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Table 3 Challenges faced by caregivers and families

From: Mapping the PIK3CA-related overgrowth spectrum (PROS) patient and caregiver journey using a patient-centered approach

Stage of life

Challenges for caregivers and families

Across PROS

Specific challenges for M-CM

Birth to toddler

Primary caregiver (usually mother) needs to work full time on childcare, monitoring medical issues, arranging appointments, and research

Caregiver becomes “case manager” balancing HCP communication, research, symptom management, health insurance claims

Brain overgrowth occurs most dramatically during the first few years, leading to many health challenges and the need for frequent monitoring and possibly surgeries

Children may have low muscle tone, frequent infections, and delayed milestones

Elementary school

Caregiver has to work with school, explain issues, navigate missed schooldays

Severely affected patients require constant care and assistance with feeding, toileting, dressing, etc

Need to prepare for and manage seizures

Caregivers may seek out community-based resources and mobility devices (eg, adaptive strollers)

Puberty/teenager

Patient becomes more involved but still dependent on caregiver for research and advocacy group involvement

Family is often still involved in care—especially in severe cases

Behavior issues may arise, putting additional stress on caregivers

Adulthood

Patient manages care but caregivers may stay involved for emergencies

Challenges with guardianship and consent after age 18

Patients still reliant on help from family with navigating medical care and health issues

  1. HCP, health care professional; M-CM, megalencephaly-capillary malformation; PROS, PIK3CA-related overgrowth spectrum