Making Waves…

So I know that this coronavirus pandemic has everyone on edge these days. However, I am here to share some GOOD NEWS to hopefully brighten your day a bit!!

Since mid-March, all of Blaise’s PT and OT has been cancelled as a result of COVID-19. I was a bit upset because he had been making such great progress, but understood why these precautions were being taken for the safety of all.

Apparently, Blaise thought that Mom and Dad’s School of Hard Knocks was a fine alternative to PT/OT. Blaise has been making some great strides these past few weeks! In January when all of this started, Blaise was not eating any solid foods at all, he refused everything I tried to give him. In late January he started eating thicker purees and has been doing an awesome job! However, a week and a half ago, he started eating small bites of food, versus only purees. Here he is eating some PB&J for lunch. He can even pick up small bites of food using a pincer grasp and feed himself! What progress!

PB&J is SO YUMMY!

Blaise also didn’t drink anything except formula nor did he drink from anything other than a bottle until 1.5 weeks ago. He finally will drink water with no problem, and can drink it from a sippy cup! We are still working on getting him to hold the sippy cup himself, but he will get there soon enough!

Drinking some water!

And last but not least….drumroll please……. Look what this joker can do on his own!!

As I have mentioned before, Blaise has hypotonia, or low muscle tone, as a result of his disease. What this translates to- Blaise has difficulty coordinating movement, like sitting independently, crawling, etc. Blaise has been doing so much work to improve his core strength, and finally he got up on his hands and knees ALL BY HIMSELF (and held it for ~10-15 seconds!). This is a HUGE step! He also has been pushing off of his arms in this position and moving himself backwards. So hopefully, he will be able to move it forwards soon!

This is such an exciting milestone for this sweet boy!

I would be lying if I said that all of the work we have been doing with Blaise was easy all of the time. Some days he doesn’t want to do the work and cries, or gets frustrated with the repetitive movements. Some days, his big brother just has to be in the middle of everything (two year olds…am I right?). And when we are the ones seeing him everyday, sometimes it is hard to see any progress at all, despite family and friends encouraging us that they see improvement. But I will say, when we get to see Blaise hit these milestones and how proud of himself he is when he does something new, it is worth every moment.

Way to go Blaisey Boo!

Welcome to Holland

So I will most certainly not take any credit for this, all of the credit goes to the author, Emily Perl Kingsley. This essay was given to me by a dear family friend, and I feel like it is a great analogy regarding discovering Blaise’s diagnosis and what came after. I’m sure sometime I will post about my personal journey on what came after discovering the diagnosis, but for now, I feel like this is a good introduction. While some days it doesn’t feel as simple as a change in destination, it helps to give perspective. If you haven’t read it- it is worth a few moments of your time (see below).

**Warning** I realize that during this COVID-19 fiasco that NO ONE wants to go to Italy. But let’s play pretend this pandemic is not happening while reading this 🙂

When you’re going to have a baby, it’s like you’re planning a vacation to Italy. You’re all excited. You get a whole bunch of guidebooks, you learn a few phrases so you can get around, and then it comes time to pack your bags and head for the airport.

Only when you land, the stewardess says, ‘WELCOME TO HOLLAND.”

You look at one another in disbelief and shock, saying, “HOLLAND? WHAT ARE YOU TALKING ABOUT? I SIGNED UP FOR ITALY.”

But they explain that there’s been a change of plan, that you’ve landed in Holland and there you must stay.

“BUT I DON’T KNOW ANYTHING ABOUT HOLLAND!” you say. ‘I DON’T WANT TO STAY!”

But stay you do. You go out and buy some new guidebooks, you learn some new phrases, and you meet people you never knew existed. The important thing is that you are not in a bad place filled with despair. You’re simply in a different place than you had planned. It’s slower paced than Italy, less flashy than Italy, but after you’ve been there a little while and you have a chance to catch your breath, you begin to discover that Holland has windmills. Holland has tulips. Holland has Rembrandts.

But everyone else you know is busy coming and going from Italy. They’re all bragging about what a great time they had there, and for the rest of your life, you’ll say, “YES, THAT’S WHAT I HAD PLANNED.”

The pain of that will never go away. You have to accept that pain, because the loss of that dream, the loss of that plan, is a very, very significant loss. But if you spend your life mourning the fact that you didn’t get to go to Italy, you will never be free to enjoy the very special, the very lovely things about Holland.

Rare Disease Conference 2020

Blaise and I went to a Rare Disease Conference in San Diego at the end of February. I feel very fortunate that we received a tentative diagnosis in time that we could sign up and attend (all of those prayers are at work!!!). As you can imagine, traveling solo with your 1 year old infant in arms for a 5 hour flight that takes off an hour before bedtime sounds like a nightmare. Luckily, sweet baby Blaise slept like a champion for the entire flight once we got up in the air!

This conference was hosted by Sanford Burnham Prebys Medical Discovery Institute which is a non-profit medical research institute, and a lot of research in glycobiology (basically “sugar science”) is completed there. Dr. Hudson Freeze is THE name in CDG research, and when we walked up the morning of the first day, he happened to be outside and greeted us warmly as if we had known each other for years. What a positive note to start the conference on!

Blaise with Dr. Hudson Freeze on Rare Disease Day!

The conference was a three day event, the first two days more scientific in nature and the third day all of the presentations were geared toward families of children with CDG. I can honestly say while I was at this conference, I felt many different emotions.

I felt empowered. I learned about a large community of scientists and doctors who are dedicated to finding treatments and cures for CDG. I honestly couldn’t believe there was such a large network of extremely intelligent individuals who dedicated their careers to improving the lives of those with this disease. I learned about progress that has been made for certain subtypes, some with cures. I learned that there are treatments in the works that might be an option for Blaise someday.

I felt hopeful. I met other families whose children have this disease. They reassured me, taught me about things that I can do to help the research effort, about things I can do to ensure Blaise gets the care he needs. I saw these families, both with typically developing and children with CDG acting like… well…families. Siblings were being siblings, fighting, then loving on each other. It didn’t matter if they had a diagnosis or not- kids were being kids. Now don’t get me wrong, there were a lot more wheelchairs, walkers, and other assistance devices than you would see on your everyday playground, but these kids did not let their diagnosis stop them from anything. That was amazing to experience. I am so grateful that I can be a part of this community now. I know these are friendships that will last a lifetime, and that I will learn so much from them. I think the best part about this community is that there are no explanations necessary among this group. Everyone understands each other and treats each other like family.

I felt a tiny bit sad. I don’t want to sugar coat things, because I am generally a tell it like it is person. Despite all of the information that I learned and all of the amazing families that I met, I still feel a little uneasy about what Blaise’s future holds. I do not know how he will develop. If or when he will walk, or talk, or –insert anything else you would normally dream of for your child. I don’t know if one of these treatments will end up working.

But I am choosing to let this tiny bit remain miniscule- because there are so many positive and optimistic things to focus on in this situation. I do not have to advocate to get researchers to pay attention. People already are and have made great strides for CDG already. I have become part of a new family, that I am eternally grateful for. And most importantly, I still have a sweet, smiling boy- who melts the hearts of those he meets, especially with his current snaggletooth situation and most recently- his glasses.

Blaise on Day 1 of the conference eating some breakfast!

Overall I have to say the conference was a huge success. We learned so much, met such an amazing community, and even enjoyed some San Diego weather outside of the sessions. This conference is going to be a must do every year, because such relevant information and the latest happenings in research is shared there. Every other year this conference is in the United States, and on the opposite years, it is an international conference. Next year it is scheduled to be in Lisbon, Portugal, and we certainly hope to make a little vacation out of it!

What’s with the Zebra Stripes?

Those of you who know me know that I am a very patriotic person and generally love all things “Murrica”. Then the blog name likely made sense to you, until you saw black and white zebra stripes where red and white should’ve been. So you might be wondering “what is with the zebra stripes?”- Well, let me explain!

As I have mentioned before, congenital disorders of glycosylation, or CDG, is classified as a rare disease. And believe it or not, there are actually more than 7,000 unique rare diseases that exist in the world at this time! If you would like to learn more about CDG or any other rare diseases, this is a really great, and reliable resource: https://rarediseases.org

Now on to the zebra: The zebra is the official symbol of rare diseases in the United States and is noted for its black and white stripes, which are central to its uniqueness. As you, or maybe a child of yours, might know- no two zebras have the same stripe pattern. So like zebras share their black and white stripes, those with rare diseases share many commonalities, but have their own unique traits.

Rare Disease Day is always the last day of February, and this year was extra special as it was Leap Year AND Blaise and I were at the Rare Disease Conference in San Diego! Thought I would share this cute picture of Blaise “showing his stripes” this year!

Have you ever seen a cuter zebra in glasses?!

The Journey to a Diagnosis…

At the end of 2019, we had concern that Blaise wasn’t hitting motor milestones- like sitting independently or pulling to stand. After many phone calls and lots of prayers, we finally got Blaise an appointment at UNC in mid-January. The rest is HIS-story and it goes something like this:

We met with a physician at UNC’s diagnostics clinic, who told us he felt Blaise had mild hypotonia (weak muscles), and then referred us to a pediatric neurologist for further work up. Between these visits, we learned that Blaise had slightly elevated liver enzymes (AST/ALT). Talk about some unsettling news, but I remained optimistic since everything else seemed to check out.

After the neurologist’s visit, Blaise was ordered to have an onslaught of blood work done for a variety of genetic and metabolic disorders. As we were waiting for the bulk of the results to come back, my husband and I looked up every disorder on the after visit summary to see if any of them sounded like Blaise. None of them did, he just didn’t seem to present the way many of the genetic disorders usually present. So we continued to wait and see what would come after all of the test results came back.

Blaise was also ordered to have an echocardiogram, and abdominal ultrasound (to evaluate his liver), and an MRI of the brain. For those who may not know, MRIs for infants are usually sedated because children cannot stay still for the duration of an MRI. Blaise was also sent for physical therapy and occupational therapy evaluations to start working on strengthening his muscles.

The neurologist told me that he wouldn’t call me unless an abnormal result came back. Fast forward to January 28, when I got a call in the middle of the day from a UNC number. I had been getting calls from them daily as we worked to schedule all of these appointments and procedures for Blaise. But this time, my heart sank as I heard the neurologist’s voice on the other end of the line. He explained to me that a test looking at carbohydrate deficient transferrin had come back abnormal. He explained that this could mean that Blaise had what is called congenital disorder of glycosylation, but that we would need a diagnostic test to confirm. I had never in all of my training in pharmacy school or residency heard of congenital disorder of glycosylation, or CDG. I was optimistic that it was a metabolic disease because it might be something that could be cured somehow. The neurologist explained he would be referring me to a geneticist for further work up.

So naturally I got off of the phone and started googling CDG. And man- it was not at all the treatable metabolic disorder that I was hoping for. It is a rare disease that less than 250 people in the United States have and less than 1,000 people worldwide. But one thing that it was- the symptom profile seemed to match how Blaise was presenting to a “T”. Blaise did have developmental delay, motor delay, hypotonia, esotropia (crossing eyes) and a very happy disposition. I had not noticed he had little fat pads right above his bum, or inverted nipples, but after reading about these as common features- I realized he had them too. Even though the transferrin test was not supposed to be diagnostic, it certainly felt that way- because these websites explaining CDG were describing my son, my baby.

We met with the geneticist who said she felt the diagnosis was 99.9% likely, based on his presentation and the transferrin results. We talked about CDG, and what would come next for Blaise. We did send off the diagnostic test, which came back several weeks later giving him a firm diagnosis of PMM2-CDG (if you want to learn more, here is a brief video about his subtype https://youtu.be/WI8-ZKWgAcU ). Currently there is no treatment or cure for his subtype of CDG, other than supportive therapies.

So now that we know, what’s next? Well, we make sure Blaise continues to get the therapies he needs to make progress and to get stronger. We will set up an appointment for him to be seen in a clinic that specializes in CDG so that we will be in the know for future treatments or trials. We will work to enroll him in some “natural history” studies that are being done specifically looking at CDG to get a database of information on this disease that can hopefully be used to find a treatment, or even better, a cure. We do not know right now what Blaise’s limitations will be long term. All I know is that a wise man that I have the honor of knowing personally, he lives his life by the mantra “Nothing is Impossible with God”. That is how we will choose to live our lives, too.

The 4-1-1

So for those of you who have stumbled upon this blog by accident, I figure I should give you the 4-1-1 on my family!

I am Kara, mom to Carl “V” (he is the fifth) and Blaise. V is a typically developing kiddo, and Blaise has been diagnosed with CDG, which makes him a kid with different needs. I am wife to Carl (yes, the fourth) and we have known each other since high school- in fact- he was the first guy I ever dated, but we took a ~8 year hiatus before reconnecting after college!

I started this blog as a way to share our story with the world, and I hope that it might one day help someone who might be going through the struggles of a child with a new diagnosis, who might be navigating the CDG waters as well, who might just have a stubborn two year old who is driving them absolutely bonkers. But before we get too focused on my lofty goals, for now, this is a nice way to share our story with those who want to know, on their own time. If you have questions- please feel free to reach out anytime or just comment below 🙂