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I don't mean to criticize anybody. I am just asking out of curiosity.
Since the spinal cord can indeed heal, why are so many millions of people still in wheelchair?
For each success story we hear about, there are hundrends of thousands of "failure" stories. Could the people that recovered have just been geneticallly capable of doing so?
The problem in MS is the fact that electrical signals can not cross the lesion. Imagine a light bulb whose wire has been cut. No matter how many millions times you press the switch, the light will never turn on.
The nervous system is not that simplistic, which makes my example totally inaccurate. But even if rewiring does take place, what about the function of the new wires? They will have to take on the function they always performed, plus the function of the damaged wires. Are they capable of?
And let's say that they manage to replace the damaged ones. Yet another lesion is created and everything starts from scratch once again. C' est la vie! I believe that MS is simply a hopeless situation and I wonder if it is worth the try...
In theory, yes, it is worth the try and effort. But in practice, I find it just hopeless. Too much effort for nothing.
I don't want to offend anyone, or make you feel depressed. I am just writing my opinion.
hi sou, some spinal cords are damaged well beyond the potential for alternate routes. my physio told me early on that there is an established growth rate for new nerves, so many millimetres per month, but that was early 2006 and i don't remember the details. ms is relapsing remitting for some, not for others, it's true. remission means spine can heal, in my understanding. there is certainly the possible future of another lesion setting a patient back, but no harm in working hard to establish as many connections as possible now, to have the most defense against future damage. and, of course, to work hard not to have the biochemical characteristics of the 'average ms patient' any more!
AFAIK, neurons may grow new axons at a rate of 1mm per day. No new neurons can be created in the spinal cord. It happens only in the nose and the hippocampus. My dogma is that the symptoms of MS can be caused by three factors:
1. Swelling: Axons are pressed and the synaptic space is diminished. Additionally, alterations in the environment of the axon severely interferes with its ability to carry signals.
2. Demyelination: Lack of insulation prevents the axon from carrying signals, especially the higher frequency ones.
3. Axonal cut: The axon is cut.
1 is somewhat reversible, 2 and 3 are not.
Remission is when the swelling disappears and some ridiculously low scale remyelination occurs. If there are spare neurons left (spare in terms of not being overused) some functional recovery can occur.
No matter how hard someone exercises, I can't expect anything significant to happen. 1 ton of effort for a nanogram of result. It is hopeless, at best.
Somebody could say: "What do you expect? You have MS!". I translate it as "What do you expect? You are subhuman!". Does the MS diagnosis mean that we must alter our will for quality of life?
I agree with all that has been said. Even Christopher Reeve was able to recover a teeny bit of finger movement. I just assumed with MS it would be different.
I had a horrible PT tell me that with MS all the exercise in the world wouldn't help in 2004 right when I was first diagnosed because of the way the disease mechanism worked so I did 0 to stop it. Knowing what I know now, learned from my docs, and good PT people I've had to deal with over the years, I would have started rehab immediately and I would still be going. After seeing what I saw today, I am going to bust my butt again.
when i wrote that bit about beyond repair i was actually thinking of trauma-related damage, and i just ran across this article which discusses the difference btw the alternate paths thing we've mentioned, and my physio's ideas about nerve re-growth http://newyorkspinalinjury.net/?p=53
Adding to the unsurety of the situation is that Jimmy is probably right. There surely has to be some criteria which dictate that the damage is beyond healing. Sadly that is also going to confirm to the masses that it's not worth the effort.
re item 2 above, what is remyelination if not a reversal of demyelination? (edit: whoops i just re-read your other post to see where you say the remyelination level is too low)
i think item 3 is the scenario where you have to take those alternate routes, and according to that 'new york' link people are spending time trying to figure out how to get nerves to grow across gaps again so that the CNS doesn't have to take the scenic route forever
I agree that there is some hope. But not for us. I can bet my head that I will die with MS and severe spasticity (I am 28). The major breakthrough in nervous system repair is just around the corner, but the corner is some 30 years away. And MS will be cured when it is no longer autoimmune. It took a century for it to become autoimmune. It may well take yet another to become something else. In other words, around 2050.
For the time being, there is no need for change. It is a cash cow and has the best financial characteristics: non fatal, early onset, not even treatable, a myriad of symptoms that require medication.
I find the CRABs ironic. Ok, they had to choose a med for MS. Anything could be equally ineffective. Why did they choose injectable, side-effect-full drugs? Is it because they wanted to raise their prestige for covering the ineffectiveness? "They can't be ineffective! They have so many side effects and they are so inconvenient. It has to be a reason for that!"
when you think about it we all exhibit plasticity daily. whether your gait or vision, or strehgth has changed due to age or progreesion of disease, we all adapt to changes in level of ability.
For instance,my lack of sensation and lack of coordination used to be a deadly combination for me when using knives in the kitchen. Now, I haven't cut myself in months (not badly anyway).
Same is true for walking, I used to fall, and walk into walls alot. I haven't slowed down, but have developed adaptive strategies to keep myself safe.
The most telling is that I won't take stairs at work if I'm the only one on the staircase.
I'm enrolled in a couple of studies for PHD students.
When I read their observations, it makes me realize what I look like to other's eyes.
Wow if I was 20 I would be on the horn with Rush or Johns Hopkins. The people who have had MS the least amount of time and have gotten the HiCy treatment are doing great. They are never seeing anymore damage, the damage they have is healing, and they go on with life. It seems the 10 year mark is the issue when it's not reversible.
Sou, I bet 100 bucks you don't have MS in 20 years and I bet if you do HiCy you won't have it next year, and even if you did reactivate you could do it again and be good for a long time between treatments. I bet this early on it would be 10 years or more.