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The Most Important Thing I’ve Learned Since My Daughter Was Diagnosed With Kabuki Syndrome

By 
Leila, PicnicHealth

Dec 20, 2021 • 5 min read

Blog post originally written by the AllStripes community team. AllStripes was acquired by PicnicHealth in 2023.

Blog post originally written by the AllStripes community team. AllStripes was acquired by PicnicHealth in 2023.

After a typical pregnancy, Leila gave birth to her first child in 2016 and knew immediately something wasn’t right: Roya was limp, pale and fatigued. What was expected to be a short visit to the NICU turned into days, then weeks — Roya was only allowed to go home after about a month. It was about five months later that Roya was diagnosed with Kabuki syndrome, a rare genetic disease with symptoms that can include distinct facial features, low muscle tone, intellectual disability, heart problems and growth delay. While Leila’s first instinct was toward exhaustive research, she says that raising Roya has taught her to live in the moment, and to meet her daughter wherever she’s at.

I'd had a normal pregnancy, so it never crossed my mind that there was even a possibility that something might not be completely “normal.” But our experience with Kabuki syndrome started on February 3, 2016, when Roya, our first child, was born. It was a pretty difficult labor, and when she was finally born, she was limp and floppy. The doctors immediately said, "Well, it was probably an exhausting process for her going through the birth canal. So we'll just take her to the NICU unit, and we'll bring her back to your room in an hour or two."

We ended up being there for a little over a month. She basically had a blood sugar issue, where her blood sugar just kept falling and they couldn't quite understand why. Feeding difficulties combined with hyperinsulinism (producing too much insulin) was a dangerous combination, so she needed 24-hour monitoring and care. She was fed with a nasogastric tube that connected to her stomach through her nose. It was a very surreal first month, but we ended up finding a medication that kept her blood sugar levels more stable, so we were able to bring her home from the hospital, but still with her nasogastric tube. 

No first-time parent really knows what they're doing anyway, but certainly in this circumstance, we felt lost at sea. We needed two people for every feed — someone had to hold the tube up high and let it drip slowly into her stomach. Sometimes her stomach would get overfull and then she would throw it all up, or she would rip the tube out of her nose, and we'd have to rush back to the hospital to have another one put in. There were many difficult moments.

We also had to take Roya’s blood sugar readings many times a day at home. I never thought I'd be able to do a heel prick ever in my life. I'm very squeamish about blood, and the idea of taking blood from your own child is just something I never thought I'd be able to do, but you just do it. You get on with what needs to be done to keep your child safe.

My mother was so helpful in this regard. I remember her telling me that she could see that I felt so bad, “hurting” my own child by taking blood several times each day. But really I should view it as a gift I’m giving her — the gift of health, of safety, of care. I wasn’t outsourcing it, or turning my head away while someone else did it, I was the one caring for her. And in doing so, I was loving her. That reframing really helped me.

When Roya was about 6 months old, we had a chance meeting with a geneticist who suggested she might have Kabuki syndrome. There was an excruciating, several-week-long period where we had to wait to get the genetic testing results back. When we finally got her genetic results back, it was confirmed that she did have Kabuki syndrome. That was five years ago. At first, it was really, really hard. 

I'm a very Type A person, so my initial inclination was to say, "Okay, well, I'm going to learn everything there is to learn about this condition.” I think that was counterproductive in a sense, because there were so few cases that had been detailed in the medical literature. And because genetic sequencing hasn’t been as ubiquitous the last decade due to cost and access, the cases that had been diagnosed tended to be the more severe cases. That initial inclination eventually transitioned into just looking at Roya for who she is, and being with her wherever she was. Not comparing, or projecting, or forecasting — but just being with her.

I remember a counselor once telling me, "Wherever she is, you just need to walk alongside her. Don't walk behind her and push her forward, and don't walk in front of her with your hand pulling her along. Just walk next to her. That's what she needs." That was a really helpful thought for me, because it helped me see all of her amazing gifts, and all of the places where she struggles, and just see her for this whole human being that she is, and not see everything through the lens of Kabuki. It's a part of her, but it's not all of her. I'd be lying if I said we've fully conquered that, but it’s a process, and I’m on that journey. 

Now, we have two other beautiful little children, and I don't worry about them like I worry about Roya. But the reality is, I don't know how any of them are going to develop, or what's going to happen in any of our lives. I do think this experience has helped me, and helped us as a family, to just let go a little bit and be in the present. 

Parents are so overwhelmed in seeking out the best care for their kids. For AllStripes to say, "Hey, we’ll leverage your time, or make it more efficient, and we've really thought about the patient experience, and we'll amass everything in one central place” — that is a resource for you, for the parent, which is extraordinary in and of itself. And that also encourages people in the scientific and medical community to pay attention to your condition, because this information is amassed in a central place, so health professionals can do their jobs better too.  

Roya has been the greatest gift of my life.  She’s taught me so much about what it means to be human. And she’s taught me that together, we can overcome a great deal. We can learn from each other, grow together, and support one another. Together, we can do great things.

Disclosure: In addition to being an Ambassador for AllStripes’ Kabuki syndrome research program, Leila Zegna is an angel investor and has invested in many companies, including AllStripes.  


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Create a List

List the names of all the doctors, hospitals, and other facilities your loved one visits regularly, along with those they have visited in the past. Try to go back as far as you can, striving for at least the last 5-10 years, but do your best. Even if you can’t remember them all, having a strong baseline can help you quickly identify gaps in records.

Ensure You Have the Appropriate Legal Status

It is important to make sure that you are fully empowered to make decisions on behalf of your loved one with Alzheimer’s. Your relationship status with the patient may not be enough to legally give you access to your loved one's medical information. It is a good idea to talk to an expert about securing special legal status, such as Power of Attorney (POA), a legal document that allows an individual to name someone as their decision maker should they no longer be able to make decisions on their own.

Gather and Organize the Medical Records in One Place

It’s important to have all of your loved one’s medical records together in one spot. This makes it much easier for you and your loved one’s physicians to accurately map the patient’s medical journey and more easily share information between doctors. Fortunately, tools exist to make record management and access simple. A free resource like PicnicHealth helps you collect and organize all of this information. PicnicHealth’s intuitive timeline allows you to pinpoint data across the medical history, eliminating your need for keeping heavy binders filled with paper records or keeping track of multiple software portal logins.

Review the Medical Records to be an Informed Advocate

The better you understand your loved one's medical history, the better you can advocate on their behalf. Access and understanding of this information will help you to ask informed questions with physicians. Through regular communication backed by the data in the medical records, you can help your loved one’s care team develop a more successful care plan.

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1. Build a support network.

When you’re juggling appointment times and insurance claims, putting a robust support system together might not strike you as the most urgent task. Investing the time to cultivate relationships with people can turn to in times of need will pay dividends. The next time you need a last-minute ride or just someone to listen, you won’t be on your own.

There are many condition-specific support groups and support groups for caregivers generally in person or online. In addition to the encouragement and empathy they provide, support groups can be a helpful source of tips, resources, and recommendations for navigating caregiving.

2. Stay organized.

The backbone of effective caregiving is organization. Keep medical information, appointment schedules, and medication lists in order. Use a planner or a digital service like PicnicHealth to stay on top of your responsibilities. This attention to detail can prevent future complications and reduce day-to-day stress.

3. Explore treatments and clinical trials.

We’ve seen incredible breakthroughs in treatment over the past couple of years, powered by patients and their caregivers participating in research. Stay in the loop about the latest in medical advancements and available resources that could benefit your loved one. Whether it’s a new therapy option or a community service that aids independence, being informed can make a world of difference in the quality of care you provide.

4. Make time for self-care.

It may seem self-centered to focus on self-care—but when you feel good, you can be a better caregiver. Whether it’s exercise, a mindfulness practice, a soak in the bath, or just time to rest when you need it, carve out those moments in the day when you can unwind, reset, and stay healthy mentally and physically. Think of it as building up your reserves of kindness, patience, and understanding—which can only benefit your loved one. No one can pour from an empty cup.

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LC-FAOD Odyssey: A Preliminary Analysis, presented at INFORM 2021

Data from real-world medical records:

(from 13 patients with LC-FAOD)

16 yrs old

Median age at enrollment

38% Female

15 providers / patient

7.5 years of data / patient

Data from patient-reported outcome (PRO) survey

(from 13 patients with LC-FAOD)

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A tablet, phone, or laptop with a working camera, microphone, and stable internet connection.
A quiet, distraction-free area with enough space to walk a few steps if applicable.
A chair that you can use during any movements or tasks you’ll be asked to perform.
The tripod mailed to you via Amazon.

What to Expect

Before your video call:

Book Your Assessment
Visit your to-do list on your PicnicHealth Research Dashboard or click the scheduling link sent to your email. Note: Search for “New task for the ORBIT-CIDP Study" to find the video call scheduling link.
Receive Confirmation
Check your email for a confirmation with your scheduled video call time and instructions.

On the day of your video call:

Click on Video Link
Join your personal video call using the link we sent by email, or text message, or find it on your research dashboard.
Meet your nurse
A Registered Nurse (RN) will guide your virtual assessment, which will last about 30 minutes.
Complete the Physical Activity Assessment (INCAT)
The nurse will guide you through questions and, if needed, physical tasks to help researchers gain a deeper understanding of CIDP.
Complete the Movement Assessment (Optional)
If you participate, a nurse will guide you through three short recorded movement activities to complete as best you can:
Chair Task
While seated with your arms crossed over your chest and hands on oppositeshoulders, you’ll be asked to stand up, remain standing for 20 seconds, and then sit back down.
Arm Movement Task
While seated with your arms resting at your sides, you’ll be asked to raise both arms out to the sides until they meet above your head, then lower them back to your lap.
Finger Dexterity Task
While seated, raise your right hand with fingers extended. Touch your thumb to each fingertip in order, then reverse. Repeat with your left hand. This will then be repeated with your left hand.
Earn Compensation

Receive up to $55 for your participation:

  • $25 for completing the Physical Activity Assessment (INCAT).
  • $30 for the Optional Movement Assessment.
Recording: Your research assessment may be recorded to ensure accurate data collection. If you participate in the optional Movement Assessment, it will also be recorded. These recordings may capture your voice and responses, but identifiable information like your face, name, or background will be removed to protect your privacy.
Opt Into the Smart Insole Study Activity
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Download the App
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For illustrative purposes only, your insoles may look different
Log In
Open the app and log in using the email address and password you used when creating your account.
Enable Permissions
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  • For Android users: Enable Activity Recognition permissions.
Connect Your Insoles
Turn on Bluetooth, and follow the app's instructions to connect your smart insoles.
Enable Notifications
Enable push notifications to stay updated on reminders and activity progress.
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Start Walking Sessions
When you’re ready to perform a walking session, tap ‘Start’ on the Ad Hoc Walking task card in the app.
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Need Help?
Should you need to contact Celestra Health support for any reason, you can submit a ticket through the Help section of the app by tapping the Submit A Ticket card and filling out the form. A Celestra Health representative will typically respond within one business day.
A fully charged device (smartphone, tablet, or laptop) with a working camera, microphone, and stable internet connection.
A quiet, well-lit space that is free from distractions.
Good lighting so your face is clearly visible; having a small flashlight or your phone’s flashlight nearby can help with skin, scalp, or joint checks.
Flexible device positioning so you can easily adjust or prop up your device hands-free if the research staff asks to view specific areas (such as your face, hands, or scalp).
Space to move in case you are briefly asked to stand or walk a few steps.
Your medication information, including your current steroid(s) and BENLYSTA® (belimumab) — either the medication bottles or a list with doses and schedule.
Time to focus without interruptions so the visit can be completed comfortably.
Before Your Video Call:
Schedule your visit
Use the scheduling link on your PicnicHealth Research Dashboard or the link sent to your email.
Tip: Search your inbox for “New task for the BEACON-SLE Study - schedule your remote visit” to find the scheduling email.
Check your confirmation
You’ll receive an email with your appointment time and instructions for joining the video call.
On the Day of Your Video Call:
Join the call
Click the Zoom link sent to you by email or text message, or use the link available on your research dashboard.
Meet with the research staff member
  • They will ask you structured questions about your health and any lupus symptoms you’ve experienced over the past 30 days.
  • If needed, they may guide you through a few simple visual checks (such as looking at your skin, hair, joints, or mouth). You can always tell them if you’re not comfortable with anything.
Receive Compensation
You’ll receive up to $60 for completing your visit.
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