Thursday, March 27, 2008

The Depth of Pain


Not Like You
by Sheri Hess


I am a mother, though not like you.
You cradle your sweet baby in your arms,
Mine are empty, but I hold him in my heart.
You brush her soft curly hair,
and tie pretty pink bows just right.
A lock of his hair is tucked neatly in a book
You pick daisies and tie them in a chain
to wear around her neck
I cut lilacs and arrange them in a vase to set at his grave.
You look forward to dreams and plans.
I hold on to memories.
I am a mother,
though not like you.

Tuesday, March 25, 2008

An Open Letter to Congress

To the Senators and Congressmen and women of the United State Government:

I do not feel that you are giving my son a fair voice in your actions. I know that as members of this great nation's government, you are all faced with many important and difficult decisions. However, I cannot begin to comprehend why it has taken over six months to act on HR 3334 or S2042. This should be an easy decision! There are no sides or finding middle ground or preserving the interests of special groups in this vote. There will be no major political fall out if you pass this bill. In fact, the only dire consequence at stake is the time being lost by your lack of action on this matter.

So, my question to you is this: why do you continue to let these bills sit without acting on them? And, why can I not get a response when I write to any of you involved in this decision making process?

I feel that none of you care about me as a voter or my son who fell victim to this terrible disease, and that is making me lose faith in this government and those in charge of it.

Signed,
Renee` Kress
Mommy to Gavin Walker Kress

Sunday, March 23, 2008

Spinal Muscular Atrophy Type I

Spinal Muscular Atrophy Type I generally appears or is diagnosed in infants ages 0-6 months - the majority of diagnoses being made within the first three months of life. Also known as Infantile SMA or Werdnig-Hoffman disease, it is the most severe form of Spinal Muscular Atrophy. It generally has a quick and unexpected onset after birth, and babies diagnosed with SMA Type I usually do not live past one year of age.

A child with SMA Type I is usually never able to lift his/her head and have trouble accomplishing the normal motor skills that are milestones in early infancy. Some of the most noted symptoms include not only poor head control, but also the inability to sit up unsupported, leg movements that are not as vigorous as they should be, and not bearing weight on the legs. Swallowing and feeding are usually affected as well, and they almost always become affected at some point. This can be linked in some ways to another symptom - atrophy of the tongue. This particular atrophy is most commonly marked by rippling movements or fine tremors of the tongue, which are referred to as fasiculations. Finally, some mothers may note decreased movement of the fetus while still in the womb.

An SMA patient's strongest breathing muscle is the diaphragm - most likely due to a weakness of the intercostal muscles, which are located between the ribs and help to expand the chest, that usually results in a smaller torso. The patient's chest may appear to be concave, and it looks like they are breathing with their stomach. Due to this type of breathing, the lungs may not fully develop, which can lead to a weak cough and difficulty taking the deep breaths necessary to maintain oxygen levels while sleeping. This means that the most common cause of death in patients with SMA Type I is respiratory failure due to these complications or because of infection.

Friday, March 21, 2008

Words Not Shared in 18 Months


Death of a Child
by Sandy Eakle

Sorry I didn't get to stay.
To laugh and run and play.
To be there by your side.
I'm sorry that I had to die.

God sent me down to be with you,
to make your loving heart anew.
To help you look up and see
Both God and little me.

Mommy, I wish I could stay.
Just like I heard you pray.
But, all the angels did cry
when they told little me goodbye.

God didn't take me cause He's mad.
He didn't send me to make you sad.
But to give us both a chance to be
a love so precious .. don't you see?

Up here no trouble do I see
and the pretty angels sing to me.
The streets of gold is where I play
you'll come here too, mommy, someday.

Until the day you join me here,
I'll love you mommy, dear.
Each breeze you feel and see,
brings love and a kiss from me.



Wednesday, March 19, 2008

Goals & Hopes for This Blog

When I started this blog, the only goals that I had in mind were bringing more attention to Spinal Muscular atrophy, telling Gavin's story, and having a more consistent way to send information to the Senate HELP Committee, and the only hope that I had for this project was that some action would be taken on the SMA Treatment Acceleration Act that has been in the hands of the HELP Committee since September; however, it has blossomed into so much more than a simple writing journey. Almost over night, it has become the foundation for a plethora of ideas that are being put into motion. Great actions inspire even greater actions, or so they say; and I am excited to share one of the biggest things that will be happening because I started writing this blog.


Though it is still in the planning stages, the first of what I hope to be many dinners will be held to raise a donation to one of the Spinal Muscular Atrophy Foundations. I'm not sure exactly what we will be serving yet; however, it seems like spaghetti is the safest bet. There will be tickets sold to the event, and possibly small raffles to help raise more funds. Tentatively, this event is planned for October 3rd, 2008 (barring any major objection from the state Health Department). The plan at the moment is to sell tickets or collect a donation at the door and to advertise the event in local papers, on the local news stations, and on the local radio stations. Of course, that means we might need a lot of spaghetti, but I am trying to be reservedly optimistic about this. Staying on point is the first big step.

At this time, I have not chosen which foundation will receive the donation, though I am looking the hardest at the three linked here in the blog. I want to make sure that the donation that I make will have the largest impact in finding a cure for SMA, and so, there is a lot of research that must be done. However, as soon as that decision has been made, then it will be announced here first.

One of the things that has been on my heart since starting this blog is how I am honoring my son and his memory; and to be completely honest, I do not think that I have been doing the best job of that over the past 18 months. Gavin deserves my every effort to find a treatment or cure for the disease that claimed him, and it is my duty to carry on that fight for him. Therefore, in addition to telling his story and providing knowledge through the words that I write, I will also be updating my progress on goals that are being set for pushing for progress in Gavin's name.

Monday, March 17, 2008

The Basics of Spinal Muscular Atrophy

Spinal Muscular Atrophy, also referred to as SMA, is the name given to a group of different disorders that all share a genetic mutation that manifests in the weakness caused by the loss of motor neurons in the spinal cord and brainstem. The affected motor neurons are responsible for the control of voluntary muscles that are used in activities such as crawling, walking, head/neck control, and swallowing. Muscles throughout the body are affected by SMA; however, the proximal muscles - those located to the trunk of the body, such as the shoulders, hips, and back - are the most severely damaged.

The cause of SMA is understood to be a missing or mutated SMN1, or surival motor neuron 1, gene. The disease itself is classified as an autosomal recessive gene disease, meaning that both parents must be a carrier of the mutated gene and both must pass it on to their child. (This makes the chances of two carrier parents having a child with SMA 1 in 4 or 25%.) The severity and onset of Spinal Muscular Atrophy is almost purely dictated by the ability of the SMN2 gene to make up for the loss of protein production. Symptoms may surface as early as the first few months of life, or they may not arise until after the age of two.

Diagnosis of SMA generally does not occur until after symptoms have begun to present themselves. The most common form of diagnosis is done in a genetic blood test that determines the lack or mutation of the SMN1 gene. In some rare cases, the results of such a blood test are inconclusive or unable to definitively diagnose SMA. It is in these cases that other tests, such as an EMG (electromyography) or muscle biopsy are used.

Taking in all forms of SMN1 related SMA, the occurrence of the disease is 1 in every 6000, and about 50% of those babies born with SMA will die before their second birthday. This also makes it the number one genetic killer in children under the age of two. It is a disease that does not have regard for age, race, or gender. It can strike anyone at anytime in their life. One out of every forty persons is a carrier for SMA, and because there are no known health risks associated with being a carrier, they often do not know until they have a child born with the disease.

Statistics and information in this post were taken from:
Wikipedia: Spinal Muscular Atrophy
Families of Spinal Muscular Atrophy

Saturday, March 15, 2008

The Beginning

My name is Renee` Kress; however, this story and this blog are not about me. In fact, I plan on playing a minimal role in this voyage.

What this blog and the purpose of writing are about is my son, Gavin Walker Kress. Gavin was born on May 1st, 2006 - a baby who, by any standards, was bright and healthy and perfect. Unfortunately, prenatal testing, the apgar test, and any other standard means of testing an infant's health could not detect the killer that was already at work within his tiny body.

At three months of age, my son started to show severe developmental delays. He was not moving properly, starting to push himself up, or gaining any form of head control. These were the first symptoms of a problem that no one could have fathomed.

The lack of head control made the doctors think that he had torticollis, or wry neck, a condition that is the result of weak neck muscles which is usually caused during positioning during pregnancy. He also had a very visible condition known as pectus excavatum, where there is a severe depression of the sternum (breast bone). We were assigned therapeutic exercises and given the aid of physical and developmental therapists. Other possibilities were discussed, but this was the best and easiest first choice in treatment.

As a family, we were both confident and hopeful that this baby boy would come out on top - a fighter and survivor. We were all vigilant in making sure that he did his exercises and kept stimulated. Sadly, he was making very little improvement.

We went back to the pediatrician about a month later, and the fact of something much larger being wrong was staring us in our faces. A genetic test was ordered, and an appointment was made with a pediatric neurologist. Strings were pulled and we were seen faster than should have been possible. A visit that normally takes two weeks to occur, happened in 3 days.

Blood was drawn, tests were done, names were given. Spinal Muscular Atrophy Type I - that was what the doctors were calling the disease that was afflicting my baby. Until that day, I had never even heard of it, despite the fact that it is the number one genetic killer in children under the age of two. I did, however, become an expert almost over night, and my parents learned along with me. We were all facing this together. Gavin had become our world on the day that he was born, and we were not going to be ignorant when he needed us the most.

While waiting for the results of the blood work and genetic test, we remained strong, continued exercises, and tried to keep life as normal as possible for everyone involved. Sadly, the results did not come back fast enough.

On September 25th, 2006, just days away from his five month birthday and just a day after we had spent the day with friends, Gavin was admitted into the hospital after he had stopped breathing.

That was one of the most terrifying days of my life. My mom and dad had taken Gavin to church, while I stayed home to get ready and go to work. I was in the bath when they were trying to reach me, and my neighbor had to come home and rouse me to tell me to call the hospital. What followed was a blur... the rush to get dressed, the speeding to the hospital, the sight of my baby with blue lips while he was struggling to breathe.

The doctors had ruled out pneumonia and promised that they had called the pediatrician. They said that things were fine, and I reluctantly left Gavin in the care of my parents. I didn't have days to miss, and my job was my livelihood that kept my baby fed. I called and checked in, and tried to hide my distress at work. However, my team lead and coworkers knew, and they graciously sent me to be with my child.

By the time that I had made it back to the local hospital, they had moved Gavin into a room and made plans to keep him over night. The pediatrician still had not come. The next few hours felt like a life and death struggle. He was barely breathing and looked so blue. There were times that his alarm went off, and I had to run and find a nurse to get someone to attend to him. The pediatrician finally arrived to find that he had been misinformed of the situation.

That's when things started happening. Plans were made to move Gavin to WVU Hospital. An ambulance was coming, and there were hushed conversations between doctors and nurses in the hall.

After that night and the sullen ambulance trip, I lived in the hospital. I watched my son die and be revived three times. The hours blurred together - sleeping, eating, and existing were all placed on hold for meetings with doctors and nurses and spending time with my son.

Three days after arriving at the PICU at WVU, we got the crushing blow delivered from an apologetic geneticist. Gavin had Spinal Muscular Atrophy Type I, and if he lived beyond the age of 18 months, we would be lucky. She gave us all the test results and documents we needed to be informed, but I already knew the truth that was hidden within.

Suddenly, I was faced with choices that no mother should ever have to make - the signing of a DNR, the type of feeding tube that would be best, when to do the operation for said feeding tube, and the use of things to help keep him from choking again. We were preparing to fight until the bitter end, and life was slowly starting to take on a new routine. I was now alone in the hospital without my support - they all had to return to work.

That, sadly did not last for long.

On October 3rd, 2006, my worst fears came to life. I left the room to go get some lunch for myself, and when I returned, there were nurses surrounding Gavin's little hospital crib. They were talking about scares and the monitoring machine being wrong. Now that I was back and more than a little shaken, they left me to be with my little boy. They weren't gone for long. In fact, I had barely started to eat when Gavin stopped breathing again.

The nurses rushed back in, and I was ushered into a doctor's office. The time I thought that I would have before needing to face the DNR was now gone, and I was being asked if I wanted to force my son to live or let him pass on to a life that would be better. I don't even remember the exact conversation that I had with the doctor or even the doctor's name and face, but I remember telling my mom that she and dad had to get to the hospital as soon as possible, and that they shouldn't ask me why.

My whole family came with her and my dad - brother, aunt, uncle, grandmother, cousins, and friends. Time was standing still, and we were waiting for our pastor to arrive and trying to act like this was anything but one of the most gravitational moments in our lives. When he came, we prayed for God to be with us, to comfort us, and to ease the pain that Gavin was in. Then, I was given my son to slowly rock into his final sleep. I don't know how long I sat there and sang to him and rocked him. For all that I know, it was a lifetime or longer until the nurse took him from my arms and we were taken from the hospital to do the one thing that we had not prepared ourselves for - go home without him with us.

Losing Gavin was the most horrible pain that I have ever suffered. A mother should never have to bury her child, especially not a child so young. For a little more than a year, I have endured quietly. I have written letters and hoped for change. However, I do not see a fruit coming from my efforts. There is a bill in congress that is still waiting for a vote. The members of the HELP committee have not responded to any letter or email that I have sent, and I do not feel that Gavin has had a voice in this. So, I have made it my goal with this blog to give my son the voice that he deserves. This blog is just the first step in that voyage of knowledge and healing.