The past few weeks have been difficult for my family. My boy, who has been known in all my writings as Tree Bear, got some disturbing test results back from a routine doctor’s visit.
With my history in Dysautonomia, I was concerned given some of the results. He has been battling a Vitamin D deficiency and clinical fatigue which we have been treating as a case of depression. As he looks to transition into a new college program later this month, I decided to request a test on other vitamin levels (B12/Iron) and have his primary care physician test his inflammation levels.
Several weeks ago those levels came back abnormally high without any known reason.
Additionally, I noticed Tree Bear’s acne was becoming unusually pusie with discolored pus (browns and greens) on his back. Concerned, I took him to the dermatologist who advised he had a bacterial skin infection and diagnosed a common antibiotic.
The next week, Tree Bear started having heart burn and digestive distress, including throwing up. I took him to his primary care physician. Concern over the physical exam leads them to perform an ultrasound where Tree Bear is diagnosed with splenomegaly.
By this time, between the vitamin deficiencies, the abnormal inflammation levels and the splenomegaly, I am concerned that he is showing all the signs and symptoms of someone suffering from dysautonomia. The genetic disorder that has devastated my physical health for so many years. I research providers at Dysautonomia International and see that one doctor is located at the Sibley Heart Center part of the Children’s Healthcare of Atlanta network and Emory University.
We get Tree Bear scheduled for evaluation for dysautonomia. At the appointment at Sibley Heart Center, an rhythmic anomaly is noted during the EKG and coupled with the vitamin deficients, splenomegaly, and inflammation levels, Tree Bear is given a “more than likely than not” diagnosis of dysautonomia. A diagnosis that Tree Bear is still fighting accepting. For him, dysautonomia is a medical boogieman who took his mother’s vitality and health from her right before his eyes. Convincing him that a healthy lifestyle and treatment early in his life would help him live a very different life than my own, is an uphill battle.
And all of this does nothing to address what dysautonomia experts call “secondary issues” a diagnosis of dysautonomia indicates. If you have diabetes and then develop kidney disease, kidney disease is a secondary health problem caused by the diabetes. In dysautonomia, the secondary issues often are where the primary symptoms spring from. For Tree Bear, the splenomegaly, inflammation levels and vitamin deficiencies all are rooted in the genetic disorder of dysautonomia, and are considered a secondary issue that requires medical attention. Often fatigue in dysautonomia is actually a manifestation of secondary issues like vitamin deficiencies, secondary infections and viral infections someone is more susceptible to because of dysautonomia.
In order to get real serious about Tree Bear’s treatment, I immediately switched him to work with Heather at Gwinnett Center Medical Associates. Heather is a great provider who has, from the get go accepted that I was that “weird” patient who has really educated herself. She acts as my personal Coordinating Care Physician. This means, she automatically gets all test results from all specialists and I have easy and great access with her nurse, Shari, to see that any tests done by Heather get sent to the appropriate specialist.
Heather saw Tree Bear and we immediately tested for mono or Epstein Bar, did an IG panel, and retested his vitamin D levels. I knew from my history, that low IgA levels are often an indicator of dysautonomia.
Today those results came back, Tree Bears’s IG levels are clinically low, his vitamin D levels are barely passible, and the Epstein Bar test clearly showed a previous infection with some viral load.
Tree Bear is schedule with a new immunologist and I spent most of this morning, going over his results, setting up online access to his different doctors, and bringing his biological father up to speed. Then I broke the news to Tree Bear myself and discussed what I know will be done Thursday.
That’s The Situation AND…
When I talk about the clinical stuff, that is all it is, clinical stuff. It is me sticking to as close to medical, testable theories as possible. And I am a mother. Tree Bear’s mother. For the past two years I have been treating Tree Bear like he was a teenager who was depressed, angry and lazy, like many teenage boys can be.
I am a bit upset with myself that I ignored the symptoms for sometime.
On the other side, I am so grateful for the personal attention I have paid to my own condition and test results. I am glad that I had partnered with Heather and knew if I took my most precious boy to her, she would listen and help me figure out what to do and where to go. It feels like dumb luck that I knew to ask for the inflammation panel, the IG panel, and check the vitamin levels. It wasn’t. It is the hard experience of my own battle against dysautonomia. It was the complete understanding that this is a genetic disorder that Tree Bear would be highly susceptible to because of his genetic link to me. Tree Bear will never again be told he is being lazy because he is fatigued. He will never suffer through a diagnosis of hysteria.
Tree Bear is learning directly from me how to interface with doctors and I am giving him lots of room and education to make his own decisions. Tree Bear has asked for the table tilt test to be done to confirm the diagnosis and I will encourage him to go to Vanderbilt University for further diagnosis and workups.
There is much that I can be grateful for in all of this.
I have learned a few things about dealing with doctors over the years as I battle dysautonomia. This chapter in my journey has taught me a few things about dealing with a chronic disorder and children.
- Doctors don’t always know. When I asked for the inflammation panel, Tree Bear was very resistant and his primary care physician even more so. Even I felt I might have been being a bit over protective. I KNEW that high levels of inflammation could indicate dysautonomia, just as I knew that IG levels are important part of dealing with dysautonomia. Too often, mothers who KNOW things let doctors and children talk them out of that knowledge. If the test you request are negative, great! Doing the tests when there is sufficient reason is never a bad thing. More information in chronic illness is always best.
- Tree Bear has to be part of the solution. I have to find ways to get him on board with this diagnosis if he is to stand a chance of a healthy life his entire life. Children of any age deserves to be educated about their condition. I have order the Dysautonomia Project book to give to Tree Bear to educate himself. He has to buy into this diagnosis and this means talking to Dr. Hebson into allowing Tree Bear to have the table tilt test.
- Chronic Illness needs all parenting partners on the same page. I spent time this morning talking to Tree Bear’s biological father. To say that we don’t get along is a bit of an understatement. However, Tree Bear needs his father’s support and encouragement to eat healthy, drink water, exercise. Further as Tree Bear’s father, he has the right to know and have access to all the information. After explaining everything to Tree Bear’s father, I sent him all the access information for the various portals so he could look for himself. How I get along with Tree Bear’s dad has no place in a discussion about Tree Bear’s condition. Keep it clinical and on point – just discuss the illness and treatment options. I also sent links to Tree Bear’s dad to get educated about dysautonomia. My hope in all this? Maybe he will see something that I miss or will find some suggested test or treatment that I haven’t run across yet. Fresh eyes and perspective can be very valuable when dealing with chronic illness.
- Working against chronic illness, requires a chronic commitment to persistence and perseverance. At least once a week, I spend an entire day thinking about my condition and current treatment plan and now Tree Bear’s condition and current treatment plan. I think about what I can do to improve my health and what other tests or options for treatment I might have not taken advantage of yet that I could. The reason disability exists is to give those who are disabled the time they need manage their chronic or permanent illness or injury. Make sure that you take full advantage of that.
Author’s Note: Tree Bear is 18 now and as a mom I still see him as that 10.5 lb, 27 inch baby I gave birth to 18 years ago.