Letters of Support

photo from http://phoenixvail.wordpress.com/2011/09/08/the-power-of-letterwriting/
photo from http://phoenixvail.wordpress.com/2011/09/08/the-power-of-letterwriting/

For all affected by kernicterus and/or supporters of picK,

picK’s leadership recently spoke with Steve Shapiro and want to share what we’ve heard from him, AND get your help. Your voices are very powerful (more on that at the end)!

What is Steve up to?

Steve is once again applying for aPCORI grant (a US government grant that is focused on doctors and researchers PARTNERING with patient organizations like picK).  It was a bummer that the last application wasn’t approved, but it also provided very good feedback that may help him achieve success this time.  The feedback provided by reviewers (the people who vote on whether a project gets funded) all suggested that the research must be more focused.

Thus the decision has been made to focus upon:

  1. A diagnostic toolkit for families to determine if they should have an evaluation for kernicterus or bilirubin induced neurological disorders (BIND) and for physicians and healthcare providers to make the diagnosis. We expect that this will allow for earlier identification and diagnosis of kernicterus, and we will be able to test if this is true. There are dozens of reasons why this is prudent, namely in helping to establish HOW OFTEN kernicterus is happening and to provide those living with proper treatment that can help optimize their futures.
  2. A Kernicterus Registry. Only by knowing who has kernicterus, what type and how severe, can we begin to find what treatments can best help individuals with kernicterus. So we will argue that by establishing registry we can determine what treatments are being used and what ones families think are helpful, and then use this information and the new registry to evaluate current and future treatments that families and individuals want so we can have good answers to families as to what works.

Why this direction?

We all very much want to see viable TREATMENT options for our kids and PREVENTION (not having the problem of kernicterus in the first place), but as a long-term strategy and after speaking with higher-ups in healthcare, we realize that it is first fundamental that people understand that KERNICTERUS IS HAPPENING.  We all know that no one wants to put effort into preventing something that they think is mythical, and as much as we know that kernicterus happens much too often, the rest of the world doesn’t. They need numbers, and this is an important step in establishing those numbers and outlining exactly what kernicterus is and how to diagnose it.

The Letters

With that being said, what’s needed from picK parents is letters of support. These letters need to be FIRST AND FOREMOST ADDRESSING THE ISSUE OF EARLY DIAGNOSIS!

The PCORI reviewers were BLOWN AWAY by the letters we sent with the last grant but also felt like many families talked about how kernicterus needs to be prevented and less about diagnosis and treatment. This time, we know what to ask you for so here it is:

  • 1 page or less
  • Submitted by midnight January 13 (Please email to picKorg@gmail.com)
  • International letters are welcomed and appreciated!
  • Focused on:
    • Support of Dr Steven M. Shapiro’sresearch
    • How early diagnosis helped OR would have helped your child
    • The importance of diagnosis (if you know you are dealing with KI, you can determine early if your child has hearing loss, and for kids with the motor piece you know in the critical EARLY months how essential tummy time is for kids with severe dystonia, to work on balance, know what specialists to see, meds to try, etc)
    • How standards for diagnosis are beneficial (how your child is easily mistaken as having autism, spastic cp etc without dr.’s having the proper info to diagnose)
    • How a Kernicterus Registry will permit future comparative studies of effective treatments that will make a big difference.

What will a PCORI grant mean?

These letters will be for the purpose of showing support for a kernicterus diagnosis kit and a kernicterus registry.  It will mean additional funds of almost 1 million dollars for the Kansas City Kernicterus Center at Children’s Mercy Hospital.  They will be actively coordinating with picK on this project and picK parents.  {As a side note, the KCKC has multiple projects and is expanding all the time.  They will continue to work toward better treatment options for our kids, and if anything this grant could amplify those efforts.}

We thank you very much for taking the time to support both picK and the efforts of Dr. Shapiro in helping to identify, treat, and stop kernicterus!!!! Your voices may feel faint, but they are by no means small.  We all have a very valuable perspective on kernicterus.  With our voices we can impact change for the better.  We can help our own children and the children of the future.  Thanks for your time and Happy New Year!

Susan, Miriam, Vicki, Kelly, and Kasey

In the Shadows

rescue

They are in the shadows.

Babes are at risk.  (Jaundice can become toxic when not managed properly.)  Children live with no viable treatment options.  Research funds are needed.  Adults live in immense difficulty.  Families struggle to hold together fractured pieces of their lives.

…all because of jaundice.

There are those shaped by “the K word” and those who are threatened by it.

They live in the shadows.  Many babes are affected by jaundice, but not all escape it unscathed.  Here in the US, there is no reporting system for kernicterus.  Due to the negligent nature of the diagnosis and the ethical concerns that accompany it, it is not always diagnosed either.  How many are living with kernicterus and do not know it?  The effects of kernicterus take months and years to become apparent.  (Newborns don’t need wheelchairs.  They aren’t expected to walk or talk.  The movement disorders, sleep disorders, hearing loss, vision loss etc all become apparent as children miss milestones.  Without proper analysis, the k word is easily swept under the rug, misunderstood, mislabeled.

And what of those living with the milder effects?  Neurological hearing loss (that can only be discovered under sedation with a test that measures brain wave response to sound.)  How often is this misread as behavioral – smart children with unpredictable hearing and difficulty communicating?  Milder forms of kernicterus also seems to come with hyperactivity – how often is that mistaken for other disorders?

The truth is that the numbers of kernicterus are hidden in the shadows.

Our kids, those in picK are likely the tip of the iceberg, and our numbers grow weekly.  And the truth is – one case of kernicterus is one case too many.  The effects are just too catastrophic!

How do we rescue?  How do we make the change?  How do we illuminate?

How do we?

  1. On the front end, we turn the light on!  We spread the word – jaundice can do that, and it doesn’t have to!  TEST!  Prevention.
  2. For those living with the K word, we support the research that will lessen the load of that K.  Research for viable diagnostic tools and treatment options that can lessen the effects of the K…diminishing it’s effects.  Rescue.

Please partner with us in shining the light needed into these shadows to rescue those living with the K!

Beyond the Numbers: What untreated jaundice means for my family

Beyond the Numbers: What untreated jaundice means for my family

November 11, 2013 by Kasey Haas, Guest Blogger

Shortly past dawn my little sister, Lexi, awakens. She coos like a baby dove, calling my mom to her. Mom nestles her in a blanket and snuggles her on the couch, urging tiny bits of food and water into her mouth.

Lexi (center) and Kasey (the author, right)

Lexi (center) and Kasey (the author, right)

The scene is reminiscent of moments from around the world as parents care for their tiny, helpless newborns. Only my sister is not an infant. My parents have been repeating this scene each morning of Lexi’s eleven years and unless something dramatic happens on the medical front, I imagine that when my mom is 80 and my sister over 40, their mornings will still be shared in this manner, because Lexi has kernicterus (KI), a lifelong neurologic injury caused by her newborn jaundice.

KI causes severe motor impairments and a form of deafness called auditory neuropathy, but it spares the intellect, trapping children in bodies that don’t work but with minds that function perfectly. As the morning progresses at our house, Lexi will multiply fractions, conjugate verbs in French, and learn about European history—but all at home as our local schools can’t accommodate a child with such advanced intellect and poor physical function.

Lexi’s story is relatively rare, but not unique. Shortly after her birth, my parents noticed a yellowish hue to her skin. Our doctor assured us that there was nothing to worry about. “Feed her often and she will be fine.” And with that we were sent home with the newest member of our family. No tests. No further instructions.

Read more here…

Let’s Make Kernicterus a Never Event

headerlexi-yawning-300x225

September 18, 2013 by Kasey Haas, Guest Blogger

In 2001, the National Quality Forum labeled kernicterus (KI)– a disability caused by untreated newborn jaundice and characterized by motor and hearing impairments – a “Never Event”. Alongside events such as leaving sponges and tools inside surgery patients, KI was classified as an event that is so easy to avert, that it should absolutelynever occur. Yet, even in the United States, we have failed to eradicate KI.

Why does it persist?  …Read more here

http://blog.d-rev.org/2013/09/18/lets-make-kernicterus-a-never-event/

DC. We came. We saw. We Conquered?

Posted on May 21, 2013 by 

IMG_0423

May 2nd 5 moms, 3 of which brought their kids with KI, (equipped with the wheelchairs that KI brought into their lives…and more than a few other pieces of medical equipment) to DC.

We were invited quests at the pediatric Academic Society’s annual meeting, particularly the bilirubin club, the global prevent kernicterus network, and the kernicterus symposium.

For those of you that aren’t familiar with us, PICK is a small grass-roots non-profit that has reorganized and reemerged from several dormant years.  We have 2 missions that fuel one another:

Prevent

 Cure

 In a nutshell, it’s this:

  1. Jaundice can be harmful to newborns
  2. Proactive care, testing, evaluation, screening, and treatment are NEEDED
  3. These steps can PREVENT KI for happening
  4. We advocate education and compliance to standards that will stop KI before it starts.
  5. For those who already live with the devastating consequences, be they severe (appearing much like spastic quadriplegia, coupled with hearing loss, inability to eat, digest food properly, speak, and sleep) or milder (appearing more like behavioral issues, hyperactivity and frustration) there is a great need for research leading to EFFECTIVE treatments…treatments that will pave the way toward a cure.

So, back to DC, our mission there, although barely articulated behind the flurry of arrangements for childcare, spouses, nursing care, lodging, fundraising (we each paid our way almost entirely…but don’t feel too sorry for us, WE BELIEVE in this and are willing to invest in it).  So our mission:

  1. Let the medical community, particularly those who are invested in bilirubin research, phototherapy, testing, neonatology, neurology and pediatrics, remember what they are about
  2. Get the word out that our membership CONTINUES to grow (this is NOT a good thing, and yet it can be used for good in that it can help us pursue better treatments and get the word out)
  3. Network with others invested in seeing KI stopped.
  4. Get the word out to connect other KI families across the globe (for more effective research and treatment)
  5. Let our kids work on something bigger than themselves…making lemonade of the lemons in their life…not suffering silently, but using their collective voice to impact change

At times, between diaper changes, tube feedings, charging medical devices, concerns about brewing troubles in their complex bodies, taking time to let the kids stretch outside of their wheelchairs etc…it felt like we just didn’t have enough to give.  Indeed our actions had to be arranged around our kids needs.  They were the stars of the show,after-all, and their needs had to be met.

luggage for 1 kid with ki and his mom

this was all of the equipment that we brought for my son

And they were AMAZING.  What highly intelligent kids sitting in bodies that would not cooperate at 7,9, and 11 years old would sit through hours of lecture on high level science behind phototherapy?  These kids!

At one point I had to wipe my boys tears from his eyes as he saw a slide of a severely jaundiced and critical baby.  He can barely utter a word, and yet, he spoke volumes, and the whole room saw it.  He knows what happened to him, and he carries a tremendous amount of compassion for other children at risk.  He’s on the team!

There was more than 1 teary eyed physician that offered thanks for our organization and for our kids and the inspiration they offered.  They shined.  Their intelligence and humor shined.  They made us laugh constantly, and many docs offered thanks to us forreminding them what they are about in the fight to stop  KI.

Our hearts broke to hear more about the extent of the global burden of jaundice, and the cataclysmic damage left in it’s wake.   But we didn’t just talk about the problem, we heard from the field, what people are DOING about it…products being developed to make testing in the field affordable and portable with minimal battery power, safer means of heliotherapy for babes that don’t require the NICU, and phototherapy options for between $200-600 that last 8 years and are built to withstand power surges and shortages.  WE WERE INSPIRED.  There is a problem, and there are people out there with their hearts and minds invested in the battle to see it stopped to stopKI!!!

We won’t lie.  Speaking about KI for 16 hours a day for 5 days, while caring for our kids – NOT EASY.  We each fought back tears of our own at different times.  Living in the reality and discussing a tragedy beyond human comprehension – it takes it’s toll.

Doing something –

Acting –

Being the one that cries out, that exposes the need for action –

Seeing the powerful voice that our children have…the voice that is so much stonger than words uttered –

…it’s medicine for the soul!

Networking.

  1. We made dozens of contacts and are in the process of developing an educational program for professionals, that will be viewed at several university hospitals.
  2. Some of our growing group in Brazil will be able to meet this week with a non-profit that is working to give Brazil access to more affordable and effective phototherapy.
  3. Our kids got to meet many heros that have fought to prevent their condition.  They inspired one another, and the docs that work hard to stop KI.
  4. We received over $7,000 in donations as a direct result of our work there.  (These expenses will be used to support research and reimburse some of the board’s travel expenses.)
  5. We were able to distribute over 500 of our brochures.
  6. Numerous board meetings and brainstorming took place (something that is often a challenge given our spread over 3 time zones and busy schedules.)

And then there are the things that don’t fall into bullet points as easily:

For the first time that I know of, in over 8 years, 3 kids with KI got a chance to spend five days together.  It gave us a unique time to reflect, as mothers, on the similarities and differences our children share.  This information might prove very useful in steering research.   And speaking of research – the leading researchers of KI and hyperbilirubinemia were THERE and they were taking it all in too! In fact, the fabulous neurologist and world-renown researcher Dr. Steven Shapiro spent a large amount of time with our kids.  There was some fabulous conversation about science, some great connections on research to benefit our kids, and educationalventures to help encourage better handling of newborn jaundice, and some fun too!

We very much look forward to the day when our organization will grow to a size that can accommodate a FAMILY CONFERENCE.  Bringing the researchers and families TOGETHER – there will be more benefits there than I can articulate.

And humor!!!  Lexi, not only has an IQ of 160, but she also has a wicked sense of humor.  Lexi does not have the hearing loss that the boys have, and is able to speak several words rather reliably.   The boys understood every bit of what Lexi was getting at.  The ability to speak does not negate the ability to understand.  We were able to ask questions and give options and get huge smiles and laughter in response…and the laughter of Lexi and Blue and Zach is a tangible piece of pure joy!!!

So, between laughter and tears and long days, and new connections, YES, we conquered!

PICK @ PAS 2013

Posted on May 3, 2013 by Miriam

PICK at PAS in DC 2013

As I post pictures tonight, I think of how deceiving pictures can be. They are the split seconds. I tried to convey some of the reality of our day. In truth, it brought the challenges of formula pumps leaking all over the restaurant floor, a footrest falling from a wheelchair, some serious reflux, concerns about abdominal swelling around a surgery site, worries about a yucky cough, a wheelchair tray that seemed to fall off every 10 steps or so, diapers leaking etc. So, no, it’s not easy…and yes, we try to breathe deep and let our children’s smiles sink into our souls.
In truth, one of the agencies that we have worked hard over the past few months to see while here, has still not responded, and that’s hard. We want to be able to help others understand the catastrophic cost of KI and do what they can to put the better protocols in place and follow them. But even with that disappointment, it is with happy hearts that we join PAS tomorrow and thank the doctors that ARE invested in the battle to #stopKI!

Miriam