MS and Backpacking

Copyright (c) - 2011 - Thomas Vetto, MD - all rights reserved

Introduction

I never thought I would be able to go to the library, take a comfortable by-the-back-window chair and write about something I love. I'm in this remarkable position because of a Sudden Change of Life.

I was diagnosed in 2004 with MS, Multiple Sclerosis and have had a front row seat at my own gradual development of more severe symptoms.

Retired from active practice of Emergency Medicine, I am faced with the retiree's question: What do I do now?

I'm a spiritual sort of fellow and originally saw MS not as a horrible disability forcing the end of my career, but an elegant challenge and a new direction for the second half of my life. I find myself with a large part of my health and much of my ambulation intact, knowing that the quality of my physical state rests largely in my own hands.

Suddenly, my job becomes solidifying my financial status: disability, taxes; stabilizing my health care and ultimately deciding the course my life will follow. I feel like I restart life with adult status, knowing the rules and looking forward to what's next.

MS is an auto-immune disease. It involves damage mistakenly done to the nervous system by the body's own immune system. Specifically, the guardian immune cells, the T-lymphocytes, see the insulation ('myelin') around long nerves as 'foreign,' and these lymphocytes do their best to destroy the insulation wherever they find it. Nerve impulses dont move well through the damaged neurons. Neither do I. Imagine a nasty flock of birds chewing the black covering off a telephone wire, exposing the copper wire within. A fair analogy. But. The body constantly repairs itself and will try to repair damage done and replace this absent insulation.

Now, let's imagine the repair cadre: a highly excitable mob of drunken automatons. The sights of the attack, essentially long-distance lines in the brain, are found in the spinal cord and in the brain beneath the cortex, the thin uninsulated surface layer ('gray matter'). Two things result from this: 1) the Cortex, the consciously-thinking surface of my brain (yes, this is symplified; ignore it and follow the thought) is relatively unscathed and 2) an MRI of my deep-brain or spinal cord looks like a night flight over Ohio because of the many areas of over-zealous repair, which themselves foul transmission of sensations from the skin and directions to the muscles. I am able to appreciate and observe my condition as it changes for the better or worse in real time.

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Growing up in the Northwest, I have backpacked with my brothers and friends on a regular basis for years. There is an absolute freedom which comes with backpacking. It is one of the few times in life when there are no set answers to the questions 'where should I go now?', or 'what should I do now?', or ' is there a bathroom anywhere around?' This feeling of freedom goes hand in hand with a sense of self-contained completeness. While backpacking I've always been a unit unto myself. With what I have on my back and in my mind, I am disconnected from all the world and its problems for a time. Too, I am somehow disconnected from MS. I have a limp. So what? Here, I would walk with a stick anyway. Poor coordination? These trails are not paved; my choice of the easiest ways over them is only natural. My speed never was fast but two miles an hour for even four hours total is still eight miles. Eight Miles? Five is closer. Four hours? Two, with luck and a tail wind. And frequent rests. MS will, over time and markedly affected by increased body or ambient temperature, slow the passage of movement instructions from brain to foot. You are clumsy and doubly need to see where you are going.

It is, I think, a mistake to say MS affects the balance. In my case at least it seems my conscious brain is surprised when specific orders given my legs are slowly or incompletely carried out. If I think my body is one place, reality is sadly different: I fall. I voice my disappointment loudly. I have to be alert.

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What follows is a series of brief connected essays with free-and-wide-ranging commentaries on MS as I think it applies in various situations centered on backpacking. All inclusive? No. How could It be? I hope to show how I deal with the common problems of a favorite hobby and glean some of the fruit to be got from activity done, from what they tell me, in a tight place.