Health Archive

Almost homebound, Darboy’s Charlie Knuth looks ‘incredibly better’

APPLETON POST-CRESCENT

March 26, 2011

Nearly 100 days removed from a potentially life-saving stem cell transplant designed to strengthen his delicate skin, it’s almost time for Charlie Knuth, 5, to come home from Minneapolis.

“(April 8) is the last day that they’ll be taking samples of his skin to check and see how it’s different now than (when) we came in,” said Trisha Knuth, his mother. “After that, I believe we’ll get to go home.”

The Darboy resident has the rare genetic skin disease epidermolysis bullosa, better known as EB.

Since birth, his body has blistered incessantly, inside and out. Typically, the blistering leads to an aggressive form of skin cancer.

But a Dec. 30 bone marrow stem cell transplant has dramatically reduced Charlie’s blistering, which could ultimately reduce his cancer risk.

“His skin looks incredibly better,” said Dr. Jakub Tolar, Charlie’s physician at University of Minnesota Amplatz Children’s Hospital in Minneapolis. “Basically 90 to 95 percent of his body area was covered in sores. It’s less than 5 percent now.”

Charlie also has rebounded from a series of life-threatening complications he endured after the transplant, including infections, kidney failure and bleeding in his lungs.

“He pulled through all this very well,” Tolar said.

Charlie left the hospital in mid-February and moved into the Ronald McDonald House in Minneapolis, where his mother said he has thrived.

“He’s excellent,” she gushed. “For a while there he was really tired. Even though he was looking good and he was doing well, he still was very exhausted from the transplant.”

Charlie’s spirits were buoyed by unexpected birthday surprise from the Build-A-Bear Workshop at the Mall of America.

Store officials opened the sterilized workshop early on March 13, so the Knuths could celebrate Charlie’s fifth birthday in private.

“Somebody called anonymously to set it up and told them his story,” Trisha Knuth said. “Build-A-Bear took it from there.”

Charlie designed a camouflage-clad rabbit to match the macho-themed gifts he has already received from well-wishers back home.

“People are still sending stuff,” Trisha Knuth said. “People are doing things that are thoughtful, not necessarily just going out and spending money. They’re doing things that require imagination.”

One Fox Valley resident cobbled a collage from photos Trisha Knuth posted on her blog about Charlie’s experience in Minnesota.

And Cindy Riess, 52, of Green Bay, made 1,000 origami paper cranes for Charlie that she hopes to personally deliver soon.

“I’m a complete stranger, (but) I felt bad for him and wanted to do something,” Riess said. “I hope it helps. When I was doing them, I was always thinking about Charlie.”

The outpouring of support for Charlie hasn’t been limited to Wisconsinites.

“We get things from all over the world,” Trisha Knuth said. “People from overseas who have children with EB are following Charlie. He’s been an inspiration to other EB kids. It gives them hope.”

As remarkable as Charlie’s progress has been, Tolar stressed that Charlie still has hurdles to overcome because the December transplant wiped out his immune system, rendering Charlie “much more fragile than a newborn.”

It will take a full year for his system to redevelop, which means he will need to wear a mask in public and avoid children who have live vaccines, such as those for measles, mumps and chicken pox.

“From a practical standpoint, it’s a bad idea for him to go to a crowded mall,” Tolar said. “It’s absolutely fine for him to go outside, especially if it’s nice and there’s no high wind, and play without a mask. It would be a bad idea for him to go to preschool.”

While the process will get easier with time, Tolar said Charlie’s situation isn’t “worry-free” yet.

“Trisha knows this,” Tolar said. “His father (Kevin) knows this. And I think on one level Charlie knows this, too.”

To read Trisha Knuth’s blog, visit http://bit.ly/CharlieKnuthBlog.

Tough As Nails

APPLETON POST-CRESCENT

October 6, 2010

It takes about five hours.

First, she disinfects every surface in his bedroom and the bathroom. She cuts and peels dozens of bandages before buttering them with ointment. She runs the bathwater, adding bleach to kill staph infection.

Then Charlie, swaddled in gauze, sits in the elevated tub.

“Once he’s in there, we start taking things off,” Trisha Knuth said.

Caring for her 4-year-old son is a full-time job for Knuth. Charlie has the genetic skin disease epidermolysis bullosa, better known as EB. The state Medicaid office recently refused to pay for a stem cell transplant that could save Charlie’s life, sparking community outrage and drawing the ire of some Fox Valley lawmakers.

Charlie was born missing the gene that binds skin together. Charlie’s skin is as fragile as a ripe peach, gingerly falling away. Internal and external blistering could one day claim his life.

To protect Charlie, his mother layers him in bandages. It is, quite literally, his second skin.

Every other day, she removes his dressings, baths him and applies a fresh coat of gauze.

“It’s extremely painful and it takes a long time,” she said. “When you put those two things together with a 4-year-old, it is a nightmare. As bandages come off and he’s no longer protected, he’ll start ripping his skin off as we’re trying to get him clean.”

There is no cure for EB, but doctors hope a bone marrow stem cell transplant will make Charlie’s skin stronger, potentially saving his life.

The state Department of Health Services initially denied Trisha and Kevin Knuths’ request for Medicaid coverage of the treatment, which could cost $1 million.

But after Trisha Knuth turned to Fox Valley officials for help, health services decided to review the denial. The review could take weeks.

Trisha Knuth called the treatment “medically necessary.”

“If Charlie doesn’t have something done, he will die,” she said.

Fewer than 1,000 people in the U.S. have EB. It is difficult to determine an exact number, because people with mild forms of EB sometimes mistake it for other skin disorders, which delays proper diagnosis for years.

“If it’s very mild, you’ll have flaking of the skin or blisters, but not as severe as some patients whose skin completely sheers off,” said Maxine Silent, development manager for the Dystrophic Epidermolysis Bullosa Research Association of America.

Silent said that while many people with EB don’t live to see adulthood, the oldest known EB patient is in her 70s.

The Knuths hope the stem cell treatment will help Charlie overcome difficult odds as well.

“Everyone says he’s going to beat this because he’s such a fighter,” Trisha Knuth said. “Charlie’s skin may be fragile, but he’s tough as nails.”

Abandoned at birth, Charlie came home with the Knuths from a Milwaukee hospital when he was 2 weeks old. His adoption was finalized a year later.

Charlie’s twin 15-year-old brothers, Alex and Hunter, and his 7-year-old sister, Chloe, help look after him.

“Sometimes Chloe can handle him better than I can,” Trisha Knuth said.

Charlie recently started 4-year-old kindergarten at Sunrise Elementary School, which Chloe also attends. A personal aide makes sure Charlie doesn’t hurt himself.

“If he were to fall down and catch himself with his hands, he would take all the skin off his palms,” Trisha Knuth said.

Charlie’s classmates have embraced him. Often, Knuth said, it is adults who don’t know how to handle him.

EB research association representative Silent said attitudes and curiosities will change once awareness grows.

“A lot of people don’t know how to treat people who have EB or don’t know what EB is,” Silent said. She hopes EB Awareness Week, which occurs the last week in October, will bring EB out of the shadows.

“We need people to learn about the disease and spread awareness,” she said.

Michael Louis Vinson: 920-993-1000, ext. 368, or mvinson@postcrescent.com; on Twitter @MichaelVinson