First of all, thank you all for your amazing support over the last week. We've had a tough month or two, but are ready to get on with our new normal.
After the Dallas ice storm early last week caused our appointment to be cancelled, we finally got in to see the geneticist on Thursday. We arrived with a list of questions, knowing that many of them could not easily be answered, if at all. I've given most of them, with whatever answers we could get below.
We also received the formal write-ups from Torsten's physical and speech therapy evaluations at Baylor. Although it is not surprising, he falls into the 2nd percentile for speech, and below the 1st percentile for physical. We will be re-starting therapy twice each week for both ST and PT. We will be rescheduling the OT evaluation that we missed for our trip to Illinois asap, but will most likely start 2 appointments/week for OT as well.
On the bright side, Torsten has been more proactive with walking. Rather than only taking steps when we initiate it, he has occasionally started turning after standing at a chair or window and will take a few steps away on his own. Although it's small, it's a huge step for him. He's also been experimenting with new sounds. He lacks confidence though, and will rarely, if ever, repeat them when we ask. Although the progress he's making is slow, we're thrilled with anything new and never fail to celebrate it.
Thank you again for all of your love and support. It means more to us than we can put into words.
Love,
Ryan, Tasha & the boys
Q & A with the geneticist:
Q: Torsten's skin sample showed the chromosomal abnormality in 5.5% of the counted cells. Does this mean that he has a "minor" case of PKS? And what does that mean for his other organs? Will they all show a 5.5% abnormality as well?
A: No - the 5.5% does not mean that Torsten has a "minor" case of PKS, nor does it mean anything for his other organs. All it means is that the abnormality was found in the sample, which means that he has PKS. The only way to figure out the percentage of cells with the abnormality in other organs would be to test all organs. Since this is not possible, we have to check for issues where we know they are likely, and treat symptoms if/as they come.
Q: Do you believe we will run into behavioral issues in the future? We can see Torsten already experiencing frustration at not being able to verbalize his wishes and concerns.
A: Some behavioral issues are quite common, but this is something that we should not worry about until it comes. Until then, we should keep up with his therapy and help him to develop his speech and motor skills.
Q: Do children with PKS have a normal life expectancy?
A: Yes and no. If children are able to survive for an extended period outside of the womb, then PKS itself will not shorten the life expectancy of a person with the condition. However, anyone with a neuro-cognitive condition will generally have a shorter life expectancy than a person without. Note: We do not believe this applies to Torsten. The doctor gave examples of how such conditions could cause a shorter life expectancy and it seems to be more about how the individuals care for themselves/attempt to care for themselves which would cause issues later in life. The other scenario would be that a side-effect of the condition could be life threatening (heart defect, epilepsy, etc.).
Q: What are the next steps for us?
A: We will need to see a cardiologist to have a full scan of Torsten's heart and check for any defects. She also highly suggested that we start seeing a neurologist to prepare for the likely possibility that Torsten will begin having seizures at some point in the future. She explained that there are only two pediatric neurology practices in Dallas and that they both take a very long time to get into. Once we are established patients, things will go much more smoothly if/when he begins having seizures and we need to see someone. She would like for us to check in with her once/year to give updates on his health, development, etc. This is more to keep a record of how he's doing than to benefit him personally.
Q: We've always believed we would like to have a larger family. Although we've been reassured many times over the past 2 years that we are not carriers of any genetic conditions, can we be sure this is true, at least for PKS? It was also strongly recommended by our OBGYN that, if we were planning to have more children, we should bank our cord blood just in case it is needed at some point later in Torsten's life, especially since we have no idea where research will be at that time. Opinion?
A: First, PKS is not hereditary. We did not pass/give it to Torsten and it is not possible that we will pass/give it to any other children. We can continue to have children for as long as possible and we will not have another child with PKS. If we do have more children, it is always a good idea to bank cord blood. However, the geneticist recommended donating it to a public bank, since when you donate, you have a better chance of receiving blood/cells if you should need it in the future. The OBGYN recommended banking it privately.
After the Dallas ice storm early last week caused our appointment to be cancelled, we finally got in to see the geneticist on Thursday. We arrived with a list of questions, knowing that many of them could not easily be answered, if at all. I've given most of them, with whatever answers we could get below.
We also received the formal write-ups from Torsten's physical and speech therapy evaluations at Baylor. Although it is not surprising, he falls into the 2nd percentile for speech, and below the 1st percentile for physical. We will be re-starting therapy twice each week for both ST and PT. We will be rescheduling the OT evaluation that we missed for our trip to Illinois asap, but will most likely start 2 appointments/week for OT as well.
On the bright side, Torsten has been more proactive with walking. Rather than only taking steps when we initiate it, he has occasionally started turning after standing at a chair or window and will take a few steps away on his own. Although it's small, it's a huge step for him. He's also been experimenting with new sounds. He lacks confidence though, and will rarely, if ever, repeat them when we ask. Although the progress he's making is slow, we're thrilled with anything new and never fail to celebrate it.
Thank you again for all of your love and support. It means more to us than we can put into words.
Love,
Ryan, Tasha & the boys
Q & A with the geneticist:
Q: Torsten's skin sample showed the chromosomal abnormality in 5.5% of the counted cells. Does this mean that he has a "minor" case of PKS? And what does that mean for his other organs? Will they all show a 5.5% abnormality as well?
A: No - the 5.5% does not mean that Torsten has a "minor" case of PKS, nor does it mean anything for his other organs. All it means is that the abnormality was found in the sample, which means that he has PKS. The only way to figure out the percentage of cells with the abnormality in other organs would be to test all organs. Since this is not possible, we have to check for issues where we know they are likely, and treat symptoms if/as they come.
Q: Do you believe we will run into behavioral issues in the future? We can see Torsten already experiencing frustration at not being able to verbalize his wishes and concerns.
A: Some behavioral issues are quite common, but this is something that we should not worry about until it comes. Until then, we should keep up with his therapy and help him to develop his speech and motor skills.
Q: Do children with PKS have a normal life expectancy?
A: Yes and no. If children are able to survive for an extended period outside of the womb, then PKS itself will not shorten the life expectancy of a person with the condition. However, anyone with a neuro-cognitive condition will generally have a shorter life expectancy than a person without. Note: We do not believe this applies to Torsten. The doctor gave examples of how such conditions could cause a shorter life expectancy and it seems to be more about how the individuals care for themselves/attempt to care for themselves which would cause issues later in life. The other scenario would be that a side-effect of the condition could be life threatening (heart defect, epilepsy, etc.).
Q: What are the next steps for us?
A: We will need to see a cardiologist to have a full scan of Torsten's heart and check for any defects. She also highly suggested that we start seeing a neurologist to prepare for the likely possibility that Torsten will begin having seizures at some point in the future. She explained that there are only two pediatric neurology practices in Dallas and that they both take a very long time to get into. Once we are established patients, things will go much more smoothly if/when he begins having seizures and we need to see someone. She would like for us to check in with her once/year to give updates on his health, development, etc. This is more to keep a record of how he's doing than to benefit him personally.
Q: We've always believed we would like to have a larger family. Although we've been reassured many times over the past 2 years that we are not carriers of any genetic conditions, can we be sure this is true, at least for PKS? It was also strongly recommended by our OBGYN that, if we were planning to have more children, we should bank our cord blood just in case it is needed at some point later in Torsten's life, especially since we have no idea where research will be at that time. Opinion?
A: First, PKS is not hereditary. We did not pass/give it to Torsten and it is not possible that we will pass/give it to any other children. We can continue to have children for as long as possible and we will not have another child with PKS. If we do have more children, it is always a good idea to bank cord blood. However, the geneticist recommended donating it to a public bank, since when you donate, you have a better chance of receiving blood/cells if you should need it in the future. The OBGYN recommended banking it privately.
My sweet boys -
Torsten found a water bottle and was "sharing" with Dane







