Danielle Drachmann talks to RARE Revolution about the condition idiopathic ketotic hypoglycemia, (the most frequent cause of hypoglycemia in children between one and five years of age) hypoglycemia can be a life-threatening event. This is a condition that she and her two children have, which has led to Danielle setting up the website Hypomom, a platform she uses to share stories from a family with hypoglycemia and offering tips and advice about living with this
But just like other rare disease parents out there, no one could have ever prepared me for what life had in store. I’d like to present to you two very different perspectives on motherhood. Before, and after the realisation that our ball of sunshine was a particularly special one!
My baby, Noah, had just had a rough night with lots of screaming and unease before he went to sleep, well what I thought was sleeping. I remember the student nurse standing with her blood sugar device, staring terrified at those two digits on the screen, her face turning ghoulishly white, before she proceeded to push the emergency button, and then she pulled my baby boy from my arms, sprinting out of the ward as if chased by a lion.
I flew up from my bed and rushed after the student nurse following her further into the hospital. In that moment I ceased to be a child, and my life as an adult began, forced by circumstance and necessity, into a journey I never thought I had the strength to live through.
Neonatal intensive care unit
Weeks later, after I had accepted Noah did suffer from a blood glucose related rare condition, I found myself in what felt like a different planet, attending the hospital ward with all the other very sick kids. I was juggling foreign words, hypoglycemia terms, the creaking sounds of breast pumps, alarms, crying parents and very sick newborns and glucose drops, while facing an army of doctors and nurses at what became known to me as the NICU.
I forgot it was difficult. I forgot I didn’t knew how to be a parent. I forgot I had to learn to navigate this new planet, with their foreign language and their hierarchical culture from scratch. I forgot I had had another life just a few days before I crashed down to this strange place, where I four years later, I find myself well-established in what is in fact a great life for me and my rare disease children.
The years of being a rare-disease-parent has taught me my biggest superpower: Trusting my gut and reaching for the right mentors and specialists. These people have all been willing to teach me everything Google and the library couldn’t, arming me with a special needs parents strongest weapon in the fight of protecting your child: Knowledge.
How I managed to let go
After the early years of childhood with my wonderful hypo-kids, one day I found myself sitting with Noah who had turned into this little human being with an actual personality, old enough to go to kindergarten and begin his first day in his life as a big boy.
Although every inch of my body wanted to embrace my children forever in our safe concrete bubble made from love, fear and delicious fat baby cheeks - the reality knocked on the door: Noah was starting in kindergarten, and he really needed it!
And to be honest, I did too. I needed to talk to grown-ups for a change, after singing “The Wheels On The Bus” for the 50th time in a day for four years, while also being tasked with handling everyday life, ambulances and seizures. Not an ideal cocktail for any new parent, and especially not for four years without breaks.
I faced my fears and wrote down what scared me the most. I came up with the following:
1. What if the staff forgets what to do, by the different blood glucose values?
2. What if the staff is so uncomfortable taking responsibility for him, they end up excluding him in order to protect him?
3. What if one of the kids ends up in a seizure, and they forget important info to the paramedics?
I mustered up all the courage in my body, picked up Noah and went to kindergarten - ready to tell them about my beloved child, who unfortunately came with a rare disease and special needs. We sat down, while Noah investigated the playground with all the other kids. The last thing I wanted was for my child to live a Dear Evan Hansen like reality, caged out from the rest of his peers.
What I witnessed in my son’s eyes when he was staring out into the playground was anything but frightful though. He was so excited about this place, new stuff and new kids. His excitement melted my heart, but I was also terrified of how much adrenaline and physical activity would be in store for him, so I was also fearful that it might trigger an incident.
After 20 minutes of explaining our situation and requirements for Noah, to the member of staff at his kindergarten, I drew in a deep breath, waiting for their response. After giving me an awkward glance, the kindergarten staffer noted the following: “So, he could end up brain damaged or worse in our custody, if we don’t discover he is in hypoglycemia?” Well, yes. That is in fact the case, and why I lay sleepless at night.
2 minutes later Noah ended up in hypoglycemia after an hour on the playground. My worst fear realised.
After stabilising him with juice and bread and having left the kindergarten, I cried. The staff had been terrified. And so was I. I considered the situation:
How would they ever be able to remember everything I told them of my child needs? To be honest, I myself have difficulty remembering everything when an emergency arises. I once I forgot Noah's social security number and could not remember if it was him or Savannah who reacted on Glucagon (and I’m their mother for goodness sake!).
If I can forget about life saving information about my kids emergency treatment, how could these strangers possibly be expected to?
The blood sugar guide
After that heart-wrecking day, I got an idea. I sat down and had a heart-to-heart conversation with my brother, Nick. He happens to be a classically trained graphic designer. After balling my eyes out for a while, I asked him if it was possible to produce some sort of easily accessible rare disease guide, to help kindergarten staffers navigate tough situations for special needs kids.
If I were to leave my kids in the hands of strangers, I needed the information in my head to be in a physical guide that I could trust anyone to follow. The first variation of the guide was sloppy, but with it, we ensured that we could provide the institutions a visual representation of how to react in any given scenario!
The guide helped us to move forward with new found enthusiasm. We feel like we’ve been able to give our two wonderful kids, the gift of childhood and the gift of friendship through their little buddies kindergarten and whatever lies ahead. We’re no longer terrified and on the verge of a nervous breakdown whenever we need the kids to be on their own, as long as we make sure the guide is handed over to whoever gets to look over our two wonderful balls of sunshine!
We feel safer than ever, and thanks to a combination of proper diet, a state of the art blood sugar guide and a loving online community, we can safely say that we’ve been on the journey of our lives, and each one of us in our little family are thankful for anywhere that fosters a safe space for parents of rare disease children.
Our hope is to open up this tool to include all rare disease children in the world. The guide is a tired but determined mom’s gift to anyone out there!
Thanks to years of work, we’ve finally acquired an understanding of how we should live a great life with ketotic hypoglycemia, which has been the underlying mission of Hypomom - to share everything we know, and show people out there, that you can live, and live well despite a rare diagnosis.
It took us a while to get here, but through many tests, trials and lots of lost nights of sleep, we’ve finally established a good understanding of our kids’ condition and special needs. We can’t quite claim victory on our own here though, as a close personal network of like-minded parents from all over the world have helped tremendously. Hypomom essentially brings an array of resources for all you rare disease parents out there, including:
Would you like a guide for your condition? You can contact us and let us know what you need in your guide, and we will make it happen here at Hypomom.com*
*This guide is a free service offered by Danielle at Hypomon.com
Patients with ultra-rare bone marrow disease set to benefit from £1.15m grant from LifeArc and The Aplastic Anaemia Trust
Supporting researchers from King’s College London and King’s College Hospital to test a personalised treatment approach for Aplastic Anaemia patients who have not responded to available therapies
LifeArc, a UK-based medical research charity, and the Aplastic Anaemia Trust (AAT) have jointly awarded a £1.15m research grant to King’s College London and King’s College Hospital to investigate the potential of a novel type of “personalised cellular therapy” to reverse the ultra-rare condition aplastic anaemia (AA). The results of this research could give new hope to people living with a severe, life-limiting form of this condition.
The grant will fund a clinical trial to investigate the safety and efficacy of using a patient’s own T-reg cells to restore the blood-making function of the bone marrow. This follows laboratory-based research from the team of scientists where T-reg cells from a patient’s own blood were collected, selected for activity and multiplied. In a test tube, these cells prevented the immune system from attacking the patient’s bone marrow stem cells.[i]
For patients with this ultra-rare disease, we’re looking for the first time at a personalised medicine approach where their own immune cells could be used to alter their disease.
Professor Ghulam Mufti, Department of Haematological Medicine at King’s College London and King’s College Hospital, and lead study investigator said: “For patients with this ultra-rare disease, we’re looking for the first time at a personalised medicine approach where their own immune cells could be used to alter their disease. In AA there is a reduction in the number of T-regs and most of the ones that the AA patients do have are non-functional. We’ve seen success in the laboratory by selecting and bolstering the number of functional T-reg cells. Now, with funding from LifeArc and the AAT, we can investigate the potential of this approach in treating AA patients who currently have very limited treatment options.”
AA is an ultra-rare life-threatening illness caused by the bone marrow failing to make enough of all three types of blood cells—red blood cells, white blood cells and platelets. Only around 100–150 people in UK are diagnosed per year, affecting all ages but most commonly people between the ages of 10 to 20 years old and those over the age of 60 years.
People with the illness are at greater risk of infections, bleeding, and can experience extreme fatigue, which leaves them unable to carry out simple daily tasks that most people take for granted. Around one in three patients with severe AA fail to respond to existing drug treatments and the other option — a bone marrow transplant – is reliant on finding a suitable donor, requires life-long treatment with immunosuppression therapy and is unsuccessful in one in three people.
LifeArc set up the Philanthropic fund to support translational research into rare diseases, where there is less interest from commercial organisations. Patients with AA can have limited treatment options; this opportunity with King’s College London, King’s College Hospital and the AAT has the potential to transform the lives of patients living with a severe form of the disease.
Dr Catriona Crombie, LifeArc’s Head of Philanthropic Fund explained why the charity had approved the funding: “LifeArc set up the Philanthropic fund to support translational research into rare diseases, where there is less interest from commercial organisations. Patients with AA can have limited treatment options; this opportunity with King’s College London, King’s College Hospital and the AAT has the potential to transform the lives of patients living with a severe form of the disease.”
The trial at King’s College London and King’s College Hospital will run for a duration of three years and aims to recruit nine patients. A blood sample of the patient’s T-reg cells will be extracted, purified and grown in the lab before being given back to the patient in a higher concentration. As patients with AA are more susceptible to infection, this personalised treatment approach is more likely to avoid the risk of severe infection and inflammation.
AA can severely impact a person’s quality of life. Through AAT’s close work with King’s College London and King’s College Hospital as a specialist centre of clinical care and research in AA, we identified the project with the most potential to directly benefit patients who are currently at a loss for solutions.
Grazina Berry, CEO of the AAT said: “AA can severely impact a person’s quality of life. Through AAT’s close work with King’s College London and King’s College Hospital as a specialist centre of clinical care and research in AA, we identified the project with the most potential to directly benefit patients who are currently at a loss for solutions. We are delighted to have partnered with LifeArc and King’s College London and King’s College Hospital to progress this ground-breaking work, which could potentially enable people living with severe AA to once again lead a normal life.”
About Aplastic Anaemia
Aplastic Anaemia (AA) is a rare and life-threatening illness caused by the bone marrow failing to make enough of all three types of blood cells - red blood cells, white blood cells and platelets. It is estimated that between 100 and 150 people will be diagnosed in UK alone every year. That is around 2 people for every 1,000,000 of population, making AA a very rare disease. In most cases of AA, the immune system attacks the bone marrow, thinking it is faulty. This makes the bone marrow function slow down, leading to the under-production of all types of blood cells.
The most common symptoms of AA are anaemia - caused by a lack of red blood cells - with the associated feeling of fatigue, shortness of breath, headaches and, occasionally, chest pains, and increased risk of infections caused by low white blood cells. Low platelets cause people to bleed easily. Being more susceptible to severe and life-threatening infection and bleeding complications makes AA a highly dangerous disease. Patients will visit hospital regularly to receive blood transfusions and treatments for infection; many will be admitted to hospital for weeks at a time while they receive treatment, and those who recover must take a lot of time regaining their strength, avoiding places where they could easily pick up infections.
There are currently two standard first-line treatments for AA: immune-suppressive therapy (IST), which uses medicines (antithymocyte globulin (ATG) and ciclosporin) to dampen down abnormal immune responses, or bone marrow stem cell transplantation, the only known curative AA treatment to date, but suitable only for a proportion of patients. A bone marrow transplant is an intense procedure that requires an immunological matched donor and may require lifelong immunosuppression therapy, which can lead to further debilitating side effects. Both bone marrow transplants and the combination of ATG and ciclosporin work in only around 2 in 3 of AA patients.
About the Aplastic Anaemia Trust
The Aplastic Anaemia Trust is the only charity in the UK dedicated to research into aplastic anaemia and allied rare bone marrow failures and supporting everyone affected nationally. We have built productive working partnerships with major research and treatment centres of excellence in England, providing us with direct access to world-class experts, state-of-the-art labs and excellent patient care. Access to this medical and scientific expertise puts us in a strong position to identify areas of need, raise funds for research, and engage with the expert community in the UK and internationally. Our vision is a world free from aplastic anaemia and allied rare bone marrow failures. Our mission is to enable vital research into the causes of aplastic anaemia and other rare bone marrow failures that ultimately leads to finding a cure, and to support everyone affected by them, so they can lead healthy and fulfilling lives.
Our strategic objectives are
LifeArc is a self-funded medical research charity. Our mission is to advance translation of early science into health care treatments or diagnostics that can be taken through to full development and made available to patients. We have been doing this for more than 25 years and our work has resulted in a diagnostic for antibiotic resistance and four licensed medicines.
Our success allows us to explore new approaches to stimulate and fund translation. We have our own drug discovery and diagnostics development facilities, supported by experts in technology transfer and intellectual property who also provide services to other organisations. Our model is built on collaboration, and we partner with a broad range of groups including medical research charities, research organisations, industry and academic scientists. We are motivated by patient need and scientific opportunity.
Two funds help us to invest in external projects for the benefit of patients: our Philanthropic Fund provides grants to support medical research projects focused on the translation of rare diseases research and our Seed Fund is aimed at start-up companies focussed on developing new therapeutics and biological modalities.
Find out more about our work on www.lifearc.org or follow us on LinkedIn or Twitter.
About King’s College London
King's College London is one of the top 10 UK universities in the world (QS World University Rankings, 2018/19) and among the oldest in England. King’s has more than 31,000 students (including more than 12,800 postgraduates) from some 150 countries worldwide, and some 8,500 staff. King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF), eighty-four per cent of research at King’s was deemed ‘world-leading’ or ‘internationally excellent’ (3* and 4*).
Since our foundation, King’s students and staff have dedicated themselves in the service of society. King’s will continue to focus on world-leading education, research and service, and will have an increasingly proactive role to play in a more interconnected, complex world. Visit our website to find out more about Vision 2029, King’s strategic vision for the next 12 years to 2029, which will be the 200th anniversary of the founding of the university. World-changing ideas. Life-changing impact: https://www.kcl.ac.uk/news/headlines.aspx
About King’s College Hospital
King’s College Hospital is a leading national and international centre for the diagnosis and treatment of blood cancers. The hospital is home to the largest bone marrow transplant programme in the UK and performs more than 160 transplants a year. King’s College Hospital is also an international centre for research into and the treatment of myeloid leukaemias, lymphomas and myeloma, and have the first immune gene therapy programme for leukaemia approved by the Gene Therapy Advisory Committee (GTAC). It is the first hospital in the UK to treat adult lymphoma patients with CAR T therapy, and it has an active CAR programme in lymphoma, leukaemia and myeloma. It is also a centre of excellence for myelodysplasia and expertise in matched and unrelated transplants for the treatment of myelodysplastic syndrome (MDS).
The haemato-oncology service:
For more information about the haematology service at King’s College Hospital visit https://www.kch.nhs.uk/service/a-z/haemato-oncology
Rare Revolution is delighted to welcome guest blogger Jodie Harris who is proud to be raising awareness for PTEN
What is PTEN? A bunch of meaningless letters to most people but for me and many others it is a different way of life that no one could ever anticipate.
On the 17th of July 2019, after finding a lump in my breast that felt a bit ‘odd’, I was diagnosed with stage 2 grade 3 breast cancer at the age of 24. This has led my life in a completely different direction compared to how I thought that I would be spending my twenties. The doctors class it as being caught early but because PTEN is the cancer suppressor gene, my tumour is growing fast and has already spread to one lymph node under my arm.
So what now? I’ve already been through my IVF injections and an egg collection as chemotherapy may affect my fertility. To follow is 6 rounds of chemo, a double mastectomy, through choice, radiotherapy and potentially 5 years of hormone therapy. That sounds like a lot for someone my age to deal with but it is the stark truth for anyone with this syndrome. You can sit and tell yourself that it will not happen to you but if and when it does you have to quickly learn how to adapt.
I’m not going to lie - it isn’t easy! There are definitely highs and lows but it’s all about how you deal with them.
Let’s get the negatives out of the way first of all.
After my first session of chemo I suffered two seizures. Completely unrelated to the chemo treatment I found out that I have a cavernoma in my brain which is an unusual collection of blood vessels which can haemorrhage. This is what happened in my case and the bleed then caused the seizures. This leads to another negative - I’m not allowed to drive for at least a year! I just got a new car and now I can’t even use it! It is such a minor issue but for a girl who is so used to independence I’m finding it quite hard.
Next, chemo side effects are no joke. In hindsight I’ve had it quite easy as I haven’t felt sick or anything like that but in terms of joint pain and tiredness it is nothing like I expected it to be. When my doctor told me the side effects my first thought was “well everyone surely experiences that in their day to day life, how hard can it be?” Turns out I was very naïve. Although I feel I have had it easy with not experiencing every symptom, it doesn’t make the ones I have had any easier to deal with. I’m now learning to listen to my body and figure out what it can handle.
I’m done complaining now, there are lots of positives in my life that have stemmed from going through cancer that need mentioning
Firstly and most importantly I have a great support system behind me and my family have been there every step of the way with me. For that and so many other things I can never thank them enough. There are also so many people that I have connected with in the PTEN community and through them I have gained so much education and inspiration from hearing all of their different stories.
Going through a life changing experience like I am right now has also made me a little braver I think! I want to make a difference and I am now gaining the confidence to do this. I have just been made a member of the PTEN International Family Council, a position which I am honoured to have and hope to use to spread more awareness and education of this syndrome. I am going to start a petition in order to lower breast screening ages as I don’t want any woman to go through what I am going through at such a young age. I am also thinking about writing a book! I am currently writing a blog but I have been told I should turn it in to a book so this is something I would definitely like to explore!
All in all, being in a situation like I am (having the PTEN mutation and cancer) is scary but I am far from alone. There is a community behind me of fellow sufferers fighting their way through each day and yet there is so much more to be done. There is still more awareness and education needed and I am truly confident that we will get there.
I am proud to be a PTEN warrior!
Noelle Kei, beloved friend of RARE Revolution's, Nicola Miller, talks about the gifts of time and faith and how this powerful rare mama is now facing her own race, having being diagnosed with diffuse systemic scleroderma and having stem cell treatment
Can you explain the process for medical insurance in funding such a novel therapy, and how you managed these financial pressures and burden?
My insurance company paid for all of my pre-transplant work, up to and including a round of chemotherapy and the placement of my port. A few weeks before I was admitted to the hospital my insurance company denied my transplant, on the grounds that it was not a covered benefit for my diagnosis in my plan brochure. If I had leukaemia or another covered condition, then they would pay for it. It was devastating.
My haematologist, along with his nurse and my transplant nurse (assigned by my insurance company to assist with approval of treatments) worked tirelessly to get my transplant covered. One day whilst sitting at City of Hope I received a call to tell me that my transplant had been approved and that they made an addendum to my policy giving an exemption for scleroderma to be covered. A short while later I received a follow up call only to be told that a mistake had been made, and I was still not approved for the transplant. This was another devastating blow.
After rapid intervention and appeals we finally got confirmation that the insurance would cover the costs. For all of the testing prior to transplant, a month long stay in the hospital with a transplant and all the post op care; my insurance company was billed more than a million dollars. The endless EOB’s (explanation of benefits), several re-billings coupled with the fact that my insurance was using a third-party company to pay and manage the claims only made things more confusing.
I had thought that what I was charged in 2018 was my final copay due. It wasn’t until a year after my transplant that I received my final bill from the hospital. That copay and co-insurance amount, coupled with the beginning of a new year of out of pocket expenses added to my hospital bill; totalling thousands of dollars.
The hospital has been very helpful in working out a payment plan with me, but nonetheless this bill along with many other medical expenses certainly adds a layer of stress to me in my recovery and to my husband.
What after-care and emotional support are you receiving post treatment?
I have had a wonderful team of doctors that have supported me throughout, including the difficult recovery post-transplant. My case has had its unique complications and I have always felt that my doctors have gone to great lengths to help me tackle any of the symptoms I have. They have always shown great concern not just for myself but for my family as well.
I went into this knowing that HSCT would not be a cure for me but had hoped it would halt the disease progression. It’s looking more and more like it has simply slowed the progression which I am still grateful for. Before my transplant I was given two years to live. While I have bought myself more time my future is uncertain, and it’s hard to predict how long I have staved off the worst of this hideous disease. Each day is a gift and I’m grateful to still be here with my husband and children. My husband has shouldered so much throughout this ordeal. From juggling the responsibilities of a job that often takes him away from home, to taking over household duties while being a caretaker to me. He truly is my hero and I’m thankful for him each day.
Between counselling with ecclesiastical leaders of our faith or with professional counsellors when needed our family has been greatly supported. Going through such an arduous treatment doesn’t just affect the patient. It effects the entire family unit. We have been blessed with a community of many that have helped to lift not just me but my entire family.
Has your faith helped you and the family during this time?
It has tremendously. I don’t think we would have been able to endure what we have without the faith and knowledge that we have. When I first heard I had a life-limiting illness it was very difficult to deal with.
I felt panic with the thought I would no longer be here for my husband and my children. Especially having a son with his own rare diagnosis and the unique measures needed to care for him. It was especially difficult as I found myself somewhat awake in between each episode where my heart stopped three times in one day. I prayed for peace that if it was my time to go I would be ok. And I prayed that my family would be taken care of.
When life has got overwhelming and my burdens too big I know that my Heavenly Father and my Saviour Jesus Christ will help carry me and my family through whatever we are going through. I have had so many people not just of my faith but many different ones praying not just for myself but my family as well. We have certainly felt those prayers. There were so many different things that just fell into place from when I got sick to the time of my transplant and I don’t think these were just chance. At times I have felt like I have had not only earthly angels looking out for me but heavenly angels as well.
What has been and is, the biggest challenge of managing your health whilst also raising a child with rare and complex health needs?
I think asking for and accepting others offers of help. We have had a lot on our plate juggling my rare disease along with our youngest child’s rare conditions and the health of other family members. When you add that to just the everyday tasks of running a household and making sure everyone is taken care of and gets to where they need to be it can be overwhelming. It was hard to accept help, but we soon realised that’s there’s no way we can do everything on our own especially with me being so sick. We haven’t been able to travel as much as a family and celebrations have been paired down because I wasn’t in a position to help. But it’s brought us closer together as a family and helped us realise that it doesn’t really matter how we spend our time together as long as we are together. And for that I am grateful for each day is a gift.
Is there anything you would like the health care professionals to know about your rare journey so far or things that they could have done to make things easily for you and your family along the way?
Listen to your patients. They know their body best. Let them help partner in their own healthcare. I am lucky that my doctors have listened to me and let me help guide my course of treatment. Because of that (coupled with many tender mercies) I was able to go from diagnosis to transplant in five months. Many patients spend longer than that just trying to get insurance to approve the transplant. I know everyone’s complications are so individual, but I think perhaps more could be done to prepare patients and their families for what to expect during and post-transplant. I would encourage clinicians to make more emphasise on the importance of educating the patients caretaker and families and supporting them in the aftercare.
What resources and signposting have you found helpful that you would like to share with others?
Glossary of terms
Systemic scleroderma is an autoimmune disorder that affects the skin and internal organs. Autoimmune disorders occur when the immune system malfunctions and attacks the body's own tissues and organs. The condition is characterised by the build-up of scar tissue (fibrosis) in the skin and other organs. The condition is also called systemic sclerosis because the fibrosis can affect organs other than the skin. Fibrosis is due to the excess production of a tough protein called collagen, which normally strengthens and supports connective tissues throughout the body. https://ghr.nlm.nih.gov/condition/systemic-scleroderma
Diffuse cutaneous systemic sclerosis (dcSSc) is a subtype of systemic scleroderma (systemic sclerosis) characterised by skin hardening (fibrosis) and problems in many organs of the body. The disease can occur at any age but mainly affects people between 40 and 50 years of age. Symptoms include Raynaud’s phenomenon; skin fibrosis beginning on the fingers and face that rapidly becomes generalized; spider veins (telangiectasias) on the thorax, face, lips, tongue, and fingers; gastroesophageal reflux; and difficulty eating (dysphagia) along with weight loss, vomiting, diarrhoea or constipation. Dry mouth and dental involvement can occur. Joint pain (arthralgias), muscular pain, weakness, cramps, and destruction of the tips of the fingers or toes (acroosteolysis) are frequent. Severe problems involving the lung (fibrosis or pulmonary hypertension) and kidney problems may also occur. The exact cause of the condition is unknown. There is currently no cure. Treatment depends of the symptoms, but may include medication and surgery.
Haematopoietic stem cell transplantation (HSCT), also known as blood and marrow transplantation (BMT), is used to treat wide spectrum of haematological, and increasingly, non-haematological disorders. Autologous transplantation uses the patient's own stem cells, which are harvested prior to high-dose therapy.
Copay is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. It may be defined in an insurance policy and paid by an insured person each time a medical service is accessed.
Everyone's talking mental health, but are we really listening?
and Mental health first aid
Torie Robinson, Epilepsy Sparks
Evaluating the Key Challenges to Advance Commercialisation & Patient Access
Holiday Inn Kensington Forum, London, UK
Workshop: 17 October 2019
Conference: 15 - 16 October 2019
As the co-chairs of the 9th Annual Conference on Orphan Drugs & Rare Diseases, SMi are very pleased to invite you to attend this event, which will be taking place on 15th and 16th October in London.
This conference will bring together a broad spectrum of experts from across the orphan drug world. The two-day compact agenda will offer a series of presentations, through which you will gain key insights into current trends and innovations in orphan drug development, using real world case studies to illustrate challenges and opportunities.
The rare and ultra-rare disease landscape is constantly changing as new diagnostic and therapeutic technologies emerge and partnerships are developed to address patient access and funding issues. At the conference, speakers from patient organisations, pharmaceutical R&D companies, health technology assessment groups, and others will lay out the current landscape and address how the orphan drug space will develop as the century continues.
Delegates will gain invaluable insights on major topics including:
Following the conference there will be a half-day workshop where delegates will deep dive into strategies for accelerating patient access to orphan drugs, addressing issues, opportunities and barriers, that are met when developing a product for patients with rare diseases.
To view the full details of the 2-day conference agenda, half-day workshop and the expert speaker line-up, please view the brochure here www.orphandrugs.co.uk/rrm
HOW TO REGISTER
For more details and to register visit: www.orphandrugs.co.uk/rrm
Email the completed booking form from the brochure and email it to the events team at: firstname.lastname@example.org
If you are interested in joining SMi as a sponsor/exhibitor, there are still a few sponsor packages available to suit your business needs, please contact Alia Malick, Director on +44 (0) 207 827 6168 today or email email@example.com
Mike Page one of the co-chair's of the conference, looks forward to personally welcoming you and having fruitful discussions at this must-attend event in London in October.
Co-Chairs for 2019 Conference:
Please share the event details with your colleagues who may also benefit from attending the conference!
No-one understands my condition, so no-one knows how to help
The aim of this study is to explore the relationship between quality of life and social support for adults living with rare genetic skin conditions.
Case study research: telling your story
Each rare genetic condition has a range of physical features: many conditions can have a devastating impact on everyday life. Each person living with the effects of a rare genetic condition has a story to tell about their personal journey through the health and social care system, from diagnosis to treatment. One case study can tell an individual story which as has the power to touch hearts, changed minds and influence policy.
A case study is a research method involving an up-close, in-depth, and detailed examination of an individual, a group of people or subject under investigation. By using a case study approach, the personal views of the participants are explored and any similarities or themes are highlighted in this study.
The social impact of living with a rare genetic condition
The social impact of living with a rare disease is often overlooked, and the psycho-social complexities of rare diseases can be misunderstood. The social effects are far reaching and can include a significant financial burden, an impact on family life, on coping, it may also result in stigma and social isolation.
Most of the focus on the effects of rare diseases, is dominated by the medical aspects of the conditions, with relatively little attention paid to the social impact on the individual, carers and families. The medical model of health is largely concerned with physical or biological aspects of disease and illness. By comparison, the social model of health considers non-medical factors which contribute to health outcomes.
Literature review - Initial research findings
This study began with a literature review which highlighted one key outcome (1) that ‘informational support’ which is provided, and expressed using good communication, had the strongest correlation with perceived quality of life.
Informational support is the provision of advice, guidance, suggestions, or useful information to someone. This type of information has the potential to help others problem-solve (2).
Emotional Support is the offering of empathy, concern, affection, love, trust, acceptance, intimacy, encouragement, or caring. It is the warmth and nurturance provided by sources of Social Support. It is also referred to as ‘Esteem Support’ or ‘Appraisal Support’
Instrumental Support is the provision of financial assistance, material goods, or services. This form of social support encompasses the concrete, direct ways people assist others. Also known as Tangible Support.
Companionship support is the type of support that gives someone a sense of social belonging. This can be seen as the presence of companions to engage in shared social activities.
The findings from the literature provided a context for the next stage of the study, which was to determine what kind of social support adults with rare genetic skin conditions required.
Once a diagnosis of EDS is handed to you, that is more or less where it stops in terms of support
On-line survey – initial results
This stage of the study included thirty-one participants who shared their experiences by completing an on-line survey. Eight participants were then selected to take part in an in-depth telephone interview. The group were characterised by rare conditions affecting the skin and connective tissue.
Those participants who completed the on-line survey were adults over the age of 18 years, with diagnosed conditions including Atopic Eczema, Brooke Spiegler Syndrome, Cutaneous Mastocytosis, CYLD Cutaneous Syndrome, Ehlers-Danlos Syndrome, Epidermolysis Bullosa, Incontinenia Pigmenti, Hypermobility Spectrum Disorder, Lamellar Ichthyosis, Neurofibromatosis 1, Ichthyosis Bullosa of Siemens.
The focus of the on-line survey was to discover what social support the participants were receiving and who provides that support. The participants were invited to rate their perception of the overall quality of the social support they receive. Initial analysis of the participants’ responses indicated that there is a relationship between social support and quality of life.
The participants were asked to consider support from family members, neighbours, support groups, religious groups and friends. The responses are highlighted in Graph 2, indicating that 23% of the group felt that their social support was ‘poor’.
A comment from one of the participants gave some insight into why some of the group rated the social support as ‘poor’. The lack of recognition and support by official bodies is highlighted by one participant living with epidermolysis bullosa.
More recognition and support from official bodies e.g. councils
Graph 3 highlights the participants’ response to who provides them with social support, highlighted a lack of support from social care professionals. One common theme among the participants was the important role the family had in providing social support, particularly with regard to emotional support. One participant shared her experience of the emotional support she needs, due to the psychological effects of looking different.
There is a distinct lack of social sympathy for my sort of disfigurement
Initial key findings
The call for integrated support for people with rare genetic conditions has been widely promoted. The need for a bio-psycho-social approach to the management of conditions is paramount. There is a lack of high quality qualitative or mixed methods research into the lived experience of those living with the effects of rare conditions. The rare disease community are experts in their own experience; their stories and perspectives have to be taken into consideration in order to address the their needs and provide effective social support.
Rare Revolution Editor