Update after seeing the dentist today ...

Self-injuries to date:

The following will give you some idea of what Alyssa has already done to herself ... so far!

* Knocked a few of her own teeth out while "teething" and caused huge ulcerated sores in her mouth, from "rubbing" her teeth on her tongue and inner cheeks

* Bitten straight through her lower lip - didn't even flinch!

* Chewed the end of her tongue off, resulting in emergency repair and incisor removal. After having the tip of her tongue repaired, she then began chewing the side of her tongue as soon as her molars erupted

* Chewed a finger almost down to the bone

* Torn entire patches of skin off, and is scarred fairly extensively as a result! :-(

* Broken both feet - and I had to argue with doctors for almost 10 weeks with one of them, because they didn't believe it was broken! Even a lot of doctors haven't heard of Pain Insensitivity!

* Broken her left leg, just under the knee, and walked about on it quite happily for at least a couple of days. We'll never know how she broke it. Any time she says "my --- is moving, all by itself," we get x-rays done!

* She had to have all of her baby teeth removed, as and when they came in, due to all the biting injuries.

She is still dealing with the after-effects of that, as a teen.

* Required spinal surgery to correct a vertebral slippage issue, which she was completely unaware of. The op itself was pretty straightforward. The post-op period was lengthy, and anything but fun.

* Developed septicaemia from one of her many episodes of cellulitis because nobody realised it hadn't gone away, and was just grumbling away as an abscess in her elbow. When she collapsed, it was scary!

* Managed to dislocate her left hip, falling from her trike .... but it took us 4 months to realise, because she didn't feel it!

* Had corrective surgery performed on both hips. Unfortunate complications ensued, which eventually caused the entire removal of her Right hip, and part of her femur.

Tuesday, 16 June 2009

Update after seeing the dentist today ...

Hi guys,

Am feeling much more relaxed now that the dentist and I have discussed the current situation, and agreed that we are "on the same page" so to speak. She has seen Alyssa many times thankfully; so is no stranger to our dental mishaps with her, and we discussed the other things I'd thought about - such as leaving one molar (either one top or one bottom) on either side and hoping that if she didn't have two at each side that she wouldn't lacerate her inner cheeks, trying to file them under GA again but that it would still be a GA and my tendency to just want them removed if she has to have a GA - considering she's already had 7 in the past 2 years ! - rather than attempt to file them, then find out a few weeks later that it didn't work ... and have to GA her again! She also said that she has been hoping that these ones could be saved, because of how far back they are and hopefully less likely to cause damage.

I agreed that I was also hoping to save them if it is at all possible (possible being no damage caused to her tongue, which has already had emergency repair!) but mentioned that we had also had this thought with the premolars. We left one at the time of tongue repair .. and then had to have her brought back in for GA about 3 weeks later as soon as the others erupted, because she almost chewed the side of her tongue off in 2 days! However; those were slightly further forward, and there is still the hope that she can manage to let these ones come in and not cause any further trauma ...

So ... the plan (I always use that term very loosely with Alyssa) now is to monitor things for the next 3-4 weeks until she goes in for the drug trial which is planned and take things from there once she's in. If she holds out until then, the dentist will come to the ward and we'll reassess for signs of damage and then create another "plan." If she starts biting herself before then, she'll be taken in immediately and have the molars removed as another emergency procedure. All in all, I'm pretty happy with that, considering. I just needed to know that "having them removed" is an option - IF it becomes necessary. Now I just have to try and hope that it's not.

Thank you all for reading our daily saga ... it means a lot! And remember - feel free to post any comments or suggestions to anything I've written. I want your thoughts and ideas, even if I've had them suggested before. It's the only way that everyone else will know the answers too! :-)

2 comments:

Anonymous said...: It's great that you have a 'plan' in place now, and that you can have that tiny bit of peace of mind at least.

I signed up to follow the blog through Google and put in my email address, and haven't gotten any notifications of new posts since (there have been two). That seems odd to me. Not sure what I did wrong or how to fix it. Grr. I will definitely check in when I can, but I'd love to have it automatically tell me when you post.; 18 June 2009 at 06:35
Alyssa's Mum said...: Yeah, I don't get notified when people leave comments either - which is a bit irritating, as was pretty much the whole point. And I thought the point of "following" was to get e-mails as well ... but apparently not. Going to ask them about that though.
Thanks for your comments, sweetie!
x x x; 10 July 2009 at 15:23

Background...

Alyssa's story is a very long and complex one, and to put it all would require actually writing a novel, so I started this blog as a way to try and document some of what it is like to live life in this way. And so anyone reading can get an insight into what it is like to live a life without normal pain sensation. I will attempt to update it regularly, though our lives can get really crazy, as most of you followers already know:

Alyssa suffers from Hereditary Sensory Autonomic Neuropathy (HSAN) Type 7 - also called Congenital Insensitivity to Pain (CIP) with Dysautonomia - and is one of the rarest conditions in the world. It is actually a very complex condition, but in an attempt to put it simply, she does not feel pain in her arms, legs, head, fingers etc. If she hurts herself; she is not aware of it, and is usually fascinated by the sign of her own blood! Which is not great! As well as constantly having accidental injuries, she will self-mutilate - because it doesn't hurt, and well ... because she can!

How it all started: She was not the "typically happy" baby that is usually found in a child who does not feel pain, and we now know that is because she suffers from frequent bouts of abdominal pain. She can - and does - feel visceral (gut) pain, and we have trialed various medications in an attempt to reduce this. Sadly, the pain which she does feel is not 'normal' pain either, so very difficult to treat. Her nervous system just does not work like most people's. There have been 2 theories regarding the gut pain - that it is more intense because she has nothing to compare it to, not feeling pain like everyone else does; and the other is that her visceral nerves are working in a directly opposite sensitivity to her peripheral nerves. Neither has been made clear, although she has definitely been feeling obvious discomfort when she something swollen - which at least makes it easier for me - because I know something is wrong much quicker these days. I don't always know what is wrong, but can hopefully narrow down the "body part" search.

Alyssa has another unusual factor for a child with one of the pain syndromes, because she has an intense "itching" sensation, which causes her to tear and friction-burn entire patches of her skin off. As she doesn't feel any pain from this - even once the flesh is entirely exposed - she doesn't learn that she shouldn't do it. As a result of this, she is very badly scarred already. She had an experimental drug trial of Thalidomide, which didn't seem to make much of a difference ... until we stopped it! It became very obvious that it had actually made a significant improvement to her overall health, in a roundabout way, and reduced the itching, by reducing the excessive sweating that is also part of her condition. Within a few days of coming off it, she was miserable, drenched in sweat, and tearing herself apart again. She had multiple wounds which became infected very quickly due to the excess sweating in them, and she tore off any areas of skin she could easily access. A few days after being back on it, she was much more settled again, and she has been on it ever since. We are about to trial her off of it again, after her being on a different drug for a few months now, and seeming fairly stable. Time will tell how that goes...

Alyssa does not react to things which you or I would find painful - such as being cut, bitten, or fracturing a bone ... but she reacts to heat and cold sensations as if they were excruciatingly painful! When she fractured her L leg at 4 years old, we didn't even know for a couple of days, because she continued to walk about on it, happily. The orthopaedic doctor was stunned to see her wander about on a leg which he discoved was broken, but scream when he tried to touch her ... because his hands were cold! His face was a picture. One we have seen many times since then! My girl is pretty unique!

Anything which you or I would find simply 'cool' or 'warm' will be either freezing or burning to Alyssa. And you do not realise how many things have a 'temperature' until you have a child who reacts to almost everything touching her skin. Almost everything which isn't fabric is an issue for her, which causes a great deal of distress and difficulty in day-to-day life.

For those researching pain insensitivity ...

The pain disorders can be very confusing, and even those of the recognised syndromes have many different names.
For those people (and to help my page be found via search engines so I may in time find others for future contact) I shall list the many searched terms:

HSAN - Hereditary Sensory Autonomic Neuropathy
CIPA - Congenital Insensitivity to Pain with Anhidrosis
Congenital Indifference to Pain
Congenital Analgia
Congenital Analgesia

There are - of course - many others, but those are the most commonly searched terms. The rest are usually only used by the medical community and they generally use HSAN too.

Understanding Alyssa ... and Pain Insensitivity - Life Through Her Eyes

Welcome to Alyssa's blog ...

Self-injuries to date:

Tuesday, 16 June 2009

Update after seeing the dentist today ...

2 comments:

For those researching pain insensitivity ...

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