Tag Archives: stem cell

Exhaustion

The vicissitudes of our daily life with Emma require a certain degree of hope in order to stave off the depression lurking in the background.  I need a plan of action, something I can refer to when I am tired, when my defenses are down, when I feel my grip on that tenuous thread of hope beginning to loosen.

At the moment I am reading about RPM – Soma Mukhopadhyay’s Rapid Prompting Method for autistic children, which gave her non-verbal son Tito a voice.  I have watched the videos, have read her book and am now rereading the book while taking notes.  I am on a waiting list to go with Emma to Texas to have a four-day session with Soma.  In addition I have just started reading Dr. Howard Shane’s book – Visual Learning.  I need to be alert while reading as the subject matter is dense and I have difficulty taking it all in.

Emma continues to wake the entire family at all hours of the night, resulting in all of us being exhausted, relying on caffeine to get us through the day with no end in sight.  Poor Nic, who is not allowed to drink caffeine, has to muddle through as best he can.  It is certainly affecting his ability to concentrate at school.

“We don’t have a plan,” I said to Richard this morning.  “We need a plan of action.”

But the truth is, I need an infusion of hope.  Like an IV – hook it up and let it drip into my veins.  Hope is the thing, more than anything else motivating me to keep pushing ahead.  Hope is the lens through which the world can seem grey and dull or bright and cheery.  I need hope.  So I think about the phone call Richard had yesterday regarding Emma’s last QEEG.  We had the brain scan done the day before we left for Panama for her second round of stem cell treatments.  Our conflicting schedules have made it impossible to meet to go over the results.  Richard is meeting with one of the doctors this Friday.  The doctor told us he thought there were some interesting things going on with that last scan.

So we wait and we hope.

The Journey Continues

Many concerned people have contacted me asking what’s going on, so I will try to explain the recent course of events.  But before I do so, I just want to say I am extremely conflicted by what we have been told to date and by the opinions we have recently been given.  Unfortunately this represents the inherent problems with autism.  One is given a diagnosis based on observation and by the anecdotal evidence provided by parents.  There is no blood test, no x-ray by which a diagnosis is made.  No one knows what autism is, no one knows what causes it and no one knows how best to treat it.  There isn’t even one thing (whether a drug, a therapy, or any other kind of remedy) that everyone agrees will help.  As parents of an autistic child struggling to make sense of all the opposing opinions, it becomes a formidable task to wade through the copious amounts of information, opinions, articles and books.  We are continuing to do our best to make sense of all we are hearing, reading and learning and will continue to keep posting as we gather more information.

To give a summary of what has happened in the past week – through a series of unrelated incidences, Richard was put in touch with the two Drs. he and I referenced in the past two posts.  They voiced their deep concerns with the stem cell treatments we have been doing with Emma.  They gave an example of a boy who evidently developed tumors as a result of stem cell treatments he received in a third world country.  I do not know any more details.  We have, since our initial conversation with them, been put into contact with a number of other professionals in the field of autism and stem cell research.  Richard and I are doing all we can to get as many opinions from different researchers and doctors who specialize in autism and stem cell research.

Last winter when we began looking into stem cell treatments, wondering if it might help Emma, we spoke with a number of doctors who felt it was worth a try.  The two doctors who have been following Emma and meeting with us over the past few years were in the process of putting together a group of 40 autistic children to take to the Costa Rican clinic before it was closed.  They had funding in place, which has since fallen through.  These two doctors were our main source of information as they had both been to the Panama clinic as well as the Costa Rican clinic.  In one conversation with them, I was shown the brain scan of a moderate to severely autistic boy before he had done any stem cell treatments and then his brain scan after six treatments, which occurred over the course of two years.  He now has a normally developing brain.  Seeing that scan was a turning point for me.  I remember standing in the doctor’s office and thinking – we have to at least try this. For another example of anecdotal success stories see comment to my last post, “Hope for Emma?”

Prior to Emma’s first stem cell treatment in Costa Rica I spoke with a couple of other doctors, a few of whom felt it was inadvisable to go, but prefaced their comments by saying they did not know of the work the Stem Cell Institute was doing personally, and two who said they were watching what the Institute was doing and hoping to replicate their treatments once it was allowed in the US.

To date we have not seen the sort of huge uptick we would hope to see on Emma’s brain scans.  We have been told we shouldn’t expect to see results so soon and that these things can take up to six months to show up.  Again these are opinions regarding a treatment, which has only been done to a few hundred children during the past few years.  Richard and I intend to continue monitoring her through our own observations as well as with periodic brain scans.  We continue to pursue the leading specialists in the field of stem cell research and autism.

At the moment, however, we have decided we cannot return to Panama and the Stem Cell Institute.  Richard and I agreed, when we began advocating for Emma, we would try anything to help her if there was no risk of harming her.  We cannot ignore what we are now being told.

I have seen progress in Emma.   She is more engaged and is engaging for longer periods of time, there is a depth to her eye contact that was not there six months ago.  She no longer wears a diaper at night and has not wet the bed for over a month. Whether any of this is due to the stem cell treatments is impossible to know.

Hope For Emma?

I have spent several hours starting different blog posts over the weekend and this morning, but have been unable to finish any of them.  I am still raw after the phone call Richard and I had with the director of the Stem Cell transplantation program at Children’s Hospital in Boston and the director of the Stem Cell Research Program also at Children’s Hospital in Boston.  See the previous post below, written by Richard on Friday.  An hour after our phone conversation in which they both expressed their concern with the stem cell treatments we have taken Emma to in Central America we received an email from them saying:  “We know that you are trying to do the best for your daughter, but given the issues we discussed, George and I think that you should not go back for stem cell treatment.”

I am feeling overwhelmed with emotions at the moment which is why I am having such a difficult time writing a post.  This blog is about Emma, not my fragile emotional state and though I have certainly written of the difficulties in parenting an autistic child I have tried to always keep Emma front and center – she is the star of this blog.  And yet, it is hard for me to write about anything at the moment because this blog is also about our hopes for Emma.  At the moment my hope is in short supply.

Research

I’m feeling stunned. Early this morning, Ariane and I spoke at length with two of the pre-eminent doctors in the field of stem cell research out of Boston Children’s Hospital. They not only called into question the theoretical basis of what we had been told about the scientific rationale for the stem cell treatments we gave Emma, but warned us that they had the potential to be “extremely dangerous.”

It is possible that this could be another case of “he said, she said,” and that the doctors who recommended the treatment we have been following are every bit as knowledgeable and experienced as the doctors who were warning us not to undergo another such treatment, but frankly, these particular doctors are so highly credentialed that I have to give their opinions more weight – at least until we have gathered more information from others who are universally regarded as experts in both autism and stem cell research.

They gave us the names of two doctors in the Boston area who are considered to be experts in autism research and (perhaps?) stem cell research as well. It wasn’t clear to me from our phone call that the doctors being recommended were definitely doing research with stem cells, but they are involved with autism research as well as a variety of other neurologically based disorders. I made a promise to myself after the phone call today to stop making assumptions, so until we speak, I’ll just say that I’m looking forward to learning more. I visited both their websites and they have impressive credentials. They are both involved in genetic research so even if stem cells aren’t part of their programs perhaps they have other promising treatments under development.

Perhaps. Maybe. Possibly. I’m filled with doubt and uncertainty as to where we go from here. I do know that we have to keep doing more research, and since the entire field of autism is rife with contradictory theories from highly regarded researchers, we have our work cut out for us. More to come.

Two Steps Forward…

Emma had another melt down Saturday night.  It went on for well over an hour and it began with wanting to eat whipped cream though it was time for bed.

“Whipped cream?”  Emma cried repeatedly.

Joe and I tried to use the following; it’s time to go to bed, it’s dark outside, which means it’s time for bed and you’ve already brushed your teeth, as reasonable explanations.  None of these statements made a difference nor did they serve to appease her.  When she realized eating whipped cream at 9:00PM wasn’t going to be allowed she said, “Vanilla milk?”

We repeated the same logic to a mind in lock down mode.  It was futile and we knew it.  Weather the storm, I kept thinking, but had a tough time being calm about it.
Eventually I raised my voice, “Emma!  You cannot stay in my room and scream.  You can scream in your own room.  Where do you want to be?  In your room or Mommy’s room?”

The fact that I was now raising my voice while telling her to lower hers was not lost on me.  Nor was the idea I was having a difficult time controlling my own emotions, yet was demanding she control hers.  It reminded me of once during a parent/teacher conference at our son, Nic’s school.  It had been a rave review and finally as things were coming to a close I asked, “Is there anything he needs to work on?”

“Well he has trouble controlling his impulses sometimes,” his teacher said.

“His parent’s are still working on that one too,” I responded.

To which his teacher laughed, “Yes, I suppose we all are.”

It was with this in mind that I was able to say, “Let’s take a deep breath, Em.”

“Stay in Mommy’s room,” she cried.

“Okay.  But you can’t scream, take a deep breath,” I said.

“Whipped cream,” Emma cried.  And on it went.  In many ways it was worse than the other night when she was crying for the four-wheeler because this time her screams were even louder and she went on even longer.  And then she began hitting herself in the head.  Hard hits with clenched fists, curled in frustration, seeking to cause pain.  I can only assume the physical pain from hitting herself lessened the emotional internal pain and frustration she was feeling.  I had to hold her wrists so she couldn’t hurt herself and thought of all those young women who seek solace in cutting themselves.  It is a terrible thing to witness your child causing injury.  That it is their own body they are inflicting the injury to makes it all the more upsetting and baffling.  Other than physically restraining her and trying to speak in soothing tones, I felt unable to help her.

Eventually she calmed down enough for me to let go of her wrists.  “It’s going to be okay, Emma,” I said.

“Whipped cream?” she whimpered.

I thought of how when Nic was a toddler I would try to distract him when he was upset.  “Hey Em, do you want to see some photos?” I asked, pulling out my iPad.

“Whipped cream?” she said, looking at the pictures.

“Look!  Here you are with Toni riding Beau,” I said.

“Beau,” Emma said, flipping through the photos.

“Wait, look here’s Nicky riding Beau.”

“Toni,” Emma said.  Then she added, “Whipped cream?”

“Oh look Em!” I said, hoping to keep her distracted, “what about this?  Who is that?”

“Joe!” Emma said staring at the picture of Joe two Christmases ago.

After ten minutes or so Emma said, “No more photos.”

“Okay.  Do you want me to talk to you?” I asked.

“Yes,” she said, surprising me.

I decided to do something I use to do with Nic when he had trouble falling asleep.  I would use a soft sing-songy voice about walking through a meadow and finding a trail that wound through a field of wild flowers.  I would go on making it up as I went until Nic would eventually fall asleep from the sheer monotony of it all.

“Your walking along a path,” I began.

“Whipped cream,” Emma whispered.

“There’s a field of wild flowers all around you,” I went on.

“Emma stop talking,” Emma said quietly.

“The wild flowers are so beautiful, pink and purple and blue.  There are lupine and poppies and Johnny jump-ups,” I continued.

But before I had gone through five or six wild flowers, she curled up as close to my body as she could without actually being on top of me, pulled my arm so it was wrapped tightly around her waist and immediately fell asleep.

Later as I was thinking about how upset she had gotten, how inexplicable it all was, I remembered how Emma often has terrible upsets in the evening after a day or days of amazing progress.   It’s two steps forward, one step back, the unsteady progress of a mind trying desperately to make sense of it all.

When we were in Panama waiting for Emma to wake up from the anesthesia after her second round of stem cells, the attending physician said to me, “It’s never like this,” he held his hand up at an angle pointing his fingers upward.  “It’s more like this,” he waved his hand up and down steadily raising it up.  “There’s progress but it’s up and down.”

“As long as she’s showing progress, you’re on the right track,” a neurologist once said to us early on after we’d received her diagnosis.  “Just don’t let her get away with too much,” he added as we left his office.

That Emma is progressing is something no one would dispute.  She is making progress, however shaky it may be, it is still progress.

Baseline

Before and after. Since we are not involved in any control group study, we need to establish a baseline reading of Emma’s brain waves before the stem cell treatment next week and then again afterward, probably a month or two post-procedure.

Joe and I will take Emma to the NYU brain research lab today where she will have a QEEG brain scan. It measures alpha, beta, delta, gamma and theta brain wave activity in the various regions of her brain illustrated with nifty color-coded pictures of her brain cross-sectioned from above and from the side. Black, navy blue, and brown – good news. Orange, yellow and red – not so good. We won’t see the results until after we come back from Panama so it will be a while until we can say anything about the ‘before’ baseline scan.

I’m hoping that we will see our doctor today and I’ll have an opportunity to ask him some more questions about the stem cell therapy. If so this will be a two-part entry. Before and after. If not, then it’s a brief blog today.