Sam, like many, many others, does not have a definitive diagnosis that explains why he has the range of issues he has. It also means we have no prognosis to allow us a glimpse of what the future may hold, or to guide us as to the best therapies to bring him on developmentally. We are, to put it plainly, in the dark.
When Sam was first admitted to hospital with seizures, the neurologist was very careful with his words as he gave us the results of the MRI scan... although there were changes, it was unclear what those changes meant for our baby.
As he gently explained, we don’t perform MRI scans on healthy infants, so it would be a waiting game to see what those changes might mean or if they were just part of normal development. Sam was, after all, an early baby.
He had stopped growing suddenly at 35 weeks into the pregnancy and arrived by emergency induction of labour shortly after. He was ready to come, the induction went smoothly and I didn’t need any additional hormone therapy to get things moving!
Seeing some developmental delays is normal in early/premature babies, and more often than not they make up that developmental ground as they grow older until there is no difference between them and their peers born at full term.
Prior to Sam’s first seizure, there had been signs that all was not well; his development was indeed delayed and he struggled to gain head control, his visual tracking abilities seemed to be regressing rather than improving.
After several weeks of feeling increasingly uneasy, I had finally managed to get our health visitor to take my concerns seriously and she was due to check him over a couple of days later... Sam had other ideas, and threw that first seizure before she had a chance! The first weeks after that seizure were terrifying.
Sam had experienced a life-threatening complication of epilepsy termed status epilepticus while at the hospital. In effect, the seizures were not stopping and unless they were stopped medically his heart would start to struggle to put him at risk of a cardiac arrest. He was all of 14 weeks old. But we knew about epilepsy - we just needed the right meds, ok?
Over the weeks that followed it became apparent that seizures were just one of Sam’s problems - his head control was cause for concern, the changes to his vision were seizure-related but that didn’t explain why he had such low muscle tone and was as floppy as a newborn.
He made a really disconcerting noise when breathing, as his airways were floppy too. He was, however, growing well and gaining weight which ruled out a lot of conditions fairly quickly.
Before he was even 6 months old, Sammy had experienced multiple blood tests, lumbar punctures and all sorts of other procedures to try and find out what was wrong. All the tests came back negative - as far as anyone could tell our boy was absolutely fine, although it was very, very obvious that this was far from the case.
As he has grown older, more issues have become apparent - Sam has a dangerously unsafe swallow and aspirates fluid and food into his lungs instead of swallowing them fully into his stomach. As a result, he is now 100% tube fed. This, however, has uncovered some new issues - Sam seems to hold food in his stomach far longer than usual, and his gastro team is currently looking into whether he has true delayed gastric emptying (gastroparesis).
His reflux has become more evident now he’s on a liquid formula diet instead of solid food, and this is playing havoc with seizure control. It took us 2 more years before we had any answers at all to explain Sam’s disabilities... it was a second MRI and a very determined medic looking at the scan very, very carefully that identified the areas of abnormal neuronal migration that gave Sam a diagnosis of polymicrogyria. PMG, however, is a description of the condition rather than a diagnosis as such, we will in all probability never know why our little boy’s brain didn’t form correctly; multiple causes have been identified including genetic, infection, etc.
Sam’s neurologist is certain that there is a genetic cause for Sam’s PMG as it isn’t diffuse but has occurred in specific regions of his brain. However, finding the answer would be like looking for a needle in a haystack, and after much discussion, we have decided not to put Sam through any more invasive tests unless they are absolutely necessary.
We have decided not to pursue a diagnosis at all costs. Instead, we are starting to accept the hand that fate has dealt us, and are loving the child we have been blessed with.
So, what does it feel like to have a child with an undiagnosed condition? It is far more difficult to get answers from professionals - many symptoms our children experience are generic and may or may not be related to their condition. Many symptoms appear to be totally unrelated, such as slow growth and sensory processing issues. Many of our children have problems affecting more than one body system - in Sam’s case he suffers neurological and gastro issues.
In many cases the Doctors are as much in the dark as we are, and that is a very difficult situation to be in... we *need* the Doctors to know what to do and to have a clear plan of how to treat our children, but when they themselves struggle to make sense of the puzzle it feels very isolating and very, very frightening. How can we make the right choices as to treatment when the people who know most about the therapies etc., are unable to advise us?
When a child has a recognised disability, getting help from local authorities, charities and other support agencies are significantly easier than if you have to say that your child has no confirmed diagnosis. It is also the most frustrating experience I have ever known.
In Sam’s case, his physical issues hide his true potential - being undiagnosed makes it too easy for the powers that be to say he is less capable than he is, and it makes it a very difficult battle to fight.
But with all the negatives come quite a few positives. We have no prognosis to read up on, or to scare the wits out of us! We have to live day to day, just like any parent would. There are no limits placed on Sam as to what he will or won’t be able to do, we just have to work with him a do our best for him. If a therapy doesn’t help him, we ditch it. If one does, despite the professionals saying it wouldn’t, we continue.
In the past 4 years, we have learned what we are capable of, and it’s far more than we imagined... we’ve discovered how strong we can be, too. Sam shows us what it is to love unconditionally, and we, in turn, adore our little hero. Due to the strong likelihood of a genetic link, and given issues I had during the pregnancy, we have made the decision not to have any more biological children; we just couldn’t put another child through what Sammy has fought through. Does that mean he’s any less of a joy to have in our lives? Of course not. Undiagnosed he may be, but his story is only just beginning x