In August, fatigued 7-year-old Ezra Tamuity-Loomis of Adams was being fed through a tube into his stomach, receiving narcotic pain medication through a mainline IV drip and being readied for a move into hospice care.

Today, he's a medicine-free, energetic youngster who eats on his own and is "very proud he is healthy now and no longer a sick little boy," according to his pediatrician, Dr. Mary Goessler, who testified last week for Butler County Children and Youth Services.

In fact, CYS contends the child never was a sick little boy, but rather the victim of his mother's fabrications.

The agency took custody of Ezra and his sisters -- 23-month-old Symia and 5-year-old Adia -- in September, saying Melissa Anne "Mannie" Tamuity-Loomis wove such an intricate web of lies and symptoms that she was able to convince the medical community that Ezra and Symia were deathly sick from a rare and difficult-to-diagnose condition known as mitochondrial disease.

She and her husband, Ron Taimuty-Loomis, are trying to reunite their family. They believe their children were sick, but that, if they weren't, the blame belongs to medical professionals who misdiagnosed the children and authorized unnecessary treatments.

It's a tricky case that is expected to continue at least five more court days as attorneys pick apart reams of medical documents and experts battle each other over differing opinions. Four days of testimony were held last week, with CYS presenting its case first.

The agency's strongest testimony came at week's end from Goessler, the children's pediatrician since April and head of pediatrics for Allegheny General Hospital, and from Mary Liddell, a behavior therapist at the Children's Institute, a rehabilitation center for children in Squirrel Hill.

Goessler confirmed for Juvenile Court Master Joe Brydon that the children had undergone a medical turnaround after they were placed in foster care Sept. 2. The court day ended before cross examination by defense attorneys Mildred Sweeney of Cranberry, representing the mother, and Jennifer Gilliland Vanasdale of Pine, representing the father.

Liddell testified that, since foster care, Ezra no longer relies on liquid food supplements and has begun surmounting his lifelong aversion to foods other than chips, cookies and peanut butter crackers. At the bottom of the growth charts since birth, he has gained a pound since November.

Though the CYS case began to gain momentum Friday, defense questioning during earlier testimony last week poked holes in the agency's case:

Dr. Basil Zitelli, a Children's Hospital pediatrician who heads a center that specializes in the diagnosis and treatment of difficult pediatric cases, testified last Monday he believes Mannie Taimuty-Loomis to have Munchausen's syndrome by proxy, a mental or personality disorder in which a parent intentionally feigns or produces symptoms of illness in a child.

He conceded under cross examination that though he considers himself an expert in the disorder, he is not a psychiatrist or psychologist and has no specialty involving medical treatment of adults.

Dr. Bruce Cohen, a pediatric neurologist at the Cleveland Clinic and a renowned expert in mitochondrial disease, testified Tuesday he has evaluated more than 2,000 people for the condition and the Taimuty-Loomis children don't have it.

Under cross-examination, he acknowledged he examined Ezra and Symia once for about 20 minutes and that, though medical history is critical in diagnosing mitochondrial, he didn't have their complete medical records when he made his diagnosis. He also confirmed he vetoed genetic testing despite another doctor's conclusion that a brother, Jonah, had died in January 2001 just shy of his 3rd birthday of cardiomyopathy "most likely" due to mitochondrial disease, which often runs in families.

Mitochondrial disease is a medical condition in which the mitochondria -- the part of a cell responsible for energy production -- fails to work properly. It can affect any organ system and can produce symptoms ranging from poor growth to muscle weakness to developmental delays.

Mars Area Primary School nurse Lynn Fey testified Wednesday that Mannie Taimuty-Loomis repeatedly portrayed Ezra to school officials as a child who had an array of problems, including food aversions, fine motor skill deficiencies, panic attacks, failure to thrive and endurance problems. Fey said Ezra, during first grade in the 2003-04 school year, had independently asked to visit the nurse 21 times because he needed to rest.

Ezra's kindergarten teacher, Sarah Moore, testified Wednesday that Ezra had some trouble with cutting and pasting and got tired toward the end of the half-day kindergarten, but not to an unusual extent for a 5-year-old. She acknowledged she had filled out forms indicating she had concerns about his "stamina and strength" and his "loss of focus" toward the end of the half-day.

Court officials have not scheduled the next court day.

Mannie Taimuty-Loomis, 30, is a stay-at-home mother. Her husband, 31, is a student at Pittsburgh Theological Seminary and is on a leave of absence from Traco in Cranberry, where he works with computers.