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                 Fragile 
                X: The Story of Luke  
                Shutdown of one gene changes a little boy's trip through 
                life. 
                
                by Amanda Gardner, HealthDay News, November 19, 2003 
                
                For more articles like this 
                visit 
                https://www.bridges4kids.org.  
                 
                  
                When Luke Solotaroff was a month old, he still did not have the 
                muscle strength to suck his mother's breast or a bottle.  
                 
                His parents had to use a tiny tube, one-tenth of an inch in 
                diameter, to coax sustenance into his baby mouth. 
                 
                By the time Luke was 2 1/2 years old, the situation was no 
                better. His legs were so flexible they could be tied behind his 
                head. He was also developing distinctive features: large, 
                protruding ears and an oval face. And while he laughed and 
                screeched, he didn't form any words. 
                 
                Luke's parents, Paul Solotaroff and Elaine Stillerman, took 
                their son to several well-known neurologists, who handed down a 
                smorgasbord of incorrect diagnoses, everything from autism to 
                cerebral palsy to something called pervasive development 
                disorder. 
                 
                Finally, as Luke approached the age of 3, the Solotaroffs got 
                their answer: He had Fragile X syndrome, a hereditary condition 
                that causes mental impairment. The Solotaroffs had never heard 
                of the syndrome, but were now told that it had no cure and was 
                the second leading genetic cause, after Down syndrome, of mental 
                retardation. The Fragile X mutation may affect one in 2,000 
                males and one in 4,000 females. 
                 
                "With my kid, there is such obvious intelligence lurking behind 
                those eyes," says Solotaroff, a Brooklyn, N.Y., writer who has 
                just published an article about his son for the November issue 
                of Men's Journal. "It seemed that all we needed to do was find 
                the person holding the right key, so we kept looking and kept 
                looking and never for a minute thought that that person wasn't 
                out there or that Luke was a door needing three or four keys. It 
                was just a question of knocking on the right door." 
                 
                In scientific terms, Fragile X can be deceptively simple. "It's 
                one gene. It stops functioning so the body is missing a single 
                protein [the FMR protein]," explains Dr. Michael Tranfaglia, 
                medical director of the FRAXA Research Foundation in 
                Newburyport, Mass. and father of Andy, a 14-year-old boy with 
                Fragile X. "The net result is that the synapses overfunction in 
                a specific way."  
                 
                In human terms, of course, the story is nowhere near that 
                simple, which is partly what Solotaroff wanted to convey in his 
                recent article. 
                 
                "I wrote a story about what life is really like in the trenches 
                of a cognitive disorder, how the heart is constantly being 
                cudgeled and, at the same time, somehow deepened by the 
                experience of fathering a kid who so desperately needs you," he 
                says. 
                 
                On the one hand, Solotaroff describes his son, who is now 5, as 
                "ebullient. He is the happiest person I know." 
                 
                But he also describes him as a "need machine." Luke operates on 
                little sleep and is in constant, albeit happy, motion: bouncing, 
                jumping, flapping his arms. 
                 
                "He'll wake up at 3:45 ready to party, wanting to have breakfast 
                and watch his first video," Solotaroff adds. 
                 
                A doctor once likened Luke's brain wiring to "a jack with 10 
                phones plugged in." Fragile X kids, Solotaroff explains "are 
                unable to filter the important from the completely 
                insignificant." The result is this "overlong stream of 
                information that you are trying to make sense out of while the 
                world is blowing by you," he adds. 
                 
                But because Fragile X kids are so sensitive and because there 
                are so many nerve endings in the mouth, even the act of brushing 
                Luke's teeth, his father says, "is an act of courage comparable 
                to what Siegfried and Roy did every night." 
                 
                Solotaroff has taken another apartment where he can work and 
                also sleep through the night twice a week. He and his wife, 
                Elaine, take turns doing night duty for their son. The constant 
                focus on Luke has taken its toll on their relationship. 
                 
                "What we've really lost with each other is the capacity and 
                opportunity to have fun," Solotaroff says. "One or another of us 
                says 'I feel like a wildly overpaid hospital attendant.'" 
                 
                Drugs can control various symptoms of Fragile X (for example, 
                the seizures or the hyperactivity) but "it is really hit or 
                miss," Tranfaglia says. None of the drugs are specific to the 
                disease so they can actually exacerbate some symptoms while 
                improving others. 
                 
                The frustrating but ultimately hopeful thing about Fragile X is 
                that it involves a single gene. This makes the disease 
                potentially curable. Not only is it a single gene, but it's a 
                gene that causes a particular synaptic process to be excessive. 
                It's easier to block an excessive function with a drug than to 
                make up for a deficiency, Tranfaglia explains. 
                 
                A compound called MPEP that blocks the MGluR5 receptor, which 
                controls the errant process, is being tested in a mouse model 
                and Tranfaglia's organization is trying to find a pharmaceutical 
                company to take it to clinical trials. 
                 
                In the meantime, Luke has started on a combination of drugs that 
                allows him and, by extension, his parents, to finally sleep 
                through the night. Solotaroff has his fingers crossed but isn't 
                counting on anything. 
                 
                Except his relationship with his son. 
                 
                "I never thought I was capable of that kind of intensive 
                hands-on fathering. I thought I would be a good batting 
                instructor for my kid. I thought I'd be a serviceable jump-shot 
                coach. I thought that I would teach him my sardonic way of 
                seeing the world," Solotaroff says. "It never occurred to me 
                that I could connect with someone who couldn't talk." 
                 
                "What I've learned is that I am capable of responding to this 
                creature in ways that I didn't know I was capable of responding 
                to anyone or anything including my own work," he adds. "I've 
                never loved anyone or anything as much." 
                 
                "It's primal, and I know this is true of other Fragile X 
                parents. There is something about their vulnerability, about 
                their defenselessness that brings out the mother or father bear 
                in you," he says. 
                 
                More information  
                 
                To learn more about Fragile X, visit the 
                
                FRAXA Research Foundation or 
                the National Fragile 
                X Foundation. 
  
                SOURCES: Paul Solotaroff, writer, Brooklyn, N.Y.; Michael 
                Tranfaglia, M.D., medical director, FRAXA Research Foundation, 
                Newburyport, Mass.; November 2003 Men's Journal 
                     
                
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