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!

Justin’s Decision: Deep Brain Stimulation

DBS

Written by Justin

(A Creative Writing English Assignment) 

            Justin talks to his mom about having deep brain stimulation (DBS) surgery, kind of like a pacemaker that can send electric charges in the brain.  15-year old Justin has kernicterus, which is brain damage caused by severe newborn jaundice.  He has athetoid cerebral palsy, which means his muscles move uncontrollably.  He uses a power wheelchair to move around.  His mom understands his voice, but others sometimes don’t, so he also uses a communication device.

Justin: Mom, I have something to tell you.  [waits for mom to stop doing the dishes and come and sit down by him at the kitchen table.]

Justin: I have been thinking about doing DBS.  I know that at first after we met with the doctors, I didn’t want to do it.

Mom:  Right.  You said that you were fine just as you are.

Justin: Now, I want to do it.

Mom: What made you change your mind? [concerned]

Justin: I’m feeling frustrated when my muscles are acting as if they have their own brains. Everything is just too hard. I tried all the medications and none of them have worked for me.

Mom: I know it’s hard.  You said last week that you’re fine with how you are.  So, what are you fine with about how you are?

Justin:  I’m happy.  I have fun watching sports and love school.

Mom: Do you think DBS will make those things harder or easier?

Justin: I think it’ll make things easier.

Mom: Do you remember what the doctors said about what’s all involved with DBS?

Justin: Lots and lots of therapy

Mom: That’s one. Can you name another one?

Justin: There are risks like any other surgery. Benefits are unknown but might calm my movement and make it easier.

Mom: I want you to have an easier life so the possibility of getting better control over your muscles seems pretty cool. Do you remember what the doctors said about how they do DBS?

Justin: I know there are two surgeries. The first lasts six to eight hours.  I’d be in the hospital for one or two nights and it would be where they put the electrodes in my brain by the basal ganglia.

Mom:  That’s right.  And you’d probably be home from school for around a week to recover.

Justin: A couple of weeks later, I’d have the second surgery.  It takes less time and is when they put the stimulator in my chest and hook it to the wires in my brain.  I’d be in the hospital for a night or two and then home for a week.

Mom: Then, do you remember what happens after that?

Justin: I’d go in to get it turned on and then have to go every month for about a year to figure out the right amount of stimulation.  That’s when I’d be doing lots and lots of therapy.

Mom: So, you know what happens.  You know the risks and that the benefits are kind of unknown.  You also know a girl with kernicterus who has had DBS and your movement disorder team did DBS with a young man with kernicterus this past year.  One thing they mentioned was that if you did DBS now, it would probably be more effective than if you waited until you were older.  Did you remember that?

Justin: Yeah.  DBS hasn’t been done on many kids with kernicterus.

Mom: Only a handful.  And it’s not a cure.  You met Lexi and she’s better than she was without DBS, but she still has a lot of challenges.

Justin: Lexi is pretty young, so maybe she’ll keep on doing better as she gets older.

Mom: It’d be nice to be able to see in the future and be able to compare your life with or without DBS.  Unfortunately, we don’t get to do that, though.  We just have to make a choice based on the best information we have and live with it. It’s not an easy yes or no answer and it’s all kind of scary.

Justin: Like a baseball game scary

Mom: Explain?

Justin: Tie game, last inning, 2 outs, one man on third, 3 balls, 2 strikes.  DBS can be like my RBI.  It’s life baseball.  It’s my hope for winning the game and knocking kernicterus on its butt!

Mom: So, you’re going to do it?

Justin: Yeah. Let’s do it and see if we can get a homerun but be happy with a base hit.

This is a pictorial view of Lexi’s journey with DBS

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!