News from Indystar.com Mar. 25, 2007

Doctor treats patients who share his disease
About 1 in 5,000 people has Ehlers-Danlos syndrome, a connective tissue disorder
SOUTH BEND, Ind. -- People struggling with rare diseases will fly thousands of miles to find doctors who really know what they're talking about.
More and more, those with the curious connective tissue disorder Ehlers-Danlos syndrome have come to the South Bend office of Dr. Mark Lavallee.
Lavallee is recognized as a national expert on the syndrome, whose symptoms range from loose joints and fragile skin to risk of organ rupture and fatal aneurysm.
But he also has something more to offer: personal experience with the disease. When he was a youngster, an astute pediatrician figured out that Ehlers-Danlos was the underlying cause of skin tears and bruising that required frequent trips to the emergency room and even cast his mother under suspicion of child abuse.
Lavallee, 39, went to South Bend eight years ago to found the Memorial Sports Medicine Institute, a fellowship program for doctors seeking to add that specialty to their credentials.
He has run the fellowship while building a primary care practice and serving as team doctor for national and international weightlifting teams.
He's also established South Bend as a national referral center for Ehlers-Danlos patients.
But he's quick to downplay the label of "national expert" on EDS with a quip about its rarity.
"If you have 10 patients with EDS, you're one of the world's leading experts," he quips.
It's estimated that only about one in 5,000 people has the condition, which is inherited and stems from defects in the genes responsible for the body's most plentiful protein, collagen.
The glitches on the microscopic scale translate into some bizarre symptoms for the people with Ehlers-Danlos. Depending on which kind of collagen is affected, people will have different forms of the disease.
Those with the so-called classical form, like Lavallee, have skin that's very frail and stretchy and that can be pulled away from their bodies like the nylon in stockings. Others have joints so flexible they can bend their fingers back so far that they make a 90-degree angle with the back of their hands.
Because it's so rare, few primary care physicians are willing to venture a definitive diagnosis of Ehlers-Danlos, treat its symptoms or advise people on how to live with it.
So once EDS is suspected, doctors from across the country, Canada and Mexico send patients to Lavallee, who's listed as a referral source by the National Ehlers-Danlos Foundation.
There is no way to repair defective collagen in people with EDS and make them normal.
So primary care involves helping people improve their general health, manage their pain and stabilize their joints with exercise, Lavallee said.
"There's no magic cure," he said. "I do a lot of goal-setting with my patients."
Ultimately, Lavallee said, he'd like to help establish written national standards of care for EDS.
By David Rumbach of the South Bend Tribune
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