As someone with Duchenne, I have to take various medications to manage particular symptoms. Despite needing more medication as I have got older, I still only have a couple of tablets each day, all of which have been prescribed by doctors and consultants. These deal with my heart for the most part but I also take Vitamin D supplements. The heart medication isn’t entirely out of the ordinary but it helps with the everyday working of the heart and its long term health.
The Vitamin D is good for people who are inactive or sit down most of the time, like me, which is why a consultant prescribed it after an x-ray showed I had mild osteoporosis. It may be useful as a Duchenne patient to ask about Vitamin D earlier to see if it would be beneficial. I wasn’t really aware of it until my late teens so it’s something to find out about.
Antibiotics are also an interesting subject in terms of Duchenne patients due to the greater tendency to develop chest infections and pneumonia. Antibiotics are often mentioned in the news and other media, but usually in a negative context to do with their over-use or resistance. For people with weakened respiratory function, however, antibiotic use is more easily justifiable to counter serious bacterial infections that are potentially dangerous. I was once told off by a GP for taking ‘rescue’ antibiotics when I had a very heavy cold and cough, but a respiratory consultant told me otherwise.
That’s not to go completely against medical advice but some men with Duchenne take antibiotics on a regular basis, so I would say trust you own instincts when it comes to chest infections. You and your family will know more about you and your well-being so you can use that as a gauge for when to intervene or get advice. I’m not a doctor though, so don’t take this as gospel.
I would not describe eating as a big health problem as such, but it is still important to keep yourself at a healthy and manageable weight. Because of the muscle problems that come with Duchenne, ordinary day-to-day activities, such as breathing, require large amounts of effort and energy so maintaining a good calorie intake is essential. Eating can be a very tiring activity which is therefore a potential issue for your health once you reach about 17 or 18.
In comprehensive school I had very few if any problems with eating and drinking because I still had the ability to feed myself easily, being able to fully use my arms and hands and not tiring. Once I got to college however, I had less chance to eat and it became more energy sapping. I did not consider this to be a problem but slowly my weight was dropping off pretty much unnoticed.
At this point, I was still feeding myself and enjoying my food but in hindsight I was eating much less simply because of tiredness due to the effort of chewing. I would also say that I was quite stubborn so eating myself was a demonstration of my independence. This carried on until I went to one of my usual health check-ups aged about 19, and discovered to my complete shock and dismay that I was just under 6 stone. There was a period of about two years when I had to see dietitians and take high calorie drinks (Fortisip if you’re interested) to get my weight back up, which incidentally is now about 58kg at last count. In that period it was suggested I might even need a PEG feeding tube but this seriously motivated me to eat more. It wasn’t as if I didn’t want to eat as I love food but it was just more challenging.
For the last two or three years I now have most of my food blended in order to maximize the amount I can intake, and I don’t feed myself these days. Despite this, what I eat isn’t like baby food and I am able to have things I enjoy like steak, cauliflower cheese and roast dinner. If you are interested please check out @battle_the_bite on intagram which is run by my sister where she posts some of my meals.
The main things to take from this are to be aware of how much you are eating and don’t be embarrassed or feel down if you need help eating or have pureed food. Also, always eat what you want and as much of it as you like.
Due to weakening of muscles over time, breathing and coughing can become a little more problematic as you get older. Doctors begin taking a greater interest in your respiratory system and you have more check-ups. Respiratory clinics may seem worrying at first but they do not need to be. Having consultants and nurses describing your breathing and respiratory function can feel nervy at times but after a while it becomes just a normal part of life.
I use two main pieces of equipment to help with my coughing and breathing but they are not at all scary so don’t be put off or disheartened when you first come into contact with them. I have a ‘cough-assist’ machine, which increases the strength of the cough reflex, and an NIV (Non Invasive Ventilation) machine that helps with breathing overnight and occasionally in the day. Both probably sound like serious and complex medical treatments, but the reality is they are simply useful pieces of kit that give your lungs a boost.
I now know that these machines are a common treatment for Duchenne patients but initially I was completely nonplussed, so don’t feel unnerved by them. For example, the first time I was presented with a ‘cough-assist’ machine it felt like a massive deal and I was very hesitant to use it as it presented a negative change. However, surprisingly I became accustomed to it very quickly and it has actually been incredibly useful whenever I have had a chest problem.
One of the major issues related to Duchenne that I want to discuss is scoliosis. This is when the spine develops a curvature to the side which normally affects people aged 11 to 15. Scoliosis can happen for many different reasons, but young boys with Duchenne can be particularly susceptible to it as I discovered. It was one of the most significant health problems for me that I have experienced in my life so far.
For me, the curve developed when I was 14, gradually worsening until I was eventually sent for an x-ray. The curve was about 67 degrees at its worst point and required surgery. Before I found out about the extent of the damage, some of the physiotherapists I was seen by suggested solutions to try and correct my posture, such as a chest harness for example, but at the time I did not want to be restricted physically as it would have prevented me from doing things I wanted to do. Despite this, I feel like it should have been impressed upon me and explained more clearly as nobody had really highlighted scoliosis before I was told just how far it had gone.
I had surgery just after my fifteenth birthday which was successful despite me ‘mis-behaving’ on the operating table according to the anaesthetist, whatever that meant. However, I think that much more attention needs to be drawn to the potential of scoliosis as soon as possible because it can have a huge impact on your life. Mine was lucky to be caught and treated in time but it should never have reached such a dangerous stage. It probably could not have been entirely prevented but doctors should definitely give their patients some more information when it comes to this.
I also think that spinal surgery should be considered earlier than it currently is, to make sure the opportunity is not missed. Not treating a curve could stop people using their wheelchairs which would be devastating for someone with Duchenne. If I was given surgery sooner my body position would be much better than at present. Surgery certainly should not be delayed for any reason, and especially not because of petty disputes between consultants and surgeons, for example.
Hopefully this information will be useful and give some food for thought. I was taken by surprise when I found out about the scoliosis but I don’t think others should be, so don’t be afraid to ask about it.
There are a number of health issues associated with Duchenne that I feel could have been highlighted to me earlier or that would have been useful knowing about sooner. Finding out about the condition can be a scary prospect so is something I have never been particularly interested in. I haven’t often researched the potential long-term implications of Duchenne in detail, but it would have been good if some things were explained to me earlier by the health professionals I came into contact with. Some knowledge can go a long way in reducing some of the stress and confusion that comes with a new challenge.
Because of this, I want to give details about some of the issues I have come into contact with and offer my own advice. Hopefully it will give some welcome reassurance and a bit of information about Duchenne. Remember, each problem you face can be overcome and sorted out, so don’t ever feel too dejected! As my Mum often says, ‘one day at a time.’