Variety, the Children's Charity of Texas, had a special evening at Globe Life Park for some super special kiddos! Variety is an organization near and dear to our hearts as they helped us to fund Gator. Anytime they ask us to show us with Miss Grace and Gator for PR purposes I am all about that. We are forever indebted to Variety and their generous donors. I don't think people truly understand how much life has changed for the better with Gator, but I will write more on that later.
We spent the first hour in the Kids Zone! It was Grace's first time to a professional baseball game and she enjoyed getting to play and climb in there.
Every staff member we encountered at the ballpark was incredible as they truly wanted to make sure all of us had the best experience ever! Every time I turned around someone was bringing Gator ice and cold water for his bowl. They sent a team member around with Miss Grace to allow her to experience all the Kids Zone activities and let me just be a Mom and interact with all the kids. Grace wanted to go down the big bat slide like she saw all the other kids doing. After several times of changing her mind she went down - just the once - but she did it and I was so proud of her!
After the Kids Zone we had to take some pictures and then we headed to our seats. We were seated behind three older gentlemen who were season ticket holders. They were super sweet in talking to Grace and listening to her endless commentary - "Where is the football team?" "When is the Indian Band coming?" "Where is the helmet?" (the inflatable helmet the high school football players run through) "Why is that man not hitting the ball?" "Why, why, why . . ."
I was THANKFUL that our older daughter was able to come help tonight when 827 was not able to get off of work. She was a huge help. She was amazed at how protective Gator was. Gator is not trained to smell peanuts, just dairy and soy, although peanuts are on the banned food list. The older gentleman in front of us was eating peanuts and it was like Gator knew that they could hurt Grace and he was standing between her and the gentleman until he put the bag away. It is amazing all he just knows to do. I am amazed my him every day and blessed to have him as my "6th child."
So now what I am getting messages about . . . why is she in the wheelchair? Back in April our muscular neurologist that treats Grace's spastic diplegia cerebral palsy told us that when she has growth spurt we are going to see some increased issues with her muscles. As she gets bigger the problems are going to increase. As a Mom that is hard for me because I see other kids with the same diagnosis that are far lower functioning than my baby girl and I think how can they have the same diagnosis? In the spring our neurologist suggested that we order a special "assistant propelled wheelchair" aka "big kid stroller" for Grace. Distances are hard for her and her muscles are much more fatigued in the evening. She is only 33lbs but she is 40.5 inches tall and she is growing fast. Her size makes her difficult for me to carry her long distances and she is to tall for our beloved BOB stroller. Her head touches the top of the canopy and that causes a whole gamut of sensory issues. So after much discussion we ordered her chair. She won't need it everyday and she can walk. We want her to walk as much as possible.
Socially she has become more fashion forward and she knows that her friends at school and church are not wearing the leg braces. We had a huge power struggle at the end of the school year and after talking to the physical therapists we decided to let her come out of those braces and work her muscles hard this summer. We have done that but she is growing and her muscles are changing. Her hips and knees are doing a lot better (Thank you swimming and water therapy!) but her knees down are just struggling. While we await her genetic testing we are going to start quarterly botox injections in her legs and feet to help these muscles. She doesn't want to wear "magic shoes" anymore and she participated in the discussion with the neurologist yesterday and understood it was magic shoes or shots. Neither of these solutions are short term. She chose injections and so we wait for insurance approval. But while we wait for that he wants us being really careful with distance and her foot that drags. We don't need her falling and breaking her arm or wrist. So the deal was we get our chair and we wait for approval to start injections. Except that our chair is still on order. We have been expecting it for the last month but it still isn't here. The dealer brought this sample for us to use tonight as we knew it would be a lot until ours is here. Grace is going to be sorely disappointed as hers does not have all the upgrades - light up wheels and sound machine that this one did. It was a huge help tonight and she could roll and wheel that thing everywhere. In fact when it came time to leave she did not want to go and kept trying to wheel her chair away from us and then when I took over control from the back she was throwing on the brakes. Little stinker! So now we wait for our pink one to come in any time now.
Tuesday, September 9, 2014
Monday, September 8, 2014
The Reader's Digest Version Update
I know I say every time I am going to do better about this whole blogging thing and I really do intend to, but you know, life happens? I am sorry. I really will try to do better. I have a lot to cover so we will just hit it in bullet points with lots of pictures of Grace & Gator.
- We got discharged from pulmonology rotation! We love our pulmonologist but we all agree that Miss Grace has flares of asthma and sleeping issues because of EoE flares and seasonal allergies. We can treat that at home with guidance from our pediatrician and developmental pediatrician. Unfortunately the ragweed in Texas is making Miss Grace's asthma a little haywire but we are dealing with that at home!
- We had another pediatric GI appointment with our fabulous EoE specialist. While I thought all the awful side effects she was experiencing were from the swallowed steroid it turns out it was the Splenda that the steroid is mixed in and swallowed! Miss Grace can add artificial sweeteners to her list of banned foods. We got her on to mixing with blue agave nectar and our life has been so much better lately! Thank you, Jesus!
- We survived her 6 month check up at the dentist. We had been told that if they were unable to get x-rays and clean she would have to be scheduled to do it under anesthesia. She wouldn't do x-rays or a full cleaning, but they were able to do fluoride really quick and they said we could wait 6 more months. As you can see Gator Dog was not so sure what they were doing to his girl. I love how protective he is of her.
- Our geneticist is running more tests. We were hoping to get discharged but that didn't happen. She is working with our neurologist to investigate some other things. The good thing is that insurance quickly preapproved the really expensive tests that now we wait 6-8 months for results on. She has not met a dog she doesn't like - real or fake!
- My precious friend and bridesmaid in my wedding found Miss Grace the much longed for Queen Elsa dress. She went though about a week where she would answer to nothing but Queen Elsa. Everyone who knows her in person knows that she LOVES to dress up and she has been over the moon excited with her gorgeous dress. She will gladly serenade you with "Let It Go" upon request.
- SCHOOL! We started school. She goes to school from a full morning of therapy so she is tired. We go straight to lunch. Things at her school have changed as it is no longer an early childhood only campus. There have been some adjustments and some sensory issues to work on. She is doing better and got treasure box two Friday's in a row! It is all about the baby steps. She goes to pre-k for an hour and spends 2 hours in the 4 year old preschool class.
- She continues to love therapy! We spend 4 mornings a week in therapy and I am thankful for our therapy team. We are going to be so sad when the outdoor pool closes the end of this month and water therapy comes to an end. We are going to pursue some other options for use of an indoor pool so pray I can work those connections. The neurologist at her appointment today said he could tell how much being in the pool had helped her legs the last 4 months. We have some decisions to make on treatment of her legs going forward. I will share more on that in the future. Just pray for 827 and I to make the best decision for her care - either decision will be a lifetime treatment and both carry a hefty price tag.
- Here is a cute picture to leave you with. Tomorrow she has an exciting evening ahead of her so please stay turned. I won't wait another month to blog it!
Saturday, August 16, 2014
Medication side effects and a slacker Mama
I apologize for not keeping on top of this blog. I try, but sometimes it is just more emotional effort than I have for the day. I pledge to do better. Forgive me?
So I have three weeks to cover and where do I even begin? August has been HOT in Texas. We continue with our intensive therapy. When Grace's biopsies came back with elevated eosinophil levels we had to increase her steroids. It has been rough. Steroids are not fun short term much less indefinitely. Grace has had a hard time calming down and resting. Her "motor" is constantly running at 100+ miles an hour. There have been many moments each day where I have been concerned about her safety as she is downright wild. It's hard to discipline and correct when it is a side effect verses a behavior. Parenthood is hard! We have been trying to do a lot of gross motor activities/heavy work multiple times a day. Grace loves the water and we were trying to swim 3+ hours a day until all of these allergens have stirred up her asthma. She also loves to ride her amtryke even when the temperature is 100+ degrees outside.
So I have three weeks to cover and where do I even begin? August has been HOT in Texas. We continue with our intensive therapy. When Grace's biopsies came back with elevated eosinophil levels we had to increase her steroids. It has been rough. Steroids are not fun short term much less indefinitely. Grace has had a hard time calming down and resting. Her "motor" is constantly running at 100+ miles an hour. There have been many moments each day where I have been concerned about her safety as she is downright wild. It's hard to discipline and correct when it is a side effect verses a behavior. Parenthood is hard! We have been trying to do a lot of gross motor activities/heavy work multiple times a day. Grace loves the water and we were trying to swim 3+ hours a day until all of these allergens have stirred up her asthma. She also loves to ride her amtryke even when the temperature is 100+ degrees outside.
Our local foster and adoptive families gathered together to celebrate the end of summer with a Back to School swim party. It is always fun to get together with families that share our heart for adoption. We had almost 80 people in attendance! We had a cookout dinner and one of the sweet ladies in charge was concerned about what Grace would eat. I told her that I would provide her food and not to worry about it. She wanted her to have a special treat though and got her favorite popsicles! Here is Grace with her sweet friend Isaiah enjoying a cold treat!
We went back to the geneticist on Monday. We were hoping to get discharged but the geneticist wants to run more tests. She wants to run another test. This test is really expensive and we have to get insurance approval first. Once it is run it takes 6 months to get the results. I am personally feeling that all of her issues are because of her EoE but I am trying to trust those with more education than me. Because Grace is adopted and we don't know anything about her paternal side she wants to make sure we have done everything we can to get answers. One thing I have learned is that doctors don't like it when I tell them "I read on the internet . . . ."
We are still working on getting her calories in. She has never been a "drinker" since we took her off of elecare (her special formula) and pushed her to eat table foods. I have struggled with it being so hot and trying to keep her hydrated. She loves to have a tea party and my Great Grandma's tea cups seem to be the key to getting liquids in her. She drinks almost all of her fluids out of a tea cup now. It's the little things, you know? Fine china, placemats and cloth napkins. These are the things "tea time" is made of.
Friday it was back to see our GI. We have been concerned about the side effects of her medicines. Our doctor feels like she is reacting to the splenda that we mix her budesonide in to make the paste that coats her esophagus to bring down inflammation and irritation. Grace has never had any other artificial sweetener so this is a good possibility. You cannot use real sugar as it would spike your blood sugars with the amount needed for the paste consistency.
Here she is talking with Gator about things that are appropriate to share with strangers. When we got to the clinic she had to potty. When we came out she walked in to the infusion lab where there where 3 men having infusions and announced to them that she "pooped big logs in the potty!" One man kind of giggled and the other two nodded their heads. We had to talk about not sharing our potty business with people outside of our family.
Anyway so our doctor wanted us to change her slurry to mix with Neocate Nutra. Nutra is a medical food (kind of formula powder texture but designed to be mixed with medicine).
We got a sample and used it last night and Grace gagged and gagged and cried and cried. She says it tastes like slime and it hurts her tummy. I am not so sure it hurts her tummy (that was probably from the retching) but it does look gross and of course now it isn't sweet. She can't have any food or drink until morning after she takes her slurry so we must keep it down. Tonight she worked herself up into a tizzy over not wanting to take it. She gagged and retched but thank God it stayed down. Pray she can take this and pray that her side effects from before cease. As my fellow EoE Mom pointed out our doctor is trying to give Grace quality of life by giving her every effort to options out there instead of going elemental yet. Elemental means where she will get nothing (even water) but formula to eat or drink. So our number 1 prayer request right now is that she will be able to swallow the slurry with the nutra and that she will be able to control/adjust to the side effects if they still persist.
This week we will find out who Grace's teacher is and I promise a post on that. Grace's big sister is getting married on Saturday so we have a full week ahead for the last week of summer 2014.
Wednesday, July 23, 2014
Discouraging news - the biopsies are in
So yesterday we jumped right back into our routine of therapy and appointments after her procedure on Monday. We started the morning with OT at 8am. She is working on some sensory issues in OT and her therapist, Ms. Heather, had a brand new dress up dress and crown for her to wear while she worked! (When it came to taking it off we were anything but smiles!)
After OT and feeding therapy we picked up 827 and Cowpoke and headed off to the eye doctor about 45 minutes away. Our pediatric ophthalmologist is fabulous and he sees Miss Grace every 3 months.
She was wonderful in the waiting room waiting to see him and then was all smiles when she found out she didn't have to get her eyes dilated and just had to play the seeing games!
When we got home she got a surprise visit from her favorite big sister! She loves her so!
Today was back to OT, PT and feeding and then a fun afternoon coloring sidewalk chalk with Daddy. We had just gotten to the pool for some PT homework when her doctor called.
So now about the biopsies and what you have really been waiting for . . . Her eosinophil numbers are back up. She has to go back on the high levels of steroids. What that tells us is that there is still something or somethings in her diet that her body can not tolerate. The sad thing is that there is so little she can eat we are getting pushed to the lots of formula point that we have worked so hard in the past 18 months to move away from. It is hard to understand why something your body needs to survive (food) that it cannot handle. The doctor wants her on the high steroids again (and she cried when she had to take them tonight) and he will see her when he is here in 3 weeks. He said we need to postpone inpatient for 6-12 weeks and let her body rest and let the inflammation go down. Sadly this probably means she is loosing her beloved sunbutter (a peanut/nut free alternative to peanut butter of ground sunflower seeds), tapioca bread and bananas. It just makes me so sad for her. I pray that very soon a cure will be found for eosinophilic esophagitis and that she will be able to eat. I pray her joint pain from the high eosinophil levels will be gone and she can run and jump and play like other kids without the pain and discomfort. I pray her crooked legs and feet would straighten and the tremor in her hands from the cerebral palsy will be gone. I pray God would restore her vision or at least stop its loss. I know He is able. I know He loves my baby girl more than me and she is on loan to us from Him. I pray her story would impact nations and Christ would be glorified in her life. As always thank you for praying for my precious little girl.
After OT and feeding therapy we picked up 827 and Cowpoke and headed off to the eye doctor about 45 minutes away. Our pediatric ophthalmologist is fabulous and he sees Miss Grace every 3 months.
She was wonderful in the waiting room waiting to see him and then was all smiles when she found out she didn't have to get her eyes dilated and just had to play the seeing games!
We did find out her vision continues to get worse. She was down to 20/80 with correction. He will see us again in 3 months and we will see what her vision is then and order new glasses at that point. Her eyes are really bad and he said LASIK can stop the vision loss but they don't do it until they stop growing and with girls is aged 16-18. That is a long way off.
We took 827 to work afterwards. There is a botanical gardens area right across from the police department. Grace always wants to go see the koi fish. Sadly it was to hot and they were all hiding deep in the pond and under the shade of the bridge. She settled for a picture with the flowers today.
When we got home she got a surprise visit from her favorite big sister! She loves her so!
Today was back to OT, PT and feeding and then a fun afternoon coloring sidewalk chalk with Daddy. We had just gotten to the pool for some PT homework when her doctor called.
So now about the biopsies and what you have really been waiting for . . . Her eosinophil numbers are back up. She has to go back on the high levels of steroids. What that tells us is that there is still something or somethings in her diet that her body can not tolerate. The sad thing is that there is so little she can eat we are getting pushed to the lots of formula point that we have worked so hard in the past 18 months to move away from. It is hard to understand why something your body needs to survive (food) that it cannot handle. The doctor wants her on the high steroids again (and she cried when she had to take them tonight) and he will see her when he is here in 3 weeks. He said we need to postpone inpatient for 6-12 weeks and let her body rest and let the inflammation go down. Sadly this probably means she is loosing her beloved sunbutter (a peanut/nut free alternative to peanut butter of ground sunflower seeds), tapioca bread and bananas. It just makes me so sad for her. I pray that very soon a cure will be found for eosinophilic esophagitis and that she will be able to eat. I pray her joint pain from the high eosinophil levels will be gone and she can run and jump and play like other kids without the pain and discomfort. I pray her crooked legs and feet would straighten and the tremor in her hands from the cerebral palsy will be gone. I pray God would restore her vision or at least stop its loss. I know He is able. I know He loves my baby girl more than me and she is on loan to us from Him. I pray her story would impact nations and Christ would be glorified in her life. As always thank you for praying for my precious little girl.
Monday, July 21, 2014
Thankful for a smooth procedure
First off THANK YOU to everyone who prayed for me, 827 and Miss Grace today! We could feel them in a mighty way. It was amazing how God worked every little detail out - from opening up traffic lanes so we could get there on time to having the same anesthesiologist we had at a different hospital last time who has taken a special liking to our Grace. Every detail went smoothly. I was able to hold her as she woke up from anesthesia and they already had her IV and leads off of her. We were in a quiet room, with a really sweet recovery nurse who knew to have a purple popsicle ready before we even told her. It is amazing how attention to detail and quality patient care makes for such a positive experience. Today was a blessing and 827 and I commented several times it was totally God at work.
Here she is waiting in pre-op. She looks like such a big girl. She knew what was coming and she was not happy about it but she held on to Gator Dog and she was okay.
We walk Miss Grace into the OR and give her a bear hug as they gas her. She doesn't do vercid ("goofy juice") well so we avoid that. Gator goes all the way into the OR. She got upset so we let her hold him for a minute and get her breathing back under control. 827 held his leash and Gator's head was right by hers as she got the gas. He was not happy that we had to leave her in there. He was pulling on his leash in the waiting room and whining. There were a bunch of older adults in there waiting for procedures in the Heart Cath Lab and they kept looking at him. He wanted his girl back!
Her biopsy pictures looked better than they did in March but not as good as they did in May. With eosinophillic esophagitis it is a biopsy based diagnosis so we have to wait and see what her eosinophil levels are. Those results should be back the end of the week. The plan will probably be to maintain the previous levels of steroids (so no weaning off like we had started) and keep her diet limited. Our doctor thinks going inpatient to do the feeding program to increase volume is the best plan so we will meet with them about that in a few weeks.
Thank you for praying for our girl! God has great plans for our warrior princess.
Here she is waiting in pre-op. She looks like such a big girl. She knew what was coming and she was not happy about it but she held on to Gator Dog and she was okay.
We walk Miss Grace into the OR and give her a bear hug as they gas her. She doesn't do vercid ("goofy juice") well so we avoid that. Gator goes all the way into the OR. She got upset so we let her hold him for a minute and get her breathing back under control. 827 held his leash and Gator's head was right by hers as she got the gas. He was not happy that we had to leave her in there. He was pulling on his leash in the waiting room and whining. There were a bunch of older adults in there waiting for procedures in the Heart Cath Lab and they kept looking at him. He wanted his girl back!
Waking up was so smooth. Our doctor and anesthesiologist were amazing. They really have taken time to know our girl and that means so much to me and 827. We were on the road and heading home within about 3 1/2 hours. Much better than the 8+ hours of her procedure in March. She was still tired. It was dark when we went into the hospital and she wasn't ready for it to be "good morning time."
Thank you for praying for our girl! God has great plans for our warrior princess.
Friday, July 18, 2014
What a week
We started off this week with wonderful news in the research of eosinophilic disorders (see previous blog post). It is not a cure but it is a step forward in understanding the in's and out's of this horrible disease. One of the current methods of treatment is high does steroids to reduce swelling and inflammation and allow the patient to eat without pain or allergic reaction.
Since Miss Grace was diagnosed with EoE in March she has been on a lot of steroids. We got her reflux under control thanks to a medicine change, but she was still on a lot of steroids. She was eating better in feeding therapy and we were please with everything but the fact that she couldn't rest and calm. Steroids make me crazy jittery just for 7-10 days much less taking multiple steroids long term. Cincinnati Children's Hospital and the endocrinology department is doing a study on children with EoE who have been treated with budesonide slurry for at least six months to see what effects long-term corticosteroid use has on the adrenal glands. There are still so many unknowns about long term steroid use in children and with everything else Grace has going on I do worry about that. After her scope was good in June I pushed to wean off steroids and work on controlling disease with diet. First we eliminated one steroid at a time and then cut the dose of the budesonide slurry in half. When we did that a lot of her symptoms reemerged. I tried to ignore them because let's be honest, she is a much more pleasant child without all the steroids. But she started not to eat well again. Last week her feeding therapist commented about it and I tried to write it off as a bad session - after all we all have off days. But it has continued and more symptoms are reappearing; she is not sleeping well, complaining of joint paint, unable to swallow bites after 60-90 seconds of chewing and more. Then on Monday her OT and PT both commented that she has developed hand tremors when doing fine motor activities (writing, threading beads, stacking blocks). Was this a result of steroid weaning or because of her CP or something entirely new? Feeding is always our last therapy of the day and after reviewing our volumes intake logs and having another difficult session our ST/feeding therapist said we needed to contact the doctor. We had an appointment already scheduled for today so she went ahead and called with her concerns about Grace. I knew in my Mama heart that it wasn't going to be good news. I have felt like a short order cook jumping through hoops and fixing anything that she even asked for, but she isn't eating. She says she is hungry, you fix her food and she doesn't eat. She has recovered her weight loss from this spring but overall she has only gained 1 ounce since January - that is 7 months.
So we woke up this morning and I posted on facebook that I could use some prayers as I was really anxious myself. Our appointment was not until 12:30pm so when I got an email about a Home Depot project build at our local library we decided to head that way for some free fun!
So for now we try and ride through the weekend and wait it out for Monday. As always the biopsy results take 5-7 days to return but with severe EoE he will be able to see immediately if there is furrowing, inflammation and irritation. We are going to watch the hand tremors and keep the neurologist advised. We go back and see him in 6 weeks and by that point we should have regained control of the EoE. So pray for a calm weekend and pray for a smooth procedure on Monday. She does great with the procedure but she is a bear with anesthesia. We don't do vercid anymore, we carry her to the OR and hold her down while they gas her. That is hard on her and on my and 827. Please pray for a smooth process. No matter the results we will continue to fight and advocate for Miss Grace. I keep reminding myself God loves her more than we do and she is just on loan from him. She is an overcomer and has survived more in 4 years than many of us face in a lifetime. Thank you for praying for my girl.
Since Miss Grace was diagnosed with EoE in March she has been on a lot of steroids. We got her reflux under control thanks to a medicine change, but she was still on a lot of steroids. She was eating better in feeding therapy and we were please with everything but the fact that she couldn't rest and calm. Steroids make me crazy jittery just for 7-10 days much less taking multiple steroids long term. Cincinnati Children's Hospital and the endocrinology department is doing a study on children with EoE who have been treated with budesonide slurry for at least six months to see what effects long-term corticosteroid use has on the adrenal glands. There are still so many unknowns about long term steroid use in children and with everything else Grace has going on I do worry about that. After her scope was good in June I pushed to wean off steroids and work on controlling disease with diet. First we eliminated one steroid at a time and then cut the dose of the budesonide slurry in half. When we did that a lot of her symptoms reemerged. I tried to ignore them because let's be honest, she is a much more pleasant child without all the steroids. But she started not to eat well again. Last week her feeding therapist commented about it and I tried to write it off as a bad session - after all we all have off days. But it has continued and more symptoms are reappearing; she is not sleeping well, complaining of joint paint, unable to swallow bites after 60-90 seconds of chewing and more. Then on Monday her OT and PT both commented that she has developed hand tremors when doing fine motor activities (writing, threading beads, stacking blocks). Was this a result of steroid weaning or because of her CP or something entirely new? Feeding is always our last therapy of the day and after reviewing our volumes intake logs and having another difficult session our ST/feeding therapist said we needed to contact the doctor. We had an appointment already scheduled for today so she went ahead and called with her concerns about Grace. I knew in my Mama heart that it wasn't going to be good news. I have felt like a short order cook jumping through hoops and fixing anything that she even asked for, but she isn't eating. She says she is hungry, you fix her food and she doesn't eat. She has recovered her weight loss from this spring but overall she has only gained 1 ounce since January - that is 7 months.
So we woke up this morning and I posted on facebook that I could use some prayers as I was really anxious myself. Our appointment was not until 12:30pm so when I got an email about a Home Depot project build at our local library we decided to head that way for some free fun!
Loving on Cowpoke - she thinks he hung the moon
All the hammering of the Home Depot projects got to be a little much for my sensory girl. She went to do a puzzle with Daddy. He ended up doing the puzzle and she snuggled Gator Dog.
Do you want to build a project?
Afterwards we headed home for an early lunch and then headed to north Dallas. Our GI came in and talked with us. He had already talked to our feeding therapist earlier in the week. He asked us a lot of questions and told us that it is suspicious and looks like she is flaring (having an allergic reaction) to something still in her diet. She is off of all dairy, soy, wheat, eggs, peanuts, tree nuts, fish, shellfish, beef and coconut. Her diet is so restricted already we don't know what else could be triggering her. She has had no new foods introduced in her diet. He said he needed to look inside of her ASAP and see what is going on. So on Monday at 7:30am she will be scoped and biopsied again to see what is going on. If her eosinophil levels are back up and her disease is progressing then we will go back on all of the steroids and we will wait 90 more days to let her body heal before going inpatient. If her eosinophil levels are low we will know that this is behavioral (she is afraid to eat as she associates eating table foods with pain) and we will go back inpatient in September for 4-6 weeks in the feeding program at Baylor Dallas so we can up her food intake volume and wean back down off of her medical formula (the only food she associates as being safe).
Waiting at the GI's office
So for now we try and ride through the weekend and wait it out for Monday. As always the biopsy results take 5-7 days to return but with severe EoE he will be able to see immediately if there is furrowing, inflammation and irritation. We are going to watch the hand tremors and keep the neurologist advised. We go back and see him in 6 weeks and by that point we should have regained control of the EoE. So pray for a calm weekend and pray for a smooth procedure on Monday. She does great with the procedure but she is a bear with anesthesia. We don't do vercid anymore, we carry her to the OR and hold her down while they gas her. That is hard on her and on my and 827. Please pray for a smooth process. No matter the results we will continue to fight and advocate for Miss Grace. I keep reminding myself God loves her more than we do and she is just on loan from him. She is an overcomer and has survived more in 4 years than many of us face in a lifetime. Thank you for praying for my girl.
Study Finds Cause of Mysterious Food Allergy, Suggests New Treatment Strategy
A few days ago we received the most promising news from head researcher Dr Rothenberg. This is not a cure or even a treatment yet, but this is well on our way to something. Best news in the history of researching Eosinophilic disorders!
Sunday, July 13, 2014
New research in Nature Genetics identifies a novel genetic and molecular pathway in the esophagus that causes eosinophilic esophagitis (EoE), opening up potential new therapeutic strategies for an enigmatic and hard-to-treat food allergy.
EoE is a chronic inflammatory disorder of the esophagus. The condition is triggered by allergic hypersensitivity to certain foods and an over-accumulation in the esophagus of white blood cells called eosinophils (part of the body’s immune system). EoE can cause a variety of gastrointestinal complaints including reflux-like symptoms, vomiting, difficulty swallowing, tissue scarring, fibrosis, the formation of strictures and other medical complications.
Reporting their results online, the multi-institutional team of researchers was led by scientists at Cincinnati Children’s Hospital Medical Center. The authors identified a molecular pathway specific to epithelial tissue in the esophagus involving a gene called CAPN14, which they found becomes dramatically up-regulated in the disease process.
Epithelial cells help form the membrane of the esophagus. The scientists report that when these cells were exposed to a well-known molecular activator of EoE – an immune hormone called Interleukin 13 (IL-13) – it caused dramatic up-regulation of CAPN14. The researchers said this happened in what they described as an epigenetic hotspot for EoE on the cells’ chromosomes.
CAPN14 encodes an enzyme in the esophagus that is part of the disease process called calpain14, according to Marc E. Rothenberg, MD, senior investigator on the study and director of the Center for Eosinophilic Disorders at Cincinnati Children’s. Because calpain14 can be targeted and inhibited by drugs, the study opens up new therapeutic strategies for researchers.
“In a nutshell, we have used cutting edge genomic analysis of patient DNA as well as gene and protein analysis to explain why people develop EoE,” Rothenberg explained. “This is a major breakthrough for this condition and gives us a new way to develop therapeutic strategies by modifying the expression of calpain14 and its activity. Our results are immediately applicable to EoE and have broad implications for understanding eosinophilic disorders as well as allergies in general.”
The study follows years of research into EoE by Rothenberg’s laboratory, including the development of novel modeling systems for the disease, and extensive multi-institutional collaboration through the National Institutes of Health’s Consortium of Food Allergy Researchers. Other key collaborators on the current study include first author Leah Kottyan, PhD, a researcher at the Center for Autoimmune Genomic Etiology at Cincinnati Children’s, and co-senior investigator John Harley, MD, PhD, director of the Center of Autoimmune Genomic Etiology.
Rothenberg’s lab years ago identified IL-13 as a key molecular contributor to the allergic reaction process in EoE. His team has since identified a number of related genes and molecular pathways linked to the disease, and they have tested drugs that inhibit IL-13 in an attempt to manage EoE severity.
“The current study links allergic responses mediated through IL-13 with an esophageal specific pathway, and answers a long-standing question in the allergy field of why people develop tissue specific disease manifestations,” Rothenberg explained. “We have uncovered that this can be explained by the interplay of genetic susceptibility elements in allergic sensitization pathways with the newly discovered esophageal specific pathway. Thus, two steps are necessary, one dictated by allergy and one dictated by calpain14 in the esophagus.”
The researchers used computer bioinformatics to conduct a genome-wide association study that analyzed 2.5 million genetic variants in thousands of individuals with and without EoE. This allowed the authors to identify the genetic susceptibility within the CAPN14 gene. The investigators were surprised to learn that CAPN14 was specifically expressed in the esophagus, compared with 130 other tissues in the body they analyzed.
Rothenberg said the findings open a new way to consider therapeutic options because calpain14 is an enzyme that can be inhibited by drugs, which means it may be possible to modify the expression and activity of calpain14. Some chemical compounds already exist that block the activity of calpains, although the researchers do not yet know the exact function of calpain14, as very little has been published about it.
Funding support for the study came in part from the National Institute of Allergy and Infectious Disease, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung and Blood Institute, the National Human Genome Research Institute, the National Center for Research Resources (grant numbers U19 AI066738, U01 HG006828, U01 HG006828-S1, U01 HG006828-S2, U01 AI066560, R37 AI024717, P01AI083194, T32 HL7752-19, K23 AI099083, P01 AR049084, TR001082, UL1 TR-000067, UL1 TR-000039, UL1 TR-00083, UL1 TR-000424), the Department of Veterans Affairs (IMMA 9) and the Department of Defense (PR094002).
Additional support came from the Campaign Urging Research for Eosinophilic Diseases (CURED), the Buckeye Foundation, the Food Allergy Research Education (FARE) foundation and the Foundation of the American College of Allergy, Asthma, and Immunology.
Other NIH Consortium of Food Allergy Researchers institution collaborating on the study included: the Icahn School of Medicine at Mount Sinai, New York; Johns Hopkins University School of Medicine, Baltimore; University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Little Rock, Ark.; the University of North Carolina, Chapel Hill, N.C. and National Jewish Health in Denver, Col.
513-636-4656
Jim.Feuer@cchmc.org
Study Finds Cause of Mysterious Food Allergy, Suggests New Treatment Strategy
Sunday, July 13, 2014
New research in Nature Genetics identifies a novel genetic and molecular pathway in the esophagus that causes eosinophilic esophagitis (EoE), opening up potential new therapeutic strategies for an enigmatic and hard-to-treat food allergy.
EoE is a chronic inflammatory disorder of the esophagus. The condition is triggered by allergic hypersensitivity to certain foods and an over-accumulation in the esophagus of white blood cells called eosinophils (part of the body’s immune system). EoE can cause a variety of gastrointestinal complaints including reflux-like symptoms, vomiting, difficulty swallowing, tissue scarring, fibrosis, the formation of strictures and other medical complications.
Reporting their results online, the multi-institutional team of researchers was led by scientists at Cincinnati Children’s Hospital Medical Center. The authors identified a molecular pathway specific to epithelial tissue in the esophagus involving a gene called CAPN14, which they found becomes dramatically up-regulated in the disease process.
Epithelial cells help form the membrane of the esophagus. The scientists report that when these cells were exposed to a well-known molecular activator of EoE – an immune hormone called Interleukin 13 (IL-13) – it caused dramatic up-regulation of CAPN14. The researchers said this happened in what they described as an epigenetic hotspot for EoE on the cells’ chromosomes.
CAPN14 encodes an enzyme in the esophagus that is part of the disease process called calpain14, according to Marc E. Rothenberg, MD, senior investigator on the study and director of the Center for Eosinophilic Disorders at Cincinnati Children’s. Because calpain14 can be targeted and inhibited by drugs, the study opens up new therapeutic strategies for researchers.
“In a nutshell, we have used cutting edge genomic analysis of patient DNA as well as gene and protein analysis to explain why people develop EoE,” Rothenberg explained. “This is a major breakthrough for this condition and gives us a new way to develop therapeutic strategies by modifying the expression of calpain14 and its activity. Our results are immediately applicable to EoE and have broad implications for understanding eosinophilic disorders as well as allergies in general.”
The study follows years of research into EoE by Rothenberg’s laboratory, including the development of novel modeling systems for the disease, and extensive multi-institutional collaboration through the National Institutes of Health’s Consortium of Food Allergy Researchers. Other key collaborators on the current study include first author Leah Kottyan, PhD, a researcher at the Center for Autoimmune Genomic Etiology at Cincinnati Children’s, and co-senior investigator John Harley, MD, PhD, director of the Center of Autoimmune Genomic Etiology.
Rothenberg’s lab years ago identified IL-13 as a key molecular contributor to the allergic reaction process in EoE. His team has since identified a number of related genes and molecular pathways linked to the disease, and they have tested drugs that inhibit IL-13 in an attempt to manage EoE severity.
“The current study links allergic responses mediated through IL-13 with an esophageal specific pathway, and answers a long-standing question in the allergy field of why people develop tissue specific disease manifestations,” Rothenberg explained. “We have uncovered that this can be explained by the interplay of genetic susceptibility elements in allergic sensitization pathways with the newly discovered esophageal specific pathway. Thus, two steps are necessary, one dictated by allergy and one dictated by calpain14 in the esophagus.”
The researchers used computer bioinformatics to conduct a genome-wide association study that analyzed 2.5 million genetic variants in thousands of individuals with and without EoE. This allowed the authors to identify the genetic susceptibility within the CAPN14 gene. The investigators were surprised to learn that CAPN14 was specifically expressed in the esophagus, compared with 130 other tissues in the body they analyzed.
Rothenberg said the findings open a new way to consider therapeutic options because calpain14 is an enzyme that can be inhibited by drugs, which means it may be possible to modify the expression and activity of calpain14. Some chemical compounds already exist that block the activity of calpains, although the researchers do not yet know the exact function of calpain14, as very little has been published about it.
Funding support for the study came in part from the National Institute of Allergy and Infectious Disease, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung and Blood Institute, the National Human Genome Research Institute, the National Center for Research Resources (grant numbers U19 AI066738, U01 HG006828, U01 HG006828-S1, U01 HG006828-S2, U01 AI066560, R37 AI024717, P01AI083194, T32 HL7752-19, K23 AI099083, P01 AR049084, TR001082, UL1 TR-000067, UL1 TR-000039, UL1 TR-00083, UL1 TR-000424), the Department of Veterans Affairs (IMMA 9) and the Department of Defense (PR094002).
Additional support came from the Campaign Urging Research for Eosinophilic Diseases (CURED), the Buckeye Foundation, the Food Allergy Research Education (FARE) foundation and the Foundation of the American College of Allergy, Asthma, and Immunology.
Other NIH Consortium of Food Allergy Researchers institution collaborating on the study included: the Icahn School of Medicine at Mount Sinai, New York; Johns Hopkins University School of Medicine, Baltimore; University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Little Rock, Ark.; the University of North Carolina, Chapel Hill, N.C. and National Jewish Health in Denver, Col.
About Cincinnati Children’s
Cincinnati Children’s Hospital Medical Center ranks third in the nation among all Honor Roll hospitals in U.S.News & World Report’s 2014 Best Children’s Hospitals. It is also ranked in the top 10 for all 10 pediatric specialties. Cincinnati Children’s, a non-profit organization, is one of the top three recipients of pediatric research grants from the National Institutes of Health, and a research and teaching affiliate of the University of Cincinnati College of Medicine. The medical center is internationally recognized for improving child health and transforming delivery of care through fully integrated, globally recognized research, education and innovation. Additional information can be found at www.cincinnatichildrens.org. Connect on the Cincinnati Children’s blog, via Facebook and on Twitter.Contact Information
Jim Feuer513-636-4656
Jim.Feuer@cchmc.org
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