And Now We Wait… Again.

Timothy Update.

In the world of parenting a children with disabilities I have always considered myself fairly lucky in regards to our diagnosis. Both in the sense that our diagnosis does not affect the expected lifespan of our son and also in the fact we received a firm diagnosis before Timothy was even 1. I didn’t even realize how lucky that second one was until I started talking with parents who were still awaiting diagnosis at 2 and 3 years old.

LCA seemed like our best case scenario when we went through testing because it wasn’t life threatening. Sure, Timothy’s condition was causing some other developmental delays but that’s to be expected…right? I mean if you can’t see it is pretty scary to let go and take steps on your own, and how can you learn the words for cup or bowl or spoon or fork when they all feel similar to each other. Not to mention the absolute lack in therapies for most of Timothy’s life in the times of Covid.

I’d say I have felt pretty secure in our trajectory and what the future held since getting the results. But maybe I was too comfortable, maybe I was missing something, or there was something I just didn’t want to face. At least that’s what one of my son’s doctors thought.

Timothy sitting in a infant swing at the playground smiling.
Playing on the swing.

So when I sat in front of a doctor in April for the first time and was told they would like to run a chromosomal array, well I wasn’t happy to say the least. I thought you don’t know Timothy, you just met him. How could this doctor sit there and question his diagnosis, it made no sense. And as I left that meeting with the words “he doesn’t look like he has a syndrome but we might as well check” ringing in my ears I started to feel a little off balance.

There was no way he didn’t have LCA. I mean we were all genetically tested. That can’t be wrong can it? It wasn’t. So after sending in our full retinal genetic report and finding out nothing came back on the chromosomal array I thought “Ha!” I won this round.

Unfortunately that was only round one. And this doctor was still not comfortable to say that his developmental delay was caused by LCA or at least not entirely. So when we spoke over the summer I was told that yes Timothy does have LCA…but (oh no) that doesn’t mean he can’t also have another condition affecting development.

Another condition? On top of LCA? I wasn’t ready for that. We got our answer a long time ago. We have accepted it (for the most part). Living with LCA is our life now. I’m not ready to go through another diagnosis.

Timothy sitting in his stroller rubbing his eye.
At our appointment in October.

Our next appointment to further discuss the testing and to possibly perform the test was scheduled for October. The reason we had to wait so long was because it is a BIG test and they had to apply for approval to fund it. It’s a test called Whole Exome Sequencing (WES) and it goes through about 20,000 genes, it can tell us a lot of information about Timothy’s genetic make up. So for the 3 months leading up to the appointment I went back and forth in my head about whether or not I felt another test was worth it.

Most of the time I landed on NO. I know my kid. I know him. I’ve watched him struggle and I’ve watched him learn. Yeah maybe he isn’t where we thought he would be, even with the LCA, but he’s making progress…isn’t he?

But as we got closer to the appointment I started to question myself more and more. Is he making progress? His speech has improved for sure but physically has he changed much this year?

I started to think about the disability funding we get and how they wouldn’t pay for therapies because he’s “just blind”. I started to think about the fact he will be in preschool next year and being able to access the appropriate amount of help for him. And I started to think of myself at the beginning of this journey. I started to think of the endless hours I spent trying to get Timothy to look at me, trying to convince myself it wasn’t what they thought it was.

And so I decided to do the test. Because not doing the test was for me. Because I’m not ready to have another diagnosis thrown at us. Because I’m scared of what could come back. Because I’m comfortable with how things are.

But doing the test is for Timothy. Because if something comes back we can manage it, we can access the appropriate help, we can learn about it and what it means for his future. And then we can begin to accept it.

So here we are 2 years later almost to the day sending blood work to Finland and beginning our wait…again.

Timothy sitting on the couch smiling.
Timothy.

Thank you for reading and continuing to support our journey.

The Results are in: Timothy and CRB1

If you have not had a chance to read Timothy’s Story yet I have linked it here so you can catch up to where we left off on diagnosing his condition.

Timothy at 4 months old laying wrapped in a hospital blanket sleeping with an IV in.
Getting a preliminary Diagnosis.

Back in August we saw an ophthalmologist at the Alberta Children’s Hospital in Calgary where we live. Within a few seconds of doing the dilated eye exam he told us that Timothy had a problem with his retina and would be required to see a specialist out of Edmonton (about 3 hours away). He wrote down the words Leber Congenital Amaurosis on a piece of paper and told me this is likely what is affecting Timothy but we will need to undergo further testing to find out.

I started doing research the second I stepped out of his office and felt like there was not one thing about Leber Congenital Amaurosis or LCA I had not already read about (or so I thought). The only thing I needed to know was if my son truly had it. We waited three months for our appointment and it was a long hard day as my husband and I decided we would just drive down for the appointment and then come back home that night (6 hours of driving total).

When we first arrived Timothy had to go for a test called an Electroretinogram or an ERG. For this test he had electrodes placed underneath each eye and then a small camera like device was placed over his eyes and flashed different lights into them with both the lights on and then in the dark. The ERG reads the response of the retina to the light signals in both the light and dark settings. This test is used to help confirm a diagnosis of LCA if the response from the retina comes back severely abnormal or almost nonexistent. After receiving that test we got to speak with the specialist. He told us that the ERG showed little to no response from Timothy’s retina in both the light and the dark, he also examined Timothy and agreed he has little or no useable vision (especially central vision).  Although he said it is clear Timothy does not focus or react to visual stimulation, he also said that we won’t know exactly what he can or cannot see until Timothy is able to express that himself.  With these findings he said that we are looking at the diagnosis of LCA and the next step would be genetic testing to confirm 100% and tell us the gene type. We were luckily able to complete the blood work before we even left the hospital and began our 4 to 6 week wait on results.

Timothy at 6 months old. He has blonde hair and blue eyes. He is laying naked in a bassinet with his hands together holding his soother.
Sweet Timothy.

As soon as 4 weeks had hit I was anxious to hear back, I was confident that they would find something but I still had that nagging feeling  of what if they cannot figure out what is going on with my baby.  At 4.5 weeks I caved and called them to check in but there was nothing yet. As we got closer to Christmas I knew that if I didn’t hear back by the 6 week mark I likely would not have a result until the New Year. So because I am one of those moms I called again a couple times and on the 6 week mark exactly I finally got the call back. First she told me it confirmed the diagnosis of LCA and then she said the gene is called CRB1.

CRB1…okay. I recognized the name from a few families I had started following on social media.  The genetic counsellor went into details on how it is recessive and what that means in terms of future pregnancies with my husband (25% chance each child) and the chances of my children being carriers. She told me how this gene is only linked to vision problems and nowhere else in the body would be affected (thankfully). She told me they would have James and I complete genetic testing as well to show the whole picture of how the “non working copies” of the gene were passed down to Timothy. She wished me a Merry Christmas and that was it. CRB1 was now the final diagnosis.

This whole time we were awaiting the results I had promised myself I would not get my hopes up for a specific gene.  There is only one that has an FDA approved treatment in the USA and then only a couple more undergoing clinical trials. See after we got this diagnosis I had emerged myself in a community of parents going through LCA diagnosis’ and I was seeing some really awe inspiring kids regaining their vision from the one treatment. For me, wanting Timothy to receive the treatment had nothing to do with making life easier or simpler but had everything to do with those waves of grief that come with the loss of his vision. Even though I had told myself not to do it I let my mind wander into the thoughts of Timothy seeing me smile at him for the first time, or seeing the snowfall outside, or maybe a waterfall, a sunset, a flower. Yeah I let myself fall too far into those what ifs. So when I heard her say CRB1 the first thought I had was not very positive.

Fortunately we have been working through this diagnosis of LCA for months and I was quickly able to bounce back into my “how can I best help Timothy succeed” mode.  Within the day I was in touch with several great families whose children also have LCA CRB1 and they were so comforting and encouraging. Then I was able to connect with Kristin Smedley who not only has two sons with LCA CRB1 but has also started the curing retinal blindness foundation for CRB1, wrote a book called Thriving Blind, and has a TED talk about her story which really resonated with me.  Connecting with these amazing families who have all been where I am now has meant more to me than I can put into words.

Writing this blog and sharing our story and continuing to share our journey has been so therapeutic for me. I have made so many connections and not only with other LCA parents but parents whose children are blind or visually impaired from other conditions. I have also gained so much support from family, friends, and even complete strangers.  I hope that through this blog one day I can help a family who is just starting their journey into LCA and that I can be an advocate for not only my son but the blind and visually impaired community. 

Timothy a blonde haired blue eyed 8 month old. He is smiling. His blue shirt says best brother in the world.
My Happy Boy.

Thank you so much for everyone who takes the time to read my posts. I can’t wait to continue on this journey together to show the world that Happiness is Blind.

A letter to the mom who’s child just received a diagnosis:

It’s okay to grieve.

Dear Mama,

I know it has been a long and tough road and yet you are only at the beginning. There has been sleepless nights, never ending days, endless google searches, and too many tears. Ever since the first thought of there being something “different” about your child, you have not been at peace. You have wondered what, why, and how. You have blamed yourself for not remembering your prenatal vitamin everyday, or for that one time you caved and ate unpasteurized cheese during your pregnancy. You have scolded yourself for not recognizing what was going on sooner, or not pushing the Doctors to look harder. And then all at once you have quickly forced yourself into acceptance and bravery. You know your husband does not understand half of the medical terms being tossed around, and your mother is beside herself with worry for your child so you have to be there to support them. Speaking of your child, how can you show them anything but bravery and acceptance? This is their life after all and they are so young and innocent. This diagnosis changes things, possibly everything. You have to keep it all together, the dishes, laundry, making meals, signing field trip forms, blood tests, specialist appointments, the list only gets longer. You make all the calls, telling family and friends the same information over and over, always answering “I’m fine” if they ask how you are handling things.

But Mama, you are not fine and that’s okay. You are allowed to feel the roller coaster of emotions this diagnosis came with. You are allowed to be angry and blame the universe if that gets you through the day. You are allowed to be afraid for every single worst case scenario that could come your way. You are allowed to laugh at things that are completely inappropriate at the time. You are allowed to eat every piece of chocolate you can get your hands on. You are allowed to ugly cry into a pillow. Your life just changed in a big way too. And tomorrow or two weeks from now you will get up and continue on with the bravery and acceptance because you are a great mom. But until then feel all the feelings, let yourself go through the healing process. It’s okay to grieve.

Sincerely,

A mama who’s been there.