Hello again

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1eye
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Hello again

Post by 1eye »

Hi.

I'm still here. Still can't walk. Have fallen twice in the last year. No injury. MS as far as I can tell is not progressing any faster than old age. I am 67. Still taking 300 mg of Biotin with rice bran filler in a 00 capsule. Only other medications are Baclofen on occasion for spasticity, ramipril for high blood pressure, Vit D, magnesium citrate, sativex, and 6 mg quetiapine per night for sleep. Use walker. Cannot stand temperature above 74 degrees F ambient.

Teaching Suzanne the Ukulele.

This is on my web space: http://sullivanweb.me/mystuff/mp4%20files/uke32.mp4

My channel is:https://www.youtube.com/channel/UCLZ2kq ... DOg/videos

Chris


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1eye
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Re: Hello again

Post by 1eye »

Hello again again:

This is a bit of a discussion re: MS/myelin/blood temperature and pressure.

One of the oldest tests for MS is a hot bath. I had a bad experience in about 2004, and have not had a hot bath since. Showers seem to be OK.

My doctor friend sayz demyelinated nerves are very sensitive to heat. I think many cadaver studies have shown that the main visible sign of MS is demyelination.

But is that all there is to the story? I think there are a few other things. I looked and I could not find any conclusive evidence that the problem with temperature is demyelination.

One thing that is clear, is that the effect of heat on MS symptoms is directly reversible as temperature lowers back to normal. This is not remyelination.

Another is that blood pressure will go up in a completely reversible way with temperature. The brain is different from other nerve locations in that it is inside a hard non-compressible shell. Another fact of nature is that liquid is not at all compressible. If it were not for veins' elasticity they would be hard as bone. I suspect there is no room for expansion inside the brain case. Therefore expansion due to temperature and pressure will have to be absorbed below the neck. The blood pressure is constant throughout the body, and its response to temperature is linear and reversible.

Temperature changes may be local. Is there a difference between the effect of core blood temperature and the effect of brain blood temperature? What about skin temperature?

In the skin there is a drop off of fast motor conduction velocity at about 33 degrees C. Is it similar in brain nerves?

I seem to have too many questions.
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Anonymoose
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Re: Hello again

Post by Anonymoose »

Hey 1eye,

Good to see your update. Your ukulele duet made me smile. Y’all should go on tour. I know appearances can be very deceiving but it looks like you’re doing really well. :)

As for the blood pressure discussion, though I agree blood pressure very well could contribute to the exacerbation of ms symptoms, it seems likely demyelination/axon degeneration is still at the center of the phenomenon. People with hydrocephalus, I think, most commonly complain of headache and nausea. When I was temperature sensitive, headache and nausea weren’t a part of my experience. It’s been a while and I didn’t have long to experience it so maybe I’m just naive about the experience in general.

Be well,
‘Moose

PS You’ve inspired me to (try to) learn ukulele. If your dog or cat starts howling, I’m singing along.
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NHE
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Re: Hello again

Post by NHE »

Heat directly inhibits the conduction velocity of the action potential via an inhibitory effect on the voltage gated sodium channel. This effect is more severe in demyelinated axons.

Uhthoff Phenomenon
https://www.ncbi.nlm.nih.gov/books/NBK4 ... e-30727.s3

Temperature escalation of as little as 0.2 °C to 0.5 °C is sufficient to close the axonally-derived sodium channel and terminate the depolarization phase of the action potential. Demyelination reduces the safety factor of axons, defined as the ratio of the current available to initiate an action potential to the minimal current required.[15] An increase in temperature further reduces the axon's safety factor. Hence, an increase in temperature (even as little as 0.5 °C) in individuals with MS results in closure of the voltage-gated sodium channels in demyelinated axons, thereby compromising action potential depolarization and decreases the safety threshold for high-fidelity nerve transmissions.[16] This can produce abnormalities ranging from delayed conduction to complete conduction block and clinically manifests as worsened MS symptom, e.g., decreased visual acuity or double vision.
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jimmylegs
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Re: Hello again

Post by jimmylegs »

absolutely. for demyelinated nerves heat goes up, function goes down, and vice versa.
re "as little as 0.2 °C to 0.5 °C" i hadn't investigated the specifics - very interesting.
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ElliotB
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Re: Hello again

Post by ElliotB »

As strange as it may seem, hot baths have helped me tremendously. I have nerve pain that comes and goes, worse at night as often is the case for neuropathy and for years have been woken up from extreme pain every few hours. Certain specific types of exercise for 20-30 minutes helps relieve the pain and keeps it away for 1-3 hours. But fortunately I discovered by chance that a 20 minute hot bath (has to be hot, not warm) also helps relieve the pain quickly and also keeps it away for 1-3 hours. Some nights the relief only lasts 45 minutes. And the best part is that the heat does not cause any negative effects for me. I used to be sensitive to heat which was a serious issue for me living in South Florida. Fortunately I am not bothered by it any longer and am able to tolerate the hot baths and hot weather. The only negative has been the effect on my electric bill!
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1eye
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Re: Hello again

Post by 1eye »

Another thing that may come into it: and I have seen a paper detailing a drop-off above a certain temperature, is that the body naturally maintains internal temperature to the point that medicine is used to citing normal to three digits of accuracy. Could it be that in MS there is not only blockage of conduction in demyelinated nerves but dis regulation of internal temperature control, and therefore an unstable negative feedback loop leading to worsening symptoms due to high-temperature blood heating the thyroid? The high pressure is only a problem for hydrocephalus-prone individuals of which I am one. It runs in my family. The symptoms my brother had included headaches and dizziness. Plus a very physically swollen head to the point his face almost disappeared.
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vesta
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Re: Hello again

Post by vesta »

1eye wrote: Sat Jul 31, 2021 10:36 am Another thing that may come into it: and I have seen a paper detailing a drop-off above a certain temperature, is that the body naturally maintains internal temperature to the point that medicine is used to citing normal to three digits of accuracy. Could it be that in MS there is not only blockage of conduction in demyelinated nerves but dis regulation of internal temperature control, and therefore an unstable negative feedback loop leading to worsening symptoms due to high-temperature blood heating the thyroid? The high pressure is only a problem for hydrocephalus-prone individuals of which I am one. It runs in my family. The symptoms my brother had included headaches and dizziness. Plus a very physically swollen head to the point his face almost disappeared.
Greetings:

Good to hear from you. Some ideas found on my site Mscureenigmas.net blog Sept 18,2016 MS Inflammation

HEAT

Dr. Michael Flanagan introduced for me the understanding that the brain is kept cooler than the body by circulation of cranial fluids, in particular the blood and cerebrospinal fluid.

See www.upright-health.com/ (Upright-health.com)
“Brain Cooling and the Cranial Veins
The other role some of the emissary veins play is in draining the head and brain during upright posture. In particular, (in the top picture) the ones located toward the back and bottom of the skull, as well as behind the outline of the ear, all drain into the vertebral veins of the spine. The emissary veins that are used to increase drainage capacity of the brain during upright posture empty into the internal and external vertebral veins inside and outside the spine and spinal canal. The vertebral veins thus help to transport heat away from the brain.
Lastly, the most important feature of the brain cooling system is the heat exchanger mechanism used by humans. In this case venous blood that has been cooled by cranial veins of the face and scalp flows through dural sinuses that serve as counter-current heat exchangers that cool incoming arterial blood before it enters the brain.”

It is important to remember that in MSers, it takes twice as long for blood to circulate from the heart through the brain back to the heart as normals. One can therefore understand why MSers are so sensitive to heat, the “coolants” aren’t there to protect the tissue. As the myelin sheath is slowly degraded, and the fluids progressively slowed, heat can only become more dangerous.

I found another excellent explanation of how the brain cools itself by an anonymous writer under the following site.
biology.stackexchange.com/.../how-does-the-brain-cool-itself

The net effect of heat production in the brain and brain cooling keeps the brain cooler than the rest of the body and is achieved by surrounding and bathing the brain with venous blood that has been cooled outside the cranial vault, by bone and fat acting as insulation, by the veins of the face and scalp through conduction, convection, sweat and evaporation and by cooled venous blood flowing through the cavernous and suboccipital cavernous sinuses cooling incoming blood in the internal carotid and vertebral arteries before it enters the brain. The combined effect of the brain cooling system keeps the temperature inside the vault and brain about two to three degrees cooler than the rest of the body. The effect is important enough that some physical anthropologists attribute the extra-large size of the human brain more to its exceptional cooling capacity than to the increase in arterial blood flow that comes with upright posture. Anthropologists refer to human encephalization due to enhanced brain cooling capacity as the "radiator theory". Reference
answered Apr 24 '15 at 4:16 Jayachandran

Best regards,

Vesta
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1eye
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Re: Hello again

Post by 1eye »

Hello hello hello,

I am checking in. I have not had covid yet. Perhaps that is because I am almost always safe at home in my easy chair.

I hope none of my ThisIsMS friends have died of it. We are at a critical juncture in human history, having lost more to this virus than many wars. Good luck to us.

I am on this thread because of the very good post from Vesta, above, which I had missed. The 'radiator theory' of human evolution seems as important as the fact that MS is often diagnosed by the hot bath test! Could there be some connection to the results of mononucleosis's presence?

Chris Sullivan (1eye)
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1eye
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Re: Hello again

Post by 1eye »

Another missed connection: Being upright again shows its teeth. If the brain cools better when we are upright does it not make sense that we should improve by sleeping with head elevated? We spend a third of our lives asleep! Maybe better to sleep upright!

As far as sleep goes, I think an article in Nature found mammals have a flush cycle that takes place during sleep, where the CSF flows backwards and removes oxidants. So get your sleep!

Chris

P.S. Hello HappyPoet (Pam). Hope you are still well, and controlling your narcolepsy. I take modafinil twice daily. Its indication is for narcolepsy.
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