I have made a 'shutdown card', any thoughts?

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Alphabetania - I wish I could. But I don't know how I switched from mostly meltdowns to mostly shutdowns, really; I didn't control it. The only thing I could think that might help you is recording when you have meltdowns what happened, and so try to figure out what is likely to trigger them, and if there are any warning signs before it gets out of control and then leave the situation you are in when there is a trigger or warning signs.
I am very lucky in that the symptoms of AS I have are very mild. The 'shutdowns' and 'meltdowns' I describe are very short but still somewhat abnormal. However, I do remember one quite recently where my limbs felt paritally numb and I felt shaky and heavy and just generally really weird, and that feeling stayed for the whole of the next day even though the shutting down had passed.

Tantybi - What i mean by a shutdown might not actually be what others mean by it. Mine are not long-lasting and not severe - I will either wander around but with less communication and response to surroundings, or I will sit down (usually on the floor) somewhere and have minimal or very mumbled speech and that will last only a couple of minutes and then I'll start to recover. A few have been worse than this, and I am aware of the slight problem that if I am very badly panicking or shutting down I may not be able to show people the card, but having it for some circumstances is better than nothing!
No one trained will perform CPR on a person who is still breathing and still has a pulse!
If someone mistook a bad shutdown for a medical emergency, it might be very awkward, but then again I might end up with my difficulties being recognised (possibly even diagnosed!) by a psychiatrist, so then it wouldn't be all bad. With my shut downs being relatively mild, I think it's unlikely. This has occured to me before, as I have a problem that when I'm very stressed I get suddenly very sleepy and just fall asleep uncontrollably if I'm sitting down. A few times at home it's been so bad that from standing, I just lay down on the floor and went to sleep. If that happened in public, I assume people would think I needed medical attention! But hopefully it'll never happen, as I'd probably have to feel quite bad to start with and then I wouldn't leave the house.
If I did need medical attention, I would not present the card and I would probably manage to say 'help'. I do make some responses to things when I've shut down, so if I wasn't properly conscious it would probably be clear.

Where I am they either have to be choking where preferred methods of clearing the airways doesn't work, and is then a last resort of trying to force it open, or they have no pulse. If they are not breathing, but have a pulse, their heart should kick start their lungs, and there are other methods that can be used instead of CPR then. CPR carries too much of a risk to the person's rib cage to perform it without being sure its necessary.

I agree. I know how to perform CPR, but I think I wouldn't push down on the chest hard enough for it to be effective if it were needed, and I'm still very hazy about when it is needed. All they tell you is the ABC where I still manage to confuse one acronym for what it is supposed to be (because my way sounds just as right). Either way, that's why I believe those classes (even the ones they do in the military) give just enough info to make you dangerous. But I can imagine someone who is more apt to shoot first and ask questions later (which is the opposite of how I am) would jump right in to give CPR to someone who is just sleeping who won't wake up when you provoke them.

Well, I'm a bit different form most people. I plan to get EMS certified.

Your shutdowns do kinda sound like what I experience sometimes now I think about it...a lot like my panic attacks.

Now some of what you say reminds me of my meltdowns. I do fall asleep after a meltdown, and I can't calm down from a meltdown until I sleep it off, so I guess I kinda know better where you are coming from. I wish I had a card to give my mom when I had meltdowns as a child (up until I picked up smoking), but nobody knew what Aspergers was when I was that age. My mom and my sister would follow me nagging me and making me worse in the process. I suppose they would do the same if they knew better as they both tend to be selfish when it comes to their emotions. Oh wait, they do know better now and they still follow my nephew around driving him crazy when he has his meltdowns. I remember one time he wanted to run away, and my sister wouldn't let him leave the house holding him in by force. I finally said to let him go and I'd follow behind to make sure he was safe. They argued with me cause I wouldn't know what I was talking about. I felt like telling my sister, well, you are a b!tch and he just needs a break from you, but I figured that would only add to the problem.

But all that you just said would be good summarized on that card: the fact that rarely but it happens that you fall asleep, that these symptoms are generally mild and only last a few minutes, etc.

Try explaining that to a border guard! I just went up to Canada from the US for a quick trip, I got randomly searched and drilled both ways. I don't make eye contact, and am pretty nervous all the time, I had apparently been screaming guilt the whole way.

I was thinking a while ago, "if only I could hand people some sort of card to explain things (don't people who suffer severe head trauma or something have explanations on the back of their licenses or something?)" Sounds like a good idea.

A friend of mine has a card that says "I have a spinal chord injury, and if I seem drunk and have a hard time with my balance, it is most likely a result of the injury." that he uses quite often when he goes to bars/clubs, and is signed by his doctor. They have these medical cards for all sorts of conditions.

There are lots of conditions where this could come in useful, particularly as many conditions can be mistaken for drunkenness, such as hypoglycemia in diabetics.

Tantybi - when I do have meltdowns, they are often followed by shutdowns and/or sleeping, I think just from the exhaustion caused by letting out so much anger. :s
I don't know about adding the sleep thing because it's not like I could show someone the card if I were asleep! Also, it's unlikely. If I become more stressed and it becomes a realistic possibility that I might fall asleep on the floor in public, I will try and get some sort of med alert bracelet or something!

As for the whole thing about CPR lessons for the general public, I don't think they endanger anyone as First Aid courses tend to say what you shouldn't do, and people believe some very bad things before the courses correct them. I don't remember a lot of the stuff I was taught now, but if you phone an ambulance they might instruct you to perform CPR, and tell you how, and if they guided me through it, it would at least be easier as I'd done it before even if I don't remember completely.

Don't bet on a psychiatrist being able to make a correct diagnosis... it's not like you'd be seeing an autism specialist. They'd probably say you were catatonic and diagnose you with schizophrenia. Hospital psychiatrists are very rarely at all competent.

In community CPR classes they no longer teach to check for a pulse, though, just for responsiveness and breathing. Apparently the American Heart Association thought that people looking for a pulse delayed CPR and/or that they'd think their own pulse was the person's pulse (you see a loved one on the floor, your heart starts racing, you can feel it all over, hoping to find a pulse, keep looking.. meanwhile,there's no blood going to the person's brain)
Hopefully they'd notice that you were breathing, though... never underestimate human stupidity, though.

For the past few weeks I was taking an accelerated EMT course, which I just couldn't finish.. there was a practical assessment part, and the class was already killing me.. when I went to go run duty on friday to get the assessments, totally froze up.. ended up spending most of the day curled up on the floor in the ladies bunkroom trying to avoid everyone.
During the classes, I was not doing well. (Well, was doing fine on the multiple-choice tests, but that's just cause I'm good at multiple choice tests.. but I was not doing well.) By the afternoon, I'd look like a zombie, kinda staring and barely responsive, I worked very, very hard to hold back the hysterical tears I'd be in when I got home.
The teacher noticed, she thought I was sick, and this is an EMT instructor who is an experienced paramedic.. and they generally consider panic attacks to be bull.



If someone is unresponsive or has altered mental status, there's implied consent. They'd have to be an idiot to try to do CPR on someone with a pulse.. but if someone thought it was a medical emergency and that your mental status was altered, you can't actually refuse treatment, like going to the ER.

Good Samaritan laws are designed to protect people who are trying to help, so that if you try to help someone, and don't abandon them, they can't sue you even if something goes wrong. The whole "duty to act" thing is unclear, it usually only refers to on-duty EMS, but can get fuzzy. They say that if you're off duty, it's just really a conscience thing.


Remember that there's no limit to human stupidity... the law is designed to get CPR started as quickly as possible to minimize brain damage. So average Joe on the street who took CPR 12 years ago may very well think you're having a heart attack. (of course, if he took it that long ago, he'd probably be looking for a pulse, lol. I'm not sure exactly when that changed)

(Everything I've said is, obviously, based on US law.. no clue about other countries. For that matter, there are a few places where Maryland EMS protocol differs slightly from national, as well..)

The ABC's of CPR...

Airway
Breathing
Cardio

If someone was shutdown, I'm certain their airway would still be clear, they'd still be breathing, and their heart would still beat.

If I was shutting down, I might be unresponsive to words. I might appear pissed (angry). I may appear distant, frustrated, confused and aloof, but clearly, my airway would be open and it should appear obvious that my heart is still beating and my chest is still rising and falling.

I'm not trained in CPR. My father died in my arms of a massive heart attack. I feel I can assure you that imminent death & shutdowns likely present differently.

EDIT: I think the cards a great idea if you feel it will help you in some of the more trying times

Well, honestly, the inention of my post above was simply that don't think anyone in their right mind would perform CPR on anyone who was just experiencing a shutdown. As you said, ABCs, and someone having a shutdown should have all of them, unless something else is at play. I wanted to learn CPR since when it comes to heart attack, my dad is a ticking time bomb. I also as stated earlier want to be trained for EMS, just because I like the whole saving lives thing.

Maggiedoll - I sometimes wonder if even a dignosis of schizophrenia or something else wildly innaccurate would be better than the lack of diagnosis I have now - it would at least prove I have problems with stuff! I've seen a psychiatrist before, I am well aware many are terrible at diagnosing AS. But the more stressed I get, the more autistic I get, so if was totally freaked out I might display more symptoms that are classic signs of autism, and they might get it right. Or maybe not.

I'm gonna print off my shutdown card tomorrow morning and carry it with me when I go the British Museum tomorrow. I doubt I'll have to use it tomorrow (I hope I won't have to use it much!), but it'll be good to start having it with me.

Then they'd toss you onto antipsychotics, you'd get worse, because of course you don't actually have a psychotic disorder, and they'd decide that since you're not crazy (because of the antipsychotics) that means they need to up the dose. You'd then spend many years, possible the rest of your life, unable to think at all because you'd be too drugged, and nobody who you tried to explain this to would believe you, because they'd figure you were just a crazy person anyways.

That is what happened to me. I had a lot of stress at age 20, had a major shutdown accompanied by some depression and anxiety. i really did not have depression and anxiety, just a situational thing where I was forced into situations that i could not handle. they put me on medications and I was practically mentally ret*d. I was put into a day/residential group home with people who are autistic and mentally ret*d who also have severe behavior issues, that verbally and physically attacked me. My "autistic" symptoms worsened and I became more depressed and actually suicidal at one point. the medications made everything worse. Now they realized that it was all situational, took me off medications,and now I am back to my intelligent self. i am going back to school and everyone around em now knows that they were too hard on me.

Kajjie - Thank you for posting this. I live in a dormitory environment, and I think it might be helpful to print something up like this and post it on my locker door. Only people who come into the room would have access to it, so I don't think I'd have as much problem with people deciding that tearing it down/apart/etc or drawing or writing on it. I also think it would be helpful for people when they come in to visit my roommate and I can't seem to speak. I could just point at my locker door when they try to include me in conversation.