Genetics/Cardiology Appointment

Let me start of by saying this week sucked.... a lot. We saw Genetics, cardiology and the pediatrician.   

I thought for sure Tuesday was going to be good. My husband managed to get off work so he could come to the appointment with us, we were suppose to see genetics for Hunter's 2 month followup, genetics for Alexis' initial appointment and then cardiology for both. The day started out good (meaning we got their on time) but quickly went down hill. They hadn't updated my insurance information in their system so when they updated it they gave me the bad news that they couldn't do there EKG/Echoes in that office because my insurance wouldn't cover it. According to them my insurance wouldn't cover it because that office was in a hospital, I asked how much it would cost without insurance... the down payment (for 1 kid) was $600+ and I would be mailed a bill for the rest. Yikes! That was out of the question. So, they decided to still have us see the doctors today but reschedule our EKG/Echoes. 

We met with the cardiologist first, she explained what she was looking for, what the game plan was and then that she had an open appointment for us on Friday to come in at their Hanover office. While she was talking to us with 2 student doctors over her shoulder, 2 techs came in and started to get vitals. They didn't come in and explain what they were going to, we just blinked and Alexis was screaming with a blood pressure cuff around her arm and Hunter was on the exam table being looked at. ....traumatic and chaotic.... Once they got what they needed the techs left and it was just the 7 of us in the room (cardiologist, 2 student doctors, me, Chris, Alexis & Hunter) Luckily, Alexis liked the student doctors so she started talking to them and they kept both kids occupied while we finished up our conversation with the cardiologist. In short, the cardiologist is looking at the size of their heart and how they are functioning. 

Then it was the genetic counselors turn, the student doctors stayed (which worked out to our benefit because they were still entertaining the kids) She started from the beginning basically the same thing I did at Hunter's appointment family history etc. We were almost done that when the geneticist, Dr. Greene came in.  Dr. Greene basically said Alexis has LCHAD even though her DNA isn't back, we talked about getting her started on MCT oil they want her on the same dose as Hunter. (4mL 4x/day) They wanted us to start MCT and then get her blood drawn on Friday to see how her acyclcarntine profile looks after a few days of MCT, and work with our nutritionist to figure out where we are going to start her diet at. Nothing really happened with Hunter just asked how he was doing and if I had any concerns. Then she asked me what questions I had. First, I asked if she had heard anything about Hunter's NBS. If you don't remember his first NBS came back slightly elevated non specific but nothing was ever said or done about it. She said that his numbers were so low that no one would have called him back in for more testing. Not even in Region 4 where they apparently call back the lowest of numbers. She did say Region 4 will probably start calling everyone back for any type of elevation now though because of Hunter. Next, I asked what the chances of Chris or I actually having LCHAD and if it was worth testing for. She said our chances are low but she agreed it wouldn't hurt to send us for testing. The genetics counselor looked up statistics for me and said about 1 in 138 people are LCHAD carriers, less than 1% of the population. I don't know about you but 1 in 138 still seems like a lot to me, I guess the odds are slim that the 1% will find each other but look at us. Lastly, I asked about the dreaded immunizations coming up. I asked if there was anything she wanted us to do different since the past two immunizations (6 months & 12 months) landed us in the hospital. Dr. Greene still thinks it's just a coincidence, I respectfully disagree. Fingers crossed we don't end up back in the hospital. 

Last up on the agenda was to talk to the nutritionist. We went over how Hunter's diet was going with the MCT oil and cornstarch at night. We talked a bit about Alexis' current eating habits and she asked me to keep a journal and then email it to her so she could come up with a diet for her. The nutritionist understood my concerns with vaccines and told me she would talk to Dr. Greene about it a little more to see what we could do to help Hunter this time. 

We left University of MD, 3.5 hours later with a stack of blood work that needed to be drawn on Friday at our EKG/echo appointment and were told we don't need to come back to the geneticist for 6 months! 

stack of paperwork...

Thursday we went to the pediatrician click here to read about it

*You know its crazy when I didnt have a chance to take any pictures... oh, well!