On August 11, 2008 we gave birth to a beautiful baby boy, Christopher Harry! Christopher was one of the first babies in GA to be picked up on the newborn screening with a rare inherited Fatty Oxidation Disorder called LCHADD (Long Chain 3-Hydroxyacyl-CoA Dehydrogenase Deficiency). As Ryan and I (Stephanie) gained more understanding about our son's condition and began to watch him grow and thrive, we had a desire to share our story and raise money for research. We hope that by sharing our story we can raise awareness/encourage education about LCHADD and provide hope to other families whose child(ren) have this condition.


This blog shares our journey, hopes, and fears. We also want this blog to contain practical information! Entries will include: yummy recipes, how we manage his LCHADD, conversations about medical issues, educational tools, and useful links on the side of the blog! If you are ever curious about something I have shared feel free to contact me personally!

What is an FOD?

WHAT IS AN FOD?


FOD stands for Fatty Oxidation Disorder. For children and adults with FODs their bodies have difficulty breaking down (or oxidizing) fat to use it for energy. This occurs when an enzyme is missing or not working properly. There are several different kinds of FODs. Some examples are SCAD, MCAD, VLCAD and LCHAD deficiency. Fatty Oxidation Disorders are genetic, which means both parents must have the recessive gene in order for their child to end up with the disorder. It also means that children with FODs will not grow out of their condition. Their condition is just as much a part of who they are as the color of their eyes or hair.

What is LCHADD?

WHAT IS LCHADD?


LCHADD stands for Long Chain 3-Hydroxyacyl-CoA Dehydrogenase Deficiency. Essentially children with this condition cannot utilize long-chain fats for energy. Did you know that the food that we eat has different size fat molecules in it? I never did until Christopher was born! There are short-chain fats, medium-chain fats, long-chain fats and very-long chain fats. I picture them as different size caterpillars (and this is how I explain it to Christopher) running around in our food. The short, medium, and very-long chain fats children with LCHAD can process. Unfortunately, most of our food and oils are primarily long-chain fats (the ones Christopher can’t process). If Christopher eats too much fat (right now he can only have 8-9grms of fat a day through food) then the fat will gather in his liver, kidneys and around his heart.


The other issue with Christopher not being able to breakdown long-chain fat is that it is a great energy source. For most of us, when we exercise or get sick and we burn through all of our glucose stores we start using fat for energy. Christopher’s body cannot do this, so his body starts to break down muscle and use it for energy instead. To say that this is “not good” is to speak lightly. When your body starts breaking down muscle you run the risk of having problems with lots of different systems in your body. Doctors worry the most about your kidneys because kidney failure can happen when your body is trying to process all of the broken down muscle (or myoglobin which is the by-product of the broken-down muscle).


In general, children with LCHADD are put on a very low-fat diet, drink a special medical formula, and most often use MCT oil (a unique oil comprised of medium chain fats) to give them a source of sustaining energy. Christopher's special medical formula, Lipistart, helps to ensure that he gets enough essential fat for brain and eye development without getting too much fat that his body can’t process. Lipistart also helps to provide a consistent form of energy for him throughout the day.



Monday, March 6, 2017

Life is Filled With Seasons!


               As I sit in front of my screen trying to process the last month and half, I keep coming back to a conversation that I had with Dr. McGuire at NIH, awhile back.  He said something like, “A person’s metabolism is always changing…and this will affect Christopher.  What he might be able to do one year he might not be able to do the next, and he/you will have to be okay with that.  He might be able to handle baseball just fine this year, but perhaps can’t do it in first grade…but does fine with it in third.” I appreciated this word of wisdom, and tucked it away in a suitcase in my brain labeled, “Things to remember”, to be taken out at a more appropriate date.
Beating mom at Rummi!
            The appropriate time was February, but it hit like a ton of bricks.  January 2, 2017 Christopher came back from our Christmas trip to Maryland and Pennsylvania and was really exhausted.  He was suppose to return to school that week, but his body was just feeling too tired so we rested.  By the end of the week he had come down with a cold.  This cold metamorphosed into pink eye, and then 4 days later into a sinus infection, which led to antibiotics.  Christopher tends to get secondary infections with colds, but this time his body was so much more tired. Then one evening after being on antibiotic for about a week, he woke up at 4am complaining that his whole body felt weak and it was hard to sit up. 
            I gave him Lipistart and honey, then watched him as he fell back asleep.  Was he breathing okay?  Had this turned into pneumonia?  Was his heart okay?  Could he have developed cardiomyoapthy?  This new word, “weak,” scared me.  It was something that I have read other LCHADDers describe.  It was something other parents talked about at support conferences, but until then Christopher had never verbalized this feeling.  I was scared.  What if I missed something?
            That day led to a plethora of observation, phone calls, questions and blood work.  Christopher’s cks came back normal, the doctor said his heart sounded fine, and yet here we were.  Christopher wasn’t feeling well, and was not his normal vibrant self.  He went through several days where I had to assist him to his bedroom or the bathroom because he felt too weak to do it himself.  Our metabolic team, and another metabolic doctor in PA both confirmed that he was still within normal range for an “LCHADD” recovery after illness.  This provided some comfort, but Christopher had missed over 20 days of school since Christmas…it was the longest he missed consecutively since he started school.  So it didn’t feel like his normal.  His pediatrician agreed with me but what could we do other than wait?
            That is what we did; wait.  For about six weeks we took it easy did low key activities and homeschooled.  As much as we could, we did half days at school.  I knew we were headed into unchartered territory with our experience of LCHADD, so I reached out to friends.  I took comfort in older LCHADD parents who shared their wisdom and experience.
When he went back for half days he had fun staying inside with a couple of buddies for low-key recess!
            Then one day he went a full day of school.  Then the next day he felt like he could play catch with a baseball.  Then his best friend came over and they ran around the house and he didn’t crash the next day.  Why?  Why did recovery take so long this time?!  I think the hardest part is that there is no way to know.  It would be nice if LCHADD was like a mathematical equation where 2+2 always equals 4.  The fact is that with a cold: Proper hydration + Proper nutrition = most often recovery…but not always, and not always as quickly as one might predict.  LCHADD just gives way to a certain level of unpredictability that, eight years in, I still struggle to wrap my mind around.
A moment I remembered how blessed I am.
            But guess what?!  Amidst all the uncertainty and the length of time of this last recovery; Christopher is doing well now!  And I am reminded that life is filled with seasons.  A sick season may prove hard and at times scary, but I hope I will always remember the beauty that is born from this season too!  First, there are the extra long story times we have, with books I never knew existed, or new board games to learn to play!  Then there are moments of puzzle fun, legos, and this January many episodes of "The Andy Griffth Show."   Scholastically, I have a better understanding as to what they are learning at school.  He gets one-on-one “mommy tutorial” (for better or worse) and is challenged to know about subjects they might not cover as a second grader (this last episode he did a research project on dynamite and we studied the body/circulation).  And so as hard as these periods of illness may be, I know and trust that these moments we have together will produce something special in him.



4 comments:

  1. This is awesome, Stephanie. Thanks for sharing! This is probably what I'm most anxious about as my little guy (VLCAD) grows up. The sea of uncertainty. And how to navigate it with as much grace and peace as possible. :-)

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  2. It's not always easy, but a wise parent painted a picture for me when Christopher was just three. She said that her daughter went into Rhabdo on the plane on their way to France. She said, "Well, you just learn to go with it. Instead of walking around Paris like we had planned to, we watched the Opera and took a canal ride." This touched my heart and I felt deeply challenged as I realized that in our lives I can either view these moments as immobilizing or an opportunity to get creative. H.G Chesteron viewed life in the same way...and so that is always what I think when these moments come, "How can I get creative with this?" You are going to be great at this too! :)

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