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

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