Sunday, November 18, 2012

Evans Syndrome: A Family Affair

Contributed by Joe Camilleri

Introduction

In 2007 and again in 2010, I was diagnosed with Evans Syndrome - a rare autoimmune disorder in which the body produces antibodies that destroy the red blood cells, platelets and white blood cells.  It has no known cause and is not believed to be hereditary. However, my situation appears to be unique even for this relatively rare disease.

Background

I was born on the island of Malta and immigrated to the United States in the 60's with my family as a child.  My older brother, who was also born in Malta, was diagnosed with ITP as a baby.  The disease went away without any treatment.

I had an uncle in Malta, who passed away from an unknown blood disorder before I was born.  It is now speculated that the disease might have been ITP and/or hemolytic anemia.  His son, who eventually immigrated to Australia, was diagnosed with ITP several years ago.  The disease went into remission after splenectomy.  He passed away last year but I don't have details because I had only recently discovered that he was my cousin.

My sister, who was born in the United States, was diagnosed with ITP about 10 years ago.  She was treated with Prednisone and the disease went into remission where it has remained.

My Struggle

I was diagnosed with Evans Syndrome in 2007.  It was initially treated with Prednisone but its effects were very short-lived.  My hematologist recommended splenectomy but I refused since my spleen was healthy and functioning normally.  A very low platelet count helped my argument against the surgery. 

At that time, Rituxan was being used as a cancer treatment but not widely used for the treatment of other diseases.  My hematologist said it had to be a last resort but I convinced her to try it anyway.  The treatment appeared to work after several weeks.

The disease went into remission for six months, after which, my platelets dropped sharply.  Once again splenectomy was recommended and once again I refused.  Rituxan was tried again and, after several weeks, the disease again went into remission.

In September of 2010, I was once again diagnosed with Evans Syndrome.  This time the disease was a little harder to get under control and I received many blood transfusions.  I was given a dose of Cytoxan to stop the hemolysis and once again treated with Rituxan.  After several weeks, this miracle drug once again came to my rescue.

My Daughter's Battle

Immediately after I had recovered from my illness, my daughter started complaining about tingling in her legs and occasionally seeing spots.  She had a sinus infection and we thought that it was somehow related.

 Her physician recommended a CT scan in order to rule out a brain tumor.  The day after the CT scan, my daughter started vomiting.  We took her to the doctor again after this continued for several days.  We were told that it was simply the flu and that the results from her CT scan were normal.

The vomiting continued on a daily basis and many tests were done but each time we were told that everything was fine.  The nurses at the physician's office were clearly becoming annoyed with my many phone calls.  My daughter was referred to a surgeon (not really sure why) who simply said she did not need surgery but recommended another CT scan.  My daughter had not been able to hold down food for weeks and now she was asked to drink the Barium shake.  That was horrible!

With still  no answers and increasing desperation, we decided to take my daughter to Emergency because her finger tips appeared shriveled.  I thought that she might be dehydrating.  After a very long examination, the ER doctor said my daughter's kidneys were functioning at 16% and that she would be admitted for treatment.

The Real Nightmare Begins

 The sinus infection could not be treated until my daughter's kidneys had recovered to a safe level.  After a couple of weeks of treatment, her kidneys stabilized and antibiotics could be administered.  Immediately, my daughter started complaining about intense tingling in her legs and trouble moving them.  The antibiotics had triggered an autoimmune response.  After the diagnosis was repeatedly changed, it was finally considered to be ADEM - an immune mediated disease of the brain.  Left untreated, the paralysis which started in the legs, would work its way up the body until the respiratory system was affected resulting in death.

Treatment for ADEM was identical to that for Evans Syndrome - Prednisone and IVIG.  After her condition stabilized, my daughter was released to a rehabilitation hospital to try to regain the use of her legs.  She was told that she may always have a mobility problem.

My daughter went to physical therapy and returned to school in a wheelchair after missing much of her senior year of high school.  Her goal was to walk again when she graduated.  She achieved her goal and made plans to attend college but not before following in my medical footsteps.

Evans Syndrome Strikes Again

Everything seemed to be returning to normal when my daughter complained about feeling badly.  We assumed it was due to her impaired kidney function and took her to the hospital.  Tests showed that her hemoglobin had dropped sharply.  Since she was still technically a pediatric patient, her treatment was a little different than mine.  Her hematologist had her do plasma pheresis, then prescribed Immuran, Prednisone, IVIG, countless units of blood, and finally Rituxan. 

My daughter's hemoglobin was 3.1 at its lowest point.  It took about 8 months until her hemoglobin approached the normal range.  After it did, it was her platelets turn to crash.

Since she had turned now 18, we transferred my daughter's care over to my hematologist.  He started with Prednisone but, like me, she showed only a modest initial response then nothing.  She started a Rituxan treatment and ultimately responded as I did.

Fighting the Disease

Rituxan appeared to play a key role in combating Evans Syndrome for my daughter and I.  However, I believe that a good support system and faith are also keys to overcoming this disease.  To me, the psychological stress was far worse than the physical symptoms.

For anyone interested, I kept a diary of my second battle with Evans Syndrome.  You may read it or watch the video presentation at http://passionwind.com.   It was my intent to record my most intimate thoughts as I once again battled this terrible disease.  I was sure that God would once again answer my prayers.  What I experienced was beyond my wildest imagination.  My story is hard to believe but none of it is fabricated or exaggerated.

I pray that you may find a bit of comfort or inspiration in what I have written.  If you or a family member is experiencing Evans Syndrome, it is easy to feel overwhelmed and desperate.  However, never lose hope.  God answers prayer.  I am not sure I honestly believed that before I got sick.  I am quite convinced of it now.

Copyright © 2012 by Evans Syndrome Community Network. All rights reserved.




Monday, August 6, 2012

Carter's Story

Contributed by Carter's Mom

Carter's Family
Our son, Carter, is a fun, energetic, absolutely adorable almost-3-year-old little boy. His story began when we found out we were spontaneously expecting not one, but two babies at our 11 week ultrasound. It was a smooth, uneventful pregnancy until my water broke, out of the blue, at 25 weeks.

Fraternal twin boys were born 3 days later, 15 weeks early, weighing just under 2lbs each.  The first 3 months of life were spent in the NICU (neonatal intensive care unit) at the University of Michigan. It was touch and go for a while and a roller coaster of ups and downs but we were extremely blessed that our boys came home strong and healthy.

One year from bringing the boys home, feeling settled into our life as a family, we were out in the yard on a snowy winter day for the boys' first sled ride. They were all bundled up in baby-blue snowsuits, and wearing sunglasses.  We had fun pulling them around. When we came inside and were taking off Carter's hat, we noticed some purple dots where the hat sat on his forehead and around his chin.  We chalked it up to either some sort of a heat rash from being bundled up or to having sensitive skin like his Dad and blamed the hat for causing the irritation.  This was on a Saturday.  

A curious and nervous mom who is the need-to-know type, I jumped on the computer to figure out what those purple dots likely were. On many pages it stated that petechiae (broken blood vessels forming tiny dots under the skin) is the only rash that is a medical emergency. Carter's spots did resemble those in the pictures, but he only had a few, unlike the pictures showing head-to-toe coverage.  As the weekend went on and the spots remained we decided to give the pediatrician a call on Monday, feeling OK that we waited based on the fact that Carter was exhibiting no other signs of being ill. The call prompted an appointment and the pediatrician immediately recognized the dots as petechiae.  However, from the minimal amount of spots, he assumed the platelet count might come back around 60,000 - 80,000, and that it was likely pediatric ITP (immune/idiopathic thrombocytopenic purpura) from which Carter would bounce back from quickly.  We were sent for a blood draw in the lab downstairs, and told we'd either get the results the next day or after hours if it was urgent. The day went on as normal with the precaution to make sure Carter avoided major impacts/falls.

Around 8pm the doc on-call phoned. In a calm manner, she asked where Carter was and how he was doing (he was peacefully sleeping in his crib) and then she informed us that the platelet count came back at 5,000. We had read enough to know this was critically low. Carter was happily asleep in his bed, so once we had family on board to take care of his brother, we were off to the ER for a hospital admittance and treatment with IVIG. There were talks of possible leukemia. We experienced immense amounts of stress from being back at the hospital we were discharged from just one year ago. We were now on the hematology/oncology floor, sharing a room with a very sick little boy fighting brain cancer.

Carter responded to the IVIG, and we were sent home with a platelet count of 73,000. Five days later the count was 90,000 and we thought we were on the way up and in the clear; so did the docs. Four days after that we noticed some spots (petechiae), and went for a blood draw that came back at 7,000. What?

The story went back and forth like this for most of the next 4+ months, as Carter was treated with both prednisone and IVIG. Finally, in May, a remission was hit after bottoming out with a platelet count of 1,000 around Mother's Day.  Carter has held strong with platelet counts ranging from 200,000 to 500,000 since (14 months).  Fingers crossed and lots of prayers still being said. The remission was finally hit after trying IVIG and prednisone combined, having tried them separately with transient response. We/the docs considered Rituximab, but we were skeptical/nervous and opted for a trial of IVIG and prednisone first, and it worked (along with many prayers).   

The first two blood draws when this all started in January 2011 revealed neutrophil counts of 300 and 1300. Carter had just overcome a cold, and the lower counts were thought to be from fighting that. Other than doing a bone marrow biopsy to rule out leukemia (ok 3 bone marrow biopsies — first sample was bad (terrifying/devastating), second was for a better sample, and third was after treatment wasn't working to make sure nothing was missed), not much attention was given to the low neutrophil count...In fact they didn't even order it on a handful of blood draws. However, as time went on and Carter's neutrophil count remained in the low to extremely low range, the docs' concern grew. The bone marrow biopsies both revealed that Carter had 10 times the amount of "baby" neutrophils than the average person. More blood tests revealed an antibody present to his neutrophils, as well as one to his platelets.  So, his body was essentially tagging and destroying the neturophils and then working in overdrive to make replacements.

Coombs tests were run twice, the first negative, the second positive. However, so far we have been blessed to stay clear of hemolytic anemia.

A diagnosis was given after ruling out many other things and going for more blood work than one could imagine a 15 month old could have gone through.  We also took Carter for a second opinion appointment at Children's Hospital of Detroit (Carter is seen at the University of Michigan), and received two opinions from docs out of state via phone and sending medical records. It took a few months to unravel Carter's case, but Evans Syndrome is his diagnosis. 

To keep a twin baby-turning-toddler boy safe from falls, bumps, and bruises was extremely challenging. He and his brother were just learning to stand and walk, and so up went adhesive bumpers on all the corners of the house and furniture. The entire first floor of our house has hardwood, so we covered that in those colorful play mat tiles you can buy. More time was spent on walks and in the pack-and-play to try to keep the bumps and bruises at a minimum. Helmets were purchased to protect Carter's little head from falls, especially when we played outside. And, we limited tumble time with his twin brother as much as we could without restraining him from being the fun, energetic little boy that he is.

Carter became really puffy from the prednisone and had petechiae and bruises from head to toe, as well as a large hematoma on his arm (that we called 911 for when we were new to all of this). It was extremely hard, to say the least.  We did all we possibly could to protect him and keep him safe. We thank God every day for the remission we hit with the platelets, and pray the neutrophils will follow in time.

The miracle about all of this is that Carter is beaming with energy and other than the blood draws, which he tolerates very well, he shows no other signs of being "sick.” He runs, jumps, plays, and wrestles with his brother just as he should. We are now on an every-other month blood-draw routine, which is fantastic compared to when we were going multiple times a week.

We know at almost 3 years old Carter's story has barely begun, but it has been so eventful from the start. 

To cope with having sick children is not easy, from a simple cold or virus to things much more complicated such as extremely premature birth and Evans Syndrome.

My mother has Lupus and Rheumatoid Arthritis, and so do three of her cousins, as did her Grandmother. I personally believe there is/can be a genetic link to autoimmune diseases, even if not completely proven by science (yet). With that said, who knows what the future holds. Obviously we hope and pray for a clean bill of health.

When faced with the ITP and neutropenia without it being leukemia or other suspects, the docs struggled for answers. I took it upon myself to read medical journal articles, contacted those who wrote ones that seemed relevant and found some wonderful, extremely helpful docs out there. All I want is for my son to be OK and live a long, healthy, happy life. I want to do all I can to help him because, although we have found some wonderful doctors, there seems to be a kind of disconnect out there in the medical world. Although I did not find it until Carter hit a remission, The Evans Syndrome Community Network has made me feel so much less alone. I kept saying to my husband and family when this was all happening that Carter could not be groundbreaking medical information; there had to be someone, somewhere who had or was going through this, too. I wanted to go on the national news and find somebody! I did even better finding this group.

May all who encounter Evans Syndrome be blessed with long remissions and may we one day find a cure.

Copyright © 2012 by Evans Syndrome Community Network. All rights reserved.

Saturday, July 21, 2012

Conner's Story

contributed by Amanda Ballesteros

Conner Ryan Lloyd 1999 - 2012
I would like to share with others the story of my Angel, Conner Ryan Lloyd, in the hope of helping others struggling with Evans Syndrome, and to let them know they are not alone. 

My son was born a healthy 8-pounds 9-ounces on September 12, 1999.  He was a perfect baby and always happy. 

In 2004, our lives changed forever. Conner started to develop bruises almost overnight. Some thought this was a case of abuse, and an investigation was opened. We ended up at Primary Children's Hospital in our hometown of Salt Lake City, Utah. 

After undergoing blood tests, we discovered Conner had ITP. He was given an infusion of IVIg, and I thought everything was going to be OK. 

A few months went by. Conner developed a cough. I took him for a check up, and they found his hemoglobin (red blood) was low. We went straight to the hospital for additional testing. After the bone marrow biopsy came back negative for cancer, we were able to sigh relief. The blood test came back Coombs positive, and the disease rare: Evans Syndrome. 

Conner was in and out of the hospital every couple of months for mostly minor low blood counts, and he always responded quickly with a treatment and prednisone. It was difficult for our family to adjust to hospital stays and treatments, but after a while we adjusted to the situation knowing it would be a chronic illness.  

Eventually we decided to give rituximab a try. Conner went into remission for 8-9 months at a time! My son was actually able to live a normal, healthy boy's life. 

In May 2012, Conner wasn't feeling well. Stomach pains, anemia, and fatigue. We were admitted into the hospital. After 11 blood transfusions, IVIG, 500 mg prednisone, Cellcept, rituximab, and a splenectomy, Conner lost his battle with Evans Syndrome. It was June 8th, 2012. His kidneys were very stressed and not able to release all the toxins from treatments, and his potassium count rose to a level that stopped his heart. 

A parent never prepares themselves enough to lose a child. I honestly did not think Conner would have passed from this disease and its complications of treatment. I don't know if there was another underlying disease that he may have had, but the pain that Conner suffered is now over. May he rest in peace. 

Conner wanted to be a doctor so he could help other kids going through a chronic illness. I believe sharing his story is a way of helping him achieve this goal. He is an amazing, brave, and dearly missed little boy. 

As part of the Evans Syndrome Community Network, I have met some wonderful families in support of raising awareness and promoting research on autoimmune blood diseases including Evans Syndrome. I want to be a part of the support that families and individuals need when suffering from this illness. I want my son's name to always be remembered. Hopefully his story helps another. 

Amanda Ballesteros
Mother of Conner Lloyd 09/12/1999-06/08/2012

Copyright © 2012 by Evans Syndrome Community Network. All rights reserved.

Wednesday, July 11, 2012

Our Family Vacation

contributed by Janet Shull Shepherd

Our journey began four years ago when Brenna was 10 years old. She had a bad virus which resulted in hemolytic anemia. She was hospitalized, given blood transfusions and steroids. Doctors assured us that it was a freak thing, and that it would never happen again. 

Fast forward--two years later...Brenna was 12 years old, Zach 16, and Jared 9. My husband and I took the kids to a beach for vacation that August. Brenna started to have bruises pop up, and purple dots on her legs, arms, and the inside of her mouth. She also started her first period, and was bleeding heavily. We took her to an urgent care clinic and they sent us for blood work. 

The doctor called our rented condo and told us Brenna's platelets were 2,000, and her hemoglobin was 5. He told us to go to the nearest hospital, and that we would be transported two hours away to a children's hospital. I went into shock and started packing up our clothing for the trip. My husband drove us to the hospital. We went on to the children's hospital, and Bill went back to the condo to stay with the boys. We were about 11 hours from home, and I had no idea what was really happening with Brenna. I just knew it wasn't going to be good. 

Once we arrived at the children's hospital, they started two IV lines to give Brenna blood, platelets, estrogen, steroids, and IVIg, plus some other things to try to stop the bleeding. She was hemorrhaging: It was more blood than I had ever seen. The doctors said she lost all of her blood volume. 

To make matters worse, my youngest son had a seizure that same night. He'd had one other seizure the year before. When my husband called and told me about Jared's seizure, I broke down. 

My parents drove down and picked up the boys. Bill came to the hospital to be with Brenna and me. It was 6 days before Brenna was stable enough to make the trip home. 

Brenna remained on steroids and was repeatedly hospitalized for IVIG and other treatments before she went into remission three months later. She missed 67 days of school that year. Our lives had become a living nightmare, and we have been riding a roller coaster ever since. 

Brenna was diagnosed with Evans Syndrome and Lupus. She has chronic hives, chronic fatigue, and is frequently too dizzy to function. She has also developed depression and anxiety issues. She is very worried about starting high school this year, and missing days due to being sick. This is so overwhelming at times, and the worry and stress I have for her consumes me. I try to stay positive on the outside, but seeing my daughter suffer tears me up on the inside. 

I keep all who are suffering with Evans Syndrome and Lupus in my prayers, and pray that there will someday be a cure for autoimmunity. 

To parents who are dealing with this: I think our strength just comes from God, as difficult as it is at times we have to be strong for our children. We can curl up and cry when we are alone, but when we are by our childrens' sides, by their beds, in hospitals, during doctors appointments, we have to be their advocates, their rocks! Stay strong--You're not alone!

Copyright © 2012 by Evans Syndrome Community Network. All rights reserved.

Monday, July 2, 2012

My Story

contributed by Kim Wright


It was 2005. I had flu-like symptoms, was very lethargic, feeling sick. I also had a terrible headache. No matter what I did, I just couldn't get rid of the headache. After five days of laying in bed in agony, my mum said enough was enough, and called for my GP. 

The doctor came to my home and tested my urine for possible pregnancy, but that was negative. My mum is an insulin-dependent diabetic, so the doctor also tested my blood sugar levels. This revealed I was slightly hypoglycemic but that was because I hadn't been eating for several days. After the tests, my doctor rang for an ambulance, as I was on the verge of losing consciousness. 

At the hospital, I had more blood tests, and was placed in quarantine: Originally they suspected meningitis. They put me on 100 mg of prednisone folic acid, as well as a vitamin tablet. That's when I met my haematologist, Dr. Watson. He came out of semi retirement because I was a cause for concern. 

Four days later, I was moved onto the hospital's blood ward, where I was told I had a condition called autoimmune haemalytic anemia. My haemoglobin had dropped to 2, which is what caused the headaches. I was given five units of blood. 

I remember this as a very distressful time. I broke my ankle three weeks prior, so I was still recuperating from that when I was in the hospital. To this day, I suspect the trauma of breaking a limb triggered my Evans Syndrome. I was given morphine for pain, and my condition was downgraded, but when I tried to go to the bathroom by myself I collapsed. There was not enough blood to circulate through my body. The second time it happened, my heart had to be restarted. 

After three units of blood, I started to feel a lot better, and was sent home after 9 days on 80 mg of prednisone. When I returned to Dr. Watson for my follow-up appointment, he told me that I had Evans Syndrome. 

In June of 2006, my platelet count dropped dramatically. I bruised at the slightest touch, and my menstrual period was unusually heavy. Dr. Watson put me on a treatment called rituximab. Thankfully, I responded.

In November of that same year, I miraculously fell pregnant. The baby was due in August of the following year. However, not long into the pregnancy, I was told by a doctor that I should consider terminating my pregnancy: The effects of rituximab on the unborn were unknown, and my child could end up with disabilities. 

I didn't even have to consider the possibilities: I would continue the pregnancy and give my child a chance. I gave birth to a perfect baby boy weighing 6 pounds 9 ounces, 6 days overdue, by c-section. We will celebrate his fifth birthday this year. 

I have been on and off steroids now for 7 years. I have been given somewhere around 40 blood transfusions. Personally, I have found Azathioprine to be the best treatment for me. Currently, I'm on 200 mg daily, with no side effects. 

I do suffer in other ways: I have irritable bowel syndrome, rheumatoid arthritis, and I battle with my weight because of the steroids. Sometimes I get very tired, but I'm still up-beat, and I don't let this get to me. 

The main thing is that I'm alive. I don't worry about relapse, and I pray for treatment success…I don't think I would be human if I didn't. I fight…and I win. 

In between all of these years, I contracted Legionnaires Disease. I was in intensive care, and was left with weakness in my left lung. I am now prone to chest infections, which lead to pneumonia. I always have back up antibiotics at home, as infections seem to be a main cause of allowing my platelets to drop. I've learned the signs, and I'm quick to react.

I owe Dr. Watson a great deal. He is not just my consultant: He and the members of his team are my friends. I can turn to them any time. 

I am now 29 years old. I hope my story helps. Thank you for reading.


Copyright © 2012 by Evans Syndrome Community Network. All rights reserved.

Thursday, June 7, 2012

Regarding Natural and Holistic Approaches to Treatment of Evans Syndrome


by C. McNamara Romanowski


Over and over we hear inquiries about natural approaches to treatment of Evans Syndrome. Our answer always has to be the same: Please check with your doctor before making any changes to your diet and/or medication. 


It would be nice if we could find a cure for Evans Syndrome in nature. And to be completely honest, a lot of the medicines we use today actually got their start in nature. Here are some interesting facts  (from David T. Teachey, MD):

  1. Most modern drugs are originally from nature. For example, Rapamycin is a drug that is currently being investigated in clinical trials for treating children with Evans Syndrome. Rapamycin comes from a bacteria that lives on the shore of Easter Island (known as Rapa Nui to the natives—hence the name of the drug). 
  2. Not all things from nature are good for you—arsenic, cyanide, and hemlock for example. These substances are poisonous…and they are found in nature. 
  3. With alternative medicine, you don't really know what you are getting. There are no FDA regulations on alternative medicine approaches.  Because of this, you could buy two (2) bottles of ginko from the same company, and one might have 100-times more ginko per pill than the other. 
  4. Herbal medicines can interact with other drugs. Check to make certain that there are no drug interactions before starting anything new (natural or prescribed by your doctor). 
  5. Some herbal products that are advertised as recommended for Evans syndrome can cause bleeding, and are therefore a bad choice in someone with Evans Syndrome.

Ultimately, the most important thing is to talk to your doctor before starting anything. Drugs.com is a great website to check for drug interactions and side effects.

Be proactive by double-checking information you get from your pharmacist. Stick with the same pharmacy all of the time: Your pharmacist knows what drugs you are taking and can make sure none of them will interfere with each other. Even talk with the pharmacist about non-prescription remedies, to make certain your prescriptions won’t be impaired by something over-the-counter.


For example: St. John’s Wort, in the US, is recommended by herbalists for treatment of depression. There is no standard dose or regulation that prevents a person from taking as much as desired. St. John’s Wort can cause an increase in serotonin levels, leading to a condition known as serotonin syndrome. Withdrawal symptoms can be extreme, and include excessive tremors, hot flushes, increased anxiety, and restlessness. On top of that, St. John’s Wort can interfere with prescription serotonin reuptake inhibitors such as Zoloft, Prozac, and so on. In the US, St. John’s Wort is viewed as a benign herb, however in the Republic of Ireland a prescription is needed for St. John’s Wort. (http://en.wikipedia.org/wiki/St_John's_wort)


Remember...you are your own best advocate, and the advocate of your children. It’s up to you to make sure you get the most appropriate care, are on the appropriate meds, and eating the appropriate diet for your circumstances and health.


Copyright © 2012 by Evans Syndrome Community Network. All rights reserved.

Every Day Is a Gift


Contributed by C. McNamara Romanowski

My name is Constance. I am 51 years old. Seven years ago, I was diagnosed with Evans Syndrome.

There were signs that I had a problem with my immune system for many, many years, actually beginning around age 2 when I was first diagnosed with a severe allergy to penicillin.  Around age 7, I was diagnosed with eczema. At age 15 I was placed on birth control pills to control crazy menstrual cycles. At 29, it was Hashimoto’s thyroiditis. In my 30s, I developed numerous allergies to various medications, primarily sulfas. Also, I started having problems with unexplained pain throughout my body. Sometimes I wondered if I would see my 40th birthday.

When I made it to 40, I thought, “Wow, every day from here on out is a gift!”

On my 44th birthday, I was diagnosed with Evans Syndrome following a lengthy period of decline that culminated in a hospitalization.

Treatment  consisted of blood transfusions, IVIg, and finally rituximab. Not so very long after my last rituximab infusion, my blood counts skyrocketed to normal but then I started having trouble breathing.

On my 45th birthday I was diagnosed with massive pulmonary emboli in both lungs due to Factor V Leiden and a Lupus trait to hyper-coagulate. Once my Evans had been brought under control, it gave the hyper-coagulation tendencies in my body a chance to wreak havoc. My life was saved by a catheter into my lungs, injecting strong anti-coagulants directly into the clots.

Sometime during my 45th year, I was diagnosed with fibromyalgia, and then Lupus. I have been lucky, though. So far, Lupus doesn’t appear to have affected any of my organs.

Throughout this journey, I have sought information with regard to what’s happening to my body. In particular, it was difficult to find much information on Evans Syndrome. Because of that, my husband, William, and I decided to start a network of people who shared this diagnosis. The Evans Syndrome Community Network was born.

Speaking figuratively…We are from every continent; we are every race; we are every age; we are every sex. We are the Evans Syndrome Community, and we are united. We may be rare, but we are not alone. Together we will make a difference, standing shoulder to shoulder.

I have been asked, “Who are your heroes?” 

I really have to answer: "My heroes are my doctors and nurses and all of the other individuals who have participated in my healthcare. My heroes also are all of the moms and dads and grandparents and spouses out there who are caring for a person with Evans Syndrome. My heroes are those who have Evans Syndrome and fight every day to overcome its obstacles."

Today I am on blood thinners, and I am in remission from Evans Syndrome. Every day is indeed a gift…every breath, a joy.

Copyright © 2012 by Evans Syndrome Community Network. All rights reserved.