Mitochondrial disease appointment update 2018

Kerissa • July 26, 2018

Hey friends,

I’m sorry it’s taken me so long to write an update on how my neurometabolic appointment in San Diego went!

Been trying to pull all my thoughts together on what we learned at the appointment.

After updating my mito dr. on all that’s happened since I last saw him, he is thinking more and more that the POLG gene variant that was found in my whole exome sequencing is the likely culprit that’s causing my mitochondrial DNA depletion.

According to the NIH genetic reference site, POLG “is a DNA polymerase, which is a type of enzyme that “reads” sequences of DNA and uses them as templates to produce new DNA.”  It is also the “ only DNA polymerase that is active in mitochondria and that can replicate (make new) mtDNA.”

Again, he said I’m very special and that he’s never had a patient with mtDNA depletion syndrome AND Wilson’s Disease. So he wants me enrolled in the North American Mitochondrial Disease Consortium…currently, there are about 1200+ patients enrolled.  It’s hard to explain what NAMDC is, so you can read all about it here:  https://www.rarediseasesnetwork.org/cms/namdc/About-Us

Please read the link!  It’s very helpful to understand.

POLG-related mitochondrial diseases can cause numerous issues, including problems like cardiomyopathy.  So he said I need to have an EKG every year and an echocardiogram every 2 years.  I also need to stay away from certain medications that can induce POLG-related liver failure.

There is a drug trial that is in phase 3 and going well, but this medication (called Elamipretide) is mainly for mitochondrial myopathy, so he said that wouldn’t be the best fit for me since I have more issues than just muscle weakness.  He did say the company that created Elamipretide is starting to work on many other promising drugs.

One of the main things we learned from this appointment is that things take TIME.  It takes time for companies to make new drugs….time for drug trials to “pass” through all the phases and get FDA-approved….time for research to discover new mitochondrial pathogenic (disease-causing) mutations and whether variants of uncertain significance (VUS) that are found through whole exome sequencing are pathogenic or not….and much more..

My POLG gene variant is a VUS, and in order for it to be “confirmed” as pathogenic, there are 2 ways that can happen.  If you put this specific variant in animal models (like mice) and they develop the same symptoms as the patient, then that variant gets labeled as “pathogenic.”  But….this route takes a ton of money to do.

The other way to confirm a VUS as pathogenic is to put a patients’ genetic data/reported phenotype in a database like NAMDC or MSeqDR (Mitochondrial Disease Sequence Data Resource Consortium), and if several patients with the same variant have similar symptoms, then that variant gets confirmed as pathogenic.

So it’s enouraging to hear all that’s being done in the mitochondrial disease world, but it’s also hard knowing that everything takes SO long to happen/do.

I asked him what my future will look like medically, and he said no one can really say (since every patient with mito presents differently)….he said mito is very serious, but he also told me that I’m coping really well.  Of note, he did say my brainstem is not functioning well….  The “sleep center” is in the brainstem which is why my complex sleep apnea is so bad.

Regarding my myoclonus, the medication I’m on for that isn’t helping the best, so he told me about another medication I could try that doesn’t worsen apnea.  I have to see my neurologist here to talk about it.

I wasn’t able to make it to this year’s United Mitochondrial Disease Foundation (UMDF) national symposium because it was in Nashville.  My mito dr. said he was looking for me there. Next year’s is again going to be on the East coast, but my dr. told me that the UMDF symposium in 2020 will probably be in San Diego! Looking forward to that!  It’s so encouraging to see how dedicated/invested my dr. is in all things mito-related.  He really cares for his patients!

In other news, I saw my physical medicine dr. recently, and he wants to make sure my osteopenia (soft bones) doesn’t progress.  It’s not good to have at my age, so he referred me to OHSU’s endocrinology/bone metabolism clinic.  Another dr. to add to my long list of specialists.. The clinic is booked out, so my appointment isn’t until September.

My hip surgery is scheduled for August 10th.  Less than 2 1/2 weeks away!  The surgery scheduler is working on setting up my pre-op appointments as well.

I saw my GI dr. today, and he wants me to try another medication for my GI dysmotility.  It’s been bad lately. Will be starting at a low dose first.  Because my vitamin D level was low despite taking 5000 IU daily, I now have to take 50,000 IU (prescription strength) since low vitamin D is bad for osteopenia.  In addition, my GI dr. wants me to start taking a vitamin A beta carotene supplement (25,000 IU) because my carotene blood level was very low as well.  He’s also going to get in touch with my general surgeon to have my j-tube changed during my hip surgery.

I hope this update about my San Diego appointment was easy to understand.  Mito is so complex which makes everything hard to explain.. :/  If you ever have any questions, feel free to comment or send me a message!

By Kerissa Lee May 15, 2026
Hi, friends, Last week, I unfortunately caught norovirus from my parents who caught it most likely from a wedding. 😞 All the vomiting caused dehydration, and my heart rate was high (up to 150 bpm). Every 30 minutes, I kept getting a notification on my Apple Watch saying that my heart rate was too high. Thankful I didn’t have to get admitted and could infuse the rest of my IV bags here at home. My neck is showing signs of weakness like after the time I got sick in Hawaii. 🥺 Really praying the muscles are just trying to recover from the vomiting/dry-heaving.. On top of that, the skin at my port site has sadly been breaking down over time. My dr. ordered a PICC line for me to let the port site heal. But the IR (interventional radiology) team said I need to have my port surgically removed because the site is “too exposed.” Definitely wasn’t expecting that! 😥 The IR team wants me to get a central line instead of another port, but I tried explaining to them that I’ve had sepsis too many times from multiple central lines. Plus, my quality of life is so much better with a port because I can shower when the needle is de-accessed. That’s just one of the reasons.. If I had a central line, I’d have to cover it and put tape all over which is not fun. I have a virtual appointment with someone on the IR team this coming Tuesday. Could you please pray the radiologist will be understanding, compassionate, and willing for me to have another port placed? I know this is in God’s hands regardless of the outcome. 💚 Surgery to remove my port and place something new (whether it’s a port or central line) is this coming Wednesday.. We’ll know the time the day before.. I’ve been reading a memoir by a young mother named Amber Emily Smith who tragically lost her 3-year old son to drowning in their family’s pool. In her book, she shared the story of the poet Annie Johnson Flint who developed a severe arthritis that left her hands disfigured and also caused her unable to walk. It was in the midst of her suffering that she became a poet. I’m sure many of you have read this poem before, but it’s such an encouraging one, and I hope it fills your heart with hope. ❤️ “God hath not promised smooth roads and wise, Swift, easy travel, needing no guide; Never a mountain rocky and steep, Never a river turbid and deep. But God hath promised strength for the day, Rest for the labor, light for the way, Grace for the trials, help from above, Unfailing sympathy, undying love.”
By Kerissa Lee April 16, 2026
Hi, friends, I just wanted to write an update on what’s happened since my last post. Sadly, the 2 different tube changes haven’t helped, and there’s still so much leaking around the tube. 🙁 The abdominal pain was decreasing each day, but for some reason, it has ramped up again and has been steadily getting worse the last several days. The pain is sharp and throbbing—it also hurts to use my abdominal muscles. I saw my primary care dr. this past Friday, and he ordered an urgent CT scan. I had that done this past Monday, and the scan shows that the balloon on the tube is lodged in my abdominal wall (it’s called buried bumper syndrome). 😥 So painful, but I’m thankful for answers! I actually had this issue many years ago, and usually, changing the tube size helps. But we’ve already tried 2 different tube sizes in March which hasn’t helped. I don’t know if the tract got damaged or what.. My PCP messaged the surgery team twice now, but they’re not responding still. Ever since my general surgeon left OHSU 2ish years ago to practice in New Orleans, it hasn’t been a good transfer to a different team. 😢 In addition, the CT scan also revealed that I have ground glass opacities in my left lung, so I have to go through work-up for that as well to figure out the cause.. Aside from these latest issues, I’m praising God that my mitochondrial disease has been stable still!! So thankful for God’s grace and faithfulness. The day I got my CT results, I read this excerpt below from one of Joni Eareckson Tada’s daily devotionals, and it was like the Lord was speaking right to my heart. I hope it’s an encouragement to you. ❤️ “Present pain and afflictions tend to heighten future joy. When is peace the sweetest? Right after the conflict. When does a cold drink taste best? When you’ve become very thirsty. When do you appreciate rest the most? After hours of hard labor. When is joyful company most pleasant? After enduring long days of loneliness. The truth is, our recollection of past sufferings may one day enhance the bliss of heaven. Eternity with the Lord will be so much more heavenly to those of us whose faith has been tested, battered, and tried, time and again.” -Joni Eareckson Tada One more thing.. I’d really love prayers for my uncle (my dad’s older brother). He’s been very sick in the neuro ICU with serious issues. First pneumonia, then bacteria in his spine which later broke his back. He had a major spinal surgery but still can’t move his legs. 🥺 On top of that, his kidneys started failing, so he had to be placed on continuous dialysis. He also had to be put on a ventilator due to fluid in his lungs. Then, he still couldn’t breathe well, so he had to get a tracheostomy tube placed in his neck. 🥺 Despite all this, he and his family are so strong and trusting the Lord which is a huge testimony to all of us and to the ICU. Could you please pray for peace, strength, and healing over his body? I know he and his family would be so grateful for your prayers. 💙 P.S. I wish I could show you my foster nephew’s sweet face in this photo from Easter Sunday! He is now 9 months old—the most precious and adorable little boy!! Our lives are so much sweeter with him in it. 🥹
By Kerissa Lee March 31, 2026
Dear Dr. Phillips, There aren’t enough words to express how thankful I am to have had such an amazing GI doctor like you these past 13 years. I think of all the hard challenges that have happened starting at age 20 and beyond: experiencing GI dysmotility, not being able to eat “normal” foods without terrible abdominal pain/distention, only tolerating soft consistencies like baby food pouches (which was not fun as a 22 year old!), needing an NJ tube placed down my nose, having a jejunostomy tube surgically placed, then no longer tolerating tube feeds, dropping down to 77 pounds, getting admitted the day after Christmas to start TPN, being surprised by the extremely high copper levels on my liver biopsy and starting treatment for that, going through septic shock which caused ischemic hepatitis (remember when my liver function test was 1674!), having sepsis 5 other times from multiple central lines and ports, requiring urgent surgery to remove my gallbladder, needing D10 added to my IV fluids for numerous mitochondrial crashes, and much more. Through all the highs and lows, you were there for me, and I truly feel like I hit the “doctor jackpot” to have had a GI specialist as caring, compassionate, knowledgeable, and kind as you. I shed quite a few tears to my chagrin at my last in-person appointment with you in February 2026, and I still do as I reminisce and write this letter. But, they aren’t just tears of sadness. They are also tears of gratitude—I know this journey would have been much more difficult if I didn’t have your wonderful care and support all these years. I’m so happy that I was able to get off of TPN back then after 5 years of being on it. Not only that, but I’m so thankful that I can eat orally to my heart’s content without pain and abdominal distention. I know that’s in part due to you, so thank you. From the bottom of my heart, thank you so very much for caring for me. I will never forget you, and I wish you all the best as you start your retirement. :’) With immense gratitude, Kerissa