"Quod me netrit me destruit."
What nourishes me also destroys me.
Showing posts with label allergies. Show all posts
Showing posts with label allergies. Show all posts

Saturday, February 26, 2011

Unthinkable



Written on February 22, 2011

It has been almost three years to the day Zane was diagnosed with Eosinophilic Esophagitis.  I spent the last two and a half of those years living in fear.  Initially, I feared Zane would be allergic to all foods.  A few months after his diagnosis we learned he is, in fact, allergic to everything.  Then I feared he would never outgrow those allergies.  I feared my daughter would also have the disease.  I feared the disease would spread.  One of my biggest fears, however, was that Zane would have to be fed through a feeding tube.  I previously wrote that a feeding tube might be the one thing that “puts me over the edge.”

About forty minutes ago, I kissed Zane goodbye so he could undergo his fourth surgery and his fourteenth endoscopy.  When he returns to me he will have his peg and I will have to learn how to administer his feeds five times a day through his tube.  I will have to learn how to clean it and care for it.  I will have to learn to deal with the comments and/or ignorance from others.  Although, Zane hasn’t come back from surgery yet, I am here to tell you that there is life after the tube.  It was a long road for me to get here.  It was a long process to be okay with this decision.  But, I finally am and it is so liberating.

At Zane’s weight in on February 21st he weighed 15.6 kilos (34.95 lbs) with his clothes on.  When we were last here in Switzerland in November of 2010, Zane weighed 17.9 kilos (39.38 lbs) with his clothing off.  So, he lost quite a bit of weight.  But, it wasn’t a rapid weight loss – it was a long and agonizing process.  One which created a lot of tension between Zane and I because I was constantly nagging him to drink his formula and eat some food and he constantly refused.  His hunger slowly turned into starvation.

In the early 80s my father glued himself to the television news for weeks to watch hundreds of thousands of Ethiopians die of a famine of “Biblical” proportions, as one BBC reporter famously explained it.  I remember one scene quite vividly.  Huge flat bed trucks arrived in one refugee village to deliver bags of wheat emboldened with the American flag.  Ethiopians flocked to them to receive their share of wheat.  They quickly became aggressive and two Ethiopians began to fight over the same bag.  Each person pulled on the opposite end of the bag until it tore in half and wheat flew everywhere.  Other Ethiopians quickly flung themselves to the ground to collect what had fallen.  I remember watching thinking that they were acting like complete savages.  But, now I know better.

Hunger is quite a powerful human feeling.  It is persistent and nagging.  It will rumble in your stomach unabated with determination until it is fully satisfied.  It is enough to drive a person mad.  Our basic animal instincts kick in and you will do anything or eat anything to survive.  I’ve seen it in Zane.  He spent nearly a year on an elemental only diet.  He begged for food.  At a park once, he spotted a kid with a bag of popcorn.  Zane’s stare immediately locked in on the bag.  He ran straight for the boy and took him down with one quick unsuspecting blow to get to the popcorn.  The boy fell to the ground and was immediately stunned into compliance.  He was merely collateral damage.  The elemental only diet was too strict and harsh for me to maintain.  I wasn’t strong enough to watch my son crave food every minute of his life until it became his one and only obsession.  So, I gave up.

This time it was Zane who gave up.  It started in November when he stopped drinking his Neocate Splash.  Then by January he stopped drinking his Elecare.  By mid-January he was eating less and less food.  It was a gradual starvation until he would go a whole day without food and would only drink a few sips here and there of his nasty, foul-tasting formula.  He was so tired of it that he would gag at the site or smell of the Elecare.  Initially, he was just a bit crabby.  Then he gradually became a bit more aggressive and unpredictable.  He was angry and frequently lashed out.  Some days he would spontaneously combust into the most horrible tantrums lasting hours until he just fell asleep from exhaustion.  A few days before coming to Switzerland he became lethargic.  He didn’t want to play as much and would fall asleep in odd places at odd times.  When he wasn’t sleeping you never knew what would set off the next big melt down.  One night he asked for rice pasta with salt and butter.  I handed it to him on his favorite blue plate.

                “That’s not what I wanted,” he yelled through tears.

                “Tell me what you want, Zane,” I said.

But once the dam broke there was no holding back the deluge.  He would go from unwanted pasta to hating school to no longer liking to wear a particular shirt.  His thoughts and emotions were random and scattered.  That is what hunger does to you.  You can’t think straight anymore.  Imagine having a small itch that can never be scratched.  It starts off small but if you don’t scratch it, it eventually takes on a life of its own.  That is what hunger is to Zane and others who suffer from eosinophilic gastro-intestinal disorders.  So, an intervention was desperately needed.

So, here I am . . .  taking on what was totally unthinkable only three years ago.  It highlights the strange dichotomy that exists when dealing with a chronic illness.  On the one hand, you have to constantly battle with the disease while also learning to live with it and accept it for what it is.  I’m trying my best to be strong and accept things.  I am also trying not to fear what hasn’t or might not even happen. 

It has been a few days after surgery now.  It will take a month and a half for Zane to gain back the weight he lost.  I already see him returning to the kid he was before hunger took over his body.  For the first time in his short little life he is no longer hungry.  He actually feels full.  His energy level is slowly coming back.  He smiles more and jokes about silly things only four year old boys think are funny. 

“Mommy, look, I can eat two things at the same time,” he said as he ate a rice cake while the nurse administered his feed.

That’s my boy.

Tuesday, May 4, 2010

Less is More . . . Dangerous

I'm a mother on a mission.  I don't just want a cure for my son.  I want to know what caused this.  And I want to prevent this from happening to anyone else's child.  Since Zane's diagnosis I sit in front of my computer almost every night reading and researching.  I'm hoping for something that will shed some light on my son's suffering.  There is nothing concrete thus far.  But, my learnings have been eye opening and a bit disheartening at times. 

Initially I felt like a dog chasing its own tail for a while until, one day,simply by accident I was listening to a podcast of Living on Earth and stumbled upon a story about endocrine disrupting chemicals found in our everyday environment that are toxic at low dose levels.  The show was called, "The Dose Makes the Poison."  Here's the thing:  endocrine disrupting chemicals, or chemicals that change or alter our genetic code, are everwhere.  And in everything.  The FDA and EPA permit them so long as the exposure is not at a very high level.  However, endocrine disrupting chemicals can be toxic at very low levels.  Some endocrine disrupting chemicals are only toxic at low levels.  For example, tomoxifen, the drug used for breast cancer patients is an endocrine disrupting chemical.  At high levels the drug stops cancer.  At low levels it causes the cancer to grow and spread.  In this particular case, less is more dangerous.

The scientist on this one particular segment on Living on Earch briefly mentioned phthalates, a plasticizer found in practically everything and everywhere in the United States.  This plasticizer is an endocrine disrupting chemical that scientists now believe is toxic at low levels.  Levels that the FDA or EPA does not test or regulate, unfortunately.  He briefly mentioned that one of the side effects of phthalates [pronounced tha-LATES] is that they effect mostly males (fetuses, babies and toddlers are particularly vulnerable) AND that they have a tendency to turn on the gene in our bodies that produce a hyper-allergic response to things.  He goes on to say that we know that allergic diseases are on the rise in the United States.  BINGO!  I felt like I was no longer chasing my tail.  I had something to go on now.

I started intesively studying phthalates and their effects on human beings and the research is compelling.  There is overwhelming evidence that at low levels phthalates are dangerous.  It is a neuro-toxin that some research is also linking to autism and ADHD / ADD.  The United States is the largest producer of phthalates with Exxon Mobile the primary company producing them.  The EPA is currently considering placing several types of phthalates on its "Concern List" as a result of their effects on human beings.  The Chemical lobbying industry is eager to prevent this from happening.

My research also led me to learn that most of Europe and even China have banned many US produced phthalates as a result of their harmful effects.  Many European countries do not permit phthalates in children's toys, baby bottles or in medical products.  BPA (bisphenal-A) is banned in many European countries.  The US was going to follow suit, however, lobbyists put a quick stop to that.  The most toxic plastics are those numbered 3, 6 or 7.  You can check underneath plastic bottles in the triangle recycling sign.  You should avoid heating plastics in the micowave, drinking or eating from plastic containers or dumping plastics in our environment.  Recycle.  Recycle.  Recycle.  We want to avoid having plastics contaminate our environment.

When I read these things, I thought back to how I used to heat Zane's baby bottles in the bottle steamer.  I would warm up his food in those plastic storage trays and let him chew on plastic teething toys.  There is a chance that I made my son sick through exposure to toxic chemicals found in our environment.  Chemicals that I thought were safe because our government allowed them to be there.  OR . . .  an even worse scenario is that the phthalates found in my body from years of my exposure to them caused a genetic anomoly when I was pregnant.  Phthalates can be found in all of us.  The damage can not be undone but we can minimize and reduce exposure by drinking from metal sippy or sports bottles, glass or ceramics.  We can also choose to avoid products that contain phthalates.  Don't give plastic toys to your child.

I can't undo what has been done to Zane.  But, I can try to prevent that from happening to anyone else's child.  I don't want anyone to know what a torture it is to have to live a life without food.  It is a painful existence.

Even though it is the only life that Zane has ever known, it is still a constant everyday struggle.  Some days are easier than others.  We have decided to stop all medications on Zane. The polmicort is a steroid that is dangerous and wasn't working anyway.  Zane hasn't gained any height or weight since last November.  His peers are beginning to outgrow him.  And Zane and his peers are taking notice.  He is beginning to get bullied and teased at school because of his size.  It's just a matter of time before they begin to pick on him for not being able to eat.  I'm trying my hardest to teach him to use his words to fight back. I'm trying to teach him to stick up for himself and to stay positive.  But, it isn't always easy.

Since taking Zane off of all meds, he is now also back off of all foods.  He is mostly drinking his formula and his intake is ok.  He usually drinks about 35 ounces a day which is a serious struggle.  I wake up in the middle of the night to feed him so that we can increase his daily intake levels.  It's exhausting.  I miss getting a full night's uninterrupted sleep.  But, the alternative is a feeding tube which I am fervently fighting against.   I know that this fight may be futile and selfish on my part.  I do recognize on an intellectual level that a feeding tube may be what is best for Zane.  But, on an emotional level it is difficult for me as a mother to reconcile with the fact that I would have to feed my son through some feeding tube.  Feeding your child is a mother's first and most basic instinct and sign of affection and love.  So, I go on setting my alarm clock usually once but sometimes twice a night to feed Zane.  I am hoping that now that we have taken Zane off of the steroids that this may also help him to gain some height and make up for lost time.  We'll never know though.

We are considering going back to doing food trials as well.  But that is another special type of torture.  Zane gets tired of eating the same food every single day for 8 weeks.  And the frequent scopes are emotionally draining.  The last scope Zane did in New York City last August was his seventh one.  The doctor ran through all the information, side effects and possible dangers that she is legally obligated to inform me about.  And I signed the papers that I am legally obligated to sign in order for Zane to have the procedure done.  At the end of her speech she says to me, "You're a pro at this.  You know all this already."  Yeah.  Maybe I do.  But, his seventh endoscopy was just as upsetting to me as his first.  I get teary eyed every single time.  The sadness never wanes.  Each and every scope is equally upsetting to Zane.  He fought against his first scope by kicking, screaming and yelling until the general anesthesia took effect.  He did the same for his seventh scope as well.

I sometimes kick myself for not knowing better and protecting my unborn child and baby against toxic chemicals in our environment.  And then other times I forgive myself for not knowing better.  But, the least I can do is warn others.  I can't state for certain if phthalates and other endocrine disrupting chemicals did, in fact, cause my son's illness.  But, I do know that they aren't safe.  I do know that less is more dangerous in this case.

Here are some links that you may be interested in reviewing:


http://www.loe.org/shows/segments.htm?programID=09-P13-00036&segmentID=3

http://www.time.com/time/specials/packages/article/0,28804,1976909_1976908,00.html

http://www.noharm.org/us_canada/issues/toxins/pvc_phthalates/phthalates.php

http://www.paramuspost.com/article.php/201003080729337

http://www.nytimes.com/2010/02/25/opinion/25kristof.html?src=tptw

http://www.environmentalhealthnews.org/ehs/news/breaking-news-bpa

http://www.sciencenews.org/view/generic/id/57949/title/Study_reports_hints_of_phthalate_threat_to_boys%E2%80%99_IQs

http://www.theglobeandmail.com/news/technology/science/eureka-less-poison-really-is-more-deadly/article1499340/

http://www.keepitorganic.org/2006/10/20/link-between-phthalates-and-increasing-allergic-reactions/


Wednesday, August 19, 2009

What a Difference a Year Makes

We arrived back from the States two days ago and what a difference a year makes. This time last year the doctors told us that Zane couldn't eat at all and we struggled on insanely restrictive food trials with formula being his sole source of nutrition. This time last year I returned from the States utterly depressed. All you had to do was ask me about Zane and I would fall to pieces and fill up with tears.
And now? Zane is eating. I can't believe it myself but it appears that the polmicort may be working. We haven't officially gotten the final results from Zane's biopsy taken on August 10th yet but it does appear to be working this time. It was so strange when the doctor said so nonchalantly, "Have you tried feeding him ice cream?" I said, "No. Why?" She was like, "Why not?" As if I was beligerently withholding food from my deprived son for no reason.


She explained to me that we have to see what happens to Zane while he is on a full diet while taking the polmicort. Mind you, this does not mean that Zane can eat anything in sight. He still does have EE. He is not cured by any measure of the imagination. Maybe I shouldn't ask for a cure anymore. Maybe I should just be happy with him eating. Although he is taking the polimicort he is still symptomatic. He gets the stomach pains, leg cramps and joint pains. Sometimes the stomach aches are pretty bad. Sometimes they aren't. The doctor told me that Zane may have to learn to deal with "pain management," which for some kids with EE (especially those on feeding tubes) pain can be really horribly bad.


Zane is still not permitted to eat any food that he has an IgE mediated allergy to. For those not familiar with "EE speak" that means he can't have any food that he gets the traditional allergic reactions from which would include: rashes, vomiting, itchey mouth and / or throat, stomach aches, diarhea, etc. Zane reacts differently to different foods but his traditional IgE mediated allergies are eggs, nuts, fish, shellfish, lentils, certain exoctic fruits and smarties candies (not the chocolates but those chalky like circular small candies). Smarties candies used to be a "free food" for him because they aren't more than sugar and food coloring but he suddenly reacted to them one day while we were in New York City so he's since stopped eating those.



Zane was over the moon with joy when he heard the doctor say that he can have ice cream. He immediately started screaming, "Mommy, I want ice cream. I want ice cream." A part of me was bursting with excitement myself to have the go ahead from the doctor. I couldn't wait to get outside and find some ice cream to feed him. Then there is another part of me that is terrified of this "food experiment." It is simply another trial and if the next biopsy shows something bad then food will be taken away from Zane. It was easier putting Zane on a formula only (or elemental) diet last year because he was barely exposed to food. Since all he was doing was vomiting and reacting to most of what I fed him he has never really had food before August 10th, 2009. But, taking food away from a kid who is used to eating is a whole different type of struggle. The polmicort gives him a false sense of security in a way. He no longer vomits the second he eats food. The drug helps to suppress many of his reactions to foods. So, he sometimes thinks that he is no longer "sick" himself. He does still vomit occassionally and we have to go to the emergency room to get it under control but he is no longer vomiting everyday all day and night long. That, thankfully, has stopped. But, my big fear remains: What if we have to take the food away again? Can Zane (and us) manage this time around without food?

The other rationale the doctor had for allowing Zane to eat was because Zane was developing an eating disorder. By that I mean that he was sneaking foods to eat. I was very good about locking up my fridge and not putting food out. We would keep Zane locked up upstairs where there is never any food around and we would never eat around him. So, if we were out and about and Zane found food on the street (literally) he would pick it up and eat it. He didn't hesitate to go through the trash. Sometimes he would go up to complete and total strangers and either take their food away from them for beg them for food (which was often worse). I've seen my son attempt to wrestle another little boy to the ground for some of his popcorn at the park. On the bus in NYC Zane found a bad of half eaten chips and put one of those in his mouth and ate it. And then there is even worse than garbage picking and begging . . . Kids with EE will often eat anything - even if it isn't food - simply to satisfy the human desire for oral consumption of food. Zane has eaten bird feathers, cigarette butts, leaves, paper, sand (repeatedly since we live in the desert and it is so abundant here), wax and playdough to name a few. He has done this in public which leaves people staring at me like I'm crazy because my son does these things. What can I do? How do you stop something like that in a child forbidden to eat?

Then there are all the behavioural issues that arise constantly as a result of having a starving child. That formula that they drink goes through them like its nothing at all. Both Elecare and Neocate Splash and Neocate are amino acid based, which means that their bodies don't have to break it down in order to consume the nutrients in it. It simply passes through their body undigested so to speak. So, about two hours after consuming eight ounces of that repulsive tasting liquid they are left feeling like they are completely starved. However, Zane got tired of the same taste and texture and would resist the drink making even hungrier. The more hungry he got the more unruly he became. He was constantly acting out and frequently angry. I was the one withholding from him what was a basic human desire to do. And so I was often the brunt of many of his tantrums and physical outbursts.



And so what is life like now that Zane can eat? In some ways, it is actually more work. I'm not complaining though. I'm just letting you know. Now, I actually have to prepare foods. I am back to carefully scanning labels to make sure none of his IgE mediated allergens are present. I have to schedule out my day to feed Zane and reign in some previously learned bad behaviors. For examples, many parents of kids with EE try to down play meal times by allowing kids to watch TV while eating or drinking their formula. Now, we have our meals at the dinner table. Many parents of kids with EE try to eliminate eating and drinking from social engagements all together. So, I was constantly providing entertainment or stimulation for Zane while food was present. Zane would be off on his own while others would eat together - encouraging anti-social behaviour in Zane. He was used to always doing his own thing and now has to learn that sometimes we have to go with the group.

The other challenge for me is that even though Zane can eat now he has a fear of eating since all of his food related interactions have a negative association. Encouraging him to try new foods is difficult and he will often tell me, "No. That food will make me sick mommy." It is taking time but we are getting there slowly. And we are doing it with the aid of medication that is taken with tons of packets of Splenda. Hopefully that stuff doesn't become known as a carcinogenic sometime in the future because many EE kids (like Zane now) are totally dependent on it to eat.

We still feed Zane his formula for two reasons: 1) We want him to stay used to drinking it just in case and 2) because his body doesn't process and tolerate food proteins well it also doesn't absorb many of the vitamins and nutrients in foods and the formula aids us with that deficiency.

What is the best part of the polmicort? Other than the fact that it means that Zane can eat and be a part of society . . . it also means fewer doctor appointments. Or at least I am hoping it does. We (especially Zane) deserve a break from that hectic mess. We would visit doctors, specialists and hospitals about weekly and Zane was hospitalized for dehydration due to vomiting about monthly. Here is a sample of my medical schedule while I was in the States:

July 20th - pediatric laser surgeon specialist for Selma - did a phone consultation instead and cancelled appointment
July 21st - Pediatric visits for Zane and Selma
July 21st - ENT visit for Zane
July 23rd - Visit to the Allergist for Zane and Selma
July 28th - Pediatric plastic surgeon visit at the vascular birthmark foundation for Selma
July 29th - Surgery for Zane to remove his tonsils and MRI for Selma under general anesthesia at two different hospitals
July 30th - ER visit for Zane to stop vomiting
August 4th - follow up visit for Selma at Vascular Birthmark Foundation
August 4th - Zane to the dentist for teeth cleaning
August 5th - Dr. Mirna Chehada - EE specialist at Mt Sinai for Zane
August 7th - Pediatric cardiologist visit for Selma
August 10th - endoscopy appointment for Zane
August 13th - follow up appointment for Zane for ENT doctor
August 17th - Nutritionist visit for Zane at Mt. Sinai's eosinophilic gastrointestinal disorder clinic
August 18th - we leave the States

Basically, the polmicort is a bandaid on the situation until Zane either outgrows some of his allergies or we find a cure. It only works on about 50 - 60% of kids who have EE. So, I am constantly mindful of those still struggling without food and thankful for what I have. I want all kids with eos disorders to be able to eat. But, I have to tell you that it makes me the happiest person in the world to watch my son finally be able to eat and enjoy most of it. There will be other bumps in the road but we'll take those as they may come. For now, I simply want to enjoy the moment.






What was his first food when Zane woke up from general anesthesia after his endoscopy? A keebler graham cracker. The nurse just brought anything she had that didn't have eggs or nuts in it. Here is a pic of Zane enjoying his first bite.

Saturday, January 3, 2009

So What CAN He Eat?


I was very naive about the severity and nature of this disease back when I posted a few months ago. I was also naive in thinking that the severity of the disease was measured by the frequency of Zane's vomiting. Since Zane was put on the restricted diet eliminating rice, wheat, gluten, nuts, seeds, soy, beef, lamb, fish, shellfish, eggs and dairy products he went from vomiting all day long to only about once a week. So, I thought he was improving. His appetite also increased but still wasn't where it should be. But, because he was eating I didn't question it too much. We were concerned about his inability to gain weight though. Most doctors kept brushing that aside as a non-issue because Zane was 'seemingly' so healthy. He is always so active - especially so when we went to a doctor appointment. The pediatric gastroenterologist in Dubai told me that Zane's activity was not indicative of a child who wasn't meeting his daily caloric needs.


However, right before we left Dubai Zane began vomiting a bit more and then stopped eating food altogether. He never even asked for a bite to eat or mentioned food at all. I would leave food out for him and sometimes he would go days without a single bite of solid food. I began to suspect that he had additional food allergies and thought the likely offenders were corn, potatos and garbanzo beans. I allowed him his Elecare only diet since he actually took in more calories on that then when we combined his Elecare intake with regular food. He would occassionally eat a few bites of regular food and then stop and say that he didn't want to eat anymore. I didn't realize that early sateity had set in. Early or premature sateity is a condition whereby the stomach sends a message to the brain telling the brain that it is 'full' when it really isn't. It is the body's way of protecting itself when harmful or offensive foods have entered the system so that the person will stop eating. This in turn leads to a 'failure to thrive' as doctors call it where kids fail to gain weight and stop growing altogether. Up until Zane stopped eating before our trip to NYC he had not gained any weight for a year. He was wearing the same clothing he did when he was one year old.


Then we arrived in New York . . . Allergy testing revealed that Zane is allergic to all environmental allergens with the exception of dogs, cockroaches and dust. A week later blood work revealed Zane is allergic to all foods that he has been exposed to thus far. This includes: chicken, turkey, pork, apples, bananas, peas, corn, potatos, oat, barely, watermelon, grapes, carrots, and tomatos. Mind you, this list of food is not exhaustive. It is only what we tested him for. When you combine this with rice, wheat, gluten, nuts, seeds, soy, beef, lamb, fish, shellfish, eggs and dairy products there really isn't much else left. He also can not eat any acidic foods because he developed severe acid reflux as a result of all his vomiting over the past year.


His biopsy on Aug 11th revealed that the condition of his esophagus is worsening. A healthy esophagus looks pinkish and shiney and smooth. Zane has the classic forrowing known amongst kids who suffer from EE. He can not tolerate foods and the doctor recommends that he be taken off of all foods and then only introduce one food at a time with biopsies conducted every 6 - 8 weeks to determine if the eosinophils have returned. If so, then we know that he is definitely allergic to that food and we try again with repeated endoscopies until we come up with a list of foods that he is not allergic to. Doctors have told us that this process could take as long as 2 - 3 years. So, the search is on for non-offensive foods for Zane and we are starting with corn.


We can not know for sure how bad Zane's case is until the pathology report from his Aug 11th biopsy is recieved and we have an exact eosinophilic count. But, I fear the number will be high. The doctor said that the eosinophils appeared 'dense.' I certainly expected some change in his esophagus but Mohamed and I were shocked that the change was as dramatic as it was in only five months.


When I came to New York City last February the doctors told me that his case was so mild that they weren't 100% sure he did have an eosinophilic disorder. Today, however, they told us that his case is now moderate and he definitely has a full blown case of the disease. But, I knew he had the disease all along. Nothing else made sense and all his other tests were negative when he tested for other allergic diseases and cystic fibrosis.


We still are fortunate in that Zane is willing to drink his Elecare - even now that he requires 30 - 35 ounces a day of it. Most kids can not tolerate the foul taste. Mohamed and I can barely tolerate the smell. Kids who can not drink it must be placed on feeding tubes. It's my biggest fear. I really don't want to have to feed my son with a feeding tube through his nose or surgically implanted in his side into his stomach. But, considering all the horrible implications of not eating - feeding tubes seem like a positive alternative.


I've gone through the whole gammut of feelings on this. I've cried about it. I've even laughed at time at how ridiculous this disease is. For example, kids with eosinophilic disorders have certain "safe foods." Ready for this one? I can freely feed my son all the water, sugar, salt, maple syrup, vinegar, and dum dum lollipops he wants. Great. Now I can rest my head with ease. What the hell am I supposed to do with that stuff? The lollipops have come in handy to satisfy Zane's desire for real 'taste.' I can't even begin to tell you how appreciative I am for dum dum lollipops and rock candy (the clear kind that is basically only water and sugar). I'm trying to get creative with maple syrup by making "juice" with it by mixing it with water. I may possibly try making slushies with the stuff by mixing it with crushed ice. I am also incredibly appreciative for Elecare. It is keeping my son alive and well.


Needless to say, we no longer have family meals. Breakfast, lunch and dinner times have turned into a multi-faceted sting operation. One of us watches Zane and keeps him distracted while the other hides and shovels food down really fast before Zane finds us and throws a tantrum because he can't have any. No one understands the severity of his allergies and the impact that this has had on all of our lives. I told family not to throw a birthday party for Mohamed and I this year because Zane can't have any of the food - especially cake. My mother replies, "Oh. Ok. I can make cupcakes instead." Thanks for the help, mom. Zane sure as hell wouldn't want to eat those. Why didn't I think of that?


Going food shopping is an exercise in emotional torture and futility. I slowly stroll down food isles to see if there is anything at all that Zane can eat. By the end of it I am usually either pissed off or in tears. I am suddenly racked with guilt when I can eat - because I know that he can't. In all likelihood he will never be able to have a full diet. Doctors want to find at least one grain and one protein before we can take him off of his Elecare.


Want to know a real irony? We are Muslims who are not supposed to eat pork. What is usually the one and only meat that kids with eosinophilic disoders can tolerate? Yup. Pork. Which is totally fine by me. I told my husband that I would gladly take one for the team on this. I'll go to hell in a handbasket in a heartbeat with the biggest grin on my face if he is able to have a big fat juicy pork roast and not get sick from it. I want him to love it and ask for it again and again and again.


Signing off from Dubai,


Nancy


PS. I will add pics of our trip to Italy and NYC soon. I'm still seriously jet lagged.PS. Here is a good link on the basics of EE, as it is called. http://www.childrensmemorial.org/cme/online/article.asp?articleID=125
(originally posted on August 22, 2008)

Medical Care in the Gulf

Dubai has the third fastest growing economies on the planet and is one of the weathiest cities in the world. It is not uncommon to see Bentleys parked out in front of your local supermarket. The mercedes is the vehicle of choice for most local families. Given all of this wealth, one would assume that Dubai, and the Gulf Arab countries in general, have excellent health care and resources. WRONG.

Up until last week, there were absolutely no pediatric gastroenterologists in Dubai. As a result of Zane's rare allergic disease and need for frequent endoscopies, an American board certified adult gastroenterologist ordered the first pediatric endoscopy unit in the Gulf outside of Saudi Arabia. The first pediatric endoscopy was performed on a child in March, shortly before we returned from the States. Prior to that, if a doctor had to perform an endoscopy on a child they used adult equipment which is extremely dangerous.

The other problem with health care here is simply a cultural one. In the East, they simply don't take certain illnesses too seriously - like allergic diseases. When we first moved to Dubai, I told the receptionist at the hotel check-in that I desperately needed a non-smoking room because I have allergies and asthma. He replied by asking me, "What are allergies?"

When Zane had his adenoid surgery last week, my biggest fear was that they would give him medication that contained one of the many things he is allergic to in it - namely soy, egg or dairy, which many medications are made from. They didn't. But, after the surgery they fed Zane food that he was allergic to and then informed us that the hospital did not have the ability to accommodate his restrictive diet.

How do the locals do it, you wonder? Some of the Gulf Arab states are welfare states. The governments provide everything and anything for their wealthy citizens. If you are an Emirati local that needs health care services the government will pay for you and your family to travel anywhere in the world to recieve such specified care. A nose job? No problem. Face lift? Check. Heart bypass surgery? Sure. You got it. The government will pay for its citizenry to stay as long as they need to with all expenses paid.Nice, huh?

Signing off from Dubai - where it was 110 degrees F today,

Nancy

PS. Zane did really well in his surgery and has healed nicely. Thank you to all for your thoughts and prayers.

(originally posted on May 24, 2008)

So Where Do We Begin?




It's been a while since I last wrote. However, I assure you that I have valid excuses for not updating all of you on our latest and greatest. So, where do we begin?We moved the end of January / beginning of February from our beach front flat to a massive villa in Umm Suquiem 2 / Al Manara area of Dubai.

I know what all of our friends and family back in the States are thinking . . . "What? Mohamed and Nancy moved?! No way. That's not like them." But, alas, it is true. We lucked out and found a bigger place which is much much cheaper and so, in Dubai, you don't pass up prime opportunities like that even if you do have full sea views.Next, Zane's health began to deteriorate very quickly and he fell very ill. We have been taking him to doctors for a year now trying to figure out what is wrong with him. It got so bad that he was vomiting every day all day long and had not put any weight on over the last year since his first birthday. We took him to the emergency room here one night only to be told that health care here in Dubai is so basic that they can not perform the tests necessary on him to help or treat him. Doctors suggested that we take Zane to Europe or the States for medical testing and that is exactly what we did for the month of February.


We were there for over a month and finally figured out what is wrong with Zane. He has severe and multiple food allergies which went undiagnosed for so long that he developed a rare and chronic allergic disease called Eosinophilic Esophagitis (also known as EE). Zane is allergic to rice, wheat, gluten, beef, lamb, fish, shellfish, soy, eggs, dairy products, nuts, seeds and certain fruits. Every time he ate something that contained any of those ingredients, the eosinophils or white blood cells in his body, would grow in his esophagus and attack the food coming down his throat causing him to vomit.

Those eosinophils have now taken on a life on their own. In normal healthy people, eosinophils act to attack only foreign substances that are harmful to your body. In Zane's case, he has a disorder where the eosinophils mistakenly attack food because his body is allergic to it - but sometimes they also just "attack." Now, they won't go away and even when he doesn't eat food he is allergic to he vomits. His esophagus has suffered some damage and scarring as a result creating a severe acid reflux problem for him as well. He must undergo frequent steroid treatments to keep the eosinophils in his body at bay and allow him to be able to eat and drink without a problem. He has had to be hospitalized a few times because of his condition as well which was hard on him. But, the vomiting has subsided considerably and we are now focusing on helping Zane to heal his esophagus and gain weight.



We are fortunate because many children with Zane's allergic disease, EE, are never able to eat again and must be fed special formula through a feeding tube to keep them alive and prevent malnutrition. Zane is able to eat and drink on his own and his "numbers" of Ige related allergies and eosinophils are not too bad. Doctors believe that Zane will outgrow some of his food allergies but not all, unfortunately. But, the EE may be here to stay for quite some time.


Ilhumdullah, Zane is still the happiest little boy ever. His smile lights up a room. I often tell people that if anyone should have to get a disease like this that perhaps it is best that it is someone like Zane because he is resilient and happy anyway - even when he isn't able to keep down any food or liquids. I still feel blessed that God gave me a wonderful little boy and I would rather spend a bad day with Zane than a good day by myself.


But, please say a prayer for my little boy that he outgrows all his food allergies and that the eosinophilic disorder goes into "remission" (if there is such a thing for EE). Zane drinks a special formula called Elecare that is hypo-allergenic yet contains all the vitamins, nutrients and minerals that he needs to prevent malnutrition and encourage growth. The problem with the stuff is that it isn't very filling and it is extremely expensive. But, we have to do whatever it takes to keep Zane healthy. He also needs to undergo frequent biopsies to measure his eosinophils and see if his esophagus is healing. He may also need to undergo more allergy testing to determine if there is anything else he is allergic to -- doctors believe that he is. It hasn't been an easy ride but God meant for Zane to fight this fight for a reason. Mohamed and I are just trying to be there to support, guide and help him all we can when he is most sick.


Finally, so I am not a total and complete killjoy over that last bit of news . . . Mohamed, Zane and I are happy to announce that we are expecting another addition to our family. Baby #2 is due on November 1, 2008 and after our last ultrasound today we learned that so far (God willing) we have a healthy and well developing baby.


All the best from Dubai,
Nancy
(originally posted April 18, 2008)