Medical Update

Ryan and I have been to a few doctors appointments recently and I thought I'd give you all an update.

Last week we went to see the Neurologist. On a bad day Ryan may have 10-20 seizures, but on a good day Ryan is down to 5-10 seizures. His seizures are not intensifying and he seems stable. With seizures meds there is a balance between given enough to stop the seizures and giving so much that Ryan becomes too sleepy to work on any of his skills. It really seems to be a fine line. Thus we have decided to not change his medicines for now. The Neurologist did order a blood check on his medicine levels and we should get that back in about a week.

We also went to see Ryan's Metabolic Geneticist. At our last visit, we discussed the possibility of Ryan having mitochondrial disease and agreed to do a trial of co-factors. Co-factors consist of CoQ10, Alpha Lipoic Acid, Vitamin E, and various Vitamin B's. The definitive way to diagnose mitochondrial disease is by doing a muscle biopsy; however, that is very invasive and painful. The way they treat mitochondrial disease is with co-factors. Thus, if giving him co-factors for several months had created a significant improvement in skills then we'd want to look at the possibility of him having mitochondrial disease. Well, after several months trial, those who did not know he was taking them saw no significant jump in skills. It is pretty safe to assume that he does not have mitochondrial disease. There are a few other things that came to mind for Dr. Gibson as he pondered Ryan's case ... thyroid, zinc, amino acids, etc. So, we did some more blood work and we'll see what those blood tests show. I'll call next Monday to follow up on the test results.

While we were at Dr. Gibson's office, we met our new GI Specialist. You might remember that I have been very unsatisfied with the level of care from our current GI specialist. His office seems to always just recommend eliminating oral feedings. Well, I *love* this new GI Specialist. She was wonderful! I finally feel like his team is complete! I always found myself saying, "We have a great team of doctors, except..." But, now I can just say, "We have a great team of doctors!" She is fully supportive of oral feedings for Ryan and is also supportive of adding more real food (ie less Neocate) to Ryan's diet, even if it's through his tube. She does not want to "artificially fatten him." I felt like she addressed the concerns I had with the chronic constipation with something that actually makes sense ... give more real food and less of the offending Neocate. She was not overly concerned about his weight loss, but would like me to work with her Nutritionist to add more calories into his diet. I especially liked that she spent time getting to know Ryan and our family, and that she even talked to Ryan. She treated him like a real person.

Today we went to visit Ryan's Ophthalmologist again. Dr. Cohen tells me that his eyes continue to improve. I love hearing good news from a doctor! He is fixing and following faster than last month. :) And, his eyes are focusing better than before. We are going to get him new glasses again as his prescription and head size has changed. We'll see if he'll wear the new pair at all. Dr. Cohen says it's not a big problem if he won't. We will go back in 3 months for a follow up visit & to see if it's time yet for surgery. We want to find the perfect time for surgery so that we can have optimum results.

On the therapy front, we have missed a lot of therapy appointments this month due to sniffles and fevers. We had a good therapy appointment today, but Ryan fussed a lot. He continues to work on prop sitting and rolling, and strengthening his arms, as well as communicating through signs. His oral feeding is going well although he continues to nurse the food off the spoon instead of taking bites. Krista, our speech therapist is coming over this week & I need to remember to mention to her that recently I've noticed that he's started to "scatter." I think that's the technical term. He's letting food just sit in his mouth again.

As for my medical stuff, I'm supposed to be working on scheduling biopsies of my full gi tract. I guess it just doesn't sound like much fun & I've been putting it off. I will call in the morning to see if I can get it scheduled. I am scheduled for my 3 month testing at MD Anderson in March. And, I'm seeing a new dentist next week to have all my old fillings replaced. Yuck. I think I'd rather have a biopsy than go see a dentist. Warped, huh?

I think I've covered it all. Plus, Johnathon is telling me all about his cooking class, David is asking for a turn on the computer, Jacob needs help with homework, Deborah wants me to read her a book in Spanish, Ryan is babbling, and I suppose I better go before I go insane trying to multitask. Merry Christmas ya'll!