Seriously…STOP with the Hair!

As adorable as Josephine may look in the first picture (God, I LOVE that smile), I hate looking at it.  Her hair was finally back and beautiful and we CHOSE to get her haircuts, both around Easter and in early July.  But, once again, I was forced to make a decision I didn’t want to make – same as last year at this SAME time – to cut off most of Josephine’s hair because of TRICH.

I wanted to cry while explaining the the hairdresser what I wanted (or didn’t want is maybe the better way to say it), but I held it back and pressed on.  Inside, though, I wanted to shout at anyone to help us with this disorder and get my girl to stop pulling.

So, as we head into her 3rd birthday, part of me is saddened to know that her birthday pictures, while filled with joy, love, friends and presents, will also hold the horrible mark of Trichotillomania, a balding head with bits of peach fuzz sprouting all around.

Trich, Trich GO AWAY! Don’t Come Back ANY DAY!

Contrary to the title of this post, Josephine’s Trichotillomania has reared its ugly head.  Ironically, it is exactly ONE year ago since her first major pull.  Why now?  Josephine is a happy and funny little girl with a love for fish, paper and her brother.  So what is it about August?

My guess is as good as any, but think it’s certainly a path to consider…

Late July of 2010, Josephine started crawling on her own.  New words started emerging.  Progress was everywhere.  Early August of 2010, Josephine started pulling her hair.  She was overwhelmed by what was happening and found comfort in her own hair (and later, mine).

The hair pulling never completely went away, but certainly subsided enough so we could start brushing, styling and cutting Josephine’s hair.

Now we are in August of 2011 and again, we are seeing major progress with her skills – standing independently, cruising and walking independently (when the mood strikes her), improvement on a cognitive level – a lot for a 3 year old to process in a relatively short amount of time (I say relative because everything happens on “Josephine time”, not “the rest of the world time”).

However, while we are seeing great strides, Josephine again is having difficulty processing all these strides and takes it out the best way she knows … hair pulling (Trichotillomania)  and hair eating (Trichophagia).

I am very bothered, both in my heart and in my head, that the Trich as come back.  I have been told it may never go away, but I have also been told that Josephine is so young, so there is little data available to accurately give a prognosis.

I know another child with Tet 8p that also pulled hair, but that symptom seems to have disappeared for her.

So, is this a new symptom for Tet 8p that needs to be explored?  Would she have had this disorder regardless of her chromosome triplication?  Who knows and I suppose it’s best not to go there because I have to deal with the here and now and not the what ifs.  What ifs will cause ME to pull out MY hair and Lord knows, we don’t need another girl in this house that’s going bald!

My heart hurts because there is nothing worse than watching your baby hurt herself to soothe herself.  We try all we can to control her emotions and keep her calm, but when you are in the car on Route 80 in Pennsylvania or on the Garden State Parkway and a major meltdown occurs, little can be done to calm her down.  We stop the car, relax Josephine a bit, start driving again and the whole thing happens over and over again.

Do I wish Josephine could control herself and her Trich?  Absolutely.  Do I wish I could let Josephine’s hair grow long enough to make adorable pony tails?  Absolutely.

Do I think hair is what defines her?  Absolutely not.  Josephine is who she is, hair or no hair.  Just trying to ride out this next wave and keep hope that we can find a cure or treatment to help our little girl and this thing called Trich.

Bubbles, Bubbles Everywhere!

It might seem a bit odd that blowing bubbles is during a PT session, but most of the session start with bubbles, which helps calm down Josephine upon first sight of Lana (poor PT is gonna get a complex!).

Josephine still has trouble rounding her lips (well, she doesn’t do it at all, actually), so the fact that she is able to blow bubbles TWO separate times is certainly a milestone in my mind.  While standing independently no less!

Mixin’ It Up!

Another posting of Josephine and food – two of my most favorites!  Can’t live without either one!

This brownie-making moment was during a speech therapy session – learning how to follow instructions, learning about different foods, learning about different textures (not a huge favorite considering her sensory disorder), and the best part of it all, EATING THE BROWNIES!!!!

A Little BONK on the Face

Oops!  Guess who found out that concrete and faces don’t mix too well???  It seems our little Josephine decided to get ahead of herself during her PT session and got a bit too close to the ground…2 bloody lips and 1 possible broken nose later…

She’s fine, by the way.

A Breathe of Fresh Air

After being redirected by an amazing security guard through the bowels of Morristown Memorial Hospital in Morristown, NJ, we arrived at the office of Dr. Arthur Atlas, Pediatric Pulmonologist.

HI!

Good news is Josephine’s lungs are working well and present no issues at this time.

Mediocre news is Josephine’s left side of her rib cage is indeed bell-shaped, meaning the upper part of her rib cage is more narrow than the bottom (uh, kinda similar to a BELL).  At this point, it’s more of a cosmetic issue than anything else.  My thought is when she wants to correct the issue, we can DISCUSS it with her.  But if it presents no danger to her, why change it?

Dr. Atlas (also an wonderfully gentle man) wants to see Josephine in a year to make sure everything in growing in proportion to each other.

This visit made me think it’s about time to see Dr. Dreamy, er, um, Dr. Donald Putman (Pediatric Cardiologist) again.  The last time he saw Josephine was when she had just turned 1 year and he cleared her of any heart issues.  But as I understand with chromosome disorders, things can change year to year and it’s important to stay on top things.

I tell ya…it never gets old seeing Dr. Putman!

No Bones About It

I would like to take this time to introduce to you, our newest doctor to enter Josephine’s world…(trumpets please): Dr. Mark Rieger, Pediatric Orthopedist, at The Orthopedic Center in Cedar Knolls, NJ.

I have read that scoliosis is a common characteristic of Tet 8p – about 1/2 of the kids, or 7 if you want numbers. And I’ve noticed since Josephine has been on her feet and moving more, she always leans one direction (don’t ask me which way since I can’t even tell MY OWN left and right at this point).

Besides, I was getting tired of the same old set of doctors and wanted to meet someone new…

Seriously, though…Dr. Rieger was very kind and had a great bedside manner with Josephine.

No scoliosis at this point. Straight spine. I am certainly relieved to hear that. But I also know that as she starts to walk more, her spine may change as well.  I tell ya, this gal’s keepin’ me on my toes!

He prescribed braces for Josephine – called Bilateral Low Profile SMOs – to help her strengthen her standing and walking. Josephine had her fitting last week and we should be getting them in the next couple of weeks.

Dr. Rieger also noted a rib cage abnormality, which we knew about. What we didn’t know was if it was an extra rib, bowing rib, missing rib, etc…

It was suggested that Josephine has a bell-shaped unilateral rib cage (good luck finding ANY information on THAT one…scoured the Internet for something to see, but came up short) and should see a Pediatric Pulmonologist to determine if her lungs are affected by the deformity.

Hi Ho, Hi Ho, it’s off to Morristown Medical Center we go (well, went, since I am so far behind)…

Plop, Plop, Fizz, Fizz…

If it were only as easy as giving Josephine TUMS to solve her reflux issue.  Alas, she is now on an OTC med (Nizatidine, generic for Axid) to stop the writhing pain she goes through with her bouts of reflux.

The visit to Dr. Sunaryo (Pediatric Gastrointerologist) was uneventful, fortunately.  Based on our description of Josephine’s symptoms, Dr. Sunaryo felt invasive testing would prove the same diagnosis, so why do tests to make Josephine more uncomfortable.  No noise from the peanut gallery on our end.

Josephine’s reflux issue comes and goes and Dr. Sunaryo said that is normal.  Some people get it all the time, while others are intermittent.  We expect her to be on this medication for many months.

I have expected this result for some time now, especially after talking with the moms of the other Tet 8p kids.  All 3 of them have reflux issues, although more severe.

So now, we are off onto another adventure in the world of special needs…I could use a vacation.