Multiple Sclerosis: How It Has Developed In Me
MS: What It Is
I think that Almighty God, perusing His Creation, saw that a turbulence had appeared in the previously-smooth surface of his Construct, Thomas Vetto, MD. He saw the problem, a mixture of anxiety, restlessness, Strang und Sturm, undirected and pent up potencies. God saw my problems and He said: 'Tom, you are bored with Life as you see it. What can We do to fix this? Lets see what you do with This!' MS, a germ, a possibility, one of many unopened genetic paths, was chosen, was opened and proceeded as it would.
This is one way to look at it; being a Roman Catholic I have the advantage of being able, on one hand, to imagine such a scenario and to take some comfort from the idea of of an All Knowing, All Loving and All Merciful Being only giving me what I can handle and what is Best for me, while, also as a Catholic, the reality of our Daily Lives can be dealt with in a very practical, down-to-earth and Secular way.
The Jesuits, founded by Papacy in the mid eighteenth century, had been set up to deal with the pernicious influence of the Masons, though this was never openly stated. The Masons were a group which claimed to have sprung up from ancient builders, starting with the construction of the Pyramids, we suppose. These rich, educated, often titled and titularly Christian or Deist or Protestant men challenged the intellectual face of the Catholic Church and had to be dealt with. The Jesuits were the answer. Themselves educated in religious and also in the sciences and new technical fields emerging from the Renaissance, they were the Masons's intellectual equals. They infiltrated the Masons. The joke was that within thirty years of their foundation, half of the Masons were immersed Jesuits.....This has nothing to do with MS or My MS, though I'm sure if I were given a minute I could connect them somehow. But this does show a part of My MS Problem. I have a problem with staying focused. So, on we go.
MS is an Autoimmune disease. My immune system has somehow gotten into its head the idea that the living protective tissue which covers my neural axons is Foreign, The connections within the tissues in my brain (specifically the 'white matter', i.e., the myelinated tracts sending information and motor commands from one Action Node of my brain to another) and peripherally running down my spinal cord and into every Moving and Feeling part of Me is covered with material which is Not Me. The presence of this layer, the Myelin, Must Be Eliminated.
Think of Myelin as the protective, black covering around telephone wires running for miles connecting transmitting and receiving stations. Within the stations themselves the connections are small and need no covering or Myelin. Outside, in the open, the wires run on. Meanwhile, a group of birds, no doubt somehow drugged or intoxicated, have decided the black protective covering on the telephone wires should be picked off, removed. They move ahead with Deliberateness. Soon, they have stripped the wires and the transmission of messages is open to disruption.The process is not over, though. There is another cadre of small beings, a repair group, (think of them as some kind of Homunculi, I guess) who seeing the bare unprotected wires start to cover these with an amaloid mixture to protect them.
This is a picture of the Autoimmune Disease which is Multiple Sclerosis. The attacking, surface-stripping birds are the lymphocytes mistakenly sent after the Myelin. The Homunculi are axon-supportive Astrocytes. Most of the Autoimmune diseases are an incorrect identification of Real Me as Invader.
The Lymphocytes have a limlted lifespan, less than two weeks. They originate form outside the brain, in the spleen, I believe and must pass through the Blood-Brain Barrier to enter my brain and do their misguided Dirty Work. One of the laughingly-expensive MS drugs I had been on is Natalizumab, whose action, simply put, is to change the shape of the entry port of the B-B barrier, so that the misguided Lymphocytes cannot enter the brain.
The real damage, though, is not done by the Lymphocytes but by the Astrocytes, which in tyring to repair the damage done, if the environment is one of significant Inflammation (think of a hot environment), tend to get excited and slather the bare, denuded Axons with gallons of amaloid, a neutral background substance, suffocating the pathways and really gluing them down until little useful neural information gets through. This is the Sclerosis they talk about. It seems, if you think about it, that if Inflammation brings on the too-agressive repair effort, that limiting this inflammation, cooling off the the over-excited repair, would limit the damage done. Cold is better for Sclerotics like me. Cool my brain and I think better. I put my clothes on easier. This also explains why I have problem crossing the Senoran Desert with extreme external Heat. (Please see previous blogs which talk about this.) After years with this condition I have accumulated sclerotic damage. I can't walk. My detrussor muscle doesn't work right and the default carrying capacity of the bladder, 400 cc, kicks in and forever how much I can drink at a time is limited. I will never sleep all the night through again but get up every four hours to micturate.
If a sliver were got in the skin, from picking up a rough-surfaced 2x4 for instance, the presence of the sliver would stimulate a cascading process of recruitment of various cells from the immune system to Destroy and Get Rid of this wood piece. (Please see your favorite Histology textbook for details. This cannot be a review-in-depth of First Year Med School. Why? I've already passed that test. Its been years since I studied the subject. God said I was bored. I have MS. Pick a reason!) In any case, the process of developing inflammation soon shows itself: Rubor, Tumor, Calor, Dolor. Redness, Swelling, Heat, Pain. Don't we love it. The skin where the sliver entered reddens, swells a little, becomes locally warm, and hurts. The sliver is isolated from the rest of the body physically by its being surrounded by White Cells working to Digest it and move it near the surface of the skin. It is eventually extruded to the Outside. Essentially a zit develops on the affected skin around the sliver and, when popped accidentally or on purpose, the offending partially-digested mote is gotten rid of. The white cells are, of course, the Pus.
As it turns out, myelin is the around-the-axon-wrapped cytoplasm of a specialized protective cell, the Oligodendrocyte. The beauty of the design (God is a Smart Guy) becomes clearer when you realize that wrapping living cells around the axon elegantly solves the question of, 'how is the myelin applied?' It also explains the so-called Nodes of Ranvier, regular gaps in the myelin covering seen under the microscope. These are simply where the Oligodendrocytes abut.
MS: Why it is and why it came to me
MS, as far as I can tell from having been an English Literature student in a past life, is a disease of the modern age. If it were common since our development as a species, we would expect some mention of it in folk tales or nursery rhymes or cave paintings, for gosh sakes.. But, no. It didn't seem to show up to be commented on until the Eighteenth Century or so. The earliest sufferer I have read of was the German poet Heinrich Heine (who was responsible for one of my favorite quotes: 'Forgive your enemies, but only after they are Hanged.'). His malady was evidently similar to relapsing-remitting MS. The problem with this is that so many people of the time had picked up Syphilis in their formative years that gleets (look it up) were felt to be a normal human developmental stage. Howsomever, the point remains: MS doesn't really show up in common records until fairly late.
It is thought by many that MS found its way into human history about 10,000 years ago with the introduction of Agriculture and specifically in the West with first use of gluten grains, i.e., Wheat. The theory is that gluten crosses the gut lining and enters the bloodstream where it it seen as foreign in folks like me with the gene for MS.it is mistaken for Myelin which then becomes seen as a foreign invader and the immune cascade previously mentioned is initiated. The evidence for all this is largely based on circumstance: many Sclerotics have increased symptoms when wheat-based foods are indulged in. And also dairy and sugar and all foods not on the Hunter-Gatherer menu. MS is less seen in Asia where rice is the principal grain food. Rice is not a gluten grain.
Now, here is something interesting. In WWII when the Nazis had overrun Denmark, they adjusted the local diet. Dairy, sugar, flour and, basically, all things tasty and worth eating were taken for the Reichssoldaten. The Danes got to eat roadkill or at least wild game, nuts and seeds, fruit in season, root vegetables; essentially they reverted to a H-G diet. The interesting point here is that during the war, rates of MS in Danes plummeted. Interesting too is that rates quickly rose when the Allies restored their previous diet.
IS DIET THE ANSWER?
Well, not completely. Like many interesting quandaries the problem seems to be multifactorial. Diet is important but recent work from various centers suggest that Vitamin D has a vital role. MS rates near the equator, really between the Tropics of Cancer and Capricorn, are very low. There are interesting videos from Brazil showing possible cure of MS with agressive treatment with Vitamin D, specifically D-3. The amount? No one seems to say. In reading as much as I could find on this, I found one successfully used dose was 25,000 IU orally per day. How much is this? A Florida lifeguard on the beach in a major state of public undress get about 10,000 I.U. per day. To us flabbier and therefore clothed Citizens, two 5000 IU pills daily. So this reported intake I mention from Brazil is a Megadose. This is less a Big Deal than you might think. Many vitamins, if taken in large amounts will hurt or kill you. Arctic explorers feasting on Polar Bear liver died sometimes of Vitamin A poisoning. We must be Careful. The so-called Daily Recommended Allowances set out by the government are sometimes risible. 60 mg/day of vitamin C in the USA is that high because we grow a lot of citrus fruit in California and Florida and want to Sell it. It is lower where Orange Trees don't grow. The RDA of Vitamin D was enough to stave off Rickets in a nineteenth century London chimney sweep's son. You can take more than 400 or 600 IU//day. A lot more. Won't it poison me, or ruin my kidneys or other Chitlins, or change my religion or Something? No. Since Vitamin D, really a pseudo-hormone, has effects on deposition of Calcium as Bone, some non-medicos suggest the concomitant use of Vitamin K at various doses to manage this. Many people megadosing on Vitamin D take 100mgm/day of K. If you are eating lotsa greens as part of your H-G MS-friendly diet, that may be enough Vitamin K. After seeing the Brazilian material, I started taking 25,000 IU Vitamin D daily until my supplies dropped. I don't drive and depend on loving people who think I am hurting myself with meds. I have decreased my intake to 10,000IU daily until I can myself get to the store and refill. No problems whatsoever have been reported from me with its use. Also, I haven't had a cold in many years. Also, I wake up with no MS-fog. Also,I am blogging.
In the USA, the population living North of a line from L.A. to Charlotte shows a rate of MS of about 1:400. South of this, with more natural sunlight, the rate is 1:6000. Both of my kids, primary blood-kin of a Sclerotic, were born and raised South of the Line.
I said the problem was multifactorial. Here is a brief list of factors, all of which raise the risk of unlocking the Offending Gene: 1) Smoking, 2) Stress or stressful work, 3) vaccination against hepatitis B, 4) lifelong inadequate Vitamin D intake which includes living in Northern climes or under cloudy skies. there are others but these are enough to outline my own case. I was born in Ohio and grew up in Oregon. My diet was American. Lotsa wheat, lotsa dairy, lotsa sugar. I became an Emergency Physician. I was thereby vaccinated against Hep B. I smoked in college and until after Med school, about a pack a day.
Boy, howdy, I moved right along on the path of opening the Allele.
A Picture Or Two
What May Result From It
I guess I may dwindle and die. I may continue to lose function of various systems, my eyes, my arms (totally) the gross functions of my legs, what's left of my plumbing and generative functions, sensation on my skin, which heretofore is not affected, touch wood; my vision and dismally so forth.
This an Autoimmune condition, which suggests to me 1) I caused it somehow and therefore, 2) I may reverse it. Regimens of diet, exercise, self-care., mental exercises, continuing to believe as a Doctor that I am after all indestructible and can expect to live Forever, or at least until I get rid of this Fresh Hell.
Why It May Be A Good Thing
To reiterate, or rather, too Iterate (a correct but uncommon use of the word), God himself, from one way of Thinking, gave this to me when I needed it, to relieve Boredom, to make me work and use my His-Given-Talents, to put Meaning back into my Life, to Give Me Something to Do.
II have studied this condition to the point where I can simplify its teaching points to where a Physician working in the Field can see the many mistakes and over-simplifications in my Spiel and follow me or not, I guess.
This can't be my Final Word. Living on, ever glib, I'm sure I will produce many more comments on this, my Purpose in life.
Please review this!
This blog was written with care and, I think, is complete and ready to be read generally. Please let it be included in my Opus.
More by this Author
A travelogue, one I think many will like to read. A young Physician with a new, bad diagnosis, taking the time to travel and talk.
Observations on the effect of environmental heat on MS sufferers. To wit: why a yearly trip to Oregon in the Summer is necessary for this MS patient.
The sudden onset of my yearly Upper Respiratory Infection, with the concomitant arrival of general Unwellness and an unforeseen, rare appearance of a family Nemesis, Renal Stone. God wot!