Our children need help NOW! PANS: PANDAS-PITAND Legislation

People sometimes ask me how they can help in our journey with PANDAS. Please read this and take a few minutes to write your representatives on behalf of children who desperately need medical care for these autoimmune conditions. Thank you!
Do you have a child or know a family who has been impacted by PANS: PANDAS-PITAND?

I encourage everyone to contact their state representatives in support of similar legislation!  This will only take a few minutes of your time and will do so much to help a child whose life has been turned upside down.

See this link: http://www.usa.gov/Contact/Elected.shtml to contact your representatives!  It’s imperative to share with them the devastating impact this has on children and their families and the urgent need for additional research, as well as ICD listing and insurance coverage!
Please, be clear that high dosage IVIG *has* been shown to be helpful for these autoimmune conditions and should be covered by insurance for all PANDAS-PITAND (PANS) children.  Each treatment costs $ 10,000 – $ 12,000 and many children (such as Faith) require ongoing infusions.  Often, they are not covered by insurance.
The NIMH page is clear and they are currently conducting another study to demonstrate the benefits of IVIG.  See: http://intramural.nimh.nih.gov/pdn/web.htm and refer your representatives to this page as well as this 1999 study: Therapeutic plasma exchange and intravenous immunoglobulin for obsessive compulsive disorder and tic disorders in childhood. Perlmutter, S. et al. 1999
Also, direct them to our website:  PANDAS-PITAND Awareness & Research Supportfor additional information. Review the list of symptoms on our home page.  Imagine your previously normal child suddenly becoming gripped by most, if not all of these symptoms at extreme levels of intensity.  These children know there is something very wrong with their brains… they live with sudden onset

  • phobias,
  • obsessions,
  • contamination fears,
  • anxieties,
  • separation fears,
  • school refusal (yes, even children who loved school and were in gifted classes),
  • incontinence
  • sleep difficulties, including fear of sleeping in their own room
  • academic decline & loss of previously acquired skills, especially Math
  • uncontrollable movements
  • emotional lability, including rages (even in children who previously did not have temper tantrums)
  • ADHD
  • Major Depression
  • Relentless unwanted “bad thoughts” (this can range from thoughts of harming others to thoughts of suicide)
  • compulsions
  • memory loss
  • inability to trust your own brain and body that are suddenly turning on you in dramatic ways

The lives of your family change, literally overnight and are never the same… unless you can get this monstrous auto-immune disease into remission.

I co-admin a group of hundreds of PANS: PANDAS-PITAND parents, that grows daily.  These families are in crisis, desperate to find help for their seriously ill child(ren).  There are only a handful of physicians in this country who are currently experienced in treating these conditions.  If you have any questions about these conditions, please message me through this blog or our website: PANDAS-PITAND Awareness & Research Support Contact page
Our children can’t wait.  They need help NOW!   Thank you for helping a child… please share this post.
PANDAS & PITAND Awareness Ribbon

PANDAS-PITAND Awareness Ribbon

Food Fun!

Food Fun!

Please feel free to share these food pics, as long as you credit and link back to my blog page where you found the food pic.

Thanks & enjoy!

😀

Hollow bell of Trombone cake
with removable large and small mouthpieces at far, right end
Hollow bell of trombone cake
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Trombone cake 2012
Front view of husband's 2012 birthday cake
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Strawberry Cake
Hope & Faith - celebrating birthdays together
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Easter Cross Cake 2011
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Creamy Parmesan Shrimp and Okra
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Orange Cream pastry, sliced open
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Chocolate “Lasagna” Cake
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Wedding Reception cake
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Easter Cross Cake 2010
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Side view of iPod Birthday cake 2010
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Steelhead Trout
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Corned Beef Brisket, Cabbage & Carrots
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Glazed Roasted Duck a l’Orange
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Coconut Macaroons
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Lemon Ginger Shrimp & Scallops over Wilted Spinach

No improvement … more aggressive treatment

If you’ve been to my About PANDAS/PITAND & Links page, you’re aware that Major Depression is a symptom in approximately 36 % of cases.  In Faith’s case, this has reached an urgent level as she is having disturbing thoughts.  We discussed it at length yesterday with her counselor and are ensuring her safety.  Her medical doctors are aware.

We met with her Pediatrician this morning, who ran yet another strep test… which was yet again – positive – even on a strong dose of oral antibiotics twice daily.  😦 This means that the antibodies are still active due to the recurrent strep throat infections and that the antibodies continue to attack the basal ganglia in her brain…. for over a year now.

He ordered antibiotics via Intravenous infusion for 14 days.

After FOUR needles sticks (not her nurses fault or hers… nurse is skilled and Faith has good veins – we think the catheters are defective), we achieved an access!  Four nurses in the room working on it… counting Momma RN, me.  The staff nurses were great and Faith was soooo patient and calm – I was so proud of her!!!  The infusion ran fine.

We are due at children’s hospital first thing in the morning for PICC line placement.  Her nurse established daily infusions of the antibiotic for her.  Our doctors are consulting about her next high dose IVIG infusion.

The troubling thoughts continue at this point… we hope that in eradicating the strep infections and arresting the auto-immune process, we’ll be able to finally stop the relentless attacks by the antibodies in the basal ganglia region of her brain.

We *KNOW* that we are in God’s loving hands.  We *KNOW* that He *WILL* heal her in His time and we rely on Him.  In appreciation of your prayers, love and support…

High Dose IVIG more often

As most of you are probably aware at this point, Faith improves a little more after every IVIG infusion; however, at just past three weeks from the last infusion, she starts to decline again.  Clearly, while it helps her, she is not yet stable.  Also, she continues to test positive for strep throat (as recently as Wednesday of this week), even on antibiotics and with the high dose IVIG infusions… she has not really cleared a strep infection in over a year.

I’ve been pursuing more research literature on Pubmed/Medline as well as meeting with doctors to seek help and determine what treatment plan they think would be best for her.

Our specialist (Immuno) wants to have Faith do IVIG every four weeks until she stabilizes.  At that point, he will re-evaluate and determine what she needs next.

So, this is a HUGE praise that she will finally be on a better track and we are hopeful that in time the treatment will help her.  Please keep in mind though, that this must be scheduled for the next infusion (she is already over 5 weeks since her last one at this point), so we are not looking at her being able to have this immediately.  Additionally, while repeat IVIG does WORK and help children with PANDAS, we’re talking about a child who has been sick for quite a while…. years… probably about 6 years and this is her second severe exacerbation.  We can’t anticipate healing to be immediate… it will take time – likely months… but we ARE hopeful that it WILL happen for her… at least much better than she is now… how much recovery, we do not yet know.  We continue to pray and trust that she… and we… are in God’s hands.

Thank you for your continued prayers for my sweet, precious daughter… God is listening and He is with us.  ♥

Update

Well… last week was pretty good.  On Tuesday, we went out for a belated Valentine’s Day luncheon.  Faith looked so healthy and seemed so happy that day.  I don’t remember seeing her so… well… herself in a long time.  She ate a good lunch, the waitress commented on what a mature and lovely young lady she is… yes, that’s true … and thank you for noticing in front of her; she needs to hear that these days.  ♥

March 15, 2011... belated Valentine's Day Luncheon

Go ahead… click on the photo for a better look… Doesn’t she look lovely, healthy and self assured here?  🙂  She is actually… much, much more!  What a remarkable young lady my heroine is!

March 15, 2011 - belated Valentine's Day luncheon

I’ve been trying to get her out for more exercise… looking toward getting her back to school and having the stamina to get through what will likely be a modified schedule.  Also, the fresh air and exercise seem to help her.  Sometimes we take our golden retriever with us when we go for a walk or a bike ride.  Other times, it’s just the two of us and we go all over the trails near our home; we’re blessed to live in a historic, lovely area with a lot of wildlife to enjoy!  🙂

Thursday evening… March 17, Faith even went outside and rode her bike with other kids in the neighborhood.  !!!!!  😀  Dan and I were so excited for her to see her do that and have a sort of ‘normal’ evening… it’s been so long, she’s lost so much childhood… so much has happened.  Yes, I do realize what a ‘normal’ activity it is for a child to ride bikes with the neighborhood children… never take the mundane normalcy of life for granted… it’s much more fragile than we realize.  I wanted to shout from the rooftops!!!  My heart sang for her!!!  😀

 

Riding bikes with neighborhood kids – March 2011

That was three weeks after her last HD (high dose) IVIG infusion.  That week was so encouraging!!  I started thinking about her going back to school…. I asked her homebound teacher to bring her work for the core classes we had not yet caught up and had her start working on those… was aiming toward getting her back for a modified schedule, even if it could only be 2-3 days a week in the mornings, for her core classes, realizing she would be tired and need to rest after getting up so much earlier to go to school.  (She continues to sleep until about 11 am – noon; her body needs so much rest to recuperate.)

This week; however, is not as encouraging… it’s more worrisome.  She’s not looked as well, physically.  Last night, she had a severe episode of separation anxiety and seemed “thisclose” to going into one of the full blown rage episodes she was having daily (and sometimes more often) around Christmas when she was hospitalized … which is usually complete with thrashing (think seizure-like, but it’s not a seizure), eyes rolling back and going limp afterward… scary for a parent to observe.  She hasn’t had one since just before this most recent infusion…

Suddenly, she “had” to be with me and hugging me… this translates into a grip in which I sometimes can’t get a breath… sometimes, it is the precursor to a rage episode, thrashing, limp, hallucinations… I did say I would be more candid here.  I realize it’s shocking to think of this lovely Christian honor roll student who is so thoughtful of others suddenly transforming into what I describe. This is what is so alarming about PANDAS/PITAND… the dramatic changes it can bring about in such a wonderful child!  … in ANY child who has a pre-disposition to an auto-immune condition.

Today marks 29 days post her most recent HD IVIG infusion.  The half life is 21-28 days.  I ran a rapid strep test as she’s complaining of strep symptoms and is convinced that she has strep – she is rarely wrong.  The rapid test was negative.  If her symptoms do not improve within a few days, I’ll repeat that myself or take her to our pediatrician.

She is not scheduled to return for her next infusion for four more weeks.  I’m pushing sleep this weekend… pushing rest, healthy diet, fluids, exercise… everything that helps her recover.  If no improvement by the early part of the week, we’re going to have to see our Pediatrician and/or our local Immunologist, who I am working with to determine if we might be able to manage most of her HD IVIG infusions here locally.  Are her IgG levels dropping?  Does she have a new infection?  Did the rapid strep test (they have about a 20% false negative rate with no known false positive rate) miss a strep infection (she remains on twice daily antibiotics; however, she has tested + for strep while on antibiotics and just after several times)?  Has the auto-immune process not been shut down sufficiently?  I don’t know the answers to these questions… I’m praying this is merely a temporary bump and she improves quickly.

Strep is a disconcerting bacteria for my child.

Group A beta hemolytic streptococcus

  1. Strep bacteria are able to disguise themselves to avoid detection by our immune systems
  2. Our immune systems do not initially recognize it as strep; however, the immune system does it’s job and creates a “template” of this new invader, which it knows is not ‘self’.
  3. The immune systems antibodies attack this foreign invader to destroy it.
  4. Sounds like all is working as it should, right?  Yes… except…
  5. We believe that the strep has, in these cases, disguised itself in such a way that it ‘resembles’ the molecules found on cells deep in the basal ganglia of the brain.
    1. This is known as molecular mimicry and is the trigger for the cascade of events in the auto-immune process.
    2. The basal ganglia are a complex group of interconnected components that are part of neurological loops in the brain.  They are involved in processing/regulating information from almost all surrounding cerebral structures, including motor function (and voluntary motor control), learning, memory, emotion, dopamine, sensory input/sensation, motivation (known as “paralysis of will”), inhibition and dis-inhibition (excitatory), vision, judgement, personality, speech.
  6. Thus, the immune system crosses the blood brain barrier (this part is not yet fully understood as the BBB was thought to be impermeable to this) and attacks those areas of the basal ganglia as well, causing inflammation and a myriad of complex signs and symptoms…. many of which are listed on my About PANDAS & PITAND and links page… transforming a previously sweet, intelligent, polite, mature and thoughtful child into one the parents find hard to recognize … personality-wise.

Looking back over the last few weeks, I realize while she has not had a full blown rage, thrashing, limp episode in about four weeks (and we clearly see that as improvement), she continues to have these really intense separation anxiety episodes… last night’s being probably the worst in a long time; although, she had a couple intense ones with me last week as well.

I’m sometimes so eager to have her life back to normal as she has lost so much of her childhood to PANDAS/PITAND, that I forget what I know:  brain injuries take anywhere from several months to years to heal.  It is only then that we have some idea where things stand for long-term prognosis.  When injury is on-going or recurrent, as it is in the case of PANDAS/PITAND, it becomes difficult to know when the injury stops and the healing process begins.

I’ve been sitting here staring at the computer trying to think of a more positive way to complete this post… I’m at a loss.  She is where she is at the moment.  She does have a few good hours some days, but they are in the midst of a challenging recovery.  Today has been difficult as well.  Time… Time will tell….

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