Pompe Disease

Down for the Count

It’s been over a year since I conducted a most epic gravity check. Just over a year ago I fell and broke my leg. I have still not fully recovered. After the surgeon put me back together again, he warned me it would take a least a year to completely heal. I didn’t believe him. I have trust issues with doctors (and television executives – but that is another story. Hint: Firefly). The doctor was right. Here it is, over a year later and I am still not back to the condition I was before my accident. 

So what about this epic gravity check you ask? It was late at night, I was tired from being a little late on my infusion, and I fell backwards off a step stool into a confined space and landed on my hip. In the world of Pompe, falling is not uncommon, minor bumps and bruises, minor (and major) humiliation, and sometimes serious injuries happen in our little awkward community. My previous falls had resulted in a concussion, mild whiplash, and a twisted knee. Those were nothing compared to this fall. I had no idea what I was in for as I sat there on the floor waiting for the aching to subside. I thought I could simply scoot my way to a nearby chair and get up. Nope. I struggled for hours and couldn’t move more than inch without excruciating pain. I had no choice but to call for the paramedics. Even then I thought maybe they could just help me up off the floor and into my bed. I wasn’t in pain, unless I tried to move. When the paramedics got there and examined me, they thought I might have just dislocated my leg. They felt that I would be in much more pain if something had broken. Ok, I thought. They’ll just put my leg back, it will be painful, and I’ll recover in a few weeks. I had dislocated my knee in dance years ago and it healed fairly quickly. My dad is the master of dislocating his shoulders and he always heals up fine. No problem, I can handle this I thought. 

When the paramedics moved me from the floor to their gurney I experienced the worst pain I had ever felt in my life. I would have to endure that same pain of being transferred from place to place over and over again over the course of the night. From the paramedic’s gurney to the ER bed. From the ER bed to the X-ray table – and then they had to move my leg all around to get good images of it. They did give me a mild pain reliever before they sent me to the X-ray lab. After the had me do what felt like yoga on the X-ray table, they transferred me back to the ER bed. And then I waited for them to tell me I had severely dislocated my leg. That was not the verdict. I had in fact broken my femur bone and it would require surgery. Not awesome.

A million thoughts ran through my head:

Like: I don’t have time for this!

I have a ComicCon to attend this weekend. Yes, that was my first concern. The entire cast of Torchwood was going to be there! I am still ticked about this. To add insult to injury, literally, just about all of my doctors attended the event. Making them cool doctors, but cruel people to not have taken me. With a little make up I could have been a zombie apocalypse victim. They could have just rolled me into convention the hall in my hospital bed. HMOs cover that right? 

Worst of all, I had never really had surgery before. For one of my muscle biopsies they put me completely under and I was sick for days afterwards. And now, with my official Pompe diagnosis, I knew how dangerous general anesthesia was to me. 

Luckily, I have one the world’s leading experts in Pompe Disease on speed dial. I got in touch with Dr. Byrne right away and expressed my concerns to my medical team at the hospital. Thankfully my medical team was more than happy to consult with Dr. Byrne about the special precautions they needed to take. Honestly, I couldn’t have asked for better care. They brought a respiratory specialist in to join my team to make sure they were extra careful not to put more stress on my diaphragm than absolutely necessary. 

Their plan was to do the surgery as quickly and as safely as possible. Then to get the tube out of mouth and sit me up as soon as possible. The surgery involved two lovely incisions, to place a rod and some screws into my leg to patch up the break. They stapled me back up and sent me to recovery. I woke up in my hospital room sitting up and without a tube down my throat. Good job docs! Apparently there was a recovery room I was in, but I don’t remember that part nor do I remember acting all goofy while coming off the drugs as a certain father of mine claims to have witnessed. There is no documented or photographic proof of this alleged behavior. I only remember waking up in my hospital room feeling a bit groggy with my leg bandaged up. 

The rods and screws that will reside in my leg forever.

The rods and screws that will reside in my leg forever. Which is why I am still experiencing pain. 

I spent two weeks in the hospital recovering. They brought in a physical therapist to work with me, I was able to stand on my leg the day after surgery. I couldn’t (and still can’t) pull all my weight on it, but I could stand on it. Nice going doc! 

The reason I stayed in the hospital so long was partially due to needing an infusion. The doctor on my case was reluctant send me to inpatient rehab, my next stop, before I had my infusion because they were not equipped to give it to me. Well, neither was the hospital really. They had not been trained on how to mix or administer Lumizyme, but they stepped up to the plate. Once again, my personal care team at Genzyme helped save the day too. They worked with my insurance company and got the staff at the hospital trained so I could receive my infusion. 

Two weeks in the hospital wasn’t too bad. The food was ok , I had a room to myself, free WiFi, a decent amount of TV and movie channels, and I had visitors just about every day. 

After my infusion it was time for me to be moved to an inpatient rehab center. This would allow me to work on recovering enough to be self sufficient. I needed to go from completely reliant on nurses to being able to move myself from place to place on my own. I had a lot of work to do, but the facility provided the perfect motivation in the form of sleep deprivation and inedible food. 

The physical therapists and nurses on this facility were top notch. My care was amazing. However, the living conditions just didn’t work for me. I was basically in a nursing home for lack of a better term. I was the youngest patient by decades. Decades. I shared a room with a patient who had to sleep with a bed alarm because she kept trying to get out of bed and she would fall or try to make a break for it. The alarm went off all night. Night after night after night. The food was almost comical. No, it was bad. I would take photos of it and send it to my friends and ask them guess what it was. A couple of friends would smuggle food in to me when they could. I would have killed for something from Del Taco. Killed. 

Guess the mystery meat - is it even meat?

Guess the mystery meat – is it even meat?

How many times has then been recycled?

How many times has then been recycled?

I think this was chicken, carrots, and some sort of mystery side dish made from 3 days worth of leftovers.

I think this was chicken, carrots, and some sort of mystery side dish made from 3 days worth of leftovers.

I worked hard to get an early release. To reach all my goals as quickly and as safely as possible. In the meantime I was still plotting my escape in case my captors were not prepared to let me go. I had friends at the ready with an unmarked van waiting to snatch me under the cover of nightfall. Luckily it never came to that. It might have led to prison time – where the food might have been better. I was released after one week. The director came to talk to me before she would sign the release papers. She had never had a patient make that quick of a recovery. I wasn’t looking to set any records, I just needed my own bed, and some food that I could identify by sight.  

I made it home and then went for outpatient physical therapy. This helped a lot, but I am still not back to where I was. It is frustrating to say the least. I am glad my surgery and recovery have gone as well as they have, but I am ready to be able to fully walk on my leg again. I am ready to take back the small bit of independence I still don’t have. It is just too painful to walk on that leg to this day. 

Where it really holds me back is with driving. Not with the actual driving, but the loading and unloading of my scooter. Since my leg still causes me so much pain, I cannot walk the length of my car to load and unload my scooter from the lift. Someone has to do that for me. Sometimes it is a friend, sometimes it is a valet. Yes, it has slowed me down. I can’t just get in my car and drive someplace without having someone either with me or people at both ends of my journey to help me. However, it has not slowed me down entirely. With help, I can still enjoy the theme parks and travel and cruising. I am still able to get out there and give presentations about Pompe Disease to the patient and medical community. 

My battle with gravity will never end, but hopefully soon my battle with my new metal infused leg will end and I will emerge victorious! I will Keep Fighting! 

Why do I do this?

I had a patient meeting yesterday in Knoxville, Tennessee. It should have been a a fairly easy journey – famous last words. They loaded about 10 of us on the plane and the Captain makes the following announcement: “Well folks, I don’t have good news. (At least we were still on the ground – geez!). The mechanics have inspected the plane and have found a problem with our right engine. That is all I know, but it was fine all the way here. We have stopped boarding and if you feel like you want to get off the plane you are welcome to do so. I will know more in about 10 minutes, but please expect at least an hour delay.” 

Waiting.

“Folks, it is not looking good. This plane is grounded until at least 3pm.” (Which is about 6 hours after the scheduled departure.) I found out later that the engine had to be totally overhauled and that plane was expected to be grounded for 24-48 hours. Delta did live up to their name “Don’t Ever Leave The Airport.” Seriously, they did a good job in a stressful situation. 

I was supposed to arrive in Knoxville at 1:30pm for a 6pm meeting. Delta tried to reschedule me for a 6pm arrival. When I told them why that didn’t work for me they found room for me on a flight that arrived at 4pm. The meeting was not close to the airport so the driver took me from the airport, to hotel to pick up the folks from Genzyme, and we went directly to the meeting. I changed clothes at the conference center.

The flight home was much less eventful. Except for the guy next to me who kept dropping his phone on my foot. Ouch! And the lady behind me who kept digging around in the seat pocket behind me. Yes, lady, that is my butt. I was already groped by TSA, so I’m all set.

And oh yes, I had to change planes in Atlanta – which I also hate. Not so much changing planes, but changing planes in Atlanta. Ugh! 

All that travel drama turned out to be worth the trouble. There was a patient who was diagnosed in the 60’s with some sort of “glycogen storage disease.” This patient now has a Pompe blood spot test kit and is making an appointment with their doctor. There were other key moments of this meeting, but this was the highlight. I would not wish this disease on anyone, but if it is between Pompe and another cruel disease for which there is no treatment, I think Pompe is the lesser evil. 

I would have been gutted if the plane delays had caused me to miss this meeting. This could change the course of a person’s life. This is why I put up with air travel for one night away from home in 30 degree weather. 

I am now going to curl up in my own bed and sleep until I have to get up for my next presentation. Tomorrow. Gainesville. 

Lumizyme “on the go”

In October I took a 3 week vacation, one my friend Leanna and I dubbed our Epic Disney Vacation. We spent a week in Anaheim, California exploring the Disneyland Resort, and then took a two week Disney cruise to Hawaii. My Lumizyme infusions are scheduled for every two weeks, so obviously some arrangements would need to be made. I become terribly fatigued and my muscles start to ache if I miss a treatment. It is a huge set back in my crusade against Pompe when my treatment schedule is interrupted.

I started working with my Case Manager at Genzyme months in advance to arrange a Lumizyme infusion while I was away from home. My infusion needed to be scheduled for the first week of my vacation because that was the only time I would be “on land” long enough for it to take place. Dr. Byrne asked where I was staying in California and found a colleague who worked close to Disneyland. Dr. Kimonis at the University of California Irvine agreed to take me on as a patient and supervise my infusion.

My Case Manager worked with the Case Manager for the Irvine area and lined up all the approvals with the hospital and my insurance company. I filled out my paperwork a few weeks before we left on our trip and confirmed my appointment. My first “on the road” infusion couldn’t have gone smoother. Everyone at UC Irvine was so helpful and their infusion chairs are the best I’ve sat in. Everything is push button, to recline, or put your feet up, watch TV, or call your nurse, you just push a button on a single remote. The chair even had heat and massage features.

I do not think this is something that could have been pulled off on short notice. It took a lot of people working together to make it happen. For that, I am very grateful. Had this California infusion not been arranged I would have gone about 4 weeks without a treatment. That would have left me feeling pretty cruddy during the cruise.

With careful planning it is possible to make this sort of arrangement for your infusion. Of course it depends on your insurance, where you are going to be, and probably a few other factors, but I believe it is worth trying if you want to travel and not miss an infusion. Be sure to give your Case Manager plenty of notice to help make arrangements for an infusion “on the go.”

Disneyland, October 2012 with my friends Robyn, Elysse, and Leanna. I’m full of energy because of my Lumizyme on the go!

Status Quo

 

I’m dusting off the blog. I have neglected it. Does that mean there has been nothing to report, or that I have been too busy to sit down and write about it? Well, a little bit of both.

 

I’ve been busy with speaking engagements, but that has more or less become a regular event in my life. In fact, I’m heading to New York this week for another one. I always look forward to meeting new people in the patient community.

 

So what else have I been up to and where have I been? I spoke at a United Pompe Foundation  (UPF) meeting. This time the meeting was held near Duke University, which is one of the few places that has experts who not only know about Pompe Disease, but who are researching new and better ways to fight it. The meeting coincided with clinic hours – meaning patients could be seen by Dr. Kishnani and other specialists at Duke who really understand Pompe. This was especially beneficial to patients who don’t have access to knowledgeable doctors at home. The meeting and clinic appointments were very successful, even the “veteran” patients admitted to learning new things. The dates for next year’s meeting have been scheduled for April 18, 2013. Keep checking the UPF site for more information, or visit this Facebook  page.

 

Genzyme sent me to Nashville, Tennessee to speak to their travel agency about booking travel for patient speakers. I repeated the presentation via video conference about a month later. There really is an “art” that goes into planning and booking travel for patients. I also did a few presentations here in the Orlando area for both Genzyme and the Muscular Dystrophy Association.

 

Sprinkled between my commitment to Pompe education and awareness I of course had to include some personal travel. I’ve been on a few more Disney cruises and am boarding the Disney Dream again in about a week. I went up to Atlanta to visit with my friend Lonnie – who I’m cruising with next week. In October, my friends and I embarked on what we deemed our Epic Disney Vacation. We spent a week at Disneyland in California. I even arranged to have one of my infusions at UC Irvine under the watchful eye of Dr. Kimonis. We went up to Hollywood, visited my friend Matt at the Walt Disney Studios in Burbank, and played tourists at Universal Studios. After a week of California fun we boarded the Disney Wonder for a two week cruise to Hawaii and back.  The trip took a LOT of planning, but it was well worth it because the trip couldn’t have been better.

 

So, as you can see…it has really been fairly routine….for me.

 

Leanna and I with my favorite puppy at Disney California Adventure.

The Lab Rat Chronicles

Over the summer I participated in the Amicus Therapeutics AT2220 Trial. The clinical trial is a safety study of a chaperone drug. The study drug basically does what the name suggests, it works alongside Lumizyme and “chaperones” it, making sure more if it gets delivered to where it needs to go. It is an oral (liquid) medication that is taken about an hour before starting regular enzyme replacement therapy (ERT).

I participated in the study at the University of Florida (UF) – where else? The team up there asked me to participate over a year ago – which should give you an indication about how long it takes to set something like this up and running. Additionally, it is a pretty big commitment on the part of the patient (lab rat) as well as the medical team. I had to commit to 6 separate, carefully timed appointments just to receive a single dose of the trial drug. I underwent several tests, including a couple of punch needled muscle biopsies, hourly blood draws during my infusion, and a couple of overnight stays in the hospital – all in the name of science.

The team at UF is amazing – but that is nothing new to those in the know about Pompe. Of course, I was a little nervous testing a new drug, but I knew I was in expert hands. After all, this is where I first started my ERT, before it received FDA approval and I’ve yet to grow a second head. In all seriousness, I couldn’t ask for a better place to be or with better people to work with. Not only is everyone so knowledgeable about Pompe and all the emerging research, they are simply a great bunch of people – the kind you just want to spend time with socially. It really makes having a sucky disease like Pompe a little less sucky.

The clinical trial is being conducted in 4 cohorts, or groups, each of which will receive a different amount of the trial drug. Patients in cohort 1 received the smallest dose, while those in cohort 4 received the largest. I was in cohort 3 and the trail should be wrapping up very soon. Preliminary data from cohorts 1 and 2 are showing promising results.

It could be a couple of years before the next phase of the trial begins, meaning more patients and more doses. Clinical trials are very closely regulated by the FDA and the smallest little mishap could set the whole study back. Which is why things can seem slow going, but it is really in everyone’s best interest that everything is done exactly right down the tiniest detail. The smallest error could result in a big set back.

Would I participate in a clinical trial like this again? More than likely, yes. I would have to take all the factors into consideration, it really isn’t something to be entered lightly. As I mentioned, it is a pretty big commitment time wise, which can seriously cut into my travel plans. It would also depend on who was running the trial. If it was Dr. Byrne and his crew up at UF and I had time – then, yes, sign me up.

Sincerely,
Your Loyal Lab Rat

How do you do it?

I’m often asked how I deal with Pompe so well, where I draw the strength to go on fighting day after day. Well, first off, the alternative is to just sit at home complaining, feeling sorry for myself, and waiting for Pompe to kill me, but that is just not how I roll. The simple answer is that I’m stubborn and I’m a fighter. I refuse to let some stupid mutated genes ruin my life. It does make for an albeit difficult, but interesting life.

Some people just deal with adversity better than others, it is a personality trait. I also draw inspiration from those around me, even those who are no longer here.

When I was in elementary school one of my best friends was diagnosed with a brain tumor. She went through surgeries, chemotherapy, and radiation treatments. The treatments made her very sick and she lost all of her hair. I watched as other kids shied away from her or stared at her, but through it all she remained positive and outgoing. She appreciated the days when she felt good and would want to go out and seize the day. Even if she was checked into the hospital for a multi-day treatment session she would ask her doctor for a “day pass” so we could go to the movies or Disneyland or shopping. It was like she understood without equivocation at 9 years old how important it was to embrace life and enjoy yourself when you could.

I learned how to be a Pompe Warrior from Jaimie. The example she set as a young child continues to inspire me to never give up fighting and never give up hope, to enjoy life and live it to the fullest. She may have been thankful that I remained her friend, that I wasn’t one of the ones scared off by her cancer, but honestly I think I am the one who benefited the most from our friendship.

So how do I do it? I get by with a little help from my friends…..and family too of course!

Today is her birthday. Happy Birthday Jaimie. You are greatly missed and continue to inspire the lives you touched.

“Wouldn’t it be great to be able to fly, over the rainbow and beyond the sky?” -from one of Jaimie’s many poems

Bonjour Genzyme!

Last week I flew to Boston to speak to members of the French media about Sanofi’s acquisition of Genzyme. The French journalists were in town to cover the story from a “one year later” sort of perspective. They regularly cover Sanofi related news items, but Sanofi is new to the whole rare disease world and it was felt the best way for them to truly understand the latest edition to the Sanofi family was to visit Genzyme in person. Part of understanding Genzyme is understanding their unique relationship with their patients….enter moi!

Before I gave my presentation, Jamie from Genzyme talked about their patient advocacy department and why they feel it is essential to their success. A big….no, HUGE fear in the patient community was whether or not Sanofi would allow Genzyme to continue their business model in regards to patient relations. The Internet was ablaze with concerns about losing our case managers and local reps. Most of us depend on these people to guide us through the tangled world of rare disease treatment. The thought of having to navigate complicated insurance plans alone was frightening. Well, it is one year later and the impact on patient relations is basically a non-issue, in a good way. For most, it has been a seamless transition – which Sanofi was happy to hear. They reassured me that they never had any intention of cutting back on patient relations, that in fact it was one of the elements that drew them to Genzyme in the first place. It is good to know first hand that today, tomorrow, 6 months from now and beyond my case manager and local rep will still be there for me.

It was then my turn to present and I started out in French. I introduced myself then thanked them for coming and allowing me to share my story. Next I told them I was going to continue in English as my French wasn’t all that great. I took them through my “diagnostic oddessey” and explained how much my health has improved because of enzyme replacement therapy, diet, and exercise. They were a very engaged audience and asked loads of questions. I really enjoyed speaking with them, and hope I provided them with newsworthy information.

After lunch I met with members of the Pompe regulatory department. These are the folks who work with the wording on all the Pompe products and deal with the FDA. They have very little contact with patients so it was a treat for both them and me to meet and discuss Pompe.

Although I only spent about 27 hours in Massachusetts, I feel like a lot was accomplished. While there, I also got to catch up with ladies from patient advocacy and corporate communications over a couple of meals. At dinner I even met up with my Boston Marathon running partner. My runner from last year, Angela is not running this year so I was paired up with a new partner named Kai. She is amazing! She is an avid runner and has run the Boston Marathon in the past. She just had a baby a mere three months ago, yet is ready to hit the pavement next month with the rest of the Genzyme team as they all Run for Rare Diseases!

2011: A Look Back

And…..scene.

As the curtain closes on another year, it is time to quickly look back before moving forward. I know, how cliché right?

2011 was a productive and exciting year for me. It was filled with a fair bit of travel, a lot of which centered around Pompe patient advocacy. The year concluded with me receiving my 42nd Lumizyme infusion and a few new stamps in my passport.

January

I was invited to Boston, Massachusetts to speak at Genzyme’s annual marketing meeting… in between snow storms. While there, I was asked to serve on their Patient Advisory Board.

February

I met up with Pompe peep Karen who was in town visiting friends. Karen is a Pompe trail blazer in her own right. While I may have been the first Lumizyme patient, Karen was one of the first adult patients to receive enzyme replacement therapy through clinical trials years before Lumizyme received FDA approval.

March

I returned to Boston for a Patient Advisory Board meeting at Genzyme. After the meeting my friend Vanessa flew in to join me, and we spent the weekend exploring Boston together. Later that month I ventured to Europe with my friend Lonnie and her sister. While in London, I had the privilege of meeting up with 3 Pompe patients from the area.

April

I spoke at patient meeting in Atlanta, Georgia for Genzyme. The trip to Atlanta also gave me a chance to visit with my friend Lonnie at her home in Athens….during a tornado warning.

May

Genzyme flew me to Washington DC to speak to members of Congress about the importance of biotech research and development. After all this “hard” work, it was time to relax for a bit, so I took a two week transatlantic Disney cruise from Florida to Spain.

June

I spoke at a patient meeting in Tampa, Florida for Genzyme.

July

I spoke at patient meetings in Los Angles and San Bernardino, California for the United Pompe Foundation. While in California, I met up with some friends at Disneyland.

August

I headed back up to Gainesville, Florida and Shands at the University of Florida. I am participating in a long term study for Dr. Bryne. I also enrolled in a respiratory study that allows me to try and improve my breathing by using a respiratory trainer. I’m always willing to try something new, so Dr. Byrne got me up on a treadmill while in a harness. It was sort of an experiment to see of there was any possible research or therapeutic value in this type of approach to exercise.

September

I was asked to appear on the Muscular Dystrophy Association’s annual telethon again. Over the summer I visited with two of the hosts at their radio station and pre-taped a segment for the telethon. They aired the segment and also interviewed me live the day of the telethon.

About 20 of my friends from the transatlantic decided they wanted to do the return trip, so I joined them. We all met up in Spain and took another two week Disney cruise all the way back to Florida.

October

The Lysosomal Disorder New Zealand patient group flew me to Wellington, New Zealand to help with their campaign to secure treatment for patients there. I spoke with members of Parliament, the media, and the head of PHARMAC. The battle continues in New Zealand as we head into 2012, the Pompe patients there desperately need enzyme replacement therapy and soon.

When I returned from New Zealand my own infusion was delayed due to paperwork. Why don’t pencil pushers realize how critical this treatment is to our survival?

I also spoke at a patient meeting here in Orlando along with several specialists from the University of Florida, including Dr. Byrne. The meeting was hosted by the Muscular Dystrophy Association through an educational grant from Genzyme.

November

It was uncharacteristically quiet which turned out to be a good thing as my health really started to decline as I waited for my next infusion. I ended up going 4.5 weeks without Lumizyme and I really felt horrible. The pain in my muscles as well as the headaches returned. My respiratory function even declined, which was a huge step back for me. When I finally received my infusion, I could immediately feel the difference. I’m back on track with regular infusions, but missing just that one really took a toll on me. I still don’t think my respiratory function has returned to where it was before my missed treatment.

I met up with Dr. Byrne at Downtown Disney and I invited to join Brad, Allyson, and me at the Magic Kingdom the next day. Dr. Byrne was in town for a conference but was able to sneak away long enough to spend a few hours playing with 3 of his lab rats….er, Pompe patients.

December

Allyson came down to Walt Disney World and we attended Mickey’s Very Merry Christmas Party.

A couple of days after the party I was on a plane to California. It was a spectacular Christmastime celebration at Disneyland with friends from elementary school, high school, and college.

Allyson’s family from New Zealand arrived at the end of the month. We passed the time waiting for their flight to arrive at Downtown Disney where we ran into Pompe celebrity/hero John Crowley!

When I was actually in town, I had several visitors, many of whom I had met on my Disney cruises. Friends from all all over the United States, Canada, Australia, New Zealand, and England visited the “the House of Mouse” and me this year.

Perhaps 2012 will be filled with even more opportunities to advocate for patients. I mean, how many people really get the chance to make a difference in the lives of others?

It was my hope to return to work in 2012, but missing just one Lumizyme infusion set my recovery back more than I had expected. Time will only tell what the future holds for me.

What I do know, is there’s a lot of hope on the horizon for Pompe patients. The next generation of enzyme replacement therapy is currently in human clinical trials and a chaperone drug is about to enter human trials. Additionally, there is the amazing work Dr. Byrne is doing in gene replacement therapy which is also in human trials and is showing great promise for our younger Pompe warriors.

2012, the Year of the Dragon….how appropriate. Keep fighting!

The Kiwi Report

After nearly 30 hours of traveling, finally arriving in Wellington, New Zealand!

I’ve spent the entire week trying to recover from jet lag from my 30 hour journey back from New Zealand. Twice this week I have watched the sunrise. Between the long flights, long layovers, and of course the time difference, I have been struggling to get back on a normal schedule. But it was all worth it because I got to spend in a week in New Zealand playing a small part in the fight for Pompe patients’ right to receive enzyme replacement therapy (ERT).

In New Zealand they have a government run department called PHARMAC. Since New Zealanders are “entitled” to “free” health care it is important to keep the costs down so treatment is available to most of the people. There are 4 million people living in New Zealand and 5 of them are currently dying from Pompe Disease, even though there is an effective treatment available – ERT. PHARMAC feels this treatment is too expensive, so the Pompe Kiwis go without. Applications made by patients and doctors for the approval of ERT have been denied with PHARMAC stating that although patients would probably benefit from the treatment, the price is just too high.

However, I believe the public feedback PHARMAC received from stating the price was too high forced them to retreat and bring the question of efficiency to the table. The ugly public backlash and slew of angry letters has mysteriously gotten PHARMAC to now say they are not sure how effective the treatment really is, that there is not enough evidence proving it does any good. They are now saying that what improvement may be experienced, is just not enough to justify the cost. I feel they know this treatment works, but had to bring cost back into play to justify denying this treatment to the patients, as placing the sole reason for denying treatment on the cost proved to be very detrimental to PHARMAC and the government – in an election year.

With a member of the New Zealand press in front of Parliament's famous Beehive building.

I was asked to join Lysosomal Diseases New Zealand’s (LDNZ) campaign to try to once again get funding for ERT approved. The day after I arrived I met up with some folks from the LDNZ, the Muscular Dystrophy Association, and 3 of the local Pompe patients. We headed up to Parliament where we met up with a journalist from Radio NZ. We passed through security and approached the reception desk. John, from the LDNZ put in a request to meet with Prime Minister John Key. During his last campaign, John Key, had promised to make orphan drugs accessible to New Zealand patients. That hasn’t happened and he is on the eve of another election, so it seemed like a great time to ask him about this seemingly forgotten campaign promise. We knew the Prime Minister was not in the building because he was attending a funeral elsewhere. It was our hope that a member of his staff would meet with us. The receptionist told us that a member of the Prime Minister’s staff would be down to meet with us shortly. We waited in the lobby and the reporter from Radio NZ interviewed us individually. Note: she kept her recorder running the whole time and captured everything, including the receptionist confirming with the Prime Minister’s office that someone would be down to meet with us. After waiting about 20 minutes or so, a security officer came over to speak to us. He informed us that no one from the Prime Minister’s office was coming to meet with us and that we had to leave. What? We were not causing a scene and this was a public building…oh, and we were just told that someone was coming to meet with us. The security officer was adamant that no one was meeting with us, and that we had to leave immediately. It became a sort of stand off between us and the young security guard. We were in a public building and we did have an appointment in a few hours with a member if the opposition party, Grant Robertson. The security officer then made some phone calls and came back to tell us that Grant would see us right away. We were escorted out of the Beehive lobby and into the adjoining building where Grant met with us.

From left to right, Laurie (patient), Grant (MP), Frieda (patient), Jenny (from LDNZ), Marty (from the MDA), Me, Dean (patient).

Grant is the MP for Wellington Central, Spokesperson for Health and Associate Spokesperson for Arts, Culture & Heritage. Grant listened to us as we relayed the mornings events and he apologized for how we were treated by the Prime Minister’s office. He was very interested in hearing how I had benefited from the treatment, how it was administered, and how much trouble I had getting my insurance to cover it. I told him how over 50 other countries have found a way to make this treatment available to patients. Grant encouraged us to continue to try and get in with the PM’s staff, specifically his Health Advisor. If Grant’s party were to win in the election, he would most likely become the new Health Minister, replacing Tony Ryall. He confirmed our theory that Tony Ryall couldn’t really do anything about the matter, that change would have to come from either PHARMAC or the Prime Minister as the Health Minister is bound by legislation that doesn’t give him the power needed to approve this treatment.

Radio NZ aired the piece about us getting turned away at Parliament on their noon broadcast. This immediately got us more media attention. The next day we met with producers from two television stations. They filmed us outside the Parliament building which brought on the attention of several security guards, but no one asked us to leave. They interviewed each of us, and again a special interest was taken in how well the treatment is working for me.

That afternoon LDNZ and the New Zealand patients hit the phones and started talking to their local media contacts about the situation. I called PHARMAC and tried to secure an appointment with their Medical Director. After talking to several people in his office, his assistant called Jenny from LDNZ back and said he would be willing to meet with me – but that they are aware of what we are doing with the media and we are not to allow the media to follow us. We agreed and the meeting was set up for the next morning.

Jenny and I arrived at PHARMAC several minutes before our meeting and waited. I was armed with my own medical data as well as data from two other Pompe patients who are being treated with ERT. The data showed stabilization and improvement of our respiratory functions. I also printed out a copy of the LOTS study.* Despite several warnings from others who had encounters with him, PHARMAC’s Medical Director Peter Moodie was very personable to us. Jenny was very surprised. I detailed how poor my health was and how fast I was dying before treatment and how much my condition has improved with treatment. Even he said my improvement was remarkable. I gave him my test results along with those of the two other patients which he showed a great deal of interest in. I stressed that this treatment needs to be approved for the New Zealand patients as soon as possibly, because they will just continue to decline and ultimately die of Pompe Disease without it. He asked if I had known about any problems in America with getting insurance to approve it, I told him that sometimes the insurance company would just need a little persuading from the prescribing doctor. For the most part, American patients can get access to the treatment. He asked if anyone was monitoring my progress as part of a long term study – yes, Dr. Byrne and the University of Florida will study me for the next 5 years at the very least. I told him that the New Zealand patients cannot afford to wait for these long term studies, that the long term studies in mass don’t exist, “I am the long term study.” He tried to express his understanding, but that he had a responsibility to all the people of New Zealand. Basically, he couldn’t blow PHARMAC’s budget for just a few people. It made it sound like Allyson, Frieda, Dean, and Laurie were just casualties of war. I told him that he better figure out how to fund treatments for rare diseases because more will be coming to market and it is inexcusable for the government to continue sentencing their people to death over a price tag. He thanked me for my time and for sharing my story with him. He invited me to send whatever data I could gather to him to help prove that ERT is effective. When I arrived back home, I sent him another publication sent to me by Dr. Byrne along with a couple of letters supporting the benefits of ERT from two doctors in England. PHARMAC only responds to data, and unfortunately there is not a whole lot out there, but I know that is not the real issue – the real issue is cost.

With all the money they spent on Happy Feet the penguin and not to mention the Rugby World Cup – don’t cry broke with me then go on a shopping spree with tax payer money, only to refuse to spend tax payer money to save the lives of those tax payers. It became very clear during the course of this meeting that PHARMAC’s model is not set up to process high cost treatments for rare diseases. They do an excellent job at keeping the cost of drugs down for the masses, such an excellent job that other countries are looking to copy their model.

What needs to happen is either the Prime Minister needs to overrule PHARMAC’s decision to decline ERT, like he did with Herceptin (the breast cancer drug) or a new department needs to be set up to deal with treatments like this.

So where do we go from here? We will continue to play PHARMAC’s game and supply them with the data as it becomes available. LDNZ will ride the media wave we started and continue their campaign in the media and with Parliament, using the election to put pressure on the Prime Minister‘s office. Angry letters to PHARMAC and the Health Minister will be useless as neither can approve funding under the current model. Plus, PHARMAC is only set up to make decisions using data. I took 26 letters from the patient community supporting ERT and it was like I was offering to put hieroglyphics in front of these people. They don’t understand hieroglyphics, they only understand data. A new department for handling this type of situation needs to be formed, this is also within the Prime Minister’s power – and quite frankly, his responsibility to the people he represents as this was a campaign promise. If the Prime Minister continues to ignore his own campaign promise, then we need to take the long way around – the slow and steady route of getting a new department formed by way of a Member of Parliament, (like Grant, for example) sponsoring a piece of legislation and having the other Members vote on it.

I will gather all the media links from my trip and post it in one spot. I will also write up an entry on the non-business related activities I enjoyed while in New Zealand, you know the fun touristy stuff!

 *From the New England Journal of Medicine, Vol. 362, No. 15, April 15, 2010, A Randomized Study of Alglucosidase Alfa in Late-Onset Pompe’s Disease, A. T. van der Ploeg and Others.

Summer Rewind

Pompe Peep Brad, my Uncle Gary, me, my Aunt Jan, Pompe Peep Allyson, and my Dad at Epcot

Life is never dull and the last few months have been crazy busy. So crazy busy, that I am ridiculously behind on updating my blog. I have been traveling and entertaining guests here in Florida as well. I will do my best to catch every one up on my comings and goings… but offer no guarantees. Hold on tight because here we go…..

Since I last blogged, I have attended a couple of patient meetings. One in Tampa for Genzyme, which was a nice relaxing dinner meeting. Just me a couple of the cool peeps from Genzyme and two other Pompe families. I also spent a couple of days in California. The United Pompe Foundation  invited me to speak at their meetings in Los Angeles and San Bernardino. This gave me the opportunity to meet with some new Pompe folks as well as get caught up on all the research that is being done by Genzyme, BioMarin, and Amicus Therapeutics. The United Pompe Foundation had a great line-up of presenters, including a representative from Medic Alert. We have been working on coming up with the ideal text to put on a Medic Alert bracelet that can be understood by EMTs and emergency room doctors….all in only 75 characters. There is a lot to tell a medical professional in just 75 character, especially taking in to account that many will have no idea what Pompe is. We are closing in on text that all involved can agree upon and when that is settled I will post the information here.

With my friends Robyn and Matt at Disneyland!

Since I was flying all the way to California, I decided to extend my stay by a couple of days to catch up with some friends and hit up my old stopping grounds – Disneyland. Disneyland was where I spent most of my childhood and teenage years, it was the location of my first job. I worked at the restaurants in Fantasyland when I was in high school. The weather was great, I made new friends at the meetings, met up with old friends, got to enjoy In-N-Out and Disneyland – all in all, a wonderful trip.

Back home in Florida, I have had lots of visitors….well, I kind of had to share them with Mickey. It was like a rotating door of visitors. Family, friends from the transatlantic cruise, friends I used to work with, Pompe friends, and of course my most frequent visitor Lonnie. It never gets old showing people around Walt Disney World. Everyone should visit at least once in their lifetime.

With my cruise buddies playing trivia. Our "Smarticle" hats helped us win!

Speaking of cruise friends…a bunch of us got together and decided the first transatlantic Disney cruise was so much fun that we needed to do it again! So me and 20 or so of my closest and craziest cruise buddies headed to Barcelona, Spain in September for another 2 week adventure at sea onboard the Disney Magic. It was wonderful! Another adventure I highly recommend….take a long cruise once in your life. With all the hustle and bustle of our daily lives, it is nice to get on a cruise ship for two weeks and just let someone else take care of all your needs. And for those of you playing the home game, yes, that means I have spent 35 days on a Disney cruise ship in one year.

And now we transition to my latest adventure. On Saturday I will board a plane for the longest plane flight of my life – yes, longer than when I was flying to China from Las Vegas. I will fly from Orlando, Florida to Wellington, New Zealand. I have been asked to help the Lysosmal Diseases New Zealand (LDNZ) patient group with their campaign to secure funding for enzyme replacement therapy. I don’t know yet, exactly what they have in store for me, but I know it will involve the media and they are trying to secure meetings with political leaders. I will meet up with 4 New Zealand Pompe patients and we will do our best to convince the powers that be that ERT is life saving and it does make a difference. How can they stare ME in the eye and tell me it doesn’t work?

How can you help?

If you or someone you know has benefited from ERT for Pompe Disease, please let me know. Leave a short, but detailed comment about how ERT has saved and improved your life. I will take all these with me and share them with whomever will listen. I will be arriving in New Zealand on Monday and we will be hitting the media circuit on Tuesday, so please try to submit your testimonials over the weekend – while I am enduring the longest flight of my life. But it will be worth it if we can get them to approve ERT for our Kiwi friends.