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Any thoughts or advice about how to help dd with her strange symptoms.

14 replies

NoHaudinMaWheest · 26/06/2014 14:32

Back story for those who don't know it.

DD is now 14 and in yr 9. Up until October 2012 she was basically fine. She had mild asthma, mild dyslexia, mild tinnitus, wore glasses for short-sight but was otherwise ok. She did however have pretty bad acne and when the GP ran out of options, he referred her to a dermatologist who started her on isotretenoin (Roaccutane) treatment. Almost immediately she developed joint and muscle pain. This is a known side-effect though it is unusual for it to happen so quickly on a low starting dose. Dermatologist suggested stopping and then starting again more slowly. Pain disappeared when we stopped and came back when we restarted. Dermatologist then stopped medication altogether

However the pain didn't stop. Her legs became stiff, then shaky. By January 2013 she could only walk with crutches, By April she was unable to weight-bear and started using a wheelchair. This Feb she developed problems with her arms, mainly right but sometimes both. A couple of weeks ago she started having involuntary jerking of her legs.

She was investigated pretty thoroughly by a paediatric rheumatologist and then a paediatric neurologist last year. They both concluded that they could find no physical reasons for the symptoms and thought that it was likely to be psychological. She was referred to a child psychologist who works in the paediatric dept. and had about 8-10 weeks of assessment with her. She thought it likely that dd had a conversion disorder (when psychological stress manifests itself in physical symptoms). She asked a psychiatrist attached to paediatrics to assess. Again her conclusion was similar.

Neither have been able to pinpoint any definite causes or difficulties that dd has. She doesn't have close friends but has no difficulties in getting along with peers or being friendly. They thought she had some anxieties but she denies that she is a worrier. Her brother has had very severe OCD and that has obviously had an impact on her life, but she says she can scarcely remember anything else. She was 5 when his OCD started.

She was referred to CAMHS with a recommendation for psychotherapy. She has just finished a 6 weeks assessment and the conclusion is that she is not suitable for psychotherapy as she is uncomfortable discussing her feelings and it may therefore be more damaging than helpful. I will get more detailed feedback next week.

CAMHS are holding a profs meeting in 2 weeks to discuss where to go next. As far as I can see their only other option is CBT. DD says she accepts that there is nothing physically wrong with her limbs but she still can't use them properly. The original psychologist felt that CBT was unlikely to help and I agree.

I don't have much faith in the CAMHS team. The psychiatrist says he has lots of experience with conversion disorder but seemed to think that telling dd there was nothing wrong and asking her to think about trying to move would sort it.

We have family therapy around ds's issues but they have taken dd on board too and seem to be telling us(me) that she is having problems because I am pandering to her and I have to be cruel to be kind. Neither psychiatrist nor family therapist can give me specific strategies when challenged.

Meanwhile SENCO wants to refer dd for ASD assessment. I'm not sure if this is her own idea or if it is prompted by feedback from CAMHS.

DD is a little quirky but just as AS is not just being quirky so being quirky doesn't mean having AS. Her lack of close friends is I think partly because of circumstances - distance from school, her lack of mobility, my lack of mobility, the difficulty of having people in the house because of ds's issues until recently. Also she is quite picky about friends and very academically able in a very mixed school.

I can't really see anything else indicative of ASD although maybe I'm burying my head in the sand.

I hadn't intended to mention it to dd until I had done more thinking about it myself but she read my Goose and Carrot post in which I had forgotten I had mentioned the conversation with the SENCO. Fortunately she thought it was hilarious and having talked about it a bit more her inclination is to go for assessment just to get people to shut up about it.

She has regular hydrotherapy which helps with the pain and helps retain the mobility she has. As she has a burn on her arm from an accident in the science lab she hasn't been able to go for a few weeks. There is no other useful input.

I can see why the medics think there is no physical cause as the movements she can and can't do are odd. I don't want to put her through unnecessary investigations. However things are getting worse and worse with no end in sight.

So HELP!!!!

(And well done if you got to the end of that lot.)

OP posts:
PolterGoose · 26/06/2014 15:42

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NoHaudinMaWheest · 26/06/2014 17:01

didn't know that existed. I'll have a look.

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OneInEight · 26/06/2014 18:13

Has "reflex sympathetic dystrophy" been ruled out? My nephew had it as a teenager and it sounds a bit similar and can affect one, two or all limbs. Don't know a lot more about it but might be worth a google.

HairyMaclary · 26/06/2014 18:51

Is she in pain or can she just not use the limbs? When DS was in hospital for ages we came across a girl of a very similar age with very similar symptoms. Will have to go back through my info to get more details but will come back if I find them!

stillstandingatthebusstop · 26/06/2014 19:03

I haven't got anything useful to contribute NoHaudin but ThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanksThanks
for you and dd.

My ds1 took Roaccutane for about a year. He didn't get the muscle and joint pain but I remember them saying that it could happen. He had very sore dry lips and nose (inside).

Hope people more helpful than me come along soon.

NoHaudinMaWheest · 26/06/2014 22:04

Roaccutane support groups seem to be focussed on suicidal symptoms. It is interesting though that they list the muscle/joint pains as common whereas we were told they are unusual.

reflex sympathetic dystophy doesn't really fit her symptoms. She is in pain sometimes more than others and some of it just from sitting in her wheelchair all day. Her limbs move some ways but not others. So for example she can get around the
house with a combination of bottom shuffling, crawling and knee-walking but if she tries to stand her legs won't support her.

Any views on the ASD stuff?
I wouldn't say she is socially awkward. She just isn't interested in common teen girl stuff. I don't think she's masking. She enjoys school and doesn't have meltdowns or any stressy stuff afterwards.

I have looked at various AS in girls sites but she just doesn't fit those pictures and she certainly is and always has been very different from ds (who does have an AS diagnosis).
On the other hand she does say that she doesn't understand some jokes or why girls like bands or makeup.
She is a lot less willing to talk about her thoughts and
emotions with me than she was when she was younger. I suppose I have just assumed that was normal for an adolescent.

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zzzzz · 26/06/2014 22:14

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Safeinourbubble · 26/06/2014 22:24

I had a colleague whose daughter, with ME-type symptoms, used NLP with considerable success. Me - I am a total fan of CBT. DS2's therapist has been amazing. The therapy has been all about dealing with change, emotion and the big questions in life - and his life, in particular.

Love zzzzz's list, too. Will be borrowing chunks.

NoHaudinMaWheest · 26/06/2014 23:27

zzzzz she doesn't usually read what I write here. It was a one off and rather an unfortunate one.

She doesn't really appear stressed and is quite good at finding ways to relax.

More exercise would be good but we hit practical problems because I can't push her far and we spend a fortune on taxis as it is.

I have been trying to find some sort of massage/acupressure/reiki type help for her but the ones in town which we can get to easily are all upstairs and the ground floor ones are all out of town and pose transport problems.

OP posts:
lougle · 26/06/2014 23:55

OK, so she has some use of her legs but can't weight bear. What is her reclining leg strength like? (I mean, can she push away from something with similar force as needed to support her body weight, indicating that she has the muscle strength to stand, meaning it's something else causing it)

Has she got normal proprioception? In other words, if she closes her eyes, can she touch her most mobile finger to her nose on request? What about in her legs. If she was on the sofa with her legs curled up, could she put her finger on her toe if her eyes were closed, or would she have to feel around until she found her foot? Etc.

What about sensation? Can she feel touch/pain at every point on her leg?

I have to say that I have real issue with 'conversion syndrome' because it seems to me that the root cause analysis is:
'Hmm, odd.... What's caused this... Can't find anything physical. Conversion.'

I don't suppose she's ever been exposed to ticks? Late stage Lyme disease has very similar symptoms. There was a lady in the use who thought she had MS, but by chance became aware of it and was tested -positive.

With the leg jerks, again, I wonder if it's a proprioceptive issue like a sensory under sensitivity. I wonder if a weighted lap pad or blanket would calm them?

NoHaudinMaWheest · 27/06/2014 00:10

The rheumatologist did test for Lyme so I don't think its that. Her reclining strength is normal. Will check her proprioception and thanks for the suggestion of the weighted blanket. That could be helpful. It is better if she sits on her legs though that gives her pins and needles obviously.

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lougle · 27/06/2014 06:55

See, the sitting on her legs will give her brain feedback about where they are. Proprioception is how we function on a daily basis. The brain is constantly sending signals down through the nerves and waiting for a reply, checking where all our body parts are. It sounds like her brain isn't too sure where her legs are, so her brain sends a stronger signal, which makes them jerk.

I would expect that the neurologist would have checked proprioception but as she's declining in her function it won't hurt for you to play some games to check it out informally.

Did she have CT/MRI scans?

zzzzz · 27/06/2014 09:38

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NoHaudinMaWheest · 27/06/2014 11:28

lougle she did have an MRI scan on her back but not her brain. The neurologist wasn't keen to do it but agreed in order to reassure us/her. She did test proprioception and was in fact very thorough. I have had quite a few neuro examinations myself so I know a thorough one when I see it.

zzzzz thanks for the info about reiki. I will look into it further.
Dd never lurks on here independently. She occasionally reads over my shoulder which is what she was doing the other night. I thought nothing of it until I remembered I had posted about the ASD. I was too late to distract her as she had already read it Blush.

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