Friday, November 16, 2018

Major surgery and MS


 Picture  from en.wikipedia.org


October 2017, a month that pain once again went into right shoulder, but this time traveled down to the fingers of the right arm.  Non of my twenty some meds would touch this pain.  I am not on any opiods other types of pain pills for this type of pain.    My GP got me into the hospital for a MRI of my cervical spine. Not all MRI machines have the magnetic strength they need to see everything. Make a note of that, and even ask hospital.you may be surprised on how old some mri's are that are in use.

The MRI showed two herniated disk, pinching on the right and left side. Of the neck, but I was only experienced pain on right side. A sharp jab in right shoulder that would not let loose. Even tried tennis balls to roll down muscle.Spine health has a good description.


A epidural was scheduled December 26th.  This is where they inject  by needle, a steroid shot into the nerve space by guidance of a   scanning machine. Made for a nice picture of needle injected, but gave me no relief for the pain.  None of my meds worked with this jab in the shoulder that traveled down the arm to zaps from fingers.

On top of this, a optometrist appointment was scheduled before Christmas. He noticed one eye  pupil was not responding to the light shined into it. Further investigation when dilated, showed what appeared to be cotton balls on the end of the nerves.  He faxed his findings to my Neurologist, and she started a five day round of steroids by iv drip in hospital right before Christmas.  So I ended up with a double whammy of steroids.

UC Davis set me up for surgery. Their plan was to put a plate and spacers where the two herniated discs were. During consulting, they pointed out two more discs, as the small town hospital we have, does not have a strong enough magnet.  Their X-Ray picked this up.

I asked my doctors about this.  I had just switched to a new GP, who showed major concern. My Neurologist had questions.  So I asked before and then again during pre-op. They fitted me into a neck brace. Being like a car salesman, not explaining anything.  I asked Dr, why a neurosurgeon was not doing operation, due to my progressive MS.

I asked how much pain was due to MS, and how much was due to the herniated discs, as  would I not have same pain going down right side also?  I asked how long will it take me to heal, with a compromised immune system. I  asked, if they were only doing two disc, wouldn't the disc above and below break off from the stress? Would my bones hold the screws, as my bone density is low.So

This is when everyone left the room. No goodbye, nothing.  I looked at my partner, and said "guess we are done here". I went to the check out desk, where a lady in front of me in good health, this was her third surgery. Yes the plate breaks off the bone above or below the operation.  They scrape the muscle, and nerves away from bones being fused together.
A ongoing surgery needing done every time.
I was glad to of opted out, and extremely glad my me GP, was able to stand up to my questions, explaining items of how dangerous this major surgery was, why the surgeon was not explaining.

My Neurologist put me on Hyaluronac Acid  and Chondroitin sulfate   He had a brand name bottle, but  it was expensive.   he wanted me on 400 mg Hyaluronic acid. That would be four pills a day.


What is Hyaluronic Acid?
A protein found naturally in the body, particularly in the joints as a component of Synovial Fluid (a lubricant that reduces friction) and in the collagen network responsible for maintaining the structure of the skin.
Hyaluronic acid (HLA) is often called "the fountain of youth" and is known to hold up to 1000 times it’s weight in water. As we age HLA degenerates, leaving us with aching stiff joints and a dried out skin structure that beneath the surface is damaged and on the surface is visible as wrinkles.

It is thought that supplementing can help replace the lost hyaluronic acid.


Chondroitin helps prevent joint degeneration by producing collagen, which keeps joints flexible and skin looking youthful and smooth. Chondroitin also regenerates cartilage, which maintains tissue integrity and helps heal wounds.


This combination was amazing. Almost instant relief in a few days.  Scouring the Internet, I found  300 mg hyaluronic acid pill from london. So 1 1/2 pills  =450 mg.  Swanson vitamin   had the chondroitin Sulfate in 600 mg capsule.  These were more in my budget.
And worked wonders.  I found these in powder form also, with proper measuring spoons, makes it as easy to take or a simple pill and 1/2 plus

A week after I left the surgery center, I get a updated report on my neck. The report, being the X-Ray,  showed deteriorated disc space between all disc. Which would not of allowed any spot to for them to of screwed and fused a metal plates to.

I would not know until The next October about  Rare blood cancer or is a rare blood autoimmune that I found out I have, that would of also voided any surgery. They would of opened me up, and gone uh oh.

Thanks for reading
JoeY

Tuesday, November 6, 2018

Phlebotomy And Multiple Sclerosis



We need to jump ahead into the present day, being October 2018.
I am treading on new ground, that my Endocrinologist, Neurologist GP, and Cancer Dr have not seen

the ancient art of blood letting,  or now called a Phlebotomy is used in only one disease.
I have primary progressive multiple sclerosis. This is not what they are using phlebotomy for.  I was not expecting another diagnosis, or was I looking for one.

I have been on testosterone therapy for years now. A Endocrinologist was watching over me for also needing 150,000 iu a week of vitamin D to keep my numbers up.  She had taken me off testosterone, to do a MRI of the pituitary gland, to ensure no tumor. Nothing was found. It was difficult on the mind to cold stop testosterone, for anybody thinking of stopping.

My blood, I've always been told it's thick, or large cells. I could not get my testosterone level up. My hematocrit and hemoglobin has always ran high for years. My heart Dr said, while sitting, it's like MS always has me running a marathon.

Many EKG done by other doctors, because of excessive pulse and numbers.  but what I was not expecting was for the endocrinologist to send me to the cancer unit.

My Newest Dr was one at ease, saying it was the testosterone therapy causing thick blood. I told him endocrinologist said it was not. He agreed to run some tests. A DNA of the Jak2 gene, and others,

The JAK2 gene mutation test identifies whether there is a mutation on the JAK2 gene that could cause a myeloproliferative disorder. Polycythemia vera is one of the diseases with a high correlation with a JAK2 mutation.
Mine was negative, but my Iron was off the chart.

He then ran the HFE gene.  I have a great GP that also mentioned This gene. This consist of the C282Y and h63d gene.  I was given one gene from each parent, along with brothers and sisters, and going backwards thru family tree on both sides, to aunts, uncles, cousins, ect.

Hereditary hemochromatosis is present at birth. But, most people don't experience signs and symptoms until later in life — usually between the ages of 40 and 60 in men and after age 60 in women. Women are more likely to develop symptoms after menopause, when they no longer lose iron. My Neurologist niece was diagnosed at the age of 17.

But I have a Quite Rare type.

HEMOCHROMATOSIS DNA, RESULT Homozygous Mutant Negative A
Homozygous for the H63D mutation and negative for the C282Y mutation in the HFE gene. Five percent of C282Y
homozygotes and rare H63D homozygotes develop clinical symptoms. Genetic counseling is recommended.

So more research, and I find only one other person in ten years

 https://www.. .nlm.nih.gov/pmc/articles/PMC4071918
https://www.. .nlm.nih.gov/pmc/articles/PMC4071918/

So with Multiple Sclerosis, I now am dealing with weekly phlebotomy, to try to rid myself of iron overload symptoms. the Gene center told All blood relatives needed contacted, as hereditary.

My blood comes out as thick or thicker than pancake batter.

  I think more studies need done, as I can not be the only one with MS, and Iron overload. Iron also effects the pituitary gland, so that tells me it crosses the brain barrier.
 Would love to know if anybody else has this rare H63d Gene, doing  phlebotomy,  and has MS.  How it effects MS, or any articles found.



Thanks for reading
JoeY

Monday, October 29, 2018

Panel member for newest MS Drug



2016 october, myself and my partner were invited to be on a panel with thirteen other people who had PPMS, and their partners.  We had just returned from another Alaska trip, which I need to blog about. But those were easy short airplane trips, a hour here, stretch, and your there, relax. Change planes, relax. But I had not recouped from Alaska, or seeing mom and our friend Larry and Karen from Sequim, when given this opportunity.

I had to really question being cooped up in a airplane for three hours, to Chicago from Sacramento, and another hour and half  car service ride to airport, plus going thru TSA checkpoint with twenty medicines, syringes, and documents.

I had failed the checkpoint on the Alaska trip, as TSA agent yelling commands to raise arms higher and keep feet on floor map as machine spun. My spasticity set off the alarms for me to be patted down.  I have since learned that I can not use this machine, and I am taken to the side of machine, and even My cane has to go thru x-ray
 My liquid medicine, even if unopened, gets opened and tested.

I finally conceded to go, when their interest in our participation was, they would put us in a sleeper car on Amtrak train, for my spasticity, for trip home.

 I had never ridden a train before.  That was awsome.! Trains are not made for The handicapped, but they gave us The handicapped suite. Beds that folded down from chairs, to make a bunkbed. A private toilet, but we used one with a door right outside our room. A Shower room was next to that.  The room Took up train from side to side. Our room attendant was wonderful. You did need to climb winding stairs, and cross quite a few sleeper cars upstairs to get to domed observation car, and dining car. All meals were included.

The meeting of the Genetech team from San Francisco, and researchers, scientists, the meeting producers, Bruno mars from Switzerland, the head scientist for the secret product we were panel members on.  It was a great opportunity, and would give input again to see steps needed to obtain FDA approval.

We were shown graphs, of what looked better,  the new drug, being a molecule away from rituxamb, which just lost its patent. Marc tells more than I can in wheelchairKamikaze.com, and I can be relaxed I did not share anything from their 24 page attorneys small print release form that we both had to sign. The Drug I had already figured out was Ocrelizumab.
ocrelizumab commentary by wheelchairkamakaze


I figured out that it was the newest drug for PPMS, as that's what all the 13 panel members had. Everyone was on Ampyra, the magical drug to help keep us walking. Everyone used some type of mobility device. Those that had stopped their primary Drug , immunology modifier, we're limited to wheelchairs. Had to take a mental note. Questions were answered with vague answers from their speaker, who was having input from their team of lawyers, and research team.

They fed us good, was a first class hotel, and a shuttle car, which I forgot about. The Chicago airport greeted me with a wheelchair, but attendant knew no english. I walked my Charlie horse off with cane, as he pushed bags around. We went up and down employee elevators, until finally getting to a airport hotel bus.  A adventure inside the Chicago International Airport.  A call when returning home told us a car service has been awaiting for us.

Matt has in his post this year, with him starting.  My First Ocrevus Infusion

My nephew lives in Chicago, so we got to take the Blue line down and have dinner with him, and see my sister in the morning, before being taken in a Lincoln navigator to Chicago Amtrak Train station.

This is when the World Series was playing and the winning events were going on. Crowds of people. Would not of found train, if it were not for red carpet treatment with shuttle to train track.I

The Amazing Race Amtrak took us straight across from. Chicago to Sacramento.

Thanks for reading
JoeY

Friday, October 5, 2018

Quinine Toxic or helpful?





What is JoeY talking about now, you will ask.--------------------------------------------

Quinine is still added to Tonic Water. This is what you can use to make Gin and Tonic, or drink it alone. The USA banned quinine in all the other medicines that were available made with this, except Tonic Water, and limits how much they can use.

Quinine is made from the cinchona bark. As you might know, cinchona bark consists of quinine, which is toxic.
 
Quinine is a unique substance. It comes from the bark of the cinchona bark.
  It has a legal limit of 83 ppm in carbonated drinks, Tonic water, the only one.   Besides the use in Gin and Tonic, it was used medically for cramps before being banned in the USA.


"take one of the most popular tonic syrup recipes, published by Jeffrey Morgenthaler: 
Basically, it's 6 cups of liquid to 1/4 cup of powdered cinchona bark, which is about 35 grams of cinchona. Extrapolate from that and we're talking about 35 grams of cinchona per 1.4 liters of end syrup, which is 25 grams per liter, and if it extracts fully, contributes 1.25 grams of quinine per liter, which equates to 1251 parts per million. That's 15 times the CFR standard.
If you use 3/4 of an ounce of that syrup in a Gin and Tonic, you're adding in 27.5 mg of quinine - more than double the amount of quinine in a commercial gin and tonic. 
Note: Does a syrup extract quinine fully from the cinchona? No - but it extracts faster from powdered cinchona versus cinchona chips or quills.
Note: Does a syrup that is sieved through a french press or a coffee filter have a high percentage of solids still in suspension? Yes - and any of the solids you swallow contribute the full amount of the quinine as your body digests the powder. "

You must also hear The researchers notes read from test done by scientist. This may be enough to make sure to talk to Doctors before use. 


The Baclofen I am on was maxed out on the limit that I could use.  Diazepam in low dose was tried.

The spasms, Charlie horse and muscles in my calves not letting up.  Botox was being used every three months, Injected into certain spots of the muscles, by a Neurologist. This would last 60 days.
Research was done when Neurologist mentioned Quinine may help. A EKG was done of my heart.

A regular quart bottle was taken of  Tonic water which contained Quinine.  Nothing,  but it has A lot of sugar, and the sugarless has a sugar substitute, what I thought had been banned twenty years ago.

But not enough Quinine, and to much sugar.

My research led me to Quinine. The Dangers of Quinine, and how to make your own.
I found some suppliers, buying a pound of Quinine bark, and following a recipie by Jeffrey Morgan


https://www.jeffreymorgenthaler.com/how-to-make-your-own-tonic-water/

Their are different types of bark, and more research. This site has a lot of information.

This would amount to taking a shot glass, or a ounce of homemade quinine, which is about 27 mg quinine. 
Drinking this elixir would immediately stop my curling toes, and the bottom of the feet to the calves. I did not use any gin, and lowered The sugar content, as the Tonic quinine is what I wanted.

The recipe, and math was gone over with my Neurologist, and Heart Dr, so I would not build up to much quinine in my body. 

30 grams per ounce is what I try to obtain. Not more than a shot in a day, and only when really needed. 

Regular checks with the heart Dr, doing EKG, Echos,  GP, and Neurologist is a must! Listen to video.

  I could say this is a wonder bark from the tree, but you need to listen to the researchers notes to know why this was pulled from the market.  You need  your GP, Neurologist, Heart Dr, and all involved in your team to know before making it, or use of this substance. I am not promoting its use, or making this, just my research, and what worked for me might not work for someone else.

I am not saying, go make your own quinine.  But try a bottle of Tonic Water. It might be all you need.

Or better yet, a Tablespoon of yellow Mustard, has wonderful properties, scientist can not explain how Mustard will bypass digestion system, and calm muscle spasms. This was A mention from my Neurologist to try years later. Mustard. A plain yellow mustard works.

Thanks for reading
JoeY

Thursday, September 27, 2018

Alaska adventure with MS



My mom lives in Alaska. I am fortunate to have Wils Mom as a "mom" also, and my mom like a mom to Wil.  I had not seen her in ten years, since she was married, and swept back to my hometown of Juneau.  I was going to just show up and surpise!!! But my Marion mom told me part of the fun is the expectation.
I had left hints, that we were going to Sitka, and staying in the old Military Hospital.
-Sitka_International_Hostel


 This was turned into a youth hostel, many years before.  But she assumed it was for MS, getting worried it was a ms hospital until I told her.

Traveling with MS, something new. Does medicine need ice? Or cool enough, as it was the end of tourist season in Alaska. A bag bigger than my day pack was used to just carry medicines.  I failed the stand in TSA machine, as spasticity was moving my muscles. I had to show and open some liquid medicine, and have a pat down.

We  wore masks on the plane to keep viruses away from us. You get some interesting looks.think one guy thought we had the plague, while another just asked.. A transfer was made in Seattle, then landing in Sitka, which was home for a few days. Sitka, a expensive place to live, but a town untouched by the huge tourist ships. The huge hotel is owned by the cruise ships though. There is a brewery there, a bus ride driven by a 92 year old, with locals telling him where to turn will get you to their location.  --------------------------------------------

Baranof island brewing Has some of the best beers I have tasted. The Hotel has some on tap, as we dried off from the rain storm and had dinner. The day we arrived. The walk across the scenic bridge was amazing to get to town. it even rained on us, to get us soaked. But the view in the rain, could not pass up. The hostel made a excellent building with history. The Fresh halibut is a wow factor to eat.

Everything was close by, and food was exceptional.  Some places were already closed, as Just because we were a few days past The tourist  season. Two days in Sitka was not long enough.

The next leg was a quick flight to Juneau. It was a packed flight with students on a trip to Fairbanks. Juneau airfield, don't miss it by a foot in landing a plane, or you will be in the ocean.

The cruise ships had stopped, and boarded up most of the town, as they move their employees and merchandise to the Caribbean. This part of town has changed since playing as a kid.  the state ferry dock used to be right down town, not right miles from town with no transportation to or from it.  The Baronof Hotel was now owned by the cruise ships, and the old paintings that made it Grand were gone. A whole section made for many cruise ships to dock, and walk a new boardwalk, a library with a seven story parking garage would be small compared to a ship next to it.

New stores, a Tram to go to the top of the Mountains, even though wooden stairs are still down the street.


 Think Wil and I spent a week at my mom, Judy, and her husband Wayne. My Aunt and her husband Don were in town from Haines. He was full of stories.. Juneau is a place to see, but not quickly on a cruise line tour. you just won't see everything , as just A few hours, as rushed by a cruise time frame.

The glacier I slid on as a kid had receded a mile, and I was not up to a hike to it, but enjoyeenjoyedd it,  and a paved road to it.

Their was a freeway!! , dirt roads paved,  The chicken park still there I played at, a new bridge across to Douglass island.  Saw my cousin, but not long enough.


 Fatigue had hold of me, so seeing places  was tiring me out extremely. Meds were my only choice, as could not bring other concoctions. Staying awake, even with modafinil was hard, but enjoying the sights, scenery, still could not be done in a week. Spasticity and MS symptoms all there.

. My mom's church invited us to a salmon lunch. A few people there, but only side dishes were on The table. The Elders were out fishing to bring the salmon fresh to the grill. Best ever!  Freshest!I
And so many leftovers for everyone.

Think our dogs missed us, as a ten day trip, watched by Marion, my other Mom.  This amazing race took place in the end of 2015

Thanks for reading
JoeY


Wednesday, September 26, 2018

Toxic Drugs used with good effects

A Drug made specifics for MS  patients, for increased walking speed. Could Ampyra do all that? It is in a timed released pill that is taken every twelve hours.

dalfampridine, also known as Ampyra, is made specifically for MS and walking.  It is derived from a toxic substances used to kill birds, or deter them from parking lots, or unwanted areas.


Ampyra helps electrical signals move better along the nerves in your brain and spinal cord. When you have MS, your nerves lose the protective coating, called myelin, that helps messages zip up and down your body.

Ampyra does have the same active ingredient as an avian poison. Many  drugs are based on toxic substances, such as rat poisons. Experimentation has even been done with spider and scorpion venom to treat various diseases. botulinum  is a deadly bacteria.  It's the way they are dosed and tweaked that make them safe to use as directed.

You also have to keep in mind, we are not birds or rats. We can test our drugs on animals, but sooner or later, those tests move on to humans..

Something toxic to them may be beneficial to us or vice versa. Look at how many things we happily and safely eat that could kill our pets...things like chocolate, avacado and grapes, for example.

what can kill or harm one animal ( a bird in this case) doesn't necessarily have to kill or harm another (human). 4-AP, the compounded in original version of Ampyra (still available) has been safely used for many years.

Hamlet, Shakespeare said, "There is nothing either good or bad, but thinking makes it so." Funny how the name attached to something turns it either good or bad.

Chemotherapy for cancer treatment is a kind of poison, but it's fine-tuned for the purpose and, although it makes people sick by itself, people wanting to survive cancer are willing to to take poison to defeat a greater evil.

Nicotine has been used as an insecticide, and ethanol can be poisonous, yet people smoke and drink without much concern about the poisonous effects because they like the other effects they get from those chemicals.

In a parallel life, 4AP is used as an avicide -- bird poison. But in controlled doses, the neurotoxin effect that kills pigeons can be used to counteract the effects of demyelination in humans. When used unwisely in humans, or in particularly susceptible individuals, 4AP and Ampyra can cause seizures. That's a lesser effect of how it kills birds. (Ever stop to think about how insects die when you use bug spray on them?) But when used in a controlled way, the same chemical allows people to walk better and resume doing things they couldn't do otherwise.


But 4AP's double life as a killer and a helper isn't much different than that of botulinum toxin.

 Botulism  for clostridiym botulinum can kill people, but when the toxin is refined and used selectively and appropriately,  such as onabotulinumtoxinA (Botox), can relieve spasticity and make people's lives significantly better.

Botox has risks, and those risks have to be weighed against its benefits. Ampyra is no different.

Brain & Life, the April/May 2018 has a great article.
Brain&Life


A must read,  on how it can relax muscles, as brain signals, which are damaged by MS, sending the nerves), to contract.

I do get Botulism Toxin injected into both calfs,  into my neck and shoulder muscles since the beginning of MS, done by my Neurologist.
 Ampyra has also helped keep me walking at a faster speed, and  has helped in other ways to be explained.


Thanks for reading
JoeY

Spasticity

Most people with MS will experience Spasticity.  There are many medicines, and names for similar ones.  I was titrated up on Baclofen quite quickly to address my calves and muscles being stiff. 10 mg, eight times a day maxes the amount Drs. prescribe.

 Baclofen has a short life span, so this why you are always taking a pill so many hours a day

I found spasticity to turn up a few notches at night time, this keeping me awake.  legs stiff, if not Charlie horsed, or vibrating from the muscles. I would have four tablets to take at night, along with gabapentin and lyrica.

  I was offered a Baclofen pump to be installed, but knowing after reading George's blog, I was quite against a Baclofen pump.   This was refused seven years into my MS.  Judy  writes a memorial about George, The Geek From Detroit. He will be missed.

Yes, I will jump around in the years, as easiest way to explain things, and things I know now, but did not know by doing much research.

Botox, also known as onabotulism type A, was also started as treatment early on.   the damage being done by my brains myelin sheath was causing nerves that control the muscles to mis-fire.

Many muscles are used to control each movement in the body. The Botox was injected into both calf muscles, as I was Having to tell the right foot to walk step by step. This treatment was started at The beginning, to try to slow The MS down. Botox was also injected into the neck muscles, and is also used for migraines in the forehead.  It's life span worked 62-64 days on me, but our government only allows injection every 90 days.

The Right leg and foot had turned to a three o'clock position on me. I walk with a cane as of today.

But the position of the foot leg pointing to This awkward position  caused  spasms, Charlie horse on both legs, and toes to curl under or outwards.  there was no room to add more baclofen to help.

The Botox helped.

A New medicine, ACTHAR.   https://www.actharmsrelapse.com  https://www.actharmsrelapse.com

  was used to try and slow the MS down. Injected into the thigh muscle for five days.

"H.P. Acthar (repository corticotropin) Gel is an adrenocorticotropic hormone used to treat relapsing multiple sclerosis (MS), infantile spasms, and nephrotic syndrome (a collection of symptoms that indicate kidney damage). "
Acthar

Achtar side effects

 My partner, Wil, had the fun of injection of the three inch needle.  I wish the insurance was not as stingy on this medicine, as I would ask to try it a few more times over the years, but prednisone would be used instead, as insurance companies like to play Dr. Giving you steroids instead.


The Next newest drug, made especially for walking was added to my concoction of daily meds shortly after, and one my next article talks about Ampyra, and the  Botulism (botox) being injected

Thanks for reading
JoeY