Monday, June 25, 2018

Types and Genetics of Long QT #Meg'sLongQTJourney

There are several classifications when it comes to the types of Long QT Syndrome.

First, there are two main forms of Long QT:

1. Inherited
2. Acquired

It's self-explanatory, but the inherited form is genetic related and the acquired form is caused by other reasons, in particular medications that prolong the QT interval.

There are two forms of inherited long QT:

1. Romano Ward Syndrome
2. Jervell and Lange-Nielsen

The main difference is that Romano Ward is the genetic version not associated with deafness, while Jervell and Lange-Neilsen is associated with profound hearing loss/deafness from birth. JLN is still genetic and this is common if you happen to inherit genetic variants from both parents.

One Step Further:

As of this writing, there are, I believe, 15 genetic types of Long QT. It is known that more genetic variants have yet to be discovered. I won't get into all the specifics of the gene variants on here.

Some general information:

  • The most common gene variants are Long QT 1, 2, and 3. 
  • Since they are the most common, the most research has been done on these three genes and more is known about these three genes than the other 12. 
  • The others are more rare and some of the latter ones have only recently been discovered. 
  • It is known that Long QT 5 is somewhat similar to type 1. 
  • Long QT 8 is also known as Timothy Syndrome. 
  • Timothy Syndrome is a type of long qt that includes other symptoms such as syndactyly (webbed fingers and/or toes) and developmental delays.
In Long QT, there are certain triggers/causes for symptoms to occur for each type. However, the triggers can also overlap. I will be going over this in my next post when I will be writing about the symptoms of Long QT.

~Meg~








Wednesday, May 30, 2018

What is Long Qt Syndrome? #Meg'sLongQTJourney

I'm bringing Meg's Long QT Journey back starting now. The plan is to post two to three times a week until I'm finished the series and I will let you know when that is at that time.

If you missed the first four posts that I originally did or to refresh your mind, you can read them here:
First Seizure
Second Seizure
Third Seizure and Diagnosis Part 1
Third Seizure and Diagnosis Part 2

Now it's time for what exactly is Long QT Syndrome. But, first, let's talk about how a normal heart works.

How a Normal Heart Works:

To understand long qt syndrome, it helps to know about your heart and how it works. The heart is a muscle and to pump blood to your body, the heart normally beats about 60-100 times a minute. It usually is faster in infants and children.

The heart has four chambers. The upper chambers, called atria, receive blood from your body and lungs. The lower chambers, called ventricles, pump blood out of the heart.

To pump blood well, the heart's chambers must work together to contract and relax at the right rate. Electrical signals that move through your heart control these actions.

The signals start in your sinus node. This is a group of cells in the right atrium. The signals move through the atrium to the atrioventricular node. When they pass through this node, they make your ventricles contract. This is called depolarization.

Your heart's electrical system recharges after each heartbeat. This is called repolarization. The heart relaxes so it can fill with blood and get ready for the next beat. Long QT Syndrome affects this process.

What is Long QT Syndrome?

Long QT Syndrome is a condition that affects your heart's electrical system. If you have LQTS, your heart works correctly as a muscle and a pump. However, your heart either takes too long to recharge between beats or it recharges in a disordered way. As a result, you could develop an abnormal heart rhythm.

An EKG records your heart's electrical activity as waves. These waves are named with the letters P, Q, R, S, and T. The waves Q through T show electrical activity in your ventricles.

The space between the start of the Q wave and the end of the T wave is called the QT interval. It measures how long your heart takes to contract and then fill with blood before the next heartbeat. 

The EKG shows whether your QT interval happens in a normal amount of time. If it takes longer than normal, it is called a prolonged QT interval. 

Overview:
Basically, Long QT Syndrome can be considered to be a type of arrhythmia, a heart rhythm condition that can cause fast, chaotic heartbeats. They can lead to the symptoms of long qt obviously, but I will get into the symptoms in a later post.

Credit and Links
All the above information about the heart works and the explanation of Long QT Syndrome gets credited to Mayo Clinic. They are one of the leading foundations for research and education of Long QT Syndrome in the United States.

~Meg~






Wednesday, May 16, 2018

My Long Qt-Versary

Yesterday marked 17 years since I was officially diagnosed with Long QT Syndrome, which means I was diagnosed on May 15, 2001. Some people may ask why I choose to celebrate this day? And the answer is simple: I celebrate because it was a life changing moment in my life. It has defined the rest of my life, although I do my best to not let it control me. After all, I'm normal in every single way, except for this one thing. I had to change a few aspects, but other than that, I'm fine.

It also means that I've been taking my beta blocker medication for 17 years as well. I'm on Nadolol and at times, it wasn't easy. I was only 14 years old when I started taking it. It left me really fatigued for several weeks and getting back to an exercise routine (with only activities that my cardiologist cleared me for) was nearly impossible. I've been through a couple dosage changes. The first one didn't effect me too much as it went only from 10mg twice a day to 20mg twice a day and it was within a year I believe of my diagnosis. It was meant to help me with my migraines at the time, but that's not part of my Long QT story. In 2009, my dosage went from the 20mg twice day to 40mg twice a day, which is where it currently is to this day. It went up then because I got too used to the old amount. That was definitely the worst I have ever felt while my body adjusted to the new amount, but I managed to get through it slowly but surely. I will elaborate on all of this as I'm bringing back my Long QT series soon. I had started it last year, but circumstances have prevented me from continuing it. I'll post my links to my story and how I got to the diagnosis at the end.

While dealing and managing side effects hasn't always been easy, I feel like it's nothing compared to the fact that I haven't had a major symptom of Long QT in these 17 years as well (my last seizure was in February 2001, only a couple months before getting diagnosis). I have had some minor issues so I can't complain. It does help that Nadolol is the preferred and best treatment in managing Long QT Syndrome. Click here for a recent article discussing this issue. This does not mean that everyone tolerates it as well as I have. 

Since the Nadolol has worked so well with me, I wanted to take the time to note the importance of taking medication as recommended. Yesterday, in one of my support groups, someone named Ellie posted the following about her daughter: 

This past Sunday, my daughter-Taylor came face to face with the ugly truth of SADS (Sudden Arrhythmia Death Syndrome)- LQTS Type 2. In 2012, our entire family was genetically tested for LQTS. We tested positive for the HERG gene a rare mutation which puts us at risk for sudden death. At the time of diagnosis, Taylor had not had any warning signs or symptoms typical of LQTS Type 2. Her recorded QT on EKGs at that time was 460. The EP and cardiologists that were on our family's case felt that treatment with a daily beta blocker would be appropriate for Taylor.  Taylor began beta blockers but struggled with the side affects. She decided on her own that she would stop the betas.
Fast forward to this past Sunday, I can say we are so lucky to have her with us today! She survived a sudden cardiac arrest Sunday evening. Her roommate found her unconscious, blue, and not breathing- He was quick enough to act and immediately called 911- by the time the first responders arrived her heart had naturally and slowly began to revert back to its natural rhythms- and CPR was not necessary by the time the paramedics arrived. She was transported via ambulance to the local hospital and admitted.
Upon arrival a 12 lead EKG revealed her QT was 525. She has been seen by both cardiologist and the EP and all appropriate tests have been run. She is scheduled for placement of an AICD this afternoon at 4pm.
Taylor's birthday is on the 16th- 26 years old on Wednesday! As her mother- I am so thankful she is here with us and relieved the cardiologists are being assertive and pro active with their treatment and the decision to move forward with and AICD placement. We will be celebrating way more than just a birthday this year!!!!
Taylor is a healthy very active and social, young adult. She had created the perfect combination of circumstances to lower her QT threshold which put her at a very dangerous high risk for the SCA to occur. She is an active water girl and had spent the weekend at the lake- water sports, lots of sun, alcohol consumption, energy drinks, little sleep...and dehydration were all part of the picture. I share this here in hopes to raise awareness of the dangers and warning signs of this rare genetic disease.
We were given permission to share, but I changed some names/places for privacy. I bear no judgement on her daughter's decision to not take the medication, but I'm putting this out there to know the risks involved. The problem with Long QT syndrome is that it can be unpredictable and events can happen at any given time, even if you haven't had a symptom in years. The purpose of betas and other treatments is to prevent events from happening, but it doesn't necessarily mean another event won't occur. That's one of my biggest fears - that I'll have another seizure or symptom at some point in my life even though the Nadolol has done its job for 17 years. It's the scary part of Long QT Syndrome and it doesn't come with any warning - the symptoms happen suddenly with little to no warning.

As I celebrate this day, here's to 17 more years symptom free.

Links:
My Journey that led to Long QT Syndrome:
My First Seizure
The Second Seizure
My Third Seizure Part 1
My Third Seizure Part 2 and Diagnosis

For more information:
Risk Estimate, Best Treatment in Long QT (I linked to this in a paragraph above as well)
Sudden Arrhythmia Death Syndromes Foundation

~Meg~

Sunday, December 3, 2017

NaNoWriMo 2017 Final Update and Review

NaNoWriMo 2017

I've been wanting to do NaNoWriMo for a couple years now, so I finally decided to do it this year for the first time. I thought I would have the time to get it done this year. But I didn't know what I had in store not long after it began. I'm become so used to things not working out for me and unfortunately, completing NaNoWriMo was no exception.

It got off to a great start for about a week and half. I was reaching the average word count each day of 1,667 words and if I didn't, I would catch up the next day or so. It looked promising until my mom got hit with a flare up of sciatica, which she is still dealing with now. It started out okay until it got progressively worse after about a week after the initial start-up. It became where she was able to get around okay, followed by not being able to walk at all (and we're still working on that). What it meant for me was that I gained more responsibilities than ever, with taking care of her, the house, doing NaNoWriMo, trying to get ready for a craft fair for this month, and trying to take care of myself. It left me feeling more tired than ever and there were days where I didn't have a moment to spare. The thing about sciatica is that you just don't know when a flare-up will occur and I had no idea that we would still be dealing with all of this as of this writing. She went to urgent care the first day, where she was prescribed a muscle relaxer and motrin. The following week, we ended up at the ER due to the excruciating pain while we were attempting to get her to an orthopedist appointment, but she was given a lot of medicine and got sent home with oxycodone, Tylenol, and more motrin . It was approaching Thanksgiving and it appeared to be getting somewhat better, but that would be short lived. It still really wasn't getting better and she started getting hallucinations from the narcotic. A couple days ago, we took her to an orthopedist with much pain at that. He only told us to keep giving the Tylenol and motrin; he didn't want to really prescribe anything stronger because he didn't want anything to mess with her heart problems. It hasn't helped much and now we're stuck at the same place.

When she started getting worse, I started having trouble keeping up with NaNoWriMo. While selfishly I want to blame my mom for having it happen when I was trying to focus on myself for a change, I don't blame her because it was out of her, as well as my, control.

I'm pretty sure by now you know what I'm about to say. I did not complete the 50,000 word count, but I did manage to write 41,210 words during November (I did write a bit more, but I wasn't able to get them in time, but it still wouldn't have surpassed 50,000).

My goal wasn't necessarily to reach the 50,000 word count. My main goal was to get myself back in the habit of writing every day. I did accomplish that by managing to write most days out of the month. Based on what I was dealing with, I am proud of myself for reaching that far and I'm proud that I went after a goal. While I do wish I could have reached the 50,000 word count goal, I reached other goals that made it worth it.

I am planning on doing NaNoWriMo again next year and hopefully it will turn out better.

~Meg~

Sunday, November 26, 2017

NaNoWriMo Weekly Update 4

NaNoWriMo Update Week 4

Okay, so I goofed and apparently didn't realize that this would be my second to last update instead of the last like I said last week.

I thought that it would get easier this week, but I still was dealing with challenges. I will be talking all about that next week during the final and overall update.

While the week didn't exactly pan out the way I thought it would, I made some steady progress over the last couple of days. I'm still not certain if I'm going to reach 50,000 words in time, but I am doing and trying my best. Right now, I'm around 34k words.

NaNoWriMo officially ends on Thursday, but my final and overall update will be up next weekend.

~Meg~

Sunday, November 19, 2017

NaNoWriMo 2017 Weekly Update 3

NaNoWriMo Week 3 Update

1. I'm still running behind the word count quota. Right now, I'm around 20 or 21,000 words out of 50,000.
2. I've made a lot of progress over the past couple days.
3. There's a week and a half left.
4. My final and overall update will be posted next Saturday. I'll be  writing about the last days, in addition to my overall outlook, of NaNoWriMo.

Happy Reading and Keep on Writing!

~Meg~

Saturday, November 11, 2017

NaNoWriMo Weekly Update 2

It's Saturday and that can mean only one thing. It's time for my weekly update on NaNoWriMo 2017.

NaNoWriMo Week 2

I wish I could say that I've been hitting my target and goals each day, but that would be lying. Unfortunately, this week I have been dealing with a family emergency that's been more important, but I haven't been able to write as much. I should have known that it would happen, but it's life and there's not a lot I can do about that.

For my story, I have had to change some things around, which is not helping me progress. At the end of the day, the word count doesn't matter. Yes, it's been a disappointing week filled with a bit of despair, but I refuse to give up. I refuse to let setbacks define me and the writing goals I set for the purpose of doing NaNoWriMo in the first place. I do have a lot of work ahead of me for the rest of the month and I believe I can still win this (by reaching or exceeding 50,000 words). Anything is possible if I just believe.

~Meg~