My Journey: There and Back

Hello, all! I am a new member.

A little information about me, I suppose, would do some good. I have had recurrent health problems for my entire (albeit, short) life. Chronic joint and muscle pain, as well as frequent joint dislocations were my main problems. I am very, very hypermobile. As you may have guessed, I do have Ehlers-Danlos Syndrome. I was diagnosed in October 2014, after nearly two years of trying to get that exact diagnosis. I was diagnosed with Postural Orthostatic Tachycardia Syndrome a few weeks prior to that, as well.

This year has been full of medical appointments. I get a lot of flack for that from my parents, as well. My parents divorced when I was 3, so my father isn’t prominent in my life, even if he is in my older sister’s life. We have a mutual dislike of each other, I guess you could say.

I’m not going to go into a full-fledged explanation of my dysfunctional family. I suppose, over time, you will all know more about that, but I am not doing well enough right now to type that all out.


On top of my other health problems, I began to develop noticeable neurological deficits this year, as well. Or, well, maybe I just became aware of them. I have severe balance issues. I also have developed dysphagia, ataxia, myoclonic seizures, loss of feeling in my extremities, and nerve pain. And, of course, the classic Chiari headaches. I’ve had those for five years, since I was 8 years old, I might add.

In late December, I had an MRI to check for any anatomical abnormalities. The MRI had huge artifacts, there was NO MIDLINE CUT, it was tilted, and it was “clear”.

I doubted that.

So, last Thursday, I am rushed back to my PCP. I’ve had a severe Chiari headache for three weeks, but the school nurse was worried because I couldn’t walk straight. (Like always.) My PCP is awesome, and there’ll be more on him at a later time, when I’m doing better. (If that ever happens.)

This morning, I was slid into the eternal, loud hell that is an MRI machine. I had a C-Spine MRI. I am waiting in results currently.

I’m posting a few of my MRI pictures, just so you all can see how screwed up they are,in terms of how they were done.
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You can see on most of my MRI images that the anterior edge of the foramen magnum is warped, therefore elongating it, preventing an accurate measurement of how much (if any) tonsillar displacement is present. Even if there is no significant herniation, it does look a little bit cramped, eh?

The odontoid is tilted, pressing into the medulla oblongata, and, also, on Image 9, the medullary is a bit elongated as well. On 10, while it is not anywhere near the midline, C2 looks dislocated, which wouldn’t surprise me if it is. It happens a lot.

I am mainly on Inspire.com, but how do you all feel about Chiari Type 0?

Welcome to the site! I am glad you posted an introduction about yourself. There is also a group on here for young people with Chiari you might be interested in, you will find it under the groups tab. Hugs.

May I ask how old you are? You said that your entire life was short and that you have had headachs for 5 years sense you were 8 so are you 13?

Yes, that would make me 13!

Welcome!

Chiari Zero... We specifically have limited this site to Chiari 1 - 4 in terms of discussion. The concept of Chiari Zero is highly contoversial, considered by most in the medical community to be an invention of "headache Doctors" posing as Neuro surgeons running Meat Markets (AKA Independent Chiari Centers or Headache Centers) "there is no physical evidence of Syrinx, diminished CSF flow, or herniation in excess of 4mm, but we are going to by gawd operate anyway and because insurance like won't pay for it we can charge full price for private pay"

While the symptoms of Chiari 0 are most certainly real and sufferers certainly entitled to all the support available here the mod team has been instructed to "moderate Chiari 0 discussions because they are simply from past experience simply too divisive. They are also opposed to the BF policy of "unapologetically evidence based." The work in the late 90's and early part of this decade on Chiari 0 has pretty much petered out living mostly on the internet.

Here's a pretty good explanation from a generally pro surgery group: http://csfinfo.org/education/physician-information/chiari-zero/ Incidenatly Chiari 0 was used to explain the presence of a syrinx in these 10 -16 year old studies.....

Devil in details, it’s sounds like you are having some severe symptoms. I’m sorry the headache is so fierce. I understand how that feels and it is truly hard. So glad you have an awesome PCP that is huge. I am sorry, though, that you may not be getting the support elsewhere, family and what not. Please know you are not alone, so many of us have severe symptoms and may not qualify beyond Chiari 1, this includes me. I don’t know what your herniation is, but with a quality image and a quality Chiari Dr you should know this in the future. My herniation was measured between 3 and 6 mm depending on the doc. So letting you know each doc measures differently, and the difference of a half mm or even several mms is realistic when something so small is measured with a human hand and eye. Regardless of size symptoms are real and that is why you are here. If you had a 15 mm with no symptoms you probably would have never had the mri.

I also have EDS, and let me say either your PCP is REALLY awesome or you are very saavy and learning about all the possibilities that Chiarians could be dealing with. You are smart and inquisitive and with this I believe you will fare well :). Please know you are among friends and comrades who are traveling this journey with you. You are certainly not alone. Have the hope that your journey will bring you to the right person who can help you because they are out there!!

Jenn :slight_smile:

Well, I originally typed this out on Inspire.com, which is where I usually go to offer/receive support. I am a part of the EDS group there. It’s very lengthy, but it explains all of my journey up to late December 2014. I don’t want to link you to the original discussion, because there are 4 pages of replies. If you are a part of that group, my name is the same name it is on here! But basically, I had to convince everyone that I was ill. I did all the research that was put into getting diagnosed. It was a pretty grueling journey. I wish I could find the same strength I had only months ago and apply it to this situation.

"Let’s start off with saying that I am currently 13 years old. I was diagnosed with scoliosis in July 2013, POTS in September 2014, and EDS in October 2014. It wasn’t easy, let me tell you.

It all started, really, with scoliosis. The school nurse comes and examines us, and I get called down to her office a few months later and she says I need to get checked for scoliosis, and it is required by the State. So, imagine 11-year-old , 6th grade me, knowing full-well my mother would never take me to a doctor.

Around the same time, (think February 2013) I became close with my art teacher. This was the jumping off point for me and the world of EDS. I was considered to be good at art, and she noticed. Every day, during roll call, she would say, “Everton, by the trash can”. I’d wait there, and she would come over, lead me to her office, and we would talk. I briefly mentioned one day that my parents weren’t very supportive of my art, and something clicked with her. I still don’t know why.

One day, I was waiting by the trash can, and I turned both feet outwards in a ballerina pose. The art teacher noticed when she came over, and she immediately asked if I was double-jointed all over. I said I was. She asked if I have ever dislocated a joint before. I told her my shoulders and hips were common culprits. I had NO idea what she was getting at. She asked if I’d ever heard of EDS, I said no. As it turns out, she and her youngest son have it.

A few days later, I go to my PCP for the whole scoliosis thing. He does an exam, an x-Ray, and notices my left leg is longer than my right by about 3/4 of an inch. The x-Ray comes up positive for scoliosis, and he tells me he’s sending me to Children’s. Also, at that appointment, he said I have a malformation in my lumbar spine, where it didn’t fuse correctly, and it’s very cracked and unstable.

I begin researching EDS. It’s nauseating; it fit all too well. Even then, I had been struggling with chronic pain. I have been since I was 7, actually. I was unknowingly desperate for answers.

July the 2nd rolls around, and I go to my first Children’s Hospital visit. I am x-rayed, examined, etc. An older doctor comes in. Everyone claims he is the “scoliosis guru”. He told me to bend forward. I did. Crooked spine. (17 degree curve) He told me to bend back a bit, and he freaked out. Then, he got curious. He told me to go as low as I could. I did a backbend and then sat on my head with utter ease. I left the appointment frustrated however–no diagnosis of EDS.

I am in physical a therapy for six weeks to build up core strength. They recognize I am severely, severely hypermobile. At the end of the six weeks, they tell me that since my pain has gotten worse, they have no idea what to do for me. I slyly bring up the possibility of a connective tissue disorder, (I had just turned 12.) and the physical therapist tells my mother and I to get an appointment at a child development center. It never happened.


January 2nd, 2014. I go back to Children’s. There is no change in my curve. I bring up EDS, and the likelihood of it. Do you know what the doctor said? “Hypermobile children just learn to deal with the pain. There really is nothing we can do for them.” My mother was furious. No, not at the doctor. At ME. She was disgusted with me.

That whole year, I researched EDS. I still am in contact with the art teacher. I speak with her a lot. My mother is always angry, always screaming. The art teacher offers to talk to my mother. I refused. That January, I meet my keyboarding teacher. She also has HEDS. We don’t talk much about it, but I thought it was odd that in the same school building, two teachers had EDS.

February 2014. My mother schedules an appointment for my “horrible acne” with my PCP. Notice the quotation marks! I bring up EDS. I felt confident that I’d get a diagnosis or a referral. Of course, that did not happen. He took one look at me, messed with a few of my joints, and told me there was no way I had EDS. I was devastated. You all know the feeling. My mother didn’t talk to me for a week.


My art teacher resigns at the end of the school year. She had brought up the fact that us, the students, are never informed of what to do in a school shooting, and the administration told her to leave. I was so, so angry. But she supported me to the very end, and that’s what helped me.

In late May of that year, I joined Inspire. I was so desperate for anything, anything to allay the pain, physical and emotional. My health was in free fall, and it was beginning to get scary.

In July, I am landed in the ER with severe, persistent tachycardia. I knew, I just knew it was POTS. The doctor shrugged his shoulders and said it was MVP. I laid in my back for FOUR HOURS, and my heart rate would not lower. No testing was done. This is where things began to pick up some steam. My mother was now aware that I was having these problems. With her, my problems are not noticed until they’re too severe to be ignored. Often, the damage is already done.


It is the second week of school. I go to the nurse’s office, and my heart rate is up in the stratosphere. She thought I was on drugs because I was slurring and stumbling! But that visit was effective. A week later, I go to my PCP, and I am dreading it. I thought he’d blow me off like he did the time before, but I was pleasantly surprised. I am sent back to Children’s. He tells me there will be a lot of testing done. At that time, it was September 2nd, and my Children’s appointment was the 16th. Fourteen days, I thought. I knew I could make it.

But, one day, my appointment is moved up to the 11th. Odd. What I didn’t know then is that my PCP moved it up for me, somehow. I still don’t know how.

The 11th rolls around, and I’m hoping for an EDS diagnosis. The doctor is young this time. The medical student that was brought in to examine me treats me like an idiot. I did NOT appreciate that at all. The doctor did at first, but as we spoke, he began to gear up. I thought he was okay, but… He completely blew me off! No testing was done! A measly Holter monitor is what I’m given, along with a diagnosis of “Orthostatic intolerance” and advice to drink more water and eat more salt… just like I’d been doing for a YEAR.

The Holter monitor recorded 22 incidents of tachycardia in 24 hours. The cardiologist said it was fine, that it was nothing to worry about.


On the 16th of that month, when I was originally supposed to go to Children’s, I was in the nurse’s office AGAIN. My heart rate would not go down, my blood pressure is all over the place. The school nurse wants me to go to the ER. My mother calls my PCP’s office, and his nurse says to schedule another appointment at Children’s, or to go to their ER. I flat-out REFUSE. Soon enough, I am in my PCP’s exam room, and we talk, and I am given a diagnosis of POTS, which is what I had “hoped” for. I am also given a script for Propranolol. Once he found out I was not tested for anything at Children’s, he was livid. That was the day I realized that he is a good man.

I go back 2 weeks later, so he can see how I’m doing with my beta blockers. He ups the dose. I hand him a note, asking if he could send my mother out of the room. He complies. I give him a short few papers on EDS, and how POTS and EDS are closely linked. I ask him for a referral to the Connective Tissue Clinic at my local Children’s Hospital, too. He is stunned that I found a link. I got the referral!

Then, 6 weeks later, I was sitting in a geneticist’s exam room. I was nervous as all hell. The geneticist was a little old man, but mentally sharp. I was examined, my family history taken down, and sure enough, he said, “You have a very clear case of EDS”. I THEN got the referral to the Connective Tissue Clinic. Like I knew would happen, I felt nothing. Empty. The battle was over, right?

Of course, it wasn’t. During this time, I was struggling with neurological symptoms. Late December, I was back at my PCP’s, and I tell him of my symptoms. I suspected it was Chiari, but I didn’t say that. He suspected it was Chiari. His mini neuro exam turned him from cool and collected to nervous and bewildered. He immediately ordered me an MRI. It came back clean, and I am currently waiting for further testing so maybe I can find relief."

DID, so you are saavy. Before my diagnosis I knew Chiari was in the diffrtential too. I can easily see that radiologists are as different in their interpretations of imaging, especially where Chiari is concerned, as any doc has been with your other diagnoses. Some think it’s 3, some, 5, some 10 or even larger. It depends on their training. To me, this disgnosis is so hard because of the differing guidelines for docs to diagnose. How is the beta blocker working?

Different doctors are going to think different things–much of it depends on their speciality and/or what “era” of medicine they were trained in. I’ve always said/thought that what specialist you go to will determine your diagnosis. With EDS affecting so many organ systems, you’re going to get a lot of diagnoses that don’t ring true. Mitral valve prolapse? Orthostatic intolerance? I have neither of those! Those “diagnoses” were various doctors not knowing, not wanting to look past conventional medicine. With EDS, things are less cause and effect, and more “this condition is going to cause this, and it’s also going to mess with another comorbidity, which will indirectly cause this”.



If Chiari really isn’t the answer, the next consideration for me is CCI. I have a lot of instability, but I have a lot of unexplained symptoms that only a syrinx and/or Chiari could explain. Honestly, even if I do have CCI, (highly likely) and Chiari is yet again “ruled out”, they’re going to end up diagnosing me with cerebellar ataxia or something.

The beta blockers are pretty unremarkable. They do enough for me to function. I struggle with my BP. My BP can get very, very low, extremely high, or just outright screwed up. (Things like 145/55 happen a bit.) I used to get very dizzy and nearly faint when I stood up. Now I’m dizzy all the time! :confused:

I don’t have a BP cuff at home, so I can’t check my blood pressure. So, if I take a beta blocker and my BP is low… well, that makes for an “interesting” day.

So what does your geneticist say about your Myoclonic Siezures? Genetic studies have demonstrated at least 6 loci for JME, 4 as I recall ,with known causative genes. It could save a lot of studies......... Most of these genes are ion channels with I think just one non-ion channel gene having been shown to affect ion channel currents. You are at the perfect age for JME. and judging from the time of your posts don't sleep much so that piece fits.

BTW I consult to one of the Children's Miracle Network Hospitals that specializes in Genetics. The first staff meeting I walked into looked like a casting call for "Grumpy Old Men" (a movie well before your time) For some reason all geneticists look like "a little old man" even the woman. I suspect it has to do with spending 12 hours a day hunched over a microscope or maybe they have a dress code.

Incidentally the raging acne is a clue also for both the JME and POTS............ The one doctor jerk or not is not entirely wrong some pointed PT and working out especially with aerobic exercises can calm some things down (natural endorphins.) Raging acne at 13 is not common. Of course I'm not sure what that means, Sounds like Mom may freak at a zit. Moms do that. I'm thinking Pizza Face

We never got to discuss the myoclonic seizures. I began to really get bothered by them a few weeks later, in late November. I did not have any form of genetic testing done for EDS. I have a very clear case, and my mother wasn’t too hard to diagnose, either. She’s a LOT better off than me. So, even if I do have a gene for JME, they wouldn’t have found it yet.



And, you are right about the sleep schedule. Mine is kind of out-of-wack at the moment. Luckily, I’m on Spring Break right now. I often will sleep 8 hours, to only have about 3 hours of energy. Unfortunately, I get a LOT of “painsomnia”. Last night was one of those nights. So, I just stayed up for most of the night watching MAS*H.



Also, about the acne: I got pretty lucky in terms of acne. My older sister (19), used to have pretty bad acne. Never went on medication for it, but it’s a lot better now. Me? Yeah, I have a few minor breakouts every now and again. I’ve had acne for 3 years! But it’s never been “severe”. My mother is simply the kind of woman to freak out over a tiny zit.



My mother often cares more about my appearances and intelligence than my actual health.

So without the genetic testing for EDS, have they narrowed down the type differentially? It would make a big difference in a treatment plan. For example, different mutations in the COL1A1/COL1A2 genes (which code for pro-α1 (I) and pro-α2 (I) chains would likely explain many of the symptoms you are having. Mutations in these genes would effect type 1 collagen and consequently while a CM may be diagnosed, treating it surgically would be highly ineffective.

The hyper-mobility type EDS that is most common and gets talked about a lot here really has no bearing on CM. Its just a popular disease right now because of genome services (now shut down or only doing genealogical stuff) made it so.

On any event you are a sharp kid. Move your reading beyond the first page and summaries on the internet, get a member ship on medscape. When reading medscape keep in mind these "studies" are just opinions vet the bibliogrphy you can really mine some good stuff there. In the right hand column there is always a link to who has quoted or used the study in additional work, This is where you learn the good stuff. as you study and read this stuff you immersed in the science from that comes understanding from there you get answers. If you just stay on the surface matching symptoms to terms, you will eventually drive yourself nuts and lose your ability to THINK and become like a doc who has seen to may patients over to many years and just spit out answers. If you are going to do this stuff use that wonderful brain of your correctly and make it a thinking machine not a rolodex. Dig deeper and deeper constantly.

Get a blood pressure cuff. I'm not a cardiologist, but I have take beta blockers. as you say it can get exciting. You should never take one unless you are monitoring your blood pressure. 27 events in 24 hours for a young teen in heavy puberty doesn't seem like serious enough POTS for that kind of meds unless something else is going on. You are sharp enough to get what you want. I'd want some more cardiology workup beyond what you have described if I were you. Sounds sorta like my teens

They pretty much narrowed it down to hypermobility type, based on my mother’s symptoms. I have symptoms all across the board! I have extremely fragile skin and it’s very prone to bruising and very hyperextensible–indicative of one of one of the Classical types, probably Type 2. I have very thin and translucent skin–you can see veins on my upper chest, palms, and on the sides of my forehead (my hair covers up most of it). They don’t really know WHERE to put me at this point.

From what I understand, Hypermobility Type is still a mutation in Type 1 collagen, they just haven’t found it on a gene yet. Considering how widespread the “stretchiness” is, it must be Type 1 collagen, as it’s pretty much everywhere! But since my mother does not have any symptoms of any other type of EDS besides Hypermobility Type, they put me in that group. Since there’s no identifiable gene, and I haven’t really had any major complications, they figured, “Why do genetic testing?” They usually won’t do a genetic test unless you have symptoms indicative of Vascular Type. (Or any other type, besides Type 3)


HEDS, I believe, is found with Chiari quite a bit. Our necks tend to be hypermobile, and when upright, this leads to a lot of displacement of tissues. General tissue weakness can also be a cause. I think Chiari can be found with any subtype of EDS.


To be diagnosed with EDS, I had to do a lot of reading and research, in order to make sure I arrived at the correct conclusion. My diagnosis included a lot of “convincing” doctors I am indeed ill. When other people would be outside, swimming, or doing social things, I’d be elbows-deep in a 60-page article about EDS, or a medical journal, anything I could read to get information. And, no, I’m not saying I’m better than anyone else because of this. I don’t think that.

To get my answers, I often gather information and research far past the point most people would. I thrive on information. Most people (like my mother) read half of a Wikipedia article and call it good. I don’t. If I didn’t research as much as I did, I’d still have the diagnosis of “growing pains”. I got to where I am today because of my intense research. Of course, I fact-check. Constantly.

My PCP has been delighted with the information I’ve gathered. It’s made it a bit easier on him, he says, because otherwise, he’d be doing too much guesswork and not enough time finding answers. He says I have a mind fit for a career in medicine. I’m not too sure about that, but it’s a nice thing for him to say.


But anyway, the frequency of my “episodes” weren’t what worried my doctors. It’s how long they lasted. Sure, some episodes will last 3 minutes, others can last 30 or more, even on medication, even when I’m doing everything I can to get my HR to lower. Also, my PCP recognized that without medication, I was pretty much non-functional. I’d constantly lose my balance and fall (and often pass out) Now, I realize a lot of that was probably due to my neurological deficits of unknown cause, but how was I supposed to know?

My BP is more often a bit high or “mixed”, as I said earlier. It gets low when I’m about to faint, or on random occasions. About half of the time, it’s something like 145/55, about 30% of the time it’s 140/100, and 20% of the time it’s 90/60. My BP (and HR) are never stable, it seems.

I'm going to keep pushing you, that doesn't mean I'm doubting anything going with you, okay? Very little of your writing is in passive voice. Keep it up and keep working on it. Its then you understand that a statement is also a question

I'm going to call BS in part your statement: "HEDS, I believe, is found with Chiari quite a bit. Our necks tend to be hypermobile, and when upright, this leads to a lot of displacement of tissues. General tissue weakness can also be a cause. I think Chiari can be found with any subtype of EDS."

There is a mistake in that that is commonly made on this site (ands a lot of others for that matter) My students should have by the time I see them a lot of basic statistics and graduate level statistical analysis. EDS (all types) occurs in 1 in 500 births. CMF arguably (much to the disappointment of many Chiarians) is one of if no the most common neurolgical disorders. If you are good with Excel (start now) you can have a lot of fun with this. In any event it occurs in 1:1000 births.

Heres the statements I want you to apply to the above but importantly imprint in your brain as you research and learn because many don't an cause themselves lots of problems.

Association does not Correlation

Correlation does not equal causation therefore:

Association does not equal causation.

There are hundreds of examples you will here through out your education that will help illustrate this.

The other thing to keep in mind is that statistical analysis is not the same thing as probability. Probability is generally totally random. Deviation (grading on the curve essentially) is not. See if you can apply that to your statement. There are at least three ways. Should almost be a no brainer for you I bet.

Ordinarily I would carry a conversation like this out in messaging, but for the most part we discourage that with our teens. (for their protection)

I agree with many parts of your previous statement. However, I believe that EDS is believed to occur in 1 of every 5000 births, not 500. At least, I think that’s the general consensus.





The medical community knows a lot about EDS, but not enough. We know certain comorbidities are more likely to be found with EDS. We also know that if you have EDS, certain complications are more likely to occur than if you didn’t have EDS. No, I don’t know the mathematical terms to describe these “phenomena”, if you will.



In my previous comment, I did not mean Chiari was found only in EDSers with HEDS, and not any other type. I meant it can be found in any type, because many doctors think that EDS and Chiari are somehow related, just like EDS and different forms of autonomic dysregulation are thought to be. I don’t have the medical expertise to really do much theorizing myself, you see. I was just using HEDS to specify, more or less. Yes, one of their theories is that upright positions cause the cerebellum to sink down pretty significantly. Theories are a,ways subject to change!







I am aware that Chiari is one of the more common neurological conditions. A lot of people seem to get disappointed when their condition is more common than they thought it was. I don’t know why! I mean, don’t you want your condition to be researched?







I’m not a statistics student (because, you know, I’m 13). Thank you for the clarification. I always just assumed the things you mentioned, but I never really had it spelled out for me.



Thank you for respecting my privacy. I do appreciate that!

I’m sorry that I am so inarticulate at the moment. I’m usually a lot better with words, it’s just that it’s hard to think with the constant headache. I hope you do understand. I have very much enjoyed your insight!

LOL, yes it is 1 in 5000. not 1 in 500. I should proofread much better than I do. I never thought you meant that it was the just HEDS type.

There is two things happening that make me very uncomfortable. There is a lot of "EDS" being diagnosed (mostly self dignosed. Its as bad as The actual occurrence of HEDS is 1 in 10,000 when you consider the other 9 or so sub types. There are not nearly as many Docs that believe CMS and CDS are directly related as one may think. (thats an interesting discussion from the cart and horse standpoint)

You hit the nail on the head with "theories are subject to change." We have sadly learned as a particular school of thought on CMS has LOTS of surgery that traditional NS would not normally do that there is not as clear a connection between headache and other traditional chiari symptoms and the actual chiari itself as they thought. One of the reasons some of these practitioners explain their 30% failure rate with is because of undiagnosed HEDS among other reasons......

Have a nice evening

Don’t worry, I am extremely guilty of not proof reading myself!

I agree. A lot of people seem to diagnose themselves with EDS. Most of them are people with a bit of joint hypermobility and joint pain, maybe some stomach issues. It makes the rest of us, that really do have to deal with EDS on a daily basis, seem lazy and/or malingerers.

I think that is correct, that HEDS occurs in about 1:10000 people, when treated as it’s “own” disease.

On Inspire, I see a LOT of EDSers that undergo decompression surgery, only to be extremely disappointed. We just don’t heal very well, and decompression surgery is a HUGE thing to recover from. Sometimes, for some reason, surgery can make the herniation itself worse (which isn’t surprising). With us, it often doesn’t relieve symptoms.

can I say you are one smart kid, and good for you in being your own advocate there are lots of adults who don't know the information you do and handle this with your grace. I know that I have had a hard time with doctors and family not getting it along with many of us on this site. You seem to be very intelligent for your age.

As a former English teacher, I must say that you are so articulate, especially for a 13 year old kid!! I am so impressed!! I must agree with, Elisa! You are so intelligent and mature, and it comes through in your posts! I am truly amazed by your ability to be your own advocate!I wish that more people had such initiative!!



You are respectful beyond your years; and that seems to be rare these days!!



Also, I have to point out how well you are written for your age!! Many adults do not seem to know that “a lot” is two words! Nice job!!



Lenni