Looking back....

Part of the recovery, not just for Alex, but for us as a family involved looking back at his life to see if there were any clues to how ill he would become, and to see if we could identify when it all started.

When he was in the last year of infants (I think that would have been around 6 years old), all of a sudden his behaviour became very erratic.  He would be hyperactive, almost bouncing off the ceilings, then angry and violent (often towards me as a 'safe' person'), then suicidally depressed.  This went on for months to the point where I'd done everything I could but nothing seemed to help, and I couldn't cope.  I finally admitted defeat (it felt), and went to seek help from the GP.  Of course, describing the individual incidents didn't make much of an impression, and whenever Alex had been to the Drs he had always been pretty well behaved, but did agree to refer us to a child psychologist even though he didn't think it was necessary.  I saw the psychologist a few times, both alone and with Alex.  She helped me analyse everything, and find ways of dealing with his behaviour and working out what the triggers were.  It became apparent that a lot of his mood swings were caused by blood sugar fluctuations, so I spoke to the school and made sure that he took a cereal bar to eat at ,id-morning break, and always took something for him to eat as soon as school finished.  The hyperactivity and violence quickly became control able.  But the depression was a frequent visitor. 

Depression is a hard subject for most adults to discuss and deal with, but when it involves young children, it is almost impossible.  How do you tell someone that your child regularly tells you they want to die, or wish they were dead?  And not just while they're arguing with you, when they're in bed crying at night because they are so deeply unhappy although they don't know why.  Who do you turn to?  In my case, I struggled through, trying to deal with it as best I could, all the while blaming myself.  Did he inherit it from me?  Was I causing it somehow?  Why couldn't I make my child happy?  It's a terrible burden to carry.

When he started in the juniors he started to complain of stomach pains, mostly in the mornings when he got to school.  The teachers and I thought it was because he didn't want to be at school, and the unhappiness was making him have the pains.  I repeatedly approached the teachers for support.  I could see he was struggling with the work, but it hadn't been picked up on.  I asked for him to be tested for dyslexia which runs in the family.  Just as we started to get somewhere we would get fobbed of.  It seemed that because he was quiet, well behaved and not totally failing at school, he was falling through the net.  In year 4 the teacher suggested he have his eyes tested to rule out sight problems.  It turned out that he did need glasses and they seemed to help a little with his confidence.  The teacher he had that year was great.  She could see the potential in him and that he just needed help to raise his confidence in himself.  He started to make progress again, and things seemed to be going well.  He still complained of the stomach pains some mornings, but he seemed happier.

Then came the following school year when he seemed to be constantly ill.  Tonsillitis at the beginning of the school year, a nasty bout of flu before Christmas, tonsillitis again in February followed by the abdominal pains which were so awful he felt like he was dying, and lay on the sofa groaning for a month before finally several months later being diagnosed with coeliac disease and recovering so well it was like a butterfly had finally been able to stretch its wings which had been crushed in a chrysalis of pain.  Yes, strange imagery I know, but its very late and I'm rather tired!

Looking at all of this, it seem to me that the coeilac disease was probably triggered during that last year of infant school when his behaviour deteriorated so badly.  Everything makes sense given the context we now have.  He still has times of depression, but they are nowhere near as severe.  He does have stomach pains, but they don't last long and are not as bad.  The sever constipation he had had for as long as we could remember has pretty much disappeared!  Now the only reason he's taking up the bathroom for an hour at a time is because he's reading a book and lost track of time.

What a difference these few months has made.

Now we wait to see the differences in Ruth.  Her symptoms were thought to have been caused by puberty (stomach pains, irritability, tiredness) until we got her blood test results.  Of course, there's no guarantee that we will see a difference, but I'd like to think she will find school easier again.  After a lifetime of swanning through school at the top of the class, this past 6 months she has found it much harder to concentrate.

Ummmm, 2 months later....

I'm being so bad keeping this updated! Sorry, I'll try to do better :)

Firstly I want to say a huge THANK YOU to all my lovely Twitter friends who I've got to know over the past few months. Cannot express how much your support and friendship has meant to me.

Right, so what's happened in the past 2 months? Well, quite a lot really. Alex is doing really well. Everyone who sees him now who knew him before comments on how he's like a different person. So full of life, funny and he eats! He had always been an exceptionally fussy eater, and we never knew that it was because food hurt him. Now he is trying new things, and discovering he likes things. Rather a novelty for me still.

Ruth finally had her biopsy on 31st October. After leaving home around 9.30am we reached Birmingham Children's Hospital at 11.30am. We had to sit on flip-up chairs in the waiting area of the Medical Day Care ward until her bed was finally ready at around 2.30. She was very lucky though, as she got a side room to herself. After checks by multiple Drs and nurses, talks with the anaesthetist and surgeon she was given the go-ahead for the procedure. Then more waiting around until the porter came to take her to theatre at 4.20. A lightening quick change into a hospital gown and it was down to theatre. She was very brave and agreed to have a cannula in her hand even though she is scared of needles. She was so brave, even though she was afraid she wouldn't wake up from the anaesthetic, and was a little teary. At 4.30 John and I went back to her room to wait to hear how it had gone. At just after 5 the surgeon came to tell us all had gone well, and that although from what they'd seen it looked like it was coeliac disease, that we should wait until the biopsy report came to know for sure. 10 minutes later we were able to meet her in the recovery room, but poor Ruth wasn't feeling at all well. Having been nil by mouth for many hours by then, coupled with the anaesthetic had left her with a terrible headache and she was so distressed it was heartbreaking. The medical staff were clearly worried that she was so upset - the team leader was stroking her forehead, just like I do. Little things like that make a difference, and show how much they care. The ward closed at 6pm, so once Ruth was back there (5.15) they were hurrying her to eat, drink and get dressed so she could go home. Otherwise she'd have to be admitted to another ward and stay overnight. Of course all she wanted to do was sleep, so she was even more distressed. Eventually she managed to drink some water, eat some apple slices and let me dress her. She stood on legs as wobbly as Bambi's and held our arms as we left the ward, only to get stuck in rush hour traffic in the centre of Birmingham at 6pm! We got home at 7.45 and she was starving, ate solidly for half an hour before falling asleep. Fortunately the school had booked her the next day off school as well, so she had a chance to recover a bit.

So now its another waiting game for the biopsy report to arrive. Hopefully it won't be too long.

I'm having an intersting time at the moment with my own symptoms but I'll save that for another post I think :)

Making a wish

Making a wish, a photo by SakuraBlythe on Flickr.

And how could I not mention Alex's 10th birthday. And our very first gluten free one. We did have a few sad moments when he missed the party food he used to love, but I made him his favourite chocolate cake which he enjoyed.

The following week we found a lovely little restuarant in Worcester that serves gluten free pasta and pizza, called Puccinis They were amazing! Alex ate about 2/3 of an adult sized pizza which is the most we've ever seen him eat, and said it was the nicest pizza he's ever had. The lovely staff even offered to wrap up the rest, so he could finish it later, which he was very happy about.

A new month a new start?

Alex and Iggy, a photo by SakuraBlythe on Flickr.

So here we are at the beginning of September, a new school year starting next week. We're still in limbo as far as Ruth is concerned. The GP haven't heard from the consultant and he is on holiday so as far as we can tell she hasn't been referred to the Children's Hospital for her biopsy yet, 5 weeks after her blood test came back positive for coeliac. As the consultant is unreachable at the moment (his secretary is also away) I'm a bit of a loss to know how to proceed, at least until she returns in the middle of next week.

Fortunately the gluten free diet is going..... ok, I'd say. Alex is finding a few more things he likes. At the moment DS (Dietary Specials) are a favourite brand. He loved the tear and share garlic bread, sometimes loves the pizza (but wasn't feeling well yesterday so didn't manage to eat much), the crispbreads and shortcrust pastry. He also likes Livwell Pita Breads (with houmous, carrot and cucumber sticks), and M&S Made Without Wheat White Bread (although our local M&S has problems keeping that in stock which is a pain). He likes Juvela Fusilli too. Biscuit favourites are Morrisons Free From Chocolate Wafers and Swirly Chocolate Biscuits (or something like that). His absolute favourite are Kent & Fraser Choc Chip Crunchy Cookies, which they have just started stocking in our local Waitrose. They're not cheap, but they are delicious. The rest of us tried the Lemon Shortbread and they were some of the nicest biscuits I've ever tried! I've tried making a few gluten free sweet things - crunchy cookies, gingerbread and chocolate victoria sponge which have all gone down very well. We had a lovely shiny new oven delivered this week so I'm looking forward to trying more things. Particularly bread :)

We finally got a copy of Alex's biopsy report. His consultant phoned to say the that the gastroenterologist at Birmingham Children's Hospital had contacted him to say that Alex was definitely coeliac and to proceed with the gluten free diet if we hadn't already, on the 16th August. A week later the report arrived and was interesting reading. Some excerpts: Duodeum bulb had aphthous ulcers. Gastric antrum mucosa showed mild lymphocytic gastritis. Duodenal biopsies showed features typical of coeliac disease with villous atrophy, crypt hyperplasia, intraepithelial lymphocytosis and an increase in lamina propria cellularity. From what I can work out, with my limited medical knowledge (but hours and hours of research into coeliac disease), he's probably had coelaic disease for several years, undiagnosed, so the damage is pretty extensive at the moment, but now he's on the gluten free diet, that will heal over several months so that he'll be like a whole different child this time next year. The photo shows him on the day before his 10th birthday when we went for a walk with friends are their dogs. Alex was in his element as he loves dogs. It was lovely to see him looking happier. Our friends hadn't seen him since just after he came out of hospital in February and said he was like a different person.

Endoscopies, Biopsies and Dietitians Oh My

So last week was super stressful. On Tuesday 2nd August, Alex had an appointment at Birmingham Children's Hospital for his endoscopy and biopsy. We had to leave home at 6am to ensure we made it in time for the 8am appointment. In actual fact we arrived at the hospital at 7.10am, before the staff arrived at the Medical Day Care Unit.

The staff were all wonderful, and Alex had a student nurse called Sabrina looking after him, who was a week away from graduation. He was taken down to theatre and put under General Anaesthetic at 9.30am. He was so good and brave. At 10.10am we were allowed to go with the nurses to recovery to fetch him. And by 10.30am he was eating Rice Crispies! He did so well. At 12.30 the consultant came to speak to us. They'd found duodenal ulcers during the biopsy, so had taken biopsies from there, the stomach and gullet as well as further into the small intestine. He is sending us a copy of his report once the biopsies have been looked at by the lab. If the ulcers are just caused by coeliac disease, we will carry on seeing Alex's consultant at the local hospital, and they should heal now he's on the gluten free diet. However, if its more complicated we'll be going up to see him at the children's hospital in a couple of weeks. Hoping and praying it is minor as the alternatives are frightening to say the least.

He also said he'd be seeing Ruth there soon when we mentioned that she'd had a positive blood test, so I guess she won't get to miss out on it after all. Probably best for her to get a comprehensive diagnosis though to put her mind at rest.

We saw the dietitian at Worcester on Thursday. She was lovely and very helpful and supportive. She's faxing through a prescription request to the GP so Alex can get some gluten free food asap. We started the gluten free diet that day, and Friday 5th was his first totally gluten free day.

So we're back to waiting again at the moment - for Alex's biopsy report, Ruth's biopsy appointment and Alex's prescription.