I want to wear blue wings and soar

above the screaming

tantrums of today

I will take you with me

(hold you)

as we gaze down

upon whispery earth

at tiny beings

scuffling about

checking their clocks

and bank accounts


the life of a bird

who does not love so much

that it hurts







The Sunny Side of the Street

There exists two sides of the street: the sun-bright, well-walked one with colorful storefronts and restaurants from which music spills through open windows to umbrella-covered tables. The sidewalks have well-designated lines in the shining concrete so that you can easily step from one block to the next if that is your thing. All is swept clean daily. Doors are open; you are welcome everywhere, and everywhere, people greet you as an old friend.

And then there's the other side--shaded, hushed--with dark alleys leading deeper into shadows. Although there is some pedestrian traffic, this side is not popular; after all, solemn offices and a few businesses reside in the upper floors while the stores below offer bongs and cheap tchotchkes or sport "Vacancy" signs. 

Just one crosswalk leads from the sunny side to the shaded side and it's one way only; all who find themselves on the shady side have either wandered away without purpose or been shoved out into traffic and forced to skirt danger until reaching the parallel sidewalk. 

While it takes but seconds to switch from the sunny side to the shaded side, it's a tedious, tortuous return. If you do manage to pass back to the merriment and vivacity of the first side, sad, frustrating, angry memories from the shady side will color each new experience. You will notice for the first time the plastic flowers embellishing the restaurants' decors, the too-sweet scents of passing women, the small crack in the corner of a window that is mostly hidden by a curtain.

Whereas in the sunny side, you had not a care in the world aside from purchasing the perfect gift for X or those new sneakers you just HAD to have, on the shady side, you cradle worries larger than yourself. Survival no longer means deciding between two trendy restaurants for your lunch. The world is racing at you from every direction in 3D and it's cruel. You must negotiate the obstacles coming from every direction and you fight against the ever-strong riptide that threatens to pull you under. You have left behind family, friends, aquaintances, to focus on saving yourself, or perhaps, as is most often the case, they have left you. 

Marooned on the shady side, you mourn the loss of gaiety, spontaneity, frivolity. After you sit for the required time allotted for grief, you notice others around you; they suffer as well, so you reach out, try to help. Aiding others somehow brings you comfort. For moments of time, you forget your woes. You find common bonds with fellow shade-prisoners; they embrace you as family might. You realize that this side is much more populated than you ever knew; in fact, most of the world is hidden here, in the alleys that were once invisible to you. 

Can you ever return to the light or are you destined to steep in the sadness of shade? You realize that you took for granted the light and in doing so, refrained from noticing the shade; even if you studied the shady side as an intellectual exercise, you could not have known it as you now do.

Was it something you did that caused you to end up here? Was it Karma, Fate, just pure bad fortune? Is there NOTHING you can do to return?

You are given glimpses of the sunny side, maybe in your dreams or at a small space between too-close skyscrapers that lets in light, and you wish to reside there once more. Yet the shade has become a permanent tenant in your heart, your being, and will always be with you going forward, wherever you venture.

Once you cross away from the sunny side of the street, everything shifts like a kaleidoscope. You must learn to live with the underlying sadness and focus on your new land and its people, for you may leave the shade but it will never leave you.


Bicycling as a Metaphor

As I passed a man on the bike path the other day, I sang out, "On your left" but added, "But probably not for long as I'll fatigue and you'll pass me."

I did lose speed. And he did pass me. And all was OK in the universe.

Only because I made the disclaimer.

Just a few weeks ago I passed four young men and there was no way I would let them catch up to me, only to pass me again, especially after I heard one of them say to another, "Don't get beat by a girl."

But then, days after, I relapsed and have been fighting to get back ever since.

Now I awake in the morning and lounge in bed for half an hour before stumbling my way to the bathroom, ankles twinging. Fatigue wraps itself around me like a lead X-ray apron. Electricity zaps my legs. 

Then, I finally had my reprieve, my first good ride in weeks. As a I passed a woman in bicycling gear, I wondered: how many miles had she already been riding? Was she healthy? While we rode the same bicycle path, we had different starting and ending points, different journeys, different stories.

Years ago, I would not have asked these questions when passing another cyclist. Years ago, I envied a friend for having the perfect body, the perfect job, the perfect brain, the perfect money. Only later did I discover that she held the same insecurities as I, perhaps even moreso. My godmother's wise words of, "Don't compare your insides to someone else's outsides" gain more significance daily.

Once, it was about winning. Winning my own private race, that is. Beating my own previous time. Pushing myself to my maximum. Adding just one more, no, five more miles. 

Today it's about doing. It's about showing up. It's about my intension to do a 30 mile ride this summer. It's about hoping that I'll be able to achieve my goal of a 75 mile ride when I'm 75 years old. I don't know what I'll endure in the years leading to 75. I don't yet know all the steps I will take to ensure that I will bike my age.

In life, we don't know how far someone has come, or what ordeals they're facing. So maybe I'm super fast in my first five miles but slow after. Maybe someone else has already ridden 45 miles or has just recovered from a heart attack and is back on the bicycle. Maybe I'm the one who cannot cycle the way I did just a month ago because my chronic Lyme has roared back to life after being chained to the cellar for a year. Maybe that guy bicycling 5 miles just accomplished something incredible.

Not riding rapidly can have benefits. Last week, I clicked out of my pedals to take a picture of an undaunted deer that happily munched leaves on the side of the path. I smelled sun-warmed plants and absorbed the light from sun-starry waters I passed.

Today, I came to an obstacle: a tree had fallen across the path. Two other cyclists stopped. One man joked about limb-ing under it. A woman asked if we could move it. The three of us tried but it was heavy and still grounded on one side, so i picked up my bicycle and carried it over. 

Just another obstacle in life, easily surmounted in the whole scheme of things. Why worry about one fallen tree blocking the path when I can easily climb over?

When I returned, it was gone. Someone, perhaps the guys working in trucks to keep the path maintained, had removed it. And I barely noticed until the area was behind me. 

Sometimes I think I need to be grateful that I have two hands that work, that I can breathe through my nose without suffering from a cold. I need to be grateful for all of the things I take for granted until I get sick or hurt. When I have a bad cold, my nose/head/sinuses become the largest part of my body. I need to be grateful, for today, that they are relegated to their proper places.

When riding downhill, I have two choices: shift and tackle the hill, watching my speed pick up. Or coast, relishing the downtime (pun intended.) 

It's summer and I'm off from teaching. Do I relax during my downtime? Catch up on my sleep? Or do I use this time to complete all the projects I have not had time to do all year? Work on my book? Play my guitar? Re-do the bathroom?

Do I even have a choice? On days like today, despite the sun glowing goldenly, I feel the heaviness of headaches and lethargy, as well as the angst of not accomplishing anything worthwhile. I haven't even taken the puppy out.

But I'm here, remembering the glorious rides, that wonderful feeling of having strength in my legs, the lack of pain in my back and feet when I rode. I tell myself I'll revel in that again as long as I persevere and believe.

Life. It's about flexing those muscles and pumping uphill or trying to catch as much speed on the downhills or coasting....


Lyme Connection Conference May 17, 2018

If you missed the Lyme Connection conference this year, read on for some notes. Hopefully, all speeches will be available online soon because they were filled with important information, wisdom and hope. I was fortunate to attend and also, with advocate friends, to again run the Lyme Disease Challenge table where we encouraged people to "Take a Bite Out of Lyme." 

Note that any errors or misunderstandings with the following information are mine. 

Mr. Lew Leone, vice president and general manager of WNYW-FOX 5 TV, was honored with the Courage in Journalism Award. He spoke about how Lyme has affected his wife and went on to thank Yolanda Hadid for she "took Lyme awareness to the next level." Fox News produced the Emmy-award winning Lyme and Reason: The Cause and Consequences of Lyme Disease and a follow up, Lyme Disease and the Voice of Change. 

Dr. Neil Spector than spoke via video. He is a top oncologist/researcher at Duke University School of Medicine. His speech about his journey from doctor to undiagnosed Lyme patient who nearly lost his life to this disease was moving and insightful; you can purchase his book Gone in a Heartbeart. He is now an integral voice for the Lyme community.

Ms. Dana Parish, award winning Sony singer-songwriter, advocate and writer, who has grappled with Lyme herself, took the podium. She stated that a few years ago, she happily attended a wedding and over the course of one weekend and a tick bite, her life changed forever. You can read more of her story here. Dana Parish has published several articles with the Huffington Post and has garnered many accolades for her advocacy work.

Despite suddenly having fatigue and insomnia, suicidal depression and hallucinations, she was "entirely failed and dismissed by mainstream medicine." Dana Parish said, "If you think you have the summer flu, it's probably Lyme." 

Some words of wisdom:

-Three weeks of Doxy fails 61% of the time according to one study and over 30% of the time according to another. That's a high statistic.

-Doctors only see what they know. They don't know how to connect the dots.

-There is always a reason when you body goes haywire.

-Don't trust anybody but a Lyme specialist when it comes to Lyme.

-Lyme and Bartonella are chronic stealth infections.


Dr. Steven Phillips, renowned doctor and researcher, was the final speaker. He spoke about treating many patients, even his own father who couldn't get proper medical help for Lyme. Dr. Phillips is currently writing a book with Ms. Parish.

-Lyme and co-infections create "a soup of infections."

-2/3 of people diagnosed with Lyme have Bartonella

-Bartonella is tightly linked to a range of autoimmune conditions

-it's pretty common to have asymptomatic Lyme in your body

-IV antibiotics are not superior to oral antibiotics; some patients respond better one way or the other; IV antibiotics do not necessarily circumvent the gut; IV rocephin gets excreted through the GI tract

-Dr. Phillips uses pulsing in his practice; the bacteria tends to hide/go dormant so pulsing kills them when they re-emerge

-You can't kill Lyme in the test tube with doxycycline or rocephin, amoxicillan or ceftin

-"Post Lyme Syndrome" is an 'idiotic fabrication" according to Dr. Phillips. You would never come up with a term like this for cancer or HIV; it's a slap in the face.

-Herxheimer's reacions can last a very long time, months even.

-"Blebbing" also occurs. Blebs are intrinsic to autoimmune illness. Spirochetes release blebs into tissues. (Editor note: this is the first time I ever heard about blebs; please comment if you have more information!)

-Psoriasis can respond well to Bactrim

-There is no definitive cure for Bartonella

-Both Lyme and Bartonella will turn off the immune response to infection (anergy)

-Diflucan can kill Lyme and is an anti-fungal

-Lyme doctors don't take insurance because they spend much more than the covered 10 minutes with a patient, often 1-1/2 to 2-1/2 hours for the initial visit and between 1/2 - 1 hour for follow-up visits. Insurance will not cover this.

-Sleep disorder is a neurological symptom

-329,000 NEW cases a year of Lyme in the USA at minimum; 20% of these become chronic

-Lyme is prevalent in Scandanavia yet there are nearly no treating doctors there

-Eating Paleo can get the pain down in some people (it helped Dana Parish) but according to Dr. Phillips doesn't help everyone

-Bad herx? Stop antibiotics, some people use Epsom salt baths, burbur/pinella

-DNA tests, PCRs--some labs use a target that doesn't get expressed with Lyme; testing for Lyme is often erroneous; there are many false negative results

-IVIG can benefit PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome)

-Dr. Phillips has seen some adult versions of PANS (and therefore maybe we need to get rid of the "P" which stands for Pediatric.)

-Flagyll is carcinogenic

-Alinia, on the other hand, does not cause cancer

-Bartonella is associated with psoriasis

-Infrared sauna can help with psoriasis

-Some veterinarians have concerns that the Lyme vaccine can cause kidney failure in dogs


Written across Mr. Leone's slide was the quote, "From caring comes courage."--Lao Tzu.

Mr Lew Leone, Dr. Neil Spector, Ms. Dana Parish and Dr. Steven Phillips have all had a personal relationship with this disease. All four have taken the knowledge and experience they gained and are courageously working to increase awareness, introduce alternative treatments and support others. All four are making change for those who yet cannot. 


On Women's HERstory Month

March is Women's History (HER story) Month and it's time to celebrate the amazing mothers who work tirelessly to raise healthy, happy children. It's time to celebrate the mothers--the Katies, the Nancys/Tricias/ Gayles, the Anitas/ Gabriellas/ Emilys/Christines/ Jaimes and Beths, the Libbys/ Julies/Giulias, the Barbaras, the Gayles/ Melissas/ Valeries and Erins...the moms who aren't (as far as I know) famous, but who fastidiously love their children and do anything needed to care for them, despite overwhelming obstacles.

But I want more. 

Each year, for Women's HERstory month, a former and beloved history teacher, now retired, returns to my classroom to share his story of an ancestor who was an abolitionist. Each year, for many years now, I have asked my students to write a story of a female ancestor of their own--someone for whom books were not written, someone who was most likely a mother, someone whose story might eventually evaporate but for the telling.

My students need to interview living family members in order to find these stories, and in doing so, they learn not only about great grandmothers or great aunts but history. They learn about Irish ancestors escaping potato famines, about Holocaust survivors, about first generations that were born out of slavery. They learn about women who went to college when few others did, about women who raised seven children single-handedly, about poverty, prejudice, survival. They learn about the character traits that are still remembered--kindness, perseverance, stubbornness, industriousness--character traits that might be passed down to future generations, whether those generations be born to them or adopted. 

I want to be remembered, and not just for being a mom. Or a mom who fought for kids' medical health. Or a mom who fought for Lyme treatments while lying in bed, fatigued from Lyme. Not that that isn't enough, but I want more. At one time, I would have been happy to be remembered for singing. But I had aimed for a different path. I would love to be remembered for my writing. Most importantly, I would like to be remembered for bringing positive change to our world. 

But today, I am tired. I'm physically fatigued. I'm worn down. I joked with a colleague a few weeks ago that if I did not return from February break, I could be found somewhere in Italy.... maybe studying music. I know I'm fighting a cold. And the cold has caused some brain fog. All setbacks perturb me. I have so many goals I want need to accomplish.

Why is it so important for me to accomplish more than parenthood? Why is it integral that I am remembered? What is our purpose here in life? Is it to achieve happiness? To learn to accept all that we cannot change or to fight for the changes that must be made? Is it to plant a tree, have a child, write a book? Is it to make the place better for others?

Where do we current mothers fit into all of this? Will my children have children or will my great grandchildren someday be researching me? And if so, what could they learn? That I dabbled in musical theater, kept returning to college and racking up degrees, (yet still suffered financially)? That I fought for PANS legislation and Lyme treatments? Will they read that I published a book sometime in the 21st century (date unknown)? Will they read that I made great changes? Will my name persist past my life? Will my children grow old and carry with them good memories of me?

Or will I slowly disappear, much as my own great, great grandmothers have done? My great grandmother Nadia (renamed Nettie) came over from Russia, lost her thumbnail in a NYC sewing factory, lost her firstborn to a hole in her heart and nearly lost her son to polio despite the fact that my great grandfather was a doctor. My great grandmother was also mother to my grandmother, whom I loved but who will not be remembered for many generations. I know nothing about Nadia's mother or Louis's mother or my Great Grandmother Rose's mother, despite their accomplishments, despite the obstacles and suffering they had to surmount. Their names and their stories are now lost to history. 

Throughout my teens and twenties, I felt desperate to know why I was alive, why I was here. I knew I had a meaning in life but it was just a whisper of importance that evaded me. When I found the stage and could make people laugh and cry, I thought that part of my meaning was involved with musical theater. I believed that writing was linked to my meaning but had no direction yet. Ironically, I majored in finance. 

Once I had a family, that urge to find meaning calmed somewhat, until I was thrust into another world altogether. This new world would ultimately (hopefully) make me a more understanding and compassionate person, one that would lead to deeper connections with others. If I had not had setbacks that brought my world so much narrower, would it have grown wider? Would I know and care so very much for the same people? 

I want more.

I want more fun, more freedom, more finances. I want to make more changes, be able to volunteer at a conference two days in a row without growing fatigued. I want to be able to be two places at the same time! I want to spend quality time with my husband, my daughter, my son, my friends. I want to learn ukulele and play my guitar and write my novel and ride my bicycle and do yoga and save the world, but I have neither time enough nor sufficient energy. I feel fractured into many different directions, which is nothing new as I have always had many passions. I just cannot do it all.

And while I ponder my story, while I try to WRITE my story, I also try to shape that of my own daughter. She has strengths I never had at her age. She has personality and gifts that are blooming. She has the potential to make so many positive changes to our world. She is a gift to me and she is also one of my gifts to the world.

"Please Gd, please, don't let me be normal!" --Luisa from The Fantasticks


PANS/PANDAS: Words from the Frontline

“My son went from a smart, happy, self-sufficient 7 year old to a tormented, angry, helpless, regressed child overnight. Our family will never be the same.” –Lori Rowden

PANS: What is it?

Pediatric Acute-onset Neuropsychiatric Syndrome occurs in approximately 1 out of 225 kids. It shatters childhoods, spiriting away children from families. PANS plunges parents into a hellish, upside-down world. With the exception of a few people, PANS is NOT understood by the other 224 out of 225 people.

PANS is an autoimmune disease that attacks the brain. Triggers include, but are not limited to: strep (in which case it's refered to as PANDAS), pneumonia, flu, mycoplasma, Coxsackie, vaccinations, Lyme Disease. PANS has resulted in a tremendous impact on the happiness, health and finances of families involved.

Lynn Becker Haber explains the sudden onset of her son: “Our older son Gary, who was in the fifth grade at the time, complained of a sore throat, which turned out to be a strep throat. He took a round of antibiotics, and we expected life would go on as usual. Only it didn’t. What happened next is nearly impossible to describe. I can’t do it justice through my words.

“PANDAS is an autoimmune reaction to strep,” continues Lynn. “Antibodies that are supposed to fight strep mistakenly attack the part of the brain that controls thought and movement. It is often described as a rheumatic fever of the brain, but unlike the heart, the brain controls behaviors, which makes many assume it is psychiatric. This is a medical illness that can range from mild to debilitating in its symptoms. For Gary it quickly became debilitating, and he went from being an advanced student to a special needs student and was hospitalized multiple times over the next eight years.”

PANS creates a nightmarish existence for patient and family. And yet, in some of these families arises an amazing inner strength to contend with such an ordeal. A well of resilience, perseverance and faith binds parents to one another, a unity that is crucial when our children and families are pioneers in this new crazed time. Parents long to educate the world, to increase awareness and to help others just going through this experience. Following are the experiences, both devastating and inspiring, of some of these warrior parents.

Diagnosis and Treatment

Diagnosing PANS is challenging and many families have taken their child to numerous doctors. Treatment of PANS is another matter altogether, with no one protocol successful for every child and many doctors not knowledgeable enough to tackle the illness. Support from family, friends and community is not always guaranteed; in fact, as PANS presents as a "mental illness", many scatter away. Lastly, the financial repercussions and fear over losing a child can break up families.

“Having doctors not understand, having family think it's far-fetched, and ending up broke is all REAL. This disease is devastating in every aspect,” says Josette Krause.

Jennifer writes: “Daughter had a tick bite at 8. PANS symptoms showed up shortly thereafter. Tested Elisa for Lyme, negative. Daughter started suffering panic attacks, crippling anxiety, and OCD. Went on for 7 years before we learned of PANS. Daughter was suicidal and had a psych admit at age 15. We learned of PANS and did more thorough Lyme testing in which she came up CDC positive. Now at 16 we are seeing a LLMD [Lyme Literate doctor], she has not been suicidal in a year and she is much more like herself, the girl I thought I was going to lose forever. Her GPA so far this year is a 97, (4 points higher than last year) while taking 4 college level courses along with other high school courses. The Lyme doctor is out of pocket, but it’s what I need to do to get my child the treatment she needs. Times are tight, but my child’s health is paramount.”

Finding a good doctor can be nearly impossible. Libby Majewski adds, “I put a call into my pediatrician days ago and he finally called me back. Anyway he asked me questions like, “Have you talked to her teacher?” When I told him that she cries every morning about going to school and we’re getting close to school refusal and when I got annoyed with his questions and told him that I do talk to her teacher quite a bit and nothing is going on at school, he started asking me more questions like, could she be bullied?

“I said basically that this is ridiculous; he and I keep having the same conversations and I’m feeling that I’m not getting anywhere and I guess I have to go back to specialists out of state to get support and pay $$. He got so mad & said he needs to investigate other possibilities for her behavior. Anyway, he came around (I think once he started looking at her labs and chart) and in the end he agreed to do the “rheumatic fever” protocol of prophylactic antibiotics. She was in the freaking car and he was on speaker. Oh well, she heard a mouthful about herself and her anxiety, sensory issues, refusal to do any activities, etc. from me as I was explaining all her symptoms to him (‘It’s not JUST school anxiety’).”

“We were so lost and had no idea where to go,” writes Tracy. “I don't want others to go through that.” She adds that her first daughter had a positive Lyme test at age 6 and again at age 8. The first time, she was given a week of antibiotics. The second times, she was given three weeks of antibiotics. When at age 11, she again had a positive Lyme test, she was told by doctors that per the CDC, all were separate and new infections and that she was fine after antibiotics. However at age 13, she was anxiety ridden, suffered from an eating disorder, explosive angry, bad short term memory.

After working with three different therapists, neurologists and the pediatrician, a new therapist suggested that Tracy’s daughters’ “problems could be Lyme-related. NEVER had anyone told us that Lyme Disease could cause mental issues....years were wasted.”

Tracy was to repeat this experience with her second daughter, who suffered from sleep issues, nightmares, hallucinations, self-injury, foot pain and suicidal thoughts/attempts.  Tracy says that this finally “led us to a holistic psychiatrist who is now treating the Lyme – she [daughter] is not done yet but has seen a lot of improvement. “Again, no one ever mentioned that Lyme could cause this,” says Tracy.

When Angel Emrey sought treatment for her child, she learned that she would have to “travel from Tennessee to Washington, DC. Of course, insurance doesn't pay anything if you have IV antibiotics. It pays a little of the doctor's appointment and some of the oral antibiotics. Any of the things that we have to take [Many doctors prescribe supplements, herbal medications, etc.) are not prescription; they’re over-the-counter or natural so they are not covered. To say treatment is expensive is an understatement.”

Some doctors do not respect patients or parents researching and advocating for themselves. Doctors have gone to school for years and some will denigrate patients who have found facts via “Dr. Google.” According to Angel Emrey, one doctor told her then 7 year-old daughter, “I see your mom has been on the internet researching things that are wrong with you.” He said this despite the fact that the child “had the bulls’ eye rash and all the symptoms, plus I brought in the tick that was attached.”

Yet another doctor told Angel’s daughter, at 14, when she complained of hallucinations, constant headache, intense pain and frequent falls that she could not possibly have Lyme because they lived in Tennessee. “At this point, she had 3 positive tests! He asked her who had hurt her feelings on social media to cause her to make al this up and then told us to take her to a psychiatrist.”

Daily life continues to be a struggle for many. One good day can lead to three good days but can also lead to a complete meltdown or flare. Some of our children seem completely lost to us. Julie Parker says, “My daughter, now 20, experienced hallucinations, crippling anxiety, depression, and became a compulsive cutter, along with unbelievable pain. There were many other issues. She went from being an honors student and playing competitive softball to being unable to remember any new facts or even what she was told hours before, and unable to get out of bed. Her childhood would also have been much different had we gotten a diagnosis when she was young. All the signs were there from birth but no pediatrician or other specialist saw it for what it was. She had OCD, her days and nights were backward, she developed irrational fears, had horrible nightmares, anger, and intrusive thoughts. We only half-jokingly said she went "from zero to Hulk in under 10 seconds”.

“At age 15, she was finally correctly diagnosed and we were both relieved and horrified as we began to learn the reality of what she faced. I still remember the day she told me she felt no pain for the first day she could ever recall - at age 16 - and how we both cried tears of joy and regret about it. She had to drop out of high school before her senior year due to memory problems, anxiety, fatigue, and pain. Treatment has cost us approximately $75k and we realize that's less than others AND that we are fortunate to have had assets to liquidate in order to treat her. We, too, travelled from TN to DC for treatment and went through three Lyme doctors before finding one who could handle her complex case.”

Gene and Suzanne share their story on their website. They write, “We visited several neurologists and psychologists, and while he was hiding and screaming underneath their office tables, nobody could tell us what was wrong and couldn’t understand that this child had not been like this before. We told them over and over that he was the top of his class, one of only two kids who got into advanced math for middle school, sweet, loving, compassionate, empathetic, never mean or lashing out.  The doctors talked about “hot feelings” and “cold feelings”, that we couldn’t let him have his way with everything.  One doctor put him on Zoloft, which made him 100x worse.  We told the doctor it was making him worse and that we needed to stop the Zoloft and he said, “It sounds like you need more, not less.”  He said, we should “try outpatient hospitalization and if that doesn’t work than he’ll need inpatient treatment.” 

[As a side note, unbeknownst to many of the psychiatrists treating children with PANS, the PANDAS Physicians Network advocates going 'low and slow' when it comes to doling out SSRIs. “Clinical experience with PANDAS and PANS patients suggests that using a low dose and slow titration minimizes the risks of activation, agitation, akathisia, and other adverse effects of the drugs. The medications MUST be started at an extremely low dose (e.g., 1/4th or less of that used for a typical child). Upward titrations should be adjusted no faster than 2-week intervals. An adequate trial of an SSRI is 10-12 weeks at maximum dosage”.]

Suzanne and Gene also assert: “Usually, children with these symptoms are prescribed psychiatric medication, as ours were, which only serve to exacerbate their conditions.  This is then followed by more medications, and inevitably the children are lost down a rabbit hole of psychiatry and neuropharmacology.  We avoided the psych meds. sparing our children from the lifetime of hell that comes with a true psychiatric diagnosis.  And miraculously, after two years of hellacious anguish and seven years of misdiagnosis, we are somehow clawing our way out of the dark and treacherous hole, only to leave ourselves wallowing in the mud.

An anonymous parent writes, “My child was bitten by a tick at 3 and started falling down after that. A cognitive decline (inattentiveness) was noted by a preschool teacher but we thought it was due to stress because my ex and I were divorcing. Very significant fine and gross motor delays were noted. We had lots of visits to doctor due to colds and infections and there were persistent complaints of bone pain in the doctor records.

“Many more tick attachments followed but the Elisa tests throughout childhood were always negative. We actually never had a western blot test performed. At 15, he was at the doctor for another infection and I checked off the box on a lab slip for a Lyme test and he got a positive Elisa test, but a negative western blot. After that I started researching and found out about how useless WebMD is with regard to Lyme and co-infections and I found my son a LLMD. After starting treatment, he crashed horribly, had to stop school and never made it back. Now he has PANS and substance use disorder.”

PANS in adolescents can look much different than it does in younger children. If PANS is not diagnosed and treated promptly, it can become exacerbated with each new flare up. Teenagers tend to self-medicate when other treatments fail to work effectively. This is why it is crucial for pediatricians, who are often on the frontlines of child medical care, to know that any change in personality should be met with blood tests for triggers. Having said this, PANS/PANDAS is a clinical diagnosis.

According to New England PANS/PANDAS Association, "PANS/PANDAS is a clinical diagnosis and one of exclusion, based on history and examination, not simply one laboratory test.  PANS is thought to result from a variety of disease mechanisms and to have multiple etiologies, including but not limited to psychological trauma, underlying neurological, endocrine, and metabolic disorders or postinfectious autoimmune and neuroinflammatory disorders. Therefore, PANS diagnosis does not require a known trigger."

Stacy Rothman Fox adds that PANS is a “major emotional roller coaster! The past four days my son has been wonderful. He is loving. I can leave him in a room by himself. I can leave the house to walk the dogs.

“But the day before, he called me just to tell me that I should fall, that he can’t stand me and I should die. He proceeded to tell me these things all day. It wasn’t safe to leave him alone at all. The week before he was violent and the week before that. While I’m loving how wonderful he is right now, I’m terrified of the switch.”

PANS and the Outside World

When questioned about whether extended family understands, Sherry Howard responds, “It seems that every time you have a good day or a good week, they say something to the effect of, ‘Looks like things are turning around’ or ‘Sounds like he is getting better’. Then they don’t understand when that is not the case. Celebrate the good moments; they can be few and far between.”

Marianne G. says, “Extended family doesn't understand that you can't just pill-and-cure a chronic, complex condition.” She goes on to tell me that family members have actually rolled their eyes when she has related to them that her daughter is immune deficient and cannot be exposed to colds and other germs.

Terry adds, “When your ex doesn’t believe the lab reports and influences your child against you, it is heart-breaking! With support, we could treat his symptoms instead of just taking him to a counselor, a podiatrist, a tutor….”  Too many stories echo that of Terry and her child, unfortunately. 

Beth speaks for thousands of parents when she writes, "The loss of your child as you knew him (or her) is challenging enough. To then be questioned about what you're doing for your child, while going through crisis, is absolutely unbearable. Whether or not your child is seeing the best doctors, whether or not you're doing enough, whether or not he is on too many medications or supplements, why he isn't in therapy, why he isn't in school, why he doesn't spend time outside, etc. is more painful than I can express. Whether these things are said to my face or I know they are said behind my back or both, the additional pain that causes is indescribable. I deserve as much love and support as any other parent who is dealing with a sick child.

PANS affects the family's role in the community at large. Gone are the soccer or basketball games, the scouting, the day trips to museums, the vacations to faraway (or near) places. Not only can families sometimes not afford excursions, but children who are ill are unable to participate because of symptoms.

"We don’t go on vacations," says Laura Carmichael. "We don’t go out to eat as a family. Social outings are a rare occurrence (and are usually cut short). We walk on eggshells because sometimes the slightest thing can cause rage. We’re trying different antibiotics, but we can’t afford IVIG, so we hope clearing the infection will eventually work to relieve his symptoms. We talk to other parents for support, and we put our faith in our PANS specialist to figure out how to help our son. But for now, we tread water." 
Beth implores, "Please ask me if I'm OK. Please ask me if I need to go for a walk, go for coffee with a friend, get out of the house and get a break from being on 24/7 suicide watch. Please just be there for me." She adds, "You cannot imagine the gut wrenching pain when you hold your wailing son after he slams his head against a wall for hours, and ask God to take him if this is what his life is going to be like. Nothing can prepare you for that kind of pain. You could never imagine having to feel that way. Just be there for us."
Jaime Heizler Tan is more fortunate than most in receiving strong support from family. "I wouldn't be where we are without the support of my family," Jaime says. "It takes a village. My parents come to every specialist appointment and conference that is offered. Being educated and armed with an understanding of how PANDAS manifests and can be treated is half the battle. I thank my lucky stars everyday I have their support!
Despite Jaime's challenges, she shares, "I believe PANDAS has made everyone's relationships closer. My daughter has a bond with her grandparents beyond what is typical. They have seen her at her worst and she now knows that no matter what, family will always be there. It can be both a blessing and a curse like any chronic illness. Luckily for us, it brought everyone together.

Moving Forward

Lynn Becker Haber writes: “We agreed to participate in the film, My Kid is Not Crazy, to spread awareness that we hope will lead those in need of immunomodulatory interventions to get appropriate treatments early on, before long-term impairments set in and make this harder to treat. The documentary gives a glimpse into the struggles faced by Gary and others affected by PANDAS. The ending is powerful and sad, but it is not the end of the story.”

“It’s totally a day-to-day situation sometimes,” says Stacy Rothman Fox. “And yes, we celebrate things others take for granted…a day without violence, a day without being cursed at, a day when our child isn’t miserable, a day when we can leave the house with our child…. We all celebrate and savor these days. We know that the next day we can be back in Hell.”

“My son just did a month of steroids," writes Heather Lovrich-Cooke, "which was fascinating. He suddenly could do math quickly and easily instead of taking forever to do one simple addition problem and the whole time saying "it is too hard and too much work." Rages came down 90%. Oppositional behavior was down 70%. OCD is down. He is acting more rational and socializing more typically. If we weren't fortunate enough to have learned of PANDAS/PANS, he would likely be misdiagnosed as ADHD, ODD, OCD and would not be receiving the anti-inflammatory treatment that just turned his life around in an undeniable way.” 

Gene and Suzanne assert: “We’ll get through this because we don’t really have a choice – there’s no way that we’re going to give up on them.  We’ll educate the doctors and the so-called experts and we’ll educate our communities, our friends, and our families.  We’ll pressure the insurance companies, and we’ll pass legislation if we have to.  We’ll get this done.”

Like the energizer bunny, we parents just keep ticking away, trying to find that mysterious cure that will save our children. While we have lost faith in some of the medical system, we do have faith in the perseverance of PANDAS/PANS and Lyme literate doctors. We have faith in ourselves to never give up.

Yet, this is not enough. There is not enough time to save our kids from losing their childhoods. Insufficient time, money and resources have thus far been invested in the research for these diseases, despite tremendous efforts of a few. These diseases are still considered “rare.” But when your child is the 1 out of 225 who is afflicted, that disease ceases to be rare. Instead, it is rarely and often belatedly diagnosed. PANS/PANDAS takes no prisoners. All who encounter it, whether parents, siblings or afflicted persons, are forever changed.


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Sending a special thank you and hug to all parents who participated and shared their experiences.