The Darkest Night

My baby boy, how I miss holding you in my arms, against my chest. I miss hearing you breath, I miss feeling the weight of you as I rocked.

Some days are dark with loneliness and Christmas time is particularly difficult. I cannot get into the spirit even almost 13 years after you slipped away to heaven.

I have fallen into the darkness again. You'd think I would have a handle on this but it just doesn't work that way.

Maybe I am psychologically dysfuctional. They call it dysfuctional grieving in my nursing diagnosis list. Phatttttttttttttttttttttttttttttttttttttttttttt to them. No parent ever stops grieving for their lost children. No one.

Sad

I am sad in a way most people could not understand. I wanted four kids. I loved being pregnant and having babies. With us carrying a genetic disease my hopes for another baby nearly dissipated. There was always the possibility of artificial inseimination by donor or invitro with healthy embryos. These ways have been beyong us financially.

I sad to give up hope. I'm sad to be aging out of the getting pregnant age. I'm sad to see my options wither away.

I am having such a difficult time accepting I'll never have a newborn of my own again. Being a grandparent is so NOT the same.

I don't kow what to do but go one with my life pushing through each day and hoping this sadness slowly dwindles away.

Alone

I am alone again. Your brothers are out and your father is asleep and I sit here by myself. If you were here you'd most likely be asleep as well.

Sometimes being so alone hurts. It causes pain beyond belief. This really has nothing to do with you except after you died and your grandmother died I slipped into the abyss of depression.

No one's fault, it was the way my mind and body reacted to unthinkable agony. I have never been as much pain as I was in watching you suffer and die. You had no control over what happened and I wanted so badly to take the pain from you. I couldn't. I was helpless. I had no control over what you went through.

I am so sorry you had to suffer. No infant should have to go through what you went through.

Familes should not be changed, transfigured by a child's life, illness and death.
I would have gladly given my life to save yours.

I don't understand why terrible things happen. I will never comprehend why you had to suffer and die.

I still love you. I still miss you. I will always love and miss you. Part of me will always be alone without you.

Suffering Sweetly

I have no answers. It makes no sense to me. Why did you, an innocent infant, have to suffer? Because You were my son, I felt your suffering acutely. I don't understand why any child has to suffer.

In Myanmar many thousands of children drowned or were blown away on high winds or hit by debris. Because of some stupid politically paranoid government, the children who survived may die of disease, or lack of water and food. Why don't people let others in the country to save the children?

In China a 7.9 earthquake killed thousands of children. They were crushed beneath buildings as the quake shook the roofs loose. Babies crushed in their cribs or with their parents in their homes.

Even thou you suffered my baby boy I was able to rock you and hold you until you took your very last breath. In some ways we were very lucky. We spent the vast majority of your ten months, 11 days together. You died in an embrace of love.
I was blessed to be holding you and you left this world and went on to the next. I'll be seeing you there some day.

Mother's Day Missing You

On your first mother's day you were 6 weeks old. You had no idea what day it was, but that was fine. I knew what day it was. My first mother's day with three children. I had you, my sweet little baby, Riley who was a 5yo boy full of energy, and Keenan who was 7 and half and thought you were one cool baby.

It was also your last mother's day. I was blissfully unaware of that information.

Yesterday your father told me I wasn't his mother. He did not buy me a card or do anything except say Happy Mother's Day. Your 17 year brother Riley did not even bother to do that.

I still feel your dad deserves props for being a dad, even thought he isn't my dad. He is half the dna in all three of you. He was present whe you, your brothers and the the babies we lost to miscarriages were conceived.

He's been through the toddler years, the soccer years, the baseball years, the junior high years and the high school years. I respect him as your father.

I feel like your father diminished my role as a mother. Like now I'm irrelevent since Keenan and Riley are in their late teens. Maybe he doesn't feel I do any mothering any longer.

I miss you Brennan and wish you could have been with me yesterday.

Feeling A Little Down

I have been pretty well acceptance and depression wise. In fact, I've been mostly even keeled which has been nice. When one has two teens and a husband secreting testosterone, it helps to be even keeled.

The Fantasy post has another side/The nightmare

If our first child had been born afflicted and began seizures at 5 months, his brain shrinking 25% on 3 weeks, losing his voluntary movement, etc we would have never had any biological children. A 1 in 4 risk is just too high for an always fatal disease. Because of the greater plan made by a greater power, I did get to feel the joy of creating children, carrying children, giving birth, nursing them, being head over heels on love with each of my sons.

We were blessed to have had that. I am grateful for that.

I always wanted children and don't know how I would have reacted if the oldest had been the one with disease. I'm glad I did not have to find out.

God is good. Sometimes my vision is cloudy.

Fantasies

I don't do this often but every now and again I think what my life would be like if Brennan had been a normal happy boy. He'd have a younger brother, number one. I wanted 4 children back in the day so I figure we'd have a 19yo, a 17yo, Bren would be 13years old and Kieran would be 10. Yes, Kieran was my next boy name.

Bren would be on the Meeker Middle school Baseball, jv, cuz he'd be in 7th grade. Kieran would be in 5th grade and on a Little League team unless he decided to be very different from his bothers and decided to play spring soccer.

Bren and Kieran would be pals but mostly at home because Brennan is, after all, in middle school and not an elementary school baby anymore. Bren would tease Kieran and then one of the older boys would jump him for being mean. At 13 Brennan would only be 5 feet tall so both his older brothers would be much larger.

Brennan and Kieran would be my readers. They would love to read on their own exploring the imaginative world in books. They'd also love computer games but there would be a time limit on that.

Kieran would be struggling with long division as everyone in the house had, and Brennan would try(after I asked him nicely)to help.

Riley would have his driver's license because I'd need the help. There's be practices and games to get to and with 4 kids things get complicated.

I believe Brennan would be more thoughtful than his older brothers.(not hard) He'd also worship them. Kieran would still be his mama's boy snuggly and caring.

If only we got to plan our lives...............................

A Little Easier To Comprehend

Hailey's Wish
A Ray of Hope


1. What are mitochondria?

Mitochondria (plural for mitochondrion) are sometimes described as cellular “power plants” because among other things, mitochondria are responsible for creating more than 90% of the energy needed by the body to sustain life and support growth. In addition to making energy, mitochondria are also deeply involved in a variety of other activities, such as making steroid hormones and manufacturing the building blocks of DNA.

2. What is a mitochondrial disease?
Mitochondrial diseases result when your body’s mitochondria fail to function properly. Your body’s organ systems are severely affected when your mitochondria can’t provide the energy needed to keep them running. Some parts of the body that require the most energy to function are: the brain, heart, liver, skeletal muscles, kidneys, endocrine and respiratory systems.

3. What are some symptoms of a mitochondrial disease?
Given the fact that mitochondria are responsible for fueling nearly all of the body’s energy needs, there is a long list of symptoms depending on which organ or tissue is having the “energy crisis.” When symptoms arise from three or more organ systems a mitochondrial disease should definitely be considered.

poor growth (failure to thrive)
muscle weakness, poor coordination
sensory (vision, hearing) problems
reduced mental functions
disease of the organ (heart, liver)
dementia
respiratory problems
hypoglycemia
apnea
lactic acidosis
seizures
gastro-intestinal disorders and swallowing difficulties
developmental delays
movement disorders (dystonia, muscle spasms, tremors, chorea)
stroke
diabetes
brain atrophy
4. How common are mitochondrial diseases?
It is now said that mitochondrial diseases are nearly as common as childhood cancer! One in 4,000 children born in the United States every year will develop a mitochondrial disorder by age 10. In adults, many diseases of aging have been found to have defects of mitochondrial function. These include, but are not limited to, type 2 diabetes, Parkinson’s disease, atherosclerotic heart disease, stroke, Alzheimer’s disease, and cancer. In addition, many medicines can injure the mitochondria.

5. When do doctors suspect that a person may have a mitochondrial disorder?

Different symptoms indicative of mitochondrial diseases may present over time. As patients begin to present with multiple catastrophic symptoms it can be hard for physicians to pinpoint the main cause. It is crucial that they never remove or set aside a symptom to try and diagnose the problem. All symptoms must be given consideration.

Mitochondrial disease should be suspected when:

A “common disease” has atypical features that set it apart from the pack
Three or more organ systems are involved
Recurrent setbacks or flare ups in a chronic disease occur with infections

6. Is there a cure for mitochondrial diseases?
There is not a cure for mitochondrial diseases. Doctors must look at each patient on a case-by-case basis and try to develop a treatment plan. Treatment may involve special diets and/or a combination of vitamins, and reducing any stress on the body.

7. How is a mitochondrial disease inherited?
The types of mitochondrial disease inheritance include:

Nuclear DNA (DNA contained in the nucleus of the cell) inheritance. Also called autosomal inheritance.

— If this gene trait is recessive (one gene from each parent), often no other family members appear to be affected. There is a 25 percent chance of the trait occurring in other siblings.
— If this gene trait is dominant (a gene from either parent), the disease often occurs in other family members. There is a 50 percent chance of the trait occurring in other siblings.
MtDNA (DNA contained in the mitochondria) inheritance.

— There is a 100 percent chance of the trait occurring in other siblings, since all mitochondria are inherited from the mother, although symptoms might be either more or less severe.
Combination of mtDNA and nDNA defects:

— Relationship between nDNA and mtDNA and their correlation in mitochondrial formation is unknown
Random occurrences

— Diseases specifically from deletions of large parts of the mitochondrial DNA molecule are usually sporadic without affecting other family members disease

8. What is Alpers?
Alpers’ Syndrome is a disease of the brain and liver. There are 3 classical symptoms of Alpers’ Syndrome. These are: 1) seizures that are very difficult to treat and have a focal component, 2) episodic psychomotor regression or dementia (loss of developmental milestones, often associated with common childhood infections),
3) liver disease. The children are born and develop normally for a period of time in virtually every case. Symptoms begin between the first few weeks of life and about 25 years of age. Two-thirds of the cases begin to show symptoms of seizures, or episodic loss of developmental milestones, within the first 2 years of life. The liver disease is often subclinical in the early stages of disease, but can appear at any time as acute liver failure.

Alpers’ Syndrome is a recessive genetic disease with a frequency of about 1:250,000 live births. Many cases die before an accurate diagnosis is made, so the true frequency is still an estimate. Alpers is caused by inheriting two copies of the POLG gene that are dysfunctional. These are called mutant copies. The function of the POLG gene is to copy mitochondrial DNA. In Alpers’ Syndrome, POLG is defective, so after a period of time, the amount of mitochondrial DNA in the cell falls below a critical threshold of about 35% of normal. When this happens, the mitochondria become sick, and begin to misfire. This leads to the brain and liver disease of classical Alpers’ Syndrome.

References:
Alpers Syndrome—A Summary for Families
Robert K. Naviaux, MD, PhD
www.clevelandclinic.org
www.umdf.org
www.mdausa.org
www.mindbodyfocused.com

Information provided is intended for educational purposes only and should not be construed as advising or diagnosing or treatment of this or any other medical condition.


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What They Think Brennan Had

Here's a lovely scientific description of the disease they assumed my baby had. They never did any genetic testing(esp back in 1995)because of the cost.


All Databases PubMed Nucleotide Protein Genome Structure PMC OMIM


#203700 GeneTests, Links
ALPERS DIFFUSE DEGENERATION OF CEREBRAL GRAY MATTER WITH HEPATIC CIRRHOSIS

Alternative titles; symbols

ALPERS PROGRESSIVE INFANTILE POLIODYSTROPHY
ALPERS SYNDROME
ALPERS-HUTTENLOCHER SYNDROME
NEURONAL DEGENERATION OF CHILDHOOD WITH LIVER DISEASE, PROGRESSIVE; PNDC
Gene map locus 15q25


TEXT

A number sign (#) is used with this entry because Alpers syndrome can be caused by mutation in the nuclear gene encoding mitochondrial DNA polymerase gamma (POLG; 174763).


DESCRIPTION

Alpers syndrome is usually characterized by a clinical triad of psychomotor retardation, intractable epilepsy, and liver failure in infants and young children. Definitive diagnosis is shown by postmortem examination of the brain and liver (Harding et al., 1995).


CLINICAL FEATURES

The illness usually begins in early life with convulsions. A progressive neurologic disorder characterized by spasticity, myoclonus, and dementia ensues. Status epilepticus is often the terminating development.

Bernard Alpers (1931) described the neuropathology and clinical features in a 4-month-old girl with a one-month illness characterized by intractable generalized seizures. He termed the disorder 'diffuse progressive degeneration of the gray matter of the cerebrum.' Ford et al. (1951) described a brother and sister with a similar disorder. (See myoclonic epilepsy (254800) for reference to the same cases reported by Morse.) Familial cases were also reported by Palinsky et al. (1954) and Christensen and Hojgaard (1964).

Alberca-Serrano et al. (1965) reported a family in which 4 of 6 sibs were affected with spastic diplegia due to anoxic encephalopathy, which they termed 'Alpers' syndrome. The parents were unrelated. Several relatives of the father may have had the same disorder. All affected members had reacted to infections with violent convulsions. The authors suggested that this represented a familial susceptibility and that the cerebral damage was secondary to anoxia.

Blackwood et al. (1963) described 2 sibs in whom diffuse cerebral degeneration (Alpers disease) was associated with cirrhosis of the liver. Wefring and Lamvik (1967) described brother and sister who developed convulsions at ages 11 and 14 months, followed by progressive hypotonia, dementia and jaundice 4 and 2 weeks before death at the ages of 15 and 20 months. In addition to the typical findings of Alpers disease, the liver showed extensive atrophy with fibrosis, inflammation and bile duct proliferation. The diagnosis was made at autopsy.

Sandbank and Lerman (1972) reported 3 sibs with Alpers disease, characterized by progressive mental retardation, seizures, rigidity, and degeneration of the cerebral cortex. Neuropathologic examination showed disorganization of the cerebral cortex with neuronal loss and astroglial proliferation. There were abnormal mitochondria of variable sizes, some with electron dense inclusions. The authors suggested autosomal recessive inheritance.

Huttenlocher et al. (1976) reported 2 sibships with 2 affected children in each. Clinical features included early onset (average 2 years) of delayed motor development, vomiting, multifocal seizures, status epilepticus, stupor, hypotonia, paralysis, increased CSF protein, and later onset of hepatic disease. Intermittent, unexplained fever occurred frequently. None of the children survived beyond age 3 years. Pathologic examination showed degeneration of the cerebral gray matter with loss of neurons and reactive astrocytosis in the brain and fatty accumulation and cirrhosis in the liver. The authors rejected the idea of anoxic encephalopathy and suggested that the syndrome was a familial disorder with autosomal recessive inheritance. Huttenlocher et al. (1976) noted that hepatic involvement was absent in some cases reported earlier, including the case reported by Alpers (1931).

Harding (1990) reviewed the clinical, neurologic, electrophysiologic, and histopathologic features of Alpers syndrome in 32 patients. Birth was usually normal, with some developmental delay in infancy, often with hypotonia and bouts of vomiting. The seizure disorder usually had an abrupt onset and although clinical signs of liver disease often appeared later, biochemical evidence of liver disease was sometimes present before the onset of seizures. EEG and visual evoked potentials were abnormal. Most patients died before the age of 3 years. Less frequently, late presentation occurred, even up to 25 years of age. Some patients also had visual disturbances. Liver pathologic findings, including fatty changes, abnormal bile duct architecture, and fibrosis, were unrelated to anticonvulsant therapy. Neuropathology showed severe cortical neurodegeneration and astrocytosis. In 12 of the 26 families in their series, 2 or 3 sibs were affected, including one pair of twins.

Frydman et al. (1993) reported the cases of 8 patients from 2 families. Onset in the first family was prenatal; in the 4 patients who were examined, severe microcephaly, intrauterine growth retardation, and typical manifestations of fetal akinesia, including retrognathia, joint limitations, and chest deformity, were found. The second family presented with an early infantile form. All of the affected offspring had micrognathia and 1 had findings of fetal akinesia, comparable to those seen in the other family. Microcephaly was mild at birth and progressed with age. Refractory neonatal convulsions, swallowing difficulties, and pneumonia complicated the clinical course of patients in both families, and all of the infants died before age 20 months. Comprehensive biochemical and metabolic studies in both families yielded normal results, and the diagnosis was supported by demonstration of extensive progressive brain atrophy on computerized tomography and typical histologic findings; for example, the parietal cortex showed spongy state with focally accentuated severe loss of neurons. The cerebellar cortex showed severe loss of almost all granular cells and persistent Purkinje cells. Anomalies of dendritic arborization were also seen. Both families were of Israeli Arab ethnicity and the parents were first cousins in both cases.

Harding et al. (1995) reported the unusual cases of 2 unrelated girls, aged 17 and 18, with a progressive encephalopathy, visual signs and symptoms, multiple types of drug-resistant seizures, and liver failure. Brain imaging showed lesions in the occipital lobe, and EEG showed slow waves with polyspikes. Both patients had a rapid degenerative course and died within 8 months of onset.


OTHER FEATURES

Cases with a disturbance in pyruvate metabolism and NADH oxidation (10,9:Gabreels et al., 1981, 1984) have been described.

In a patient with mtDNA depletion and Alpers syndrome, Naviaux et al. (1999) found global reduction in respiratory chain complex I, II/III, and IV activity and deficiency of mitochondrial DNA polymerase gamma activity.

Gauthier-Villars et al. (2001) confirmed the mitochondrial respiratory chain abnormalities in the liver of 4 unrelated patients with Alpers syndrome. One patient had a complex I deficiency, another a complex IV deficiency, and 2 had a combined deficiency of complexes I and IV.


MOLECULAR GENETICS

Naviaux and Nguyen (2004) reported 3 patients with Alpers syndrome who were homozygous for a mutation (E873X; 174763.0008) in the POLG gene. They later published a correction (Naviaux and Nguyen, 2005) stating that 2 affected patients from 1 family with Alpers syndrome were compound heterozygous for 2 mutations in the POLG gene: E873X and A467T (174763.0002). Naviaux and Nguyen (2005) stated that the existence of a common 4-bp insertion in the POLG gene yielded the incorrect initial results. The clinical features of the family had been described by Naviaux et al. (1999).

In 4 patients with Alpers syndrome, Davidzon et al. (2005) identified compound heterozygosity for 2 mutations in the POLG gene (174763.0006 and 174763.0013). Liver biopsies from 3 patients showed mitochondrial DNA depletion ranging from 87 to 94%, and all 4 patients showed decreased activity of mtDNA-encoded respiratory chain complexes.

Ferrari et al. (2005) identified mutations in the POLG gene in 8 patients with Alpers syndrome.


GENOTYPE/PHENOTYPE CORRELATIONS

Nguyen et al. (2005) reported a child with Alpers syndrome who was homozygous for the A467T mutation. Unlike other children with the disorder, he showed late-onset at age 8.5 years and death by age 9 years.


HISTORY

As noted by Harding (1990) in a review of Alpers syndrome, there was much confusion in the past regarding the nosology, pathogenesis, and diagnosis of the disease. Some reported cases seemed to be caused by anoxia at birth or illness, whereas others were familial with normal births. Cerebral damage was also thought to be a result of intractable seizures or hepatic toxicity, and hepatic damage was believed in some cases to be caused by anticonvulsive drugs.


REFERENCES

1. Alberca-Serrano, R.; Fabiani, F.; Deneve, V.; Macken, J. :
Familial spastic diplegia due to anoxic encephalopathy (Alpers). A contribution to the study of vascular fragilities of the nervous system of genetic type. J. Neurol. Sci. 2: 419-433, 1965.
PubMed ID : 5878525

2. Alpers, B. J. :
Diffuse progressive degeneration of gray matter of cerebrum. Arch. Neurol. Psychiat. 25: 469-505, 1931.

3. Blackwood, W.; Buxton, P. H.; Cumings, J. N.; Robertson, D. J.; Tucker, S. M. :
Diffuse cerebral degeneration in infancy (Alpers' disease). Arch. Dis. Child. 38: 193-204, 1963.

4. Christensen, E.; Hojgaard, K. :
Poliodystrophia cerebri progressiva infantilis. Acta Neurol. Scand. 40: 21-40, 1964.
PubMed ID : 14108415

5. Davidzon, G.; Mancuso, M.; Ferraris, S.; Quinzii, C.; Hirano, M.; Peters, H. L.; Kirby, D.; Thorburn, D. R.; DiMauro, S. :
POLG mutations and Alpers syndrome. Ann. Neurol. 57: 921-924, 2005.
PubMed ID : 15929042

6. Ferrari, G.; Lamantea, E.; Donati, A.; Filosto, M.; Briem, E.; Carrara, F.; Parini, R.; Simonati, A.; Santer, R.; Zeviani, M. :
Infantile hepatocerebral syndromes associated with mutations in the mitochondrial DNA polymerase-gamma A. Brain 128: 723-731, 2005.
PubMed ID : 15689359

7. Ford, F. R.; Livingston, S.; Pryles, C. V. :
Familial degeneration of the cerebral gray matter in childhood with convulsions, myoclonus, spasticity, cerebral ataxia, choreoathetosis, dementia, and death in status epilepticus. Differentiation of infantile and juvenile types. J. Pediat. 39: 33-43, 1951.
PubMed ID : 14851183

8. Frydman, M.; Jager-Roman, E.; de Vries, L.; Stoltenburg-Didinger, G.; Nussinovitch, M.; Sirota, L. :
Alpers progressive infantile neuronal poliodystrophy: an acute neonatal form with findings of the fetal akinesia syndrome. Am. J. Med. Genet. 47: 31-36, 1993.
PubMed ID : 8368248

9. Gabreels, F. J.; Prick, M. J.; Trijbels, J. M.; Renier, W. O.; Jaspar, H. H.; Janssen, A. J.; Slooff, J. L. :
Defects in citric acid cycle and the electron transport chain in progressive poliodystrophy. Acta Neurol. Scand. 70: 145-154, 1984.
PubMed ID : 6439001

10. Gabreels, F. J. M.; Prick, M. J. J.; Renier, W. O.; Willems, J. L.; Trijbels, J. M. F.; Ter Laak, H. J.; Jaspar, H. H. J.; Slooff, J. L.; Van Haelst, U. J. G. M.; Sengers, R. C. A. :
Progressive infantile poliodystrophy (Alpers' disease) associated with disturbed NADH oxidation, lipid myopathy and abnormal muscle mitochondria.In: Busch, H. F. M.; Jennekens, F. G. I.; Scholte, H. R. : Mitochondria and Muscular Diseases. Beetsterzwaag, The Netherlands: Mefar (pub.) 1981. Pp. 165-171.

11. Gauthier-Villars, M.; Landrieu, P.; Cormier-Daire, V.; Jacquemin, E.; Chretien, D.; Rotig, A.; Rustin, P.; Munnich, A.; de Lonlay, P. :
Respiratory chain deficiency in Alpers syndrome. Neuropediatrics 32: 150-152, 2001.
PubMed ID : 11521212

12. Harding, B. N. :
Progressive neuronal degeneration of childhood with liver disease (Alpers-Huttenlocher syndrome): a personal review. J. Child Neurol. 5: 273-287, 1990.
PubMed ID : 2246481

13. Harding, B. N.; Alsanjari, N.; Smith, S. J. M.; Wiles, C. M.; Thrush, D.; Miller, D. H.; Scaravilli, F.; Harding, A. E. :
Progressive neuronal degeneration of childhood with liver disease (Alpers' disease) presenting in young adults. J. Neurol. Neurosurg. Psychiat. 58: 320-325, 1995.
PubMed ID : 7897414

14. Huttenlocher, P. R.; Solitare, G. B.; Adams, G. :
Infantile diffuse cerebral degeneration with hepatic cirrhosis. Arch. Neurol. 33: 186-192, 1976.
PubMed ID : 1252162

15. Naviaux, R. K.; Nguyen, K. V. :
POLG mutations associated with Alpers syndrome and mitochondrial DNA depletion. (Letter) Ann. Neurol. 58: 491 only, 2005.
PubMed ID : 16130100

16. Naviaux, R. K.; Nguyen, K. V. :
POLG mutations associated with Alpers' syndrome and mitochondrial DNA depletion. Ann. Neurol. 55: 706-712, 2004.
PubMed ID : 15122711

17. Naviaux, R. K.; Nyhan, W. L.; Barshop, B. A.; Poulton, J.; Markusic, D.; Karpinski, N. C.; Haas, R. H. :
Mitochondrial DNA polymerase gamma deficiency and mtDNA depletion in a child with Alpers' syndrome. Ann. Neurol. 45: 54-58, 1999.
PubMed ID : 9894877

18. Nguyen, K. V.; Ostergaard, E.; Ravn, S. H.; Balslev, T.; Danielsen, E. R.; Vardag, A.; McKiernan, P. J.; Gray, G.; Naviaux, R. K. :
POLG mutations in Alpers syndrome. Neurology 65: 1493-1495, 2005.
PubMed ID : 16177225

19. Palinsky, M.; Kozinn, P. J.; Zahtz, H. :
Acute familial infantile heredodegenerative disorder of the central nervous system. J. Pediat. 45: 538-545, 1954.
PubMed ID : 13212595

20. Sandbank, U.; Lerman, P. :
Progressive cerebral poliodystrophy--Alpers' disease: disorganized giant neuronal mitochondria on electron microscopy. J. Neurol. Neurosurg. Psychiat. 35: 749-755, 1972.
PubMed ID : 4647849

21. Wefring, K. W.; Lamvik, J. O. :
Familial progressive poliodystrophy with cirrhosis of the liver. Acta Paediat. Scand. 56: 295-300, 1967.
PubMed ID : 6033104


CONTRIBUTORS

Cassandra L. Kniffin - updated : 2/15/2007
Cassandra L. Kniffin - updated : 10/13/2005
Cassandra L. Kniffin - updated : 8/31/2005
Cassandra L. Kniffin - reorganized : 8/15/2003
Victor A. McKusick - updated : 8/8/2003



CREATION DATE

Victor A. McKusick : 6/2/1986



EDIT HISTORY

wwang : 2/21/2007
ckniffin : 2/15/2007
carol : 11/15/2005
ckniffin : 10/13/2005
wwang : 9/6/2005
ckniffin : 8/31/2005
tkritzer : 8/13/2004
ckniffin : 8/4/2004
ckniffin : 7/12/2004
mgross : 3/17/2004
carol : 8/15/2003
ckniffin : 8/15/2003
carol : 8/8/2003
alopez : 6/10/1997
mimadm : 11/12/1995
terry : 4/21/1994
warfield : 3/7/1994
carol : 9/1/1993
supermim : 3/16/1992
supermim : 3/20/1990


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Dear Brennan Who Never Got the Opportunity to Grow up

My dearest son,

I'm 46. It's been 12 years since you were ripped from our family by a bizarrely rare incredibly odd disease. You lived 10 months and 11 days. I have no idea how you comprehended your small time with us. In spite of pain and guilt and extreme frustration; I am delighted I got to love and nurture and care for you during your short life.

I was ecstatic when I learned we were pregnant with you. I had a miscarriage a few months before that was traumatic in a physical manner but not so devastating emotionally. This time I got to see the baby I miscarried, so there was a final closure to the event. My attitude was OK, God felt there was an inborn error that meant that baby could not survive.

Your father and I waited 6 weeks and tried again. We were thrilled to be trying to create you with the help of God. It never mattered if you were female or male, we just wanted a healthy infant to love, to show the product of our love, and to enjoy parenting. We relished raising your brothers at 6 and 4. They were more of a joy than work and they were loving, snuggly, loving children. I was fabulously happy being a full time mother and wife.

So when we got the news you were coming we were happy, slightly leery but happy. The pregnancy was different from my others. I chose a midwife. I didn't have a happy energized pregnancy with you as I did with Riley. I was more tired with you being 32 at the time. I had a child in 1st grade and one in preschool plus soccer for both.

My hair went flat ad lifeless for the first time ever-thanks. I had very little nausea or headaches as I had suffered through with your brothers. I was more tired.
Kinda klutzy as I fell through the stairs at Charmaine's. Nice bruises on my arms and knees

I fell another time in the middle of the night when Ry went pee in his bathroom but it was clear and I did not see it. WHAMMO went my 7 months pregnant body. I twisted so the brunt of the fall affected my back and upper side. I did need to call your dad to help me get up. I was fairly unwieldy by then (like a beached whale).

There was the exciting(yeah right) time Riley was sleeping bed with me and you inside me and he threw up all over my back and hair. Once again, I screamed for Daddy for help. You, I and Ry took a nice warm shower and Daddy did the laundry. He was such a good daddy/husband.

I would lie in bed and feel you move. You never matched the level of the frenzy of your brothers but you did move. You were breech from early on. Your hard head was under my ribs, your ankles tickled your ears and you little butt was wedged firmly down in the pelvis. You would get the hiccups and I would grin internally because I know this meant you alive and most likely normal.

Your time inside me was a gift. It's a gift to create a life. I can not describe the radiance and peace I felt when you were inside me. You were our child but again, a child is a gift, leaving the future to be unknown. We were okay with that risk. After 2 healthy boys and 2 miscarriages, we understood(or we thought) we understood the risk to love outweighs the fears.

Pop Up Feelings

Because of our move a whole 11 blocks south, I've been sorting and packing in the last 10 days or so.

I came upon my breast pump accessories, totally unexpected, and I lost it. I wept for over 30 minutes.

I wept for a life cut short.

I wept for a future denied.

I wept for the sweet boy I never got to see turn into a toddler let alone a teen.

Brennan Reed would have been 13 on March 22.

I wept for the suffering my innocent infant had to bear.

I wept, selfishly for me. For that family picture of all three boys in baseball uniforms lined up tallest to smallest. The picture that only existed in my mind.

I wept for the sadness I carry with me everywhere, even if it invisible to others.

I did not feel better or worse after I stopped crying. I just felt very much alone.

I miss him~always.

Feeling It

After our traumatic trip to the ER last week plus the traumatic drug reaction that brought me as close to psychotic as I ever want to be, I'm feeling the loss.

This time 12 years ago Bren was very very sick. He tried to die several times but my female Christian friends came to sit deathwatch with me. Six women who cared so much for Brennan and me. Brennan refused to die.

I wasn't ready to let him go quite yet. I literally willed that kid to live. He slept on my chest, sitting up on the couch, every night. I had a double receiving blanket under his head because he drooled incessantly. The poor dear was unable to swallow. He was also unable to keep his mouth closed. The part of his brain that controlled those things was damaged. He was not paralyzed but had very little voluntary movement.

He would lie his head on my chest, listening to my heart that kept beating despite my pain. He would whimper when not comfortable and hum when I sang to him or played his lullaby tape(by Micheal Card). I would sing and talk to him until I was sure he slept. Then I would sleep right there, sitting up, feeling his small heart still beating.

He was on an oximeter to measure how much oxygen he was getting. He was being fed through an NG tube 18 hours a day. He needed to be suctioned out because he could not rid himself of mucus. This became a routine part of the day. I also gave him his medication through a porta-cath on schedule. He was on a med that was every 4 hours for awhile and I set the alarm to get up to do it.

He slept on my chest every night for the last three weeks of his life. I would catch naps when the home pediatric nurse was there. I did not want to be away from him because I knew soon he would be gone forever.

My poor little boy who never had a chance at life. Who would never grow up to drive me nuts as a 7th grader(where he'd be now). He never got to even crawl. He did not know what he missed. He took comfort in Geo, my women friends who loved to hold him, the noises he could hear from his brothers and from me. We were one in a way that is impossible to describe.

I miss him. I miss him as a baby. I miss him as he would have been the last 12 years if he had been healthy. I just miss him. I pray we will meet again in heaven one day.

A New Viewpoint

This is not meant to be a put myself down or blame myself for my reactions to what we went through. I just had some scales fall from my eyes so I could see how those around me were affected by Brennan's death and the way I reacted.



I have done my family a disservice. These events did not just happen to Brennan and me. They happened to the entire family.

This is where our fairly happy and functional family started on the long road to dysfunctionality and my long pity party.

I have always thought of this as my tragedy. My baby died. That little boy who grew in my body, was fed from my body, was a physical part of me~it was my loss more than anyone's. Wrong. It was our family's tragedy and my martyr type behavior caused the cracks of dysfunction and anger that we are now trying to deal with.

I hugged my anger and my grief to myself for far too long. Anyone who tried to break that shell around me paid.

I think my biggest fear is that someone would know I was to blame for his death. Not rational but I was raised Catholic and our God was vengeful. Brennie was too young for God to be angry enough so in my self centered way, it must be my fault. Maybe Geo's fault. Someone had to be at fault. If no one was at fault, why did it happen?

I thought I was coping well, I lied to myself. I needed drugs to barely cope, I used the drugs to blunt my anger and grief, and that fact became obvious to me in the last few weeks.

Who helped Geo? Not me. I just chalked it up to men grieve differently and left him to twist in the wind.

I think I did okay with the kids except the after mother was not like the before mother. I still loved them, but my grief drowned them out many, many times.

I wallowed in my pool of martyrdom alone. I used people so that I could wallow without the kids around.

I had some great insights and I was completely blind.

I offered no comfort to my inlaws. I have no mercy for them. They were the enemy because I could feel what I thought to be my SIL's hostility. I thought she thought she could take better care of my kids.

Selfishly, I clung to my extreme anger not knowing who to be angry with.

Time to kick the martyr out of me.

Brennan was loved by many and I unfairly held him close to me.