A simple Blood test could have prevented so much...

*Please NOTE: I am not a physician or a medical professional in any way and the information contained here is simply my interpretation of what my child's doctor explained to me today. Any questions or concerns you have about this post I would recommend you discuss with your own physician.

So about a month ago I brought both my children in for some bloodwork that was ordered by their psychiatrist. It was a genetic blood test that looks at DNA typing as a way to prevent adverse drug reactions and it was something that she just recently started ordering for her patients, especially those who seem to be not responding well to medication. This blood work tests an individual's ability to metabolize drugs using certain enzymes that we possess.

Why is this important? Through scientific research it has been shown that the safety of many drugs depends on the rate of drug metabolism accomplished by a certain family of enzymes. If you are deficient in these enzymes, or if they are overactive, and a medication that you are taking is dependent on these enzymes in order to be metabolized, then you can experience adverse reactions to this medication. There are other medications that inhibit these enzymes and what that means is if you are taking one of these medications and at the same time you are taking another medication that needs this enzyme to metabolize it then you are decreasing the effectiveness of that medication, or exposing yourself to a higher risk of an adverse reaction.

In layman's terms, say your child is taking Risperdal or Abilify, both of which depend on the enzyme CYP2D6 to metabolize it but your child has a deficiency in this enzyme. Then those side effects that are listed for that medication are much more likely to occur for your child than any one else who does NOT have that deficiency. This medication is also LESS likely to be effective for your child. Now say, on top of that, he is taking Benedryl which also relies on CYP2D6 for metabolizing. Now the effects are even worse.

If we take the same child on Risperdal but with NO deficiency in CYP2D6 but then add in something like the antidepressant Amitryptiline (Elavil) which acts as an inhibitor of CYP2D6 then your child is still at risk for those side effects from the Risperdal because the Elavil is inhibiting the enzyme which is making it less able to metabolize that medication. Does this make sense?

Now, for my children, not only were they deficient in one of these enzymes (so much so that it is completely inactive in their systems) but they were deficient in TWO of them. Some medications can metabolize on more than one enzyme so if you are deficient in one but not the other one that it can metabolize on then you have a higher chance of being okay on this medication. The two that my children are deficient in are the ones that most medications in the psychotropic medication list needs (CYP2D6 and CYP2C19)and this explains why we have been having such a hard time with medications.

Not only psychotropic medications are effected. There are many medications (analgesics like Advil and Celebrex, antihistimines like Benedryl or Zyrtec, Antidepressants, anticonvulsants, stimulants and ADHD medications, etc) that are also dependent on these enzymes for metabolizing. I cant tell you how many medications I have taken that have either made me SO violently ill that I ended up in the ER or so irritable or moody that I felt like a completely different person.

Justin was on a medication that combined with his Risperdal (which we now know he should not have been on) caused him to be suicidal. Tyler was on Singular and after only one day became suicidal. We had tried him on two different anti-depressants and he was hallucinating and was so hyper that he didn't sleep for 36 hours straight. Now he is on Allegra and just recently started becoming suicidal again and we had no idea why this kept happening.

We are now in the process of weaning Justin off of Abilify (another medication that he should never have been put on) and because of the CYP2D6 deficiency we have to go extremely slow because he is much more prone to the serious Tardive Dyskinesia side effect that some children experience when coming off of this medication than other children are. But this also explains why when we tried to increase this medication his irritability increased dramatically.

All of this could have been avoided with this simple bloodtest and I encourage everyone who has a child who is either on, or you are considering putting them on, any psychiatric medications to have your doctor order this bloodtest. Because both of my children have this deficiency it means that either their father or I also have this deficiency. I am betting that it is me because I have a lot of problems with medications. It seems that there are very few medications that I can take that dont have a negative effect on me in one form or another which is why my fibromyalgia is so impossible to treat. If you find yourself being oversensitive to medications this might be something you might want to look into for yourself.

Another thing, it is also possible to have TOO much of this enzyme which means that they require a lower dose of a medication than most other people. The danger with this is that if they are given a normal dose for their age/weight they could possibly overdose on the medication.

One more thing, there is a breast cancer medication out there that is getting ALOT of publicity because of this very issue and they have found out that patients who have this deficiency in CYP2D6 should NOT take the medication Tamoxifen especially in conjunction with any of the antidepressants that rely on CYP2D6. This combination has been seen to not only reduce the effectiveness of Tamoxifen but has also been shown to possibly increase your chance of recurrence of the cancer. So if you know anyone with Breast Cancer or receiving Tamoxifen to prevent Breast Cancer (usually if they have a high family risk) then please warn them about this and suggest that they have DNA typing done to test these enzymes.

I hope you found this helpful. Please leave me a comment and let me know.

2009 in Pictures

The past few days I have been feeling a little nostalgic and decided to do a slide show of 2009. I hope you enjoy it.

Trusting in the Kindness of Strangers

There are days when I admit, I lose faith in humanity and in the world in general. I look around and everywhere I turn there are people doing bad things. You cant turn on the news, or read a paper without reading about all the bad things that bad people do. You cant go to the store without someone trying to steal your parking space or cutting in front of you in line. You cant drive anywhere without someone speeding by you in the breakdown lane just to get one car ahead of you.

I have spent my life, from the time I was a small child, being hurt by people I put my trust in. In 43 years I can still count on only two hands (not counting my immediate family), the number of people who were truly kind and didn't hurt me in some way.

Living with children with autism has shown me many disappointments in people. Those who judge without knowing. Those who look at your children like they are numbers or annoyances. Those who lie and cheat and only care about their budget and their job rather than standing up for what they know is right, even though what they are doing or what they are watching others doing they know to be so wrong. I have had to fight against having my children stuffed in small wooden boxes, locked in closets for hours, held face down on a floor, and so many other abusive acts that day by day my faith in people has been whittled away until there was nothing left.


And then there was Jack. Jack is an older gentleman in his 70's who visits the woman who lives next door to me. He is there almost on a daily basis doing jobs around her house. I have lived in this house for 5 years and in all those years I had never talked to Jack until a couple of months ago. We would wave to each other, and I remember occasionally getting letters in my mailbox from him offering his services for lawn care, but I had never really stopped to say hi.


Two months ago was the first time I talked to Jack. I was outside cleaning out my garage and he was next door doing some late fall cleanup. It started with a wave. Then he asked how I was. One of those questions that people ask just because they feel like they need to say something but didn't really care what the answer was, so I just replied "good, and you" and then started to walk away not really expecting an answer. But instead, he started talking. I admit, at first, I was kind of annoyed. I really had alot of work to do and I wasn't comfortable talking to this complete stranger but I didn't want to be rude so I kind of stood there, nodding my head and smiling while my mind wandered around thinking about everything I still needed to do.


I am not sure when it happened, but suddenly I realized I was listening to him. Not only was I listening but I was talking about myself too. Soon, I was telling him about my recent separation and trying to raise my two difficult children and he was telling me about his wife dying and how he and Diane (my neighbors) have been life long friends and an hour later I was still standing there listening to the life adventures of this man that for the past five years I only waved to. He asked me if I knew what family meant, where the word came from and when I said no he said that Family stands for "Father And Mother I Love You" and that it symbolizes the love a mother and father have for their children. He also told me about trips to Italy and Venice and England and the Vatican. He made me laugh with his stories of antics he and his friends got into and made me tear up when he talked about losing his wife and finding Diane again after all these years. Time just flew by.


Finally it was time to get back to work and we said goodbye and he looked at me and he said, "I know its hard to ask people for help, but if you ever need anything, even just a friend to talk to, let me know". He also warned me to be careful when I decided I was ready to start going out because the world is a scary place now and I never know who I am going to meet and where they have been or what they have done. Now, being the person I am, and finding it hard to really trust in the kindness of strangers, I just nodded okay, and thought to myself, "nobody does anything without wanting something" and "what did I get myself into" and "what is he going to want from me".


For the next couple of months, whenever I came home and saw him outside, I would wave but then quickly duck into my house. I really didn't want to risk getting into another conversation only to see what I was expecting from my messed up way of thinking. Someone who was only being nice to me because they wanted something back. So I ran.


Well, yesterday it snowed. It didn't just snow, it was freezing out and very windy. School closed early, afternoon activities were canceled and because of the cold my fibromyalgia was really flaring up. I could barely walk without a great deal of pain and I kept looking out the window at the snow piling up and thinking there was no way that I could get out there and shovel. I kept telling myself that there really wasn't enough out there to shovel anyway. Later in the afternoon I heard a noise outside my front door. I went to look out the window and my entire driveway was shoveled and there was Jack shoveling off the steps of my front porch.


I couldn't believe it. My husband has been gone since June and not once has a single one of my neighbors come over to see if I needed help even though it is very obvious that I am alone now. Even when they were standing outside watching me struggle with the lawnmower (something I never learned how to even turn on, never mind operate) not one person came over to see if I needed help. And here was this stranger, someone who doesn't even live here, trying to sneak and get my whole driveway done without me even knowing.



I stood there for a minute struggling to decide what to do. Finally I opened up the door and he looked at me and said, "I was bored". He had been over Diane's finishing up some painting and then realized he had time on his hands and not only did he shovel her driveway and mine but he did the driveway of the man on the other side of Diane's house as well, even though that man has a snow blower and was very capable of doing it himself. I didn't know what to say. Should I offer him money? Should I just say thank you? What do I do?



Finally I settled on saying thank you and mentioned to him that I had been thinking of hiring someone to do the shoveling for me this winter and if he was interested I could hire him. He looked at me like I had offended him and immediately I felt really bad. He told me that the winter was really hard time for him because he really missed his wife. Not only that, but his son just recently moved out and his house is empty. He cant stand to sit still and do nothing because it makes him miss his wife even more so from about 4:00 in the morning until 11:00 at night he is going around to all his friends houses doing work for them just to keep busy.


He said, it's not about the money. He doesn't want money. He doesn't want anything. He just likes to help people. He started talking about how he sees that I am a good mom (which, by the way, he told me spells WOW upside down) to my kids and that I have alot to deal with and my only priority right now should be taking care of my kids and myself. He told me that he is leaving in a week to go to South Carolina, but when he comes back, if he notices my driveway needs to be done and he has time he will come do it for me.


He told me to take care of myself and to be careful out there now that I am all alone and again he said that if I needed anything to let him know. He then turned and walked away. That was it.


Now I know there are people out there like me who think, this old man was probably hitting on me or he is wanting something and I have spent my life being one of those people who would think the same thing. I have a choice here. I can keep going through life expecting everyone I meet to hurt me or let me down in someway, or I can find a way, once more, to trust in the kindness of strangers. Yes, I know that doing that opens me up to more hurt, and a part of me is really not ready to do that. But a bigger part of me, the part that looks at my children and realizes that someday I wont be there for them and they will need to rely on the kindness of strangers, feels that its time to start letting go of all that pain and hurt. It's time to at least open up a little part of myself to hope. I choose to trust in Jack. To trust that there really are some people in this world who just want to be kind and don't want anything in return. Maybe I'll get hurt. And maybe I will find a part of me that has been missing for so long and find that I really can let go once in awhile and trust that things will be okay and that there really are people out there who are just kind.

What is an Autism Warrior Mom?

Well, I guess that can mean something different to everyone but for me, being an autism warrior mom means that I am not content to just sit back and let things just happen whether right or wrong. It means doing everything I can to make sure that my children have the best chance possible of living a healthy, happy and successful life and that they aren't discriminated against, abused, forgotten or judged not by who they are and what they are capable of, but what disorder they have or how much they can or can't do. It means fighting for my children's rights and for their education and helping to make the world a better, more accepting place for them.

That doesn't mean that in order to be a warrior mom you have to be relentless every second of every day banging down doors of politicians and running all sorts of groups and making sure that everyone knows your name and who you are. You can be a warrior mom and still be quiet and unknown. Maybe you aren't beating down the doors of the politicians up at the capital but you are storming into the school and demanding that your child never be put in another restraint again. Maybe you are online talking to friends and supporting them and offering advice to them about what has worked for you and doing what little you can to spread the news about how prevalent autism is and what changes need to be made to make our community a safer place for our children. You don't have to be in every newspaper and on every TV show and have your name known by every state representative and senator in order to be a warrior mom. You just have to be a mom fighting for your kids against the wrongs and injustices that our kids face on a daily basis. That's what it means to me, but you might disagree.

Let me just clarify something. I am not talking about the same WARRIOR MOM that Jenny McCarthy talks about. The mom that tries anything and everything out there to help their child, which trust me, I have no problems with or want to offend in any way. I am talking about a different kind of warrior mom. A mom who loves her child just as much and will be a warrior when it comes to fighting for her children's rights. And for the record, I have tried just about everything, including the diets and maybe, someday, I will talk about that. So I hope I don't offend anyone or break any rules by calling my blog Life of an Autism Warrior Mom because that isnt my intent. I am not comparing myself to anyone else and I am not trying to steal anything.

Let me introduce myself. My name is Phyllis Parmelee and I am a mom to two wonderful, loving, extremely smart boys who just happen to also be autistic. They are Justin, age 15, and Tyler, age 10 and while they have many similarities they are also completely different. The saying goes, "if you have met one child with autism, you have met one child with autism." Everyone is different with different strength's, weaknesses and needs. My children are no different.

I am a stay at home mom who also happens to have fibromyalgia, a non-curable, chronic condition characterized by widespread pain in your muscles, ligaments and tendons, as well as fatigue and multiple tender points — places on your body where slight pressure causes pain. I also am recently a single mom, an Avon representative, and an autism warrior mom.

I don't think there is an administrator in our school district who hasn't heard my name, most likely with the terms hysterical, over-protective or some other negative term attached to it but that's good because they know, I am not one of those mom's who just sit back, accept whatever they tell me and let them do whatever they want if it isn't what's best for my child. They know that they need to stop, sit back and think about how I am going to react to something that may or may not be in my child's best interest.

For example, having your child in 39 restraints in one school year is not what is best for my child. Having a behavior plan that utilizes the child's strength's and interests and rewards rather than punishes is best for my child. Making changes to my child's program and behavior plans without informing me first is not what is best for my child. Discussing those changes with me and allowing me to have some input into the plan since I am the one who knows my child best, is what's best for my child. See? A warrior mom. Not someone who is quiet and doesn't want to know because I don't want to deal or because I just accept that the professionals know more than I do. Someone who learns, who acts and who fights when a fight needs to be fought. Anyone can do it. Give it a try.

What do I hope to accomplish by creating this blog? Absolutely nothing. It's one more tool for me to reach my goal of being an autism warrior mom. Its a way for me to record my thoughts to help me deal with the stresses of being a mom to two autistic children, while going through a divorce, dealing with a chronic illness and being an Avon representative. Maybe in the process I will jot something down that might help someone else and that would be awesome. But mostly, this is for me.

And while the title is "Life of an Autism Warrior Mom" that doesn't mean that all of my posts will be about being an autism warrior mom. I will post about whatever I feel like posting that day whether its autism, fibromyalgia, my kids accomplishments that day, my avon business, being a single mom or the weather or anything else that comes to mind. It's just a title.

I don't mind peekers, lurkers, or anyone else who wants to share in my trials and tribulations. All are welcome to take a trip with me through this thing called life and while mine might be more hectic and stressful than most, I know there are always people out there who have it harder so this isn't about bragging about how hard my life is. This is just my life. I hope you will stay tuned and find something helpful but if not, that's cool too.