Blog of Rebekah, mom of Ricky, 17 years old. Ricky has cystic fibrosis, bipolar disorder NOS, multiple learning issues, Asperger's Syndrome, a seizure disorder, and a connective tissue disorder.
Monday, May 31, 2010
Journal prompt for last week -- my relationship with Ricky
My relationship with my son, Ricky, is complicated. He is not a touchy-feely type of kid, but when he is happy to see me he will lean on me and love on me and I know that he loves me. He is often standoffish in social situations, because he doesn't know how he should be acting. But when he leans on me and loves on me, I know he's either not feeling well, or showing me that he loves me.
Recently, a new dynamic has come into play -- Ricky becoming a teenager. I get a bit of attitude from him now. He is hostile and even aggressive toward his brother. I know that, even though he's a wiry, skinny kid, I can probably not restrain him now if he gets to be out of control. And I am on my own, a single mom, so if that happens, it's all on me.
Nowadays he frequently moans and groans at me about his breathing treatments. When he is angry and volatile, sometimes he refuses his meds. That really scares me too. I try to be patient with him but sometimes it's hard to remember that he's different from most kids -- that he doesn't always understand. Most of all, when he's in the middle of a rage or is being unreasonable, it's not under his control. He can't understand reason. When I try to reason with him at one of these times, it's like talking to a brick wall. I have to wait until he has calmed down and only then can we go over what happened and try to figure out a solution.
In the end, and at the end of the day, Ricky is my oldest. My first baby. My initiation into parenthood. And what an initiation it was... A premature baby with multiple health, and later, developmental issues. But from the moment I first held him, when he was a couple of weeks old, I knew I was his mama. My relationship with him has not always been solid or easy, but I am always his mom. I think he knows that, even when he's having a rage. I don't know what I'd do without him. I know I'm going to be facing that eventuality because of his cystic fibrosis... He won't always be around. But for now, I am going to enjoy the relationship I have with this amazing kid.
Thursday, April 29, 2010
Long-overdue update!
Lots!!! Where do I start? Well, his cardiology appointment started with an ultrasound of his heart. It still showed a dilation of the ascending aorta, just like a year ago. The cardiologist let us know that it had not changed in size from a year ago. She drew a picture of the heart and its arteries and veins and explained that most likely this would never cause Ricky problems. On the other hand, this sort of defect is almost never found in a child who does not have a syndrome of some type.
And in that department, a couple of weeks back I got word from the genetic counselor that the first genetic test, which was a long shot anyhow, had come back negative. This week, I got a call from her about the other test we were waiting for, a genetic array. This time, an abnormality was found. Ricky has extra genetic material (known as a duplication) on one part of chromosome 11. We are not sure yet what this means -- in truth, the field of genetics is really still in its infancy. The next step is for them to test my DNA (they already took blood when they took Ricky's 2 months ago) to see if I have this too, and if not, they'll want to test the boys' dad. He has offered to be cooperative with medical stuff, so we shall see (if it comes up). On the other hand, from what I have read online, many times these sorts of defects happen spontaneously during or just before conception, and have nothing to do with inheritance. So mysterious!
Ricky has had one ER visit lately; it was due to some pretty severe abdominal pain. It turned out to be nothing, and his lungs look(ed) great. He has been on Dulcolax on a regular basis since then and it seems to help.
He is still having pretty bad dizzy spells. I am so frustrated with the neurologist that I haven't called there in a while. I was supposed to call the nurse to tell her how we had decided to proceed. I upped Ricky's morning dose of Topamax, which hasn't done a lot, but may have improved things.
Had a recheck with the psychiatrist, mostly to check in, and things are looking good.
I took both boys to their new dental center, which was amazing! Disney Channel, video games, all kinds of fun stuff. Wow. Unfortunately they were unable to work on Ricky's complicated teeth... He needs to have his bicuspids (all four -- adult teeth) removed so his cuspids can come in (I may have that backwards). He needs this stuff done before he can have orthodonture. This dental center felt uncomfortable doing this work (or even cleaning his teeth) given his medical history and all of the meds he is on. They gave me a referral to take him to the dental school at UCSF, where the procedure would be supervised by a physician as well. I am glad they're being careful, but jeeeeez.
School is going okay. He has good and bad days. He has days where he refuses to do work at all. We had his IEP meeting last month and decided on his placement for high school -- it happens to be the same place I went to high school. I need to make an appointment for Ricky and me to go visit the classroom. I met the teacher at the IEP meeting and the program sounds really good.
There have been sibling... Issues. Ricky and Andrew both have limited understanding of what Misty is capable of "getting". She wrecks their stuff, that sort of thing, and they can't figure her out. They think she is being malicious but I honestly believe that at her age (almost 4) she is mostly being... 4. Curious.
Ricky's digestive enzymes, Pancrecarb, have not been approved by the FDA by its digestive enzyme approval deadline (April 28), so the CF clinic staff has been scrambling to get people set up with new enzymes. We have quite a few bottles of Pancrecarb left, but after he runs out he'll be on Creon. We are not sure of the future availability of Pancrecarb, which appears to have a grim outlook. Creon was what Ricky was on from when he was diagnosed to when he was put onto Pancrecarb, so it will probably be okay. It just sucks to have to switch to something else after what he's been on all this time has done so well for him.
His labs also came back with his vitamin D being significantly low, so he's going to have to go onto an extra supplement (besides what is in his multivitamin) for a little while. Don't want him to get rickets! Yow!
So, now we wait to see how things go with the genetic tests. CF-wise, Ricky has been out of the hospital since November and things are looking good. His lung function is great. :)
That's all for now!
Wednesday, March 17, 2010
update - doctor visits
Ricky had an eventful week last week. On Monday, in addition to a bunch of other labs that he gets done yearly, he had his three hour glucose tolerance test, which ended up being normal, yay. That day he also saw his gastroenterologist and that went well, too.
On Tuesday, we had an eventful day. Ricky saw the endocrinologist, who looked over his other blood tests from the day before. His thyroid level was, as always, borderline low. Most of the other stuff looked normal. He has grown two inches in the past year, and the endocrinologist decided to put off any intervention with regard to his delayed puberty. They want us to come back in a year.
Next he had his yearly full pulmonary function tests. Those went well, and his numbers looked great.
Then Ricky saw the pulmonologist. His weight has flatlined and his growth curve is actually dropping. We're supposed to push lots of weight gain shakes. His lungs sounded great and the doc was pleased with the results of the PFTs. His iron was a bit low too, so we're temporarily decreasing his iron supplement frequency.
Ricky's dizzy spells, meanwhile, have been debilitating now that the Topamax dose has been decreased. Monday he spent much of his school day sleeping off another dizzy spell. So I called the neurologist's nurse to ask what we should do. She called me back to tell me she'd ask the doctor and get back to me. She called back and left a voicemail... I couldn't believe her response. Either we increase the dose back up... Which will make him sleep all day again... Or he just "gets used to the dizziness sensation." Seriously? What kind of a choice is that, exactly? I was so livid I couldn't even call her back to tell her what our decision was (for now, I have not increased the dose). I don't know what to do. Second opinion? Angry voicemail to tell her just what I think of her message?
I've also been playing phone tag with the cardiology clinic. Ricky is supposed to go there for another heart ultrasound with regard to the enlarged aortic valve that the geneticist mentioned (the pulmonologist explained it to us, so now I know a little bit more about what we're looking at).
The aortic valve issue and the dizziness (in this case referred to as dysautonomia) could also be symptoms of Ehlers-Danlos. Of course, he's not going to be tested for that unless the genetic tests we're waiting on come back as normal. And we won't have those results for weeks.
Also made another psychiatrist appointment... It's been a while since Ricky's been to see his psychiatrist.
Things just never get dull around here, eh?
Thursday, March 4, 2010
Another diagnosis? And an update.
For a long time some of Ricky's other doctors and I have been wondering if there might be something else going on with him... Some other genetic disorder. You may have seen me post about this here before. Among other things, he has these signs of "something else":
-hyperflexible joints
-high, narrow palate
-heterotopias (undeveloped gray matter) in the brain
-soft, thin skin
-thin veins
-issues with teeth
-issues with vision
We saw the geneticist back in 2006 and were supposed to go back a year later. Unfortunately, with Misty being born, time slipped by and I just finally got him another appointment. This time around, the geneticist did a lot of diagnostics, including examining Ricky's fingers and toes, measuring his eyes, his armspan, etc.
Finally, the geneticist and genetic counselor explained what they planned to do. First of all, blood was drawn for a full chromosome analysis. They did this when we were there in 2006, but as time goes on there end up being more and more genes identified. As the geneticist says, "In genetics, time is on our side." My blood was also taken as a control for this test. Secondly, he had blood drawn for another test that is for one of the connective tissue disorders that relates to the heterotopias -- it's more common in females . One of these tests will take 6 weeks (done at Stanford) and the other one will take 8 weeks (sent to Boston). If they are both negative, he will then have testing for Ehlers-Danlos Syndrome. Based on what I see on that page... Well, it really sounds like Ricky.
Here's something else I learned: When Ricky had his EKG (heart ultrasound) in April of last year, when he was in the hospital for his CF and was also having his dizziness investigated, the result was a finding of an enlarged aorta. Now, that would have been a useful thing to know, wouldn't it? I was pretty upset to find this out in via an offhand remark by the geneticist! The genetic counselor subsequently emailed Ricky's pulmonologist, who out of all of the specialists basically manages his care, to ask about a visit to a cardiologist. The pulmonologist agreed that Ricky should see a cardiologist to find out if there is really a problem. (Heart issues are also common in some connective tissue disorders.) So we are waiting for a call on that.
I have mixed feelings. If Ricky does have Ehlers-Danlos or some other connective tissue disorder, it would be good to know. It would be nice to have some answers. On the other hand -- jeez, how much does one kid have to deal with!?
In CF news, today I got a call back from the CF nurse in regard to Ricky's visit last week. His DEXA (bone density) test was normal (yay). His sputum culture showed pseudomonas aeruginosa and stenotrophamonas maltophilia, both bugs he has had before, though the second one is fairly new. We'll start up his TOBI (inhaled antibiotic) tomorrow.
The rest of us are doing okay... Misty apparently wants some health attention of her own (well, okay, I know she doesn't WANT it) and has a virus that's made her wheezy and miserable. She was seen by her pediatrician this week and her chest x-rays were a bit iffy for pneumonia. So we are monitoring things. It's probably just a virus and hopefully she improves soon. She has been having breathing treatments regularly. The coughing spells are pretty brutal on her. :(
Guess that is it for now!
Wednesday, February 24, 2010
We have a plan.
He had a neuro visit scheduled for 1 and the CF nurse called back later and said to come in at 11. So Ricky and I dropped Misty off at day care and headed up to Stanford.
Ricky has lost a little weight and is down to 97 pounds but he's up to 62 inches (5'2"). His oxygen saturation was 98 -- excellent -- and his spirometry was right where it has been for quite some time. His lungs sounded great as well. The doctor asked a lot of questions and, combined with the physical examination, concluded that whatever is going on with him, which is definitely significant, is not pulmonary.
So we had lunch at Taco Bell and then came back for his neurology appointment. First we saw a resident, because Ricky's doctor had been called to the OR. He came later. Both of them did thorough neuro exams on Ricky and apparently he was okay there. The ultimate decision was to back off on the Topamax so that he'd be on his old dose, and see if all of this stuff stops.
Our last appointment of the day was his bone density scan. That was fine... He was very good for it. :)
So I backed off on the Topamax tonight and by tomorrow he'll be on his old dose (25mg two times per day). Hopefully he starts to feel better.
Ricky's sick
The CF doc prescribed Septra, which I couldn't understand. This was clearly a virus as far as I could tell and the CF nurse could tell.
Well, then, today, Ricky slept all day yet again (he has had at least 4 hours of nap(s) every day since this started) and this evening, even after his breathing treatments, his chest was tight. He said that last night he'd had trouble getting to sleep because his breathing was bad.
Tomorrow he has an appointment with the neurologist and an appointment for his yearly bone density scan. Those are both up at Stanford and I'm going to try to get us there early so we can maybe see someone in the CF clinic. I do not like how quickly this has gone downhill!
Monday, January 25, 2010
status quo for now

Wow! It has been a long time since I posted... Over two months!
Just wanted you all to know that Ricky is doing very well. We have had a couple of emergency room visits for CF issues that turned out to be not as serious as we feared, thank goodness.
He still hasn't entered puberty, so we're going to the endocrinologist soon, and we will also be visiting the geneticist again, in March. We are supposed to go there periodically for a chat and further blood tests, since it's suspected he's got something else going on (yeah, like we need something else!) and there are new genetic tests available all the time. Also have a pulmonology appointment coming up, the same day as the endo visit, and he'll also have full PFTs that day. Going to be a very exhausting day.
Unfortunately, Ricky's dizzy spells are back in nearly full force. The neurology nurse gave me the go-ahead to up his dose of Topamax to see if that helps, so I've started the titration process. I hate that these spells are back because they totally incapacitate him and make him miserable.
Things are going well in school. He continues to be a teacher's aide in the office and they all love him there. We are gearing up for the transition to high school (!!!) this fall. I'm not sure yet where he's going to be going, but one of the options is my alma mater! Now that would be weird! Anyhow, we're having the transition IEP meeting in March and I should get more details then.
Keep your fingers crossed that Ricky stays healthy through the winter!
Sunday, November 15, 2009
new post on Hopeful Parents
Thursday, November 12, 2009
Home!
So we left the hospital at around 2:30 on Monday and Ricky was even back at school the next day. This kid is so resilient. He came home on oral antibiotics and is back on inhaled.
Go Ricky, go Ricky! :)
Saturday, November 7, 2009
Update
FINALLY, on Friday things, well, improved. He was officially out of danger. It was also clear that he had started to feel better. Yay!!! The plan for discharge became official: He will have spirometry done on Monday and come home if he has improved. That will have given him a full week of antibiotics and he might come home on oral antibiotics.
Friday night, Ricky got angry when he was woke up to take his meds. In the end, he had TV, his DSi, the phone, and his Halloween candy taken away from him. Today he started cooperating again and he got everything back. Whew!
Friday and today Ricky and I went for a walk around the roof (the only place he's allowed to go outside of his room). Sunday I'll see him for a couple of hours and Monday I'll go hang out with him til he gets to come home. Yay! I need to remember to remind him that he kept himself out of danger by following directions, taking his Miralax, etc. He did well!!
