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Name From Comments<br />

7,394. DANIELLE<br />

TERBORG<br />

WANUT CREEK, CA (cont<strong>in</strong>ued from previous page)<br />

grow<strong>in</strong>g. As <strong>the</strong> weeks progressed we were head<strong>in</strong>g <strong>in</strong><strong>to</strong><br />

Christmas and <strong>the</strong> New Year we were mov<strong>in</strong>g and my<br />

Husband was gett<strong>in</strong>g ready <strong>to</strong> go <strong>to</strong> Chicago for tra<strong>in</strong><strong>in</strong>g for<br />

his new job. <strong>We</strong> had a lot go<strong>in</strong>g on.. it was crazy!!! After<br />

<strong>the</strong> first week of tra<strong>in</strong><strong>in</strong>g my Husband came home for <strong>the</strong><br />

weekend and was play<strong>in</strong>g with our son he had noticed that<br />

when he would cry it appe<strong>are</strong>d <strong>to</strong> be weak and pa<strong>the</strong>tic.<br />

The previous day my mom had mentioned his constant<br />

coo<strong>in</strong>g .I was star<strong>in</strong>g <strong>to</strong> wonder but he was eat<strong>in</strong>g<br />

,sleep<strong>in</strong>g,normal diapers and normal color. The next day<br />

he wasen't eat<strong>in</strong>g as much his appetite decreased and he<br />

was lethargic . I thought perhaps <strong>in</strong> all <strong>the</strong> chaos and it<br />

be<strong>in</strong>g cold and flu season perhaps despite our best efforts<br />

maybe he was com<strong>in</strong>g down with a cold. Later that even<strong>in</strong>g<br />

we had planned <strong>to</strong> go <strong>to</strong> my <strong>in</strong>-laws for d<strong>in</strong>ner with <strong>the</strong><br />

baby while visit<strong>in</strong>g Grandma had noticed that he was<br />

hav<strong>in</strong>g difficulty breath<strong>in</strong>g. THAT WAS IT!!! I called <strong>the</strong><br />

advise nurse and she advised us <strong>to</strong> get <strong>to</strong> <strong>the</strong> hospital<br />

immediately.<strong>We</strong> wisked ourselves <strong>to</strong> <strong>the</strong> emergency room<br />

and were quickly brought back where <strong>the</strong>y began breath<strong>in</strong>g<br />

treatments and oxygen . I held my baby helplessly as <strong>the</strong>y<br />

worked on stabaliz<strong>in</strong>g him. My husband and I fe<strong>are</strong>d <strong>the</strong><br />

worst.It was January 16,2011 my Son and I rode <strong>the</strong><br />

ambulance as my husband followed us <strong>to</strong> Childrens<br />

Hospital Oakland. Where <strong>the</strong> cont<strong>in</strong>ued <strong>to</strong> do everyth<strong>in</strong>g <strong>to</strong><br />

make our son stable and comfortable. There <strong>the</strong>y<br />

specialize <strong>in</strong> children and were better equipped <strong>to</strong> handle<br />

his needs.<br />

Here is some <strong>in</strong>fo on his diagnosis:<br />

S.M.A.R.D. = Sp<strong>in</strong>al Muscular Atrophy with Respira<strong>to</strong>ry<br />

Distress. SMARD is a neuromuscular condition caus<strong>in</strong>g<br />

weakness of <strong>the</strong> muscles. It is <strong>the</strong> second anterior horn cell<br />

disease <strong>in</strong> <strong>in</strong>fants <strong>in</strong> which <strong>the</strong> genetic defect has been<br />

def<strong>in</strong>ed. SMARD1 is not l<strong>in</strong>ked <strong>to</strong> <strong>the</strong> SMN1 gene locus on<br />

chromosome 5q13 (classic SMA), but is caused by<br />

mutations <strong>in</strong> <strong>the</strong> IGHMBP2 gene on chromosome 11q13.<br />

Despite a substantial overlap <strong>in</strong> cl<strong>in</strong>ical features, <strong>the</strong><br />

phenotypes of SMA versus SMARD1 can be dist<strong>in</strong>guished.<br />

In SMARD1, <strong>the</strong> predom<strong>in</strong>at<strong>in</strong>g symp<strong>to</strong>m is a severe<br />

respira<strong>to</strong>ry distress due <strong>to</strong> a paralysis of <strong>the</strong> diaphragm.<br />

Most patients present [show symp<strong>to</strong>ms] at <strong>the</strong> age of 1 <strong>to</strong> 6<br />

months with respira<strong>to</strong>ry failure and progressive muscle<br />

weakness with predom<strong>in</strong>antly distal lower limb muscle<br />

<strong>in</strong>volvement. Sensory and au<strong>to</strong>nomic nervous systems<br />

may also be <strong>in</strong>volved. Early <strong>in</strong>volvement of <strong>the</strong> diaphragm<br />

and predom<strong>in</strong>ance of distal muscle weakness clearly<br />

dist<strong>in</strong>guishes SMARD1 from Type 1 SMA. Essentially, <strong>in</strong><br />

SMA1, symp<strong>to</strong>ms manifest <strong>in</strong> reverse order. Infants with<br />

SMA1 will become floppy due <strong>to</strong> weakness of <strong>the</strong> proximal<br />

(cont<strong>in</strong>ues on next page)<br />

Page 339 - Signature 7,394

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