WEBVTT 00:00.000 --> 00:30.000 position:50% align:top line:0% *This machine-generated transcript may have errors. If remediation or a manually-generated transcript is needed, please contact NLM Support at https://support.nlm.nih.gov.* 00:04.920 --> 00:05.780 Hi Jenna. 00:05.790 --> 00:07.900 It's nice to see you today. 00:07.910 --> 00:10.700 Would you like uh old humpty dumpty? 00:10.720 --> 00:11.880 Okay. 00:11.890 --> 00:12.830 There you go. 00:12.860 --> 00:13.270 Well, 00:13.270 --> 00:13.940 Mrs Jackson. 00:13.940 --> 00:15.700 It's nice to see you again the other day, 00:15.700 --> 00:18.140 we had an opportunity to talk to you about your son, 00:18.140 --> 00:20.840 Jeff and his health problems and 00:21.500 --> 00:24.410 established his medical record here in our 00:24.410 --> 00:25.090 clinic. 00:25.100 --> 00:28.040 And today we're looking forward to the opportunity to 00:28.820 --> 00:31.080 hearing from you about Jenna. 00:32.550 --> 00:35.390 You told us that 00:35.400 --> 00:38.090 Jeff had congenital adrenal hyperplasia was 00:38.090 --> 00:40.830 identified when Jenna was born. 00:40.830 --> 00:43.790 And so the thing I think we'd like to hear about first 00:43.790 --> 00:46.080 is how all this happened. 00:46.350 --> 00:49.280 And from the 00:49.280 --> 00:50.310 beginning from the beginning, 00:50.310 --> 00:52.100 from Jenna's when Jenna was born. 00:52.100 --> 00:54.090 And you first encountered this problem. 00:54.100 --> 00:55.630 Let me see if I can't quiet her down. 00:56.170 --> 00:57.960 Be quiet now while mommy's talking. 00:57.960 --> 00:58.420 All right, 00:59.250 --> 01:01.770 okay, 01:01.780 --> 01:02.150 Well, 01:02.160 --> 01:02.720 that's well, 01:02.720 --> 01:05.550 just those kind of happy sounds. 01:05.560 --> 01:07.740 Don't bother us one bit okay, 01:08.610 --> 01:11.510 when she was born and she had we had 01:11.510 --> 01:14.330 Dr Mackenzie smith come in to give her the once 01:14.330 --> 01:16.080 over as all newborns, 01:16.080 --> 01:16.700 I guess. 01:16.710 --> 01:19.700 And he detected that she, 01:19.750 --> 01:21.830 I'm not sure on this. 01:21.830 --> 01:24.610 You might have to check the records yourself to see exactly how 01:24.610 --> 01:25.150 this goes, 01:25.150 --> 01:26.950 but either she had 01:26.950 --> 01:29.410 a it's a fused 01:29.420 --> 01:30.900 vaginal opening. 01:30.910 --> 01:33.600 So in order to get to the bottom 01:33.610 --> 01:35.490 of why this happened, 01:35.500 --> 01:38.350 he did suspect maybe this could be the 01:38.350 --> 01:41.130 adrenal problem because also her coloring, 01:41.130 --> 01:42.870 which was a little dark. 01:42.880 --> 01:45.770 And So they 01:45.770 --> 01:48.770 did a 24 hour urine test in the hospital, 01:48.770 --> 01:49.940 which wasn't, 01:50.070 --> 01:51.480 they didn't complete it. 01:51.480 --> 01:53.160 It was a little difficult to do it? 01:53.180 --> 01:53.810 So, 01:53.810 --> 01:55.520 at three weeks of age, 01:55.530 --> 01:58.010 she went into the hospital and had 01:58.010 --> 02:00.950 to 24 hour urine collections. 02:00.950 --> 02:03.770 And then this detected that this is a, 02:03.780 --> 02:05.600 you know what she did indeed have. 02:05.610 --> 02:06.570 Okay Jenna, 02:06.570 --> 02:08.020 if you want to go out with her some toys, 02:08.020 --> 02:09.290 you just go right ahead. 02:10.820 --> 02:12.550 So she was in the hospital. 02:12.560 --> 02:15.440 The abnormality was something the doctor picked up in 02:15.440 --> 02:17.930 the general area with the fused vaginal folds 02:18.350 --> 02:20.530 and perhaps some 02:20.540 --> 02:22.720 darkening color of the skin. 02:22.740 --> 02:24.460 And then after a couple of weeks, 02:24.460 --> 02:27.010 just to be sure they had her in the 02:27.010 --> 02:29.720 hospital to collect urine for 24 hours for two 02:29.720 --> 02:30.770 consecutive days. 02:33.110 --> 02:35.830 And after that test was done then 02:35.840 --> 02:38.780 uh DR Mackenzie smith talked to you about the 02:38.790 --> 02:39.560 problem. 02:40.460 --> 02:41.800 And where did you go from there? 02:43.520 --> 02:45.020 Well, 02:45.730 --> 02:48.720 kind of in dr smith and the 02:48.720 --> 02:51.630 orthopedic hospital and they worked together 02:51.640 --> 02:54.520 and mostly it was through the hospital and they 02:54.530 --> 02:57.510 had us come out and checked have been checking 02:57.510 --> 03:00.410 her I think at first it was once every month and then 03:00.410 --> 03:01.780 it went to once every now. 03:01.780 --> 03:03.330 It's once every three months. 03:03.340 --> 03:05.720 And they take blood tests. 03:05.720 --> 03:08.595 And they also she's been in to have the 03:08.595 --> 03:10.925 collection I think in the hospital twice. 03:10.935 --> 03:13.655 And then we have done it at home I think 03:13.655 --> 03:16.345 about she's two now and I think we've done it maybe 03:16.345 --> 03:17.675 five times at home. 03:17.685 --> 03:20.565 So it's periodically whenever they have either 03:20.565 --> 03:23.545 changed the dosage and they want to check to see if it's right 03:23.565 --> 03:26.015 then they'll call for a collection. 03:26.670 --> 03:29.580 But other than the initial collections when she was 03:29.580 --> 03:30.130 three months, 03:30.130 --> 03:31.620 it's just the clinic visits, 03:31.630 --> 03:33.610 Clinic visits and blood tests and urine testing. 03:33.610 --> 03:36.610 Now you're getting to be a collector of 24 hour urine at home 03:36.610 --> 03:37.190 on occasion. 03:37.200 --> 03:38.810 You say she takes medicine. 03:38.810 --> 03:39.880 When did that start? 03:39.890 --> 03:42.490 Well now that started at three 03:42.490 --> 03:44.080 weeks when they detected it. 03:44.090 --> 03:47.010 And it was certain that this is the problem that she had. 03:47.020 --> 03:49.770 And I had to give her 03:49.800 --> 03:52.590 shots every I think at 03:52.590 --> 03:55.160 first it was every day for about a week or two. 03:55.250 --> 03:57.000 And then it was every other day. 03:58.540 --> 04:00.980 And she finally did take the oral at a year. 04:01.810 --> 04:04.740 So for the first year you were playing nurse giving injections 04:05.640 --> 04:07.120 and this was something to get used to. 04:07.130 --> 04:08.850 It never did get used to it 04:12.350 --> 04:14.850 when she was first found to have this 04:14.850 --> 04:16.060 abnormality. 04:16.070 --> 04:18.110 Uh And you waited two or three weeks, 04:18.110 --> 04:21.100 she appeared to be to you at least you went home 04:21.100 --> 04:22.420 a good normal healthy baby. 04:22.490 --> 04:23.580 Yes she did. 04:23.590 --> 04:26.270 I think they had us watch the 04:26.270 --> 04:28.770 vomiting problem when she was little 04:28.780 --> 04:31.080 and she didn't have much. 04:31.080 --> 04:33.300 I didn't think it was anything 04:33.310 --> 04:36.200 extraordinary and that I had Jeff and knew what he was 04:36.200 --> 04:38.400 like to thinking that everything was fine. 04:38.420 --> 04:41.340 So once in a while she would and it would 04:41.340 --> 04:41.890 alarm me. 04:41.890 --> 04:44.850 And I tell them this but they were worried about the 04:44.850 --> 04:47.520 salt losing problem and the vomiting 04:48.010 --> 04:50.500 as far as the abnormality in the genitalia is concerned. 04:50.500 --> 04:53.390 Was this something that was so something you had noticed 04:53.390 --> 04:56.020 or is it uh was it that abnormal that 04:56.030 --> 04:58.420 you would have been concerned about it if they hadn't told you? 04:58.420 --> 05:01.060 Do you think I probably would have. 05:01.060 --> 05:03.780 But in talking to the to the physicians 05:03.780 --> 05:06.680 out at the hospital and the clinic apparently it 05:06.680 --> 05:08.680 isn't that abnormal. 05:08.690 --> 05:11.210 And um when she was born 05:11.220 --> 05:13.270 and um 05:13.280 --> 05:16.100 the the doctor that delivered 05:16.100 --> 05:18.850 her took a look at her and thought everything was fine. 05:18.860 --> 05:21.010 So it wasn't that obvious 05:21.010 --> 05:24.000 apparently and the clitoris wasn't so enlarged that this 05:24.000 --> 05:26.300 was grossly abnormal to your inspector. 05:26.350 --> 05:28.780 And it's not required any kind of surgical correction. 05:28.780 --> 05:30.300 Everything that's good. 05:30.430 --> 05:33.400 How did she grow during those first 05:33.400 --> 05:36.280 few months or say for the first year what was her growth rate? 05:36.340 --> 05:39.220 They kept pretty good watch on her and they kept her 05:39.220 --> 05:41.510 right smack in the middle of the charts. 05:41.510 --> 05:44.200 They had the the height and the weight and 05:44.440 --> 05:47.270 and planned it out for me and 05:47.270 --> 05:49.260 showed me exactly how she was going. 05:49.270 --> 05:51.350 And if it dropped a little or she 05:52.170 --> 05:55.100 wasn't going on the steady upgrade of the way 05:55.100 --> 05:56.070 she was supposed to go. 05:56.070 --> 05:58.360 Well then they would do something about her 05:58.390 --> 05:59.820 dosage of medicine. 05:59.830 --> 06:02.280 So they controlled and monitored 06:02.330 --> 06:04.920 her growth progress and manage the 06:04.920 --> 06:05.660 medicine. 06:05.670 --> 06:06.600 Keeping with that. 06:06.600 --> 06:09.420 What about blood pressure did they discuss blood pressure with 06:09.420 --> 06:09.890 you? 06:10.230 --> 06:12.570 There was a problem with blood pressure when she 06:12.570 --> 06:15.570 was thought to be assault 06:15.570 --> 06:17.750 loser and she was given 06:17.750 --> 06:20.500 the gosh that name 06:20.500 --> 06:20.950 again. 06:22.070 --> 06:23.430 Record shot. 06:23.440 --> 06:25.790 And apparently right after the accordion 06:25.790 --> 06:26.460 shot, 06:26.500 --> 06:29.250 the blood pressure was off and I can't give you any numbers 06:29.250 --> 06:31.950 because I don't understand that but it was 06:31.960 --> 06:34.930 off and they wanted to see her I think in two 06:34.930 --> 06:37.190 weeks or one week to check it again. 06:37.200 --> 06:39.960 So instead of giving her the accordion 06:39.960 --> 06:42.400 shot once a month like they should, 06:42.520 --> 06:44.290 they thought they would have to, 06:44.360 --> 06:47.250 they decided to take her off of it to see if the blood 06:47.250 --> 06:50.140 pressure would would um go back to 06:50.140 --> 06:50.790 normal. 06:50.800 --> 06:53.790 And in this way they have come to the conclusion 06:53.790 --> 06:56.510 that she has probably kind of a borderline cases 06:56.520 --> 06:59.480 as far as the salt losing goes and her blood 06:59.480 --> 07:01.630 pressure did stabilize. 07:01.640 --> 07:03.800 And you've never had to really 07:03.970 --> 07:06.930 control increasing her salt or provide extra salt 07:06.930 --> 07:08.010 for in her diet. 07:08.020 --> 07:08.630 No, 07:08.640 --> 07:09.080 I've, 07:09.090 --> 07:11.920 it's been mentioned to me to go ahead and and 07:11.930 --> 07:14.450 give her some saltier things, 07:14.450 --> 07:17.040 especially when she has had maybe a temperature or 07:17.040 --> 07:19.770 something or is sick has a 07:19.770 --> 07:21.920 cold fine. 07:21.930 --> 07:24.360 So neither the blood pressure nor the salt 07:24.360 --> 07:27.350 losing has been a particular problem 07:27.350 --> 07:29.630 and the growth has stayed within a 07:29.870 --> 07:31.600 narrow band of normal. 07:31.610 --> 07:33.480 She's on a little short. 07:33.490 --> 07:35.110 But I think she would be anyway. 07:35.120 --> 07:35.790 Yes, 07:35.790 --> 07:37.130 there's this, 07:37.410 --> 07:39.890 there are some genetic influences that 07:40.200 --> 07:42.990 exert very definite influence. 07:42.990 --> 07:44.580 There has she had other illnesses now. 07:44.580 --> 07:46.990 Besides this problem during the first year. 07:47.020 --> 07:50.010 No she hasn't and no 07:50.010 --> 07:52.510 colds or infections or bad falls. 07:52.520 --> 07:54.810 No I think she did have a burn. 07:54.820 --> 07:57.540 She had a burn on her foot which was about the 07:57.540 --> 07:59.400 size of a dime. 07:59.400 --> 08:02.390 Maybe it was on the the side of 08:02.390 --> 08:05.340 her foot and I can't tell 08:05.340 --> 08:05.510 you. 08:05.510 --> 08:08.500 I think it blistered and it was a trip 08:08.500 --> 08:09.040 to the doctor. 08:09.050 --> 08:12.020 Yes there were a couple and it had to be checked again and again. 08:12.060 --> 08:14.980 So she didn't have trouble with respiratory infections 08:14.980 --> 08:17.840 or any problems like 08:17.840 --> 08:18.010 that. 08:18.010 --> 08:20.890 How she didn't say during the second year now 08:22.590 --> 08:24.160 she just started the second, 08:24.170 --> 08:25.950 she just started the second year. 08:25.950 --> 08:28.700 But she's been really I 08:28.700 --> 08:31.530 think it's unusual Jeff I had 08:31.530 --> 08:32.340 so much, 08:32.350 --> 08:35.150 so many colds and with her she's never had one 08:35.150 --> 08:36.390 that's really caught on, 08:36.390 --> 08:39.090 she did have a stomach flu once and that 08:39.510 --> 08:42.180 that put her out of commission for a day or two. 08:42.180 --> 08:43.120 But that was it. 08:43.940 --> 08:44.620 Her birthday. 08:45.230 --> 08:46.990 Her birthday is 08:48.060 --> 08:50.380 I have birthdays on a roll 08:50.380 --> 08:52.300 September 30, 08:52.310 --> 08:53.590 september 30th. 08:53.600 --> 08:54.250 Uh huh, 08:54.890 --> 08:56.120 71. 08:56.130 --> 08:59.130 So she's just 08:59.140 --> 09:01.640 to just to and 09:01.640 --> 09:04.510 Jeff's birthday the other Children on september and october 09:04.520 --> 09:06.570 Jay's is September 09:06.570 --> 09:09.520 14 and Jeff's December 09:09.530 --> 09:12.470 one so she's 09:12.470 --> 09:13.140 just 09:13.780 --> 09:16.780 well I thought mothers did well with 09:16.780 --> 09:19.540 that fathers can get in 09:19.550 --> 09:22.030 trouble remembering birthdays and names sometimes 09:22.040 --> 09:25.010 but we have a girl who's in just two in the 09:25.010 --> 09:25.540 second year. 09:25.540 --> 09:27.520 She's been unusually healthy And 09:27.760 --> 09:30.760 uh no serious problems and 09:30.760 --> 09:33.690 there's been no surgery or no accidents except the burn that took her 09:33.690 --> 09:34.150 to the doctor. 09:34.160 --> 09:36.020 I might add that one time. 09:36.020 --> 09:38.550 I think it was the stomach flu I was talking about. 09:38.560 --> 09:40.390 She did react. 09:40.390 --> 09:43.350 I think a little unusually I was of course when 09:43.350 --> 09:46.170 they give you all these things to look for at the hospital, 09:46.170 --> 09:48.930 you are so conscious of every little thing. 09:48.940 --> 09:51.560 So she was 09:51.710 --> 09:53.260 just completely 09:53.810 --> 09:56.450 Motionless after she had been sick for a day or 09:56.450 --> 09:57.220 two. 09:57.530 --> 09:58.810 She hadn't, 09:58.990 --> 10:01.940 I think she had had the vomiting a day 10:01.940 --> 10:04.450 or two before with the stomach flu and had 10:04.450 --> 10:07.340 diarrhea and the whole thing with the, 10:07.620 --> 10:08.720 with the bug, 10:08.720 --> 10:09.640 so to speak. 10:09.650 --> 10:12.110 So I think it was a full day later. 10:12.110 --> 10:14.270 And then she just really reacted. 10:14.270 --> 10:16.390 I thought unusual for her. 10:16.400 --> 10:17.880 She just didn't. 10:17.920 --> 10:18.680 First of all, 10:18.680 --> 10:19.480 she slept a lot. 10:19.480 --> 10:19.890 I couldn't, 10:19.890 --> 10:21.800 I had to go and wake her up at about 10:22.330 --> 10:25.240 Say 1130 and she was usually up at 10:25.250 --> 10:27.050 7:30 every single day. 10:27.060 --> 10:28.270 When I did get her up, 10:28.270 --> 10:30.270 she wanted to go back to sleep. 10:30.280 --> 10:33.140 And then when she was up, 10:33.140 --> 10:35.330 she just laid on the couch or wherever. 10:35.330 --> 10:38.000 I just wouldn't move any arms and 10:38.010 --> 10:39.300 legs or anything. 10:39.310 --> 10:41.830 And at this point I did call 10:41.840 --> 10:44.550 uh my pediatrician and we went down 10:44.560 --> 10:47.350 and he checked her blood pressure and all her vital 10:47.350 --> 10:50.340 signs right there and then and he did report that 10:50.340 --> 10:53.320 everything was fine and this happened a second 10:53.320 --> 10:53.810 time. 10:53.820 --> 10:56.710 And at this point this was another 10:56.720 --> 10:59.300 maybe five or six months later. 10:59.310 --> 11:02.310 At this point I called the clinic and 11:02.310 --> 11:04.760 they just had me increase the dosage of 11:04.770 --> 11:07.420 cortisone and 11:07.740 --> 11:10.570 that idea and then she snapped out of it after a few 11:10.570 --> 11:11.280 hours. 11:11.290 --> 11:13.660 Do you recall what the dose of medicine is? 11:13.660 --> 11:14.970 She's on now? 11:14.980 --> 11:16.880 She's on two 11:18.160 --> 11:19.350 mg. 11:20.050 --> 11:20.610 Mhm. 11:21.230 --> 11:23.980 So she's had I suppose now some of the immunizations of 11:23.980 --> 11:26.520 course by the time she's two years 11:26.520 --> 11:29.420 old and the 11:29.420 --> 11:31.470 whooping cough and media and 11:31.480 --> 11:34.250 tetanus and diphtheria. 11:34.260 --> 11:37.130 Smallpox vaccination with the 11:37.130 --> 11:37.990 scar, 11:38.000 --> 11:40.360 the measles and german 11:40.360 --> 11:43.350 measles and 11:44.970 --> 11:46.660 mumps vaccine, 11:46.900 --> 11:49.290 not Just the two measles 11:49.300 --> 11:51.650 tuberculosis skin test just very 11:51.650 --> 11:54.240 recently and that was negative. 11:55.570 --> 11:56.200 So 11:56.210 --> 11:58.940 uh now 11:58.940 --> 12:01.740 just to check out a few things as she with her 12:01.740 --> 12:04.740 cold as she had any that she had did it settled in 12:04.740 --> 12:05.170 her ears. 12:05.170 --> 12:08.170 Did she have any ear infection And she hasn't had 12:08.170 --> 12:09.530 sore throats and things you say, 12:09.540 --> 12:11.490 no concern about her eyes, 12:11.500 --> 12:13.400 lungs and harder. 12:13.400 --> 12:14.080 All right. 12:14.600 --> 12:16.890 She had the one episode of stomach flu. 12:16.890 --> 12:18.370 She had any other stomach upsets. 12:18.370 --> 12:21.140 Her constipation isn't a 12:21.140 --> 12:22.900 problem. 12:23.690 --> 12:26.160 And any in full urinary tract 12:26.160 --> 12:27.150 infection. 12:27.160 --> 12:28.180 Has this been a problem? 12:28.180 --> 12:28.540 No, 12:28.640 --> 12:31.210 I've been told to go ahead and watch that pretty 12:31.210 --> 12:33.830 carefully but no 12:33.830 --> 12:34.490 problems. 12:34.990 --> 12:36.980 And she's had no seizures. 12:36.980 --> 12:39.860 But this one episode of weakness where she did was 12:39.860 --> 12:42.800 a little bit of concern following the diarrhea and 12:42.800 --> 12:43.780 vomiting. 12:43.790 --> 12:46.670 I suppose I was just more concerned because I've 12:46.680 --> 12:47.880 been told to watch it. 12:48.770 --> 12:49.470 So at all. 12:49.470 --> 12:51.890 And this obviously is something that the doctors I know I've been 12:51.890 --> 12:54.430 emphasizing to you and we would also, 12:54.440 --> 12:57.440 it's a point of of a very 12:57.440 --> 13:00.220 real concern particularly associated with vomiting 13:00.220 --> 13:02.700 diarrhea when there can be unusual salt loss and 13:02.710 --> 13:05.390 anyone when you were uh 13:05.400 --> 13:07.230 pregnant and carrying Jenna, 13:07.240 --> 13:10.060 uh did this pregnancy seemed to be about the 13:10.060 --> 13:11.680 same as your previous experience? 13:11.690 --> 13:14.470 Uh Jeff I think on the whole it 13:14.470 --> 13:17.420 was maybe I didn't, 13:17.430 --> 13:18.590 I was, 13:18.600 --> 13:21.320 I had the nausea for maybe about 13:21.320 --> 13:23.830 four months or something where as with Jeff, 13:23.830 --> 13:26.380 I didn't have any and it wasn't that bad that I ever 13:26.380 --> 13:27.030 vomited. 13:27.030 --> 13:29.930 But I did feel I think generally a 13:29.930 --> 13:31.740 little a little 13:31.810 --> 13:33.090 worse. 13:33.800 --> 13:35.270 And the delivery. 13:35.270 --> 13:37.130 Was this remarkable in any way? 13:37.140 --> 13:37.780 No, 13:37.780 --> 13:39.120 in fact it was, 13:41.030 --> 13:41.870 she weighed 13:41.870 --> 13:45.960 777. 13:47.610 --> 13:50.610 So and did you 13:50.620 --> 13:51.290 breast feed her? 13:51.290 --> 13:53.860 Was she fed a formula formula? 13:53.870 --> 13:55.050 And what kind of formula 13:56.630 --> 13:58.460 did they have? 13:58.460 --> 13:59.670 The iron in it or? 13:59.680 --> 14:00.260 No. 14:02.040 --> 14:04.810 And you live in a community that has 14:04.810 --> 14:06.680 fluoride or did have fluoride in the water? 14:07.390 --> 14:08.570 I think we'll wait. 14:08.580 --> 14:09.220 No, 14:09.220 --> 14:12.090 that I'm getting mixed up I think with Jeff we had to 14:12.090 --> 14:14.050 give it wasn't in the water at the time. 14:14.050 --> 14:16.460 But Janet has been for the full two 14:16.460 --> 14:19.420 years in 14:19.420 --> 14:19.980 the family. 14:19.980 --> 14:22.940 Has there been any history of an endocrine problem or a gland 14:22.940 --> 14:25.640 problem such as this that you could find neither your husband's 14:25.640 --> 14:26.740 family or your family. 14:26.750 --> 14:27.170 No, 14:27.170 --> 14:28.570 not that we could do. 14:28.570 --> 14:29.670 You come from a large family? 14:29.680 --> 14:30.460 Yes, 14:30.510 --> 14:31.130 I do. 14:31.140 --> 14:32.600 How many brothers and sisters? 14:32.610 --> 14:35.580 I have three brothers and one sister. 14:35.590 --> 14:36.200 one sister. 14:36.200 --> 14:37.130 And your husband, 14:37.130 --> 14:38.240 does he come from a large family? 14:38.240 --> 14:41.240 He has three sisters and 14:41.240 --> 14:42.930 the cousins and so forth. 14:42.930 --> 14:45.850 And your nephews and nieces on both sides 14:45.850 --> 14:47.490 have not had anything similar to this. 14:47.500 --> 14:50.450 You know in the family, 14:50.460 --> 14:52.990 your parents and your husband's parents and 14:53.000 --> 14:55.830 these uncles and aunts and cousins 14:55.830 --> 14:56.500 etcetera. 14:56.510 --> 14:58.380 Has there been any tuberculosis, 14:59.000 --> 15:00.180 kidney disease? 15:01.590 --> 15:02.670 Heart disease? 15:03.630 --> 15:06.540 Paul's mother passed away 15:06.540 --> 15:08.190 from heart disease 15:08.960 --> 15:11.930 And anyone has any neurological 15:11.930 --> 15:12.390 problems, 15:12.390 --> 15:13.680 seizures Or 15:15.310 --> 15:16.700 has there been any bleeding, 15:17.280 --> 15:18.830 no problem or anemia? 15:18.830 --> 15:20.090 Anyone being treated for anemia? 15:20.090 --> 15:20.420 Yes. 15:20.430 --> 15:21.250 Now that's, 15:21.360 --> 15:23.570 I think my mother's side, 15:23.850 --> 15:25.300 it's a fallacy mia 15:25.820 --> 15:28.760 has that going down the 15:28.770 --> 15:29.940 line. 15:31.310 --> 15:32.540 And uh 15:34.000 --> 15:36.830 what national origin 15:36.830 --> 15:38.710 is your mother's side of the family from? 15:38.720 --> 15:41.580 She's italian italian southern 15:41.580 --> 15:42.860 Italy or northern Italy, 15:43.360 --> 15:44.890 Central Central Italy. 15:45.720 --> 15:48.470 Has there been anyone in the 15:48.470 --> 15:51.370 family that has had the serious form of the 15:51.370 --> 15:54.260 disease that had to be treated with blood transfusions 15:54.260 --> 15:55.170 and so forth? 15:55.180 --> 15:55.990 No. 15:56.130 --> 15:58.450 Oh well this is an 15:59.610 --> 16:00.500 in your mother's family. 16:00.500 --> 16:01.990 My mother is my grandfather, 16:03.790 --> 16:06.460 apparently they when he did die, 16:06.460 --> 16:07.820 he was 82. 16:07.830 --> 16:10.650 But when he died uh they instead 16:10.650 --> 16:13.450 of in other words the cause of 16:13.460 --> 16:16.330 death was acute leukemia and had finally 16:16.340 --> 16:17.660 gotten to that point, 16:17.660 --> 16:20.320 although I think there were other complications involved. 16:20.330 --> 16:21.470 And he was. 16:23.080 --> 16:24.650 Yes. 16:27.940 --> 16:29.790 So uh 16:31.170 --> 16:31.500 well, 16:31.500 --> 16:33.000 to get back to Janet, 16:33.000 --> 16:34.780 there's in the family now, 16:34.780 --> 16:35.830 a younger sibling, 16:35.830 --> 16:37.020 she has a young brother 16:37.820 --> 16:40.470 who's a year old. 16:40.480 --> 16:43.210 Uh He came along 16:43.220 --> 16:46.200 after you knew about the adrenal 16:46.200 --> 16:49.100 genital syndrome or congenital adrenal hyperplasia. 16:49.110 --> 16:51.180 And the doctor has had an opportunity to talk to you 16:51.180 --> 16:52.370 about 16:53.140 --> 16:55.980 the implications of this as 16:55.980 --> 16:57.670 far as other Children were concerned. 16:57.680 --> 16:58.610 Yes, 16:58.610 --> 17:01.580 they had and it 17:01.580 --> 17:02.850 was just one of those things, 17:02.850 --> 17:05.390 you take some precautions and this. 17:05.390 --> 17:08.050 You haven't sat down and planned and decided you would take the 17:08.050 --> 17:10.220 25% risk involved. 17:10.220 --> 17:10.530 No, 17:10.540 --> 17:10.840 no. 17:10.840 --> 17:13.100 He was one of those surprises. 17:13.110 --> 17:15.400 And with this in your, 17:15.410 --> 17:16.200 in your history, 17:16.200 --> 17:16.760 had you, 17:16.760 --> 17:18.760 did you give thought to interrupting the pregnancy? 17:19.610 --> 17:20.510 No. 17:20.990 --> 17:23.610 And I knew what it was going to be. 17:23.610 --> 17:26.490 I knew that he'd be in the hospital at three weeks and I knew 17:26.490 --> 17:29.340 he'd be tied down and it would to get that 17:29.350 --> 17:32.150 urine collection which is so sticky and it 17:32.160 --> 17:34.880 caused me a lot of concern and I would 17:34.880 --> 17:37.160 have rather had it otherwise. 17:37.170 --> 17:39.140 But things worked out for the best. 17:39.140 --> 17:41.780 And so far he's Jenna was doing so well 17:41.780 --> 17:44.660 and Jeff that you felt 17:44.660 --> 17:45.950 if this happened again, 17:45.950 --> 17:47.750 you could live with it, 17:47.760 --> 17:48.860 I guess. 17:48.860 --> 17:49.790 So, 17:49.980 --> 17:50.860 I can remember. 17:51.160 --> 17:52.290 Yes, 17:52.290 --> 17:52.710 it was. 17:53.380 --> 17:54.000 Mhm. 17:54.010 --> 17:54.540 Well, 17:54.540 --> 17:57.370 one other factor related to the adrenal gentle 17:57.370 --> 17:58.120 problem. 17:58.130 --> 18:01.070 Uh I spent uh many years being 18:01.070 --> 18:02.870 supported by school teacher's salary. 18:02.870 --> 18:05.070 And I understand that paul teachers school, 18:05.080 --> 18:07.950 this must represent a uh 18:09.200 --> 18:11.960 having Children requiring this much medical care must represent a 18:11.960 --> 18:13.850 significant financial burden. 18:13.860 --> 18:16.840 Do you have you made special arrangements 18:16.840 --> 18:19.670 of any kind to try and take care of these things or you just 18:19.670 --> 18:21.070 work it into the family budget? 18:21.080 --> 18:22.710 That's what we have been doing. 18:22.720 --> 18:23.900 I think that too. 18:23.900 --> 18:26.880 I just realized here not so long 18:26.880 --> 18:29.510 ago that the clinic will 18:29.990 --> 18:32.770 is starting some sort of a family type 18:32.770 --> 18:34.850 plan and they'll go ahead. 18:34.860 --> 18:37.860 Of course they interview quite thoroughly and what you can 18:37.860 --> 18:40.800 pay uh is about all that they'll really 18:40.800 --> 18:41.590 require. 18:41.600 --> 18:44.000 So it's taken the 18:44.010 --> 18:44.890 pressure off, 18:44.890 --> 18:45.510 so to speak. 18:45.510 --> 18:45.740 You know, 18:45.740 --> 18:48.410 as far as having to to go the whole, 18:48.420 --> 18:51.080 you haven't had to go back to work or make any 18:51.080 --> 18:53.610 undue disrupting arrangements to meet 18:53.610 --> 18:55.140 your medical expenses? 18:55.150 --> 18:58.060 We had our insurance of course, 18:58.070 --> 19:00.340 after you get past the deductible, 19:00.350 --> 19:03.330 it pays for taking care of 19:03.350 --> 19:04.000 some of it. 19:04.460 --> 19:04.680 Now. 19:04.680 --> 19:07.680 Your your husband's name is paul and he does 19:07.680 --> 19:09.190 work as a school teacher. 19:09.190 --> 19:10.030 How old is paul? 19:10.210 --> 19:10.720 He's 19:13.170 --> 19:14.110 and how old are you? 19:14.120 --> 19:15.840 MS Jackson 29. 19:19.780 --> 19:22.560 And as we were chatting when we talked about 19:22.560 --> 19:23.090 Jeff, 19:23.100 --> 19:23.940 he's a coach. 19:24.910 --> 19:27.600 And does this allow him coaching is a very demanding 19:27.600 --> 19:27.990 business. 19:27.990 --> 19:30.660 Does he get home to be with the 19:30.660 --> 19:31.990 Children a bit. 19:32.070 --> 19:32.870 He does, 19:32.880 --> 19:35.710 we're close to the school within three miles. 19:35.710 --> 19:38.700 So he does and he spends a lot 19:38.700 --> 19:41.650 of time and dedicates a lot of time to all three of 19:41.650 --> 19:42.610 the Children. 19:42.610 --> 19:44.830 He's a good father coaches, 19:44.830 --> 19:45.780 make good fathers, 19:46.180 --> 19:48.750 there's no reason why a good father can't be a coach. 19:48.770 --> 19:49.370 I guess. 19:49.370 --> 19:50.680 That's what I said. 19:51.050 --> 19:52.990 And you do have some time in the summers. 19:53.000 --> 19:55.550 What does paul do in the summer now? 19:55.550 --> 19:56.920 That's an interesting, 19:56.930 --> 19:58.510 interesting subject. 19:58.520 --> 19:59.560 He was, 19:59.570 --> 20:01.290 he just completed his master's degree. 20:01.290 --> 20:02.960 He went three summers. 20:02.970 --> 20:05.940 This was prior to this summer and this 20:05.940 --> 20:08.520 summer he got a job and he 20:08.540 --> 20:11.330 drove a truck for Plymouth poultry. 20:11.340 --> 20:14.260 And Jeff went to preschool his first day of 20:14.270 --> 20:17.270 preschool and they asked him what his father did and 20:17.270 --> 20:20.260 he told me he was a chicken truck driver. 20:20.460 --> 20:22.770 So the nursery school, 20:22.770 --> 20:24.920 I would imagine that's a status occupation. 20:24.930 --> 20:26.700 So do you have a home? 20:26.710 --> 20:29.340 You live in an apartment in the place for the 20:29.340 --> 20:29.780 Children? 20:29.830 --> 20:32.220 So would you say that you're a 20:32.230 --> 20:33.780 close knit family? 20:33.810 --> 20:35.090 Yes. 20:35.290 --> 20:37.900 Who stays with the Children when you can get 20:37.900 --> 20:38.490 away? 20:38.500 --> 20:40.700 We have babysitters come out, 20:40.700 --> 20:43.020 but we don't go away very often. 20:43.030 --> 20:44.970 We've never left them overnight. 20:44.980 --> 20:47.610 They come with what are some of 20:47.610 --> 20:50.090 Jenna's most significant recent 20:50.090 --> 20:50.790 accomplishments? 20:50.790 --> 20:53.000 Does she begin to dress herself a bit now? 20:53.560 --> 20:54.350 No, 20:54.360 --> 20:57.210 she can put boots on and a hat on and she 20:57.210 --> 20:58.170 wears those often. 20:58.170 --> 20:59.820 She talks very well. 20:59.830 --> 21:02.580 She says nursery rhymes and can count. 21:02.590 --> 21:04.140 And uh says her a. 21:04.140 --> 21:04.320 B. 21:04.320 --> 21:04.740 C. 21:04.740 --> 21:04.890 S. 21:04.890 --> 21:07.460 And has been doing for a little while, 21:07.470 --> 21:08.400 that sort of thing. 21:08.410 --> 21:11.330 Uh She's 21:11.330 --> 21:14.010 pretty competitive with the with Jeff and have to do 21:14.010 --> 21:14.970 everything he does. 21:14.970 --> 21:16.880 And that includes physical thing. 21:16.880 --> 21:19.800 She's kind of a daredevil as far as that 21:19.810 --> 21:20.280 goes. 21:20.720 --> 21:23.520 And obviously she's not upset about 21:23.530 --> 21:25.160 being separated from you. 21:25.170 --> 21:27.980 This she does easily you can you can be with 21:27.990 --> 21:29.370 and so forth. 21:29.370 --> 21:30.200 She a good scribbler. 21:30.230 --> 21:31.160 Yes. 21:31.170 --> 21:33.580 About she have some blocks at home. 21:33.580 --> 21:34.910 How many does she stack Up? 21:34.920 --> 21:37.710 Oh I'd say she just stack some blocks 21:37.710 --> 21:38.470 before we came. 21:38.470 --> 21:39.540 I'd say about six. 21:39.550 --> 21:41.820 She got up to six big blocks 21:41.840 --> 21:44.690 fine and she uses some words 21:46.090 --> 21:47.520 besides mama and dada. 21:47.870 --> 21:49.900 Oh she speaks very well. 21:50.320 --> 21:51.880 How many words together would you say? 21:52.840 --> 21:55.000 Well I think she, 21:55.010 --> 21:57.150 I don't know if anyone else can understand her. 21:57.150 --> 21:59.430 I think they can but she speaks 22:00.420 --> 22:01.360 45, 22:02.010 --> 22:03.030 5000 words together. 22:03.040 --> 22:04.210 She had a tricycle. 22:04.210 --> 22:05.950 Children don't have anymore. 22:05.960 --> 22:06.940 He has a tricycle. 22:07.740 --> 22:08.340 Yes. 22:09.410 --> 22:12.310 Well she's a very 22:12.310 --> 22:15.190 accomplished young lady and so very 22:15.820 --> 22:16.800 nice to see her. 22:16.800 --> 22:19.790 I think this is about all the 22:19.790 --> 22:22.690 questions we have for now and we'll check 22:22.690 --> 22:25.550 her over and see just how very 22:25.550 --> 22:26.570 well she has been doing. 22:26.570 --> 22:27.870 I'm sure