Inspirational story of teenage girl with MS

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David1949
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Inspirational story of teenage girl with MS

Post by David1949 »

It's not often that a teenage girl can be an inspiration to an old guy like me, but this girl is.
http://fbshare.sfglobe.com/2014/11/24/c ... bfan_20016

I give her an A+ for guts and determination.
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1eye
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Re: Inspirational story of teenage girl with MS

Post by 1eye »

Many have probably seen the occurrence of heat exhaustion. Many have likely seen people crash or bonk, or collapse after a race. This happening is different. The girl has MS. Well, heat affects your brain, and this girl's brain likely got hot during the race. That is true. The hypothalmus in the brain controls temperature all over the body, by adjusting blood flow, controlling sweating, etc.

Does heat disable the "MS" hypothalamus?

It is also known that during a race, the body temperature is elevated. The efficiency of running is quite good compared to a car or bicycle, somewhere around 45%. That means 55% of what is expended is lost as heat. The power consumed depends on the racer's speed, but it is known that a healthy runner's body's core temperature rises, If is rises above 104 degrees Fahrenheit, the runner has gotten too hot, and unless running is curtailed, health problems are inevitable. The blood moves towards the skin, and the skin sweats. Sweat evaporates, and while the runner is moving, the sweat will cool the skin and take away the waste heat.

When the finish line is crossed, the heat production stops, the sweating continues, and in normal people, the body may cool down. In most instances, it does.

Consider what happens to the girl with "MS". She immediately becomes completely paralyzed. The heat production has nowhere to go, because although the sweating has continued, the air movement that had been evaporating it has stopped. Her body doesn't get rid of heat as well now, because the sweat doesn't evaporate. In addition, the blood flow that had more evenly distributed the hotter blood around the body, and closer to the sweating skin, slows down drastically, and the core heat does not leave the body. This chain of events means the core temperature will spike just after the race ends, especially in someone who does not do a warm-down jog after running. All these elements combine to cause the core temperature spike, not because of "MS" interfering with the hypothalamus, but because the runner is suddenly stationary.

While she was running, the blood-flow and sweat took care of the heat production, but now, she just gets hotter.

We suspect that there is inflammation due to "MS" and immune cells. I also suspect there is a global, body-wide, overproduction of iNOS (inducible Nitric Oxide Synthase) by the immune cells, catalyzing an overproduction of nitric oxide. That has been interfering with mitochondrial ATP production, hampering O2 uptake. It will make running very difficult, requiring more O2 than it should. This chemical reaction, which results in poor oxygen utilization, happens more, and with greater effect on the runner, as her internal temperature rises.

She should take a treadmill test with O2 and CO2 analysis, to find out how her O2 uptake is going. She should try to get a core temperature during, and after this exercise.

The effect of stopping running is so sudden that I think this chemical reaction that interferes with O2 uptake and ATP might be not only exacerbated by heat, but also by the sudden slow-down in blood circulation. That makes the heat stay in the core, even more, speeding up the nitric oxide synthesis.
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NHE
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Re: Inspirational story of teenage girl with MS

Post by NHE »

Heat is likely the issue. She says that part-way through her run that she can no longer feel her legs and that's why she collapses when she stops. The movements required for running are probably being driven primarily through a learned pattern and are not dependent on proprioceptive feedback. I know next to nothing about competition running, but I think a cooling vest would be a big help. ActiveMSers did a review a while back. http://activemsers.org/gear/reviewcoolingvest.html She could also try taking up another activity such as swimming.
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1eye
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Re: Inspirational story of teenage girl with MS

Post by 1eye »

I am interested in this for my own reasons, but having said that, I am very very impressed, and indebted to this person for her determination. She is showing that you can still do big things even with obstacles like she has.

I would really like to know if this thing conveniently labelled with the name "Uhthoff's Phenomenon" is really a problem with nerves, or is perhaps a chemical reaction, actively affecting ability of mitochondria to use O2 and produce ATP. This chemical reaction would be affected instantaneously in the severity of its effect on all of the body by virtue of the fact that it permeates the blood, and is sped up by blood temperature.

It could be that all the peripheral systems affected by the temperature spike have local demyelination that only is a problem once the temperature rises. It could also be that control and sensory nerves in the brain have the same temperature-sensitivity, and they are only a problem above a certain temperature. It would seem that if there were an accurate animal model this could be determined with precision.

What I suspect is that there is no local demyelination that explains this effect. I also suspect that the cooling needs to be applied to the core temperature because it is not nerves in the brain that need to be cooled off. I also think the temperature of the blood itself is of primary importance because it is controlling a chemical reaction without which no muscle contraction is possible, even with un-demyelinated nerves, unaffected by "MS", controlled by areas of the brain which are similarly healthy. These muscle contractions are possible throughout the race, and the nerves controlling them work fine. They even work when there is no proprioceptive awareness, and the legs feel numb. But they stop working above a certain temperature. It is not the peripheral nerves controlling the muscles, or nerves in the brain, which have overheated. It is the muscles themselves, and the blood which feeds them.

It seems to me that such things should be visible in vitro.
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"I'm still here, how 'bout that? I may have lost my lunchbox, but I'm still here." John Cowan Hartford (December 30, 1937 – June 4, 2001)
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