Since I last posted ...

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.

Sunday, 13 December 2009

Since I last posted ...

Alyssa developed a rash which quickly spread from her face and neck, bottom and legs to her arms and started showing on her chest. Now she was brewing something before we started the antibiotics - she'd been fighting a low-grade fever and cough/cold for about 3 weeks prior to this - but the rash didn't show until she started the antibiotics. And I then remembered that last time she had one of these antibiotics in particular, she also developed a rash - though less severe a rash as this episode. Again, was not convinced it was the antibiotics because she has had this one many times before and been absolutely fine ... but the spots on her face, neck and legs this time were really fiery - as were all her "regular" wounds! Which concerned me. Usually once she's on antibiotics, her other wounds which are just permanently there (because she always tears at them) start looking better because the bugs she's just used to having, also get killed off by the antibiotics.

However; I also knew that the abscess (the reason she was ON the antibiotics in the first place) was already a bit smaller than when she started the antibiotics, so I was in a bit of a quandry. I phoned Alyssa's paediatrician and we debated the options. She was also surprised - and probably a bit skeptical - that Alyssa should be reacting to the antibiotics after having them so many times previously without any problems, but we decided that with Alyssa having reacted so badly to the carbamazepine last christmas (and tearing/burning her entire chest/throat and neck skin off) that we should probably try to change them just to be on the safe side. She phoned the lab to check the results of the cultures, and Alyssa was definitely on the correct antibiotics for the bugs in her wounds but they felt that if she was showing a reaction, she should be changed to another one. This one was not easy to source but they managed to find me some at another hospital and arranged for them to be delivered to mine that afternoon.

Alyssa had a higher fever by this point (still not horrendous, but clearly unwell) and we collected the new antibiotics Thursday evening. She was started on them immediately and is still on them. They do not taste very nice (even worse than the previous ones) and she was gagging on them to start with, but at least not actually vomiting like she did when she was little - she vomited VERY easily then! So she's actually looking forward to them at the moment ... because she's getting chocolate buttons straight afterwards, to take the awful taste away! ;-)

The abscess is still there but is definitely shrinking, and is now starting to crust over which I am very relieved about! Her other wounds are now starting to look better and are also crusting over too, so perhaps - just to be nice to us for once - these will also be left alone to heal over! I am not particularly expecting of that last sentence ... but it would be nice. Her nose wound is still being attacked daily so I have no expectations whatsoever that that will be healing any time soon. She is still unwell, but better than earlier this week and the rash is disappearing. Still not sure if it was the antibiotics or something viral, but at least the abscess is looking better.

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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:

Sunday, 13 December 2009

Since I last posted ...

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For those researching pain insensitivity ...

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