What I Want You to Know About Mitochondrial Disease

As we begin Mitochondrial Disease Awareness week, I am finding myself tempted to share statistics or re-post articles that have me nodding my head. I still may do these things. More importantly, I wanted to try and describe my personal experience with mitochondrial disease and how it affects my family.

This is what I wish for you to know, and to understand:

1. Mitochondrial disease can affect anyone at any age. It can be quite obvious, or very subtle. Patients can manage to participate in sports, or can be confined to wheelchairs. In our case, Joshua falls somewhere in the middle. He has exercise intolerance, but he can walk short distances. He uses a wheelchair for longer walks. Sometimes he rides for shorter ventures if he is just having a bad fatigue day. We are thankful to have the wheelchair. We are also grateful he does not, at this time, need it constantly. But it still sometimes makes my heart ache that we even need one at all.

2. Many physicians have been involved in the diagnosis and care of Joshua. We still lack a specific diagnosis for his health problems, (despite all their expertise), therefore, they say he has "unspecified mitochondrial disease." It is common to spend years to even get this generalized diagnosis, much less a specific one. Even the newer, more sophisticated methods of "combing through" all the DNA will not find EVERY type of mito defect out there. We are currently waiting for results of a whole exome sequencing test from TGen that makes us feel hopeful. This has not been an easy road, seeking answers. It makes me upset when someone says that they would stop looking and "relax" if it were their child. You would? You would not want to know what affected your child's daily life in such a dramatic way, or what it meant for their siblings or future generations? Think about this for a minute.

3. There are many issues Joshua has that are considered secondary to his mitochondrial disease, which include: gastroparesis, GERD, hypotonia, autonomic dysfunction, asthma, food allergies, tachycardia, neurogenic bladder, immune deficiencies, dysphagia, heat intolerance, hip dysplagia, cerebral palsy, autism spectrum disorder, visceral hyperalgesia, convergence insufficiency, etc. Even dealing with just ONE of these problems can be hard. So we juggle them all, like a crazy, multi-ring circus! We are constantly adding new issues to the mix, and trying to figure out how to manage them.

4. In many moments, on a good day, Joshua can appear pretty typical. What a blessing! However, I am aware that people also do not take into account all that we go through to make this so. Before leaving the house for school, for example, we give him his medical formula, four medications and a supplement. He takes three additional meds in the afternoon, and he needs approximately ten interventions or meds before bed, depending on his status. There is no cure for mitochondrial disease. There are only meds to help the secondary issues mentioned above, and supplements that are believed to aid in mito function. Almost every thing is a shot in the dark, all the time. We give things, often paying out of pocket, in hopes that they provide some benefit.

5. I have encountered a vast support system of other mito parents online, and some in person here in Phoenix. I am thankful for their support, and I hope sometimes I can help them as well. We share advise and experiences. We have each other to vent to when no one else gets it. Some of them have children who are no longer living. But they still come on the Facebook groups to offer support to the others. These are incredible human beings. Never can I express enough my sorrow for their losses, or my appreciation that they still fight for the other mito kids.

6. I am a pretty positive person, but I have tough days. Sometimes I worry a lot about my other children. I worry about my own health issues. I worry about Joshua's future. I enjoy posting on Facebook and texting my friends, or going out, but there are times I feel I cannot be completely honest about the difficulties I am facing, and therefore I withdraw into my own world for a while. I cry more often than I like to admit. On the flipside, there is love. So much love. I do not take much for granted. I am determined to be an advocate for my child. One of the ways I can do this is by allowing myself to open up at times like this and do my part to make mitochondrial disease a household word. If you would like to find out more, please consider checking out www.mitoaction.org

On Eating Out With Special Needs Kids: Why We Still Try

Saturday was Cinco de Mayo, and so I decided I "had" to have some chips and salsa (ok, and a margarita, too). The way the restaurant experience went was pretty typical for us. It wasn't one of our better outings with the kids, but it certainly wasn't the worst, either. We went to a local Mexican restaurant, which took about 15 minutes to drive to. During this time, my 7 and 4 year olds hit each other with a toy drum stick, which of course my husband took away, which then caused more screaming. When we finally arrived, there was a 10 to 15 minute wait for a table. My 4 year old fussed and moaned so much that I finally picked him up, hoping some cuddles would calm him down. Once we got seated, we realized the booth was pretty tight for our family of 5, but we didn't want to wait for another spot to free up, so we decided to make the best of it. Now on to the next challenge... Two of my children and myself have food allergies. This was a restaurant we had been to before, so I knew what I could eat, but it had been a while since the kids went to this particular place with us. I was racking my brain trying to remember what things were ok from the menu. Once I got that figured out and the order was placed, I remained busy trying to keep everyone hydrated and happy. My 4 year old requires thickener in his water, so I luckily had remembered to bring that. Usually when we go out, I also bring some extra snacks such as cereal or fruit chews, plus some baby food and his medical formula. This provides a "safe guard" in case he doesn't feel like eating much from the restaurant (which is often), or, in case the food allergies are too hard to figure out at an establishment. If I am lucky, I also have remembered to pack some form of entertainment, although on this day I really didn't have anything with me that excited anyone! Once the meals came to the table, we checked carefully to make sure they had been prepared to the specifications we need, and then we got busy eating. Well, some of us did. My 4 year old pushed food around on his plate. I think he finally ate one french fry. My older kids did fine. However, they are not immune to table time issues, either. Sometimes they get restless and try to act too silly at the table. Other times, an allergen winds up in my 7 year old's food. (He can't have dairy). Sometimes my 11 year old suffers from swallowing difficulties. Even my husband can struggle with this at times, thanks to a disorder referred to as "EE" or "EoE." We have been in restaurants before when one of my kids had a tantrum, cried about reflux, or worse, vomited at the table. With all of this on board, you might wonder why on earth we don't just stay home all the time. Here is why: I like going out to eat. My kids also, generally, enjoy this change of scenery from our normal life. We have a small house and an even smaller kitchen. It's fun to spread our wings now and again. Aside from that, eating is social! I have two children on the autism spectrum. That, or the food allergies and other digestive issues could scare us off from eating in public, but I think of all the opportunities they would miss if I simply isolated them from meals out, picnics, school carnivals or birthday parties. Almost everything social involves food! I would hate for them to grow up believing it is too hard for them to join in these activities. When they become adults, I want them to feel confident that they can handle a noisy restaurant, and that they can navigate a menu. I want them to accept the invitation to a friend's birthday party, wedding or baby shower. At the very least, they can eat ahead of time and simply go for the sake of supporting friends and mingling. This is what it is really about. If I keep instilling in my kids that they CAN do this, then it will positively impact their future. Until then, though... I might be needing an extra margarita!

Sweetest Valentine

This past week was Valentine's Day, a holiday that I think is fun at my kids' schools, but that I have no major emotional attachment to, or so I thought. That was before I received the most beautiful valentine ever.

My husband took the kids to school that morning and collected paperwork from the teacher, and so it was not until later in the day, when we switched cars back, that I saw a red and purple correspondence lying on the floor of my van. There was some sparkly paper folded up with a heart sticker in the middle. In retrospect, I wish in some ways that I had waited to be with the card-maker (my 3 year old, as it turned out), before opening. But in other ways, I am glad he missed my emotional reaction. I carefully peeled back the sticker, and inside was a small, red construction paper heart with a photo in the middle. The picture was cut jaggedly into a heart-shape also (obviously done by my preschooler with love). The photo showed him sitting in the sand of the playground, looking down contently at a bucket. It summed up the innocence of the age he is at now.

As any mother would, I then thought about how he would not always be this little and sweet, and how time was moving too fast. But then, something else hit me unexpectedly. I got a rush of emotion about his diseases, and it slapped me in the face, more than it ever has before, that I might outlive him. Yes, I have thought of that before, and I have even blogged about it. But this time, in a way that is tough for me to explain in words, it was different. It was the most I have ever faced the enormity of it all. And I realized I don't know how I could ever be on this earth without my son. My heart hurt and I couldn't breathe. His lack of exact lab findings on mitochondrial disease have left me the ability to ignore reality many days, or to assume the best (maybe he doesn't have it!) But the fact of the matter is, he has something metabolic for sure, and also, we know that he has gastroparesis. His stomach has slowed down a lot lately to the point where we are having to search for more and more medicines to get things going, as well as get second and third opinions and consider drastic measures like gastric pacemakers. We now also give him several supplements believed to increase energy. Take a minute to think about that oddity, as I did. He is in preschool. He will be 4 next month. Usually at this age, mothers are chasing their children, and saying they cannot keep up with them! It is common to hear things like, "I sure wish I could bottle that energy!" And here I am, giving my child a "cocktail" of remedies just so he can (sometimes) get off the couch. I have to encourage him to try and play, as do his teachers, where as normally you'd be telling a child this age to slow down or relax!

So, how to take these sad feelings and reality and make them positive? I think the answer is the same as it has always been for me. Don't dwell on the future. Appreciate every day. And, when grief does want to take over, let it come for a while. It's acceptable to grieve normalcy. It's ok to think about how much you will miss someone when they are gone. And then... hug. Cuddle. Say "I love you"- a hundred times. Don't stop believing in the possibility of a cure.

The precious heart card is now in a frame in my family room. I knew I needed to keep it close and make sure it was preserved. It doesn't make me sad to look at now, as it reminds me of all that is good in my life, of all I have to be thankful for, and of love, in it's purest form. Nothing could be better than that.

Embracing Miracles

It's that time of year again. Christmas is upon us, and it's time to reflect on the past twelve months. It's nice to think about our successes as well as our shortcomings and how we hope the new year will be better. It's a good time to consider what we have learned. Somehow, in the midst of the mundane yet crazy busy year, I have learned to truly believe in miracles. Maybe I always did, though. Maybe this blind faith was always lurking just beneath the surface, but needed something concrete and personal to bring it forth.

Let me explain. My youngest child is now age 3 1/2 and has demonstrated the ability to eat a normal meal only a handful of times. By "normal," I mean an age-appropriate portion or consistency, and I also mean that the meal would take place without gagging, choking, pain, tears or vomit. Actually, just getting him to the table at all is sometimes a feat. The main issue is gastroparesis, a condition that makes it hard for him to take a lot of food in at once, as the stomach doesn't pump efficiently. A recent trip to the nutritionist shed light on the fact that he is getting only half the amount of calories daily that a child his age and size should receive. This is not despite our best efforts, of course. He is still on formula, and it's done well keeping him alive, but he can't drink enough of it or add enough regular food to meet his appropriate caloric intake.

Despite this, he is not losing weight. He is, in fact, gaining. It's very slow, but it has happened. Because of this, he isn't a logical candidate for a feeding tube yet, even though the tube would ease our minds. In fact, his stomach moves so slowly, that if a tube were to be placed, it would go into his intestines instead of stomach, anyhow. That makes me really realize how tough this disease actually is. And yet... somehow... he thrives. Several doctors and therapists have mentioned that they can't explain scientifically how he could be doing as well as he is. In our numbers and facts-obsessed world, this just isn't ordinary.

During another recent appointment, I was told to consider that maybe Joshua simply doesn't even NEED those extra calories the way a typical child would. One theory is that he is often fatigued and therefore not overly active. Still, this thought is hard to feel at peace with. It's asking me to believe in unusual circumstances. It's asking me to trust in things I cannot see or have the knowledge to understand. It's asking me to believe in something that, in some of my darkest days, I have doubted, and that is a higher power.

But, this is what it has come down to. Until we reach a point where something tips the scales the wrong direction or some other decline happens, we have to just trust that all is well. Within that, believing in miracles has really become not an option, but a necessity. On a daily basis, I have learned to coast along on faith. The logical side of me still argues with this idea at times. It is very hard to put your child to bed at night knowing you weren't able to nourish him the way a chart would say you should, and yet trust that he is alright. There are still moments of doubt and tearful calls to the doctors. They question their judgement at times, too. It's a tough situation for all of us to navigate.

However, there always comes the blessing of a new day, with Joshua in his little footed sleeper, smiling and announcing he is ready to cuddle. I am always ready for the challenges we face, even when I feel slightly deflated. His smile and blue eyes inspire me. That, and the chance to look for more miracles. If I have one in my life, there must be more waiting. I look forward to another year of discovering them.

Merry Christmas and Happy 2012!