Logan L |
When my ex-husband called to tell me our son, Logan, was being transported by helicopter to Children’s Hospital of Wisconsin in Milwaukee I was in disbelief. Logan was a normal, healthy, active 15 year old. He was a sophomore in high school, eager to get his driver’s license and training for the school tennis team. da, he had been sick for a couple weeks with what seemed to be an upper respiratory infection and then possibly even asthma, but when I heard he had cardiomyopathy, I couldn’t believe it. I knew all too well this was an enlarged heart.
Our oldest daughter, Justine, also a healthy child had been diagnosed with the same condition 20 years earlier when she was six years old. At that time the doctors told us they believed a virus attacked her heart. They could find no other cause and said this sometimes happens. There was nothing they could do for her. The subject of transplant was brought up, but quickly dismissed. Medical technology didn’t make this a realistic option 20 years ago. Within seven months she died. We had no other children at the time, but we were assured this should not be a concern for any future children we may have. Two years later Latreace was born, and then three years after that we had Logan. Both were healthy and routine wellness visits to their pediatrician never indicated there was any cause for concern. This was not supposed to happen again! Why? Within the next couple weeks of April 2005 we were question by doctors trying to figure out what the connection was between Justine’s and Logan’s heart condition. We also found medical advancements had made treatment much different. Within two days, Logan was listed for a heart transplant. But his condition was deteriorating quickly and he needed to have surgery to put him on a left ventricular assist device (LVAD) to support him while he waiting for transplant. Surgery went fine, but over the next few days we realized something was wrong. Logan was in status with subclinical seizures and not waking up. He had no previous history of seizures. Now neurologists were consulted. They could not control his seizures with standard mediation techniques and as an only option decided to try putting him in a deep drug induced coma. They started sending blood, muscle, skin and spinal fluid specimens for testing to laboratories throughout the country. Our daughter, Latreace, was also tested. She was fine. Some of the initial results pointed to the direction of some type of metabolic disorder, but we were told it would take months to know exactly what we were dealing with. In the mean time, while Logan was still in a coma, genetics was called in. They recommended starting Logan on a “cocktail” of supplements that would be beneficial to someone with his suspected range of disorders. Finally after a month, something worked. Logan was awake without seizures. Now he required intense physical therapy to get his body strong enough to be re-activated for transplant. June 18, 2005 the day came. This surgery went remarkably well and a week later we received the lab results we had been waiting for: Propionic Acidemia (PA). Logan had an elevated C3 level in an acylcarnitine profile, and his urine tests showed chemicals that suggested it was PA. I had no idea what this was, but spent several weeks searching for information. Logan just didn’t seem to fit. He had never been sick as a baby or child like these other unfortunate children I was learning about. I was told Logan has a mild (tardiv) case. I felt I should be thankful, but was rather puzzled by what a “mild” case was capable of. Skin and heart muscle were sent away for enzyme analysis for propionyl CoA carboxylase that showed he has 4% enzyme activity. While his enzyme activity is low, most children that are sick as newborns have 0% activity, which is likely why he is “mild” and didn’t have any symptoms until his cardiomyopathy appeared as a teenager. Logan left the hospital a month after his transplant and with the help of tutors was able to catch up on his studies and complete high school with his class. In many ways Logan has been a normal teenager. He does have many doctor appointments with cardiology, neurology and genetics and takes many medications and supplements, but he had been doing well. He has been attending Tech school and shared an apartment with several roommates. Unfortunately, ianuarie 30, 2009 Logan was admitted to the hospital again. He is now dealing with severe rejection and is in need of another heart transplant and possible kidney transplant due to poor profusion. He again is being supported by a ventricular assist device (BIVAD), dialysis and a tracheotomy. He is not healthy and strong enough to be listed for re-transplant yet, but we are hoping he will be soon. Genetics continues to be consulted to determine how his metabolic disorder plays a role in his symptoms and treatments. In the last several years our family’s DNA mutation have been tested. It was confirmed that Logan’s father and I are both carriers of PA, and our daughter Latreace is also a carrier. I am sure there are other cases like Logan’s and I often wonder if Logan’s condition could have been prevented if he was diagnosed and treated early in life. Newborn screening for propionic acidemia is now done in most states in the US, but it is unknown whether infants with mild PA will be detected and treated to prevent sudden cardiomyopathy. Special thanks to Amy White, MS, CGC for assistance in preparing Logan’s story, and thanks to the entire talented and dedicated staff at Children’s Hospital of Wisconsin, Milwaukee. Debra L Logan (19) PA
On July 20, 2009, Logan received a new heart. On August 27, 2009, Logan chose to be in a better place. His battle was long but his love for life will always persist. Logan is an inspiration to us all. |
A challenging medical journey and a full loving life. Her faith, courage and strength are an inspiration. May her memory be eternal. October 20, 2008-Iulie 30, 2015
Our daughter Angelica had her first ‘metabolic crisis’ at three days old. Within twenty-four hours of bringing her home from the hospital after birth, she had become so lethargic and unresponsive that we had no choice but to contact the nurse on call, who instructed us to immediately call an ambulance. The staff in the emergency room (thankfully, we live less than ten minutes away from the fantastic resources of the University of Michigan Hospital) were able to stabilize her to a degree, but were very troubled by her ammonia levels and other test results, though they did not know the cause at that time. A conclusive diagnosis of PA was reached by the following day, and after another harrowing four days in intensive care undergoing hemodialysis she was moved to a moderate care wing. We were able to return home about a week after that, once she had regained enough strength, and more importantly, her appetite. Now she is a little over four months old, and while there have certainly been bumps in the road, it does not seem like we could have asked for a much better situation. She has an incredibly hearty appetite for her special formula (“power milk”) and is the sweetest, happiest, most easy going kid you could ever hope to see, and has even been letting her mom and dad sleep through the night, pretty much since we came home! She is tough (and stubborn) as well, having survived intensive dialysis at such a young age and showing no signs of damage from the ordeal. The pediatric genetics staff at the UM Mott Children’s Hospital are a great resource, and having them so close at hand is an incredible luxury that we definitely don’t take for granted. We are also blessed with a very competent and understanding daycare provider–they take everything in stride, whether it is diluting formula as needed, providing medications, or even ketone testing. With everything we have at our disposal, the inevitable problems we are going to encounter do not seem nearly as daunting as they once did. Best Regards, Joe and Toula |
Nicholas P. |
Iulie 24, 2001 – Aprilie 23, 2012 Nicks buoyant attitude and gentle tenacity taught his family and friends how to love selflessly and carry on through hardships. His example will be a guide and comfort to those grieving his loss. He was a devoted aquarium enthusiast and played baseball with the Rivermont Dream League. He loved the River Park, his collection of movies and books (especially Cars), horses and his dog Buster.
Click below to sign his guest book and view more photos of Nick. |
Family Story – Cindy X. |
Hi, everybody. My name is Tad. Firstly I should say I am fortunate. I am fortunate to get the opportunity to join the university, where I met my girlfriend, who became my wife 10 years later. I am fortunate to get my present job as a petroleum geologist after I got my PHD degree from RIPED, where I met a lot of good friends. I am fortunate to have a beautiful daughter, Cindy, în 2012. Totuși, things changed from the day I received a call, which told me the results of my daughter’s lab test. The doctors suspected my 20-day old daughter to have PA. Looking at the cute baby, we all doubted the results. But we went to a doctor the next day, and did some normal lab tests. According to the tests result, the doctor didn’t think Cindy has PA. Then we went back home, with a burden unloaded.
But after that day, my wife got nightmares nearly every night. I have to say, I began to believe the saying of mother-daughter-one-heart. After one week, we decided to do some more professional tests to confirm the situation. About one months later, all the results reflected that Cindy do have PA, which is PCCB in subtype. The result shocked us, and even the doctor. She said she never see a PA baby in such a good condition during her career. Then we began to give her special diet with XMTVI Analog formula and SigmaTau L-carnitine. In the beginning we know little about PA, so we cut off every milk including her mother’s milk. What a pity baby and stupid parent!
I want to say I am fortunate again, thanks the God. We then met a professional doctor who told us how to feed Cindy. Before that we suffered a lot, even Cindy had to be sent to PICU once when she was 1year old. After that, Cindy began to sit, walk, talk at normal age. But then, things became worse, the XMTVI Analog was forbidden to sale on Mainland China. We have to change into another formula, OA1, which is difficult to buy in China. During the period, I joined in to an PA organization in China. We talked a lot there and learned a lot from each other. There are totally about 134 parents with PA or MMAW kids. The organization is really awesome! And as you all know, as most of PA kid, now Cindy begins to dislike the formula and her food, she wants to eat meat. She is now still in the hospital for the past 20 days eating less. So I want to change her diet according to my self’s knowledge, for we cannot get more suggestions from our doctors any more. I will add more formula with little protein but high energy and other minerals.
Now I am in the USA to do a co-research program leaving my family in China. One of the reasons why I choose to come here from such a long way and in such a critical time for my family is that I want to learn something about PA here in the USA |
Evan M. – updated March 2015
Evan is now 8 years old. He had a partial liver transplant in March 2012. Whilst the 1st years was very tough, unfortunately he was diagnosed 6 months after transplant with Lymphproliferative Disease. A type of Lymphoma brought on by the immunosuppressants needed to stop his body from rejecting his new liver. He needed a few months of chemotherapy but thankfully got the all clear from this a few months later. Since this however, Evan has come along so so much.
The transplant wasnt a ‘cure’ but is a huge help in managing Evan’s condition and giving the best chance at living a normal life. He can tolerate alot more protein which in turn helps his development and generally makes him look healthier. He is in his 2nd year in the local special needs school and he absolutely loves it. He runs out to the bus in the morning and always has a smile on his face wen he gets off the bus when he gets home! He loves the attention and being with others his own age. His speech and communication is coming along although we still can’t converse with him and his eating is steadily improving. Although foods still have to be pureed, he is open to trying new things and experimenting and playing with food whereas before he showed absolutely no interest in food and mealtimes.
He is still tube fed most of the time via a mic-key button in his stomach. His feed consists of Energivits, Nutrini and MMA/PA Gel and all medications we give to him via this tube. So even though he still picks up every bug and infection going and does have long bouts out of school and the odd admission to our local hospital the future is looking bright for Evan. There is no doubt life is tough living with PA, we do our best by our children.
Not everyone agrees with our decision to go for a Liver Transplant but even though the 1st year was tough we don’t regret our decision. Our thinking was that if something happened during or after the transplant at least we are doing everything possible and in our power to give our child the best chance possible to have a normal life. Life with PA is so unpredictable.
Sarah (Evans mam)
———————————————————–
Evan is 4 and he was diagnosed with Propionic Acidemia when he was four days old. normal pregnancy, normal delivery and evan arrived a healthy 7lbs 11ounces three days early. On day 3 he was getting very lethargic, he wasnt feeding and was breathing funny from his nose, like he had a cold. He was brought to the Special Care Unit by a nurse and we were told he would be back up soon so we presumed it was just to be checked out. An hour later, he was on a ventilator as doctors were afraid he would stop breathing. A number of tests were done and doctors in Cork narrowed it down to a Metabolic Disorder but they were not the experts in this field, The Metabolic Center of Ireland is in Dublin so Evan was transferred up when he was 3 days old where they diagnosed him the day after. Evan was in the hospital for 3 months until well enough to return home. Since then he has been admitted to the local hospital a handful of times, for flus, bugs and infections but thankfully since birth he has had no major decompensation. He has a good enough appetite and drinks his XMTVI Maxamaid orally during the day and eats about 6 of his restricted 8 exchanges of protein orally, totuși, anything he does eat has to be liquidised with no lumps whatsoever. He also has a continued feed during the night through PEG Tube. We travel to his doctor in Dublin every 3 months for check ups, where they take blood and check his levels are normal, and we speak to dieticians etc. Evan is a wonderful, happy, sociable, and boisterous 4 year old , he struggles with speech and communication which can get him frustrated and he has regular speech therapy, physio and occupational therapy. Evan has been on a waiting list for an Auxiliary Liver Transplant for 7 months now.
Talli S. (Născut pe 04 octombrie, 2001 A trecut pe 17 februarie, 2019) |
Talli îndurat cu grație și cu înverșunare imoralitate teribilă a acidemia propionic; ea a plecat din această viață cu un scorecard sepsis de Talli 5 și sepsis 1.
Ea a întâlnit doar două boluri de Nacho sos de brânză pe care ea nu a iubi; frecvent devorat gustări de fructe Scooby-Doo, cu excepția celor de portocale; și a fost determinată să fie independentă și de a face lucrurile în felul și ordinea ei, cu excepția cazului în ea a vrut să fie slujitorul ei. Ea ar putea construi un turn Lego de stabilitate mult mai mare decât discutabile 4'8 ei″ de sine. adolescenți de sex masculin sportivi de la biserica ei, au fost uimiți de rezistenta si puterea ei în a ține pasul cu ei, în timp ce împinge un cărucior de mână de mile într-un mormon Trail Reconstituire. Ea ura să rateze serviciile Bisericii la Naperville treia secția de Mormoni, chiar dacă ea a fost internat în spital sau vărsături și ar spune cineva care ar asculta “ceas Tales Veggie pentru a învăța o lecție”.
Ea a fost extrem de anticiparea ultimului an de studiu, anul viitor, la Naperville Central ridicat și a simțit că a fost unul dintre sportivii de stele Special Olympics, echipa de foc 203 în baschet, bowling, și urmăriți. Ea a iubit întâlni alții care au PA; dacă aceasta a fost la o întâlnire PAF sau călătoresc în țară și de oprire de a le vedea la casele lor. Ea a avut numeroase complicatii de la PA, inclusiv pierderea cea mai mare parte viziunea ei și a avut un sistem imunitar compromis; totuși, ea a păstrat o atitudine pozitivă și tratate provocările ei cu hotărâre.
Talli is seemingly always on the go, atunci când ea nu este ea vrea să știe care sunt planurile de după școală și în week-end. She loves to go to school and hates missing class if she is sick or has an appointment. She can’t stop talking about an upcoming trip to see her grandparents in Oregon and a sleep-away camp with the teenage girls from our Church over the summer. She loves technology, music, and live performances. We have had to put on parental controls on her tablet just like her typical peers have. She got braces on just after her birthday in the fall. She is in the 7th grade at our local Junior High School. She is in an Instructional class for her core classes and is mainstreamed for PE, science, choir, and a period that rotates between art, technology/engineering, sewing, and cooking. This year she was on the school’s 7th grade cheerleading squad and she just excelled! She attended practice every day and then came home and practiced some more. She is very excited for next season. Overtime, new health challenges have some up and she now has some complicated treatments. She was fortunately newborn screened; we found out a week after she was born. She was already in crisis at the time and took several weeks to stabilize her in the NICU. The biggest challenge at that time in keeping her stable was severe food allergies and reflux. She vomited every feeding! Thankfully, she has outgrown some of her food allergies, totuși, tree nuts and latex can affect her by just being around them. She had frequent infections and was hospitalized every couple weeks when she was an infant and toddler. After starting IV immunoglobulins (IVIG), she had a significant reduction in the number of illnesses and hospitalizations. She has had sepsis several times, one of those times infecting her hip which required surgery. She has a significant Long QTc wave and had an internal defibrillator placed when she was in the 2nd grade. She also has hypothyroidism and was recently diagnosed with growth hormone deficiency, so takes daily growth hormone injections. After many years of going to the hospital for IVIG infusions, she will be starting weekly subcutaneous at home. This will keep her better protected from infections, but also free up her (and our) schedule and cause fewer side effects. She had received IVIG at our local hospital which has a Pediatric Critical Care Unit because of poor tolerance to it. Eating always seems to be a concern for newly diagnosed families. Talli eats inconsistently. We think that a lot of it has to do with her severe food allergies. She had a g-tube placed when she was 6 months old as she was failure to thrive. Her growth only improved once all of her allergens were removed from her diet and her esophagus was allowed to heal (she had erosive esophagitis). She eats a lot more when she can have whatever she is craving at the time (right now it is Taco Bell) and when she is around her friends. She consistently eats about a third of her calories by mouth. She is learning to weigh her food and typically does her own feedings at school, if they are needed, with her nurse supervising her. She is also learning to read labels for her allergens and protein content. Update May 2015 ———————————————– Talli is a thrilled-seeking social butterfly. She will turn 8 years old in October and she is just finishing up the 1st grade. She is mainstreamed in our local elementary school with resource support, speech and OT. She participates in jazz and ballet and Daisy Scouts. She LOVES to build with Legos, take things apart, play with her friends, and visit Disney World. Her favorite rides are the Tower of Terror, Splash Mountain, Space Mountain and Journey to Atlantis at Sea World. She was diagnosed with Propionic Acidemia from newborn screening, although she was well into her first crisis situation when we received the results of her testing. She spent nearly a month at CHoP to stabilize her and get her diet just right. She has had over 20 hospitalizations because of illness. For the past 3 ani, she has had received IV immuglobulins every four weeks. She is unable to have the infusion run quickly, so she always has an overnight stay in the hospital. We attempted to have her use a port-a-cath, but after a year of no problems she had two episodes of sepsis, the last one being fungal and bacterial. She has other health challenges that have made it difficult to keep her stable all of the time and also just adds to her complexity. She has Long QT Syndrome, hypothyroidism, allergies, asthma, esophagitis, GERD, secondary immunodeficiency, and occasionally, she has neutropenia, low platelets, and anemia. She has a history of sleep apnea, is on her 4th set of ear tubes, has had her tonsils removed once and her adenoids twice. |
Nalani |
My daughter Nalani is in High School!! Her middle school educational experience was the toughest we have had thus far. The IEP’s were giving me panic attacks. Nalani was getting more and more withdrawn and unhappy. I had to do a lot of research and soul searching to decide what to about high school. We live in a really good school district and I am aware of the importance of inclusion but, after visiting one of the special school districts self-contained schools I decided we would give it a try. Nalani has not attended one of the special school district schools since preschool age 3-5.
Din prima zi de la Neuwoehner High School parea mult mai fericit,en. The school is awesome, she is able to do things that she would not have been able to do in the district high school, but is still allowed to participate in “Sparkle” a district inclusive cheerleading program after school at the public high school. Her class consists of a total of 6 students, 2 aides and 1 teacher. The students are put in classes according to their abilities. Her new school has lots of family activities and so far 2 school dances one of which they crowned her and a few of the other new girls homecoming queen. They offer a “bootcamp” activity where the students at all levels work together to perform tasks, she loves this. Her teacher writes me notes everyday about what she does at school and sends pictures of special activities. I send her pictures of activities she has done over the weekend and they discuss them at school on Monday. She gets books and educational material to help at home. They check on her when she is sick, which may not seem like a big deal but, it really means a lot to me. She has been there a little over 6 and a half months and just had her first IEP. They changed a majority of the things I had been asking to be changed at the middle school in her IEP before I even had to ask. The speech therapist is so amazing that after 10 years we have stopped paying out of pocket for a private speech therapist. During the IEP they brought her in and had a PowerPoint presentation, including pictures of some activities she had done. The staff went around the room and everyone said something positive about Nalani. She really loved this, and was so incredibly proud it brought tears to my eyes. For the first time in years I enjoyed her IEP and did not feel like I was going into battle, I felt more like it was a group of people that cared about Nalani working together on a plan for her. I always hear about advocates of inclusion and being in the least restrictive environment. Someone said to me when I made the decision to pull her out of public school where she was included in general education classrooms, that she needs to know what it is like in “real life situations”. I still worry about this but, when I look at the new confidence that Nalani has I believe I have made the right choice for her. I know that each child and family has a unique set of educational needs, I just wanted to share my experience with a self-contained school, and share a photo of my homecoming queen! Angela Mother of Nalani age 15 PA Xavier age 18 months update 3/2015 —————————————————————————- My daughter Nalani just turned 14 years old!! Things are going great with her lately so I thought I would write an update. She is in 8th grade and loves school. Every morning she wakes up asking if she can go to school even on the weekend. Next year for high school I am planning on sending her to a self-contained high school instead of the public high school in our district. I think this will be better for her socially and she is so tiny (4ft 9in) I am worried that the high school will swallow her up. At her school they just started a cheerleading activity that we are very excited about. Nalani is currently in a Basketball class that is run by physical therapists that she loves. She is also participating in a dance class. One of the best things we have done is the Miss Amazing Pageant-LOTS OF FUN!! She also recently received a new adaptive bike from the St. Louis Variety Children’s Charity, we are really looking forward to riding it! She has a speech therapist in the evening and a tutor. Nalani has a speech therapist, Pam that we love! We have been seeing her for about 9 ani. She has at home tutors, Ann and Hope that have been WONDERFUL. Ann was a teacher that Nalani had in grade school. She attends our IEP’s with us and helps with what to ask and what the school should be doing. One thing I regret is that I was not more involved with Nalani in her early education. She had so many hospitalizations and medical hurdles that I was more focused on her health and not her education. I have always had therapist that come out to the house to work with us, and her teachers were great so I knew she was in good hands but, now it seems like I am struggling on how to handle things with her education. Metabolically recently things have been so much better!!! She was running a 100+ ammonia levels for years and after changing to Peptamen Jr. her last 3 of 4 ammonia levels have been in the normal range!! This is huge for her, those ammonia levels kept me up worrying at night. Constipation has been another problem she has had. I have been doing my best to stay on top of this, because it seems like that is key to keeping her from developing ketones and vomiting. She is fed by g-tube still, she eats a little by mouth her favorites are lemon pudding, salty chips with salsa and onion rings. Echo’s have been normal and seizure free for 6 years now. She sees Orthopedics for a curve in her spine. We have chosen to put her on birth control because she had been getting very unstable at times. Allergies were also an issue. 2 years ago she got a type of sedated Lasik surgery, so she no longer wears glasses. She is just now losing the last of her baby teeth so we are going to talk to the Orthodontist about what can be done to help her speech. I think this will be our next hurdle. Nalani is at around a 4-5 yrs old level as far as speech but, she reads at a 3-4th grade level. Math is very difficult for her she is working on using a calculator but, does not have a real concept of quantities. She LOVES to read and play on her Ipad! She is on Propimex 2, Peptamen Jr and I give her some of her protein by foods I have blended up in the Vitamix. Her meds are Phenobarbital, Citra K, Carnitine, Flagyl, Miralax, L-alanine, Valine, and Nasonex. Nalani is a wonderful daughter, a terrific big sister and truly a remarkable person! |