Saturday, January 10, 2015

Fighting – and writing – to stay healthy: ten years of 'At Risk for Huntington’s Disease'

Ten years ago today, I launched this blog to explore the depths of living at risk for Huntington’s disease and to unburden myself of the fear of its inevitable symptoms.

Frankly, I did not expect to still be writing at 55.

At that age, my mother had developed chorea (the involuntary movements associated with HD) and was experiencing serious emotional and cognitive symptoms that would soon prevent her from speaking and caring for herself. This year marks the sad 20th anniversary of her official diagnosis. She died of HD in February 2006 at the age of 68.

I tested positive for the HD genetic mutation in 1999.

I strongly believe that my work on this blog – research, reflection, writing, advocacy, and networking – has helped me delay my own HD onset.

I cannot scientifically prove this, but evidence strongly suggests that mental stimuli and other forms of enrichment can positively affect the course of this disease and other neurodegenerative conditions.

Researchers have told me privately that they believe my mental activity has helped keep me stable. “Keep doing what you’re doing,” they say.


Gene Veritas with his tenth anniversary blog posting (photo by Gene Veritas)

Launching the blog

Life can be an emotional roller coaster. HD families ride the tallest and most twisted one, with HD gene carriers like me facing a terrifying descent into symptoms.

Starting in 2001, I wrote and edited Conquest, the tri-annual newsletter of the San Diego Chapter of the Huntington’s Disease Society of America. However, while revealing the stories of many HD-affected individuals and their families in Conquest, I never wrote about my own family’s plight.

I started At Risk at the urging of Norman Oder, a fellow Yale University graduate and colleague at the Yale Daily News.

As a young journalist in the 1980s, Norman by chance wrote an article about a New York area HD family. After we reconnected years later, he edited some of my Conquest articles. Coincidentally one told the story of that same family, part of which had moved to California.

In the early 2000s Norman and I brainstormed about how to increase media coverage of HD, including my own story, as a way to strengthen the cause and attract potential donors.

With that goal in mind, I initiated the blog to address the many complex issues faced by presymptomatic mutation carriers like me as well as untested at-risk individuals.

I didn’t realize at the time how much it would help me sort out my thoughts, engage with others in the HD community, and nudge HD activism. In February 2011, I examined this blog as an advocacy tool during my keynote of the Sixth Annual HD Therapeutics Conference, sponsored by the CHDI Foundation, Inc. In June 2011 I was named HDSA’s Person of the Year, an honor I never could have achieved without this forum. “I know, too, that this award is not just for me,” I wrote, “but for everybody affected by HD: the at-risk, the gene-positive, the symptomatic, the families, and the unsung heroes of America, the caregivers.”

From the start, Norman has applied his editing skills to virtually every article, almost always sending back revisions within a few hours. He has also suggested a number of topics and pushed me toward rigor when it’s tempting to just hope.

Norman is my “HD alter ego,” and a great friend.

(Later in 2005, Norman began his own long-running blog, a daily account of Brooklyn’s most controversial real-estate project, now called Atlantic Yards/Pacific Park Report.)

A stalwart supporter of my activism, my wife Regina has reflected with me on the content of numerous articles. Our daughter Bianca has witnessed me writing and posting articles. Now a teenager, she has a record she can consult of her grandmother’s demise and her father’s writing and coping strategies.

Explicitly and implicitly, Regina and Bianca permeate the pages of this blog. More than anything else, their presence and love motivate me to fight HD and to improve as a husband, father, and human being.


Gene Veritas (left, aka Kenneth Serbin), Norman Oder, and Regina Serbin (photo by Bianca Serbin)

Bringing hope

In that first year (2005), I wrote 17 articles. However, over the next three years I could only write 18 articles. I was distraught over the death of my mother from HD. I even acted out HD symptoms.

During those first four years, I focused primarily on my family’s struggles to care for my mother and how living with the gene affected my feelings and life.

With the help of my psychotherapist and a more effective set of medications for depression and anxiety, I started to turn the corner in late 2007.

In late 2007 I also wrote my first blog article about the potential of stem cell research for finding HD treatments. Along with other southern California advocates, I set up the very first presentations about Huntington’s disease before the state’s stem cell agency.

From that point on, the hope for treatments buoyed me emotionally and became a frequent theme of At Risk for Huntington’s Disease.

Expanding the research updates that I wrote for Conquest, I started doing on-the-scene reporting and in-depth interviews with researchers. In April 2008, I visited Isis Pharmaceuticals, Inc., in nearby Carlsbad, CA, to produce an article on the company’s ambitious efforts to stop HD very close to its genetic roots.

This year Isis will conduct the long-awaited Phase I clinical trial to test its potential gene-silencing drug.

Broad coverage

The blog expanded to cover many of the difficult issues impinging on the HD community, including abortion; advocacy for a congressional bill to update the government’s disability criteria for HD;  the difficult discussions young at-risk people face during dating; and the challenges of finding adequate nursing home care for HD patients.

I really absolutely admire your bravery in exposing this disease in a realistic and unapologetic way,” wrote Stella, another HD blogger, in a comment on one of my articles. Such comments help keep me going.

Writing the blog helped me think through the process of going public about my HD status after nearly 15 years of advocating anonymously and seven years of blogging under the pseudonym “Gene Veritas,” which I maintain as a symbol of our community’s fight for the cure.

Now, as I meld my HD advocacy with the career of Kenneth P. Serbin the professional historian, I have come to view the blog as a primary historical document of the “new and harrowing human experience of living in the gray zone between a genetic test result and onset of a disease.”

An emotional vent

Above all, the blog is an emotional vent.

With you, my readers, I can share my feelings about facing a terrible, currently untreatable disease, build forces to defeat the profound stigma surrounding HD, and bolster advocacy to improve care and seek the cure.

Through At Risk for Huntington’s Disease – and the HD community I have reached on Facebook – I have gained many new brothers and sisters determined to survive HD and passionate about the noble aim of bettering humanity by solving a major medical and scientific puzzle.

Often, producing articles for the blog envelops me for hours and sometimes days as I research, travel, photograph, shoot video, write, revise, and post, and then engage with readers via e-mail and social media.

Sometimes I go to bed too late – not good for someone at risk for a disease that disturbs the body’s natural rhythms.

As I prepare to post an article, I experience a torrent of emotion, followed by a deep sense of relief.

The memories of twenty years of dealing with HD come flooding back, but in the end I have hope.

Awaiting effective treatments

This article is posting number 197 in At Risk for Huntington’s Disease.

I am grateful that very soon I will be able to post number 200.

Tonight I will raise a glass to the blog.

I know it’s still a long shot because of the inevitability of HD symptoms, but I want to remain healthy long enough to write the article celebrating the discovery of a treatment so effective that I can stop worrying about HD and retire the blog.

Tuesday, January 06, 2015

Police killing of man with Huntington’s disease spotlights need for affected families to emphasize proactive, dignified approach

The shooting death of a Philadelphia-area man apparently suffering from Huntington’s disease, which perhaps led him to try to run over police officers with his car, has once again raised the perilously common issue of how police misunderstand HD.

Beyond prompting anger and the need for better police preparation, the death of Joseph A. Pacini can also stir the HD community to combat the stigma of the disease, redouble efforts towards treatments, and emphasize the dignity of affected individuals.

According to reports in the Philadelphia Inquirer (click here and here), Pacini, 52, died Dec. 30, 2014, in a town near Philadelphia after officers from three departments fired at least 22 shots, wounding him in the head, neck, shoulders, and chest.

Pacini’s one-time girlfriend and a close friend told reporters that he suffered from HD. Family members said that Pacini’s father, who had HD, committed suicide when Pacini was 21.

For the second time in less than four months, the incident raised the issue of police response to HD-afflicted individuals. In September, police in the small town of Westover, WV, held down Jeffrey Bane for nearly ten minutes after he clashed with officers; he struggled to breathe and pleaded for help. A bystander captured the scene on video (click here to read more).

Investigators in the Pacini case are conducting tests to confirm his HD status and whether he was using drugs and/or alcohol. The local district attorney is also investigating the justifiability of the shooting.

(Sadly, most media reports missed the HD angle. One, in the New York Daily News, reinforced the ignorance and stigma surrounding neurologically and mentally impaired individuals by poking fun at Pacini and referring to him in tabloid parlance as a “sicko.”)


Joseph A. Pacini (from his Facebook page)

A volatile situation

According to the Inquirer, Pacini led a troubled life, failing to finish his college studies, posting conspiratorial and threatening YouTube videos, and fighting with his mother, the police, and others.

“[HD] is very often confused with schizophrenia, especially with those who do have the mental disorder predominant in the beginning," Louise Vetter, CEO of the Huntington's Disease Society of America (HDSA), told the Inquirer. She said that HD can involve "paranoia, anxiety, really, really strong fixation on things.”

“HD does not fit well into the norms of society,” advocate Jonathan Monkmeyer, a Philadelphia-area resident whose wife Sheryl died of HD in 2009 at 46, said in a Facebook conversation with me. Jonathan did not know Pacini, but as Sheryl’s full-time caregiver for many years he understood the awkward and difficult social situations HD people face.

“This describes another tragic end to a difficult life for a person thought to have HD,” Martha Nance, M.D., the director of the HDSA Center of Excellence at Hennepin County Medical Center in Minneapolis, MN, and the author of the preface to HDSA’s Law Enforcement Training Guide, wrote in an e-mail after reading press coverage of the incident.

It is easy to focus on the police departments’ actions that directly led to Mr. Pacini’s death, and shout for a different approach, criticize the police for ‘not knowing he had HD,’” she added. “But I’m not sure that the presence or absence of HD would necessitate a difference in the officers’ approach to a volatile situation.”

In the Pacini case, mental illness independent of HD seemed to play a role, Dr. Nance observed. She pointed to the “general issue of access to mental health care” as a key factor in such situations.

“In medicine, we believe that the police need to be involved if there are homicidal threats, and we, too, call the police if we feel that we are unsafe or in danger as we see a patient in the clinic or the hospital,” Dr. Nance emphasized.

‘Be more public about HD’

“The other issue, and more relevant to the HD community, is WHAT CAN WE DO to keep our Joseph Pacinis from getting to these kinds of crisis points,” Dr. Nance continued. “And I think the first thing is to be more public about our disease.  HD families, more than anyone else, treat their disease as a terrible secret, a stigma, something to hide and be ashamed of. This creates a mindset that passes through the generations, that HD is like being in a terrible underground tunnel filled only with darkness, and the only way out is suicide, or to emerge with explosiveness and anger.”

By avoiding genetic testing and contact with doctors, HD people “delude themselves into thinking that they are not entering the dark tunnel,” she wrote.

The community needs to stop viewing HD “with hopelessness and despair,” she added.

“What makes a difference is what you do BEFORE you die,” she wrote. “I can tell any number of amazing stories of amazing people with HD and their families who have done amazing things for themselves, each other, the HD community, and the world at large.  There IS life after a diagnosis of HD, but it can’t emerge if you are stuck in the dark tunnel.”

Everybody in HD families can and should to get involved, Dr. Nance observed.

“If you are scared, find a support group, or talk to your parent, sister, cousin, friend, pastor, teacher, or perhaps even your doctor,” she wrote. “If you have a family member who is unconnected, floating out there, undiagnosed, struggling, reach out to them. Bring them to an HD meeting, or have them come with you to YOUR appointment.”

Enroll-HD: proactive participation

I was numbed by the news of Joseph Pacini’s death.

After I had explored the Jeffrey Bane incident and then noted in my most recent article that HD activists had skillfully reacted by building HD awareness at an international police officers’ conference just weeks later, the Pacini incident seemed surreal.

Emotionally, I cast about for a way to react. I concluded that I could do nothing in the case of someone who had already died.

Then, reflecting on Dr. Nance’s encouraging words, I focused on how I could best contribute to the cause: I went for my January 5 appointment to register in Enroll-HD, a worldwide registry and observational study of HD patients, HD gene carriers like me, untested at-risk individuals, family members, and volunteers.

Enroll-HD aims to facilitate scientific understanding of HD, identify potential participants in all-crucial clinical trials, and therefore speed the process of finding treatments. Enroll-HD is sponsored by the CHDI Foundation, Inc., the non-profit virtual biotech focused solely on developing HD therapies.

I recalled what Joe Giuliano, CHDI’s director of clinical operations and the chief Enroll-HD administrator, told me last year: the larger the pool of potential clinical trial participants, the faster trials can take place.

At the HDSA Center of Excellence for Family Services and Research at the University of California, San Diego, I provided a research assistant with information on my health and HD status, answered several health- and HD-related questionnaires, performed a battery of cognitive tests, underwent a neurological exam, and gave three vials of blood, which will be used to confirm my gene-positive status and provide evidence in the search for HD biomarkers (signs of the disease that can be used to test the efficacy of potential drugs).

I also participated in several HD research studies sponsored by the Center of Excellence.


A nurse (above) prepares to draw blood from Gene Veritas for the Enroll-HD study (photo by Ajay Nathan, HDSA Center of Excellence research assistant). Below, Gene Veritas and Ajay Nathan discuss Gene's participation in Enroll-HD (photo by Andrew Herndon, HDSA Center of Excellence).


Striving for a life lived well

During the four hours of testing, I worried that I might someday lose control as Joseph Pacini did.

My thoughts were troubled: what if I act aggressively towards my wife and daughter?

I found strength in Dr. Nance’s concluding observation about the HD-affected and gene carriers:

“A life lived WELL with HD can resonate into future generations just as easily as a difficult life or a terrible death.”

As long as I can, I will strive to defeat HD by assisting in the search for treatments and by spreading awareness and understanding.

Tuesday, December 23, 2014

Six cool L.A. ladies ‘bare the truth’ about Huntington’s disease, highlighting an exceptionally creative year for advocacy

From a pie-in-the-face challenge to documentaries to a plan to light up Chicago in blue, Huntington’s disease activists rose to new creativity in 2014 in their quest to raise awareness.

One of the most ingenious initiatives, #BareYourTruth, materialized as a photograph of six naked women advocates from the Los Angeles area, their bodies partially shielded by placards with the letters C-U-R-E-H-D.

Tastefully sexy but haunting, #BareYourTruth captures an essential issue for the HD community: ill and at-risk individuals like me and our families have struggled to exit the terrible and lonely HD closet, tell the world of our plight, and focus society’s energies on improved care and the search for remedies for this untreatable neurological disorder.


From left to right, Rachel Giacopuzzi-Brown, Angelica Randall, DeAnna DeNaro, Adriana Venegas, Taryn Renau, and Amy Morris O’Keefe (photo by #BareYourTruth)

The goal of #BareYourTruth is to “share the truth about HD,” explained DeAnna DeNaro, 49, a participant in the project. She lost her half-sister Denise DeNaro to HD on February 26.

“There isn’t anything fun about Huntington’s – it’s raw and it’s bare,” said Deanna in a phone interview on December 21. “When you’re naked, it’s a rawness, and you’re showing everything. If you can do that – to talk about something so raw and painful – ‘bare’ means you’re showing everything. We didn’t want to say ‘bare your soul.’ We wanted to do ‘bare your truth.’ Each one of has a truth about Huntington’s. When you talk about the truth, being naked is showing everything.”

Denise was 59 and had two children, now young adults. In 2001 DeAnna’s half-brother Donald DeNaro died at 52. He was believed to have HD. He had three children, today also young adults. DeAnna, Denise, and Donald shared the same father, but Denise and Donald had a different mother, who had HD. Of DeAnna’s five nieces and nephews, only one has tested for the disease. The result was negative. The other four remain untested and at risk.

Cross-country trips to offer care

For more than a decade, DeAnna traveled an average of five times per year from her home in Redondo Beach, CA, to Miami to help care for Denise. During that time, she has served on the board of the resurgent Los Angeles chapter of the Huntington’s Disease Society of America (HDSA), the last three years as president.

“I would go there a month at a time,” DeAnna said. “Each stage that she would enter into, we as a family had to collaborate to evaluate her care and what was the best for her, including her doctors and caregivers.”

As a result of her experience with HD, three years ago Deanna left her career as a manager in the construction business and opened a caregiving business. She will continue in that field when she moves next year to Germany, her husband’s homeland.


DeAnna DeNaro (photo by #BareYourTruth)

The birth of #BareYourTruth

Denise’s death spurred DeAnna to create #BareYourTruth and to recruit other women advocates. 

“I am not at risk for HD,” Deanna said. “It does affect me personally. Those are my siblings, regardless of the fact that we are half-siblings. We were very close.”

The photo shoot (with services donated anonymously by a professional photographer) took place in September. On September 28, a copy of the photograph was auctioned for $200 at the HDSA-LA Team Hope Walk, which netted $76,000 for the organization.

DeAnna witnessed HD for the first time in 1990 when she was 24 and visited Denise and Donald’s mother and an HD-affected cousin in a nursing home.

“It was the most horrific thing I have ever seen,” DeAnna said. “I was in shock. I learned very quickly that I wouldn’t be able to help my sister. It was obvious. I would be watching my sister suffer and die from this disease, which she did. Taking care of my sister was extremely challenging. I feel compelled to do this, now that my sister is gone.”

Reactions to nudity

DeAnna at first worried whether the photograph was an appropriate form of advocacy.

“I wasn’t sure of how that was going to be perceived,” she confided. However, she quickly adopted a “don’t care” approach because of the urgency of the HD cause.

“We kind of threw this picture around to a lot of people to see what they would say,” DeAnna said. “Not one man said anything sexual about the photograph. And I think they were being honest.”

So far, Deanna has gotten only positive feedback: “If you look at the faces, it’s so gratifying to see the combination of the pain of HD and our determination to do something about it. I think people are seeing that. They are reacting to what they see in the photograph, not that we’re naked. Talking about Huntington’s disease can be very difficult for many people. That’s how #BareYourTruth came out.”

DeAnna’s and fellow advocate #BareYourTruth advocate Rachel Giacopuzzi-Brown’s husbands at first balked at the idea but, after seeing the photo, “totally loved” it, DeAnna said.

A terrifying reality

In early October the women set up a #BareYourTruth Facebook page, where each has explained her connection to HD. Each has added a phrase to the hashtag #BareYourTruth that reflects each's personal story and its broader meaning for the HD community.

“I think there is still the part of me that is terrified to know the truth for fear that I wouldn't be strong enough to handle it,” Adriana Venegas wrote about her decision to test for the HD gene. “#BareYourTruth, even if it terrifies you.”

On November 3, Adriana received her result: she tested positive for the gene. In an e-mail, she told me that she is still mentally processing the result.

You are my sister in HD,” I wrote her. “I am gene-positive, too. I am here for whatever you need.”


Adriana Venegas (photo by #BareYourTruth)

Seeking media attention

“I am now in my early 40s, with two young children and I am at risk for HuntingtonĘžs disease,” wrote Amy Morris O’Keefe. #BareYourTruth for those at risk.”

“Every day I watch my former Marine husband struggle with memory issues, myoclonic seizures, emotional instability, cognitive function, etc.,” wrote Rachel, who used the phrase “BareYourTruth for your children.” “As these symptoms became harder to hide, we struggled with how to break the news to our three children. In the end we decided that because of the behaviors he was exhibiting it was better to tell them the truth than to have them think that Daddy didn't love them. Ever since that day they have been amazing with him.”

Other women have shared their stories and photos. DeAnna and her collaborators have stimulated further discussion with a series of “truths,” or brief commentaries, about HD. So far, they have published nearly 60, posting several times a week.

Deanna calculated that through the page her story has reached more than 14,000 people.

#BareYourTruth hopes to attract more media attention. The group is producing a two-minute public service announcement that will include a message from HDSA CEO Louise Vetter, DeAnna said. They plan to post the video on Videolicious.com, with the hope that it will go viral.

Catchy initiatives

“Six very cool L.A. ladies,” I texted a friend about the #BareYourTruth initiative.

#BareYourTruth echoes past HD awareness-building efforts such as the “faceless faces of HD” project created by James Valvano, one of the seeds in the creation of the advocacy organization Help for HD International.

In 2014, other thought-provoking and catchy initiatives emerged.

At mid-year, HD-affected writer and blogger Sarah Foster Parker produced an interesting twist on the famous ALS Ice Bucket Challenge – which raised $115 million in a matter of weeks – with the creation of the HD Pie in the Face Challenge. This effort increased HD awareness on Twitter and other social media as well as donations to the HD cause.

HDSA’s Illinois Chapter has started a petition drive to have several of Chicago’s major buildings lit up in blue, the organization’s official color, during HD Awareness Month in May 2015 (click here to read more).

Many other ideas abounded in 2014, too numerous to detail here.

Informing the police about HD

Josh Bane, the nephew of Jeffrey Bane, a West Virginia HD-afflicted man roughly handled by the police as he begged for help, started a Justice for Jeffrey Bane page on Facebook.

Disturbed by the online video of Jeffrey Bane’s mistreatment and the ongoing mishandling of HD patients by police officers, a group of HD advocates set up an information booth at the 121st Annual International Association of Chiefs of Police Conference in Orlando, FL, October 26-28.

Some 250 individuals, most with no prior knowledge of HD, obtained information at the booth. (Click here to read more).


Josh Bane (personal photo)

A dance, a twitch, and a lion’s mouth

The year brought the release of three documentary films about HD. In January, HD patient and activist Chris Furbee’s 85-minute Huntington’s Dance premiered at the Slamdance Festival in Park City, UT, winning a jury special mention for “most compelling personal journey.”

Stanford University student and HD advocate Kristen Powers launched her short film Twitch, which chronicles her journey to testing for HD. Kristen is currently holding private screenings of the film for the HD community. (I will review the film.)

Director Lucy Walker recently released her short documentary, The Lion’s Mouth Opens, about filmmaker Marianna Palka’s decision to test for HD. The film, which will appear on HBO in spring 2015, has been short-listed for an Academy Award in the short-subject documentary category (click here to read more).


Kristen Powers discussing Twitch in San Diego on October 9 (photo by Gene Veritas)

Scientific progress, but urgency for a cure

Scientists made immense progress on the search for treatments, including the announcement by Isis Pharmaceuticals, Inc., that it will commence a gene-silencing clinical trial in the first half of 2015.

The CHDI Foundation, Inc.,the non-profit virtual biotech focused solely on the development of HD treatments, is preparing to sponsor the landmark Tenth Annual HD Therapeutics Conference in Palm Springs, CA, in February.

Noting the legal existence of assisted suicide in some jurisdictions and also the use of non-approved, still experimental drugs in the race to stave off a worldwide Ebola epidemic, HD advocate Andy Meinen wondered why HD patients could not receive potential drugs still undergoing testing.

“Allow the dying to determine which risks they will choose for themselves,” Andy wrote on his Facebook site. “Ebola is hell, so is HD, give us our treatments now.”

He added in a Facebook message to me: “Once adequately informed of the risks inherent to experimental treatments, patients should have access to those drugs without interference from regulators.”

That’s a controversial idea. (I will explore the context and implications of Andy’s ideas in a future article.) Nevertheless, Andy made a valuable observation about how clinical protocols might need adjustment as both the challenges of disease and the potential of science evolve.

In 2015, the HD community will once again need creative, sharp-thinking advocates to drive home the demand for better care and a cure.

As I enter my eleventh year as an HD blogger, I'll do my best to report on new initiatives.

Tuesday, December 09, 2014

Sharon’s inspirational journey with CrossFit in the fight against Huntington’s disease

With her indomitable spirit Sharon Shaffer has not given up the fight against Huntington’s disease, despite a decade of struggling with symptoms that forced her to quit her job and stop driving, and which hamper her ability to speak.

On December 7, Sharon starred in her own HD educational fundraiser, “Sharing Sharons CrossFit Journey” (#CureHuntingtons and #SharingSharonsJourney). The event raised nearly $2,000 to support Sharon and her family’s plans to hold a much larger fundraiser for the Huntington’s Disease Society of America (HDSA).

More importantly, it gave several dozen participants and onlookers in the CrossFit gym insight into Sharon’s practice of regular, intense exercise as a strategy for slowing the inevitable progression of her untreatable condition.

“I believe that CrossFit has helped me bounce back from major falls and accidents that I have had,” Sharon, assisted by daughter Alexa, said in a speech before CrossFit trainers led her and participants through a regimen of exercises. “Although my balance, swallowing, and speech are worsening, I am confident that without exercise my symptoms would be worse.”

You can watch Sharon tell of her struggles with HD and her involvement with CrossFit in the video below, with an introduction by Lee Razalan, the owner of Stay Classy CrossFit, the gym that sponsored the event.



A rigorous workout

The trainers at Stay Classy CrossFit, a central San Diego outlet that is part of a national network of gyms, designed a program for the Shaffers’ event. It was geared specifically for HD-affected individuals.

Along with the other participants, I jumped on a box, lifted weights, swung on a pull-up bar, and did pushups and squats.

We rotated among the five exercise stations every 90 seconds, moving through the entire sequence three times over about 17 minutes.


The #CureHuntingtons WOD (workout of the day) (photo by Taylor Shaffer)

I found the workout very rigorous. Indeed, I had to stop several times to catch my breath.

Over the next couple of days, my muscles felt considerably sore. But it was a good soreness, the kind you get from using neglected muscles. Today one of my doctors gave me the go-ahead to stick with CrossFit, but only as long as I don’t overdo it.

It occurred to me that HD people and presymptomatic gene carriers such as I need more events such as this to help us refocus on exercise and holistic approaches to the disease.

For Sharon, CrossFit has not just served to stimulate her brain and strengthen her muscles, but also linked her to a whole new network of friends who literally support her as she sometimes stumbles through the exercises.

In addition to Stay Classy Crossfit, the event received support from Lululemon and Sushi on a Roll.

You can watch the CrossFit participants, including me, in the videos below.





Racing Across America again

The Shaffers put on “Sharing Sharons CrossFit Journey” in preparation for their fourth participation in the Race Across America (RAAM), a coast-to-coast, non-stop bicycle race from the pier in Oceanside, CA, to the boardwalk in Annapolis, MD. The Shaffers’ participation in the June 2015 event requires donations in kind and funds to cover such costs as a motor home to accompany the riders.

The Shaffers’ “Team 2 Cure Huntington’s Disease” participated in RAAM in 2006, 2007, and 2010, anchored by Renato. He also led a team in the Race Across the West in 2008.

These and affiliated events such as annual RAAM golf tournaments have raised more than $110,000 for HDSA. “Team 2 Cure HD” has also increased awareness about HD across the nation.

In addition to Renato, the 2015 team includes RAAM veterans John Sylvester and Jason Tate and newcomer Mikel Clementi. Their 2015 goal is to net $40,000 or more.


Renato Shaffer (photo by Gene Veritas)

Inspiration

Renato and his three team members have completed past RAAM events in less than ten days. To call RAAM grueling is a gross understatement, especially since Renato turns 50 today, December 9.

In their RAAM donation request letter, the Shaffers describe the race as “both physically and emotionally taxing” but that pales before “the realities that HD patients suffer from on a daily basis. Over the past ten years our family has changed drastically with the progression of Sharon’s symptoms. Nonetheless we live with purpose, hope and gratitude. Our purpose is to shed light on HD, to maintain realistic hope despite Sharon’s circumstances and always remain grateful for the selflessness of others who have helped us.”

Renato, the RAAM team members and support staff, the extended Shaffer family, and supporters and friends of the HD cause draw deep inspiration from Sharon.

My goal […] is to try to succeed at things that people would deem impossible given my condition,” said the 48-year-old Sharon, who has practiced CrossFit for five years. She believes that all HD-affected individuals can discover an activity or hobby for keeping active.

“Huntington’s does not define us,” she said. “It’s just another fork in the road.”

At the conclusion of the CrossFit program, we participants all gathered around Sharon and one of the trainers as he reflected on the purpose and the lessons gained.

I touched Sharon’s shoulder. She and her thoughtful event for HD families had motivated me to recommit to exercise and healthy living as I face my own inevitable onset. Once again, I acquired strength from my HD sister.

We all put our arms in the middle of the circle. Then we raised them as we cheered: “Cure Huntington’s!

(Stay tuned to this blog for updates on RAAM 2015 and how you can help. Scroll down for other photos from Sharon's event. Photos by Gene Veritas.)



Race Across America veteran and 2015 repeat participant John Sylvester



2015 Race Across America initiate Mikel Clementi



Alexa (left) and Taylor Shaffer



Sharon Shaffer and mother Fran Walker



Andrew Herndon, coordinator of the HDSA Center of Excellence for Family Services and Research at the University of California, San Diego



HD advocate and support group member Amy Anderson (left) and HD support group facilitator Sandy Jerkins

Thursday, October 30, 2014

Another major supplement, creatine, proven ineffective in the fight against Huntington’s disease

For the second time in less than three months, a widely taken and long-studied dietary supplement envisioned as a potential treatment for Huntingtons disease has been proven ineffective, bringing a halt to a clinical trial.

Creatine, a supplement popular among body builders and readily available in health food stores, was studied in a clinical trial called CREST-E (Creatine Safety, Tolerability, and Efficacy in Huntingtons Disease), which began in 2009 and was to be completed in 2016.

On October 29, the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health (NIH), announced that it was discontinuing CREST-E because a preliminary analysis of the data “showed with high confidence that it was unlikely that the study would be able to show that creatine was effective in slowing loss of function in early symptomatic Huntingtons Disease.”

The study was carried out by the Huntington Study Group (HSG) and led by Dr. Steven Hersch of Massachusetts General Hospital and Dr. Giovanni Schifitto of the University of Rochester School of Medicine.

“The entire point of the CREST-E study was to determine whether creatine slows the course of HD or not, and the answer is, no, it does not,” Martha Nance, M.D., a member of the HSG executive committee, said in an e-mail. “Although this result is disappointing, it is still important, as it gives us a definite answer to the question: ‘I have HD. Should I take creatine?’ The answer is, ‘no.’”

“I recommend that all stop taking creatine,” Dr. LaVonne Goodman, the founder of Huntington’s Disease Drug Works (HDDW), said in an e-mail.

False hopes

Huntington’s disease typically reduces people’s energy levels. Scientists thought that creatine, which cells use to store energy, might help compensate for the energy deficit in brain cells and enable them to survive.

Positive results in animal studies regarding the impact of creatine, the rise of HDDW’s “treatment now” program ten years ago, and the advent of both CREST-E and a companion study in presymptomatic individuals known as PRECREST led to much discussion about the supplement in the HD community.

Many people have taken or considered taking creatine in the hopes of avoiding or ameliorating symptoms.

I have taken creatine for about ten years, beginning with my participation in the HDDW program.

Just after receiving the news about CREST-E yesterday, I received an e-mail from an individual inquiring about where to purchase creatine and what amount to take. I responded that “it is now recommended that nobody take creatine.”

HDBuzz.net also reported on the end of CREST-E, calling the new evidence against creatine “compelling.

Awaiting HD-specific remedies

In mid-August, the National Institute of Neurological Disorders and Stroke and the HSG stopped a clinical trial for coenzyme Q10, another widely taken supplement.

I outlined my approach to HD supplements and the pros and cons of the matter in a February article titled “To take, or not to take, unproven supplements in the fight against Huntingtons disease.” That article also reported on the hopes for PRECREST and CREST-E.

With the elimination of both coenzyme Q10 and creatine in rapid succession, the HD community is suddenly left without two potential treatments that supplied significant  hope.

However, supplements lack what researchers refer to as HD-specific approaches to treatments. They were not designed or marketed with HD in mind, whereas the new treatments currently under study will potentially attack the specific causes of Huntingtons.

Hope for effective treatments is on the rise as researchers and pharmaceutical firms gear up for new clinical trials such as the Isis Pharmaceuticals, Inc., gene-silencing approach announced for the first half of 2015.

“The important thing right now is to learn from ‘negative’ outcomes like this,” the HDBuzz article observed. “Studies like CREST-E have helped us, as a community, to get really good at designing, enrolling and running clinical trials, and understanding why particular treatments don’t work. Now we have the result of CREST-E, all that energy, enthusiasm and experience can be directed into testing other experimental treatments with a higher chance of success. One very solid benefit is that hundreds of volunteers are now freed up to sign up for other clinical trials enrolling now or in the near future.”

For the latest news on HD research and clinical trials, watch the video below for the update by Jody Corey-Bloom, M.D., Ph.D. (Note that the talk took place on October 27, before the announcement about creatine.)


The dire need for neurological treatments

I am now rethinking my approach to supplements. I have stopped taking coenzyme Q10.

I agree with the doctorsrecommendations to halt creatine. My breakfasts and dinners will no longer include a heaping teaspoon of fruit-flavored creatine dissolved in a glass of water.


Container with over-the-counter creatine (photo by Gene Veritas)


I will discard my remaining supply of creatine but keep the container as a piece of historical evidence in the quest for HD treatments.

It will also serve as a reminder of the dire need for truly effective approaches against a devastating disease that has reminded the world how the discovery of the first effective drug for any neurological disorder has continued to elude science.