Sunday, October 3, 2010

new neuro...

This past week we went to a new neurologist.  This doc was recommended by her pediatrician and was a fantastic referrral!  He is part of Cincinnati Children's, but is at a different location.   Hannah and I both LOVE this new neurologist.  From even the first moments, he seemed to really "get" Hannah.  It was a very daunting feeling for me to try to explain Hannah in a 1-2 hour session.  Dr. Neuro really eased my feelings and made it very easy to talk.  We talked about these new seizures.  He agrees that puberty is reeking havaac.  He basically said to pull up my boot straps and know that it isn't going to be an easy time, but we will get through it.
About half way through the appointment, Hannah was being... ahem... very distracting.  I was having difficulty concentrating on what he was saying because I was having to "manage" Hannah.  He saw and understood this.  He stood up and told Hannah "come on... let's go for a walk."  He took her down the hall and to the nurses station, sat her down at a comupter to play games.  He came back and in the room and we continued to talk.  He said "it's okay... i deal with this all the time.  She will be fine out there and she is entertaining the nurses!!"
He really gave me hope that there ARE more medications to try.  But, he wants to continue to give Depakote a try.  But he DOUBLED her dose and changed her to an extended release tablet.  Dr Neuro thinks it should work better.  He said she wasn't on near enough Depakote.  He also increased her Diastat to 20 mg from 12.5 mg.  And, Dr. Neuro wants to add Ativan into her resue meds.  He said it works a little better and is much easier to give (squirts in the mouth in between cheek and teeth).  We will go back in 2 months to see if the changes in meds are making a difference in her seizures. 

At some point, I started to cry.  I was feeling so overwhelmed that we finally have  a doctor who understands Hannah.  He can see the "whole Hannah" and not just looking at one part of her and sending us on our way....


And then he dropped the bomb shell..........










He asked if she has even been tested fro Dravet Syndrome.  I told him I had talked with genetics a year or two ago about testing for it.  They poo pooed me saying she wasn't "severe" enough.  Dr. Neuro said that absolutely is not true.  There is a range of severity just like in Down Syndrome. He said there are kids on his caseload that look just like Hannah.  They are considered Higher Functioning Dravet kids.... He said they are really smart over there (genetics), but they don't know seizures....  He really feels she has Dravet.  Dr. Neuro thinks given her history, how she looks, how her seizures have changed, how she acts... that we may have FINALLY found a diagnosis.  Holy cow.  I really don't know how to feel.  Part of me is relieved and the other part of me is freaking out!  I am scared and giddy all at the same time.  At one moments, I feel like, yes, this really fits her.  And then other moments, I feel like, nope, no way...

From the Dravet Syndrome Foundation:  http://www.dravetfoundation.org/

Dravet syndrome, also known as Severe Myoclonic Epilepsy of Infancy (SMEI), is a rare and catastrophic form of epilepsy for which there is currently no cure. Seizures begin in the first year of life in an otherwise typically developing infant. Initial seizures are most often prolonged events and, in the second year of life, other seizure types emerge. All seizure types are remarkably resistant to medical therapy and the prognosis for Dravet syndrome is poor.



Individuals with Dravet syndrome face a higher incidence of SUDEP (sudden unexplained death in epilepsy) and have associated conditions, which also need to be properly managed. These conditions may include:


•behavior and developmental delays


•movement and balance issues


•growth and nutrition issues


•sleeping difficulties


•chronic upper respiratory infections


•sensory integration disorders


•disruptions of the autonomic nervous system (which regulates things such as body temperature and sweating)



Children with Dravet syndrome do not outgrow this condition and it affects every aspect of their daily lives.


Unless a cure or better treatments for Dravet syndrome is found, individuals with this disorder face a diminished quality of life. Current treatment options are extremely limited. The constant care and supervision of an individual with such highly specialized needs is emotionally and financially draining on the family members who care for these individuals.




So, we did lots of bloodwork and urine testing.  And now we wait.... we should have the results in 6 weeks.  I know it won't change the treatment... to have a name.... but we will HAVE A NAME!!!  All the doctor's for 9 years have all felt there is a syndrome, but have not been able to come up with one....  We will see...

1 comment:

Danielle said...

I'm hoping & praying that you find your answer!!!

...danielle

Beautiful Hannah...

How this journey started....

Hannah was born prematurely at 34 weeks gestation. She was a relatively healthy preemie; initially having difficulty maintaining body temperature and needing to grow. She weighed 4 pounds 9 ounces at birth. When she was four months old she began to drool, non stop. We were told the first year she was "teething." At 18 months old, we really started searching for reasons of why her shirt was always soaking wet. We saw various specialists who always sent us to another specialist, saying "everything looks okay." She spent years in oral motor/feeding therapy to help her not to drool. It wasn't until she was four years old and in preschool that we started to get some answers. Her preschool teacher commented one day that she wasn't reponding when her name was called. I took this information to her pediatrician who then orderd an EEG, "just to rule it out." Much to our shock and amazement, the results showed, she was having seizures. That is the day our journey REALLY began. Once she began taking seizure medication the drooling almost stopped completely. (She will still drool to this day when she is having seizure activity). Since then, it has been a roller coaster; countless medications and medication changes. She has never really reponded well to any medication.

About two years after she was diagnosed with epilepsy, the doctors noticed that her blood pressure was running high. After many tests, she was diagnosed with hypertension. We still are not sure why, but her cardiologist feels her blood vessels are thicker than normal.

About this same time, we also began looking into why Hannah was such a horrible sleeper. She would thrash, talk, move every which way, during her sleep. The sleep studies revealed that she has alveolar hypoventilation sydrome, which means she has too much carbon dioxide in her system when she sleeps. To help this, she wears a BI-PAP at night. This has been monumental in giving her more effective and quality of sleep.

Every day is a challenge for Hannah and our family as a whole. Blitzen has been an absolutely wonderful addition. She calms herself sometimes just by petting and loving on him. He has been trained in behavior disruptions and will sometimes be able to stop a meltdown from getting out of control.
It has been extra hard on the whole family since daddy is deployed to Iraq. He has been gone since January 09 and will gone until Jan 2010. We get to talk with him by phone and on the web cam; which is nice, but not the same!! Blitzen has helped to make his absence go just a little smoother....