DC - Justina gets standing ovation from Congress

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Is it my imagination or has her hair loss has increased to a disturbing level. That is very concerning.

It does look worse, but it's hard to say for sure. We've seen photos where her hair is worn loose and no bald area is visible. When she wears it pulled back tightly the bald area really stands out.
But we don't know the cause. Maybe it is a reaction to some medication.

I do know that there is a psychological disorder called trichotillomania, an OCD-like disease that causes the sufferer to pull out strands of hair, creating bald spots. It happens in reaction to stress, and Justina is suffering enormous stress.
I do not think she has alopecia, another condition that causes baldness, because that disorder causes the loss of all hair, including eyebrows, etc.
 
There are no tests to diagnose a somatoform disorder.

But there are tests that can rule out all kinds of illnesses, including the muscle biopsy and blood workups that characterize mitochondrial disease. IMO, BCH and Yale would have done those in their effort to pinpoint whatever Justina has.

With psychological conditions such as somatoform, there are behavioral criteria that confirm that diagnosis, which are the "tests" for it.
 
There are no tests to diagnose a somatoform disorder.
Thank you for picking up my typo. I normally scan through my responses to avoid this kind of error. What I intended to say was "The court likely would have required, and DCF would have authorized any necessary tests to diagnose a mitochondrial disease.

... since you mentioned it, it is not completely accurate to say that there are no tests to diagnose a Somatoform disorder. It is true that there is no blood test or radiological scan that can definitively diagnose Somataform. However, there are a number of standard psychological assessments that are used to assess the patient's somatic symptoms, level of Hypochondriasis, and anxiety about their health and other issues. These tests are used in conjunction with the psychologist's evaluation and the absence of a medical explanation for the symptoms to arrive at a diagnosis of Somatoform Disorder. Like many medical and psychological issues, Somataform is a clinical diagnosis.
 
Clinical diagnosis: A diagnosis made on the basis of medical signs and patient-reported symptoms, rather than diagnostic tests.
 
From Rev Mahoney's twitter account:
"I can't go into detail right now, but Justina and the Pelletier family need our prayers right now. Please join with me." #freejustina
5:13PM December 11, 2014
 
It's annoying that they won't tell just what GI problems are going on. It also seems unusual to keep someone not deathly ill in the hospital lying in bed this long. I keep mentioning it, but am concerned that the flushes have somehow ruined her colon and they may remove it, leaving Justina with an ostomy.
 
It's annoying that they won't tell just what GI problems are going on. It also seems unusual to keep someone not deathly ill in the hospital lying in bed this long. I keep mentioning it, but am concerned that the flushes have somehow ruined her colon and they may remove it, leaving Justina with an ostomy.

That's an excellent point. The doctors must believe she still has some motility function or they would have probably already done a resection and colostomy.

Does anyone know how long she has had problems with bowel function? I know her father reported she had a congenital constriction removed but I don't recall what age that happened or if she had problems since birth.

I am in no way saying she doesn't have a physiological disease or disorder but the mind-gut connection has been the subject of many recent scientific studies. Stress and emotional upset will aggravate any GI disorder. Also, vice versa. Scientists have discovered that many of the chemicals that the brain uses to regulate mood are produced in the intestinal tract.

90% of the body's serotonin is found in the intestines where it is produced.

http://en.m.wikipedia.org/wiki/Serotonin


"Just as gut bacteria affect the brain, the brain can also exert profound influences on the gut microbiome."
http://www.apa.org/monitor/2012/09/gut-feeling.aspx

It sounds like seeing a psychologist or psychiatrist would be very beneficial to her. I hope her parents haven't become phobic about that. Some people believe admitting there is any kind of problem like that is an admission of moral failure. Nothing could be further from the truth, IMO.
 
A passing thought about a psychologist/psychiatrist: I believe I read her mother is from Romania, so I'm going to go ahead and assume therapy isn't welcome in the family. MOO pure speculation on my part.

I also wonder if the missing hair is from compulsive hair pulling... It seems to be localized in one spot. Of course we can't see the back of her head...
 
That's an excellent point. The doctors must believe she still has some motility function or they would have probably already done a resection and colostomy.

Does anyone know how long she has had problems with bowel function? I know her father reported she had a congenital constriction removed but I don't recall what age that happened or if she had problems since birth.



I am in no way saying she doesn't have a physiological disease or disorder but the mind-gut connection has been the subject of many recent scientific studies. Stress and emotional upset will aggravate any GI disorder. Also, vice versa. Scientists have discovered that many of the chemicals that the brain uses to regulate mood are produced in the intestinal tract.






It sounds like seeing a psychologist or psychiatrist would be very beneficial to her. I hope her parents haven't become phobic about that. Some people believe admitting there is any kind of problem like that is an admission of moral failure. Nothing could be further from the truth, IMO.

Far as I can recall from reading various reported stories, Justina has had the bowel issues for many year, beginning in childhood.
 
It was asked earlier if Linda Pelletier was from Romania. Here is what the long Globe story from Dec 15 2013 says:

"Linda, a sturdy, 55-year-old former skating instructor, had learned not to give up until she got answers. Although she never finished college, she prided herself on having the smarts to navigate difficult bureaucracies, skills she had learned from her parents, who had fled communist Czechoslovakia."
 
From Rev Mahoney's twitter account:
"I can't go into detail right now, but Justina and the Pelletier family need our prayers right now. Please join with me." #freejustina
5:13PM December 11, 2014

So does anyone know what was that about? Just the transfer?
 
So does anyone know what was that about? Just the transfer?

Nothing new has been posted for a while on the Miracle site; nothing new since the Meghan Trainor item. But when the Rev. gets into the act, it is usually followed up by a new heart-tugging pitch for donations. I strongly doubt that Pennsylvania DCF has gotten involved...that would trigger a flood of news stories and outraged comments.
 
So does anyone know what was that about? Just the transfer?
It is unlikely it was about the transfer. She was reportedly transferred on December 1st (and there is a post on the Miracle page on December 2nd from another mom at CHOP who had talked to Linda). Rev Mahoney's tweet was on December 11th. I think it is more likely that the family received news from the doctors that they were less then happy with and have chosen not to share publicly.

I did find it interesting that Rev Mahoney's tweet was not reposted on the Miracle site and was not commented on at all. That is very unusual. His past social media postings have been reposted and extensively discussed. In fact, Rev Mahoney has often been the first person to publicly discuss downturns in Justina's health and negative situations. He was the first to report both hospitalizations at Yale New Haven, the meeting with the doctors, and the possibility of a transfer. The wording of this unanswered tweet - that he could not reveal details but they needed prayers - certainly leads me to believe there is something very negative that the public is not being told.
 
It is unlikely it was about the transfer. She was reportedly transferred on December 1st (and there is a post on the Miracle page on December 2nd from another mom at CHOP who had talked to Linda). Rev Mahoney's tweet was on December 11th. I think it is more likely that the family received news from the doctors that they were less then happy with and have chosen not to share publicly.

It is very unlike them to go silent for so long. I hope this does not mean that Justina has grown even more ill. Perhaps it is that the family has received a diagnosis that rules out mito, and they are figuring out how to spin that. In any case, I hope Justina will do better in CHOP than she has so far at home or at Tufts, CT Children's. BCH or Yale-NH.
 
A new posting today on the Miracle site thanks supporters for sending gifts and cards to Justina and then says more would be welcome and gives their home address. But not a word on her current condition, diagnosis or treatment. So we still do not know why the Rev. rang the prayer alarm bell the other day.
 
A new posting today on the Miracle site thanks supporters for sending gifts and cards to Justina and then says more would be welcome and gives their home address. But not a word on her current condition, diagnosis or treatment. So we still do not know why the Rev. rang the prayer alarm bell the other day.

They recycled a picture they posted during her hospitalization at Yale New Haven, again asked for gifts, and gave their home address all while she is reportedly still hospitalized in Philadelphia? I realize that her sisters are driving back and forth to visit her, but why would they want the added hassle of dealing with hauling gifts (4+ hours) to PA? If they are concerned about inappropriate content, why ASK for gifts at all? Are they opening the packages before they give them to her? The fun of receiving mail for a hospitalized child is usually the mystery of opening the package, not the accumulation of "stuff." And honestly, the accumulation of "stuff" is a problem of its own. Like many children's hospitals, CHOP has some fairly strict rules about the amount of stuff you can bring into the room. A comfort item like a blanket is welcome (as long as YOU are washing it regularly) - multiple blankets and pillows and personal sheets on the bed are generally not. A couple of (regularly washed) stuffed animals, cards and notes pinned to the walls or bulletin board, and a few Mylar balloons and/or flower arrangements are welcome and encouraged - an explosion of "support" gifts are generally not. Depending on the type and size room she is in, she just does not have much room for tons of stuff. CHOP actually has written policies asking long term hospitalized patients not to bring more then 1 week's worth of supplies (clothing etc) into the room at a time and all patients to keep personal items off of counters, bedside tables, windowsills and the floor. http://www.chop.edu/patients-and-vi...-visit/guidelines-clean-safe-room#.VJRn2coAIA I am guessing that they are well aware that the hospital does not want to be flooded with gifts and cards and stuff (and the associated debris) for a single patient, which is why they are asking people to send it to their home. But in that case, why ask for it at all? Why not ask for web greetings, youtube videos, etc like they have in the past? Someone posted to the "Miracle" site asking that they provide names of OTHER children at CHOP who would like to receive mail. So far, they have not responded. It will be interesting to see if they do.

Hospitals work very hard to get all but the most critically ill children home for the holidays. She can go home in a wheelchair if she is unable to walk, she can go home with a feeding tube if she is unable to eat, she can go home with an IV if she is unable to drink, she can even go home with appropriate care if she is unable to use the bathroom. Family members can be trained to give IV medications or home health services can be ordered. If she is not released in time for Christmas, it means the doctors are treating her for something other then mitochondrial disease. This could include things like cancer treatment that can't be temporarily stopped, organ support while waiting for a transplant, more extensive life support, psychiatric care, or concerns about abuse or neglect in the home. I would rule out the first three immediately life threatening issues because if she had cancer or organ failure, the Pelletier family would tell the world - while, of course, blaming Boston Children's Hospital. Unless I am missing something, that would leave severe psychiatric issues (mild to moderate issues would allow her to go home with support) and child abuse. Wasn't that Boston Children's Hospital's and MA DCF's contention all along???

The above is, of course, my opinion only.
 
snipped
I strongly doubt that Pennsylvania DCF has gotten involved...that would trigger a flood of news stories and outraged comments.

I don't think PA DCF is involved to the point of taking custody. I do believe that, at a minimum, they are monitoring this case very closely. This is a very high profile situation with past allegations from 2 different state DCF's and at least 2 different hospitals. If CHOP did not inform PA DCF that she was inpatient there, and something happened, the hospital would be negligent. If DCF knows she is there and does not at least keep a watchful eye on the situation, and something happened, DCF would be negligent. I personally believe that either the social workers are handling the family very well and soothing their tempers while they work with them, or the family has learned that fighting and belligerence are sure ways to lose custody - at least temporarily. If they lose custody of Justina again, their core rabid supporters will go crazy, but most of their more levelheaded supporters will realize that there is something truly amiss.

I also believe that CT DCF was monitoring the situation while Justina was at Yale New Haven Children's Hospital. We did not hear anything about it because they did not go to court to seize custody. However, that does not mean that they were not visiting Justina regularly, monitoring her care, and evaluating her family situation to make sure that it was safe to send her back home again. I believe that every time they seek hospital/surgical care for Justina in the next few years, some sort of social service support will be brought into the loop.

Just my opinion.
 
Once again, we are grateful for these well-informed, well-reasoned and very well-written posts from Annahanna.

IMO, these recent posts make a good case for the suspicion that Justina has a serious and so-far undisclosed health issue. If she does not go home for Christmas, I agree it would suggest it is really serious and it could well be a psychological condition.

IMO, it's fine for the family to request prayers from their faithful followers. But it's more than a little icky that they keep asking for gifts and/or money donations.
 

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