- Joined
- Jun 13, 2016
Actually Rett is fucking terrifying because they are aware of how sad their situation is. It's better to think of it like an extreme form of Parkinsons than mental re.tardation.
A hefty percentage of them have no mental impairment, in the sense that they can understand what is going on. They just can't coordinate meaningful movements so speaking, signing, writing, pointing, anything that looks like communication to most people is out of the question. Even breathing can be difficult and they have these crises where they can't coordinate the movement to breathe properly and will involuntarily hold their breath or hyperventilate.
However, it's been shown that if they're treated like other children their age and instead of like potatoes, they can understand spoken language as well as or almost as well as their non-Rett peers. Some of them even learn to "speak" through eye gaze computers, like this little girl, although these things are prohibitively expensive.
The exception is usually the girls who have comorbid problems that take their own toll on mental development. Most of the ones that are truly intellectually disabled present with microcephaly from birth or intractable epilepsy in infancy, whereas other girls will be born totally normal but their head growth will slow and seizures develop as they age.
The second terrifying thing about Rett is it is progressive and goes through stages. They start off normal and hit all their milestones, including learning to walk and speak, then start to decline sometime between their first and second birthday (some earlier). At first it looks like autism; they might wring their hands frequently and have difficulty with eye contact and they start to miss milestones. Sometime around age 3 they'll start to rapidly decline. Usually the first thing to happen is they lose all control of their hands. Their hands just do all sorts of crazy shit they can't control like they'll look like they're washing them over and over and over again or they'll clench their fists behind their back and not be able to move them. They lose language, they lose the ability to walk, the terrifying breathing crises start, they cry or scream inappropriately and uncontrollably, etc.
Then it levels out and, with seizure control and a lot of PT, can improve. This is the stage cute little Maggie up there is in. She has learned to balance and coordinatewell enough to surf and skateboard and is able to create increasingly complex sentences through her eye gaze computer. Her parents are kind of amazing human beings and I've been in contact with them a few times in the past through Rett events. When there's something she wants to do that isn't yet adapted for her impairments, her dad finds a way to make it happen.
However, barring some breakthrough (and there's some really promising shit happening in the research world right now so it could be on the horizon), even ones who make remarkable strides like girls with the Zapella Variant (who can regain language skills after the rapid destructive phase) don't live very long and continue to decline in age. They enter a slow regression stage after usually a prolonged stabilization/improvement phase. Most only live into their 30s, 40 at best. Many die very suddenly of cardiac arrest from arrhythmias or GI obstructions caused by failure of even involuntary movements.
And the third terrifying thing is it's a de novo mutation in almost every case, meaning it's not something parents can predict. On the plus side it means the odds of having two girls (and they're almost all girls because boys with the mutation tend to die instead) with Rett in the same family are slim. On the other hand, since the parents aren't carriers of the mutant gene it's not like they can decide not to have kids because they don't want to risk that they bring someone with this awful condition into the world.
Edit: Ah, fuck, I just checked out Maggie's dad and she's starting to regress again. Lost seizure control and can't coordinate eating and drinking anymore so she's schedule for a PEG. Fuck this disease in the eye socket.
I think the absolute cruelest diseases are the ones that strike babies after all seems well. Parents worry during pregnancy and birth about diseases but once they go home from the hospital with an infant given a clean bill of health they feel safe. They bond and fall in love with the baby and start watching it grow and learn and then find out something is horribly wrong and their child is going to suffer and start losing abilities? I really don’t know how some parents manage, it’s got to be the most gut wrenching pain imaginable.
I have all the empathy in the world for parents who are hit with a unexpected and tragic diagnosis of an infant or toddler. These parents had no warning, were hit with an unimaginably tragic diagnosis and now do the best they can for their suffering child.
It makes people who do find out about terrible diseases during early pregnancy, and chose to continue it, all the harder to understand. But ofc most of the people who make such choices are extremely religious. They package it now as “God’s plan” but last century they were more up front with the we are “born to suffer” shit that seems far more appropriate to these cases.
That's seriously one of the most terrifying disorders I've ever heard of.
Oh, there’s plenty of them. Ever hear of Tay Sachs disease?
A author named Emily Rapp Black wrote a book “The Still Point of the Turning World” about losing her son to Tay Sachs disease. Tay Sachs is one of the worst disease imaginable, always fatal, terrible pain and debilitation and only discovered after a healthy baby suddenly starts regressing. It’s associated with Jewish populations and there are genetic prenatal tests for it now. But Emily, who was mostly Irish as was her husband, even had the genetic screening but she had a rare mutation that wasn’t detected. The book is beautifully written but I couldn’t finish it - it was too painful to read about so I can’t fathom how parents live through it.