Friday, 8 June 2012

A"head" of the curve....

Yep, I am blog happy this week....lots to say, lots to say.  I got a "gift" in the mail today.  Really, it was.  I have switched the boys' pediatrician 3 times in the past year while searching for a combination of personal attention and progressive thinking.  In the process, the boys' full medical records were kind of scattered and it has taken me quite awhile to track them all down.  Today they finally came in the mail.  I gave up on the idea of having them forwarded straight to the pediatrician awhile ago, I was afraid it wouldn't happen, and plus, I was curious about what they would say.  Also, there are so many specialists that are going to want to see this information, makes sense to just make my own copies, right?

I feel like about 15 more pieces of the puzzle that is Nathan just fell directly into my hands.  All of his medical information from those first 18 months of his life where he was seemingly developing "normally".  Other than multiple chronic illnesses.  And several other NOTABLE abnormalities.  Now of course, hindsight is 20/20, right?  But after all of the research I have done in the past year it took me about 5 minutes of perusing Nate's history to see some typical characteristics that have been described in the autism community:

1.  frequent antibiotic use:  Nate had antibiotics on the following dates in the first 18 months of life (and yes I made a spreadsheet, and no I'm not embarassed)
9/3/10, 9/20/10, 10/20/10, 11/23/10, 2/9/11, 4/5/11, 4/19/11, 4/22/11 (switched to stronger)

I have read multiple research articles and opinions alluding to the fact that frequent antibiotic use, while it does not "cause" autism, contributes to symptom severity and to things like gut problems/food sensitivities.  It also causes problems with yeast overgrowth.  Which brings me to another point- Nate had thrush in August 2010, before ever having antibiotics.  Thrush that wouldn't clear, he was on nystatin for about 2 months.  In my busy mommy haze, I had forgotten.  So there was a yeast issue before we killed off all the good bacteria in his gut.  Sigh
Have pasted a few articles about this below....
http://www.ageofautism.com/2008/11/antibiotics-and.html
http://www.greatplainslaboratory.com/book/bk7sect1.html
http://www.theautismdoctor.com/antibiotics-and-autism/
http://www.ncbi.nlm.nih.gov/pubmed/15607562

So that's the first thing that jumped out at me

2.  Head circumference:  I have read multiple articles that an unusual increase in head circumference in the first year of life is associated with autism diagnosis.  And I know Nathan has a large head circumference, I mentioned in a previous post that he qualified for a study with NIH investigating the growth of the brain and it's association with autism.  I was still on the fence about participating....consider that fence jumped.  Here is Nate's data:


                   12/22/09     2/2/10       4/6/10      6/23/10    7/21/11       6/8/12
age                  2 wks       2 mos        4 mos       6mos        18mos    30 mos
head circ         35.5cm     39.5cm      43cm        45cm        50cm      52cm
percentile          15th        50th            75th         90th          95th          97th

Hmmmmmmm........now I know what you're thinking, maybe he just had some growth spurts?  Just to clarify, his height and weight have consistently been in the 30-50th percentile throughout his life.  So nope.  And if he just had a big head, it would be big consistently right?  When I saw this, it made me feel ill.  And the other thing that makes me ill is that half the reason they measure head circumference is to watch for jumps like this to r/o issues with the brain.  So WHY, when they saw this large increase during his first 6 months of life, did they not bother to measure it for a WHOLE YEAR?????
More articles:
http://ucsdnews.ucsd.edu/newsrel/health/07_15_Courchesne.htm

"It was found that the head size of the autistic children at birth was, on average, in the 25th percentile, meaning that the circumference measurement for these children was smaller than 75 percent of other newborns. During the first year of life, however, these same children experienced sudden, rapid and excessive brain growth, that put them in the 85th percentile at about 12- to 14-months of age. From then on, the brain growth slowed"



"The early-warning sign – abnormally accelerated rate of head, and therefore brain, growth – occurs well before the first clinical signs of autism. It also appears to predict the severity of clinical outcome as well as the degree of brain abnormality at a later age. Currently, the disorder is not typically detected until ages two to four, when a child develops behavioral signs and symptoms, such as delayed speech, unusual social and emotional reactions, and poor attention to and exploration of the environment."


Feels like I am reading an article about my child....


http://autism.mit.edu/sites/autism.mit.edu/files/Piven%20--%20Circumference.pdf
http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2011/11/28/head-size-tied-to-regressive-autism-in-boys

Our current pediatrician has suspected that we might see this curve in Nate once we had his records in hand, and she was right.  Obviously this doesn't change anything we do now, but it does make me sad.  Was this occurring right under my nose?  While I thought he was developing normally?  Part of me is glad for my previous ignorance- I enjoyed his infanthood way more because of it.  But maybe we could have intervened earlier.....at the end of the day, I guess I have to cling to the fact that he got intervention before the age of 2, and I know that I can take much of the credit for that.  When I look at Nate's 18 month checkup, the physician had really "glossed over" my concerns about his language, and states in his notes that he told me it "wouldn't hurt" to consult infants and toddlers.  Um, yeah.  At least the second pediatrician was better than our initial pediatrician, who told me that Jack didn't have a developmental issues, he was just "spoiled and manipulating me".  Until he saw the developmental pediatrician's report diagnosing him with aspergers, at which time he completely retracted his previous statement.  And THAT was the day that he was kicked to the curb!

And just in case you were wondering, Jack's head circumference has consistently been 50-60%-ile, and he had 1 course of antibiotics in his first year of life.  Also, Nate's head is currently larger than his brother's.  That's right, the 2 1/2 yr old's head is bigger than the 5 yr old's.

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