No News is NOT necessarily Good News.

The old adage "No news is good news", doesn't always apply.  In the case of this blog, no news just means I am feeling too defeated to type the same thing over and over again.  

Our much anticipated and long awaited trip to the Endocrinologist was a bust.  After doing yet another hour long medical history and ANOTHER full physical, all the same questions and answers, all the same physical checks (down to 49lbs! crap!), tests and responses, we got the same answer as always...."We have no idea".  or "There is definitely something going on with her, but it isn't something that falls within our specialty."  or in this case, "There is absolutely no hormone in the human body that can cause the types of issues that Leah experiences."  

As a bonus, they agreed to do some blood work, to repeat it every 6 months and to continue following her for the next couple of years to see if anything develops -  but basically they threw up their hands and shrugged.

Based on bloodwork and medical history they ruled out Ehlers-Danlos Syndrome, Parathyroid disease and Fibromuscular Dysplasia - I had added these three to my list due to recommendations and research.

For Leah it is the same old thing - usually misses at least 2 days a week of school, the cooperation at the school is still less than desired but we are at lease getting the bare basics of what we requested.

We are struggling so hard to find a balance for Leah.  If she does "too much" at night, she doesn't have the reserves to make it to school the next day.  Currently, too much amounts to a 30min swimming lesson and 20-30 minutes in Games Galore (running, playing games in the YMCA gym) on Monday nights - it doesn't even push her bed time back, but it is too much.  I don't think she has made it to school on a Tuesday since Christmas!  If she plays outside "too much" after school, she doesn't make it through supper and may or may not make it to school the next morning.  She already misses her outside playtime during lunch at school while she is taking a nap, and soon will be kept inside the school on the hot/humid days.  She had to give up gymnastics, she only goes to the house of her best friend to play, no other play dates, she has to stay within sight of the house or with an older sibling at all times.  We are already (hotly) debating letting her go on the family vacation to the cottage this year - my instincts say no, but my heart says yes.  

When does she get to just be a kid and have fun?

Following along on that thought, I came across an excellent story written by a lady with Lupus - it is about how she finally stumbled upon a way to describe what having a chronic illness is like.  It is called "The Spoon Theory"

                                                                

It has spread like wildfire among the disease/syndrome forums.  I am in complete agreement with her explanation as it exactly illustrates what Leah goes through.  As such I have added this photo of Leah.  She is now an official "Spoonie"!

Please keep Leah in your thoughts and prayers as we await a decision from the Mayo Clinic.  A month or so ago, I stumbled upon a chain of links while doing research that led to a Mayo Clinic Self Referral form.  Feeling a little foolish and a whole lot nervous, I filled it out and sent it off.  I sent along the introductory letter I have created and keep up to date with all of Leah's symptoms and medical history to give to each of her doctors.  A couple days later they requested copies of Leah's medical records, scans, MRIs, doctor's letters, THE WORKS!  I organized all that info and sent it off.  A couple days ago I was notified it is being reviewed by a doctor and they will decide if they want to see her.  They have an entire department set aside to deal with "International Patients" and really make an effort to keep us informed of where we are in the process.  My understanding at this point, is that if they feel Leah could benefit from their expertise or that THEY could benefit from diagnosing, researching and treating Leah, than we would go to Minnesota to be seen by some of the best medical minds in the world!  Since she seems to have stumped the ones in Ontario, lets move onto the ones in Minnesota!  

Dexadrine

Dexadrine (Dextroamphetamine) is a powerful psychostimulant which produces increased wakefulness, energy and self-confidence in association with decreased fatigue and appetite. It works primarily by inducing the release of the neurotransmitters dopamine and norepinephrine from their storage areas in nerve terminals.  (wikipedia)  It is used with great success in treating ADHD, narcolepsy and chronic fatigue.


Well whatever it does and whatever it  is, it is certainly working.  As long as Leah takes the pill in the morning and then again after her nap at school she is able to stay at school.  If, like this morning, her dose is forgotten, the school is calling by about 10am.


As for noticeable side effects for Leah...have you ever seen the movie Hoodwinked?  She is a little bit like the character Twitchy on caffeine.  Chatters a mile a minute about the minutiae of her day, is restless and amazingly enough quite distract-able. This gradually wears off by about suppertime and then shortly after that she is ready for bed.

Her morning dose keeps her going until about 11, then she is able to take a nap at school, eat lunch and get her next dose.  It hasn't affected her appetite too much at lunch as she gets to eat prior to taking another one.

On the weekends and other school holidays, she does not get the meds.  This does result in episodes and extra sleepiness on those days but we believe her body needs a break from the medication and we want her to be eating as much as she can on those days.  Currently I do not plan on keeping her on it over the summer break.  

In less than a month we finally get the appointment with the Endocrinologist. Our success with the Dexedrine might be the key we are looking for in getting a diagnosis.  Hopefully it will help him at least narrow down the possibilities.

FRUSTRATION!

Today we went to the paediatrician's office for a follow up on Leah's extensive bloodwork and EEG.  The bloodwork had been ready on September 26th, and for some reason we were not called.  The EEG was ready some time last week, and again we were not called as promised.  I called McMaster to find out the status of it, and when told it had been read, dictated and printed, called the paed's office and made the appointment myself.

The waiting is tough enough, never knowing when the phone call is going to come and even worse, what it is going to say.  But to wait, and wait, and wait, and never get the promised call - for no apparent reason, really burns my butt!

Results

EEG - bottom line,it  is still showing as completely normal.  His response was, if the CT Scan and two EEGs are normal we can assume the brain is not involved.  But we will still wait for the Neurologist appointment.

Bloodwork - her thyroid hormones are normal - this means there is neither hyper nor hypothyroidism at work.  However, the other tests that use thyroid indicators(anti thyroglob, microsomal anti & TSH) are high and have been slowly increasing all summer.  This points to an autoimmune problem and based on that he has sent out a referral for her to see a Paediatric Endocrinologist at McMaster.  As well her CK (muscle enzymes were still high), her Blood Gases were a little off (PCO2 high, PO2 low and HCO3 high), and her red count high.

As usual the statement I received when asked for a more definite diagnosis was, "It shows something is going on, but nothing is high enough to point to one thing."  Hence another referral, more waiting, another chance to explain 3 years worth of symptoms in a 20 minute appointment, more tests, more questions, more exams and more WAITING!

In the meantime, Leah is missing on average two days a week of school - not including doctor's appointments.  So far, this is not impacting on her learning.  The work she is bringing home is excellent and she is still loving being there.  She has grown a couple of inches and gained a couple of pounds since July which is good, but her eating is still a little sketchy, so we have started giving her a bottle of Pediasure a day in addition to her vitamins.