Friday, March 26, 2010

Following your instincts


This article was recently published in 'Pep Talk' published by

The Association for Children with Disability.


There are times when you have to hear the very worst of words from medical specialists; to absorb a prognosis you’d never imagine for your own child. When Nicole and Michael’s daughter Alice was 25 weeks of age, they couldn’t have been told more difficult news. Alice is going blind and is dying.

Suffering more than 30 life threatening seizures a day due to a rare genetic condition known as CDKL5, Alice had a very difficult start to her young life. She’s one of just five children in Australia to be diagnosed with CDLK5 which causes intellectual and physical disability, life threatening seizures and gastric dysfunction.

“But you know what,” explains Alice’s mother Nicole, “I have always believed Alice is meant to be here; she has always had a way of letting us know she wants to be here and, that she is here for a reason. She’s just celebrated her fourth birthday.”

As the family came to grips with the confusing and little-known diagnosis, there was never a moment they stopped believing in Alice and maintaining hope. Armed with this faith, Nicole has defied early medical expectations of Alice’s lifespan and development. She has turned to a range of specialists, including alternate therapies, to assist her daughter; and has even travelled to Italy in search of answers.

“Our therapy and treatment approach may not be right for every one,” explains Nicole, a practicing Speech Pathologist, “but for us and with so little known about this condition, it was important to investigate all options. Drug therapy was not assisting Alice’s seizures but making them worse, and as a parent who knew my daughter better than anyone, I knew it was time to seek other opinions and answers. It’s like looking for the pieces of a puzzle – we are slowly piecing it together and starting to see more of the whole picture.”

From ‘take her home to die - there’s nothing more we can do,’ at a time when Alice was so heavily medicated she was unresponsive to stimulus and only woke for seizures, Alice is now crawling and even learning to walk. She takes no anti-convulsant medication and now only has three to four seizures a week.

With a team of professionals ranging from a doctor who has studied Nutritional and Environmental Medicine, through a range of therapists and experts, and a strong focus on nutrition and supplementation, Alice’s seizures have gradually improved. While also under the care of a neurologist and paediatrician for advice and assistance, it was the family’s proactive approach to Alice’s care that shifted this baby’s life from one of constant seizures to one of a little girl developing and growing.

Brave and committed to Alice’s continued improvement, last year Nicole attended a genetics conference in Milan, Italy. Sitting with the world’s leading genetic engineers and scientists may have been daunting. But it didn’t stop this Tasmanian country Mum from standing up, microphone at the ready, and asking her questions (which were translated into five or six different languages) to the panel of medical experts sitting before her.

The conference focused on Rett Syndrome and for the first time CDKL5, both of which have been mistaken for one another due to their similarities. Both are genetic conditions, but where sufferers of Rett Syndrome seem to develop normally then present with the condition, CDKL5 usually presents not long after birth.

“I listened to statistics and developing theories, and increasing research is taking place into CDKL5 (especially here in Australia), but not much was offered in the way of answers or treatment,” says Nicole, “I wanted to know not just the statistics or features which define and help diagnose our children, but how we can ensure a better quality of life and a more positive outcome for our children.”

The determined Mum left her mark on the conference and was approached by many of the experts herself, still keeping in contact with scientists and specialists from around the world. She met with inspiring parents who shared their own stories and, who also wanted to know about Nicole’s experience with supplements and sound nutrition, and how this approach assisted Alice’s quality of life.

Nicole believes that through good nutrition and supplements, de-sensitisation and physical therapy, Alice has improved immensely. She believes that maximising health will minimise the affect of seizures and help to maximise potential. This approach may not stop every seizure, but gives Alice the health and strength to recover and minimise the impact these seizures have.

There is no doubt that some days are hard. A four year old who cannot walk, talk or even feed herself can complicate a family’s life when you are trying to tend to the chores of everyday life. It has certainly not been an easy path for Alice’s family including her five year old brother. But as always, the family remains strong.

Having just turned four, the future is looking bright for young Alice. She has spanned 211 days seizure free around the age of three, and although suffers from three to four seizures per week currently, is certainly a long way from her fragile early days of life.

“She can crawl now,” says Nicole, “she’s unstoppable around the house and is also learning to walk with her walking frame. She plays with toys, can feed herself finger food and is far more aware; she even picks up on the emotions and feelings of others; laughing at our jokes, or growling at me when I growl at her brother!”

There is no doubt that young Alice will blossom and share far more of her personality in years to come. This is only the beginning for Alice.

Alice Hansen

Saturday, November 21, 2009

Words that inspire!

I wanted to share some words that are meaningful to me - words that friends have shared, words that inspire me.

This is a photo of Alice and I in the garden. The song "I saw what I saw" is on an album called "Tell me what you know" by Sarah Groves - it was given to me by a special friend who said she always thinks of Alice and I when she listens to this song.

(Thanks Shaelene xxx)

*** See YouTube link, left side of site, to hear music ***





This is a photo of Alice. The song "Beautiful Child" is on an album called "Station Wagon", also by Sara Groves - given to me by another wonderful friend, at a time when Alice was very sick and I needed it most. (Thanks Sharynn xxx)

*** See YouTube link, left side of site, to hear music ***


I collect Quotes.

Only ones that are relevant and have meaning to me.


My favourites are here to share.


"Success is never final. Failure is never fatal. It is courage that counts" (Sir Winston Churchill)


"You never know how strong you are until being strong is the only choice you have"


"Aspire not to have more but to be more" (Oscar Romero)


"Attitude is a small thing that can make a big difference"

Wednesday, August 19, 2009

A quick update




A photo of Alice standing tonight.




A photo of me lighting a candle in the Duomo, Florence, Italy - for Alice XXX



It has been a long time since I last wrote in Alice's blog. I thought I should give a quick update of where we are at. Since I last wrote, there have been many changes and there are still many more to come including: Alice's progress, diet and seizure activity.

I went to a BioMedical conference in Sydney and met some wonderful people who have become involved with the finer details of Alice's diet and supplement regime (See www.mindd.org for an amazing look into BioMedicine and its importance in the treatment of ASD and other genetic based disorders).

Then I went to a genetics conference in Milan, Italy - I went hoping to meet someone who could help me find answers for Alice .... I sat with some of our worlds leading scientific and medical minds in relation to genetics ... I stood up in front of them with a microphone, having my questions translated into half a dozen different languages, and I talked about my Alice, discussed my theories and asked questions (I was so nervous I didn't know whether to pass out or vomit!)... I met the German Geneticist who discovered the CDKL5 gene. I met other scientist who were genuinely interested in what I had to say, I have contacts from all over the world who will help, in any way they can; people who are inspired to make a difference. It was one of the most amazing experiences of my life. I also hugged mothers who were strong enough to go on after watching their child die in their arms, and mothers strong enough to fight against; a medical system that is failling our children, or governments who only offer token support for health issues that affect so many children around the world - I was inspired - these were people with passion like I have never known before - amazing people who give real meaning to 'life'.

So, now I want to say a quick Thank You, to some wonderful people with incredibly generous and giving hearts, who put a little sunshine in my life; Kelly who looks after my beautiful horse who I have only been able to ride twice in the last 3 years, Lisa who left her own babies to be my 'strength' in Italy ("How you doin"), Ffion who sings, those special people who drop gifts at my back door, mow my lawn or bring a meal to the door some nights when I feel like crying at the thought of cooking, the doctors and therapist who answer my text messages in the middle of the night and will be by my side even when I don't ask, the friends who understand when it takes me two weeks to get back to their phone message or understand why I have not called them, then there are all those special friends from around the world who know just what to say at just the right time - you are wonderful and I love you! X N

Monday, May 18, 2009

Alice's diet!

Currently Alice's diet is: Dairy free, gluten and soy free, free of artificial colours and flavours and... we have to be careful with just about everything else she eats. Red meat makes Alice vomit, peas turn her bowel motions to liquid acid and apricots send her seizures out of control (to list a few). Testing has highlighted dairy as a food Alice will probably never tolerate (it's like giving her arsenic) but, hopefully, as Alice's gut health improves she will be able to tolerate a wider range of foods.

Alice is able to eat: chicken, fish like ling and sword fish, rice, fresh fruit and vegetables (carefully chosen) and breads, muffins, biscuits etc which I make at home.
Alice's diet is rotated; even foods which she can tolerate are reacted to if she eats too much of them.

Alice's diet is low in salt (we use Celtic Sea Salt in some cooking).
Alice drinks LOTS of water - Natural Spring Water ... not tap water with Chlorine and other toxic chemicals in it.
Alice also drinks broth - usually made with chicken bones - she loves it and it is rich with nutrients!

We are considering the GAPS diet (Gut and Psychology Syndrome) as it has been successfully used as a gut healer. Enabling people with allergies/intolerance's to eat a wider range of foods.

I think it is also important to mention that I am a Speech Pathologist with a 'special interest' in swallowing and meal management AND I always consult with Alice's Dietitian and Doctor, and other nutrition specialists, when making any changes to Alice's diet and supplement regime; to ensure optimum health and nutrition.

Supplementation - What and Why?

Alice’s Supplements
* Flora Care for KidsProbiotic for gut health
* Floradix with Iron – Multi vitamin
* 5HTP – Precursor of the Neurotransmitter Serotonin
* Calcium – Important for cell physiology
* DHA/EPA – Essential fatty acid: For brain and eye function and intellectual development
* Melrose Greens – Phytonutrients
* Cal Four – Calcium, Potassium and Magnesium
* L-Glutamine – Energy source for the cells of the intestinal tract and the immune system
* D 5000 – Vitamin D is important for cell growth, immune
system, nervous system and more
* Energetic Drops – Integrative Medicine
* Digestive Enzyme – To assist digestion
* CoQ10 - Antioxidant and nutritional support for heart function
These supplements may change - as we discover more about Alice's health and requirements; to provide maximum benefit and nutritional support.

Wednesday, May 13, 2009

We need to find answers


A Mothers Love

At first glace Alice looks like any other happy three year old. Then you notice she can’t walk or use her hands the way other children her age can. That’s because Alice is one of only 3 girls in Australia diagnosed with a condition called CDKL5. CDKL5 is a genetic condition with no known cause, treatment or cure, which affects mainly girls. Children with CDKL5 have a prognosis of intellectual and physical disability, life threatening seizures and gastric dysfunction. “When Alice was younger she could have up to 30 seizures a day, she slept on my arm every night so I could feel when she stopped breathing; we were told she was going blind and dying. Now Alice still sleeps in my room but she cries out before a seizure so I know when she needs me … we get a little more sleep now than we use to”. Alice spent most of the first 2 years of her life in and out of hospital battling to stay alive, now she is strong enough to crawl and can almost stand up and she loves playing with toys and with her friends. Alice still has regular visits to her specialist in Melbourne but most days she is healthy enough to participate in therapy; helping her learn to walk, talk and to develop other skills.

Medications appear to make Alice’s seizures worse and for a long time Alice vomited constants and was chronically constipated. I was told nothing could be done for her. I’m not the sort of person who believes nothing can be done so now Alice is on a strict diet with no dairy, soy, wheat, gluten, additives or artificial colours in her diet. She rarely vomits, her bowels are regular and she is physically very health”.

I have just returned from a Bio-Medical conference in Sydney, organised by the Mindd Foundation (http://www.mindd.org/). The Mindd Foundation was initially set up to support families of children diagnosed with Autism Spectrum Disorder but is a wonderful organisation for anyone interested in children's health. The conference was primarily focussed on; looking at the link between a genetic predisposition to disease and the affect of toxins on health. Discussion focussed on a need to reduce toxins, detoxify the system, and heal the damage in order to restore optimum function.

CDKL5 is being discussed for the first time ever, at a European genetics congress in Milan, Italy, In June. “What an incredible opportunity for me to meet some of the greatest scientific and medical minds, in relation to genetic conditions, from around the world. I am going to the congress armed with questions specifically about my Alice but also with data collected from other parents around the world including America the UK and Europe, whose children have CDKL5. We have all found that food and nutrition affect our children in different ways – helping to control their seizures and manage their digestive dysfunction. I aim to present our information, I hope I will learn from the experts but, I also think we the families have some important information to share with them, so that together we can find some answers. It may take time, and we may not get the answers we want in time to save our own children, but if we could help other children and their families in the future, that is important too”.

I think misdiagnosis, mistreatment and over-medication has impacted significantly on Alice’s overall condition including intellectual functioning – if we can find answers for these children, with the support of science and medicine to back up our findings – then maybe in the future other children and their families won’t have to go through the trauma we have.

CDKL5 is such a rare, unknown condition that no one knows what causes it or how to treat it … the prognosis is fairly gloomy with the seizures becoming worse and the children having a fairly short life expectancy but “no scientific study would be validated on such a small sample size (60-70 children diagnosed worldwide) so to me that says there’s hope, there has to be answers. What I’m doing is like piecing a puzzle together, I have some pieces of the puzzle and some are still missing, I need to find them - there are answers out there – I believe all questions have an answer, some are just more difficult to find than others”

If you would like to know more about CDKL5 visit http://www.cdkl5.com/ and if you would like to know more about Alice and her friends from around the world click on ‘personal stories’ on the left side of the website front page.

Doctor's Report




Alice DOB 11.2.2006
Alice is the second child of Nicole and Michael, and is one of only three female children diagnosed in Australia with CDKL5. This is a rare genetic condition with no known cause or cure. Alice’s prognosis is one of ongoing intellectual and physical disability, severe gut dysfunction and uncontrollable seizures, which are reported to be the most likely cause of a premature death.


I would like to present a succinct summary of Alice’s life thus far.


Alice was first thought to have developed seizures at 8 weeks of age. On presentation her symptoms were as follows:-
· Staring episodes associated with blinking eyes
· Rigid body and jerking movements
· Arching of the body
· Head lag
· Colic


In May 2006, at 13 weeks of age Alice was transferred from Hobart, Tasmania, Australia to the Royal Children’s Hospital in Melbourne, Australia, under the care of Dr Simon Harvey, Director of Children’s Epilepsy Program (RCH) Children’s Neuroscience Centre.
Alice had the following investigations:-
· MRI scan - normal
· Ophthalmological investigations - normal
· Video EEG - confirmed seizure activity
· Metabolic tests


Alice returned to Tasmania on a cocktail of medication: phenytoin, omeprazole, midazolam, and the formula Neocate. She returned to Melbourne in August for further intensive investigation which included samples taken for: glucose lactate, pyruvate and amino acids. Samples for protein and CSF neurotransmitters were also done together with bloods for UEC, LFT, B12, folate, VLCFA, mtDNA, and poLG. Skin biopsies were taken for EM and fibroblast culture and, a urine sample sent for amino acids and organic acids.


There were no clues as to the aetiology of Alice’s seizures from the history or examination, and at this stage Alice appeared developmentally normal. There was no evidence of an under-lying cerebral abnormality or metabolic disturbance. It was stated that Alice’s case was very difficult, and she was discharged home. Alice developed increasing hypotonia and gastrointestinal disturbance. She did not feed well and had intermittent coughing and spluttering that correlated with her drowsiness. She had foul smelling bowel motions and straining, often associated with increased seizure activity. Further investigations followed which are too numerous to list in this short summary. Alice was commenced on more medication in August 2006. By this stage Alice’s mother, Nicole was convinced there was a connection between Alice’s seizure activity and ongoing gut disturbance.


Nicole initially presented Alice to my sister, Dr Jane Chapman in October 2006. It was clear that Alice needed intensive investigation for her brain-gut connection dysfunction. Alice had numerous investigations including hair tissue mineral analysis, whole blood copper levels, whole blood zinc levels, food IgG antibody levels, and faecal microbiology investigations. Other investigations included amino/fatty acid blood tests and a range of conventional blood tests, resulting in numerous abnormalities being reported.


By May 2007 I was treating Alice with numerous nutritional supplements. I suggested a consultation with Dr Jacques Duff may be of assistance and Nicole and I went to Melbourne to attend a weekend lecture regarding the brain-gut connection where he was presenting. At this time Alice was having up to 30 seizures a day, awake or asleep, accompanied by screaming, especially when she was starting to come out of a seizure or attempting a bowel motion. Alice experienced extreme straining at times when passing stools; which were often jelly-like in consistency, putrid foul smelling, marbled black/green containing mucous, and often occurring directly before or after seizure activity.


Alice was assessed at the Austin Health Comprehensive Epilepsy Unit by Professor Ingrid Scheffer (Paediatric Neurologist), and it was decided that her epilepsy was likely to be a generalised process without a surgically amenable focus. The Ketogenic diet was discussed, according to Professor Scheffer’s advice, with the Ketogenic Diet Team and it was decided to commence this diet.


By November 2007 Professor Scheffer had completed a thorough assessment of Alice. By this time Alice has undergone 3 MRI scans which were all normal. Alice was now 21 months old and Professor Scheffer thought there was a genetic basis to Alice’s disorder. Rett Syndrome features were identified, although Alice did not have all the typical features.
It was discovered that testing for CDKL5 could be sourced through the United States. Epilepsy genetic researchers helped facilitate this investigation. Further exploration of the possibility of surgery was discussed but seemed extremely unlikely as numerous EEG, MRI studies, and PET scans showed no focal features to suggest a lesion in the brain that could be resected.


The Ketogenic Diet was adhered to thoroughly by Nicole; however there was no improvement, in Alice’s condition, on the diet. By May 2008 Alice had commenced on a wheat and dairy free diet, with ongoing supplements, and was becoming more alert and interactive.


At age 2 ½ yrs Alice was having 1 seizure a week. At that stage there were no bowel problems and Alice was on a number of specifically selected supplements. At 2 yrs 8mths Alice was on a diet excluding yeast, soy, gluten and dairy, and avoiding artificial colours and flavours. Her well being was improved with rare vomiting. Alice looked happier and healthier and her weight was 13kg. Supplements Alice was taking included Calcium, Multi Flora, multi-vitamins and 5HTP. Alice’s emergency medication was midazolam, given by intranasal or buccal administration only for clusters of seizures or seizures with breath holding or of increased duration.


At this time a laboratory result from Paris showed Alice had a likely mutation of the gene CDKL5. This gene has only been found in the last 4 to 5 years; therefore the future of Alice’s condition is unknown. The risk of death with this type of epilepsy is understood to be at least 25% mortality by age 20 but the figures specifically are unknown as there are only 60-70 children diagnosed worldwide.


I received correspondence from Professor Ingrid Scheffer in April 2009. Alice is now 3yrs 2 mths old. She is making definite developmental progress and had an amazing 211 days without seizures until March 2009. Her seizures have reoccurred which Nicole attributes to a slight change in Alice’s diet. Alice was having almond meal, wheat and dairy and had 5 seizures in the week beginning 23 March 2009. Since then these allergens have been removed from her diet and Alice has had one or two mild seizures per week. Alice’s bowels are not yet as regular as in her seizure free period.


Alice remains on no anti-epileptic therapy. She is on a variety of treatments including Calcium, Multi-flora, multi-vitamins, 5HTP, doses of pure fish oils and amino acids.
Alice has a de novo change as neither Mike nor Nicole carry the gene mutation found in Alice.


Nicole will attend a conference in Milan in June 2009 on CDKL5 disorders. Nicole has found that generally all the children suffering from CDKL5 disorder have gastrointestinal difficulties.


Alice now weighs over 14kg, is crawling and is nearly able to stand. Alice is also starting to use her hands more functionally.


I look forward to watching and assisting beautiful Alice’s progress through life.


Dr Sally Chapman
MBBS, FRACGP, MACNEM
7 May 2009