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Rare disease diagnosis strengthens bond between twin sisters: ‘Doing our best’

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Rare disease diagnosis strengthens bond between twin sisters: ‘Doing our best’

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As twins and best friends, Natalie and Monica Rex had spent their entire lives together — and were looking forward to continuing those shared experiences into adulthood.

But right before college graduation eight years ago, the twins — now 30 — were shocked to discover that Natalie has Friedreich’s ataxia (FA), a rare, genetic and usually fatal neurological disease that affects only 6,000 people in the U.S.

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The sisters joined Fox News Digital for an on-camera interview about how the little-known disease has changed their lives — and further strengthened their unbreakable bond. (See the video at the top of this article.)

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Natalie was nearing the end of her senior year in college when she started noticing symptoms — primarily issues with her balance.

“I was doing a 5K with my college roommates, and I was just feeling super awkward and clumsy — I would hit about three miles and feel really tired,” she told Fox News Digital.

Natalie and Monica Rex were shocked to discover that Natalie has Friedreich’s ataxia (FA), a rare, genetic and usually fatal neurological disease that affects only 6,000 people in the U.S. (Natalie and Monica Rex)

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That was abnormal for Natalie, who grew up playing sports in a very athletic family.

“I knew something was off,” she said.

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After seeing multiple doctors, having her blood drawn and getting tested for vitamin deficiencies, Natalie finally saw a neurologist.

“He had seen FA before, which was such a gift, because normally the path to diagnosis — particularly for a rare disease — is much longer, and mine was a very short time frame,” she added.

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The diagnosis was a lot to process for Natalie, who was three days from graduation and about to depart for a new job in New York.

“I remember thinking, ‘I can’t imagine what life would be without Natalie.’”

“I was trying to figure out how to get excited about life when I was experiencing everything crumbling,” she said.

“I was an emotional wreck — my whole family had never heard of FA, and we had no idea what to expect and how it would impact things.”

The twins, now age 30, were about to graduate from college when Natalie received her diagnosis. (Natalie and Monica Rex)

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Monica also had a difficult time processing the news.

“It felt like our lives were going to be drastically different and also diverge quite a bit,” she told Fox News Digital during the same interview.

“I remember thinking, ‘I can’t imagine what life would be without Natalie.’ It was a brutal time.”

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Monica has not yet gotten tested for FA, which she said was an “intentional decision.”

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“In the beginning, there would be moments where I would trip on something and would wonder if I should get tested,” she said. “But after seeing some of Natalie’s progression, I don’t think that I have FA.”

She added, “If I do have it, we’ll find out when we need to — but there’s no need to expedite that.”

What to know about FA

Friedreich’s ataxia (FA) is defined as a “genetic, progressive neuromuscular disease,” according to the Friedreich’s Ataxia Research Alliance.

Initial symptoms include balance and coordination problems, which ultimately lead to a loss of mobility.

“It felt like our lives were going to be drastically different and also diverge quite a bit,” Monica (left), the twin who does not have FA, told Fox News Digital. (Natalie and Monica Rex)

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Some people with FA also suffer from diabetes, scoliosis, fatigue, slurred speech, heart conditions, and vision and hearing impairment, the Alliance states.

As FA is genetic, a diagnosis is made by testing for a mutation in the gene FXN, which is responsible for causing the disease.

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Most people are diagnosed in childhood between 5 and 15 years of age, according to the Alliance, but about a quarter of people experience symptoms as adults, which is known as late-onset FA.

The disease is classified as “life-shortening,” with life expectancy typically ranging from 37 to 50 years.

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“It’s brutal to watch the person you love most in the world go through something they can’t control.”

While there is not yet a cure for FA, there are medications that can help control symptoms.

Natalie has participated in clinical trials for a drug called Skyclarys (omaveloxolone), the first FDA-approved therapy designed to slow progression of the disease.

Sisterly support

After Natalie’s diagnosis, she and her twin sister moved in together in Washington, D.C.

“Monica has taken on the role of being sister, friend, roommate and caregiver,” Natalie said. 

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“She wanted to stay close to help us live a very celebratory life while I’m in my more mobile years.”

“I think it’s really drawn us very close, which has been amazing,” Natalie (right) said of the twins’ experience of navigating life with FA. (Natalie and Monica Rex)

In many ways, the sisters enjoy life as they always have, hosting dinners and movie nights with friends — but in other ways, Natalie’s disease has resulted in two very different experiences for the twins.

“I think it’s really drawn us very close, which has been amazing,” Natalie said. 

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“But it’s also created a lot of moments where we have to understand that our limits and our constraints are different, and we have to work together to give each other the freedom to do things differently.”

Monica expressed her pride in her sister’s determination and tenacity as she navigates FA, including taking “agency and ownership” of her health and participating in physical therapy and personal training.

As Christians, the sisters have drawn comfort and support from their faith as they navigate the challenges of Natalie’s disease. (Natalie and Monica Rex)

“It is an incredibly unfair situation, but she is completely taking it in stride,” Monica said. 

“It’s brutal to watch the person you love most in the world go through something they can’t control that impacts every day and every moment — but we’ve just tried to take it day by day together.”

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The sisters see their friendship and relationship as a “unique gift,” Monica added.

“There have been moments of tension as we figure out what it looks like to navigate this together — but we will always be there for each other, and we’ll always have each other’s backs,” she added.

      

“At the end of the day, we truly just want what’s best for each other.”

Leaning on faith

As Christians, the sisters have drawn comfort and support from their faith as they navigate the challenges of Natalie’s disease.

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“I lean heavily into my faith to understand and process the purpose and hope that can come from a hopeless diagnosis like FA,” Natalie told Fox News Digital.

“The physical decline of Natalie’s body is a daily reminder that this world is not our home — and that one day, all things, including our bodies, will be made whole and healthy in eternity,” said Monica. (Natalie Rex)

One of Natalie’s favorite Bible verses is 2 Corinthians 4:16, which says, “Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day.”

Monica added that she trusts God has a “bigger plan” for their pain. 

“We’re going to have really hard moments, but we’re doing our best to make good things come from something hard.”

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“The physical decline of Natalie’s body is a daily reminder that this world is not our home — and that one day, all things, including our bodies, will be made whole and healthy in eternity,” she said.

Despite her day-to-day struggles, Natalie strives to stay as positive as possible, focusing on “disrupting the myth that that joy can only be found in a pain-free life.”

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“Life is not going to be perfect, but we can still make it really good,” she said. 

“We’re going to have really hard moments, but we’re doing our best to make good things come from something hard.”

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Health

Common nighttime noise exposure may trigger heart problems, study suggests

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Common nighttime noise exposure may trigger heart problems, study suggests

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Living near heavy traffic could negatively impact your heart health.

A European study, published in the journal Environmental Research, found that exposure to nighttime road traffic noise is linked to changes in the blood, leading to worsened cholesterol and cardiovascular risks.

The researchers considered data from the U.K. Biobank, Rotterdam Study, and Northern Finland Birth Cohort 1966, including more than 272,000 adults over the age of 30, according to a press release.

Nighttime road noise exposure was estimated at all participants’ homes based on national noise maps. Researchers also took blood samples to measure the participants’ metabolic biomarkers for disease, then mapped the link between nightly noise levels and existence of biomarkers.

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Exposure to loud noise was associated with increased concentrations of cholesterol-related biomarkers. (iStock)

The study found that people exposed to louder noise at night — especially sounds above 55 decibels — showed changes in 48 different substances in their blood. Twenty of these associations “remained robust” throughout all cohorts.

Exposure to loud noise was associated with increased concentrations of cholesterol-related biomarkers, especially LDL “bad” cholesterol, IDL (intermediate-density lipoprotein) and unsaturated fatty acids.

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As noise levels increased, starting at around 50 decibels, cholesterol markers rose steadily, the release stated.

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The authors concluded that this study “provides evidence that nighttime road traffic noise exposure from 50 dB upward is associated with alterations in blood cholesterol and lipid profiles in adults.”

Researchers noted a link between traffic noise and cardiometabolic disease. (iStock)

Study co-author Yiyan He, doctoral researcher at the University of Oulu in Finland, noted that in this type of research, small effect sizes are expected, and environmental exposures such as traffic noise are “typically modest.”

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“Despite this, we observed statistically robust and consistent associations across many biomarkers, especially those related to LDL and IDL lipoproteins,” she told Fox News Digital.

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“We also identified a clear exposure-response pattern starting at around 50 dB, suggesting that metabolic changes become more evident as noise levels increase.”

This aligns with public health guidance, as the World Health Organization recommends lower nighttime noise limits at around 40 to 45 dB, Yiyan He added.

“This finding may clarify the association between traffic noise and cardiometabolic diseases,” the researchers wrote. (iStock)

“The 55 dB level is often used as an interim benchmark associated with substantial noise annoyance and sleep disturbance,” she said. “In our study, we observed associations not only at 55 dB, but also indications of effects emerging at around 50 dB.”

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The strength and consistency of the cholesterol-related associations were surprising, as these changes are usually “subtle.”

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“Instead, we found consistent associations across multiple large European cohorts, which strengthens confidence that the findings may reflect real biological patterns,” Yiyan He went on. “We were also interested to see that effects were minimal below ~50 dB, suggesting a possible threshold-like pattern.”

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The researcher noted that these findings were consistent across genders, education levels and obesity status.

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The study was restricted to White Europeans, which posed a limitation. There was also a lack of information on the fasting status in the UK Biobank.

Changes in cholesterol levels were more severe than researchers expected. (iStock)

“Fasting can influence levels of certain metabolites, particularly fatty acids,” Yiyan He said. “However, based on UK Biobank documentation, fewer than 10% of participants were fasting for at least eight hours, and our main findings focused on cholesterol-related biomarkers, which are generally less sensitive to short-term fasting.”

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The researchers also lacked information on bedroom location, indoor noise exposure and time spent at home.

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“These factors may introduce non-differential exposure misclassification,” Yiyan He said. “Additionally, noise exposure estimates were based on participants’ temporary residential addresses at the time of blood sampling, without considering the duration of residence.”

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“Many of these limitations would tend to bias results toward the null, so the consistent associations we observed remain noteworthy.”

Experts recommend taking measures to limit traffic noise at night. (iStock)

Based on this latest research, Yiyan He noted that nighttime noise is a “health-relevant exposure,” not just “an annoyance.”

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“Our findings suggest that nighttime traffic noise may subtly but consistently affect metabolic health,” she said. “While the changes in cholesterol and lipid levels for any one individual are small, traffic noise affects a very large number of people, which means the potential public health impact could be substantial.”

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The researcher recommends taking measures like improving sound insulation, using noise-reducing strategies and placing bedrooms on the quieter side of the home when possible.

“Because sleep is a key pathway linking noise to health, protecting the nighttime sleep environment is especially important,” she added.

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