Charlie

This article originally appeared in a 2013 issue of the Our World newsletter as part of the All About Me project.

Charlie is two years old and lives in Stanley, County Durham with his mum Kay, dad Stephen, two brothers and two sisters; Callum (11), Phoebe (8), Shay (6), Grace (4). Below Kay tells the Information Point all about Charlie.

This is my beautiful boy Charlie and he has an autosomal recessive form of myotubular myopathy called RYR1 where he inherited two changed copies of the same gene (one from me and one from his dad). This means Charlie, our other children and ourselves are at risk of malignant hypertension, where we could have a severe reaction to certain anaesthetics which can be life threatening. His official diagnosis is RYR1 related congenital myopathy, he has bulbar dysfunction and ophthalmoplegia. He has a tracheostomy and is entirely PEG fed.

When Charlie was born, we immediately realised something just wasn’t right. He was very limp and we actually thought he had died as the hypotonia was so bad. Charlie had no breathing problems but he had a very weak suck so he was moved to a special care baby unit to have an NG tube inserted for feeding. After two weeks he had it removed and was finally allowed home but his feeding didn’t improve and he was rapidly losing weight.

At three months old he saw his neurologist for the first time and he realised that Charlie needed help. He decided he would need an NG put in again and a suction machine to manage his excess secretions that were unmanageable because he was essentially drowning himself. We were sent to the local hospital where they put in his NG but refused to give us a suction machine as they believed he didn’t need it and we were overreacting.

We took him home and carried on but he still couldn’t gain weight and by four months old he’d dropped off his growth centile chart, having not gained any weight for so long. We asked for help from our health visitor and GP but they just said he’d catch up and we felt completely helpless.

At five months Charlie got very poorly. He got a nasty chest infection from aspirating all the time and after three courses of antibiotics with no improvement he became very very ill and we had to call an ambulance to rush him into resus. That was the 18 March 2012, Mother’s Day and little did we know that Charlie wouldn’t come home for another eight months.

Charlie was put on oxygen with no real improvement so a team from The Royal Victoria Infirmary in Newcastle came to intubate him and transfer him to the PICU in their hospital. The next few months were a blur of moving backwards and forwards from PICU to the respiratory ward, being intubated then not, there were nights when we didn’t know whether he’d make it through the night but he fought for his life and came through every time with a smile on his face.

During this time we were asked if we’d consent to a muscle biopsy to try and find out exactly what was happening to our baby and we agreed. This was an extremely difficult time for us as we have four other children who we hardly saw due to being at the hospital all the time and they wanted to know what was wrong with their little brother and when he was coming home but we really didn’t have a clue ourselves so we couldn’t give them any answers. Charlie’s dad also had to go part time at work, eventually having to leave entirely because Charlie needed us.

We also had to move house and away from all of our family and friends to find a house suitable for Charlie’s needs which also meant the other children moving schools so things were very very hard. We finally got him stable enough to have a PEG inserted and he slowly started to gain weight, looking healthy for the first time in his life.

Then the muscle biopsy results were back. We were invited to meet the muscle team at The Centre for Life in Newcastle and we were told that he had a congenital myopathy but they weren’t entirely sure which type but that they didn’t think he would live to see his first birthday. We were completely devastated and didn’t know what to tell our families and how they’d cope with the news so we decided not to tell them, we wanted to see how Charlie coped as up to now he’d fought with everything he had.

We carried on as normal and after he’d arrested several times due to blockages that couldn’t be reached, we opted for a tracheostomy. By this time he was fully ventilated via BiPAP so it would mean that we had access to remove any blockages but also his vent could be attached to his trache and we could see his beautiful face instead of having to wear that awful mask.

Linda

What form of CNM/MTM do you have?

I got it from my father and he is also sick so I think I have the autosomal dominant form but I’m not sure.

When did you first get diagnosed?

2004.

What symptoms prompted your diagnosis?

Weakness.

How long did it take to get your diagnosis?

About 6 years.

How were you diagnosed?

Muscle biopsy.

What impact did the diagnosis have on you?

Weakness, tired, I’m using a wheelchair.

Have you explained CNM/MTM to family members and what was their reaction?

Yes and my father, his cousin and sister and my cousin is also sick. It’s very hard and tough for the family but I can always talk to my father and I know that he knows how I feel. We are very close, and we have come closer because of the disorder.

What implications do you think it has it had on your family?

We have become closer.

Has it affected you e.g. telling your children, starting a family, genetic counselling?

Yes it’s harder for me to meet somebody since I got sick, I really want children and I know I can do Preimplantation Genetic Diagnosis. I’m very happy for that.

Do you have advice for people who are looking for a diagnosis?

Don’t give up!!!

What are your current symptoms?

Pain in muscles, joints and nerve pain. Very weak. I use a wheelchair, tired, I can walk indoors a couple of steps, I fall very easily. Tired in my eyes.

What treatment are you having, and have you had?

Not much, pain killers. I’ve been in Tenerife at Vintersol on rehabilitation and I’m going to start some water training.

How did you find a doctor?

My father got the diagnosis before me so I went to the same doctor as he.

What has been your experience of the healthcare system and healthcare professionals?

Both good and bad, I was wrongly diagnosed for four years and I took very strong medicine because they thought I had SLE. When I got the right diagnosis I started seeing a whole team at Neuromuskulärt Centrum in Gothenburg Sweden but we have only one doctor for 900 patients because of money problems.

Has your diagnosis had any health insurance implications for you?

Yes.

What advice would you give to someone who has just been diagnosed with CNM/MTM?

Don’t give up, I know its a tragedy but live is still full of opportunities.

What did you want to be when you were younger?

Singer and a dancer. Musical artist.

What is a favourite/memorable event from your childhood?

One is when I was in the ballet when I was 12 and I was dancing in a big opera. And when I ran 2.5 km in 8.09 minutes in a competition and won the race.

Who do you think has most influenced you in your life and why?

My grandmother and my mom. The are two very strong women. Because they always
believed in me, and told me I could do anything.

Kris

What form of CNM/MTM do you have?

I am diagnosed with centronuclear myopathy but do not know what form of the condition I have.

When did you first get diagnosed?

2006.

What symptoms prompted your diagnosis?

Pain, weakness, could not stand on tip toes, difficulty with stairs, falling often, balance issues and major fatigue.

How long did it take to get a diagnosis?

Two years.

How were you diagnosed e.g. muscle biopsy?

EMG, muscle biopsy and multiple blood tests.

What impact did the diagnosis have on you?

Typical stages of grieving, but now I’m fighting back!

Have you explained CNM/MTM to family members and what was their reaction?

Yes – my mom did a biopsy too and has been very supportive, as have my husband and two kids. My entire family is very loving and supportive of my illness.

What implications do you think it has it had on your family?

More work for my husband, carrying in groceries etc.

Has it affected you e.g. telling your children, starting a family, genetic counselling?

No.

Do you have advice for people who are looking for a diagnosis?

Be your OWN advocate! Don’t settle for a negative doctor. Stay positive!

What treatment are you having, and have you had?

No treatment, however currently I am on the ‘Eat-Clean Diet’ and am gaining more strength and stamina every week. It’s the best thing I’ve ever done.

What are your current symptoms?

My symptoms the past five years have been extreme weakness (even a glass of water made my hands shaky as I brought it to my mouth), more than one flight of stairs was nearly impossible. I had to push myself up from a chair, I could not jump or stand on one leg, I could not open a water bottle, I could not pick up my children, I could not carry a large load of laundry, standing in one place (like in church) caused severe pain in my feet, my hands hurt severely while typing, my wrists hurt always, I was very fatigued / needed to lay down from 3-6 p.m. daily, I could not enter my home while carrying anything (the extra weight made the one flight of stairs too difficult).

Now though, since ‘eating clean’ (getting a LOT of protein), ALL symptoms have improved. I feel 75% better and can now carry things in from the car, I can carry my laundry, my feet don’t hurt as badly, I am now back in the gym, and I can jump (about 2″ off the floor, but it’s a big improvement). I no longer need the three hour rest / nap and I’m back in the kitchen baking (which was too painful before). I can do 40 pounds on the leg extension machine at the gym now. In my 20’s I could easily do 90 pounds but since my diagnosis I became weaker every year until I could no longer do the weight machines at the gym.

Because of the new diet, my myopathy has significantly improved. I am hoping my strength continues to improve. I’m not a doctor, but this diet has helped me so much! I have my children eating lean meats, nuts, veggies, fruits, and whole grains too now. It’s very strict, but well worth it. I haven’t told my MDA doctor of my improvements yet as I’ve only met with him once. My last appointment was in December when he told me I was 60% as strong as a normal ‘Healthy woman my age’.

How did you find a doctor?

I searched the internet to find my doctor in Charlotte, North Carolina. He is a neuromuscular specialist who has 20 + years of experience. He treats muscular dystrophy and myopathy patients as well as MS and many other illnesses but is not an MDA doctor.

What has been your experience of the healthcare system and healthcare professionals?

Mostly pessimistic/telling me I WILL need a wheelchair by age 50.

Has your diagnosis had any health insurance implications for you?

No.

What advice would you give to someone who has just been diagnosed with CNM / MTM?

Stay positive and eat clean.

What’s your favourite book/film/music?

Book: The Purpose Driven Life by Rick Warren.

What did you want to be when you were younger?

Nurse/rock star.

What is a favourite/memorable event from your childhood?

Vacations at Grama and Paps and Aunt Carol and Uncle Bruce’s house.

Who do you think has most influenced you in your life and why?

God – my faith has helped me significantly.

What’s the best advice you’ve been given?

Eat clean and stay as fit as possible.

George

George is 3 years old and lives in Melbourne Australia with his mum, dad and two brothers. Below, mum Michelle tells the Information Point all about George.

What form of CNM/MTM does George have?

George has centronuclear myopathy but the form of the condition is unknown.

When was George first diagnosed?

April 2008.

What symptoms prompted George’s diagnosis?

When George arrived, he was completely floppy, not breathing on his own and very purple. George was intubated and transferred by the Neonatal Emergency Transport Service (NETS) team to the Royal Children’s Hospital which it was felt would be the best place for George to be and where he could be looked after. Lots of possible diagnoses were talked about from Prader Willi to Spinal Muscular Atrophy, all of which had pretty grim out looks and our little angel had to undergo a barrage of tests as well as two pneumonias. Finally, after most of the tests came back negative, George had a muscle biopsy and two weeks later we had our diagnosis – centronuclear myopathy.

How long did it take to get a diagnosis?

It was a long 12 weeks, before we found out what the future could possibly look like for our darling. It was then also, that we were introduced to Professor Andrew Kornberg, Head of Neurology at the RCH, who was our saving grace and finally was giving us a very positive outlook for George. Since then, George has had a Fundoplication, Gastrostomy and Tracheostomy and has pretty much gone from strength to strength. On July 6, 2008, George finally made it home and has been by our sides ever since and we plan to do everything in our power to make sure he develops to his full potential.

How was George diagnosed?

Muscle biopsy.

What impact did the diagnosis have on you?

Earth shattering.

Have you explained CNM/MTM to family members and what was their reaction?

We have tried to explain as best we can, but it is mostly too confusing for people.

What implications do you think it has it had on your family?

It has completely turned our world inside out and upside down but with many positive experiences as well.

Has it affected you e.g. telling your children, starting a family, genetic counselling?

We won’t be having anymore children now that we know that we carry this variation. We are blessed with three beautiful children already.

Do you have advice for people who are looking for a diagnosis?

Get a biopsy. It’s the only way to know for sure.

What are George’s current symptoms?

George’s progress has been slow but steady. He is on 24 hour CPAP but does come off for brief periods in the hope that one day, he may come off altogether. He still requires constant suctioning. Although he still has profound muscle weakness, George’s movement and strength have greatly improved since birth. George attends his local kindergarten two days a week and he loves seeing his friends there and they all love him. George has an infectious smile and obviously loving and placid nature. He enjoys his older brothers so much, especially when they are entertaining him with their crazy antics and they equally love him. George is part of a large extended family and very much loved by all. We are also lucky to have many wonderful friends that have provided much love and support during this difficult time.

What treatment is George having/has he had?

None.

How did you find a doctor?

Through the Royal Children’s Hospital, Melbourne (RCH), the hospital that George was in from birth.

What has been your experience of the healthcare system and healthcare professionals?

The team at RCH have been so wonderful. Nothing is ever too much trouble and they are always willing to help George in anyway shape or form. However, disability services in Australia are completely lacking and it has been a constant struggle to get equipment for George. Australia is currently looking at a new model called the National Disability Insurance Scheme that would provide funds for the disabled on an individual basis – we completely support such a system.

Has your diagnosis had any health insurance implications for you?

No.

What advice would you give to someone who has just been diagnosed with CNM/MTM?

It’s a long and tough road, especially for kids, but everyday is so precious!! Incredibly, for a little person that has many obvious physical limitations, everyone that meets George, falls in love with his gentle, loving and bright spirit that seems to shine through every bit of adversity and are somehow touched by his life.

What does George enjoy?

George enjoys The Wiggles.

What’s the best advice you’ve been given?

Family friends that have a Downs Syndrome son (36 years old) once said to us; ‘If we knew then, what we know now, we wouldn’t have worried so much. Just live and love!’

Elly

Elly lives in Stockport in the UK with her husband Carl and was recently diagnosed with an unknown form of centronuclear myopathy. She works part time and her main passion in life is animals, wildlife and spending time visiting rescue centres, wildlife parks and zoos.

What form of CNM / MTM do you have?

Unknown.

When did you first get diagnosed?

I was diagnosed with an unknown congenital myopathy about 10 years ago when I was 32, my diagnosis of centronuclear myopathy was a couple of months ago.

What symptoms prompted your diagnosis?

I was born with club feet and was described as a ‘floppy baby’ with poor muscle tone and had to be tube fed. My mum had polyhydramnios (excess fluid) while she was expecting me and noticed that I hadn’t kicked like my older sister had. My feet were fixed with physio and strapping and I eventually started to walk when I was two.

My parents were told to give me a high protein diet to build my strength. When I started school I had to be taken in a pushchair as I still couldn’t walk very far and I was always way behind the other children in PE. I’ve always struggled with stairs and have never been able to do a single sit-up. It was when I went to live away from home as a student that I began having problems walking and suffering with a lot of lower back pain. I suppose before that I’d always been around friends and family who I’d grown up with and they had made allowances for me being a bit slower. As a student I struggled to keep up with my new friends when out socialising. I put my pain and difficulty walking down to a back problem and saw the doctor who referred me to an orthopaedic consultant. I had x-rays which showed I had a slight scoliosis and I thought this was the cause of my problems.

Throughout my twenties I saw various consultants including a heart specialist, but no one could find anything wrong with me. One consultant suggested that I probably needed to exercise more to build strength. I took his advice and joined a gym which I went to two or three times a week. After going to the gym for two years, I had hardly made any progress – apart from my forearms which don’t seem affected. When I was about thirty, I was referred to a new orthopaedic consultant. I explained that no matter how much I exercised, I didn’t get any stronger. He thought my legs seemed weak and I may have a neurological problem. Several years ago I had an appointment at the Newcastle Muscle Centre, here it was noticed that I have a high arched palette, spinal rigidity and finger contractures which are consistent with some myopathies.

How were you diagnosed?

I had an MRI scan which showed my nerves were healthy, so was sent for an EMG test where I had needles inserted into my muscles to measure electrical activity. The EMG was abnormal, so I was sent for a muscle biopsy from my shin. Last year I had a second biopsy from my thigh where a much bigger sample was taken, as the sample from my shin had been quite poor. The second biopsy was prompted after I’d had an MRI scan of my muscles. The MRI was to see if a diagnosis could be reached by looking at which groups of muscles were affected, Pompe disease was suggested but ruled out with a blood test. I’d heard of someone who had got a diagnosis after using MRI scan results to pick a good site for a biopsy, so I asked my neurologist if he could do this.

How long did it take to get you diagnosis?

I was diagnosed with a congenital myopathy about six months after my first biopsy, and it was after six months again when the second biopsy showed that the nuclei was in the centre of my muscle cells.

What impact did the diagnosis have on you?

It was actually a huge relief. I could finally explain why I struggled physically, and I no longer had to use the excuse of a ‘bad back’ when I couldn’t do something.

Have you explained CNM/MTM to family members and what was their reaction?

Not yet, I did explain about myopathy when I was first diagnosed, but I’m still getting my head around centronuclear myopathy myself. I have an appointment at a rare disease clinic at the Newcastle Muscle Centre in a couple of months, hopefully they’ll be able to tell me which type I have and how it’s inherited. I’ll probably explain CNM to my family when I know more. I’m the only member of my family with CNM, so I guess I’ve most likely got the recessive form.

Do you have advice for people who are looking for a diagnosis?

Keep at it and don’t be afraid to ask for tests. I kept going back to my GP saying something really wasn’t right when all tests were coming back negative. I requested my second biopsy although my neurologist didn’t seem keen.

What are your current symptoms?

Muscle weakness, mainly in my legs, torso, upper arms and neck. I also have mild weakness in my face. I have a lumbar lordosis and get a lot of lower back pain. I often feel fatigued and sometimes get a bit breathless – especially in hot weather.

What treatments are you having or have you had?

I’ve had a lot of physio over the years, but it was always a fixed number of sessions and any benefit was soon lost after the sessions ended. I’m now going to the Neuromuscular Centre (NMC) in Cheshire for physio once a month. I also go swimming.

How did you find a doctor?

The neurologist at my local hospital referred me to a neuromuscular specialist when my EMG results were abnormal.

What has been your experience of the healthcare system and healthcare professionals?

Mixed, I had a lovely GP and although he didn’t know what was wrong with me, took an interest and made referrals. He retired a few years ago and I couldn’t get along with his replacement. I changed surgeries, and fortunately found another good GP. I find it frustrating that none of the healthcare professionals I saw for the first thirty years of my life picked up my neuromuscular condition.

Has your diagnosis had any health insurance implications for you?

Not health insurance, but I had trouble getting life cover on my mortgage – mainly because I was waiting for biopsy results at the time. I also have problems with the DVLA as they’ll only issue me a three year restricted licence. The process always takes ages because they can’t categorise my condition, they have even made me retake my driving test.

What advice would you give to someone who has just been diagnosed with CNM / MTM?

Try to be positive and live life to the full.

What’s your favourite book / film / music?

I don’t really have a favourite book but I like reading biographies and factual books by people who inspire me such as Jane Goodall, I think her work with chimpanzees is amazing. My music tastes are mostly 70s and 80s punk and ska with a bit of pop.

What did you want to be when you were younger?

Something creative, I studied art and jewellery design, but have ended up working for a small electronics company, doing purchasing, logistics and admin.

What is a favourite / memorable event from your childhood?

Probably going to a static caravan we had in North Wales every summer.

Who do you think has most influenced you in your life and why?

My family.

What person would you most to meet (living or dead)

Chris Packham – naturalist, broadcaster and photographer.

What’s the best advice you’ve been given?

My mum always says “suit the wearer, blow the starer” meaning wear whatever you like as long as you’re happy and comfortable. I used to insist on trying to wear high heeled shoes if I was going to a party or wedding because I thought I should, even though I could barely walk in them. I wish I’d taken that advice on board a lot sooner – nothing but flats and trainers for me now.

Barbel

Bärbel (short form of Barbara), is 35 years old and lives in Weinheim, Germany (near Heidelberg). In 1982 she was diagnosed with Myotubular Myopathie. After finishing school in 1995 she worked as an apprentice her parent’s Drogerie (a mixture of pharmacy, photoshop, parfumery and beautycenter). In 2001 she again worked as an apprentice to be a cosmetician and later opened her own beautycenter within her parents shop. Bärbel describes herself as a very creative person; her hobbies include making dolls and teddies, writing short stories for children and her two cats.

What form of CNM/MTM do you have?

I don’t know which form I have.

When did you first get diagnosed?

When I was diagnosed in 1982 by the age of seven, the doctors had less knowledge about MTM. The only thing they said is, that my muscle fibres were not matured. They said the white muscle fibres (don’t know the word, sorry, is it fast glycotic fibre???) are completely missing. This is why I am a weak person. But I do have perseverance.

My parents do not know very much about MTM and after going from doctor to doctor and making a lot of training we stopped all this in 1985. My parents made a lot of good training with me by going on walking tours. I never worried about MTM because the doctors said, this is so seldom. But since one year I thought, that my muscles get weaker (for example, I have now the same problems in going up stairs like I had when I was a little child). And this is why I looked in internet and I was very surprised to find so much about MTM. I made a appointed time with my doctor and he said that he wanted me to do a new biopsy. Perhaps I will have it in spring 2011. I hope I will get more information by then.

What symptoms prompted your diagnosis?

When I was born, the doctors said, that something was wrong with me. I showed less motion and I had some problems with breathing. Later as a baby and little child I had problems in holding my head and in sitting without a pillow right next too me. They operated my left sinew, because they thought it was too long. But later they said, that this wasn’t necessary because the sinews only were slack because of the muscle-weakness. They plastered my legs for more than one and a half years, and this was not good because my muscles could not be trained by then. As a little child (learned walking by the age of 3) I often fell down very easily had much problems in going up stairs, and had much problems holding my head (for example, when I look in the air, my head is ‘falling’ into my neck and then I do not have balance).

What impact did the diagnosis have on you?

This is difficult to answer because I think it is much easier to be born with a disease than to get it for example by accident. I do not know life without having MTM and I think I can live with it quite good. I’m trying to live a normal live as far as it is possible. But I also arranged my way of living that there is help when I need it. For example I have a flat on my own. But it is in my parents house. I have a little beautycenter (doing treatments and massage for relaxing) but it is involved to my parents shop. So there is much help when I need it for example in all the things, when you need to have strength (for example cleaning with the vacuum cleaner). I have an identity card for being handicapped (degree 80). I can go by train and bus for free and I can take a second person who takes care of me with me for free too (for example cinema, theater, parks). Sometimes I have to wear stockings for compression because by less motion my blood supply is not good. I made my driving licence but only on an automatic car.

Have you explained CNM/MTM to family members and what was their reaction?

All my family members and friends know about it and they help me when I need help. In school all the other pupils helped me (for example in carrying my bag). Today I try to speak about it very openly if someone is asking a question and even my clients know about it. I only know appreciation. Sometimes I thought it is a problem that you cannot see my form of MTM. It often happens that I walk very normally in front of a person and then, by going up stairs there are many problems. And then the people ask me some questions and sometimes this is hard.

What implications do you think it has it had on your family?

I think because of having MTM I have got the best big brother a girl could have. When I was a little child he was very watchful when we were in school and he looked at me during the breaks that nothing will happen to me (like falling down when the other pupils are running).

Has it affected you e.g. telling your children, starting a family, genetic counselling?

Right now I am single but I do not think that is because of having MTM.

Do you have advice for people who are looking for a diagnosis?

Don`t be afraid to have a diagnosis. It is much better to know everything about it, so you can be trained. Don’t stop being in action and train your muscles.

What are your current symptoms?

I have much problems in going up stairs, I cannot hold my head (for example when the car stops suddenly, my head is falling into my neck or when I look into the sky, my head is falling into my neck too and then I lose balance). I have very much problems in standing up from low chairs, I have a low voice, I fall down easily, I am a weak person (for example even having problems in little things like opening a bottle).

What treatment are you having, and have you had?

I do not have any treatment right now. Perhaps I will have another biopsy in 2011. I have had a special gymnastic for increasing my muscles last year, because I had an accident and had a ‘patella luxation’. But this did not help me very much. Since having the accident, my right feet is getting much weaker. I cannot do any sports but I often go for a walk (in my speed). I make some ‘sport’ with the Thera-Band and a big ball to sit on. Last year I bought myself a Wii-station, so I can do the exercises in my living-room by holding myself at a chair and nobody can see it and ask some stupid questions.

How did you find a doctor?

My general doctor is very good and he gave my parents the information. I am living next to Heidelberg and Mannheim, who both have got good University and specialists.

What has been your experience of the healthcare system and healthcare professionals?

The doctors do not know much about MTM. When I had the accident last year, the doctor said, that my muscles have to increase much faster. I explained to him, that this is because of having MTM and he looked very stupid and said, that he never heard about it.

What is your favourite book/film/music?

Book: The Parfum by Patrik Süskind and everything from Thommy Jaud and David Safier. Film: Gloomy Sunday, The Marvellous World of Amelie, Lord of the Rings, Willow. Music: Tori Amos, Blackmore’s Night, Annett Louisan, Muse, Ich+ich, Element of Crime.

What did you want to be when you were younger?

A novelist, especially for books for children I had very much fantasy and I often played that I am a strong and powerful person like Zorro or someone like that when I was a child.

What is a favourite / memorable event from your childhood?

Christmas and holidays with my family. A caravanning tour with my brother in a very old van to France, Swiss and Czchechoslovaky (it was a great adventure). A holiday with school class at the Nordsee by bike. When the other pupils of my class heard, that I could not go with them if they do it by bike, they rented a bike for two persons without me knowing it. It was a great surprise and all the boys in my class wanted to drive it. The driver was sitting in front of me and I had to do nothing!

Who do you think has most influenced you in your life and why?

My brother in music and styling and way of live. As a scout he took me with him on hikes, this was great. My parents in job and my grandmother because she is a strong person who never gives up (she is 90, has got cancer and lots of chemotherapy but she is still happy).

What’s the best advice you have been given?

Try everything. You don’t know if you can do something or not without having tried.

 

Alayna

Alayna lives with her mum and dad in Illinois, USA. She celebrated her first birthday earlier this year and loves Spongebob Squarepants. Below mum Krista writes about her daughter.

What form of CNM/MTM does Alayna have?

Unknown.

When did Alayna first get diagnosed?

Alayna was about 4 months old when she was diagnosed with centronuclear myopathy.

What symptoms prompted Alayna’s diagnosis?

Alayna had clenched fists and did not move her legs when I was pregnant with her, I also had a lot of amniotic fluid. When she was born she was in respiratory distress. Alayna was not moving, very stiff, and vent dependent. Alayna also had pulmonary hypoplasia from her not swallowing in my belly.

How long did it take to get a diagnosis?

We got the results back in about 6 weeks.

How was Alayna diagnosed?

First Alayna was given an EMG to determine if it was a muscle disorder, came back that she did. She was diagnosed with centronuclear myopathy with a muscle biopsy.

What impact did the diagnosis have on you?

It was pretty hard on us, being her parents, and not knowing how to make it all better. After being upset with the diagnosis I told myself I would still look at her as my baby and not a diagnosis. Everything she has been through is our ‘normal’.

Have you explained centronuclear myopathy to family members and what was their reaction?

Some family members just don’t understand and others that are very understanding and don’t look at Alayna any differently than they would another child.

We still get the questions…when is she going to walk and talk. I just answer politely and say we don’t know. To her Dad and I, we don’t care. As long as she is a happy, healthy girl.

What implications do you think it has it had on your family?

It has put some stress on me and some family members, our relationships aren’t as close as they used to be.

Has it affected you e.g. telling your children, starting a family, genetic counselling?

We have decided to not have anymore kids. We had a still born little boy named Bryce at 32 weeks. I could not chance losing another child or putting another child through what Alayna went through. No child deserves that.

Do you have advice for people who are looking for a diagnosis?

Don’t put so much time and energy on a diagnosis. I understand the importance of having a diagnosis because of the future but that shouldn’t change anything. Your child is still your child no matter what they have. At first I wanted a diagnosis, but then I thought, why? It won’t change my feelings for her and I will still try to make Alayna the best person she can be.

What are Alayna’s current symptoms?

Alayna is mainly behind on motor development. She is trying to crawl and walk. Both of her hips are dislocated so I believe that is giving her problems with stability and rotation. She can get on all 4’s and rock like crazy, she just isn’t sure how to move her legs. She is also a little behind on cognitive because she spent so long in the hospital but she is starting to catch up.

What treatment is Alayna having and has she had?

Alayna was on a ventilator for three months and cannula for eleven months. She also eats through a g-button. Alayna has been off O2 for almost four months. Alayna had hip surgery on November 10th. Both of her hips were out of socket and they needed to be put back in surgically. The surgery consisted of re-shaping parts of her pelvic bone, cutting tendons, and putting the hips back into the socket. This was a major and scary surgery for all of us. Everything went great, now we are waiting on the cast removal!! She doesn’t like being in the casts because it limits her movement. Before she was rolling, army crawling and walking everywhere in her baby walker! Alayna currently gets developmental, occupational, physical, and speech therapy.

How did you find a doctor?

Alayna was transferred from our local NICU to St Louis Children’s NICU. When she left the NICU we already had all of our doctors except our pediatrician and ortho.

What has been your experience of the healthcare system and healthcare professionals?

St Louis is very good with Alayna and careful. They are amazing with her. They know what to do with her, her local doctors aren’t as wonderful. The ER and PICU here knows Alayna but are not familiar with myopathies so they try to tell us stuff they know nothing about. She went to the PICU because she was desatting, she was on cannula O2 at the time and the doctor asked me why she wasn’t on a trach. I was very confused, obviously she was breathing on her own. He wanted us to go back to St Louis to get one, well we and St Louis said no. If she needed one, then definitely lets do it, but not if she doesn’t need it.

Has Alayna’s diagnosis had any health insurance implications for you?

Not as of now.

What advice would you give to someone who has just been diagnosed with CNM/MTM?

Love your child every day and don’t take a single day for granted. There will be times of frustration but remember your child can’t help what is happening with their body. Their body is in control and will do what it wants to do.

Tracey

What form of CNM/MTM do you have?

I am a manifesting carrier of x-linked myotubular myopathy.

When did you first get diagnosed?

I was officially diagnosed with the condition in January 2009.

What symptoms prompted your diagnosis?

I was taken into hospital with very little oxygen in my system in March 2008 and while being treated for this on a specialist ward, the nurses all noticed I was having difficulty getting up from chairs etc. I was then put under a neurologist who delved into the death of my son Andrew in 1986 from unknown causes. She came across his muscle biopsy results from just after he died which proved he had XLMTM. I had a blood test and bingo, the reason for my weakness became known. Unfortunately, I also found out at this late stage what my son Andrew had had and became filled with guilt all over again.

How long did it take to get you diagnosis?

I started seeing a neurologist in May 2008 and after several tests including a painful needle biopsy, I had the blood test in October 2008 and got my results in January 2009, so 9 months in total. However, it probably would have taken longer had Dr Brierley not found Andrew’s results.

How were you diagnosed e.g. muscle biopsy?

Diagnosed by son Andrew’s previous results and then a blood test.

What impact did the diagnosis have on you?

Scared about my future. Worried about whether I had passed on to my daughter, if my sister also had it and her daughter as well. Worried about telling my mum as no history in the family and didn’t want her to blame herself. However the biggest problem was getting used to the breathing machine I have to wear every night / all night and keeping my husband awake.

Have you explained CNM/MTM to family members and what was their reaction?

Can’t keep any secrets from my family!!! As soon as they found out they were all on the internet finding every article they could. Everyone wanted to know how it had happened to me, what my future held, if I would end up in a wheelchair etc.

What implications do you think it has it had on your family?

Caused a lot of problems between my husband and I. We had just started going on holidays 2 – 3 times a year abroad and enjoying ourselves after bringing up our daughter and we saw that as being taken away from us. Also caused problems with my machine as husband is a light sleeper. Thought we may have to move house when I found I couldn’t manage our steep stairs but instead got a stair lift fitted. Had chair raisers fitted to sofas and hand rails installed in shower. A lot of changes happened at home and had to fit new bathroom with walk in shower as I could no longer get into bath for shower.

Has it affected you e.g. telling your children, starting a family, genetic counselling?

My daughter Caroline who was 22 just after my diagnosis decided she wanted to be tested to see if she was a carrier. Her test results showed she was not which was such a weight off my mind that I had not passed it on to my one remaining child. Plus I could look forward to grandchildren in the future. I was very emotional when she received her results – a positive at last after a bad year (I also lost my dad from cancer in December 2008). After Caroline we followed through with my sister Julie and she was also tested as negative.

Do you have advice for people who are looking for a diagnosis?

My advice would be to find a good neurologist first and foremost. Mine is marvellous and has just moved from Ipswich to Bury st Edmunds hospital, so I have transferred with her. Next ask questions in the family to see if there is any family history. Unfortunately that turned up blank in my case. Don’t keep anything back from your neurologist. With hindsight, I had struggled getting up from chairs and with stairs for years, but didn’t want to admit there was anything wrong.

What are your current symptoms?

I have bilateral diaphragmatic weakness which means both diaphragms don’t function properly. I wear a machine to correct my CO2 levels during the night. I become tired easily during the day because of this. I have weakness in both legs, although the left is the weaker and use a walking stick. Both arms are getting progressively weaker, I notice most when doing shopping, reaching for things on high shelves and hanging out washing. I suffer from pain in my neck and shoulder blades.

What treatment are you having and/or have you had?

I have 24 care available through the physio at Ipswich hospital. I go to Papworth Hospital every 6 months for an overnight stay to monitor my breathing and to Bury to see my neurologist every year. I also have a heart scan yearly about 2 months before my next neurologist appointment.

How did you find a doctor?

I was very lucky in that I was given to Dr Brierley as she was based at Ipswich hospital and I was referred directly to her.

What has been your experience of the healthcare system and healthcare professionals?

The doctor who was treating me for Asthma from December 2007 to March 2008 nearly killed me by not recognising the symptoms of oxygen deprivation. I was admitted to hospital initially in March 2008 with infection in my leg from a scratch. Prior to that I had been seeing the same doctor at my surgery complaining of no energy, sleeping all day and not being able to walk more than four paces without stopping for breath. At no time did he check my oxygen levels. I still feel very angry with this doctor and it is part of my life that still haunts me and gave me nightmares for a long time. Other than this one person, I have been given nothing but honesty and the best care from all others, apart from when I was first made to wear my machine and was very panicky. I think I gave the night nurses hell for a few days – it takes your doctor to tell you wear it or you die to make you take note sometimes!!

Has your diagnosis had any health insurance implications for you?

I was able to get Travel Insurance at a premium rate, but have so far been unable to get Life insurance. As I am nearly 47 now, I figure I may as well wait until I am 50 and then retry.

What advice would you give to someone who has just been diagnosed with CNM/MTM?

I had a lovely counsellor offered to me to help with post diagnosis and to supply any further information I needed, so check if there is such a person available to you in your area. I also attended an Expert Patient Program for 6 weeks in June – August 2008 and can highly recommend this. I hated the isolation I felt and although no one else on the course had my condition, they all had long term problems and everyone felt the same feelings of frustration and anxiety about the future. I spent my spare time, of which there was now plenty as I was also made redundant in April 2008, on the internet doing as much research as was possible and managed to find Toni and her wonderful people to talk to. I also found out what help there was out there for me from Occupational Health – they supplied and extra bannister up the stairs, chair raisers, a raised toilet seat (although we didn’t get along with this) a half step at the front door and got me in touch with a place in Ipswich to try out stair lifts and other hand gadgets to help with opening jars etc. Also if you need a walking stick – go to the physio and she will find one that is just right for you. I was getting pains in my back and wrists from using a wrong stick and I also was less confident when walking on my own.

What’s your favourite book/film/ music?

Books – anything by Jeffrey Deaver, Tess Gerriston or my fave is The Davinci Code. Music – Robbie Williams rules for me!! Film – Miss Congeniality.

What did you want to be when you were younger?

When I was younger, I wanted to be a physiotherapist and work on injured footballers especially the ones I had a crush on!

What is a favourite/memorable event from your childhood?

Booking up a family holiday the day before we went and having the time of our lives.

Who do you think has most influenced you in your life and why?

My parents have taught me that a close knit family that sticks together through good and bad are to be treasured. I am so lucky to have my family around me.

What’s the best advice you’ve been given?

My aunt has recently said to my Mum that I need to “stop living in the past and bringing up bad memories and look to the future with a positive attitude”. I realised that was exactly what I was doing and now try not to look back, only forward. A Facebook friend also recently said “if someone tells you you can’t do something, think how you will feel when you prove you can”. Thanks to Scott Crane for his words of wisdom that always inspire me!!

Marie

Marie lives in Ireland with her husband John and the couple have lost three sons to MTM. Nathan was born in 2000 and lived for 16 days, Sean was born in 2004 and lived for 31 days and Alex was born on Christmas day 2008, living for just 20 minutes. Marie is diagnosed as an x-linked manifesting carrier.

What form of CNM/MTM do you have?

I have x-linked MTM.

When did you first get diagnosed?

I was diagnosed in 2003.

What symptoms prompted your diagnosis?

I had my first son Nathan in 2000 and it was actually my eye doctor who suggested I get tested as I had a lazy eye.

How long did it take to get you diagnosis?

Not too long, I had it within a week.

How were you diagnosed e.g. muscle biopsy?

Muscle biopsy.

What impact did the diagnosis have on you?

Not too much but I learned that I was not lazy at sport and walking stairs as everyone including myself had thought.

Have you explained CNM/MTM to family members and what was their reaction?

I think people knew it before I had got my results so they were fine. I was a bit bothered myself by it at first but then I was fine.

What implications do you think it has it had on your family?

My own form of MTM has had no major implications, the fact I have passed it on to my three sons is the only problem I had with it.

Has it affected you e.g. telling your children, starting a family, genetic counselling?

I have had three sons who have passed away from MTM and planned on trying IVF for one more child in the hope they would not carry this gene but found out in September 2010 we are expecting again naturally in April 2011.

What are your current symptoms?

Problems with stairs and getting up off couches and chairs.

What treatment are you having or have you had?

I had occupational therapy a few years ago that was it.

How did you find a doctor?

To be honest apart from my genetic counsellor I have not found anyone who understands it that well over here in Ireland.

What has been your experience of the healthcare system and healthcare professionals?

As good as they can be with very little knowledge.

Has your diagnosis had any health insurance implications for you?

None.

What advice would you give to someone who has just been diagnosed with CNM/MTM or is looking for a diagnosis?

Get as much background information as you can and find others always willing to to talk to you about it.

What’s your favourite book/film/music?

Book: Twilight books. Film: The Departed. Music: Anything.

What did you want to be when you were younger?

In the navy.

What is a favourite/memorable event from your childhood?

My school days and my set dinners from my granny every day she’s the best in the world.

Who do you think has most influenced you in your life and why?

My husband, it might sound corny but he is my life and I can’t imagine having gone through what we did with anyone else but him he is my rock.

What’s the best advice you’ve been given?

Live for today.

Connie

What form of CNM/MTM do you have?

I am an x-linked manifesting carrier.

When did you first get diagnosed?

I was first diagnosed as a carrier when my son Calder and I participated in a genetic study with Gail Herman in the late 1990s. Calder was born in 1995 with traditional symptoms and diagnosed at age 4 weeks from muscle biopsy. He, sadly, died at age 4 from complications of XLMTM.

I was a late-in-life mom, age 44 at the time of Calder’s birth so it was not long before I began to connect 2+2 and seriously wonder if I might be manifesting increasing symptoms I had seen throughout my life. I, finally, saw a neurologist in 2009 who confirmed I was ‘not normal’ and was experiencing, what he called, a ‘slow moving glacier’. I have learned since from research studies that most often women who are manifesting carriers are not completely symptomatic until their fourth or fifth decade.

What symptoms prompted your diagnosis?

I have always been what I would describe as accident prone and a weakling. For example, I am left-handed and I used to challenge right-handed girlfriends to arm wrestle me just for fun with their left hands. I have never met anyone who could not beat me fairly easily. I also spent a year working with a personal trainer in my early 50s. She described me as low-normal at the end of the year. This is after many years of consistent aerobic exercise and fitness training efforts to control my uncontrollable weight problem!

I am definitely NOT low-normal now. In 2009, I was having difficulty breathing when walking and my strength to move around the office and outdoors was diminished. Stairs were increasingly difficult but did not require more than one handrail for up to 3-4 steps. I had to be very focused when walking to keep balance and not step on something that would throw that balance off.

What symptoms prompted your diagnosis?

I met with the neurologist two times.

How were you diagnosed?

He did both a strength exam and an electric needle exam. Since we already had my DNA results, he knew I was a carrier so it was not difficult to confirm I was showing weakness.

What impact did the diagnosis have on you?

It is startling to hear you are not normal and are experiencing a ‘slow moving glacier’. You know it is true but like any other shock of this nature, you initially want to deny its truth. Then you want know just where this ‘glacier’ is moving and where it will take you. This is very hard to ascertain as there is not a lot of research and not a lot of women I have found in similar condition. Currently I am communicating with two others, one in a little better condition, one in a little worse.

Have you explained CNM/MTM to family members and what was their reaction?

I was engaged to my husband Max when I received my diagnoses. He has been nothing but great and very supportive. I am very fortunate to have found such a kind and loving man. I did try to explain to my mother in 2009 but she was very uncomfortable with the idea when I first mentioned it. So I have not discussed it again with until this summer. I decided to talk more freely with both my parents. They don’t like the idea of it, but they are glad to know now and of course, are very concerned. In the 90s when we knew I was a carrier, we certainly looked for other family history, but thankfully there doesn’t seem to be any and there are healthy boys born to every other generation, cousins and to my sister.

What implications do you think it has it had on your family?

None other than what I have mentioned.

Do you have advice for people who are looking for a diagnosis?

Be persistent. Be your own advocate with healthcare professionals.


What are your current symptoms?

I cannot climb stairs without using BOTH hands on a handrail. This symptom worsened in my early 50s to the point now it is REALLY difficult to climb even 2 or 3 steps and street curbs. I cannot stand for longer than a few minutes without discomfort. I cannot walk on uneven ground without danger of falling and I cannot walk easily without pain or unsteady gate. I tire very easily even when typing or doing simple things like laundry. I have breathing problems and wear c-pap at night since last year.

The sleep study revealed my oxygen saturation was dipping into the 70s without it! I have been diagnosed with heart stiffening. I also have a raised hemi-diaphragm (found in other manifesting carriers as well). My left arm is probably ‘low normal’ but my right is not. I cannot raise my hand above my head and even when lying down to exercise range-of-motion, it is now hard to lift the weight of the arm itself.

What treatment are you having, and have you had?

Beside wearing c-pap at night, I heard recently from US women that some are taking L-Leucine and L-Carnitine for energy and muscle health. I have not started taking them, but I am planning to try them. I was given doctor recommendation to see a physical therapist to help with range of motion issues.

How did you find a doctor?

I have a lot of challenge finding a doctor who grasps this disease; I have not been really successful yet. The doctor that diagnosed me is a neurologist specializing in muscle disease issues. I have learned that another neurologist in Kansas City (only three hours by car from where I am) has at least two patients who are x-linked manifesting carriers. I know that because he is thanked by the authors at the end of a research article. My primary care doctor is trying to get me an appointment with him now. And frankly, I am not sure my primary care doctor is the right one for me.

Has your diagnosis had any health insurance implications for you?

I have moved several times recently from on city to another so I have seen a wide variety of doctors. I am not sure how I would rate their understanding or ability to help. It is hard to understand this disease since it rare and it seems hard for them to advise me.

What advice would you give to someone who has just been diagnosed with CNM/MTM?

I live in the US and we are covered under my husband’s health insurance. He is a retired Boeing engineer and it is a large company and there have been no problems.

What advice would you give to someone who has just been diagnosed with CNM/MTM

Have hope, don’t give up and seize the day!

What’s your favourite book/film/music?

My favorite books have been by Martha Beck. Beck is a Harvard Ph.D. in Sociology, but writes from her own clinical perspective about living life to it fullest. I HIGHLY recommend her ‘Finding Your Own North Star’ and follow-up ‘Steering By Starlight’. They are great books to read, process and re-read.

I have been a performance facility coordinator and executive director of several performing arts groups. I love lots of music, but I would have to say my favorites are Americana/Vernacular/Mountain music fused with Jazz, Classical or Bluegrass. There are some amazing trained artists who are doing incredible work in this field, most that I have had the honor to work with. They include: Edgar Meyer, Mike Marshall and Caterina Litchtenberg, Darol Anger, Joshua Bell, Bela Fleck, Howard Levy, Eugene Friesen, Glen Velez, and Philip Aaberg.

I love independent films that are not necessarily blockbusters. But I do enjoy a sweet romantic comedy.

What did you want to be when you were younger?

I am an artist; I paint colorful people in a colorful manner. I have always wanted to be an artist. I also teach college classes in art appreciation, but it is getting harder to do this and I have cut back some.

What is a favourite/memorable event from your childhood?

In my family, we are noted for enjoying the tall tales of our memories. I have a few pleasant memories of Christmas dinners at my grandmother’s house with cousins, aunts and uncles and my sister and I loved to sing and used to sing and dance on the fireplace mantle entertaining ourselves for hours (I am sure that was enjoyable to our mother who had to endure it).

The sharpest memories are of a different kind–like the vacation time my father went on to climb the mountain and got lost after my mother returned to the cabin with my sister and me. Fortunately, he made it down on his own near sunset. Or another time when going to art lessons, the car my mother was driving lost braking power–very scary!

Who do you think has most influenced you in your life?

I have been blessed with incredible parents, the kind all your friends envy and want to hang out with. I have been even more blessed that they are both still living to influence and inspire me weekly. My father has inspired my adventurous, outspoken leadership style. My mother has inspired my considerate and quiet approach to others. Both have always encouraged and supported my creativity. They are very creative as well, but did not have careers in the arts.

What’s the best advice you’ve been given?

I have liked this quote for years. I see it as all the more relevant now:

Though much is taken, much abides; and though
We are not now that strength which in old days
Moved earth and heaven, that which we are, we are:
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

~ Tennnyson

Don’t quit.

Update November 2019

Since 2013 I’ve worked very hard and have managed to lose nearly 100 pounds, nearly 60 of it this year. Naturally I am able to move about more and stand for longer. I’ve actually spent an hour plus on my feet. I do have to recover afterwards by resting but I’m really pleased that I’m able to move more easily.

Zak

Zak Hughes is 15 years old and lives in the UK with his mum Wendy, dad Simon and sister Sophie. Zak’s story was the first to appear on our website when we started out in 2001. Below Zak and Wendy talk about Zak’s life.

What form of CNM/MTM do you have?

Zak: I have X-linked myotubular myopathy.

When did you first get diagnosed?

Wendy: At 6 months of age it was decided that Zak should have a muscle biopsy because of the number of times he had lung collapse and because until then, Zak was mostly in SCBU and hospital in Bristol very floppy, with lots of secretions and by then, three episodes of lung collapse and pneumonia.

None of the genes for MTM were discovered and the diagnosis could only be made by muscle tissue analysis. So they really didn’t know what type of myotubular myopathy they were looking at / dealing with. Before the biopsy, they suspected a whole series of different diseases like Prader Willi, Spinal Muscular Atrophy (SMA) to a benign hypotonia. We were told however Zak had given them serious concerns. It was actually a relief when we got a diagnosis because it gave us some idea of what the progression of Zak’s condition would be, although we had to rely on out of date papers dating back from the 1960’s! Although the outlook was bleak – we rebelled against these horrible ‘gloom and doom’ papers and it totally changed our perspective in life and attitude towards how we should be expected to treat our disabled son. We rebelled against his disability and his medical fragility and decided to treat our boy as normally as possible, pushed him on physically and just hoped for the best.

What symptoms prompted your diagnosis?

Zak: Poor respiratory function and being floppy.

How long did it take to get your diagnosis?

Wendy: We didn’t get to know which gene was implicated in Zak’s form of MTM until he was nearly 18 months old – this was when the team at Cardiff discovered the first MTM1 gene. Although at that time they couldn’t say whether I was a carrier or not, my DNA had to go off for further analysis.

How did the diagnosis come about?

Wendy: Muscle biopsy and DNA test.

What impact/implications did the diagnosis have?

Wendy: We had decided not to have more children anyway, although it was my dream to have at least four after we had our first born, Sophie. Testing for an affected baby was possible but seemed like a much more complicated process back then with more risks about needing a late termination. There was only amniocentesis available at that time (but now you can be tested within first few weeks to determine the sex). Although it must still be a scary process for anyone to go through and I admire the bravery of the parents who do go ahead with further pregnancies.

Have you explained CNM/MTM to family members and what was their reaction?

Wendy: I have two sisters and a few nephews and nieces, so obviously, as a carrier myself, they might also have been implicated. My sisters did give bloods for DNA analysis to see if their children were affected but it appeared that I am the first carrier of MTM in our family history. It amazes me how a genetic disease like MTM can suddenly appear ‘spontaneously’ in families with no earlier family history!

Do you have advice for people who are looking for a diagnosis?

Wendy: Some genetic centres will test for all the genes. If you are not happy with the advice you are given, go to see a specialist linked to a genetic diagnostic testing centre – such as Dr Heinz Jungbluth or Dr Fiona Norwood in London.

What are your current symptoms?

Zak: As I’ve become a teenager and grown, I have not been able to walk and need to use a powered wheelchair and help and also need NIV night-time ventilation, but generally I’m pretty well.

Wendy: No other family members have any symptoms, although there is the possibility that Zak’s sister could be a carrier like me.

What treatment are you having/had?

Zak: I take tablets called pyridostigmine (mestinon) three times, sometimes four times a day if it’s a busy day and it makes me feel a bit more energetic. I hated the nighttime ventilation at first and the first machine and masks were awful. But the Brompton sorted that out. The machine was quite noisy to get used to (a ‘breathing monster’) but now I’ve got more used to it and a more comfortable mask, so I have it on from when I go to bed until about 5.00 a.m. It gets slightly uncomfortable if I keep it on too long, so I like to have a couple of hours sleep without it too!

How did you find a doctor?

Wendy: A doctor in Bristol realised that this was a condition he wasn’t 100% familiar with, so referred Zak to Professor Francesco Muntoni’s team at the age of one year. Thankfully he had worked with Professor Muntoni at Hammersmith Hospital, London, so had the foresight to realise that rare conditions are often better treated by people who are very familiar with it – he has seen Zak his whole life. (Professor Muntoni has now transferred to Great Ormond Street Hospital, London).

What has been your experience of the healthcare system and healthcare professionals?

Zak: I have quite regular appointments, and when I come out of an appointment I think ‘thank God that’s done’ because it’s boring isn’t it being picked around and prodded and poked. But I suppose it has to be done and they do give very good advice.

Wendy: We have been lucky to be linked to a specialist hospital – that really does make all the difference and we always learn so much from these specialist appointments. If we visit our local team, it’s more often the other way round – we tell them stuff!! But that’s not to say they don’t pick up on and help to provide the equipment and services that are recommended by the specialists who really know the condition, at GOSH. And hopefully it’s helping to extend their knowledge too – so we have always found it really beneficial all round, to see teams locally and at the specialist hospitals.

Has your diagnosis had any health insurance implications for you?

Wendy: We have had to pay for special medical insurance cover for holidays and trips etc but have never had a problem getting it and so no it’s not really applicable. The NHS covers all treatment costs, although we have had to buy some equipment ourselves, because NHS will only cover the basic essentials.

What advice would you give to someone who has just been diagnosed with CNM/MTM ?

Wendy: To read as much as possible to learn from other parents / individuals. Try to plan ahead as much as possible in terms of adaptions or equipment so there is a smooth transition if things do change (and it’s not a last minute panic to adapt things in your life) but bear in mind everyone is different and you / your child will follow their own course. Try not to treat yourself or your child as ‘disabled’ – really push them to do things physically and join in with ‘normal’ childhood activities – there is usually some way around difficulties. Although it might not feel like it in those early years when things seem bleak – often, things can get better and improve, so always remain hopeful and optimistic and enjoy every minute of every day (with no regrets).

In this respect, we benefited from not knowing the course of Zak’s condition because there just wasn’t the information or internet back then and we may have treated Zak differently if we had known more about the statistics of the condition – even perhaps not pushing him to try to do as much as he did. We put our heart and soul into our children don’t we and all we can do is our best for them and hope things will improve for them. Regular exercise like hydrotherapy and even horse-riding (if tolerated) can really help to build up strength and stamina.

Zak: Try to be determined in your outlook and have a go at anything suggested to see if it makes a difference, it usually pays off.

What is your favourite book/film/music?

Zak: My favourite author is Robert Muchmore, because they’re action-packed and thrilling – in my own writing, I like to be adventurous. My favourite film is ‘Enemy At The Gates’ which is about a Russian sniper.

What do you want to do when you are older?

Zak: I’ve no idea at the moment, but I would like to go to University and at the moment I’m quite keen on Modern History. I also quite like the idea of computer programming.

What is a favourite/memorable event from your childhood?

Zak: Going to Florida on holidays. Swimming in the warm water, sunshine, swimming with dolphins, driving boats in the intercostals waterways and eating ‘popcorn shrimp’. My mum reckons it was a tonic and helped make me stronger. Something that was verified by my respiratory consultant – she thought they should be handing out ‘prescriptions’ for holidays in Florida to patients with chest complaints!

Who do you think has most influenced you in your life and why?

Zak: Stephen Hawking – because he shows me that you can do anything with your life! I really admire his brain too.

Zak and Wendy: We think Toni Abram and the Information Point is truly inspirational to us and many other families and individuals affected by MTM / CNM. So we want to take this opportunity to congratulate Toni on her 10th birthday and thank her for her dedication, hard work and commitment in everything she does for our community.

Toni knits us all together so nicely, inspires us with wonderful stories, signposts us to services and information to help our everyday lives and helps us to feel less isolated, like we are part of a great big FAMILY! We are so proud of you Toni and everything you have contributed and achieved and strived to do to make things better for MTM / CNM over the past 10 years – you are truly inspirational!

What’s the best advice you’ve been given?

Zak: To have a go at anything and not let your disability get in the way of your aspirations. My grannie wrote some words by Edward Everett Hale from the story ‘Ten Times One Is Ten’ in my christening card which says: ‘To look up and not down, to look forward and not back, to look out and not in, and to lend a hand’ which I think is good advice.

Zade

Zade is 18 months old and lives with his mum and dad in Texas. Below his mum Ashli writes about Zade.

What form of CNM/MTM is Zade diagnosed with?

Zade has X-linked myotubular myopathy.

When did Zade get diagnosed?

Zade was diagnosed at the third hospital he was transferred to when he was about four months old, but two months old if you count by gestation.

What symptoms prompted Zade’s diagnosis?

I gained 15lbs at the end of month six of my pregnancy which enduced the whole labor process, after losing 37lbs during my pregnancy. Then when Zade was born he was a skeleton baby, no muscle tone, elongated face, couldn’t breath, his eyes were still not open, he could not swallow or hardly move, he had what they call floppy baby syndrome.

How long did it take to get Zade’s diagnosis?

About four months.

How was Zade diagnosed?

He was diagnosed by lots of blood work with muscle biopsy during his tracheotomy and g button surgery. Everything was done at the same time.

What impact did the diagnosis have on you?

Prior to the diagnosis we knew Zade was different but when he was diagnosed it just put worry in our hearts, like if our son was going to be able to have a chance at a normal life, were we going to be able to financially support all of his needs. I was a little sad that I never got my mother son bonding time but now our bond is stronger than ever. I still have my worries and fears but he is my world.

Have you explained CNM/MTM to family members and what was their reaction?

I have vaguely explained it to them. Most treat him as if they are going to catch his condition, some don’t even come around any more or call to check on him after finding out that he will be this way always. It is sad that some of their reactions were bad but we still have a few members that still love him the way he is.

What implications do you think it has it had on your family?

Well since his diagnosis and the whole hospital experience I am more knowledgeable about how the medical world works. I am more picky as to what type of nurse cares for my son as we have had some bad things happen to my son. When he first got home we believe he died for three minutes or so and the paramedics got him back. When he came back to us he was blind, it took him a week to get his vision back to close to what it was like before, so we don’t take anything for granted.

How has the diagnosis affected you e.g. telling your children, starting a family, genetic counselling?

It has affected my husband and I as we want more children but don’t think we can go through all the emotions and worry like with Zade. So we are still iffy about having more kids, even though if it happens again we will still love him or her just the same

Do you have advice for people who are looking for a diagnosis?

Diagnosis isn’t a cure but it will give you clues as to what will happen in the future. Never give up and if you feel the doctors are not sure and they are only going on speculations, push and push for the correct diagnosis.

What are Zade’s current symptoms?

Zade’s symptoms are low muscle tone, he can’t swallow, can’t cough, can’t talk, can’t walk or crawl, barely holds his head on his own, is trached, vent dependent and suction dependent, has bad reflux, glaucoma and fluid build up in the ears.

What treatment is Zade having/has he had?

He has had not treatment, we are just letting Zade tell us what he needs by what his body tells us and in his reactions to vent changes, suctioning, medicines etc.

How did you find a doctor?

We found his pulmonary doctor at the fourth hospital he was in and this doctor has remained his doctor. His pediatrician was found by family recommendations.

What has been your experience of the healthcare system and healthcare professionals?

Our experience of both the healthcare process and the nurses has been horrible. I feel like I have seen everything but I still get shocked at things that happen.

Has your diagnosis had any health insurance implications for you?

Health insurance don’t want to help on certain things. Zade is the only one that has health insurance because I was denied. Things seem to be getting worse too and it feels like I have to fight for everything Zade needs.

What advice would you give to someone who has just been diagnosed with CNM/MTM?

My advice is to be an advocate for your child, don’t give up the fight. It is hard and you must take a break for yourself every once in while – you will need it.

What is Zade’s favourite film?

Zade’s favourite movie is Elmo movies.

What’s the best advice you’ve been given?

The best advice that was given to me was keep fighting.

Zade