medscape:Fatigue predates MS by years

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medscape:Fatigue predates MS by years

Postby CureIous » Wed Jun 08, 2011 4:26 pm

And of course Mark Freedman is quick to water it down
For each patient, the 3 years preceding the index MS claim were analyzed for diagnoses of chronic fatigue syndrome or malaise (ICD-9 diagnostic codes 780.71 or 780.79), as well as fatigue-related prescriptions, other diagnoses, and MS-associated symptoms.

A total of 5305 patients were identified with an index MS claim made between January 1, 2005, and September 30, 2009. Three quarters of the patients were female, and "an overwhelming majority" (67%) were between the ages of 40 and 59 years, said Dr. Berger.

In 1534 (29%) of the identified patients, at least 1 diagnosis of fatigue or malaise preceded their MS diagnosis, and 42% presented with more than 2 such claims.

"To me that's somewhat astonishing because I seldom put fatigue down as a diagnostic code, and I suspect that's true of many of us," said Dr. Berger. "So my belief is that this is probably an under-representation of the number of people that actually have fatigue in advance of the diagnosis of clinically definite MS."

… my belief is that this is probably an under-representation of the number of people that actually have fatigue in advance of the diagnosis of clinically definite MS.
Among those with a diagnosis of fatigue or malaise, a third received the diagnosis 2 to 3 years before their MS diagnosis, and a quarter received it 1 to 2 years before. For the remainder, the fatigue diagnosis came within the year leading up to the diagnosis of MS.

One third of patients with fatigue/malaise had no other neurologic symptoms suggestive of MS, and 38% of the patients with a cluster of symptoms had fatigue present as the first symptom in the cluster. Other symptoms included visual and movement disorders, muscle and speech disorders, facial neuralgia, dizziness, paralysis, and disturbance of skin sensation.

Although fatigue preceded the diagnosis of MS by an average of 501 days, only 10% of patients received such medications as amantadine, pemoline, modafinil, dexamphetamine, methylphenidate, or dextroamphetamine, said Dr. Berger.

Sorry if this is old http://www.medscape.com/viewarticle/744198
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby CureIous » Wed Jun 08, 2011 5:31 pm

I guess it's not an extreme stretch of logic, that if fatigue, being one of the "global" symptoms, is one of the symptoms that is relieved by resolving CCSVI, and that same fatigue predates an MS dx in a sig %, then it stands to reason that for many of us, CCSVI predates MS, and that MS can poss. Be prevented, or is that so much preaching to choir ;).

Hopefully E1 will sign up for a free Medscape acct and read the full article
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby Cece » Wed Jun 08, 2011 6:13 pm

Amen & hallelujah.... ;)
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Postby 1eye » Wed Jun 08, 2011 6:17 pm

Sounds to me like the fatigue is directly attributable to low oxygenation. I wonder how temperature figures into all this? Maybe cooler thicker blood goes through slower and the brain can get more oxygen out of it during the slower transit?

I would have thought heat would make the blood thinner and move quicker, improving the situation. Do we need more oxygen when hot?
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Postby CureIous » Wed Jun 08, 2011 8:48 pm

1eye wrote:Sounds to me like the fatigue is directly attributable to low oxygenation. I wonder how temperature figures into all this? Maybe cooler thicker blood goes through slower and the brain can get more oxygen out of it during the slower transit?

I would have thought heat would make the blood thinner and move quicker, improving the situation. Do we need more oxygen when hot?


All these heating and cooling relationships in the body fascinate me 1eye, as this is part of my trade, namely heat transfer to and from various units and pieces of machinery, from air conditioning to cooling towers.

The body, not quite as simple, there's so much to it beyond just "blood carrying heat away from the body", as you intimate, oxygenation etc. etc.

I will echo others like Cece, relapse or remit all you like, even though I was not in a verifiable exacerbation, the infernal fatigue would NOT remit no matter what I did or how I did it, my guess in relation to your comments, is that our oxygen starved CCSVI plagued systems, already in a deprived state, are (in a heated/overheated situation), now working doubletime, attempting to increase flow to the head which the body is always keen to protect first, but it can't get through anyways, during increased cardiac output, the flow can be as much as seven fold (say like running), while this is of course not necessarily bad for us (increased respiration equals increased thoracic pump, always a plus), at some point it will be out of equilibrium, there just wont be enough throughput to stave off fatigue and oxygen deprivation, of course this is dependent on the individual, location of the stenosis or valve issues and who knows what else.


http://www.biosbcc.net/doohan/sample/htm/COandMAPhtm.htm

The flow of blood through the vessels of the circulatory system is a function of the pressure in the system and the resistance to flow caused by the blood vessels. Blood flow is directly proportional to pressure and inversely proportional to resistance.

If the pressure in a vessel increases then the blood flow will increase. However, if the resistance in a vessel increases then the blood flow will decrease.
Resistance in the blood vessels is effected by three parameters:

1. Length of the vessel. The longer the vessel the greater the resistance.
2. Viscosity of the blood. The greater the viscosity the greater the resistance.
3. Radius of the vessel. The smaller the radius the greater the resistance.

Image


Image

Of all of the factors that effect blood flow, the radius of the blood vessel is the most potent. Blood flow is proportional to the 4th power of vessel radius. This means that if the radius of a blood vessel doubles (by vasodilation) then the flow will increase 16 fold (2 to the 4th power is 16). On the other hand, if the radius of a vessel is reduce in half (by vasoconstriction), then the blood flow will be reduced 16 fold. Because small changes in vessel radius make very large changes in blood flow, it is no surprise that the body controls blood flow to specific areas of the body by controlling the radius of arterioles servicing those areas.

Gotta go but this is so fascinating to toy with in the mind, I keep up on my celphone at work all day when there's down time.

Toss in your garden variety vasoconstiction contributors beyond just physical stenosis/valves etc. and it's really no wonder some of us are so fatigued, I think we all get that this doesn't explain everything in everyone, but it sure does seem to cover enough of a LOT of us, that to suffer like this for one more day than necessary seems so unnecessary, of course in that perfect world where we go in once, get our veins fixed and skip off into the sunset... sigh.


Mark.
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby CureIous » Wed Jun 08, 2011 8:58 pm

Wanted to add you don't necessarily have to spend hours on google for this stuff, I signed up for google news alerts, keyword ccsvi and another one for keyword multiple sclerosis, every day at around 2 pm I get two emails with various links to news stories and such, and a very interesting mixture at that, it's like Christmas every day...

Here is the link where anyone can sign up for it and it's really easy to do!

http://www.google.com/alerts

Many of the items that come through are old hat, but some like this one:
http://www.newschannel5.com/story/14859827/clarksville-mayor-ready-to-fight-ms-diagnosis?

leave you thinking, wow, maybe if she at least hears about CCSVI?? Be nice to have a lower level politician on board you know? One that's not involved with big money politics and worries about big campaign contributors etc etc...
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby 1eye » Thu Jun 09, 2011 9:26 am

CureIous wrote:Toss in your garden variety vasoconstiction contributors beyond just physical stenosis/valves etc. and it's really no wonder some of us are so fatigued...
Mark.


OK so: heat causes demand for more blood flow for cooling purposes, but it can't possibly be met, so we just suffer whatever the ill effects of not being able to get rid of heat fast enough are, including possible worsening nerve problems, and ultimately, death? Not necessarily a positive feedback oscillation, but destruction anyway? And only connected to oxygenation because that's one of the effects of low flow. We may not be more fatigued, we maybe can do less because of more paralysis.

The only good thing I know about temperature-caused problems is they seem to be more temporary. As soon as we can get rid of heat, we do, and they can go away.
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
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Patients sans/without patience
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