Our History
Mowat-Wilson Syndrome (mowatwilson.org)
Jump to new updates 6/4/04 - 9/25/04 - 1/20/05 - 8/1/05 - 9/8/05 - 12/15/05 - 1/1/06 - 2/1/06 - 3/7/06 - 7/4/06 - 11/23/06 - 4/9/08
Chase was born 30 days premature. He was diagnosed with Hirschsprung's Disease, Cryptorchidism, dysmorphic facial features, microcephaly, patent ductus arteriosus, and pulmonic stenosis. He was in the NICU for 25 days. At 5 days he had a colostomy and at 10 days a PDA ligation. One week after he came home, he had to go back in the hospital for pyloric stenosis and have that corrected surgically. At 4 months old he had pull through surgery to close the ostomy and reconnect his colon. He was in the hospital for 10 days, came home for 12 hours and went back because of vomiting due to spasms. He was in and out of the hospital for the next few months for the same problem. He had feeding problems due to gagging, but improved slowly but surely over the next several months. His development was slow and we hoped that was due to all of the time he spent in the hospital. It seemed every time he would start to recover from one surgery, he ended up back in the hospital for another. At 14 months he had surgery to bring down his testicles and was circumcised. He was just beginning to sit independently by then but that surgery set back his progress in that area. Again we attributed many of his delays to all the surgeries and nutrition. From early on his way of exploring things was by thumbing, he tapped on everything with his thumbs. His development always seemed to start and stop. He would start to babble and then for no reason stop, he started to crawl at 21 months and started to cruise around furniture and pull himself up at 2. He never mimicked speech and still doesn’t seem to try. He started using a walker at 2 1/2 and took his first steps independently this past January, but walking seems to be hit and miss too, we know he can do it but he doesn’t seem overly interested in doing it. He still taps, but now with his wrists, and more aggressively, we wonder why they aren’t black and blue and why it doesn’t seem to bother him. He has always had the sweetest disposition (99% of the time) and seems to be very happy. He can entertain himself for hours. He has been in physical and occupational therapy since he was 2 with varying results. Chase was involved in Nevada’s early intervention program until he was 3, then began to attend early intervention preschool through the school district. He loves to play with other children and has made real progress in social skills. He has always startled easily and has a real problem with noise, but he is getting better now that he is exposed to more at school.
(For more symptoms associated
with MW see the article from the Center for
Genetics Education on the Links Page)
Special Thanks To The Following -
Dr. John Graham Jr., Dr.
David Mowat, Dr. Goosen, Dr. David L. Rimoin,
Dr.
Yelena Silvanskaya and Marcy Polsky
LCSW.
We will continue to update this page as things progress or we have more information that might be useful to others like us.
Here is an update based on the diagnosis and information we have been able to gather ourselves.
Chase is considered severely mentally retarded; his language skills will be limited or none (based on the small number of other children diagnosed with this condition) but he seems to comprehend a lot of what we say to him. We understand that there is some success with sign language, so we are trying to introduce him to more of that and hoping for some positive results. The hard part is the repetition involved, but it’s the same trying to teach him anything, you just don’t get results very quickly, and you have to keep at it constantly. There is a 90% chance of him developing seizures, but that usually happens in the first 2 years, so maybe we will be lucky. His pediatrician tried to put the percentages into perspective, he said 90% of 45 cases is not as convincing as 90% of 4500 cases, there just aren’t enough comparisons for the percentages to really hold true. (top)
Thanks to responses to
this website and some more research we have gathered more information to pass
along. We have found out that the seizures can develop as late as 10 years old.
We think Chase had a febrile seizure in April, he was sick and running a fever
and when he awoke in the morning he was very listless and it seemed as if the
one side of body was limp, and his breathing was rather shallow. We called an
ambulance but by the time they arrived he seemed to be doing better, but we
transported him to the closest hospital to be safe. They don’t have a pediatric
unit and after doing blood tests, a lumbar puncture, etc. to make sure he was
stable, they then wanted him transported to another hospital that does have a
pediatric unit. They ran their battery of tests and about 10 hours later we
brought Chase home. He has been fine since then just the usual stomach virus
etc. The biggest problem he has when he gets ill is his sensitive gagging
reflex. We have a hard time getting him to eat or drink, as soon as he sees food
or his cup he starts gagging. We’ve found that if we sit him in his little chair
and turn on cartoons (golf, football and tennis work good too, I think it has to
do with the color green) and sneak up on him so he doesn’t see the bowl or cup
we can get some food in him before he starts again. He has been walking for a
while, but we have to get him up and started by holding his hand. If he is
standing he holds on to something, and if he wants to get somewhere else he’ll
drop to the floor and he’ll crawl there, even if it’s just a few feet. His
fourth birthday is next week and he gave us an early present. We
were in the kitchen getting dinner ready and out of the corner of my eye I saw
movement and when I looked it was him walking across the room to
the patio door. He had pulled him self up in front of the TV and decided to go
see what was going on in the backyard. It did our hearts good to see him take
off like that, but I fear we’ll be getting a lot more exercise trying to keep up
with him soon. He has braces to wear because his feet lean in so much, it looks
like he is almost walking on the inside of his ankles without them. He is still
in the early intervention preschool and he rides the bus by himself to and from
school. He is much better with noises now although he still doesn’t like crowded
rooms with a lot of noise if it’s a new environment.
(top)
We think Chase had another seizer today. I don’t know what else to blame it on considering his behavior. It was 5:00 am and he started making moaning noises as if he was waking up, he usually wakes between 5:00 and 6:00 am, so nothing unusual about that. Then suddenly he started crying as if he was in great pain, I went to his room to see what was wrong and he was in bed kicking his right leg and grabbing at his neck. I picked him up to try and calm him but he continued doing that. I took him out of the room and laid him down and he stopped but his eyes were closed as if he was still asleep. My first thought was Night Terrors. I had heard of children having really bad dreams and being that way until they awoke but, he wasn’t waking up. This kept up in cycles and wouldn’t stop. When he would stop crying his eyes were shut tight and he wouldn’t respond. He seemed to be in such pain during the crying cycle that we called 911 and had the paramedics come to the house. They said he appeared to be coming out of a seizure and suffering from the affects of it. They took him in the ambulance to the hospital and he continued those cycles until about half way there when he finally opened his eyes and started acting somewhat normal. The whole cycle lasted at least 45 minutes to an hour.
After all the tests at the hospital came back normal they felt that he did have a seizure and prescribed an anti-seizure medication until we can have him checked by his neurologist, but I doubt he will prescribe another course of action. Now our biggest concern is that the medication will sent him back due to the side effects which include drowsiness, double vision and dizziness. How do you know if that is a problem with a child that can’t speak? I guess all we can do is keep an eye on him and hope it doesn’t affect his progress.
Now the good news. Chase
is now walking more than 50% of the time. He still can’t stand with out pulling
himself up on something but once he is up, he walks all over the house carrying
his toys with him. We are working on eating with his spoon and fork and he is
making really good progress on that. He really tries to get the food off his
plate, and then into his mouth. Sometimes he misses the plate or doesn’t get any
food on the fork and sometimes he gives up and drops the fork but, sometimes he
gets it right.
And that is a wonderful thing.
(top)
8/1/05 Update
We took Chase to
Cedars-Sinai again in March for a 1 year follow up. There wasn’t any new
information for us regarding MWS; in fact they told us that Chase was still the
only case they had diagnosed. We did supply them with blood samples from his
mother but couldn’t get his father to do the same (they had Chase’s blood
samples from our previous visit). They told us they would grow DNA samples to
send to France for genetic testing and also to Stanford
University, where they are supposed to be taking on MWS as a research program. We
still haven’t heard back from anyone yet, but they did tell us it would take
time to grow the DNA and then have it
tested. I guess the bottom line is no matter what the results are, it won’t
change the outcome, but it would be nice to get the final results. The good news
is the Trileptol seems to be working (knock on wood). Chase hasn’t had another
seizure since the one in January. His over all health has been good also; his
immune system seems to be growing stronger as he gets older. The only thing we
notice is that one of the glands in his neck seems to be somewhat swollen most
of the time, but it doesn’t seem to be a problem for him. Like one of the
doctors told us once, what toddler isn’t fighting off some kind of bug most of
the time, it’s part of building the immune system as they come in contact with
new virus’ etc. Chase still has no speech so we have started working with him on
the PEC’s system, (picture exchange communication) and he seems to be grasping
the idea behind it, but as with everything else, it take so much repetition with
him, only time will tell. He now walks about 80% of the time, although still a
little awkward. One of his biggest problems is he doesn’t watch where he is
going and trips on his toys on the floor and even bumps into walls etc. every
now and then. He will be in preschool again this fall but next year he will be
put into regular classes, which frightens me to no end. Normal children can be
quit insensitive, especially when they don’t understand another child that is
different from them. I wish there was another option but in Las Vegas there
aren’t any other resources that we have found. We are also working on potty
training. If we put him on the potty when he wakes in the morning or after his
nap we can get him to pee (with a little help from a spritz of warm water) and
sometimes he will poop, but he hasn’t gotten to the point where he will request
to use the potty. I’ll say it again, repetition, repetition, repetition! The
next thing we need to start looking into is a new bed for him. He is getting too
big for his crib and we are concerned about letting him roam about in his room
until he falls asleep. He likes to bounce in his bed for about 5 minutes before
he goes to sleep and if he was not confined I don’t know how long it would take
him to calm down and go to sleep especially being able to get into his dresser
drawers or look out the window etc.. He also wakens in the middle of the night
sometimes and plays for an hour or so and I can’t imagine how long he would be
up if he had the run of his room. It’s hard enough to sleep on nights like that
knowing he is safe in his crib let alone if he could get around in his room
unconfined. I guess we would have to bolt the dresses to the wall and latch the
drawer so he couldn’t pull one down on himself.
(top)
9/8/05 Update
Well the waiting is over; we got a phone call today from Cedars-Sinai with the results from Chase’s DNA testing confirming his clinical diagnosis. It is a bitter sweet day. We finally have an end to our search for answers and need look no further, but it still doesn’t alter the future, it is just the end of this chapter. We still don’t know what the future holds for sure because there is no true map to follow. From what we have read it seems all of these kids develop in different ways and at different levels depending on the severity of their condition, so only time will tell. Now for good news. Chase can now stand from a sitting position without holding on to anything or pulling himself up. He also walks unaided 99% of the time although a bit unsteady at times and is getting very good at bending over to pick things up. He also drinks from a regular cup and manages not to turn it over on himself most of the time. His seizures also seem to be under control since he started taking Trileptol. He still has a very happy demeanor and is beginning to show a sense of humor. He knows when he is doing something that he shouldn’t and when caught he stops and runs away laughing, it is quite cute to watch. We hope this information is useful and will continue updating as things evolve. (top)
12/15/05 Update
Chase had his third seizure on Friday the 2nd of December. Once again it started as he was awakening, but this time from a nap, and Deby saw him convulsing on the TV monitor we have in his room. That lasted about 10 minutes and then the slow process of him coming out of the seizure that lasts about 45 minutes where he cries and is rather incoherent and non responsive. The ironic thing is that day was the fact that we had an appointment with his neurologist that day and ended up at the hospital instead. We have a new appointment this Thursday 12/15. In the mean time they told us to increase his medication. I don’t know if we had been able to go to the neurologist would have made any difference though because he hasn’t put on much weight since his last visit there and my understanding is that the dosage is based largely upon body weight. In fact his pediatrician has told us to start giving him some Pedia Sure or a glass of instant breakfast everyday to try and boost his calorie intake and help him gain some weight. The amazing thing is that he has a great appetite and eats everything we feed him including a morning and afternoon snack on top of 3 meals a day.
We are still working with the PEC’S system, with no major breakthroughs, but he does seem to be trying to mouth some words. We did hear from a new contact in California that told us not to give up on the speech therapy because her son didn’t show much improvement until he was 11 years old and then started making great progress.
Not much progress on the potty training either, hopefully that will improve over time also.
We took Chase to a birthday party a few weeks ago at a pony ranch here in town and were concerned he would be afraid of the ponies. When we first put him in the saddle he was a bit leery but once he got going he loved it, he had the biggest smile on his face and he held on to the horn of the saddle so well it was amazing. (see photo) Once the weather improves we are going to try and take him there on a weekly basis, I think it will be good for his balance and it’s worth it just to see him so happy. (top)
Well that’s about it for now.
We would like to wish all of you a Happy Holiday Season!
Dave, Deby and Chase
1/1/06 Update
Chase had his 4th
seizure today, not a good way to start off the New Year. He had gotten over his
cold or virus from early December, but then came down with another. We took him
to the doctor’s office on the 26th of December and he was diagnosed
with a sinus infection this time around. He never had a high fever, 99.6 max,
but was coughing due to his head congestion and having a hard time eating and
was very gaggie. They gave him a shot of antibiotics and prescribed an
antihistamine and more antibiotics. He seemed to be getting better by New Years
Eve. Then on Sunday morning we put him down for his nap and Deby started to
prepare some breakfast, she heard unusual noises from the monitor in his room
and went to check on him, sure enough he was having another seizure. The same
type as last time, twitching and incoherent, that lasted about 15 to 20 minutes
and then when the twitching stopped he starting crying. He didn’t become
coherent for about 30 more minutes and went through the usual cycle, crying and
then still and silent, off and on again. We call 911 and took him to the
hospital. The emergency room doctor told us that antihistamines lower the
threshold for seizures for people prone to them. That was a hard lesson
learned. So now we need to do some research on what types of
medications we can use the next time he gets that congested to take the place of
the antihistamines. We have an appointment with his ENT on the 9th so
we plan on asking him what options we have.
(top)
Dave
2/1/06 Update
I wish I was doing this update for some good news for a change but that isn’t the case. Chase had his 5th seizure today. When he woke up this morning he felt a little warm so I took his temperature and it was 99.2 so I didn’t think much of it. He acted normal all morning, had a good apatite and ate a good breakfast. We put him down for his usual morning nap and all seemed fine. After a while Deby heard some unusual noises through his monitor and checked the video monitor to see what was going on. She saw that he was starting to convulse and went and got him up. He was still somewhat coherent and was making eye contact with her, but she still call 911. After a few minutes like that he became incoherent and went into full convulsions. When the paramedics arrived they put him on oxygen, did a blood sugar test and checked his temperature. He was running a fever at that point so they transported him to the ER. When the doctor checked him out he told us “his throat is a mess”. They did a strep and mono test which both came back negative, which was the good news. So we are guessing that while he was sleeping his fever spiked quickly and caused him to go into the seizure. I’m just amazed at how quickly this whole episode came about. The combination of being non-verbal and what seems to be a high threshold to pain makes it extremely difficult to know how these kids are truly feeling. I guess the only ray of light in these last 3 seizure episodes is the fact that all were brought on because Chase was coming with some sort of illness so hopefully once this cold and flu season is pasted things will return to normal. (top)
3/7/06 Update
This post is a little late in coming but it’s been a rough week. It started on Saturday night February the 25th. Chase had another seizure, once again he was feeling warm and he started getting Tylenol and Motrin to try and keep him from running a fever. He was put to bed around 8:00 pm but awoke about a half and hour later convulsing. It lasted about 13 minutes so he was transported to the hospital. It turned out he was getting another ear infection and apparently his fever spiked which caused the seizure to start. We got him home around 2:00am on Sunday morning. As usual they started him on antibiotics and kept up the Motrin and Tylenol to keep his temperature in check. Then around midnight on Sunday he awoke and started vomiting severely. He threw up everything he had ingested that day (which was very little) and then started throwing up a dark brown substance that had black spots in it. We were afraid it might be blood so we call 911 and once again they transported him back to the ER. Chase finally stopped throwing up around 1:30am and the doctors wanted to keep him overnight for observation and finally admitted him around 6:00am on Monday. They gave him antibiotics by IV and since he was still gagging they gave him Ativan because we couldn’t give him his Trileptal. The Ativan knocked him for a loop and we ended up in a heated debate with the doctors to stop giving it to him and let us try and give him his Trileptal, which we finally won. (He could hardly walk for 2 days after we got him home he was so drugged). Of course they wouldn’t release him until he would eat and drink so he spent Tuesday night there also. We got him to finally do both on Wednesday and they released him. The diagnosis was that he may have had some Gastrointestinal bleeding from all the vomiting and or the Motrin may have caused some bleeding in his stomach. Chase is home now and is doing fine now. We do have a lot of follow ups to do. We are taking him back to his ENT to have his tubes checked and replaced if necessary, and too see his Gastroenterologist to make sure there is nothing else wrong. Well that’s the latest for now.
One of these days I will do some updates that are much more upbeat. (top)
7/4/06 Update
As I said I would update this page with something more upbeat, so here it is. The bad news is that Chase has been ill almost monthly. The good news is that since we have changed his medication, he has been seizure free. (Knock on Wood) He seems to get ill every 4 weeks, but since we have changed his anti-seizure medication he managed to make it through 4 bouts of high fever with no problems. His ENT wants to keep an eye on his tonsils, that seems to be the cause of the majority of his problems, and if he has any repeated episodes of tonsillitis over the next few moths, he suggests that we consider removing them. As he has discussed with us the benefits of the surgery, even considering the risks, out weigh the long term problems from the side effects of repeated seizures, and we agree with him. So we will keep you posted.
Chase is now getting ready to start kindergarten this fall, and just like when he started preschool, it is a time of excitement and concern. Developmentally he is still far behind and as he gets older the more acutely aware I become. I know we can’t try to measure his progress against other children his age, all we can do is take what progress he makes, as he makes it, and rejoice in the fact that he is making head way in a positive direction. Our biggest concern is what will happen as he gets older, as he grows he becomes a bit more difficult to handle. He is becoming too heavy to lift and more difficult to control, he has turned out to be quit a strong, but still rather skinny boy. I hope we can keep up with him. He is still the light of our lives and brings us joy in ways that are impossible to put into words.
We are still working with the PEC’S system with him but with limited success. It’s more of a game to him and he is willing to play for the time we have to work with him, most of the time, but he is not ready to use it as a full time means of communication. He has gotten rather good at using sign language to ask for eat, drink and more so that helps some. Well that’s about all for now. We will keep posting as things progress and we find the time. It is a bit harder to type up these updates now that he is very mobile, one of us needs to keep and eye on him at all times. (top)
It wasn’t a good start to a long Thanksgiving weekend.
Chase awoke around midnight so Deby went in to check on him to see what the
matter was. She checked his diaper thinking that he might need changed, but he
was clean and dry. So she got him up and gave him a drink thinking he might be
thirsty. Deby said he didn’t feel warm when she got him up, but as he sat in
her lap watching T.V. he began to feel warm. She decided to take his
temperature and the thermometer just kept climbing. It topped out at 101.8 and
she got me up to help give him some Motrin. Within 10 min. of giving him the
Motrin he began throwing up and then he got a blank stare on his face and became
unresponsive. We then realized he was going into seizure. It was quite
different than seizures in the past, he wasn’t as convulsive as before, just his
left arm was twitching, but for the first time he started to throw up during
this one. It had to have lasted at least 10 min. and we were afraid to give him
the nasal Midazolam because of the vomiting, so we called the paramedics
instead. The other odd part of this time was, as he came out of the seizure he
didn’t go through the crying stage that he normally went through in the past,
and was very coherent and surprisingly happy. It has been 8 months since his
last seizure, during which time he had been ill and run a fever with no ill
effects, so we thought we had them pretty much under control. They checked his
Depakote levels at the hospital and they were on the low side, so I’m sure we
will adjusting his dosage when we get in to see his neurologist. We are sure
that the combination of the low Depakote levels and the spike in his temperature
were what caused this seizure. We now have a new symptom to look out for in the
future seeing how differently this one started out. On the bright side he is
making slow but sure progress with his PEC’s system and is starting to mimic a
few sounds when prompted. We also found out that the Shriners offer speech
therapy through their organization for a minimal fee so he now gets speech
therapy twice a week.
(top)
Sorry for the long absence on this page but we have found that as Chase gets older he has become more demanding of our time and attention, not complaining, just stating the facts.
All has been well since the last update and Chase is growing like a weed. He goes to school full time now and really enjoys it. He rides the bus by himself both ways and also seems to enjoy doing so. At his last IEP Deby told the staff that when Chase gets home from school we always ask him if he has had a good day and what he learned. They thought that was a wonderful idea and created a PECS sheet that he brings home everyday telling us what he did that day, what he learned and what he had for lunch so he can tell us now what went on at school. He really seems excited to do this everyday.
On the behavior front he has started some bad habits. He is starting to try and bite; luckily so far they have just been more like nibbles and is pulling hair and pinching. If we don’t keep his nails clipped short, the pinches end up being scratches and he has a knack for somehow finding the same spots over and over again. We recently had an interview with a behavior specialist through a state funded program and are waiting to start having sessions with him. He told us that now is the time to intervene and start working on correcting this sort of behavior because by the time he would be 16 or 17 years old the bodily damage would be a lot worse and the behavior much harder to correct. So we are looking forward to getting started. We also discussed sign language and PECS with him and he had some interesting theories on both systems. The one thing that struck us most was regarding sign language. He explained that when teaching sign language one of the biggest mistakes made is teaching a child to use the sign for “more” before he has a good repertoire of objects he uses consistently. What happens is the child learns how to ask for more and then it becomes your problem to figure out what he wants more of, which can become frustrating for both of you. Chase is still working with his PECS book; he can get to it anytime he wants. There are a lot of times he will ask for things he already has and times when you give him what he asks for it’s not what he wanted or thought he was asking for at the time. It can be frustrating at times but you have to look at the big picture and hope that as time goes by he will become more proficient using the system. He does have a V-Tech video game that we got him a few years ago that he is finally, after all this time, starting to understand that the buttons on the console make things happen on the television screen. He now actually plays with it instead of ignoring it. To see that happen is encouraging, watching him finally recognize the cause and effect for the first time is very satisfying.
Health wise Chase has been illness free for a long time. We did have a bout of strep throat about a month ago. We took him to the doctor because he was not feeling well and when they checked his throat said it was a mess. They gave him a shot and sent him home. About 2 weeks later he wasn’t acting like his normal self. He was sleeping in late and falling asleep very early at night. His appetite was very poor and he started having diarrhea to the point that his bottom was getting very sore. We took him back to the doctor and sure enough he had strep again, or more likely never got over the first bout of it. Once again they gave him a shot, only a higher dose this time, and he seems to be fine now. Speaking on the sore bottom front, (excuse the pun) we have started giving him Benefiber twice a day in his drink and it has done wonders keeping him regular and his butt rash free. We used to go through bouts of diaper rash that were unbelievable.
Well I think that is all the latest. I will try and update
more often.
(top)
Hirschsprung's Disease: - A congenital condition in which the colon does not have the normal network of nerves; there is little urge to defecate so the feces accumulate and cause mega colon. (top)
Cryptorchidism: - Undescended testes (top)
Dysmorphic Features: - Malformed facial features. (top)
Microcephaly: - Abnormal smallness of the head (often accompanied by microencephaly) that results in a lack of stimulus for the head vault to grow. Microcephalic children are usually mentally and developmentally retarded. (top)
Ductus Arteriosus: - An open artery that connects the aorta and pulmonary artery before birth. Normally closes after birth but if it doesn't, then surgery or medical treatment may be required. (top)
Pulmonic Stenosis: - Abnormal narrowing of the orifice between the pulmonary artery and the right. ventricle (top)
PDA Ligation: - Procedure to close the artery that connects the aorta and pulmonary artery. (top)
Pyloric Stenosis: - Narrowing of the pylorus (the lower outlet from the stomach) that blocks the passage of food into the duodenum (the first part of the small intestine). The condition can occur in both babies and adults. (top)
Special Thanks To The Following
Dr. John Graham Jr., Dr. David Mowat, Dr. Goosen, Dr. David L. Rimoin, Dr. Yelena Silvanskaya, Marcy Polsky LCSW.