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Tag Archive: Cleveland Clinic

May 25 2013

What the hell happened yesterday?

While it’s a bit overdue, I wanted to share what happened when we met with Dr. Clark yesterday at Akron Children’s Hospital.

Basically, our purpose is going was to find out if the fact that Gavin’s brain is improperly controlling his heart, has a negative impact on his heart itself. 

Does that make sense?

We have been worried by his rapid heartrate and didn’t really know whether this was bad for his actual heart or not. 

So what did we find out?

Put simply, Gavin’s heart is physiologically fine and while the numbers are high, they aren’t adversely impacting his heart health.  Basically, as far as his physical hearts concerned, we can ignore the numbers, at least for now.

His heart rate is more of an indication as to his current autonomic status and not the actual condition of his heart.

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That was basically, the long and short of it. 

I mean, there were tons of things in between but that’s the meat and potatoes of the conversation. 

We learned that over the 24 hour period of time that Gavin  was wearing the Holter Monitor, his average heart rate was about 107/bpm.  He explained that the reason that’s lower than what we see is because takes into account when he sleeps. 

During the day we see his heart rate in the 120′s – 130′s very consistently. 

However, when you factor in what his heart rate is while he’s sleeping, the average is only 107/bpm and nothing to worry about.  :-)

We talked about (what we already knew) how his heart issues are a symptom of something else (in this case autonomic dysfunction). Essentially, the heart is doing what it’s told to do and that’s all. 

Dr.  Clark didn’t want to make any changes because of how complex Gavin is.  He is however, sending a letter to the Cleveland Clinic, advising them of his findings and providing some heart related things to consider if they feel it’s necessary.  Since this is truly a neurological problem, it really falls outside of his area of expertise and he deferred Dr. Moodley at the Cleveland Clinic.

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Having said that, Dr. Clark was a huge, huge help to us because he was able to provide us with something we haven’t had in a long time, peace of mind.

He will always be there if we need him again and I believe we are going to have regular followups with cardiology to track things very carefully to make sure that Gavin’s heart health stays good. 

While we still have to watch his numbers as they are an indication of his current autonomic status, we no longer have to worry about whether or not his physical heart is being damaged in the process, at least for now.

One less thing to worry about, now that’s a victory.  :-)


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May 24 2013

Our 4th and final trip to @AkronChildrens this week is the most important yet

In but  a few hours, we will be making the trip to the  Akron Children’s Hospital Heart Center.  We will be meeting with Dr. Clark, one of the top pediatric cardiologists in the country. 

The subject today will be Gavin’s ongoing heart rate issues. 

Going into this, I am aware that this will be an unusual appointment because while Gavin has heart problems, they aren’t actually heart related, per say.

Let me get you up to speed so the above statement makes more sense.

One year ago this month, something began happening to Gavin that was later identified as the extremely rare form of autonomic disorder that has all but taken over his young life.

Our first run in with this was last May (2012),when Gavin was hospitalized for 4 days (if I recall correctly) due to some unknown conditions.  This condition basically rendered him unconscious for a few days and caused his heart rate to soar into the 150-170 range.

His entire system was out of whack and his doctor at the time was talking about moving him to the PICU.

However, as quickly as this mysterious condition hit, it was gone and Gavin began doing much better.

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This was the very first of many, autonomic crises that he would face in the over the next year.  In that time, he was hospitalized many times for similar but in some cases, less severe symptoms and his autonomic care was transferred to the Cleveland Clinic. 

We learned that Gavin is physiologically incapable of sweating and that he indeed has marked autonomic dysfunction.  Basically, his brain doesn’t control things like heart rate, blood pressure, body temperature and other involuntary functions correctly.

This leads to Gavin’s health being extremely fragile as just about anything can trigger the next life threatening crisis. 

Autonomic dysfunction (think dysautonomia or POTS) is rare but not unheard of.  Our doctor at the Cleveland Clinic treats hundreds of kids with this disorder.  What makes Gavin so incredibly rare and extremely complex is that fact that while autonomic dysfunction isn’t all that uncommon at the Cleveland Clinic, autonomic crises are. 

In fact, Gavin is the only child to ever be seen at the Cleveland Clinic with this disorder and our specialist has only ever seen 2 other cases in his career, both outside the United States.

Complex and unknown is the only accurate ways to describe what we are up against. 

Now that we have thing in context, let me continue to explain what’s going on today at the cardiologist. 

Since the first crisis last May, Gavin’s resting heart rate has been in the 130′s almost constantly. When it does drop down to normal (say 80/bpm) he typically experiences a crisis.

If he does just about anything that requires him to move around much, his heart rate skyrockets and he becomes unstable. 

Even with the multiple cardiovascular medications he’s on, nothings lowering his heart rate.  The concern right now is ware and tear, what constitutes a danger and how can we intervene.  Basically, we have no idea what to do and right now, all we have been able to do is severely limit his activity.  His autonomic specialist has stressed just how serious and life threatening this is and that we have to be very diligent.

Basically, whenever a crisis hits, we don’t know if it will ever end. 

The reason I said this will be an unusual appointment is because while Gavin’s heart isn’t functioning the way it should, his heart isn’t the problem, it’s his brain.

I belive that most often times, when someone has rhythm or rate issues, it because something within the heart isn’t working correctly.  The cardiologist can identify this problem and address it. 

However, in Gavin’s case, everything is different and we don’t know how to address it. 

Hopefully, Dr. Clark will be able to give us some guidance and possibly even provide Gavin with relief. 

I’m nervous about this 4th trip to Akron Children’s Hospital because we already know that we can’t fix the problems within his brain.  I feel like we have very few options as Gavin’s autonomic dysfunction continues to worsen. I’m worried that his heart will be collateral damage.


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May 19 2013

More pieces to the mysterious puzzle

Lizze discovered that Gavin is losing control over his bladder.  We’re finding his clothes and they are soiled.  I’m not sure exactly when this is happening or why.

My guess is that this is tied to the autonomic dysfunction.

Bladder control can be affected by autonomic dysfunction and he has had troubles with this, even before he went to stay with Lizze’s parents.  While they never said anything about this being a problem while at their house, I can’t imagine how it wasn’t. 

I expect to hear from Gavin’s autonomic specialist at the Cleveland Clinic early this week.  I’ll be sure to let them know what we are finding. 

In the past, this has happened at night.  However, Gavin’s never had this type of problem before, so this wouldn’t be considered typical for him. 

Hopefully, we can figure something and provide him with some relief, if that’s even possible. This is really sad and I truly hope we can help him. 

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May 15 2013

Big Update: I spoke with John’s Hopkins today

I spoke with someone from the A-T Clinic as John’s Hopkins in Maryland this afternoon.  I learned even more information than I had before. 

Her gut says that based on what I was explaining to her, she would guess that it was not ataxia-telangiectasia.  Basically the reasoning for that is because typically, the symptoms begin at a much earlier age.

Having said that, it could also be that Gavin is just so complex that there are overlapping and unrelated symptoms going on.  This sorta mucks up the water and makes things more difficult to sort out. 

However, we do know the next step and that’s finding out if Gavin has had a AFP (alpha-fetoprotein) test and if so, what his levels were.

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This is Gavin’s Heart Rate Monitor Watch

I have a call into the Cleveland Clinic and Akron Children’s Hospital to find out if this was ever done..

This is basically an exclusionary symptom. 

If his levels are normal, than its almost certain that he doesn’t have A-T.  If the levels are elevated or even borderline, we will have to proceed with the next step, whatever that may be. 

The nurse explained they believe that there are approximately 600 people in the US with Ataxia-telangiectasia and they have seen over 400 of them come through their clinic.  They have never had a child come through with normal AFP levels and have Ataxia-telangiectasia.

At this point, I have to wait to hear back from Cleveland and Akron.

I hate waiting, especially for things like this.  However, we’ve been waiting a decade and so another day or so wait for information that can alter the course of our current journey with Gavin, doesn’t seem to bad. 

We just really need these levels to be normal……


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May 13 2013

Operation Hope: Finally some good news

It’s not often that I can share really positive news and I’m super excited to be able to do that right now. 

We got the first round of lab results in from the 14 vials of blood drawn at the Cleveland Clinic last week. Everything is back to within normal or acceptable range. 

The really big news is that she tested negative for any type of clotting disorder.

This means that she can safely receive hormone replacement therapy, without increased risks of more clots. 

Apparently, the DVT she had in here a few years ago, was just a fluke and was not genetically driven.  This is awesome.  This is really, really awesome. 

What does this mean?

Well her levels normalizing is something that was expected.  During menopause, much like puberty, her hormones will be all over the place.  All over the place will sometimes include being normal. 

Nothings changed on the menopause front and we didn’t expect that it would.

Right now,  we’re really happy that she doesn’t have a clotting disorder and can receive estrogen, to help her through this difficult process.

Thank you Cleveland Clinic…

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May 11 2013

Today’s #Autism Victory: Patience

I meant to post this when it happened but sadly I forgot. I should have shined the spotlight on this because of how hugely positive it was.

Better late than never.

While Lizze was at the Cleveland Clinic visiting the endocrinologist this week, Emmett and spent the 2 hours we were there, just waiting for her to finish with her appointment. 

Mr. Emmett John did so incredibly well. He was patient and very, very well behaved. 

This was my favorite picture of him that day.  He’s sitting on the steps in the Crile Building, waiting patiently for his Mommy to finish up and come see him again.

These were the steps that Emmett and I walked up and down about half a dozen times that day. 

He kept telling me that bit was really good exercise.  :-)
Emmett John, I’m so proud of you for doing so well and patiently waiting for Mommy’s appointment to be done. 

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May 09 2013

I just don’t think I’m strong enough

I have about 5 minutes to do a down and dirty update. Right now I’m exhausted, frustrated and confused.  I think I’m just done for today. :-(

We met with the endocrinologist this afternoon.  What we didn’t know was that this was a very special endocrinologist, that is very similar to a GYN.

I still don’t fully understand the difference right now because they both seem to be filling a very similar role. 
It’s official…  Lizze is in menopause. Although at her, extremely young age, it’s known as premature ovarian failure. We learned today that they are the same thing.

For those wondering, this is not a good thing. 

Not a good thing at all. 

Lizze had 14 vials of blood drawn for a ridiculous amount of tests. 

She has to return for a bone scan, in order to establish her current bone density and a baseline to help address bone loss.

She also needs a mammogram every year now and has significantly increased her risks of heart disease and cancer. 

There are more problems but that’s all I have for now. 

We also learned that her body is so ridiculously low on vitamin D that she needs to take 100,000 UI per week for right now because it appears that her body isn’t absorbing vitamin D.

Lizze is not in a good place right now.  Honestly, she’s in a really bad place right now. 

This has been one of the shittiest weeks in some time.

Between everything going on with Gavin and Lizze, I’m so far over the edge, I can feel myself just shutting down. The problem is that I can’t allow that.  This isn’t about me. It has to be about them.

I just don’t think I’m strong enough.

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This site is managed via WordPress for Android, courtesy of the @SamsungMobileUS Galaxy Note 2 by @Tmobile. Please forgive any typos as autocorrect HATES me. ;-)

Check out my #Autism Awareness Store to find really cool and unique #Autism Awareness Clothing and Accessories, designed by me. ;-)

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