Sunday 28 December 2014

[DAY +47] This morning's exercises:

(1) Marching - 3 x 10 per leg [right leg is weak, it wants to lockout when I lift my left leg]
(2) Standing on one foot (while holding onto chair), write numbers with other foot - 3 x 10 per leg
(3) Kneeling in crouched position with ball in front of me, raise up to kneeling position, then roll ball away from body, pause while extended, roll ball back towards body, slowly drop to crouched position, repeat - 3 x10
(4) Seated toe raises (shin muscle) - 3 x 10 [right leg weaker]
(5) Calf raises (on stairs) - 3 x 10 [legs shake during this exercise]
(6) Lunge  - 3 x10 per leg
(7) Pushup (kneeling) - 2 x 10

It's getting easier to do lunges and pushups - my 'form' is much improved - so I must be getting stronger.  Onward and upward.

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To my knowledge there are three types of MS: (1) relapsing-remitting (most common) (2) secondary progressive (secondary, because the disease morphs into this after some initial timeframe as r-r MS), and (3) primary progressive (primary, because this is the initial diagnosis; this is what I was diagnosed with).  The question of whether all 3 types of MS are auto-immune diseases has been debated recently.  There has been discussion in scientific circles that progressive MS may not be auto-immune, and therefore it likely has a different 'driver' of the disease than r-r MS does.  It has been established that progressive forms of MS have more of a neurodegenerative (death of nerve cells) effect on the patient's central nervous system, and relapsing-remitting MS has more of a demyelination effect on the patient's CNS.  The reason I bring this up is that somebody in the HSCT forum I am part of asked about the r-r vs progressive debate, and the best explanation I have read to date was provided by one of the more knowledgeable forum members, George Goss:

Autoimmunity and neurodedegeneration are not mutually exclusive as both can exist simultaneously. I have heard many doctors claim that relapsing and progressive forms of MS are two different diseases. But what are such statements based upon? My own view is that such belief is false and based solely upon superficial manifestation with no supportable underlying scientific basis (i.e. based upon superficial observations and no in depth research). Although it is true that the underlying etiological cause of MS is still a mystery, it is not necessary to know what actually causes it to treat it because the pathological operating mechanism of MS is reasonably well understood; self intolerant (lymphocytic) autoimmunity. Relapsing MS 'manifests' as demyelination, and progressive MS 'manifests' as axonal dystrophy (neurodegeneration), but this doesn't mean that they are fundamentally different diseases. The most plausible and rational explanation that fits the facts is that they are indeed all the same disease but simply with differing antigen binding repertoires in which progressive MS has an expanded epitope compared to the episodic form. This is why RRMS most often transitions to SPMS in which evolution epitope spreading (diversity expansion) occurs. This explanation would also perfectly explain why HSCT is the MOST effectively demonstrated medical intervention for ALL forms of MS, both relapsing AND progressive. . . .http://media.wayne.edu/2011/02/22/wayne-state-university-researchers-publish-results-settling

My opinion (based on info I have read) was, and is, similar - MS is an auto-immune disease.  No matter the type. And therefore, my belief is that HSCT is a feasible treatment for all types of MS since they are all auto-immune diseases, and here's my basic analogy: If I have a disease due to my liver secreting stuff that attacks my intestines (I have no idea, nor do I care if this is even possible - but it works for my analogy), I would guess that Doctors would opt for a procedure that goes after the problematic parts of my liver.  Since my disease is due to my immune system attacking my central nervous system, I opted for a procedure (HSCT) that goes after the problematic parts of my immune system.

Different types of MS result in different damage to one's central nervous system (as stated above), therefore there will be different requirements for healing (re-myelination, and/or establishment of new nerve pathways since nerve cells are very slow to grow, and may not even grow at all) once the disease is halted.  Healing occurs at different rates for different people, and healing may not occur at all, since it is very patient-specific.

I need a sandwich.

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