The Positive Impacts of Your Donations Explained


(Thank you, Laura Mitic and the Bluefield Project for all you do and providing feedback so we can share with the world the great things you are doing).

Post overview.  -
  1. Analogy to add perspective to what frontotemporal dementia (FTD) is
  2. Summary of what your previous donations have gone towards and the benefits so far
  3. Details and explanation of hope for a cure/prevention

1. FTD Perspective


To the audience:
If this were in person, I would ask you to close your eyes as I take you on a journey.  

In lieu, I’ll simply ask you to read on with an open heart:
I'd like you to imagine yourself being relocated to a remote Chinese village.  Somewhere where you do not speak the language nor can you read or understand it. 
You've been sent there alone, and not by choice.
Now imagine, you've been told you will be there for the remaining days of your life.
At first it would be a struggle, but you, think, "I'll be resourceful and adapt: body language, photos, and just plain pointing goes a long way."

Now imagine, despite immersion into the culture and language, your comprehension declines the longer you are there instead of improving.

You look at a menu or any written instruction and it becomes more and more foreign to you every day.

Your intelligence is still intact.  You are aware of what is happening.  But you are alone in this foreign village where you cannot grasp what people are saying, you cannot read the written language, you cannot write it; even if you are looking right at it, your brain cannot tell your hand how to replicate it.  Before you know it, your writing is that of a child's.
The world is hustling and bustling around you, but you can’t keep up. 

Your ability to speak, slowly, deteriorates as well; until after a few years in the village, you have lost your voice altogether. 

And then, comes the physical decline.   Incontinence, walking and balance declines, muscles stiffen as they begin to atrophy.  Eating, now a challenge; swallowing is no longer instinctual….

In 2008, my mom, at the age of 56 was sent to a foreign village.  My grandmother quickly followed.
That village is called frontemporal dementia (FTD).  For some, no one knows why they get sent there.  In my family's case, we have one of the familial forms of FTD, the genetic mutation-- FTD-GRN.

In a nutshell, “FTD-GRN is a rare, early-onset and rapidly progressive neurodegenerative brain disorder that can affect behavior, cognition, language and motor skills, due to a reduction in the progranulin protein”...it is fatal.  (FORUM Pharmaceuticals Press release, Oct 2014).  For anyone in the family that was passed the gene, now live with the 50% risk of passing it on to our children. 

Three years ago, on March 13, 2013, after five years of FTD entrapment, Mom took her final breath and let go.  She was only 61. She lives on through her husband of 35 years, 5 children and a growing number of grandchildren (almost 7!)

For the past three years, all of you have helped raise over $15k, in memory of my mom, Mary Hall.

All proceeds have gone to the Bluefieldproject based out of UCSF (and collaborates with other researchers across the U.S., Canada and Europe). 

But what has been the benefit to your donations to date?  Below explains what your generosity has impacted.
 

But first and foremost:

~~~~Thank you~~~~~

~~~~~~~~~~~~~~~~You have made all the difference~~~~~~~~~~~~~~~
The skinny: 

Because of all of you, there is progress and hope.  Your donations accelerated the preliminary research which secured a larger grant for clinical trials!!  On people, not rats. Real clinical trials!  I repeat:  Clinical trials for FTD with GRN Mutation, have been funded!!!


Read on to learn more on:
  • Details on how the trial came to be
  • What the trial will entail
  • Details on how you find out about other clinical trials occurring and more info FTD in general.

While we still have a long way to go, thanks to all of you, we are on our way.  If there is any silver lining to having a genetic mutation that causes dementia in the prime of one's life, rapidly declines and is deemed fatal ... FTD-GRN is the "low hanging fruit" and your donations have given my family and the other 100s of thousands caregivers and affected TANGIBLE HOPE.  We still have a long road ahead of us.  Trials can take years, if not decades.  But this is a huge step in the right direction



Mom would be proud and humbled, as we are as well.



With Love,

~The Hall Family~


2007 - Just a year before diagnosis, Mom, Dad and Heidi celebrate Tina graduating.



The Details:

As we all know, the research and medical world is not cheap.  On a shoestring budget, devoted doctors (Howie Rosen, MD at UCSF and Brad Boeve at Mayo Rochester) have been collecting research data, mostly in the evenings and weekends, for 10-15 years.  

Drs. Rosen and Boeve have collected research data on several hundred subjects (patients and unaffected relatives participating in research programs) from families with known FTD mutations. These research data included extensive clinical assessments, structural and functional brain imaging, and blood and CSF samples. In many cases, these data were collected prospectively, before we knew gene mutations caused FTD, with the expectation that they could be used in exploratory studies. As our understanding of the genetics of FTD increased and patients were genotyped, this became possible. Drs Rosen and Boeve aimed to mine these data to better understand changes that occur with familial FTD over time - and indeed they were doing so, on a shoestring budget, at night and on the weekends, but it was slow going.  They needed help organizing and parsing their data.  

Your donations went to support two research assistants (one at each center) to collate and analyze the data, thereby accelerating the completion of the analysis. Their completed analyses were included in an NIH grant application that proposed studying changes in familial FTD patients over time with additional (in some cases, newer) techniques. This kind of longitudinal study is key for estimating rates of change across clinical stages.  In turn, knowing rates of change across clinical stages is key for understanding whether drugs are efficacious in slowing or reversing disease. So this is a very important study, but it's difficult to get funded because one needs to demonstrate


1) an existing infrastructure and the ability to collect these kind of data and

2) preliminary data that look interesting enough to convince others that limited federal research dollars should be spent here.


In fact, Drs Rosen and Boeve had twice applied to the NIH for funding but had been denied based on lack of preliminary data.  With the inclusion of these new data, which was funded by your donations, they were awarded the grant -- details of their award can be found at http://projectreporter.nih.gov/project_info_description.cfm?aid=8760412&icde=22317742






2014 - Mom was survived by her father ("Grandpop/Jack" and 5 (soon to be 7) grandchildren (L-R: Emma, Henry, Finn, Lily and Josh).  We will carry on, but we will never forget.




About the trial:

The below is provided by Bluefield project and excerpt from the FORUM press release explaining the significance and hope of this trial: 


“The trial will focus on what is known as FRM-0334. A mutation in one of the two copies of the progranulin gene that an individual carries* results in abnormally low levels of progranulin protein and culminates in the development of FTD.  


(*Note: (you receive a copy of progranulin from each parent, see the post on the science on the March 13th, 2014 –“It’s Already Been a Year; FTD/PPA Explained:  here” for more details)


Therefore, drugs that elevate progranulin levels by increasing gene expression from the second, unmutated copy of progranulin hold promise as potential therapeutics if they are able to restore levels in mutation carriers.


...FRM-0334 is a brain-penetrant histone deacetylase inhibitor (HDACi) that increased progranulin expression in cultured rodent neurons and, most importantly, in cell lines derived from patients carrying progranulin mutations. Phase 1 safety studies [completed] showed no toxicity or side effects. 



And now, on to phase 2 – clinical trials:

FORUM’s clinical trial will enroll 30 individuals at multiple participating research sites across the United States and Europe. Individuals must carry a mutation in progranulin and know their mutation status. Trial participants will receive either FRM-0334 (low or high dose) or placebo for 28 days, and progranulin levels in both plasma and cerebral spinal fluid will be measured before and during the dosing regimen to determine if FRM-0334 raises progranulin protein levels.”


2007, a year before diagnosis, - I am so grateful for Mom to see me graduate!


Want to learn more?  Below Additional details and links:



Laura Mitic, from the Bluefield project explains more here: http://www.bluefieldproject.org/news/phase-2-trial-in-progranulin-deficient-ftd-announced   



Interested in learning what other dementia related clinics trials are out there?   Another great place for clinical trial info is the federal website - https://clinicaltrials.gov/ct2/show/NCT02149160?term=FRM-0334&rank=1





Two Years

First – I apologize in advance, this post is an explosion of thoughts, and may not be very orderly...

March 12th, 2015...

As I was getting ready for work yesterday, I got a text from a friend back home saying “Thinking about you all today.”  I was most definitely confused… but also running late (as usual) so I temporarily dismissed it and continued to get ready. 

Fast forward 30 minutes, I’m pulling into the parking lot on base and I start racking my brain again…what did Jess mean by that text??

And it hits me.

I am instantly overwhelmed.  Tears threaten my eyes and the wind has been knocked out of me. 
Today is March 12th.  Mom would take her last breath tonight, about 1am, two years ago.

I forgot.

I forgot.

How could I forget???  What kind of person am I?

And now it’s all flooding back.  I’m not sure if it’s the guilt of forgetting or just the shear reality check (or both) but I suddenly am overwhelmed and wanting to hug my mom more than anything in the world…but I can’t.

To catch a few of you up, I relocated from Pittsburgh to southern California for a job on Marine Corps Base, Camp Pendleton in December.  The job opportunity was one I did not want to pass up, but I’d be lying if I didn’t admit I also saw California as a fresh start.  My family and I spent almost 6 years watching dementia take away my mother and grandmother.

And since March 12th, 2013 – we’ve had to bury my mom, followed by my grandmother 6 months later (who also had frontotemporal dementia (FTD), and then just this past October -- our grandpop—a man who loved his wife so much that he stayed by her side for 67 years—and until my grandmother took her last breath, slept on a chair next to her, refusing to leave her side (if that’s not love, I don’t know what is). 

Then to top it off, in early Nov, I had to put Woody down – Woody was my mom’s dog that eventually became mine.  He was in our family for 15 years.

So, needless to say, it’s been an emotionally exhausting few years.  And since I’ve been out here, I’ve selfishly taken a break from it all.  I haven’t finalized this year’s benefit yet (thinking pig roast, everyone???), I haven’t written on here in ages…

I’ve relocated the FTD bracelet from my wrist to my gear shift in the car….
Heck, most people out here know nothing about my past at all.   As Christina put it, “we are in the quiet after the storm.”

….

My friend’s text brought me back to reality.  And while it’s not an easy one to face – I spent most of yesterday with a very heavy heart and holding back tears—this is reality none the less.  

FTD is a part of my family's past, it will be part of our future, and while I may have forgotten, for a moment, yesterday morning, FTD is part of everyday life too, even in California.

Every time I mess up a word and say “drive” when I meant “fly” or “spoon” when I meant “knife” – my throat tightens and my inner voice screams “FTD! FTD! It’s coming!!” and I suppress my fear and externally laugh off the mistake to the surrounding audience.

Every time I see my nieces and nephews, I pray to God they are safe and ok. 

I have not forgotten.

And so, in tribute to my mom on her death anniversary, and to remind everyone out there whom also have loved ones with dementia, that as hard as it is to see them in their current state – that’s not them, that’s the disease; I want to close by sharing one of my favorite memories of my mom before she was sick.  A memory that demonstrates her true personality – one that always thought of others first.

/////

When I was 20, I studied abroad in England.  My 21st birthday was celebrated over there and I returned later on that summer.   On my return trip, I had a 7 hour layover in Chicago; which I was not looking forward to.  When I landed there, I turned on my phone for the first time in 8 months.  I quickly skip through all of the very outdated voicemails, but stop in my tracks when I get to the very last one.

It’s my mom’s voice.

“Hi Betsy!!  I wanted to surprise you in Chicago and take you around the city…but as usual, it’s raining in Pittsburgh and my flight is delayed. I’ll see you soon!  Love you!”
I couldn’t believe it.  My mom was flying to Chicago to spend a whopping 7 hours with me.  Of course, I’m crying with happiness and laughing at the ironic circumstances. 


My mind instantly gets to work.

Paper, I need paper.

I have none. 


I go straight to the bathroom – paper towels will do.  I find a table and lay out my paper towels and begin to write.

I hold up my masterpiece.  “MOM, Welcome to Chicago.”  Perfect!

I look up her gate number, and head there with my “sign” – ready for her arrival.

And I wait.
And I wait…

Nearly FIVE hours later, my mom arrives.  I give her the biggest hug.  She looks at me and says, “Well, I think we have just enough time to buy you your first legal beer in the US before we need to get on the plane back to Pittsburgh.”

And we do just that.  I did not see Chicago.  But I don’t care.  I had my first legal beer in Chicago O’Hare with my mom, who flew there only to give me a hug, tell me she loves me, and get right back on a plane.



~I love you, mom.  I miss you, mom.  And I wont forget.~