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Crash course medical specialist Costello Syndrome

Vera received the diagnosis: Costello Syndrome within 3 weeks of birth. That’s extremely fast. A tough message for parents who are still recovering from an emergency C-section/having a new baby/the baby is a heart patient/weeks at the intensive care unit/baby won’t eat/what about caring for our other daughter? News that’s hard to digest. I remember flashes from the “bad news consultation”.
HRAS diagnose costello syndrome

“…she has been tested for an anomaly in the HRAS-gene and it turns out she has this condition. Which is bad news.”
“…this will mark your lives.”
“…mental disability…”
“…fortunately, people with this syndrome have a very friendly personality.”
“…this is a rare syndrome. You will educate yourselves and within a few months you will know more than your doctor.”

Fast forward two years. We are very thankful for the very fast diagnosis. It gave us clarity from the beginning. It helped us make decisions, like asking for a PEG-tube instead of a feeding tube through her nose (because she wouldn’t be eating on her own for a while according to other parents and because it was so uncomfortable for Vera) and it gave us contact with others who were experiencing the same thing: an extensive international group of parents to exchange experiences and compare medical information with. Because the syndrome is certainly medical. Over the past two years we have taken the crash course: ‘Costello Syndrome in Real Life’. We know a lot about the syndrome thanks to the doctors, nurses, therapists and several articles. But we learned the most from other parents. Because they know from real life experience how much mucus a little body can produce and spit up. They know what it feels like when the small body of a child responds to different types of sensory input. At night they wake up constantly from a restless baby. They know which creams prevent skin irritation or help with premature wrinkles in young little hands. Which feeding pumps, syringes and types of gauze are best. And not in the least: which forms of treatment and what medication works for children with Costello Syndrome. They have to in order to create quality of life for their child, for themselves and for their other children. And now we are a part of this group of parents as well.
Last Thursday was a classic Costello-moment. Vera had to go to the Children’s hospital in Utrecht for an IV-drip with bisphosphonates to help strengthen her brittle bones. But starting an IV-line in a person with Costello is like throwing darts while blindfolded. The skinfolds are deep, the skin is sweaty, the veins run differently, are invisible when the child is stressed and disappear when the needle first enters. And Vera has had enough people poking and prodding her, so at the first sight of a white coat she was hiding away close to mom and dad and started a heartbreaking cry.

operation room WKZ Utrecht
Luckily we had a nurse who knew Vera and didn’t even attempt to put a line in, but called the anesthesiologist instead. Who then didn’t succeed either. There was only one other option left: putting the IV-line in under sedation in the operating room. But in order to do that, she needs to have an empty stomach. So we had to wait 2 hours. The OR is now a familiar place for us and one of us carries her onto the table and stays with her until she falls asleep. And minutes later, there you are again as parents waiting in the hallways. “Putting an IV-line in doesn’t have to take this long, does it?” “Why has it been 45 minutes?”

Finally we were allowed to see her again. IV-lines in both arms (you never know if one might fail), she was wrapped up warmly but not feeling well from the sedative. But we could finally get started!

Thankfully Vera did not experience any major side effects from the infusion itself (just a minor temperature and a bit listless) even though the doctors had told us to be prepared for side effects.
And when we were finally back home again and were sitting on the couch at 9:30 PM, Vera, with her hands wrapped in bandages like little boxing gloves was sitting there, smiling the biggest smile. Because a Costello has a friendly personality. And she marks our lives. We already learned that in lesson 1.

bokshandschoen

Vera ‘s-avonds weer in vrolijke stemming met ‘bokshandschoenen’ nog aan

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Roller coaster

We have received such sweet and overwhelming reactions to Vera’s website. Thank you! Several donations have come in already for which we are so thankful and happy. Thank you again! Unfortunately, we have had to switch quickly from all the positive attention to big concerns for Vera these past few weeks.

Two weeks ago we received a phone call from the pediatrician about some results that had come back for the many tests that had been done to figure out why Vera has been having ongoing issues with her bowels. It was bad news: raised values in 2 components of Vera’s urine that point to neuroblastoma. Vera has a greater chance of developing neuroblastomas, a form of cancer, due to her syndrome and the ongoing diarrhea could be caused by a neuroblastoma in her body.
Two days later an x-ray was ordered for her chest and we were called that evening with bad news. The x-ray showed several anomalies that could be tumors. Everything started to point in the direction of neuroblastomas and we were starting to get really, really worried.
Two days after that new tests and exams followed at the Academic Medical Center in Amsterdam where the pediatric oncology specialists are.

Our talk with the pediatric oncologist at the end of the day took a completely different turn however. The anomalies that were seen on the x-ray turned out not to be tumors, but two broken ribs and all of Vera’s bones looked very brittle. Apparently, Vera has quite porous bones and with that another medical issue. Vera will be examined for this in Utrecht this week to find out why her bones are so porous and what would be the best treatment option.
Now that the spots turned out not to be tumors, the neuroblastoma suspicions are a lot less and we will find out if further examination is necessary or whether a new check will be done in 3 months to monitor her for raised values.

And then there are still the long term ongoing issues with her bowels that have not been diagnosed yet. We will continue the search for answers after her bone examinations.

The past couple of weeks have been an emotional rollercoaster, we were very concerned about cancer and the doctors seemed to be preparing us for this. As it turns out, cancer appears not to be the case, but our girl does have another added issue: porous bones. And the bowel problems continue to exist.wkzbrieven
In the coming week things will still be tense with 5 appointments in the hospital. We hope and pray for a good outcome and effective treatment.  In the mean time we buckle down tightly again for the next rollercoaster ride.

Niels

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Giving, receiving and asking for help

We have both had a lot of experience in giving help. Whether at work, at church or elsewhere, helping is usually a rewarding experience (no wonder I became a therapist myself). You make a difference in someone’s life, people are thankful and it feels good. I believe there is even such a thing as ‘helper’s high’, a euphoric feeling you get from helping someone and a pleasant calm afterwards. Once you are aware of this, you would never do anything else!

Receiving help was a lot more rare in our lives. Usually centered around a specific event such as moving or having the flu for a week.

And asking for help… we almost never needed it and certainly rarely did so. Perhaps with the exception of borrowing a cup of sugar from the neighbors. gemeenschap

Right now we receive a lot of help in many ways and we are learning to accept it. We are even learning to ask for it sometimes. But it takes some getting used to. Perhaps because we know it’s not just for a short period such as a week of the flu or the early weeks after giving birth or moving.

We will need this for a while.

It is admitting that we cannot do it on our own. That we need other people to help us do the normal things in life. That it is essential for us to be able to keep going, individually, the two of us and us as a family.

The African saying: ‘It takes a village to raise a child’ is the message here. And with a handicapped child it is not just teaching the child life lessons, our village consists of doctors, nurses, family, friends, neighbors and members of our church. And our village helps with medical care, mental support, pans of soup and pasta (and sometimes even chocolate cake), time and giving attention to our other healthy daughter, places to spend the night, cards and prayer, painting our garden storage unit, vacuuming our house and spending time with family and friends, a night of good sleep. And the village can even help us with much needed financial support.

Raising and caring for a child with disabilities requires parents who can accept help, who are learning to say yes and have the courage to ask. We have started doing this.
Leonie

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