Parents hope 2-year-old child gets into experimental trial

Morgan Saville, 2, spends two hours per day in an apparatus that helps her muscles stave off the effects of spinal muscular atrophy. BILL TIERNAN/THE VIRGINIAN-PILOT

 
By ELIZABETH SIMPSON, The Virginian-Pilot
© August 13, 2005


The milestones in the life of 2-year-old Elizabeth Morgan Saville differ from most girls her age:

There’s the purchase of her first wheelchair. The trip in the ambulance after she stopped breathing and turned blue on an Outer Banks trip. The night of a fund raiser last fall that gathered thousands of dollars to help find a treatment that could help the Virginia Beach girl live longer.

Morgan has blond hair, blue eyes, a winsome smile and a genetic disorder called spinal muscular atrophy. The condition causes nerve cells in her spinal cord and brain stem to degenerate. That, in turn, leads to muscle weakness.

For her first eight months, she looked perfectly normal. Then she started showing signs of the disease. She had a hard time sitting up. Her limbs turned floppy. When other children her age were crawling and toddling, she wasn’t. Just lifting a sippy cup was a chore.

To understand why the disease steals lives early, imagine all the things muscles are used for: Coughing. Swallowing. Breathing.


 
Morgan Saville today.

To learn more about Spinal Muscular Atrophy:

- Families of Spinal Muscular Atrophy: www.fsma.org

- SMA Support Inc.: (Includes information about the 2005 SMA Support Inc. Family Gathering in Virginia Beach from Aug. 19 to 21): www.smasupport.com

- Morgan Saville and the local Fight SMA chapter: www.our-sma-angels.com/morgan/

Background: January 2004 profile
A simple cold can kill.

Morgan will turn 3 in October, and her parents, Stacy and Bill Saville, hope her next milestone will be enrollment in clinical trials of medications that could stave off further erosion of her muscles. The trials – called Project Cure SMA – test two medications, valproic acid and carnitine, on children 2 to 17 years old with SMA.

It’s not a cure, but researchers hope it can stabilize and even strengthen some children, to buy them time until more effective treatments – say, stem cell or gene therapy solutions – are discovered.

One in 6,000 children is born with SMA, the leading genetic killer of babies and toddlers. There are different types of the disease, the worst of which can cause children to die within a few years. Morgan has a less severe Type II of the disease. These children sometimes live into adulthood, but some die sooner when weak chest and respiratory muscles lose the battle of fighting infections.

As soon as Stacy found out her daughter had the disorder, she recast her life. She abandoned plans to return to her accounting profession and instead threw herself into advocacy groups to help find cures for the disease. She founded a local Fight SMA chapter called “Morgan’s Buddies” to raise money for research. She got involved with SMA Support Inc., which helps families across the country with education, support, equipment and medical costs.

On Aug. 19 to 21, about 30 families of SMA children will convene for a national “Family Gathering” in Virginia Beach that Stacy helped organize. Because a small number of children in any given area have SMA, families rely on a national network of families for support and education.

“So much of this is trial and error,” Stacy said.

The families also track the latest research. Children with SMA have a malfunctioning gene. Normally, that gene produces proteins necessary for the development of motor neurons, which power muscles for activities such as crawling, walking, swallowing. Researchers are trying to figure out how to increase production of those proteins.

Right now, Project Cure SMA, which began at the University of Utah under the approval of the federal Food and Drug Administration, is generating a lot of discussion among SMA families.

Morgan is on the list of children who meet the criteria for the second phase of the clinical trial, so her parents are eagerly awaiting news of whether she will be one of the children who will participate at six sites in the U.S. and Canada . Children started being selected in July, and the site the Savilles chose – in Detroit – is scheduled to make selections as soon as next week.

The first phase of the trial, which tested safety, has already been conducted, according to Connie Garland, a genetic assistant at Indiana University who is helping to link the study’s researchers with SMA subjects.

The second phase will focus on effectiveness.

Some, but not all of the children showed improvements during the first phase. Generally, the younger children did better, because the disease had not progressed as far.

Because Morgan is only 2, the Savilles believe the treatment will help her.

In the meantime, Stacy directs a mini-boot camp of sorts for Morgan in their Lake Smith Terrace home, using thousands of dollars’ worth of equipment to keep Morgan’s muscles limber and toned.

A machine helps her to cough. A special vest – Morgan calls it the “shake and bake” – vibrates her chest to force air out of her lungs. Morgan can’t walk, but she stands in an apparatus that puts her in a standing position for two hours a day. Stacy hopes to work up to three.

A physical therapist and an occupational therapist come once a week, giving Stacy exercises to do every day with Morgan to work her muscles. Morgan also does exercises in a pool for an hour and a half a day.

It’s not easy for Stacy to be coach to her own 2-year-old. She wonders whether Morgan ever feels like she’s picking on her. But she keeps on.

“I just want to do the right thing for her,” Stacy said. “I have tried to keep her flexible, keep her hips stretched out. I am constantly trying to figure out what I should be doing.”

When Morgan got tired of counting up to 10 doing her repetitive exercises, Stacy switched to Spanish. Now the little girl knows her numbers in both languages.

Recently Stacy enlisted Morgan’s 3-year-old brother, Clayton, to help her with Morgan’s exercises to keep the experience fresh.

Morgan’s cognitive and verbal skills, meanwhile, surge ahead. They are right on track, even ahead of most children her age. She enjoys playing with her brothers, Clayton and 12-year-old Zeke, reading books and being outside.

She laughs and smiles a lot.

She’s getting old enough, though, to know she is different. Her two older brothers like playing basketball, and Morgan wants to play, too.

One day when the family was out playing, Stacy called to her, “Come on over, Morgan.”

Morgan couldn’t get the joystick on her wheelchair to work, because her arm muscles are weak.

“I can’t,” she called back.

The two-word sentence still sticks in Stacy’s mind.

Stacy still hopes that her daughter will someday walk, though she knows it’s a long shot.

If the experimental medications can just slow progression of the disease, help Morgan cough stronger, talk louder, breathe easier, Stacy will be happy.

“Even an ounce of strength would be better, ” she said.

Some of the children in the study will initially not receive the real medication. However, later in the two-year study, all the children will get the combination of drugs.

If Morgan is chosen, she will need to go to Detroit every two or three months, for several days.

Morgan sat on her mother’s lap as Stacy talked about the trials, interrupting at one point to softly say, “That chair.”

“Which chair?” Stacy asked.

“That chair.”

“Which chair are you talking about. This one?”

Stacy pointed to the one next to her.

Morgan nodded.

She wanted to sit on her own instead of her mother’s lap.

So Stacy sat her in the chair. A few minutes later, Morgan teetered to the side, and Stacy sat her back up, like a doll.

She wants her independence, Stacy noted.

That’s one milestone that’s right on time.

Reach Elizabeth Simpson at (757) 446-2635 or elizabeth.simpson@pilotonline.com.