Mark Nicholas ([info]cosmicity) wrote,
@ 2009-01-08 21:48:00
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Current location:48310
Entry tags:fundoplication, infantile spasms, sandifer's syndrome, surgery, zoe

Zoe - A bad day. Diagnosis doubts. What the future holds.
Things with Zoe are not well.  Her episodes look worse and she is now very clearly behind on her development (missing milestones), and that's been confirmed by our Pediatrician a couple of weeks ago and our U of M Neurologist today. What seemed like a clear Sandifer's diagnosis just over a month ago is now in serious doubt, so the remaining doctors are trying to figure things out the hard way now: She'll be going in for Fundoplication surgery soon in an attempt to stop her reflux, and then see if that stops her episodes and gets her overall development back on track. It's really our only remaining play, as we've done literally everything else you can do (from scans and tests for epilepsy to medicines and treatments for reflux - nothing resulting in anything concrete to help her or diagnose her.)

If the surgery fails (which it might - it only has a 60% success rate, depending on what article you read - plus they have no idea if the reflux is truly the 'cause of all of her other problems) then we're back at square one trying to think of something else. 

I wish I had better news to share with people when they ask about this because we have so much support and optimism always pouring in, but it's just bad right now.  She's in pain all the time and she's 6 months old with the skill set of a 2 month old.  That's just the way it is.  Still, I really appreciate everyone's inquiries and support.

There's more to the story, but the details go on for years so I won't get into all of them. In short, we'll also be getting her a hearing test soon, and revisiting the eye doctor in Feb., among other things. With as bad as things are with Zoe, it's really tough to tell what's working right and what's not, so you've just gotta keep ruling things out, just to make sure.

We'll also be contacting Early On so we can get some help moving her development along as best we can. On Zoe's bad days she's all episodes and sleep, so there's not much we can do on those, but on good (episode-free) days she seems to have the strength to try, so we'll just have to make the most of that time so that she can hopefully start accomplishing a few of these milestones (like sitting up, rolling over, grabbing objects, etc.)

The Neuro doctor today also spent a lot more time than we would have liked talking about Infantile Spasms. That is definitely what her episodes look like on the surface, no question about it (and that diagnosis would explain her lack of milestone development), plus we had fresh video to show him which illustrates that her episodes look even more severe now than even a month ago. But obviously all of the other doctors we've ever seen (including two other Neurologists) and hospitals have thought of this before, and it was ruled out after 3 - yes 3 - normal EEGs including a 24 hour video EEG (as well as numerous other brain scans). Still, this Neurologist says that if we have no luck with her reflux surgery (which he definitely wants us to do first, ASAP), that we'll have no choice but to have yet another EEG and check for it again. We'll cross that bridge if we have to come to it, but we definitely don't want to. Infantile Spasms are a life sentence - they're not like other forms of epilepsy that can be treated with medication and fade with age. If Infantile Spasms were the diagnosis, she would never be normal (mentally retarded, at the very least).

-m




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[info]elviswannabe
2009-01-09 03:51 am UTC (link)
Aww Man. I am so sorry to hear that it wasn't better news. Well, Julie and I are still very much pulling for and hopeful for Zoe and you two!! Let us know when you get the surgery scheduled and by all means, let us know if there's anything that Julie and I can do for you all.

You are definitely in our thoughts!!

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[info]dhumphrey73
2009-01-09 04:40 am UTC (link)
Wow. Surgery sounds scary for such a little baby, but I hope it'll help Zoe, you and Sara get relief. As for the rest of the neurologist's news, let's hope that the other two neurologists were right earlier! I found this guy online by reading some blogs and wonder if he's one of the ones you saw? He's at Children's Hospital in Detroit, and across the board everything I read referred to him as one-of-a-kind. His name's Dr. Harry Chugani. https://www.childrensdmc.org/?id=660&sid=1 Supposedly he's a world class PET scan reader and is very well connected. I have no idea what PET scans and EEGs are, but maybe this guy could look at the stuff you've already had done...?

D

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[info]cosmicity
2009-01-09 04:43 am UTC (link)
He's one of the two Neurologists we've already seen. We found him within two weeks of the onset of her episodes. He administered not one but two PET scans of her brain, both of which showed no abnormalities. He's world-renowned, and he was baffled and gave up on Zoe in a matter of weeks when she was only 3 months old.

THAT'S how bad this situation is.

-m

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[info]dhumphrey73
2009-01-09 05:07 am UTC (link)
Actually, that is kind of GOOD news, considering why I suggested him. He sounds like he might be THE guy who finds the stuff no one else can diagnose. People come from all around the world and a few described him as their last hope. If you saw him early and he was like "wow... I got nothin'..." that sounds pretty good to me.

I don't mean to meddle, of course, I just read obsessively whenever you guys find something so I can try to understand it. Knowing that you saw him already, I'll rest a little easier tonight. Hope the same could happen for you too... a tiny bit?

D

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[info]cosmicity
2009-01-09 05:20 am UTC (link)

I appreciate you looking things up, I really do. You never know who's going to stumble across what. I don't consider it meddling.

I don't really find the Chugania thing comforting, though. Chugani was INCREDIBLY pessimistic about Zoe after that 2nd PET scan didn't show anything. (Perhaps the most pessimistic of any doctor we've ever seen.) He may be the world expert at PET scans and brain surgery to fix abnormalities, but once you rule that stuff out, I'm not sure what he's got. Literally all he had for us after my BEGGING for any other ideas or next actions we should take was "if she starts missing milestones in a few months, go to see a Neurogeneticist."

Yeah? Well, we did that and they were tapped out of ideas in 2 hours. I mean, maybe the DNA test they're going to run will yield some results in a couple of months, but even they think it's a longshot. It's like shooting a shotgun into the dark and hoping you hit something.

I do find it comforting that he read our 24 hour EEG results and PET scan results and didn't find anything. It does give me a pretty high level of confidence that there really isn't a brain abnormality or epileptic activity in her brain. And that gives me a good level of confidence that it's not infantile spasms. That is indeed all good stuff. It just doesn't make me feel any better that it's not something else because I think that's where his expertise ends.

Oh well. I think we just need to focus on the surgery, put all of energy into that being a success... because it's really all we can do. We can't change anything else about Zoe's situation, so we need to just focus on this possible ray of light.

-m

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[info]dhumphrey73
2009-01-09 06:09 am UTC (link)
I'm glad to do it. I don't have a child, so I can relate only up to a certain point. Reading other people's stories is probably easier for me. I empathize, but I also just zip through looking for tidbits because all I care about is Zoe. I haven't met her yet, so all I know is what you guys tell me. At this point, for me it's all research. I'm all business. If what I read doesn't sound like what you tell us is going on, I just click another link and zip through someone else's story. I bookmark lots of stuff, so someday I could go back and find something if you need it.

Where you said "I do find it comforting..." is *exactly* what I was going for. Ruling him out and having him rule Zoe out would probably be better vs worse. Not good for solving the issue at hand, of course. If you needed another neurologist, this guy looked like he could find a needle in a haystack AND he's in your backyard. You already saw him and he couldn't help you... maybe that wasn't bad news?

I do hope that this surgery could actually BE that ray of light...? This could be a big step in the right direction. I hope so at least. I have all of my positive energy focused on it, and on Zoe being in the 60% who have success with it. Let me know when the surgery is. I have an idea of a little pick-me-up to send to help get everyone through it.

D

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[info]miss_ania
2009-01-09 05:18 am UTC (link)
mark, i can't even begin to comprehend what you and sara and zoe are going through. i just keep hoping for a good outcome, and soon.

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[info]jacklattie
2009-01-09 01:29 pm UTC (link)
Not that you guys are rolling in the dough (or time, or energy) for travel right now but I wonder what Detroit Children's Hospital's competitor facilities might have to say? Could there be experts in other cities worth consulting?

Found this listing: http://www.usnews.com/directories/hospitals/index_html/specialty+IHPGAST/state+/page_number+1/page_size+10/sort+/name+/metro_area+/zip+/distance+/detail+less

To be honest I thought Children's Hospital in Detroit was at the top of lists like these but they're not even on the list US News & World Report put out above. That surprised me a lot. Ann Arbor's C.S. Mott Children's Hospital is listed so I suspect you've been to see them already.

If there's one thing I know it's that we'd all pool resources in a heartbeat to get you guys wherever you needed to go (out of state or wherever) to find answers and experts who can spell the end of this ordeal for you. If you decide you need to hit one of these other healthcare facilities you know you can count on all of us to help in a pinch.

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Infantile Spasms normal eeg
(Anonymous)
2009-01-09 08:16 pm UTC (link)
I got a google alert for Infantile Spasms that contained your post about little Zoe. My daughter is diagnosed with a CDKL5 disorder. It is not uncommon for children with this disorder to have normal eegs in the early months while having IS.
Please have a look at http://www.cdkl5.com
A support group is set up for families with CDKL5 disorders or those suspected of having one. The details for joining are on the website. You are more than welcome to join and maybe get some answers for your dear little girl.
L, mother of AB & G

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Re: Infantile Spasms normal eeg
[info]cosmicity
2009-01-09 08:48 pm UTC (link)
I guess I feel like it's important to note that the none of the 3 EEGs (including a 24 hour EEG during which she had 5 episodes) detected any epileptic activity whatsoever. So, we're not just talking about the IS pattern they look for, but nothing at all. You've heard of cases where they have the disorder and have completely EEGs like that?

I'd feel very strange joining the site without a CDKL5 diagnosis - it's a very specific website.

-m

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(Anonymous)
2009-01-13 08:32 pm UTC (link)
Early On is a great resource. Michigan also has a program called Healthy Families (which is more of a support system for first time parents). They can help you find resources you may not be able to to find otherwise. I work with our women's resource center that offers the Healthy Families program and Great Parents, Great Starts. I love having someone come in every week to talk and help us out a bit. You might also try to find out about Respit care. It may sound awful to you at the moment, with so much craziness going on, but the workers are very heavily trained and background checked. They are assigned a number of hours each month or week, and can care for your baby to give you guys a bit of a well needed break. My children do not have near the challenges your daughter has, but after four years of never getting to take a break, it is really nice to be able to take a couple of hours to myself. Respit is designed to give parents of special needs, disabled, challenging, difficult, etc. children and caretakers an opporutunity to have a small break. I just know how hard it is to try and deal with so much with my kids and the medical challenges they have without any kind of break or help. Respit has been a wonderful thing that I wish I could have found out about years ago. It may be something to consider later on.

That said, I truly hope that a solid diagnosis can be made for your family. I was grateful for my son's reflux diagnosis, much the same you were a month ago. My daughter faces bronchial problems that require several breathing treatments a day. It's hard to live with, and I have been more than burned out by it all, but they are so very worth it. Someone will be able to help your baby. I hope they come soon.

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[info]rob_danger
2009-01-16 08:09 am UTC (link)
mark

i really don't have words to describe how sorry I am for you, your wife, and zoe. I saw the most recent vids, and I understand all of your concerns because, the spasms do resemble IS.. She looks healthy and happy though otherwise.. I'm just so sorry.

I pray for Zoe every day, and have been also in touch with different families on youtube with children with IS fears. One family has a blog. they just celebrated their sons 200th spasm free day.

I hope it is not Is. but whatever it is Mark you are in my prayers.. and I know Zoe has so much support and love. We are all thinking about you.

-Rob

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