Who should be tested?

anonymous

New member
I don't know if this is the right place to ask but I don't know where to ask. I know this is for families with CF but I didn't know who would have this knowledge.

I just had a DNA screen for CF. It came back that I have one gene mutation and so I was told I am a carrier. My allergist had me tested b/c my peak flows and PFTs are on the low side and have gone down the last few years even though I am on various medicines. I haven't ever smoked and haven't ever lived with anyone who smoked. He also had me tested for alpha trypsin 1 and that is not a problem. I don't have CF in my family but my mom always said her family seemed to have weak lungs. My Grandma developed COPD (emphysema) even though she never smoked. My Grandpa smoked though. My aunt has had numerous bouts of pneumonia and now has BOOP. Anytime my mom gets anything upper respiratory she is wheezy and has to sleep sitting up etc. She has had pneumonia a few times also. My youngest brother was diagnosed with asthma as a child and still has problems. Another brother and I were diagnosed with asthma as adults and my other brother has had wheezing episodes but not many.

The allergist told me I may want to get my children tested for CF. The pediatrician said he would do it if I want but he thinks it makes more sense to have my husband tested to see if he is a carrier b/c if he isn't then our children would be fine. Our five children range in age from 3 to 21 and it seems like if they had CF we would have known by now. I was worried when our fourth one was a baby b/c he had really smelly bowel movements even though he was only breastfed and that didn't happen with the others. He also didn't gain weight very easily and was super skinny. He nursed and then ate like crazy and stayed skinny and then suddenly when he was almost 2 he started to grow really quickly and is now (at age 8) in the 75 to 95% for height and weight. He also has some allergies and asthma but currently doesn't have to be on meds unless he gets an upper respiratory infection. He still seems to have bowel problems but he is so big that CF doesn't seem to fit.

Do you think it makes more sense to have my husband tested or my children tested? I have read that the DNA screen doesn't catch all the mutations so then I wonder if we will really know for sure.

Thanks
 

EmilysMom

New member
I would have your husband tested first. If he's not a carrier, then you're done. If he's a carrier, then you need to think about testing the kids. Whether you think they "seem" healthy or not; we have met adults on these boards who have gone through most of their lives before they were diagnosed. It does happen. There are some really good testing protocols now, so you should be able to get tested and get an answer that you're happy with. Keep us posted!
 

julie

New member
Anonymous,

What kind of DNA test did you have? Did they test you for just the 25-89 most common mutations? If so, I would recommend that you get an extended panel test done. Quest Diagnostics currently has a CF carrier screening test that is 99.9% accurate at detecting all of the 1000+ Known CF mutations.

Just because your youngest son isn't "small", doesn't at all rule out CF. My husband is 6ft and currently 198lbs. Not typical CF at all, but he has 2 of the most common CF mutations.

I would recommend that you have an extended panel test if you have not already done so just because of the athsmatic type problems that you have listed in your family. I would also recommend your husband be tested to see if he is a carrier, but you might start with the less expensive test for him.


Take care and keep us posted,
 

anonymous

New member
Thanks for answering Barbara and Julie. I am going to have my husband get tested and ask about my test. I don't think it was the extended panel. The prescription just said DNA screen or something like that and the lady at the hospital in the out patient lab had to go and look for what she had to collect for it b/c she wasn't used to that one. I think she just got two tubes of blood. I don't watch it coming out and then I am fine. I haven't seen my results. My doctor just called and told me that I was a carrier b/c I had one gene mutation. I am going to ask for a copy for myself.

Your husband is larger than my husband so I guess size isn't necessarily an indication. Of course I have only known a few people in my life with CF. One of my friends in 4th grade had 5 siblings with CF (they also had 6 kids without CF and a baby that died of something else) and the ones I met were pretty skinny. Of course this was back in 71/72 and so the care wasn't the same. Our oldest daughter had a little girl in her school with CF back in elementary in a different state and then a girl in high school but they were both really thin.

Congratulations to you Julie on your pregnancy with twins!!! I was reading on the forums for a few days before I dared to write and that is super exciting!!!

Thanks again, Chelley (I did sign up but keep forgetting to login until I am already writing.)
 

Alyssa

New member
I wouldn't waste time testing your husband. I say get all the kids tested -- especially the youngest - they are who will need the treatment should they test positive.

Also just because the youngest is now growing well isn't really conclusive. I'd still want to know for sure. Many people are being diagnosed later and later in life. My kids were age 13 and 18 years old when we got genetic testing on them. It can be missed for a lot of years. Be pushy and get the full test done on all of them.

Both of my kids are pancreatic sufficient -- my daughter has some weight issues (trying to keep her weight up), but my son is getting a little too heavy -- 5' 9" and nearly 200 pounds.
 

anonymous

New member
I would get your kids tested because they may want to have children of their own soon enough and it will be good for them to know if they are at least a carrier since you are. I would say if you only get your husband tested then your kids will eventually want their own test anyway so why not do it now.

I hope all tests come back negitive. <img src="i/expressions/face-icon-small-smile.gif" border="0">

Dee
 

anonymous

New member
Get testing done on the persons you are worried about, which sounds like the kids. And I'd second the advice about the extended testing panel. My mutation was not detected so my spouse and I thought we were in the clear during her pregnancy. It turned out to be wrong and it caused considerable grief when our son was born and had the signs of CF but our tests made it seem unlikely. We did not bother getting me tested, but did the extended panel on our child and found the rare mutation I contributed that way.
 

busymom

New member
Thanks for the replies Alyssa, Dee and anonymous. Now I have more to think about. It is the possibility of the rare mutations being missed that is making me nervous.

Our oldest has been married for more than a year and now they are expecting their first baby in about 30 more weeks. She told her OB that I tested as a carrier and he told her it wasn't worth testing her and her husband as possible carriers b/c the test misses some mutations so they should just wait and see. I thought that was a weird attitude.

Is the extended panel lots more money or why don't they just do that panel first?

Thanks, Chelley
 

anonymous

New member
chelly, the extended panel is a LOT more expensive, that's why they don't opt for it first.

Your daughter and son's OB seems ignorant and neglegent. ANY family with a family history (even carrier status, and since you don't know your husbands yet...) should have the offspring (your son and daughter in law) tested (preferable BEFORE conception) but you are past that point now.

I would recommend that if your daughter is interested in getting tested and the doctor still refuses, have her go to her primary care for a referral and or test. There is no reason why a doctor should refuse this!!!!!!!!!!!
 

Alyssa

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>anonymous</b></i>

Our five children range in age from 3 to 21 and it seems like if they had CF we would have known by now.

That's what I said when my kids were diagnosed at age 13 yrs & 18 yrs !! Please get them all tested -- extended panel if at all possible. Be pushy and get what you need !!
 

anonymous

New member
Alyssa,

I just wondered how you happened to find out that your kids had CF at 13 and 18. Had they been having problems all along or was it just a surprise?

This is all such new territory just b/c the allergist decided to have me tested as a long shot. I have only known about being a carrier for a little over a week.

Thanks, Chelley
 

Diana

New member
My brother and his girlfriend ound out they were very unexpectantly pregnant about 3 weeks ago. Because my daughters have CF the rule of thumb is in Australia that if someone related to you has CF, you should be tested. The doc sent them for genetic testing straight away and we were expecting the odds to be my brother would be a carrier and she would be clear.....we were wrong. It turns out that he is clear and she is a carrier of Delta f508. Straight away the doctors said they had ordered the extended panel of testing to make sure my brother didn't have a rare mutation.

I guess I am trying to point out that your sons doc had no right to place his "personal" opinion on this and limit your sons choices. I just think some docs can be rude. As I said before I would get your kids tested so that they a clear mind of what to expect in their own lives.
 

anonymous

New member
Thanks Dee and everyone else who is encouraging me,

It is actually our DD21 who is expecting with her husband and they live in a different state about 1400 miles away from us and it was the first time she had met this doctor and it was just the day after I found out I was a carrier. Hopefully now that I have learned more she can go back with more info and tell him she wants to be tested and have her husband tested.

Our pediatrician will test DS17, DD14, DS8 and DD3 if we really want but he just thinks it makes more sense to see if my husband is a carrier first. Now that I know that the original screen misses mutations I think I will feel better if I just get the kids tested instead of or in addition to my husband.

My DNA screen wasn't done at a CF center but there are centers available in this area so the kids could go to one if they need to have tests done there.

Thanks again for the encouragement, Chelley
 

Alyssa

New member
Chelley,

I started to answer your question and it got to be verrrrry long. I then realized that perhaps that's what I should start my blog off with. So if you feel like reading the long version check out my blog

<a target=_blank class=ftalternatingbarlinklarge href="http://blogs.cysticfibrosis.com/index.cfm?forumid=20
">http://blogs.cysticfibrosis.com/index.cfm?forumid=20
</a>
The short answer is my daughter was misdiagnosed at age 5 because her sweat test number is within the normal range. It wasn't until she was 13 years old and having trouble with numerous lung infections that she got the genetic testing and we found out CF was the cause. We then decided to test her brother and found the same two genes.

My daughter clearly has more lung involvement than my son, but she has been very healthy and that did make diagnosis a little more difficult -- nobody really suspected CF, plus her sweat tests had already been shown to be normal.
 

anonymous

New member
I am 13 years old and my mother has the gene for CF. I am not sure if my father has the gene though. Should I be tested?
 

Diana

New member
I am not sure of your background but hopefully you a healthy 13 year enjoying your youth. The fact that your mother is a carrier of the gene will become something of interest to you when you are thinking about having your own children (some years away yet). You may already know that both parents need to carry the gene for the baby to have a 1 in 4 chance in getting CF.

Honestly the best advice will probably come from your parents so bring it up with them and see what they say.

<img src="i/expressions/face-icon-small-smile.gif" border="0">
 

Alyssa

New member
To the anonymous 13 year old poster - that depends on a couple of things... your health so far, any siblings with symptoms of CF or a diagnosis of CF, your mother's health (she could have one identified gene and one not identified posibly?) does she show any signs of CF or are you sure she is only a carrier?

How/why did you find this site? If the answer is something like "my brother has CF" or "I cannot maintain a decent weight and I cough up junk all the time" then I would say YES YES YES you should be tested.

It would be helpful if we had more information to base our advice to you on.
 

busymom

New member
Alyssa,

I just wanted to thank you for your blog. It made me realize that CF is not always obvious and how people can go undiagnosed for years. Thanks for the time you spent writing all that out.

I have shown my husband all the answers on here and now we are discussing what we should do.

Thanks for all the help.

Chelley
 

julie

New member
Yeahhh!! Chelley got a screen name <img src="i/expressions/face-icon-small-smile.gif" border="0">

I just wanted to mention to you Chelley that if you are doing a genetic test, it doesn't really matter where you have the blood drawn (CF accredited center, family doctor, some sort of specialist) as long as they are sending it to a laboratory that does the extended panel CF test. The sweat test is what's important to have done at the accredited center!

As far as I know (and I could be wrong about this), Quest diagnostics is the Only lab with the really advanced version. A company called Ambry genetics DOES have an extended panel test, BUT.... many doctors aren't familiar with them and won't send the blood there, and they analyze the mutations differently and frequently miss mutations that quest later finds (thre is a woman named Amy on here who this happened to.)

Best of luck and keep us posted,
 

Alyssa

New member
Chelley,

You are welcome, I'm glad you found it useful. I think it is going to be handy to refer others to over time, because it seems that people in your position show up on here quite often and I was telling my story over and over, now I don't have to do that... I can just send them to my blog ! Yay!

Please be sure to let us know what you guys choose to do and what the results are.
 
Top