Saying Farewell

It is with the utmost sadness that I have to inform anyone who reads my posts, as little as I write them, that my son passed away on August 9th 2015. He was only 37 years old. I am struggling to understand why. Nathaniel was severely autistic, as I have mentioned before. When he was 5-6 he started to develop very disturbing self-injurious behaviors such as pulling his hair out and biting his arm. At one point the local school recommended that he be institutionalized, something that both his mother and I did not want, but we did visit a facility about 45 minutes away from our home. That visit cemented our resolve to do anything to keep Nathaniel out of an institution. Since I am a scientist and worked for the National Institutes of Health, I knew some of the programs that were being conducted at the National Institute of Mental Health. I was able to find a doctor there that was investigating a new drug to control OCD in autistic children. So we signed up. There was a remarkable improvement in Nathaniel's behavior, and it was mentioned both to me and in the research paper that was published that Nathaniel did the best on the drug. Of course, that drug is used frequently now - Anafranil (generic -clomipramine). His quality of life was greatly improved and I would not for a second change my mind on using it. However, I do believe that the drug contributed to my son's death. The official cause of death was accidental water intoxication. This is sometimes seen with athletes who drink gallons of water after strenuous exercise. This of course made absolutely no sense since he is cared for 24 hours a day. His care provider says that Nathaniel had a good Saturday, drank his normal amount of coke, his favorite, said his prayers before going to bed (prayers he learned as a small child and repeats more as a compulsion than anything else since he will not go to bed, ever, without saying them to someone) and went to bed. However, Nathaniel always gets up about 10 minutes after going to bed, goes to the bathroom, slams the door, all very ritually. His care provider, while in bed, realized the he didn't do that, so she got up to check on him. He was unresponsive, lips blue, and lifeless. She got him on the floor, started CPR and called 911. Although she thought that she felt a heart beat, the EMTs were unable to get a response. Only the toxicology showed a case for water intoxication, and I have to say that the limited tox studies seemed to be geared to only confirm the diagnosis. So much more could have been checked. I know without a doubt that Nathaniel didn't drink gallons of water that day, so I looked for any condition that might mimic water intoxication and found one. An extremely rare side effect of the drug he was on can cause a condition known as "Syndrome of Inappropriate Antidiuretic Hormone Secretion" which causes an imbalance in electrolytes in the blood. With low sodium and low potassium, heart failure may ensue. I believe that this is what caused Nathaniel's death. Nathaniel received yearly physicals and yearly EKGs, and it is not likely that this condition would have turned up. Maybe if a blood testing had been performed very recently, a problem might have been seen, but Nathaniel showed no signs of distress at any time, but without any speech, he would not have been able to tell us specifically if he was having any problems. Anafranil gave Nathaniel many good years he would not have had and I do not blame the drug, or myself, for his passing. This of course does not make it any easier to lose my only child. I cry every night and say the prayer that Nathaniel always said to me when we were together. I miss him terribly.