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I have been on sole night duty since the beginning of November and I've been pretty exhausted as a consequence. This may have some bearing on the deterioration in symptoms especially myoclonus and walking since the beginning of the month. I have also noticed a few more movement induced phosphens and increased sensory deficits of the face. I've also had a day of twitching muscles in the face but that may have been lack of sleep which has been significant over these last few weeks. As Dr Simka noted a defective valve in the right jugular especially when my head is turned to the right I am to start using a neck/head brace at night to see if I can stabilize my head and keep the jugular veins open until angioplasty next year.

I have noticed a few more movement induced phosphenes recently, I have also had to add a column for a symptom which has troubled me since the birth of Arthur and this is dizziness. I have never suffered from dizziness before but now feel dizzy on a daily basis. My walking and night spasms have been rather worse this month also. I would say that my walking and night spasms are much the same as they were before the stent operation. My bladder really is the stand out in that I now hardly ever suffer urgency whereas before the stent operation I felt urgency every hour or so. I also suffer less from hesitancy when I need the toilet although to void completely I still use massage and I am not always able to void fully. I also feel that all of my symptoms are very steady with the left leg and facial sensory deficits being very quiet.

It was also obviously tricky to find them and I strongly suspect that Zamboni is right; you need proper training and equipment to view these things and you won't see them if you are lacking in either.

I'm booked in for angio in Edinburgh and look forward immensely to getting the blood flowing again.

Well, I went to the Essential Health Clinic, located in a rather unpromising-looking car park in Glasgow.

I've noticed quite a few more shoulder spasms and facial tingling this last month. I have been focused on improving the bowel control by taking 2.5 grams of capsaicin at breakfast and lunch and this has the added benefit of keeping me very awake/alert and reducing spasticity. I have also been trying to drink more which may explain why I have felt that my bladder control has worsened a bit. My night spasms have improved a bit. The dizziness has improved enormously. I walked quite far the other day with my cane and didn't trip too badly so I think maybe that's improved. Otherwise everything has been very stable. As you can see from the chart most of my symptoms remain better than before the stent operation.

On the 22nd May I underwent ballooning in Edinburgh with Dr Reid and within 24hours or so I noticed much improved spasticity and greater ease of walking, significantly reduced myoclonus or night spasms and much improved bladder control! The improvements in the night spasms have since dissipated but the walking and bladder control remain much better. I still get shoulder spasms and facial tingling but my bowel has been somewhat better even without capsaicin although the magnesium citrate may be the factor there. Curiously I've noticed more movement induced phosphenes since the operation. The left leg sensory deficit has seemed a bit less active although there are bursts of pain on going to bed and lying down.

Acta Physiol (Oxf). 2011 May 3. doi: 10.1111/j.1748-1716.2011.02323.x. [Epub ahead of print]

Local oestrogenic/androgenic balance in the cerebral vasculature.

Krause DN, Duckles SP, Gonzales RJ.


Source

 Department of Pharmacology, School of Medicine, University of California, Irvine, CA, USA  Department of Basic Medical Sciences, University of Arizona College of Medicine, Phoenix, AZ, USA.


Abstract

Reproductive effects of sex steroids are well-known; however it is increasingly apparent that these hormones have important actions on non-reproductive tissues such as the vasculature. The latter effects can be relevant throughout the lifespan, not just limited to reproductive years, and are not necessarily restricted to one gender or the other. Our work has established that cerebral blood vessels are a non-reproductive target tissue for sex steroids. We have found that oestrogen and androgens alter vascular tone, endothelial function, oxidative stress and inflammatory responses in cerebral vessels. Often the actions of oestrogen and androgens oppose each other. Moreover, it is clear that cerebral vessels are directly targeted by sex steroids, as they express specific receptors for these hormones. Interestingly, cerebral blood vessels also express enzymes that metabolize sex steroids. These findings suggest that local synthesis of 17ß-estradiol and dihydrotestosterone can occur within the vessel wall. One of the enzymes present, aromatase, converts testosterone to 17ß-estradiol, which would alter the local balance of androgenic and oestrogenic influences. Thus cerebral vessels are affected by circulating sex hormones as well as locally synthesized sex steroids. The presence of vascular endocrine effector mechanisms has important implications for male-female differences in cerebrovascular function and disease. Moreover, the cerebral circulation is a target for gonadal hormones as well as anabolic steroids and therapeutic drugs used to manipulate sex steroid actions. The long-term consequences of these influences are yet to be determined.

© 2011 The Authors. Acta Physiologica © 2011 Scandinavian Physiological Society.