Dear Santa,
When my hound Doolittle and I stopped in front of the "Letters to Santa" mailbox in downtown Mystic, Connecticut, Doolittle’s look of optimism gave me the idea to write to you. Perhaps you can grant me my deepest, sincerest wish—that no more babies will suffer from congenital cytomegalovirus (CMV).
My daughter
Elizabeth, born on December 18, 1989, would have been 27 this Christmas 2016 if
she hadn't been born with congenital CMV.
Expecting Elizabeth, due to be born on Christmas Eve of 1989, had been an exciting experience. But the moment she arrived on the 18th, I felt a stab of fear. My immediate thought was, “Her head looks so small—so deformed.”The neonatologist said, "Your daughter has microcephaly--her brain is very small with calcium deposits throughout. If she lives, she will never roll over, sit up, or feed herself." He concluded that Elizabeth's birth defects were caused by congenital cytomegalovirus (CMV). Women who care for young children are at a higher risk for catching it because preschoolers are the majority of carriers. Pregnant women need to be careful not to kiss young children on or around the mouth or share food or towels with them.
Why hadn’t I heard of CMV before and the precautions to take? While I was pregnant with Elizabeth, I not only had a toddler of my own, but I also ran a licensed daycare center in my home. I felt sick at what my lack of knowledge had done to my little girl. In milder cases, children with congenital CMV may lose hearing or struggle with learning disabilities later in life. But Elizabeth's case was not a mild one.
When my husband Jim heard Elizabeth's grim prognosis, he stared at her and said, “She needs me”—just like Charlie Brown with that pathetic Christmas tree.It took me about a year, but I eventually stopped praying that a nuclear bomb would drop on my house so I could escape my overwhelming anguish over Elizabeth's condition. Life did become good again—but it took a lot of help from family, friends, some Valium, and the Book of Psalms. We were eventually able to move forward as a happy, "normal" family.
Sixteen years later, I awoke feeling so proud of Elizabeth. It was her 16th birthday and just one week before her 17th Christmas. When the song “I’ll be home for Christmas” played on the radio, I cried thinking how hard Elizabeth fought to be home with us, overcoming several battles with pneumonia, major surgeries, and most recently, seizures. Weighing only 50 pounds, she looked funny to strangers as a result of her small head and adult teeth, but she was lovely to us with her long, brown hair, large blue eyes and soul-capturing smile. Although still in diapers and unable to speak or hold up her head, Elizabeth was very happy and loved going for long car rides. She especially enjoyed going to school and being surrounded by people, paying no mind to the stares of “normal” children who thought she belonged on the "Island of Misfit Toys."
Less than two months after she turned 16, I dropped Elizabeth off at school. Strapping her into her wheelchair, I held her face in my hands, kissed her cheek, and said, “Now be a good girl today.” She smiled as she heard her teacher say what she said every time, “Elizabeth is always a good girl!” With that, I left.
At the end of the day, I got the call I had always feared. “Mrs. Saunders, Elizabeth had a seizure and she’s not breathing." The medical team did all they could, but she was gone.While holding Elizabeth’s body on his lap, my husband looked down into her partially open, lifeless eyes and cried, “No one is ever going to look at me again the way she did.”
As we prepare to celebrate our 11th Christmas without Elizabeth, it is with some heartache that I bring down the holiday decorations from the attic. Elizabeth used to love to sit on the couch with her big, once homeless old dog Riley, and watch us decorate. (Their story is told in my memoir, Anything But a Dog! The perfect pet for a girl with congenital CMV.)
Now, I perform a new Christmas tradition. I carefully unfold the black and red checked shirt Elizabeth wore on her last day and hang it over an empty chair beside our fireplace. Although she can't be home for Christmas, I feel that she is my “Tiny Tim” who would say, if she could, “God bless us, everyone!”
Although I miss Elizabeth, I’m glad she is free from suffering, glad she is safe in her new, Heavenly home.
I knew I would need reminders of where Elizabeth was and what she is enjoying, so engravers etched on the back of her headstone that she is dwelling in the house of the Lord where: "...the lame leap like a deer and the mute tongue shout for joy" (Isaiah 35:6). Many times when I was lost in despair those first few years, I visited her stone, hugged it, and left somewhat cheered when I pondered her new life.
When my time comes, I will see Elizabeth again.
My father wrote a fairy tale that I found very helpful after Elizabeth died, The Woodcutter’s Tale. To read it on my blog, click here, or download the free pdf with its color images and comments by a therapist on grief by clicking here.*
The Only Thing I Can Do for Elizabeth Now
Since Elizabeth no longer needs my care, the only thing I can do for her now is to care for those not yet born—to prevent them from suffering as Elizabeth did. I do that by speaking and writing about congenital CMV prevention. I'm thrilled to say that Connecticut legislators finally passed a bill requiring congenital CMV testing for infants who fail their hearing screen. The prevention education part didn't pass, however, because of funds, so it is still on my wish list for Christmases yet to come.
So, I must continue in my quest, begun in my misadventure travel memoir, Mystic Seafarer's Trail, to become thin and famous so people will listen to me!
After presenting the story of Elizabeth's life at the first international Congenital CMV conference held in the U.S, at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA, in 2008, scientists from all over the world approached to thank me for inspiring them to continue their work. Mothers, on the other hand, pushed their children towards me in wheelchairs and asked, “Why didn’t my OB/GYN tell me how to prevent this?” One mother even asked, "Learning what you did, why didn't you do all you could to shout it from the rooftops?"
Until OB/GYNs make CMV prevention a standard practice of care, I'm trying to "shout it from the rooftops" through my writing, speaking engagements, and contacting agencies I hope will help. Thankfully, there is a large army of CMV parents and medical professionals doing the same thing (see CMV organizations and legislation below).
As a storyteller, I found the following ways to share a CMV prevention message:
Santa, below my signature are ways you and your helpers can learn more about congenital CMV and how to stop it.
Merry Christmas and “God bless us, everyone!”
Sincerely,
Lisa Saunders
Congenital CMV Blog
LisaSaunders42@gmail.com
PO Box, 389, Mystic, CT 06355
U.S. LEGISLATION
In 2011, United
States Senate passed legislation recommending that “more effort be
taken to counsel women of childbearing age of the effect this virus can have on
their children” and designated
the month of June as National Congenital CMV Awareness Month.
In 2015, Connecticut passed testing of newborns who fail their hearing screen, but not prevention education because of funds.
“In
five states (Hawaii, Illinois, Tennessee, Texas, and
Utah),
laws regarding CMV awareness have been passed that require healthcare providers
to discuss CMV with pregnant women, and in eight additional states, CMV
legislation has been proposed or is in discussion.” (Cytomegalovirus:
The Virus All Pregnant Women Should Know About Now by
Gail Demmler-Harrison,
MD (Dec. 2. 2016)
U.S. ORGANIZATIONS THAT WORK TO STOP CMV
Congenital CMV Disease Research, Clinic &
Registry
Gail J Demmler-Harrison, MD,
Professor, Pediatrics, Section Infectious Diseases, Baylor College of
Medicine, Attending Physician, Infectious Diseases Service, Texas Children's
Hospital, CMV Registry, CMV Research and CMV Clinic. The CMV
Registry supports CMV research, disseminates information and provides
parent support. Visit: https://www.bcm.edu/departments/pediatrics/sections-divisions-centers/cmvregistry.
Dr. Demmler-Harrison’s Blog: http://www.texaschildrensblog.org/author/gdemmler/
Contact: 832-824-4330, gjdemmle@texaschildrens.org
National CMV Foundation
Congenital Cytomegalovirus Foundation
Lenore Pereira, Ph.D., Founder of Congenital
Cytomegalovirus Foundation, and Professor, Cell and Tissue Biology Department,
University of California San Francisco. The Congenital CMV
Foundation raises awareness about maternal testing for first infection
during pregnancy, newborn testing and the need to develop a vaccine. Excellent
research papers available at: http://www.congenitalcmv.org/
Contact: lenore.pereira@ucsf.edu
National CMV Registry for Pregnant Women
Stuart Adler, M.D., Professor Emeritus of
Pediatrics and Professor of Microbiology and Immunology, Virginia
Commonwealth University. He organized the National CMV Registry for Pregnant
Women. Visit: http://www.cmvregistry.org/, contact:
sadler@vcu.edu
PREVENTION RESOURCES FOR OTHER
DISEASES
CDC: Read “Protect Your Unborn Baby or Newborn from Infections” to learn
about preventing CMV infection as well as Group B Strep (GBS) disease,
listeriosis, and Zika at: www.cdc.gov/features/prenatalinfections/
CONGENITAL CMV ORGANIZATIONS IN
OTHER COUNTRIES INCLUDE:
Australia—Congenital
CMV Association of Australia: http://cmvcanada.com
Canada—Canadian
CMV Foundation: http://cmvcanada.com
United
Kingdom—CMV Action: http://cmvaction.org.uk
Japan—
TORCH Association Japan: http://toxo-cmv.org/; info@toxo-cmv.org; https://www.facebook.com/toxocmv/; (TORCH: Toxoplasmosis, Other infections, Rubella, Cytomegalovirus,
and Herpes simplex virus, which can cause serious conditions in
the fetus or newborn following maternal infection)