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Heat, MS and the disease process

Posted: Fri May 30, 2008 5:15 am
by Abe
It's widely acknowledged that heat makes MS symptoms more noticeable.

This is generally though to be because nerves transmit information faster in the heat and are therefore more likely to misfire in the case of MS.

However I read an article which recounted a woman with MS dying whilst sunbathing. Also my first noticeable 'MS attack' occurred after using a very high powered sun bed in a poorly ventilated room with no cooling system.

So I wonder does anyone else feel that excessive heat actually impacts upon the disease process eg. can actually cause an attack / disease progression - rather than just making MS symptoms more noticeable?

If so, how do you think this happens?

Posted: Fri May 30, 2008 5:27 am
by Punchy
I don't think it causes disease progression per se, but I think extreme heat like a sun bed or hot tub could possibly cause one's previously silent lesions to inflame and relapse.

Posted: Fri May 30, 2008 5:37 am
by jimmylegs
i think i read something that slammed that ms sunbathing report, something about her having some other underlying issue but i can't remember where i read it!

Posted: Sat May 31, 2008 4:57 am
by Terry
Yikes, guys. Heading to Florida in a couple weeks. I have only been there once- not used to the heat and sun. I was already a bit worried about the effects. NOW?? I hadn't imagined that it might KILL me! :x :wink:

Posted: Sat May 31, 2008 7:52 am
by mrhodes40
I sunbathe all the time, usually with an ice pack on the underside and a slurpy style drink at hand to keep the body temp down.

I have been doing this since diagnosis in '91

Posted: Sat May 31, 2008 8:23 am
by Alicia
Hello,

I have been told that heat slows down the electrical current that travels along your nerves. So if your nerves have been damaged the heat amplifies whatever nerve damage you have. One of my friends that has MS will start to shake if she gets too hot but then when she cools down the shaking will stop. She has had many severe relapses in the past. I have noticed that it is a lot easier to function in cool weather than in the hot. So far (knock on wood) I have not had any major problems being able to function in the heat.

Alicia

Posted: Sat May 31, 2008 8:35 am
by cheerleader
Here's the forensic abstract report on the poor young woman who died sunbathing:

Fatal Hyperthermia Secondary to Sunbathing in a Patient With Multiple Sclerosis.

American Journal of Forensic Medicine & Pathology. 21(3):204-206, September 2000.
Henke, Alan F. D.O.; Cohle, Stephen D. M.D.; Cottingham, Sandra L. M.D., Ph.D.
Abstract:
A 27-year-old white woman with a history of multiple sclerosis was found dead lying on a lounger, clad in a bathing suit. She had been sunbathing for 4 hours. Significant autopsy findings consisted of numerous variably sized demyelinated plaques involving the periventricular cerebral white matter and cerebellum. Elevation of core temperature in patients with multiple sclerosis leading to transient or permanent adverse neurologic signs and symptoms has been documented for more than 60 years. This case illustrates that a modestly increased core body temperature, even from a usually innocuous activity such as sunbathing, may be fatal in patients with multiple sclerosis.

I dunno....I kept putting Jeff in the hot tub spa before his diagnosis, to help what I thought was a "pinched nerve." I probably could have killed him, since there have also been hot tub deaths linked to MS. He felt horrible after those hot tub soaks, dizzy. numb and exhausted. He also has alot of lesions in his cerebellum (body temp. center) But we live in LA, and he bikes and hikes on some pretty warm days and feels fine. The hot tub was extreme and prolonged heat.... 104 deg. for one half hour. Not so good. He's forgiven me :)

I suppose if heat sensitivity is part of your MS, and you have many cerebellum and white matter lesions, use caution.

AC

Posted: Sat May 31, 2008 8:48 am
by cheerleader
Terry...
because you're going to Florida, and I want you to have a great time, and not freak out about going to the beach, I'm going to give you the good side of sunbathing by an Australian DOCTOR with MS who believes sunbathing has kept him healthy!

I love this guy...Dr. George Jelinek- (cute speedo!)

Multiple sclerosis is on the rise in Australia, and no one knows why. Could part of the reason be that some people aren’t getting enough sun and they’re getting MS as a result? Dr George Jelinek is convinced this is the case. Since being diagnosed with multiple sclerosis himself five years ago he sunbathes whenever he can. In fact George embraces a number of ‘alternative therapies’ to treat his MS. He sticks to a strict diet and even meditates every day, because he believes his state of mind affects his health.

http://www.abc.net.au/catalyst/stories/s1048944.htm

So once again, everyone has a different opinion. What else is new?
Have a great trip, Terry!

AC

Posted: Sat May 31, 2008 9:06 am
by Loriyas
Terry
Please don't worry and plan to have a great time on your vacation. I have lived in Florida for 5 years and actually moved here from Ohio because of the sun. I have stated before that I felt much better when we vacationed here, which I attribute to the sun and vitamin D. That's why we ended up moving here. I don't lay out in the sun but I also don't avoid it either. When I feel too hot I either escape to the air conditioning or jump in the pool. Going to the extreme in any situation is what can get a person into trouble. When you feel hot or get light headed go inside and cool off. Then go back outside and enjoy the sunshine and get your vitamin D naturally!

Have a good time! Where are you going in Florida, anyway?

Lori

Posted: Sat May 31, 2008 11:04 am
by Terry
Thanks everyone. I don't have the heat sensitivity much, so maybe I'll live. :wink:

Lori,
I'm going to Madeira Beach. Are you near there?

mrhodes,
If I have a bad time, I'll definitely try the ice bag.

Cheer,
Oddly about the heat... I used to chew ice constantly. I had the flu in Feb- no real symptoms except a mild cough and high fever. I ran 104 and didn't take a fever reducer. I came out of that illness with no desire to chew ice anymore. I didn't take meds because I have run high fevers before and I know I can tolerate 104, and I kind of buy into the theory that a virus or bacteria is the cause of MS. I thought I'd take the opportunity to kill off a bug or two. I'm not sure whether I did that, but I sure weaned myself from the ice quickly! Something happened! Maybe the sun and heat there will do the same for me and be helpful in some way.

And... I just came back from trying on swim-suits. Death might be a better option! :lol:

Terry

Posted: Sat May 31, 2008 12:41 pm
by HiCy
To all,

The fact that heat bothers MS symptoms is really pure physics. Your myelin acts as an insulator like the coating on a wire. As your lesions become worse and your disease progresses the myelin or insulation has greater damage. The heat can now get to the electrical signal traveling through your nerves and interfere with the signal. If you damage the insulation on a wire and run current though it the wire will heat up and short just like your nerves do. The signal become attenuated. Electrical current runs better in colder conditions because there is less interference from the surrounding atoms.

If anyone has ON and blurry vision try taking a cold bath and submerging your head under water to cool your head. Your eye is very sensitive and can notice the smallest change in the disturbed current that is causing the vision problem.

HiCy

Posted: Sat May 31, 2008 3:44 pm
by cheerleader
so HiCy and Abe...
just to be clear. This means that the heat isn't what can kill, it's the effect that heat has on nerve transmissions, right? If an MSer has a lesion in an area of the brain that controls breathing, or the heart, or some systemic survival mechanism, and the heat causes an interruption of nerve transmission in that area, it can cause the body's systems to shut down. Do I got that right?

Good advice to cool the brain down if vision get wonky, hicy.

And Terry....don't even get me started on swimsuits, girl :roll:
Leaving for a pool party now. ugh.

AC

Posted: Sat May 31, 2008 4:56 pm
by Loobie
Madeira Beach. That's a fun spot. We usually stay in St. Pete Beach or Indian Rocks Beach, but they're all right there together. I haven't been to Florida since I started having advanced symptoms. I was still running every day and did it on the beach early in the morning. I've always been severely heat sensitive and was actually diagnosed with the Uthoff's symptom of Optic Neuritis. I'll tell you Terry, I spent a buttload of time in the water. I got a kick ass tan, and to be truthful, actually felt better once I acclimated. I have no idea how I would react right now. I imagine it wouldn't be pleasant for me. I wouldn't ever say not to go, but I would not make a strenuous itnierary. I remember just lazing about mostly during the day, most of the time in the water. The evenings felt good and we ate good and drank well and had a great time. I wouldn't be scared to go, I just would not overdo it. Have a great time!

Posted: Sat May 31, 2008 7:18 pm
by Terry
Hey Lew,

The Florida itinerary consists of LAZY LAZY LAZY! So, maybe I'll be okay.

Lew, I had a crying day not too long ago when I woke to find numbness exactly where it had started during my dx relapse. I expected the worst.
I'm with you in that I don't normally get too upset, but once in a while, something will trigger the tears. Kind of like Mrs George and her brace.
We all just need to keep fighting. Someone's gonna figure this out sooner or later.
Terry

Posted: Sun Jun 01, 2008 6:43 am
by TwistedHelix
Hi Terry,
I think it would be a good idea to pace yourself: laze around and the sunshine for a bit, then get up and move around to see if you feel sluggish, heavy, or detect signs of ON – if you do, take steps to cool down – at least then you will have some idea of where your tolerance limits are. Sometimes you can feel fine while laying still, and it's only once you start to move that the effects show.

Action Potentials, the electrical spikes of nerve impulses, are generated biochemically by the movement of sodium and potassium ions across the cell membrane to briefly cause the inside of a cell to become positively charged. The opening and closing of the channels which allow this is obviously crucial, and an increase in temperature causes the sodium channels to close early thereby causing a reduction in current, so the heat is affecting our bodies chemically/biologically and not just electrically.
Also, myelin is wrapped around nerves so that it looks like a string of sausages, with tiny gaps in between. These gaps are called the nodes of Ranvier, and normally the impulse leaps from gap to gap giving a huge increase in speed and efficiency, (saltatory conduction). Nerves are actually quite poor conductors and the strength of the impulse quickly fades, so any reduced capacity caused by demyelination combined with heat induced axon fatigue will make previously hidden damage show up.

End of lecture.
Terry, serious heat effects are very rare and I wouldn't worry too much about them. Just keep an eye on yourself and enjoy your holiday!
PS Did you get the PM I sent you?