Robert is an undiagnosed child. Multiple Pituitary Hormone Deficiency has been identified as a part of his condition and treatment is able to be given for this. Here his Mum tells us about Robert’s first year.
I had a problem free pregnancy and at 35 weeks I was stood talking to a colleague when I realised my waters had broken (like something from a comedy film) and I should possibly go and be checked out at the local hospital.
That night our beautiful boy was born and despite arriving safely he stopped breathing and had to be whisked off to the Special Care Baby Unit.
Once I was sorted out and on the postnatal ward I sat there for hours with a little instant picture of Robert, on my drip, being brought cups of tea and toast. I kept asking to go and see him. I kept being told that a doctor wanted to come and speak to us. I was totally naive at this point,oblivious to the fact this could mean something bad. I also remember being elated to get my own room, but with hindsight this was probably also not a good sign.
A Neonatal Consultant and the nurse looking after Robert that day came to speak to us, as soon as they arrived I realised the game had changed. We were told Robert had deteriorated and was needing a lot more support from the ventilator. He was also floppy, they suspected a brain injury and were cooling him to prevent it getting worse. He looked a bit unusual and they thought he probably had some sort of syndrome. The future for him was uncertain, he might have profound disabilities or he might be relatively “normal”. Nobody could say and it would be a long road before we got any answers.
The consultant delivered the news so clearly and so well but I think my heart broke into a million pieces during that conversation. The fact that Robert was going to face a lot of challenges did not really sink in, I just wanted to know if he was going to live. There was no worries about that.
I wiped my tears and realised I needed to see Robert. A kind healthcare assistant got me sorted and wheeled me down whilst my husband called our families to update them.
I saw Robert lying in his little babytherm cot so small and helpless and cold and I loved him more than anything in the world.
In the next few days instead of the predicted improvement everything got worse and I was scared at one point as the doctors seemed to really be scratching their heads. The plan of getting him off the ventilator was not working, he needed to be switched to the oscillator as he was struggling so much. His blood pressure was very low, and it would only remain stable with cortisol. Robert was tested for various conditions, some horrifying, none with a great outlook, and these tests had all come back negative. A blood test showed his T3 (thyroid levels) were rock bottom which is when a pituitary issue was first suggested. I didn’t know anything about pituitary glands apart from it was something to do with puberty from year nine science. We had a lot to learn.
A doctor who is now Robert’s Endocrine consultant came into the Intensive Care area one day. I stood there baffled as she said she thought Robert had an issue with his pituitary gland, and if medications were given he would be able to breathe without the ventilator. I must say I was a bit dubious but a few days later he was back on a normal ventilator, instead of the oscillating one, and then one day when I went in I was told he had pulled out the ventilator tube whilst the doctors were trying to get blood. When he was nine days old I was finally able to hold him for the first time.
In the next few weeks the massive improvement we had been expecting didn’t come. He was still working hard to breathe and tube feeding was a nightmare. At this point his endocrine issues were stable apart from the fact he kept becoming hypoglycaemic so it was decided he should start on Human Growth Hormone and this seemed to do the trick with stopping his hypoglycaemic episodes. It was hard to inject such a tiny, skinny baby but it has quickly become part of our routine.
After 8 weeks in SCBU Robert was transferred to the respiratory ward in the Great North Children’s Hospital. This was excellent preparation for coming home and we started to feel like he was truly our baby as we were fully responsible for him.
He got home just before Christmas 2014 after 81 days in hospital but that wasn’t to be our happy ending. At this point he had a nasal pharyngeal airway (a tube we had been taught to put down his nose), as it had been discovered his upper airway was floppy. This was a nightmare to look after at home and to be honest he was still quite poorly. He was readmitted in the January and it became apparent a tracheostomy was the best option for him. We were horrified at the prospect but it has been the best thing for him being able to breathe well he was finally so happy.
He has been through another op, a Nissen’s fundoplication to stop him vomiting all the time and had a mickey button (a feeding tube into his stomach), which again whilst very worrying has helped him enormously. Not constantly being sick means he has gained weight and his development has come on in leaps and bounds.
Robert finally was able to have an MRI scan of his head, which showed his pituitary was not formed correctly. Thankfully the rest of his brain looked OK. This confirmed he did have MPHD as the normal chemical tests were not possible due to him presenting so dramatically when he was born.
We have been told to wait and see how Robert will develop, as he is overall an undiagnosed child, with MPHD as part of a wider suspected syndrome. We see him making excellent progress all the time and cannot wait to watch him grow and make more memories together as a family. We are sure as he grows his MPHD will present more issues, and we are thankful to have the CGF support group to consult for reassurance and advice. We are fortunate to receive excellent care for him at the Royal Victoria Infirmary in Newcastle.
As well as the CGF the following groups have been very helpful to me and I would recommend them if your child faces similar issues to Robert.
When Holly’s daughter entered early childhood, she noticed puppy fat around her daughter’s breast area. After much discussion, Holly and her partner decided to check it out. Little did they think that at 18 months, their daughter would be diagnosed with the onset of puberty. But this would not be the only diagnosis their family would receive.
Four months into our relationship myself and my now husband found out we were expecting another bundle of joy. Already parents to two girls each from previous relationships, at our 20 week scan we knew that our little baby was going to be another girl. This was confirmed by the sonographer and we were elated. Due to already having four girls we knew exactly what treats were in store for us and what to expect. Well, this is what we thought…………
Our daughter was born in March 2011 and we were simply over the moon. Weighing a healthy 8lb 10oz she was a normal chubby, bouncing baby girl and nothing seemed out of the ordinary. As she grew and started to become more active, her body frame started to slim down leaving her chubbiness behind. This is when we noticed what we thought was puppy fat around her breast area. Chatting to my husband and family members with daughters, it became apparent that maybe it was worth getting her checked out by a doctor.
Initially the doctor was not concerned but, as precaution, sent us along to the endocrine consultant at our local children’s hospital. We were not told anything by the GP just that he thought it was a condition called ‘Thelarche’ which is the onset of female breast development. We didn’t really think anything of it and thought maybe it was extra oestrogen that was exchanged at the time of our daughter’s birth.
When we were greeted by the consultant she weighed our daughter and also took her height. She agreed that our daughter was over the percentage she should be when it came to both of these measurements and quickly discussed a condition called Central Precocious Puberty. It wasn’t a long discussion more a passing comment and booked our daughter in for the following week to have blood tests to check her LH and RH levels to determine if she had the onset of early puberty.
This was such a distressing thing for her to go through at the young age of 18 months; however, we are so glad that we went with our gut instinct to get her checked as 5 weeks later she was diagnosed with the onset of puberty.
We were so devastated and of course started googling the condition and reading horror stories of how tumours pressing against the pituitary gland could be the cause. After the diagnosis, our daughter started hormone injections every 28 days and was sent for an MRI scan and a scan on her uterus.
This time for us all, as a family, was heart wrenching waiting to hear the results felt like weeks not days. The results came back and nothing showed up on the MRI; however, her uterus was the size of an eight-year- old girl. More bone scans were done on her wrist to check her bone development and yet again proved to be older than her years.
Our daughter is now 5 years old and is doing great, still visiting our local hospital for hormone injections every 28 days and has built up a great relationship with the endocrine nurses, she has almost become desensitised to the injections now and takes it in her stride. I tell her she has them because she is special and to keep her little. She does, however, still continue to have mood swings like a pre-menstrual teenager. She can lash out and has real trouble sleeping at night, which appears to be a side effect from her hormone medication.
She needs personal hygiene care during the night and can show some teenage girl traits; greasy hair, outbreaks of spots and body odour. Pubic hair has also become prevalent as time has gone on.
This condition has been hard to get a grasp of. There isn’t a lot of information online and all appear to be from American sources where they use different medications to medicate with.
Our daughter will stop treatment at the age of ten and hopefully go on to have a normal menstrual cycle, although I do worry what the future will hold.
This condition has been a big part of our lives and although manageable hit us with another bombshell in winter 2013. At the age of 7 and a half years, my biological daughter from my previous relationship came home from school telling me that she had found blood in her knickers. On closer inspection it appeared to be period blood. I was completely beside myself thinking, ‘not again, what have my family done to deserve this?’ Trying to hold back my tears and console my daughter at the same time was just unbearable.
I called the endocrine team who informed me that I would have to go through the GP for a referral. I am not going to lie, I was upset at this and wondered, that with another child with a rare condition and the same symptoms, why could they not just see us straight away?
After a GP referral, consultant appointment and blood testing our worst fears were confirmed; my daughter had started puberty at 7 and a half years old! After numerous discussions the consultant gave us a choice whether to let my daughter continue to menstruate or to medicate her with hormone injections. Apparently it’s considered normal for a child of eight years old to start menstruating.
We went home that day trying to fathom how to discuss this with my daughter. She hates needles and really was against the idea of monthly injections, however, as parents we felt like she wasn’t mature enough to have a period and have to deal with that every month (it’s bad enough for us as women). We all agreed that the best thing to do was to start treatment asap and her biological father agreed with this, too.
Obviously, being that much older than my younger daughter, I had to sit down and explain why periods happen. Something that I didn’t want to do at such a young age, however, it was appropriate for us as a family. Even my six-and- a-half- year-old daughter was intrigued.
My eldest daughter continued with the injections for two years but, unfortunately in November 2015, started bleeding again, breaking through the injection. It was decided that in my daughter’s best interest, she would come off the injections as she really did struggle with them, although they were moved to one every 11 weeks they just were not having the desired effect. This was due to her weight and height. She hasn’t had a period now since January 2016 but, her mood swings are all over the place. She looks a lot older than her years and her body shape is like a curvy woman’s.
Although this condition has been a big part of our life we cannot thank our lucky stars that we pop into the hospital once a month and get to bring our daughter home after her treatment, something that other parents aren’t so lucky with.
Having recently raised a whopping £1,220 for the CGF we asked member and mum to Olivia, Kelly Biggs, to fill us in on how, along with her family and friends, they raised such a fantastic amount!
Why did you want to raise money for the Child Growth Foundation?
We felt very privileged to have had (and still are) getting so much support and advise from the Child Growth Foundation, they have literally been our life line. Knowing you are not alone is such a relief. Through the Facebook group CGF members themselves are always there to offer advice and quite often a shoulder to cry on when times get tough. We felt strongly we wanted to give something back and contribute to keeping the charity going for many more years to come so other families like ours get the support they deserve.
There weren’t many people apart from immediate family and very close friends who actually knew we had concerns about Olivia’s growth or that she was even being investigated, we just smiled politely as people quite often commented on her tiny size. We knew by fundraising we would be opening up about what we were dealing with and face the many concerned questions regarding Olivia’s health. It happened by complete coincidence when Olivia had been admitted into hospital. Olivia came home after discharge with an ng feeding tube. The questions we predicted were being asked so we thought it was the best opportunity to make people aware of our situation and how important CGF had been to us over the past almost 2 years.
Where did the idea of a Sponsored Toddle come from? And what is a Sponsored Toddle?
We wanted to do something fun for the children to get involved in so my family and I thought of a few different ideas over the following weeks, there was lots of different ideas flying around at first but I wanted to make sure whatever we did was going to bring in the best possible amount of money.
We originally planned for a “toddle waddle” for around 30 children. The idea was to walk the children a distance around our local park and charge £10 per child to attend, in effect raise £300 for CGF.
How did you organise the event? Who did you involve? And how did you find your sponsors?
We thought deeper and had a little brain wave! We decided we could hand out sponsor forms to each child taking part and they could then collect sponsors from their own family and friends. This then turned a “toddle waddle” into a “sponsored toddle”!
With that we scrapped the £10 charge idea feeling we would raise more from sponsors and didn’t want to put people off by asking for an entry fee plus sponsors! I set up a Facebook events page and invited all the children from our family and friends along.
What happened on the day itself?
We didn’t just want to turn up at any old park walk around then go home. We wanted it to be a fun filled for the children. I contacted our local park which had a farm and spoke to the Events Organiser, she advised us that a local craft fair was due to come in the following weeks and it would be a great day to have our toddle.
More thinking and the idea of a big picnic after the walk was then put into place, what a great way to unwind and rest their tired little legs! One phone call later and we also had the use of the farm at discount price. The idea of just a sponsored toddle was becoming bigger and bigger and before we knew it we had a whole afternoon worth of fun. My sister offered to do face painting before the walk, we had our picnic planned, I organised farm passes, bought balloons on sticks and made lots of sweetie bags!
How much money did you raise and how did you collect the pennies?
We raised a massive £1,220.00. Most of our donations were made through a Just Giving page we set up and the rest was collected in after the event. I gave a desired date of two weeks after the toddle as I knew how important and beneficial it was to the charity to get the money raised to them as quickly as possible so they could use it accordingly.
This isn’t the first time you have raised money for CGF, how else have you fundraised?
We did some small fundraising events prior to the toddle and for us that was a good starting point, we had people on board and everyone wanted to help.
I used the CGF small change box in my work place and added chocolate treats for a donation, this raised nearly £30. At Olivia’s 4th birthday party we held a cake sale which was very kindly financed by a close family friend, Lauren. This event raised a larger amount of £75.
I began dropping ideas of bigger events and everyone said they would help in any way they could. Before we even began to plan we knew we had the support.
We asked Kelly to share some simple ideas on how CGF members can help raise money for the CGF
Your child/children’s birthday — take the opportunity to sell cupcakes at their parties! Pop a cocktail stick in the top with a CGF sticker attached to either side to give that extra touch and spread awareness! It’s a great way to make a few quid and no one minds throwing a small donation in for a cake.
Chocolate sale in the works staff room — anyone will make a small donation for a chocolate bar especially on a Friday afternoon! We got a six pack of Twirls for just £1 at the local Home Bargains, we split the packs and added stickers which were kindly posted out by CGF, a good return was made.
Do your children attend after school club such as swimming, martial arts or football? Why not try a sponsored activity? Get the whole team involved with a sponsor form each! Set a target such as number of metres swam. Or a kick-a-thon at martial arts class? 100 kicks in 2 minutes? Maybe hold a Charity five-a-side football match charging a ticket price? Great one for the Dads too!You could also do a few ‘spot the ball’ cards whilst their playing or a hotdog sale to raise extra funds?
Do you have any further plans to fundraise?
Our family and friends are very much aware of how passionate we are about CGF, how very close to my heart it has become and what it means to us as a family to give something back. We had such a fantastic day at our sponsored toddle with lots of excellent feedback and questions of “can we do it again” well the answer is yes! We’ve decided to do it again next year, and hopefully make this an annual fundraising event which can only get better! The support we’ve had from family and friends has been amazing. I’m bursting with happiness at what we’ve achieved and feel so proud of all who was involved, we couldn’t have done it without them.
A massive thank you from everyone at CGF to Kelly, Olivia and your family and friends for all your support and fundraising efforts, you are true superstars!!!
Chloe Lane is studying for a Ph.D. at the University of Sheffield. She is looking for both children and adults with Sotos to take part in a research project to find out about the cognitive abilities of individuals with Sotos Syndrome.
The study will involve using a number of different tasks to measure abilities such as remembering information, understanding a conversation and making patterns.
All individuals who take part will be given detailed feedback about how well they performed in each of the tasks and this report can be given to teachers, employers or anyone else who would benefit from having a clear understanding of the cognitive strengths and weaknesses of the affected person.
She is hoping to recruit as many people as possible so that we can gain a really good understanding of the cognitive profile of Sotos syndrome. Once the research has finished, she intends to produce a detailed overview of the findings which can then be given to schools. This will help teachers to understand what to expect from a typical Sotos child when they first start school or move to a different school. For more information or to take part please click here. You can also email Chloe who will be happy to answer any questions: email@example.com.
This is James’ Sotos story as told by his mum, Michelle. From birth, James appeared generally floppy and lethargic and he struggled to feed. Several different conditions were suggested and tested for which came back clear. After months of being in and out of hospital, a Sotos diagnosis was finally made.
James was born on 4th December 2011 after a pretty uneventful pregnancy, apart from the fact I was absolutely huge! We put this down to him being my third child in fairly quick succession but when he was born it was obvious this wasn’t the reason why but his 60cm length and 10lb6oz weight!
During labour it was evident that something was amiss and scrapings from his scalp showed issues with his blood gases. An emergency c-section ensued and after a traumatic entrance to the world, James was rushed off to the Neo Natal unit to be given antibiotics, glucose and oxygen. It was some 12 hours later when I eventually got to meet him. It was strange seeing such a large baby lying next to the tiny premature babies. James wasn’t able to feed and had no sucking reflex so was tube fed but even then his milk had to be changed several times as he kept bringing it back up. Nobody really knew what was ‘wrong’ with James and several things were suggested, Cerebral Palsy and Mitochondrial Disease being amongst those suggestions due to his generally floppy tone (yet very tight in some areas) and lethargic state. James barely woke, couldn’t open out his hands and seldom even moved his head from side to side. At 4 days old the geneticist from St Georges, London came to see us and thought he could possibly have Weaver’s Syndrome. Xrays were taken of James’s arms and these were sent off to Sheffield for review. Some weeks later we got the news that they didn’t think he had Weaver’s.
After two weeks in the Neo Natal nursery, we were allowed to take James home as they believed he was feeding ok from a bottle and as he was stable and off oxygen there was nothing more they could do there than we could do for him at home. Once we got him home he seemed to sleep more than ever and his feeding was most definitely not ok. He would take one suck and then fall asleep so the nights consisted of a constant round of 20 mins sleep, one suck and back to sleep before waking for another suck. Of course, this meant that James was then losing weight. After two weeks at home and visits from the health visitor we were readmitted to the local hospital for them to review and observe his feeding. After a few days in there they sent us home with some Gaviscon.
During the very early weeks James seemed to have every test going — CT scan, MRI, XRays, EEG, ECG and more blood tests than most would have in their lifetime. Back home we tried to get into a routine as our older son, Spencer, was at nursery and our daughter, Emma, was at the childminder’s once a week so she could still see her friends there and keep her space for when I returned to work. It was only a matter of weeks before we were readmitted again, this time after me calling the GP surgery desperately trying to get an appointment as James again was particularly sleepy, sounded very chesty, was taking practically no milk and just looked very grey.
I recall the Nurse practitioner on the phone telling me that babies get colds all the time and they didn’t take much milk when feeling unwell. I stood my ground and said I thought she should see him so she reluctantly agreed but as soon as we got there and she saw him she sent us straight up to the hospital where James was given a full examination and ended up with an NG tube again and IV antibiotics as they thought it could be Pneumonia. After a chest XRay they could see dark patches on his lungs. We stayed in hospital for a week until James recovered but I still battled with the nurses who thought I just wasn’t feeding James and I had to persuade them by getting them to try themselves, that he just didn’t suck.
James’s consultant arranged for us to see the geneticist again for more bloods and also referred him to the Evelina Children’s Hospital in London to see the metabolic team there as he was convinced he had Mitochondrial disease. Thankfully, after a four month wait the results came back clear. He also arranged for James to have a swallow study there. The team at Evelina were great and the swallow study proved James had a disorganised swallow and had been aspirating silently which was causing all the chestiness, especially with his reflux. Omeprazole and Instant Carobel became our best friends and seemed to really help with his feeding. He was put onto Nutrini milk which helped with his weight gain and his health started to improve.
After seeing the geneticist again she advised she was going to test for Sotos Syndrome. Like most people we indulged in a spot of ‘Dr Google’ and we could instantly see the similarities. James received his official diagnosis in September 2012 when I had already been back at work a month.
With regards to childcare, we were very lucky that we had great childminders who looked after James once a week and even they had commented that James looked like a child they had looked after within their group of Childminders, who, incidentally, had Sotos Syndrome.
James also has a diagnosis of Global Developmental Delay and has yet to meet a milestone on time. He didn’t sit up by himself until July 2013 (we were in Brighton hospital at the time and he thought the tilted cots were great fun, slamming himself back down each time he managed to get up). He was cruising around the furniture at around 30 months and started to take a few tentative steps indoors in October 2014.
James received Portage sessions from about 7 months and these came to a close when he was offered a place at his nursery in September 2014. It is a Special School for children with Severe learning Disabilities and Complex needs. He loves going there and is making real progress. Although James cannot talk we understand what he wants from his brilliant facial expressions, body language and the tone of his voice. We have had hundreds of appointments in the past 3 years — more therapists than you can shake a stick at but thankfully these are now fewer due to the nature of the school and being able to incorporate the appointments there.
We are lucky enough to have my parents come and look after James, Spencer and Emma during the times my husband and I are at work and he is not at nursery and he has developed a fantastic bond with them. James is also very lucky that Emma (5) is like a second mum to him and absolutely adores him.
James is a truly adorable little lad, always a smile on his face and although the erratic sleeping patterns, feeding difficulties and mobility issues make life more awkward than for most, we love him to bits and look forward to seeing more progress as the months and years go on.