Clos What Is Canavans? Canavans, first recognized about 60 years ago, belongs in the cate- gory of leukodystrophy diseases, which result from the destruction of the normal coating, or myelin, of the body's nerve cells. This rare ailment is a genetic disease (it is not contagious) that primarily affects, but is not limit- ed to, Ashkenazi Jews. There are three types of Canavans. The first is the neonatal form, which comes at birth and res t in death in the first several wee of life. It is characterized by irri tability, lethargy and difficulty in swallowing and feeding**,.. With the infantile form the disease appears in the first few months of life, generally resulting in death by the time the child is - 3 - years old. Symptoms are poor psy- chomotor development, blindness and seizures. The third form of Canavans is the juvenile form, which appears after the child is 5 and usually results in death by adolescence. While there are medicines control certain aspects of the ease,there is no cure. There is, however, a simple blood test to see whether you carry the Canavans gene. For the child to contract the disease, both parents must have the gene, and then there remains a 507,- percent chance that the child will not be affected. The most common genetic disorder among Jews is Gaucher disease, a blood and bone disor- der which affects 1 in 10 Ashkenazi Jews. The gene for Tay- Sachs, a fatal neourde- generative disease, affects 1 in 27 Ashkenazi Jews. About one in 40 Ashkenazi Jews carry the gene for Canavans. For more information, contact the United Leukodystrophy Foundation, 2304 Highland Drive, Sycamore, Ill. 60178, (815) 895-3211. Nurse Simmons says Chaya Leah's knowledge of Hershy's condition, her understanding of what he needs, and her care of her son make her "excep- tional." Chaya Leah, for her part, couldn't make it without the nurses. They help dress and bathe Hershy, work on his visual and auditory skills, and accom- pany him to Wing Lake School where, Nurse Simmons says, he loves wheel- chair square dancing, the hydrotub, and arts and crafts. Hershy can't go out much these days because it's too cold. But in the spring and on mild summer days he and his nurse often take a walk. Securing money for nurses' care and Hershy's many medical needs has been a challenge of its own. Insurance pays for part of it, but there are a number of items, like Hershy's formu- la, that the family must pay out of pocket. The problem is that Hershy has allergies and can only take soy for- mula, Chaya Leah explains. Insurance will pay for some formulas, but this one isn't on the list. . Soon after she arrives, Nurse Simmons puts on a tape of happy children's songs, like "Good Day, Sunshine" and "Feelin' Groovy." She finishes dressing Hershy in a white shirt and soft-blue pants, hoists him into his wheelchair, and empties his diaper pail and strips the bed. She packs a bag with a change of clothes, medicines, a stethoscope, "everything he'll need for the day," and places Hershy's liquid_food in a blue back- pack attached to the wheelchair. Chaya Leah then bundles up her boy, complete with grey-wool socks over his hands. "We couldn't find wool gloves," she explains. Hershy's immune system is especially vulnera- ble. He can start with a slight sniffle in the morning, and by 2 p.m. it will be a 103-degree fever. Untreated, it can turn into deadly pneumonia. Chaya Leah cradles Hershy's face in her hands and smiles at him. "Okey dokes, we're ready to go!" They are on their way for a haircut and to the doctor, but first comes a minor crisis. The trouble occurs when Chaya Leah tries to raise the hydraulic lift, which brings Hershy's wheelchair into the van. It jumps up and down, down and up, but won't go back in place. As the lift shakes and jolts so does the van, and Hershy laughs. It's the noise, Chaya Leah says. Hershy loves loud noises, and especial- ly the sound of Velcro on the straps that hug his legs and head so he won't fall , out of the wheelchair. In-between bites on a peanut-butter sandwich and sips from a Poland Spring water bottle, Chaya Leah is on the phone trying to get help. Finally, a g ood 20 minutes later, a mechanic arrives. With a few twists of his screw- driver he manages to fix the lift — temporarily — then tells Chaya Leah what to do if it breaks again. So now, in addition to mother and nurse, she is a mechanic. At last, jumping into the van, Chaya Leah looks at Hershy and his gaze seems to stay, if just foi an instant, on his mother. It must take a great deal of effort on his part to focus 55t.Strgi - NK ari414 CC INRCE SOi €14 0 .* .: . " 46) kail(1.42.7 a 47 4 ctic..4044,R. 'fr*AireV ' PHI ; e*VP .41. ;';'1" Like soldiers on duty, medicines are lined up in Hershy's bathroom. 11/28 1997 80 in that glance — a loving, helpless glance. "Okay, Hershy," she says, sighing. Chaya Leah pulls out of the driveway. "Now we're really going." C • haya Leah Tinman was born and raised in Detroit. She completed high school, went to Israel for a year, started college, then married Michael Tinman. There's a test for it now, but 15 years ago little was known about Canavans. Both parents must be carriers for a child to contract the disease, and even then the chance is 50 percent that he will be affected. The Tinmans, who are now sepa- rated, had two healthy girls before fiershy was born, Alarm, now 13, and Rachel, 11. Initially, he seemed fine. But then his eyes began to cross, he was excep- tionally quiet, and he couldn't hold his head up like other babies. It took a long time for Hershy's ail- ment to be identified, though every- one knew it was not good. At 17 months, he became terribly ill and "they told us that he wouldn't live to see the end of the week, then it was that he wouldn't live to the end of the month, and then that he wouldn't live to see his second birthday," Chaya Leah says. "Doctors know a lot, but they're not God." Once Canavans was diagnosed, the W Tinmans knew their son's time was limited, and so they do what they can to make Hershy's life full, joyous. Until several months ago, he slept with them in their bedroom. He goes on all the family vacation's, and to simpler outings, like movies and the mall. "Sometimes he's so sick I don't know whether he'll make it to the end of the day," Chaya Leah says. "Sometimes I have such a fun time with him that I just can't imagine giv- ing him back." The Tinmans' daughters have yet to be tested to see whether they are carri- ers, though Chaya Leah says they will be tested once they turn 18. No ances- tors on either side of the family were known to have been affected. A great deal has changed in the way the disabled are regarded now and the way they were treated when Chaya Leah was young. "When I grew up, we didn't even look at a person in a wheelchair," she •