stand over me and prompt me to clear it up.Ā JAMIE - Help clear it up safely.
ROBYN - I could clear it up safely but I need prompting, because itā€™s a new situation every time, because a glass always goes in different directions and it looks different, and itā€™s a lot of information processing. And glass is dangerous. So, I need somebody to watch over me for five minutes to make sure that I actually do it properly.Ā 
JAMIE - My support is much the same. One of the things we found is I have a support agency, and the support agency deal with my routine. They turn up at seven and I hide from them, and I only communicate with them via text message. We have written down the wall in my flat a support routine: food, pack bag for tomorrow, clothes for tomorrow ā€“ weirdly I canā€™t remember it because Iā€™m trying to think in words rather than pictures. But the amount of control that I give them is to just get me through my routine. If I have a bath I completely lose track of time and they might need to prompt me two or three times to remind me to get out of the bath. The other thing that they canā€™t often prompt me with is, ā€œHave you washed the shampoo out of your hair?ā€ because the number of times that Iā€™ve slept badly for three days because I had a bath, forgot to wash the shampoo out of my hair, went to bed, didnā€™t realise that was the sensory problem I was having, and then had really bad sleep for three days. So, similar sort of thing, thereā€™s lots of structured stuff which we need to do every day. For the unstructured stuff that just happens, when stuff goes wrong, thatā€™s why being around people that I know is useful. My friendā€™s mum that lives up the road quite often Iā€™ll text her and go, ooh itā€™s gone wrong. Or if the flatā€™s not going to burn down I used to just escape the flat, go to the cafĆ©, and then chat to friends via the internet to arrange to get that thing fixed, or when person x is home from work theyā€™ll pop over and help me with this thing. So, the cafĆ© kind of worked as like an escape pod as well which I could then solve other problems with. Losing the cafĆ© is a right pain in the butt.Ā 
[Jingle - 1800 Seconds on Autism, with Robyn Steward and Jamie Knight.]
ROBYN - When Iā€™m ill I canā€™t work out what the problem is. I know Iā€™m ill because I know somethingā€™s wrong, something feels different and it doesnā€™t feel different in a good way, but I canā€™t necessarily work out what the problem is.
EMMA - Thereā€™s no doubt in my mind that Iā€™m ill. I can feel everything. Your body stops working the same way.
ROBYN - Can you tell whatā€™s wrong with you though when youā€™re ill?
EMMA - Yeah. Do you know when you have a headache?Ā 
JAMIE - Generally speaking yes, but it can be hard to work out itā€™s a headache, not a stubbed toe.
EMMA - If I have a headache I sit holding my head, Iā€™m trying to get my head comfy, Iā€™m putting maybe cold things on my head.Ā 
JAMIE - I donā€™t. I just have a headache. Until I decide that Iā€™m going to do something, like I donā€™t instinctively have those behaviours. Itā€™s the same as you know when you have young children you know they need to go for a wee because of how they act, I donā€™t do that. I donā€™t do a wee dance. I just go, ā€œI need a wee!ā€ with no warning whatsoever.Ā 
EMMA - So, you donā€™t get that, thereā€™s a really obvious wee feeling? Robyn, do you know what I mean?Ā 
ROBYN - Yeah.Ā JAMIE - I get pain.Ā 
ROBYN - The other day me and my dad we went out for dinner and my dad went to the loo before we left, and so I was really focused on, oh okay I need to stay and look after my dadā€™s coat and my coat, so Iā€™m just going to sit here and wait for him to come back. Anyway he came back, and about 20 minutes later we were walking and I was like, ā€œI really need the looā€. And then oh no, I really have to go to the loo now, weighty.Ā 
JAMIE - How do you tell the difference between I need a wee and Iā€™ve got a tummy ache? Because theyā€™re both down that sort of area.Ā 
EMMA - Totally different feelings. The wee feeling is in a tiny area of where you wee, and it feels ooh, what does it feel like?Ā 
ROBYN - Sharp.Ā 
EMMA - I wonder if the wee feeling is different for girls and boys. Boys in the other room, whatā€™s the wee feeling like for a boy?Ā 
DAMON - Slightly sort of tickling or burning feeling Iā€™m thinking. Pressure.Ā 
ROBYN - But do you feel that in your penis or in your tummy? [Laughter]
DAMON - I didnā€™t know I was going to have this conversation today.Ā 
ROBYN - You donā€™t have to answer anything that makes you uncomfortable.Ā 
DAMON - Itā€™s just your lowerā€¦
JAMIE - Well, needing a wee makes him uncomfortable, so itā€™s already an uncomfortable topic. The idea though is youā€™re connecting two things: this feeling means this thing.Ā 
EMMA - Yeah.Ā JAMIE - Mine are just not that precise. And thatā€™s why I almost died of gallstones because theyā€™d go, ā€œWhere does it hurt?ā€ and Iā€™d be like, ā€œDunnoā€.Ā 
ROBYN - The time I got diagnosed with IBS ā€“ Iā€™m sure I told this story on the podcast before ā€“ but I wasnā€™t sure if I had appendicitis because I had pain somewhere in my stomach. So, I went to the doctors and they were like, ā€œWeā€™re not really sure but go to A&E if you still feel like that in the eveningā€. And Iā€™m like, Iā€™m not going to go to A&E. An autistic person by themselves in A&E, that doesnā€™t sound like a good idea to me.Ā 
JAMIE - Correct.Ā 
EMMA - Has that happened before, have you guys been to A&E by yourselves?Ā JAMIE - Oh yeah.Ā 
ROBYN - Yeah.Ā 
EMMA - IBS is irritable bowel syndrome?Ā 
ROBYN - Yes, IBS is irritable bowel syndrome.Ā 
JAMIE - Not by myself; Iā€™ve never been to A&E by myself.Ā 
EMMA - So, whatā€™s happened when you guys have been? What are the less good situations that have happened in A&E?
JAMIE - Weā€™ve got examples of this galore. Before I get into that, a little editorā€™s question: Ollie has taken me every time I had the gallstone problems; he would be amazing at explaining what happens. Because I donā€™t remember, because I was really broken by the experience.Ā 
EMMA - Okay, Ollie? You up for that?Ā 
JAMIE - Does Ollie want mic-ing and joining in?Ā 
EMMA - Heā€™s coming.Ā 
JAMIE - Cool.Ā 
OLLIE ā€“ How can I be of service to you?Ā 
JAMIE - We are talking about times when Iā€™ve been to A&E and what happens in A&E. And as you have done that with me a lot I thought you might want to be on mic and explain some of it.Ā 
ROBYN - Hi, Ollie.
OLLIE - No worries. Let me just do a quick test, test, test.
JAMIE - Hey Ollie.Ā 
OLLIE - Hello.Ā 
JAMIE -What the hell happens when I go to A&E?
OLLIE - A&E is a perfect mix of things to break Jamie. Itā€™s a combination of transitions, you go from crazy, annoyingly loud spaces to inside, to outside, to very bright. Itā€™s a combination of youā€™re probably in hospital because thereā€™s a problem and so youā€™re already low on spoons.Ā 
JAMIE - And I probably have no idea to be able to explain beyond ow, and pointing.Ā 
OLLIE - Yeah. And just from a sensory perspective theyā€™re pretty terrible for the autistic person. So, what happens to Jamie is he will instantaneously become non-verbal, which isnā€™t particularly useful when youā€™re trying to do a medical diagnosis. And it just becomes an extremely difficult place to navigate. You canā€™t walk very fast, you canā€™t process, so it becomes extremely difficult.Ā 
EMMA - So, you literally canā€™t remember any of this Jamie?Ā 
JAMIE - Snippets. We did multiple trips to the hospital for gallstones. I can remember a doctor poking me and going, ā€œDoes this hurt?ā€
OLLIE - That was the first time we went to A&E and they didnā€™t know what it was. And the first time he poked you you completely shut down. And then he thought from that it meant that you were okay; whereas what he was expecting to happen was if you had a problem you would scream. But you donā€™t scream when people poke you in painful bits.Ā 
JAMIE - Exactly. So, he poked me, caused a huge amount of pain, and my body just turned off. I just stopped working for four days, something like that?Ā 
OLLIE - Yeah. So, that day he just basically shrugged and was like, ā€œCome back another dayā€. And then by the time you were well enough to go back we had organised an ultrasound where they accidentally found that you had these gallstones the size of grapes that were going to literally kill you if you had a puncture.Ā 
JAMIE - Get them out pretty damn quickly.Ā 
EMMA - So, if you donā€™t remember going and you donā€™t present your pain in the same way how did you both know that you needed to go to A&E?
JAMIE - So, for the gallstone stuff what I started doing was I knew that my insides hurt so Iā€™d say, ā€œIā€™m in 10 out of 10 painā€ and Iā€™d started running baths of only hot water and then lying in these baths so that I could get as hot as I could so that I could balance the pain on the outside with the pain on the inside and sleep. So, Iā€™d taken to sleeping in the bath four or five nights a week.Ā 
OLLIE - That was like 18 months of two hours a night sleep if you were lucky. I remember that was basically Jamie at his least functional.Ā 
EMMA - And was there a massive summit going on with all your support people saying, ā€œOh my goodness, whatā€™s going on here? How do we figure this out?ā€
JAMIE - Yes.Ā 
OLLIE - Kind of, but the problem is Jamie masks his pain incredibly effectively.Ā 
JAMIE - Because Iā€™m not aware of it.Ā 
OLLIE - He doesnā€™t know heā€™s in pain; he doesnā€™t know to express that heā€™s in pain. We can just determine that somethingā€™s up. But somethingā€™s up might be, I really need the toilet, or it might be, Iā€™m literally dying. And thatā€™s one of the things that makes it very difficult toā€¦ We did all feel very guilty about the fact that it took you so long to be diagnosed.Ā JAMIE - It was 10 months of the real bad pain. And the thing with the gallstones is if it ruptures and it spews the infected stuff all over your insides you die before an ambulance can get to you. Two days before the ultrasound I was mountain biking in Wales, and if Iā€™d fallen off I probably would have died and bled to death before anybody got to me internally.Ā 
OLLIE ā€“ I would like to reiterate we all feel very guilty about that.Ā 
JAMIE - That was fine. You didnā€™t know; we didnā€™t know. I have another example of how we can diagnose that Jamieā€™s got a problem. If I go and do something like a shower that normally takes, say, one, two spoons, and it takes four spoons, I know something is wrong because the amount of effort to do things gets really high.Ā 
ROBYN - And if I donā€™t want to do things that I normally enjoy doing normally thereā€™s a problem. And yeah, I just have to be really careful about how much energy things take out of me.Ā 
JAMIE - There are the things that can be the biggest problem is that a mundane, easy to fix issue has to escalate to something quite big before itā€™s noticeable. And one of the ways that we get around this is Ollie, and all the other support people, we have almost like a debug routine where they will go, ā€œHave you eaten? When did you last go to the loo? Are you hot? Are you cold?ā€ They ask very specific questions that I can answer yes, no, by looking.Ā 
EMMA - We have loads of parents listening; is this a good thing for them to know about?Ā 
ROBYN - Yes, ask those specific questions. My mum and dad do the same thing.Ā 
OLLIE - Can I just chuck a quick one in? Rather than saying, ā€œAre you hungry?ā€ itā€™s, ā€œHave you eaten?ā€ because are you hungry is an extremely subjective one. And also with the sensory processing stuff itā€™s like, could be hungryā€¦
JAMIE - Could be.Ā 
OLLIE - But have you eaten is a fact.Ā 
ROBYN - Or when did you last eat.Ā 
JAMIE - Yeah.Ā 
OLLIE - Or, ā€œHow many calories have you had today?ā€
EMMA - Have you learnt all of that, Ollie, from knowing Jamie? Is that where youā€™ve learnt all of this? So, you donā€™t need to have some sort of qualification or go on a course or anything like that?Ā 
OLLIE - Absolutely. I have absolutely no formal, in inverted commas, training in autism care or care. Itā€™s just about being around and caring for somebodyā€™s needs and gaining an understanding of how they communicate.Ā 
[Music]
ROBYN - Well, I think we should rename this programme the Jamie Manual after all that. Weā€™re really honest in these podcasts and I hope listeners get something from it.Ā 
JAMIE - Robyn, what would be the top tip in the Robyn Manual?Ā 
ROBYN - Give me plenty of processing time.Ā 
JAMIE - The exact thing we didnā€™t do when we asked you that question.Ā 
ROBYN - Exactly.Ā 
JAMIE - Subscribe to 1800 Seconds on Autism on Ā鶹¹ŁĶųŹ×Ņ³ČėæŚ Sounds or wherever you get your podcasts from. And you can still email us at stim@bbc.co.uk.Ā 
ROBYN - Thanks for listening. Bye.Ā 
JAMIE - Bye.Ā 
[Jingle - That was 1800 Seconds on Autism.]Ā 

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