Brisan and Parker Stults | Living with Niemann-Pick Type C

Archive for the ‘Updates’ Category

How many times have you been looking for something at your house but you accidentally find something you previously were missing? Wouldn’t it be a shame if the prize you were seeking was within reach but you discounted that it could be that easy? What if understanding Niemann-Pick Type C disease opened up the door to help millions of Americans with other disorders involving cholesterol? Of course nothing in life is easy nor will it always be within reach. With being human comes the tendency to make oversights.

It has been almost 13 years in July 2010 that the NPC1 gene, on Chromosome 18 for Niemann-Pick Type C was shared with the world on its discovery. This was a huge step and monumental discovery with associating cholesterol with a certain gene/chromosome at that time. To arrive at this point, it took decades of work which shed an abundant light into how a cell metabolizes cholesterol. In short, Niemann-Pick Type C causes progressive deterioration of the nervous system by blocking the movement of cholesterol within cells.

From a press release dated July 10, 1997 from Bethesda, MD:

“This discovery is an excellent example of how research on rare brain disorders often pays off in other ways,” says Zach W. Hall, Ph.D., Director of the National Institute of Neurological Disorders and Stroke (NINDS). “By identifying this gene, we not only take a crucial step forward in understanding this devastating disorder, but also gain insights into problems that affect every one of us.”

In 2001, cardiovascular disease was responsible for more than 39 percent of all deaths in the United States (American Heart Association: Heart Disease and Stroke Statistics 2004). Atherosclerosis is a disease where plaque builds up in your arteries. We all know those aren’t important to our lively hood at all. OK, just joking but plaque is made up of fat, calcium, cholesterol, and other substances found in our blood that over time builds up but hardens in the passage ways of our arteries. Imagine if you’re driving through a two way tunnel but one side is now closed off?  It would be kind of hard to get through to the other side in a timely and relaxing manor with additional objects in your way? Just like that situation, this affects how we get our blood to important areas in our bodies. With millions of people dying each year, this is a huge number of people. What if Niemann-Pick Type C could provide some insight?

Other diseases such as Adult onset Alzheimer’s, Stroke, Cystic Fibrosis, Duchenne Muscular Dystrophy, and even HIV-Aids will benefit from the research into Niemann-Pick Type C. Did you know that children can experience dementia to? Crazy to imagine because most of us think that only our elderly family members get that! With the combination of deaths due to these diseases, could you imagine if we had a more collaborative research environment? Unfortunately big companies aren’t going to sacrifice revenue opportunities to help a blip on the radar screen but they will invest if they see it helping thousands of people; this means a return on their investment. This reality is sad but true.

Rare diseases OUR important to you, me, and everyone we know. Each of us has a Chromosome 18 that is vital to us being a living human being.  I encourage you to help out in some way. That could be donating to several charities that fund research for NPC like the National Niemann Pick Disease Foundation, Ara Parseghian Medical Research Foundation, Hide and Seek Foundation or the Niemann-Pick Children's Fund. That could be becoming and advocate in lobbying our government for better health care. It could be you just passing the word and spreading awareness.

We all are in this together and have been affected in some way by one of the diseases mentioned in this post. One person can make a difference in the world and that person could be you.

Additional Resources:

• http://www.lef.org/protocols/heart_circulatory/coronary_artery_disease_atherosclerosis_01.htm
• http://www.ninds.nih.gov/news_and_events/news_articles/pressrelease_fatal_childhood_niemannpicktypec_071097.htm
• http://www.strokecenter.org/patients/stats.htm
• http://www.ninds.nih.gov/news_and_events/news_articles/pressrelease_fatal_childhood_niemannpicktypec_071097.htm
• http://www.cdc.gov/nchs/FASTATS/deaths.htm

*All pictures belong to their respective parties.

A day late and a dollar short… maybe. No approval from the FDA took place this week. In other countries like the European Union, South Korea, Brazil, Russia, Australia and Canada, Zavesca has been approved for use in adult and pediatric patients suffering from this fatal disease called Niemann-Pick Type C.

Our understanding of the news that broke out a few days ago was that they want more testing done from pre-clinical and clinical studies to develop additional information.

Jean-Paul Clozel, M.D. and Chief Executive Officer of Actelion commented: “We remain committed to bringing an approved treatment to patients suffering from NP-C disease and in this spirit we will continue the dialogue with the FDA.”

It appears that Actelion is committed to finding the additional information needed to show the FDA that this could be one of the first FDA approved treatments for Niemann-Pick Type C.  Although this doesn't mean they will be cured, it could give someone like Brisan and Parker a few “extra” days living with NPC. As parents affected by this disease we are thankful that we currently have the opportunity to be apart of it even though Brisan and Parker aren't taking it. They will resume sometime in May this year.

That presents a different challenge for our family because we currently are on COBRA. It will be interesting what 12 months from now will look like especially if it isn't FDA approved because our future insurer might say H-E-double hockey sticks NO!

Here is a link to one of many articles: 

• Actelion receives FDA complete response letter for Zavesca (miglustat) for the treatment of Niemann-Pick type C disease

• FDA Does Not Approve Actelion’s Zavesca in US

• Actelion receives FDA complete response letter for Zavesca

Ding ding, round 2! Brisan and Parker started this week the 2 phrase of the N-Acetyl Cysteine (NAC) Drug Trial at the NIH. For the first week they have to ramp up on the drug again. Parker is at 9.5 ml x3 and Brisan is at 10ml x3. On the first phase it was 36ml x3 for Parker and 40ml x3 for Brisan.

As I posted originally on www.blog.bripardun.com, a diagram that I used from NNPDF's site to show how this crossover study is taking place. You can read more about it here: NAC Drug Trial. Essentially they are looking how they can reduce oxidative stress on the cells. The main issue they can't fix yet but if they can find little things to help the “side effects”, then that is  a very small win overall for NPC. We haven't seen any major changes in how they act. If there is they are very minor that they aren't completely noticeable.

Overall the drug is pretty safe. You can actually purchase it from any pharmacy. It doesn't taste bad either! We view this as an opportunity to help in the research of Niemann-Pick Type C!

Parker is just a funny kid! Below is a video we took while we were waiting on Dr. St. Peters to come into the room. He was being silly then as soon as I turned on the camera he stopped!

Overall March 24th is the date that they are going to due surgery. They aren't however going to do a fundo which is relieving for the time being. Now after the GT if he is aspirating or having things come back up, then it will validate if he is really having reflux. This is a completely safe guard (GT) since he loves to eat but he just isn't chewing his food like he needs to. I know we just hate seeing “stinky” or any of the boys go through these things.

During that surgery they will put a line in underneath his collar bone since Parker and Brisan both have had weekly infusions since November 09′. They are getting stuck way too much! This will make life a bit easier for everyone involved.

On another note please pray for Jonathan Fletcher of Independence, MO. He is a 5 year boy who is near his time due to a cancerous tumor inside the base of his brain stem. Pray that God takes away his pain and fears. Even more importantly pray for his parents. We don't want to imagine those feelings anytime soon.

Tomorrow we have an appointment with Dr. St. Peters at Children's Mercy Hospital to go over whether or not Parker will get a G-Tube like Brisan has. They say it is better to be proactive when they don't really need it than before they do. The poor little man has some weird eating habits. I've nicknamed him “Hoover” because not even that vacuum could out dual Parker in an eating contest! He isn't chewing his food. Basically just inhaling and swallowing.

In neurological disorders, especially like Niemann-Pick Type C (NP-C), they have difficulty swallowing which leads to aspiration, choking, and potential prolonged meal times (can you say stressful for the family!). Sometimes a person with a neurological disease that slowly takes these rights away from us, may dread eating at all. I highly doubt Parker is dreading eating but we are glad that he still shows strong interest in it!

Unlike Brisan, Parker will take his medications orally. I remember last year when we went through this with Brisan and how after surgery things seemed to get worse for him. I know that I don't want to see that for Parker. I also personally worry that everything is so crowded and enlarged in his stomach region that if we do this surgery how will this play into things? I mean this is a pretty big deal and I'm not really ready to have two of them with one!I know they are brothers but they don't need to have two of the same “toy”.

Please keep Parker and our family in your prayers. We truly only get through the days with continued support emotionally from all types of loving individuals such as yourself. Here is a diagram of what this whole thing is!

To learn more about a Gastronomy Tube please read more here.