Mitochondrial disease appointment update 2018

Kerissa • July 26, 2018

Hey friends,

I’m sorry it’s taken me so long to write an update on how my neurometabolic appointment in San Diego went!

Been trying to pull all my thoughts together on what we learned at the appointment.

After updating my mito dr. on all that’s happened since I last saw him, he is thinking more and more that the POLG gene variant that was found in my whole exome sequencing is the likely culprit that’s causing my mitochondrial DNA depletion.

According to the NIH genetic reference site, POLG “is a DNA polymerase, which is a type of enzyme that “reads” sequences of DNA and uses them as templates to produce new DNA.”  It is also the “ only DNA polymerase that is active in mitochondria and that can replicate (make new) mtDNA.”

Again, he said I’m very special and that he’s never had a patient with mtDNA depletion syndrome AND Wilson’s Disease. So he wants me enrolled in the North American Mitochondrial Disease Consortium…currently, there are about 1200+ patients enrolled.  It’s hard to explain what NAMDC is, so you can read all about it here:  https://www.rarediseasesnetwork.org/cms/namdc/About-Us

Please read the link!  It’s very helpful to understand.

POLG-related mitochondrial diseases can cause numerous issues, including problems like cardiomyopathy.  So he said I need to have an EKG every year and an echocardiogram every 2 years.  I also need to stay away from certain medications that can induce POLG-related liver failure.

There is a drug trial that is in phase 3 and going well, but this medication (called Elamipretide) is mainly for mitochondrial myopathy, so he said that wouldn’t be the best fit for me since I have more issues than just muscle weakness.  He did say the company that created Elamipretide is starting to work on many other promising drugs.

One of the main things we learned from this appointment is that things take TIME.  It takes time for companies to make new drugs….time for drug trials to “pass” through all the phases and get FDA-approved….time for research to discover new mitochondrial pathogenic (disease-causing) mutations and whether variants of uncertain significance (VUS) that are found through whole exome sequencing are pathogenic or not….and much more..

My POLG gene variant is a VUS, and in order for it to be “confirmed” as pathogenic, there are 2 ways that can happen.  If you put this specific variant in animal models (like mice) and they develop the same symptoms as the patient, then that variant gets labeled as “pathogenic.”  But….this route takes a ton of money to do.

The other way to confirm a VUS as pathogenic is to put a patients’ genetic data/reported phenotype in a database like NAMDC or MSeqDR (Mitochondrial Disease Sequence Data Resource Consortium), and if several patients with the same variant have similar symptoms, then that variant gets confirmed as pathogenic.

So it’s enouraging to hear all that’s being done in the mitochondrial disease world, but it’s also hard knowing that everything takes SO long to happen/do.

I asked him what my future will look like medically, and he said no one can really say (since every patient with mito presents differently)….he said mito is very serious, but he also told me that I’m coping really well.  Of note, he did say my brainstem is not functioning well….  The “sleep center” is in the brainstem which is why my complex sleep apnea is so bad.

Regarding my myoclonus, the medication I’m on for that isn’t helping the best, so he told me about another medication I could try that doesn’t worsen apnea.  I have to see my neurologist here to talk about it.

I wasn’t able to make it to this year’s United Mitochondrial Disease Foundation (UMDF) national symposium because it was in Nashville.  My mito dr. said he was looking for me there. Next year’s is again going to be on the East coast, but my dr. told me that the UMDF symposium in 2020 will probably be in San Diego! Looking forward to that!  It’s so encouraging to see how dedicated/invested my dr. is in all things mito-related.  He really cares for his patients!

In other news, I saw my physical medicine dr. recently, and he wants to make sure my osteopenia (soft bones) doesn’t progress.  It’s not good to have at my age, so he referred me to OHSU’s endocrinology/bone metabolism clinic.  Another dr. to add to my long list of specialists.. The clinic is booked out, so my appointment isn’t until September.

My hip surgery is scheduled for August 10th.  Less than 2 1/2 weeks away!  The surgery scheduler is working on setting up my pre-op appointments as well.

I saw my GI dr. today, and he wants me to try another medication for my GI dysmotility.  It’s been bad lately. Will be starting at a low dose first.  Because my vitamin D level was low despite taking 5000 IU daily, I now have to take 50,000 IU (prescription strength) since low vitamin D is bad for osteopenia.  In addition, my GI dr. wants me to start taking a vitamin A beta carotene supplement (25,000 IU) because my carotene blood level was very low as well.  He’s also going to get in touch with my general surgeon to have my j-tube changed during my hip surgery.

I hope this update about my San Diego appointment was easy to understand.  Mito is so complex which makes everything hard to explain.. :/  If you ever have any questions, feel free to comment or send me a message!

By Kerissa Lee November 17, 2025
Dear friends, Thank you so much for praying for me when I had that bad reaction to the autoimmune medication last month. I’m so incredibly blessed by your love and support. ❤️ I saw rheumatology recently, and instead of trying to prevent actual autoimmune disease from starting, they want to just monitor without any medication therapy. In other words, they want to see if more symptoms like fevers or rashes will appear (besides the joint pain that I already experience).. The medicine I did try (which worsened my mitochondrial symptoms) is actually the “safest” out there, and the other treatments for autoimmune disorders are much harder on the body—the team doesn’t think I’ll tolerate those well.. It’s difficult for them to know if all the bad antibodies that have been found in my blood will cause “actual” disease, and only time will tell.. So the plan is to just monitor and follow up with them in February. I wanted to see if my body could recover from this setback without having my IV fluids switched to a higher dextrose percentage. But by the last week of October (week 3 of this mitochondrial flare), the muscle weakness and increased pain all over was sadly still persisting, so I told my doctor. He sent in a new IV fluids order with the higher dextrose, and I’ve been receiving it for about 2 weeks now. I have definitely noticed an improvement in the muscle weakness which has been a huge blessing from the Lord. It was such a gift to feel well enough to go to a friend’s wedding reception at my church last week. 🥹 My cup was filled because I haven’t been able to see so many church friends in years! Regarding the piece of plaque that traveled to a small artery in my retina, I just had the carotid duplex scan completed last Tuesday to see if there’s any narrowing in the neck arteries. I also have the heart echocardiogram scheduled for tomorrow. My biggest, ongoing struggle has been my sleep. I’ve sadly been in a “catch 22” situation for many months now. I mentioned before that I was started on a new and safer pain medication this year. A rare side effect is insomnia, and it’s simply horrible. Night after night, every single day, I’m not able to fall asleep until after 4-6 AM. 😢 Believe me, I’ve tried every type of trick…from different sleep medications that my sleep specialist has prescribed, to all sorts of sleep supplements, praying, listening to worship music or white noise, stopping caffeine intake, etc. Nothing helps. The thing is, if I didn’t take this “new” pain medication, the pain from Mitochondrial DNA Depletion Syndrome is difficult to manage and it’s like an 8-9 on the pain scale. So then I’m up through the night, in horrible pain, and not able to sleep. But when I do take this medication, the pain is manageable, and it’s much safer to be on... Yet, I can’t sleep well while on it... Catch 22. I don’t know what to do, and it’s hard not to feel alone in this struggle. I’m so thankful to God that my health in other areas has been pretty stable.. In fact, this month (November) marks ONE WHOLE YEAR since I was last admitted to the hospital! Isn’t that soo amazing? Aside from these occasional mitochondrial flares/crashes (which happened in December, May, and October), I’ve been doing incredibly well, now that the neck weakness has resolved. But, this sleep struggle persists day after day.. I would love to be able to attend my church’s morning service in person or do many other activities in the morning. 😞 But I’m super exhausted. So many times, I ask God, “How do I go on and keep doing this every single night?” One thing I’ve learned is that God’s grace is truly sufficient for each day. He is the one who supplies me with the energy and grace to keep enduring. It’s hard, and I don’t know how long this sleep trial will last.. But, as Thanksgiving draws near, I’m reminded that I do have so much to be thankful for. Some of the biggest things: being physically able to help babysit my 4-month old foster nephew, shopping at the grocery store, having hand strength to design new note cards like the ones shown here, no longer experiencing neck weakness, and much more. The verse from Zephaniah I recently hand lettered above has been so encouraging lately. God is right by my side; he is mighty to save and will keep helping me through anything that I face. ❤️ 
By Kerissa Lee October 19, 2025
Dear friends, At the beginning of October, I started taking a new medication for the autoimmune disease. I thought I was tolerating it just fine, but after several days passed, I began experiencing nausea, loss of appetite, weakness all over, and increased pain. 🙁 It’s like I’m experiencing another “mito crash.” I found out that this specific lupus medication affects mitochondria. That is, it causes an overproduction of reactive oxygen species (ROS). This, in turn, causes cell damage and oxidative stress. I sure wish the rheumatologists would have known about this before prescribing. But I have to remember that Mitochondrial DNA Depletion Syndrome is rare, and they’re not “mito experts.” Anyways, the last time I felt like this was back in May.. I’m so grateful to God that I haven’t needed to be hospitalized from this, but at the same time, I’m also sad that this happened at all, especially because I had such a nice stretch of stable health. I’d really appreciate your prayers, that this muscle weakness can resolve soon, and that this increased pain all over will get back to my baseline. Every time I have a “mito crash,” it feels like I’m fighting the flu which always sucks. The pain has been hard to bear. And whenever I’m in the thick of it, it’s difficult to remember that this too will eventually pass. 😢 Pray that I will endure and follow Jesus’ example like this passage from Hebrews 12:1-2– “Let us run with endurance the race that is set before us, looking to Jesus, the founder and perfecter of our faith, who for the joy that was set before him endured the cross...” Thank you all so much for praying for me. ❤️
By Kerissa Lee October 4, 2025
"Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness." James 1:2-3