Long appointment update 6/17

Kerissa • Jun 18, 2014

Hey friends,

Still trying to process everything, but here’s a summary as short as I could make it.๐Ÿ˜‰

This morning, I had a 2 hour appt. with a famous mitochondrial disease specialist in San Diego.  I waited 11 months for this, and it finally came.๐Ÿ™‚ It gives me so much hope to now have a dr. who understands mito and other neurometabolic disorders—he’s been diagnosing/treating these rare conditions for over 40 years!  He’s almost 70 years old.๐Ÿ™‚

Anyways, my case is very complicated and difficult.  Dr. H is concerned that I may not only have a possible mitochondrial cytopathy but also other conditions on top of this, including a spinal cord problem.  Based on my neurologic exam, he also wonders if I had a small stroke on the left side in 2012 (when all this really started) because my reflexes are more pronounced on the left side which often indicates a stroke.

Another dr. who is visiting from Saudi Arabia also mentioned possible Mitochondrial Neurogastrointestinal Encephalopathy (MNGIE) based on my clinical symptoms.  This specific disease has a poor prognosis.. :/  But please don’t worry, I’m leaving this in God’s hands.๐Ÿ™‚

So here’s the long plan:

1. I had lab work done today (and will have more later this week) to check all kinds of labs like lactate, CPK, thymidine, and plasma/white cell coQ10 levels.  They’re also going to do an Oligoarray comparative genomic hybridization profile which will check for any microdeletions in my DNA.  Sounds complicated, right?๐Ÿ˜‰ In addition, Dr. H ordered a plasma acylcarnitine panel.

2. This Friday, I have a skin biopsy (to check fibroblast cells) and open muscle biopsy scheduled (and I have to be awake during it!) which will be sent off to a lab in Georgia.  They will be doing mtDNA testing.  In addition, he ordered electron transport assays and histochemistry.

3. He also mentioned possible whole exome sequencing which looks at 30,000 genes, but he doesn’t want to do that yet because it’s very complex.

4. At Cincinnati Children’s last year, I had blood mtDNA sequencing done which found a rare mutation (13376T>C in ND5).  He wants my mom to have that done as well to see if she carries this particular mutation.  If she does carry it, then that is not causing my symptoms since she’s asymptomatic.

These results take up to two months!  And he wants to see me in 3 months…sooner than I was expecting!  He warned that some of these results (muscle biopsy especially) can often be normal.  That doesn’t mean nothing’s wrong….mitochondrial disease is an ever-growing field.  If that’s the case, he said I may have a disease never before seen..  I hope not!

Depending on these results, he mentioned that there’s a promising drug trial I could try, but I would have to be here at least 10 days.  So we’ll see..๐Ÿ™‚

And that’s about all!๐Ÿ˜‰ The mito clinic gives comp tickets to the San Diego Zoo, so we’ll get to visit either tomorrow or Thursday!

I’d appreciate prayer that I will be able to tolerate the biopsies on Friday.  I have complex regional pain syndrome, and that makes me hypersensitive to any type of invasive procedure..

Love you all!

P.S. I’ve had the NJ feeding tube for more than a month now!  Less than 2 weeks left before I get to have it removed.๐Ÿ˜€ I have to gain about 8 pounds in order to be back to the weight that I was at in October..  It looks like I will have to get a permanent J tube surgically placed.  But here’s the nice thing….I won’t have to have a tube through my nose and down my throat!๐Ÿ™‚

By Kerissa Lee 16 Apr, 2024
Read Part 1 if you missed it. ๏ปฟ | Part 2 | Just 2 days after I was discharged from the hospital, I started experiencing severe nystagmus (shaking eyeballs) along with nausea, vomiting, and retching. I didn’t know what was happening and was again so scared. ๐Ÿ˜” I was told to go to the ED since I wasn’t tolerating any of my oral medications. The doctors gave me IV fluids and lots of different IV anti-nausea and pain meds. They told me I needed to be admitted and talked with the neurology and internal medicine departments to see which one should admit me. But….to my dismay, both teams made a bad judgment call when they decided not to have me admitted (my mom has since talked with a patient advocate for guidance on what to do if “this” happens again). Even the ED observation unit didn’t want to take me because I was “too complex.” ๐Ÿฅบ I was sent home still vomiting and in so much distress (with mitochondrial disease, anything like untreated vomiting/diarrhea is a big “no-no” to put it simply because it’s a huge stress on the metabolic system). My body was really struggling, and I experienced very drooping eyelids and worsening weakness all over. The next day, I was seen by my PCP’s colleague, and after much discussion, he directly admitted me to the internal medicine floor. I’ll always be grateful to him for his quick action and the very thorough letter he wrote. There were sadly no beds available, so I waited at home. But, the following day, God was so kind to bless me with a private room that became available. Once I was inpatient, the doctors tried to get a handle on the nystagmus and vomiting. All the usual IV anti-nausea meds didn’t resolve things, so they gave me an “off-label” medication that can sometimes help nausea. That did the trick, but another issue soon arose—I started showing signs of mental confusion. I remember not being able to explain what was on my mind, and if I did talk, it didn’t make sense! For example, 2 nurses were in my room helping each other, and I made a comment about them being married. ๐Ÿซ  Another instance, my family later shared that I asked them if they could see the ocean out the window. I can’t recall a lot of my time in the hospital because I was so confused.. My mom wondered if the confusion was from the off-label nausea medicine, so the team immediately discontinued it. By God’s grace, that did the trick…. Hospital life was definitely a roller coaster. You know that whack-a-mole arcade game? Once one problem ended, another popped up. After not receiving proper nutrition for many days, I started trying to eat orally again and resumed j-tube feeds, but for some reason, I wasn’t able to tolerate either like before. My stomach became so huge and distended….even with the feeding pump setting of just one teaspoon per hour. It didn’t make sense, especially since I tolerated a high rate of tube feeds two weeks earlier when I was admitted for the neurological weakness. I kept trying to increase the tube feed rate, but my GI tract didn’t tolerate it. The doctors brought up the possibility of TPN (IV nutrition). I was very discouraged and so homesick. With no progress increasing the formula rate, I did in fact have to be placed on TPN. Emotionally, it was a struggle dealing with this new problem on top of the mitochondrial crash.. ๐Ÿ˜ข Up next: Part 3…
By Kerissa Lee 13 Apr, 2024
Dear friends, It’s been almost 3 months since I last blogged.. So much happened, and it’s very hard to believe how quickly things changed. I know many already know the whole story. But for those who haven’t heard it, I will try to recap here. It’s quite the tale, but I wanted to share it on my blog to look back on because God truly carried me through the unimaginable. โค๏ธ When I requested urgent prayer for the sudden onset numbness and weakness in my whole left leg back in January, I had a routine follow-up already scheduled with my primary care dr. on January 25th. I was so thankful I could see him right away for this new issue. I showed him my worsening weakness, and he sent me straight to the ED to make sure I didn’t have a condition called Guillian-Barre Syndrome (GBS). While waiting for a bed to open up on the neurology floor, the muscle weakness spread to my right foot and up my right leg to the point that I could barely lift both legs up. Words can’t express how truly scared I felt that I was going paralyzed. ๐Ÿฅบ๐Ÿ’” It was the hardest time of my life, and I continually wept, not just because of the physical pain (which was the worst leg pain I’ve ever experienced) but also because of the emotional distress.. The “foot drop” in both feet was so severe that my soles were almost parallel to the hospital bed when laying down. It was devastating. Due to the weakness, I couldn’t even walk to the bathroom and had to use a bed pan. The team was concerned about possible heart/lung issues, so I had to be placed on a continuous cardiac telemetry monitor (which is different than the standard one). Twice, they asked me if I’d be okay with life-saving measures like getting intubated (placed on a ventilator) if the weakness kept spreading like it was.. I underwent countless neurological exams by nurses, medical students, residents, and attending neurologists. To rule out GBS, a spinal tap had to be done as well as extensive brain and spinal MRIs (cervical, thoracic, lumbar, and sacral). Not feeling well, it was incredibly difficult to lay in the very narrow MRI tube for more than 2 1/2 hours without a break. When GBS was ruled out, we still didn’t know what was causing the weakness. To be honest, in a way, I WANTED to have GBS because they explained GBS has a good treatment. So, not knowing the outcome and prognosis was very hard. ๐Ÿ˜ข Looking back, I remember how I shared a verse from Isaiah when I wrote my “2023 reflections” blog post at the beginning of this year: “Let him who walks in darkness and has no light trust in the name of the Lord and rely on his God” (Isaiah 50:10). When I posted that on January 1st, I never could have imagined how dark life would get. I knew God had a plan, but I was still so terrified. And there was nothing I could do but trust him (even though my faith felt so weak while in the thick of it). I cried so much and struggled with great fear. But in the midst of that dark time, I thought of a well-known passage from 2 Corinthians: “So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison…” (2 Corinthians 4:16-17). A phrase stood out to me: “light momentary affliction.” This trial weighed heavily on my shoulders….it definitely didn’t feel “light” OR “momentary.” I had so many questions. Could I surrender all and trust that God has my best interests at heart? I prayed that he would grant me the eyes to see everything from an eternal perspective and use this hard time for his glory and good purposes. After spending 9 days on the neuro floor, I was sent home.. The neuro team attributed this whole event to a “very unusual mitochondrial crash.” And only time would tell how I would recover. Up next: Part 2…
By Kerissa Lee 23 Jan, 2024
Hi, friends, I had a whole other post ready to go with some good news, but instead, I have an urgent prayer request. I started experiencing sudden onset numbness, tingling, and weakness in my whole left leg, and it’s been so scary. ๐Ÿฅบ It just came on out of the blue. I was doing so well with physical therapy each week (able to walk fast on the treadmill and leg press 40 lbs), and now, I have to limp because my left leg is soo weak. I really want to avoid the ED as much as possible, so I saw one of my doctors today. She’s concerned I’m having a big motor nerve issue. ๐Ÿ˜ญ The plan is to see a physical medicine specialist, have a nerve conduction study, get an urgent MRI done, as well as see my PCP and pain doctor on the 25th and 29th for further evaluation/testing. I know I already said this, but it really has been so scary to lose function so quickly. Can you pray that I will trust the Lord and not worry? It’s been very hard, so I’d really appreciate your prayers and support in the coming weeks. Thank you so much. โค๏ธ
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