Saturday, April 29, 2017

Pharmaceutical Hell

Devastated.  That's the only way to describe the feeling of knowing that the path ahead for your child was going to be so difficult and uncertain.  Infantile Spasms was no ordinary form of epilepsy.  It was insidious and it was devious.  The seizures associated with them don't look like the seizures you typically think of.  When I think of a seizure, I think of someone convulsing uncontrollably.  With these, they were quick and in some cases, barely noticeable.  The damage was being done internally, to the brain itself. 

The best analogy I can give to Infantile Spasms is that it acts like an Etch a Sketch to the brain.  Everything Rhythm had learned up through seven months had vanished, like someone had shaken the Etch a Sketch and wiped away what had been drawn.  That happened with every attack.  Rhythm was not advancing developmentally much beyond a 1-2 month old baby, even as the days and months were passing.

Part of this issue can be attributed to the very things that were supposed to be helping her - the medications themselves.  In the hospital, the only priority was stopping the seizures.  She was given a witches brew of pharmaceuticals starting in the hospital and beyond.  A seven month old child's body can only handle so much.  Every one of these drugs had side effects, much like you see on television every time they show a commercial for something that cures something but has 25 awful side effects.

Here is what they prescribed to her, and the associated potential side effects:

Phenytoin Sodium IV - this was given at the hospital in the form of an IV.  Notwithstanding how traumatic it was for both daughter and mother as they kept sticking the IV in places all over her body trying to make it work.  The condensed list of side effects include:  Toxic Effect on Brain or Spinal Cord, Drowsiness, Easily Angered, Fever caused by Administration of a Drug, Involuntary Eye Movement, Involuntary Quivering, Nausea and Vomiting, Overgrowth of Gums Onto Teeth, and Rash.  That is not even half the list.  THIS DID NOT STOP THE SEIZURES.

Rivotril - This was the first of three medications that Rhythm was to start taking together after being discharged from the hospital.  The condensed list of side effects include: Drowsiness, dizziness, tiredness, loss of coordination, increased saliva production, easy bruising/bleeding and signs of infection (such as fever, persistent sore throat).  Rhythm was almost always asleep and in a vegetative state.  THIS DID NOT STOP THE SEIZURES.

Valproic Acid - the second of three medications, and one of the most damaging.  Although it is known as an anti-epileptic drug and is often used together with other meds, the list of side effects is jarring: diarrhea, constipation, upset stomach, dizziness, drowsiness, weakness, hair loss, blurred/double vision or other vision changes, ringing in the ears, shakiness (tremor), unsteadiness, weight changes, unusual or unpleasant taste in your mouth, chest pain, easy bruising or unexplained bleeding, fast/slow/irregular heartbeat, swelling of hands or feet, uncontrolled eye movement, feeling cold/shivering, rapid breathing, or loss of consciousness. THIS DID NOT STOP THE SEIZURES.

Phenobarbitol - the third of the medications for Rhythm, and one that was supposed to calm the brain during times of seizures.  Standard side effects include: drowsiness, headache, dizziness, excitement or increased activity (especially in children), nausea and vomiting.  THIS DID NOT STOP THE SEIZURES.

During the several months that Rhythm was on all three of those medications, she was either asleep or crying or having seizures.  It was absolute hell for Jen.  She did not have a child who would laugh, smile or even make eye contact.  It was as if Rhythm was blank.  She always had a sad look about her.






It was heartbreaking, and as insidious as Infantile Spasms is, these medications were just as bad.  They weren't stopping the seizures, so what is their use?  To turn our child into a vegetable?  Most every child with Infantile Spasms has a reason that it happened, such as a traumatic brain event at birth, damage to the brain or even genetic factors.  The doctors who initially worked on Rhythm did not delve deep enough into her cause, and some of the more effective medications such as Sabril were not even available in the Philippines.

Jen could not sit idly by and watch as the meds and the seizures took their toll on Rhythm, and potentially even threatened her life.  It was time for a different path.

NEXT BLOG TOPIC: THE PHILIPPINE CANNABIS COMPASSION SOCIETY



Tuesday, April 18, 2017

The Road Block

Despite everything that Rhythm went through in that tumultuous first month of her life, once she was home, she was doing great.  We always looked at her development in terms of her being two months premature, but despite that, she seemed to be progressing normally and doing all of those fun things that babies do.


In October 2015, Rhythm became a US citizen.  On this trip to the Philippines, I saw a huge change in Rhythm from that time that we had brought her home from the hospital.  She was adorably chubby, she smiled and laughed a lot, rolled over and even seemed to have a sense of humor.  I left there in early November really pleased that she was progressing so well.  There were so many potential effects from her prematurity, and it felt like we had really dodged a bullet.

That trip was the last time I saw that version of Rhythm.

One morning in January 2016, Jen sent me a video of Rhythm.  I watched and didn’t quite grasp what I was looking at.  Rhythm was making movements that seemed unusual, and each time those movements were made, she had a scared look on her face.  Jen was sure something was wrong.  I wasn’t sure what to make of it.  We monitored it and Jen sent the video to her doctor.

The doctor didn’t seem very concerned at first, but these movements only increased and Rhythm seemed more in pain each time it happened.  Jen was becoming frantic.  She knew this was something.  Some of her friends who had watched the video made an observation – Rhythm was having seizures.  These weren’t violent seizures, but calm ones.  As it turned out, these calm ones were even more dangerous.

Jen spent a lot of time researching online and watching these signs that Rhythm was displaying.  It became clearer and clearer that these were Epileptic seizures, a type called Infantile Spasms.  This type of epilepsy was rare, but extremely dangerous.  This not only impacted her brain, but would affect her development.  She was 8 months old now, and not doing certain things that babies her age would do.  A trip to the hospital and an electroencephalogram would confirm the diagnosis. 



Rhythm’s future was about to become a lot more complicated and troubled.  For some babies, Infantile Spasms can be fatal.  Many years of medication were up ahead.  Dangerous, awful medications that will probably do more harm than good.  The Road Block to a normal childhood had been put in place.

NEXT BLOG TOPIC: PHARMACEUTICAL HELL

Monday, April 10, 2017

Rough Beginnings


May 20th, 2015 was a day that will go down in my own personal infamy.  I shudder to think how devastating it could have been.  The events that unfolded in the city of Laguna, Philippines as I sat nervously pacing in Somerset, New Jersey were on the verge of tragic, only I had no idea how close.  The next month would, in my eyes, be the closest thing to a miracle that I would ever be a part of or witness.

Jen set up an appointment on May 20th to go visit a cardiologist at a hospital close to her home.  She had been dealing with a worsening case of pre-eclampsia and edema had begun to affect her eyes and vision. The cardiologist noted that she was not looking good. The doctors were highly alarmed that her blood pressure was at about 180/100. They gave her medicine to try and get it down. Jen became extremely sick.  Over the next hour, Jen’s blood pressure had plummeted to 70/40 and she slipped into a coma. The doctors made a decision to perform an emergency C-Section.  It was not looking good, for either Jen or Rhythm. Survival was not a guarantee for either one.

In a later conversation, Jen relayed to me her experience during this time.  She said she felt peaceful, as if all the pain had gone away.  She wanted to let go.  But she decided to fight for her life, for two reasons.  She wanted to be there for Rhythm.  And she didn’t want me to be “forever sad”.  The two of us stayed in her thoughts as she battled.

Back in New Jersey, I finally got the news from Jen's sister. Here it is, word for word: “Patrick, I’m not sure if this sounds like good news to you but, Rhythm is out now.  She’s fine and she’s safe.  Jen’s also doing better now.  Though the baby of course still needs to fully develop her organs.  But they are doing better now.  Jen’s blood pressure has finally been stabilized.  Congratulations, Patrick.  Hope everything gets better.” 

Rhythm had been taken to the NICU and immediately placed on oxygen due to her undeveloped lungs.  Her APGAR scores were low.  Her color was not good.  Rhythm would be fighting for her life for several weeks.  Jen began to awake from her coma and learn what had happened.  She immediately wanted to go to the NICU to see our daughter.  It didn’t take long before she willed herself to do just that.  Jen was an incredibly strong woman.

Over the next two weeks, I received pictures and updates from Jen at he hospital.  There were some ups and downs.  Rhythm had trouble with her oxygen levels and with blood infections that required multiple transfusions.  But she was strong, and made it through and improved every day.  As she began opening her eyes and looking around, I could see the life growing each and every day.  She was connected to so many tubes to help with breathing and feeding, that those were permanent fixtures in those first few weeks of pictures.  She began to smile, which melted all of our hearts.

Week 1 - Touch and Go




 Week 2 - Battling



 Week 3 - Gaining Strength



 Week 4 - Going Home






I arrived in the Philippines to meet this brave little girl who fought for her life and won and her brave mommy who did the same.  We watched Rhythm improve each day, breathing on her own and feeding without the assistance of the feeding tube.  The timing was setting up so that Rhythm was going to be released to go home about three days before I was set to return to the US.  Rhythm was checked out by several doctors, and was finally cleared to be released.

On June 20th, Rhythm was discharged from the hospital and we were able to bring her home.  I spent my final 3 days holding on to and playing with Rhythm, and had an early birthday celebration for Jen, who said her only birthday present wish had already been granted.  She and Rhythm were home, safe and sound.

NEXT BLOG TOPIC: The Road Block