Jenna (14) and Jesse (12) Kiel are siblings with MSUD. Many of you have read their history in earlier Newsletters. So now as we are heading into the teen years, I’ve been asked to update you on their life. Carl & I have four children in our family, the two oldest Adam and Sara do not have MSUD. They are now both in college, at Michigan Tech and the University of Michigan respectively. Jenna was the first baby in Michigan to be diagnosed by Newborn Screening, so she was treated for MSUD at 5 days of age. Jesse has been treated as of birth, as we had an amniocentesis done. I could not even imagine life for them when I first heard the news. But 14 years later, we are doing much better than I had anticipated in those early days.

Jenna started high school this fall. This is a big change, as our kids go to a small school near our house, and high school is a blending of 6 schools with a class of 200 kids. She has loved it so far! Jenna Living Well With MSUD drinks 20 ounces of formula throughout the day. She has formula before school, after school, and at night - so the diet is not really an issue at school. Her levels have been very low since school started. We did have a scare this summer. After a 2 week vacation, she started menstruation and her levels rose dramatically. She vomited twice, and we thought she was recovering at home, but her levels kept rising instead of falling. After a week, we checked into our metabolic clinic at Detroit Children’s Hospital and she went on IV fluids with saline, but never needed TPN. She was eating well, and we were back home in 4 days. I believe she was just completely run down, and then the hormones on top of everything else. This was her first hospitalization in 10 years - since she was in preschool.

Aside from MSUD, Jenna lives a normal teenage life. She loves to read, knit (she’s working on Christmas presents now), IM her friends on the computer, and she shares a weekly newspaper route with Jesse. People usually say they cannot believe she has MSUD. I spent parent teacher conferences at the high school educating her teachers about MSUD and Jenna. They were all surprised. Jenna does pretty well in school - she gets A’s in English and reading, but math and science... well, let’s just say they are not her favorites. Jenna will be taking Driver’s Training in the spring. We’ve already set parameters for driving - she must do more frequent DNPH tests and it must be clear for her to drive. She also wants to go to our church’s Youth Convention this summer in Arizona. So that will take a bit of planning for her diet and accountability.

Jesse is in 7th grade. He enjoys playing percussion in band, takes piano lessons and plays keyboard, and shares the newspaper route with Jenna. He recently bought a drum set and has now started a garage band with his friends. It’s a little noisy at our house during their practice!! Jesse is an excellent student, having been involved in Jenison’s Gifted & Talented learning program. He also was 4th runner up in the Regional Spelling Bee. He’s hoping this year will be his year to win. Jesse also drinks 20 oz of formula per day, but does not take it to school anymore. This is an agreement we made when the kids started middle school.

Both kids have spent a week at camp while in 6th grade. We coordinated the menu with the kitchen help, and it really worked out great! Jenna was voted "Best Camper" for being so responsible about her formula and diet.

I believe our biggest challenges right now are: weight gain and hormones. Both kids have put on more weight since hitting puberty. I think all the calories from the formula plus the calories from the food they are eating are just too much. I know this is a common problem in the MSUD population. We have been working with our dietitian to make changes in their formula to lower calorie intake. Also, for Jenna the problem of monthly hormone fluctuations have caused elevated levels. We have adjusted her diet (lowered her protein just before her period) to anticipate for that, and things have been much better the last few months.

I am not trying to over-simply life with MSUD. We have definitely been blessed that Jenna & Jesse’s defect allows them to eat more protein than many MSUD kids - they normally eat 10+ grams of protein per day. They also have been quite resilient to illness and high levels. We have had only 2 hospitalizations in the past 10 years. Until this summer, Jenna had not been in the hospital since she was 4 (over 10 years), and Jesse has had only 1 serious hospitalization which was 5 years ago. I believe life with MSUD has gotten easier past the toddler years. But I am like that rest of you. You always worry, you always wonder, and God gives you the grace and courage to allow them to live their lives. I think the hardest challenge for me as an MSUD parent is to let go. This requires a lot of training and educating of my children, and yet is SO rewarding when you see them making good decisions and choices on their own. Both kids want to go to college like their brother and sister. Oh boy... more letting go!

Galen Carrington Classic MSUD age 27

Galen Carrington is a 27 year old Indiana resident who has classic MSUD. He underwent liver transplantation 5 years ago at Children’s Hospital

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From The Editor

Hello to my MSUD family! The power of this family hit home this summer, when Hannah (Classic MSUD age 23 years) and I visited Israel.

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Updates To Nutrition Management Guidelines

The Nutrition Management Guideline for MSUD was first published in 2014. Since that time, there have been reports of new research and experiences that have prompted updates of the guideline.

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Sweet Odyssey

Artur Santos was born on January 18, 2002, the second son of Soraya and Idario Santos. They never imagined how their lives were about change as the second baby arrived.

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My Trip To Israel

I met Avi, Dikla, and Tamar Starr last year at the MSUD Symposium in Raleigh, NC. Tamar, classic MSUD, was 2 ½ at the time, and they invited me to come to Israel and stay with them for a year.

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Adjusting Protein In An Adult With MSUD

A little over a year ago, in January, Jeff was just not himself. He had limited energy, was not eating well, and often appeared slightly agitated.

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A Child's Life

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