Hematopoietic Stem Cell Transplants to Fight MS

Hematopoietic stem cell transplant (HSCT) is a process that uses blood-forming stem cells (SC) to treat patients who have cancer, blood disorders and serious problems with their immune systems.

HSCT is currently the only medical hope offered to people suffering from multiple sclerosis (MS) who want to stop the disease – that effectively shuts down the immune system – from progressing further. While there are some relatively new medications that are approved by the FDA, that reduce and slow down the development of MS, so far none of these is able to stop or reverse the condition.

HSCT has been proven to halt MS. Even though it is a grueling process that is tough on the body and soul, and certainly should not be taken lightly, there is considerable evidence that it works. The result is a growing body of patients willing to face the process in their desire to escape from the debilitating chains of MS.

Because it is considered experimental in the USA, and because there are other major technical “roadblocks” in this country that prevent most of the population from getting access to the treatment, most of those opting for HSCT for MS are forced to travel abroad, to countries like Russia and Israel for treatment.

Understanding Multiple Sclerosis

Multiple sclerosis is a chronic disease that involves an immune system attack against the vital central nervous system. It doesn’t follow any set pattern, and its onset is frequently accompanied by impaired vision and stumbling that is caused by a lack of balance. Over time a variety of symptoms and pathological lesions are disseminated anatomically.

The symptoms of MS are varied and its severity, as well as the speed at which it progresses, is unpredictable. Typical mild symptoms include numbness in the toes, fingers and limbs in general, while severe symptoms may include temporary blindness and even paralysis. Even though these are well known, doctors often have difficulty diagnosing the disease until it is deep-seated, and the patient is severely disabled.

Nevertheless, most people with MS are believed to have a reasonably normal life expectancy, based of course on other health factors as well as weight and environmental issues.

How HSCT Works to Halt MS

Blood cells give us immune protection; and the SCs that are responsible for constantly renewing these blood cells (as well as the immune cells) are called hematopoietic stem cells (HSCs). The two hallmarks of these cells are their ability to produce cells that generate different blood cell types, and their ability to renew themselves.

Basic steps in any HSCT process include:

  • Stimulation of SC growth
  • Collection of SC
  • Chemotherapy
  • The transplant itself
  • Engraftment of the SCs and new immune system
  • Recovery

Mobilization of Stem Cells in the Patient’s Body Historically, hematopoietic stem cells were extracted from bone marrow that also contains other cell types. Today the medical profession harvests the stem cells from peripheral blood that is circulating in the body, stimulating (or mobilizing) the stem cells to migrate more quickly, and in greater numbers, into the blood stream. Since only a very small percentage of the cells in the blood will be HSCs, this improves the odds.

Apheresis After about four days of mobilization, apheresis (which is the collection of the stem cells) takes place. The process takes anything from two to four hours during which time it is withdrawn through a catheter and circulated through a machine that separates the different types of cells. Red blood cells are returned to the body and the SCs are frozen and stored in readiness for the transplant.

Chemotherapy This is carried out over a period of days and is done to “shut down” and effectively destroy the existing immune system. Care must be taken that the patient is not exposed to infection.

HSCT The extracted cells are defrosted, and in a process that is very similar to a blood transfusion, returned to the patient’s body. Side effects often include nausea, coughing and chilling, fever and hot flushes, headaches, and stomach cramps.

Engraftment After a couple of weeks, the SCs should be growing well and a new immune system that has no memory of the multiple sclerosis should be developing. One the blood count rises and the while blood cells are able to fight any infection, the patient is discharged.

Recovery This is gradual, and it often takes several years for patients to be able to evaluate the results of the transplant. While the results will vary – some patients having greater success than others – generally the progression and activity of the MS will be halted once the transplanted stem cells have regrown and established themselves.

Is MS Hereditary? Important Factors to Consider

Multiple sclerosis destroys the myelin sheath on the nerves. This eventually impacts on many areas in the body including the nervous system, muscles, bowels and bladder, eyes, speech and sex organs. So how do you develop MS? Is MS hereditary? Do some people have a higher risk of developing MS than others?

Research suggests that there are a number of factors which can increase the risk of a person developing multiple sclerosis but this does not mean that everyone that fits this criteria will go on to develop MS.

One of the major concerns parents with MS have is whether their children will go on to develop the disease. There are numerous research studies that are on-going trying to unlock the mysteries of MS some of which concentrate solely on attempting to answer this question.

Family history

Studies have found that although MS is not considered directly hereditary having a family member with MS increases your chances of developing the disease especially if that person is a parent or sibling. There is also some research to suggest that if the parent with MS is your father the risk is higher than if the parent with MS is your mother. It also suggests that the risks of the identical twin of a MS sufferer developing MS are only 25%.

Parents with a diagnosis of multiple sclerosis need to be aware of the increased risks but can rest in the knowledge that approximately 80% of people with MS do not have a first relative with the disease and that there are others factors such as gender, ethnicity, environment (where you live) and age that play a role in whether a person develops MS or not, providing further answers to the question is MS hereditary.

Gender

Women are twice as likely to develop multiple sclerosis as men. Researchers are trying to determine whether hormones have a role in this bias of MS towards women.

Ethnicity

Multiple sclerosis appears to be more likely to occur in Caucasians who are of northern European ancestry. It also appears to be less likely to occur in persons of Native Indian, South American, Japanese and other Asian ancestry. Research has shown that persons of Aborigine, Bantu, Maori, Gypsy or Inuit (Eskimo) descent may never develop multiple sclerosis. Why is there such a difference in prevalence between ethnic groups? Is there a genetic connection or is it something to do with where they live, how they live and what they eat?

Environment

Where you live can definitely have an impact on what you eat, how you live and to some extent external things that enter the body such as poisons and parasites. Where you live can also impact on the attitude you have towards your illness and can shape your coping mechanisms. Continuing studies in this area is providing vital information to answer is MS hereditary or not.

Scientists are currently studying whether the sun and Vitamin D provide a protective factor against MS for those living near the Equator.

Age

MS commonly affects persons between the ages of 20 and 50 however as scientists continue to seek answers about multiple sclerosis and medical knowledge and techniques continue to improve they are discovering that there are older persons (50+) with MS in existence, some of whom have been living with the illness for about 24 years. They have also determined that MS can affect children and teens.

Multiple Sclerosis Disease – Why MS Patients Are Living Longer Than the Average Healthy Person

When we hear Multiple Sclerosis disease we often think long term and progressive disability. It can be a dooming and powerless feeling to think you have been cursed some how with a random disease and have no idea of the cause let along any idea of how to prevent or cure it.

Somewhere along the way people have become lazy, less of an advocate, and victims in their own health care. It’s understandable to feel despair on a subject matter like this. However, when you can understand and respect the biological system of the human body you better understand that your system has certain requirements for optimum function and performance.

In order to overcome MS, you will have to retake control of your health. There are people who were diagnosed with MS who are living healthier than the so-called average healthy person.

How is that possible?

They assessed their lifestyles, found out what wasn’t working and changed it. Many people who have overcome MS note that they changed their diets, tried different herbs, got more sun, kept active, eliminated heavy metals, balanced their body’s pH,, lowered stress levels, remained optimistic, and sought alternative practitioners who were knowledgeable on the subject.

Herbs

There may not be herbs specifically for MS but there are herbs for the damage MS causes. Herbs for the nerves and brain are ideal. Dherbs.com has a great selection of trustworthy herbal combinations. They even use vegetable capsules instead of gel capsules which are better absorbable for the body system. That way everything swallowed is used for the body’s benefit. They have herbs like lady’s slipper, yerba mate, valerian root, and gotu kola. Just look for their products called Brain Tuner, Mucus Buster, and Nerves Formula.

Diet

You have heard it a million times but there is no way around it. A good diet is your best defense against any illness. You wouldn’t expect hair grease and vinegar to make a car that requires gasoline to function properly. So why would your body be expected to function properly off of things it was not designed to operate off of. The body requires nutrition and tender loving care. When the body has been subjected to inadequate food for a long period of time a malfunction occurs such as cancer, high blood pressure, diabetes and in the case of this article MS.

Sun Bath

That’s right. Getting adequate sunshine without sunscreen is important. Let me be clear….don’t go out and get sun burned. Just allow your body and even your eyes to bask in sunshine from time to time. It is the best source of vitamin D. We spend a lot of time indoors and when outdoors we are “protected” by sunscreen. The human body really misses its connection with nature’s light.

Stay Active

It is tempting to stop moving when issues such as muscle stiffening, fatigue, and staggering set in, but move anyway. Yoga, Qi Gong and Tai Chi are REALLY good. Qi Gong is the best in my opinion because it really helps the eyes, balance, and blood circulation.

Heavy Metals

Heavy metal problems are found more so in developed nations. Developed nations also have the highest MS cases in addition to other diseases. Stay away from them. They are found in your water, household products, hygiene products and food. Be more aware about what you are purchasing and consuming.

Balance pH

A normal body pH is about 7.3 and most adults are under that meaning they are more acidic than alkaline. In order to perform in optimum capacity you should be balanced. Acidity is caused through consumption of sodas, sugars, salt, starches, dairy and meat. Consuming alkaline water will raise it. Also, the obvious fruits and vegetables especially the green ones will also help balance it.

Better Oxygen

The brain requires adequate oxygen and most people are not receiving that. People usually are not getting enough oxygen because they are not breathing properly. In addition, they are not getting good air quality due to pollution and air poisons. Since MS is a neurological illness, anything that will aid the brain and nervous system is what you want. Practice deep breathing. Slow and deep breathing is good. Investing in an air purifier and household plants would be a good idea. House hold plants are natural air purifiers so coupled with an air purifier would be a wise choice.

Lower Stress

People have gotten themselves in a trap. They are always running, hustling and striving for power, money or status. It is a vicious cycle to be in because the body is not invincible. It was not designed to be under unreasonable stress. Many people get either anxious or angry on a daily basis. That has got to be eliminated if there is going to be any hope of recovery. Realize you can make a difference but you should pick your battles wisely. Find peace of mind.

Remain Optimistic

You have to believe that you can overcome it. The vast majority of society believes it is a doomed situation, so don’t expect much optimism there. This is one of those cases where you are going to have to really see the glass “half full”. Strap up those boots, stir up that will power and see yourself back in good health. Don’t expect it overnight. This is not a race for the swift. You have to have stamina.

Alternative Health Practitioner

A good alternative health practitioner is priceless. They are knowledgeable and caring. When you find one who has ancient and precious knowledge, you feel like you have stricken gold. They are somewhat rare depending on where you live. A few have websites but many are the one’s you hear about through word of mouth. Use one if you feel you can not do this on your own. They will provide assistance where needed.

My mother and aunt were diagnosed with MS. My aunt ended up in a wheel chair and has since died. My mother took a different route. She fights everyday for her right to good health. She stays active even when she had to drag her right leg along She changed her diet and does not let up or give in. She is serious about her quality of health and does what she has to do in order to have it.

I volunteered once to help a MS patient in a rehabilitation center. She was very young, still in her thirties but looked older. She had to have weights on her wrists to keep her from trembling so badly. She used a wheel chair but required most things to be done for her. She really touched my heart because she was once a model and had pictures of herself everywhere. She told me something that stands out in my head everyday. Whenever I begin to get worked up over something, or when I begin to eat something I know I shouldn’t and when I begin to pass up an opportunity to pamper myself and relax, I can hear her say “Be Kind to Yourself”. She had a shaky memory, as some severe case MS patients do, so when she said that, I held on to it.

Ataxia and Multiple Sclerosis

Ataxia is the term given to any number of abnormal movements that take place while doing some voluntary movement. It sounds simple enough.

I guess that whenever medical terms or definitions are involved things can get a little (if not a lot) complicated for most of us so, I’ll try to put it in layman’s terms.

Folks suffering from ataxia have problems coordinating muscle movements. Often, these problems manifest themselves in the legs but also in the arms, eyes and in muscles used in speech. Some of these involuntary movements result in you experiencing incoordination or interruption in your movements. Lots of MSers have experience this type of Ataxia when we under – or over – shoot something we intended or target with our hand, arm, leg or eye.

This missing of target is a type of Ataxia known as Dysmetria. Since my diagnosis, I started to experience Dysmetria of the hand. This can make your writing and picking things up difficult or even impossible.

Your cerebellum is the part of your brain in charge of synchronizing all voluntary muscle movement throughout your body, cerebellar ataxia is the result of lesions on the cerebellum or in the nerves that connect into it. Cerebellar ataxia can result in:

Uncoordinated walking – gait ataxia.

Inability to maintain a steady posture – hypotonia.

Shaking when attempting fine movements – intention tremor.

An inability to coordinate the muscles involved in speech – dysarthia

Jittery eye movements – nystagmus

If the damage is located in the spinal cord – in its posterior columns to be more exact – the type of Ataxia that occurs is known as sensory ataxia.

Whenever you experience not knowing exactly where your limbs (hands and feet) are, you are experiencing Sensory ataxia. Another manifestation of this type of Ataxia happens when you experience an unstable stance. Common problems seen by this type of Ataxia are:

Loss of position sense

Inability to detect vibrations

Unstable stance also known as Romberg’s sign

In multiple sclerosis, the last type of Ataxia is known as vestibular ataxia which is caused by lesions to the brainstem and the vestibular nuclei. Common problems seen by this type of Ataxia are:

Loss of Balance

Dizziness

Nausea and

Vomiting (vertigo)

Jittery eye movements – Nystagmus

I know now that I experienced this type of Ataxia when I had my first MS relapse. It came with a loss of balance, dizziness, vertigo and a little jittery of the eyes (nystagmus) besides the optic neuritis that never really went away.

Contrary to what most people think, Ataxia is not a direct result of muscle weakness (atrophy) but a dysfunction in the sensory nerve inputs or motor nerve outputs.

HOW COMMON IS ATAXIA AMONG MSers?

It is estimated that between 80 and 85% of MSers will experience ataxia or tremors at some point during their disease. Ataxia is quite a common symptom in Multiple Sclerosis but is also seen in other conditions such as:

1. Spinal cord compression

2. Diabetic polyneuropathy

3. Acute transverse myelitis

4. Vacuolar myelopathy

5. Tumor or cord compression and

6. Hereditary forms of ataxia

HOW IS ATAXIA TREATED IN MSers?

In order to help you manage these symptoms, several different treatments currently exist. They can be categorized by:

Physiotherapy

Neurosurgery

Oral medications – Some of them containing marijuana or cannabis extract, isoniazid or baclofen.

The Cochrane Collaboration, currently published in the Cochrane Database of Systematic Reviews 2010 Issue 11, Published by John Wiley and Sons, Ltd. concludes that there is not enough evidence to suggest that any treatment (drugs, physiotherapy or neurosurgery) provides sustained improvement in ataxia or tremors.

The one thing everybody seems to agree on is that more research is required.

Last but not least, along with the multiple problems caused by ataxia, you may experience tremors.

Tremors are rhythmic shaking movements of different amplitudes.

Whenever I stand in the same place for too long, I experience tremors in my right knee. These tremors are nothing serious and once I start moving they just vanish. While researching the subject I found out that tremors in MSers are mostly affecting the head, neck, vocal cords, trunk or limbs.

TIPS & EXERCISES FOR ATAXIA

In ataxia the person presents.

  • Incoordination
  • Tremor
  • Disturbances of posture
  • Balance and
  • Gait

Physiotherapy is directed at promoting postural stability, accuracy of limb movements, and functional balance and gait.

Postural stability can be improved by focusing on static control (holding) in a number of different weight bearing, antigravity postures (e.g. prone on elbow, sitting, quadruped, kneeling, plantigrade and standing). Progression through a series of postures is used to gradually increase postural demand by varying the base of support and raising the centre of mass and increasing the number of body segments (degree of freedom) that must be controlled. Specific exercise techniques designed to promote stability include:

  • Joint approximation applied through proximal joints (through shoulders or hips) or head or spine
  • Alternating isometrics (PNF)
  • Rhythmic stabilization (PNF)

Patient with significant ataxia may not be able to hold steady and may benefit from the technique of slow reversal- hold (PNF), progressing through decrements of range. The desired end point is steady mid range holding. Dynamic postural responses can be challenged by incorporating controlled mobility activities such as:

  1. Weight shifting
  2. Rocking
  3. Moving in and out of postures or movement transitions

The patient should practice important functional movement transitions, such supine to sit, sit to stand and scooting.

Distal extremity movements can be superimposed on proximal stability to further challenge dynamic postural control. For example, resisted PNF Chop or lift patterns combined upper extremity movements with trunk movements (flexion rotation or extension with rotation).

An important goal of therapy is to promote safe and functional balance. Static balance control can be improved by using force platform training. The person with ataxia learns to reduce the postural sway (frequency and amplitude) and control centre of alignment position. The added biofeedback from visual and or auditory feedback display can improve control in some patients. Somatosensory, visual, and vestibular inputs can be varied, as appropriate, to assist in sensory compensation in sensory system less involved, for example:

  • Standing with eyes open to eyes closed
  • Standing on flat surface top a foam surface

Prolonged latencies (onset of responses) should be expected. Dynamic balance control can be initiated using self initiated movements (e.g. reaching, turning, bending). A movable surface can also be used. For example, sitting activities on Swiss ball are an excellent way to promote balance control.

Control of dysmetric limb movements can be promoted by PNF extremity patterns using light resistance to moderate force output and reciprocal actions of muscles for example: slow reversals, slow reversal- hold. Frenkel’s Exercises can be used to remediate the problems of dysmetria. The exercises are performed in supine, sitting and standing. Each activity should be performed slowly with the person using vision to guide correct the movement. The exercises require a high degree of mental concentration and effort.

For those patients with prerequisite abilities they may find helpful in regaining some control of ataxic movements through cognitive processes.

Ataxic movements have sometimes been helped by the application of light weights to provide additional proprioceptive loading and stabilize movements. The use of Velcro weight cuffs (wrist or ankle) or a weight belt or weight jacket can reduce dysmetric movements and tremors of the limbs and trunk.

The extra weights will also increase the energy expenditure, and must, therefore, be used cautiously in order not to bring about increased fatigue. Weighted canes or walkers can be used to reduce ataxic upper limb movements during ambulation.

For patient with significant tremor, this may mean the difference between assisted and independent ambulation. Elastic resistance bands can be used to provide resistance and reduce ataxic movements.

The pool is an important therapeutic medium to practice static and dynamic postural control in sitting and standing. Water provides graded resistance that slow down the person’s ataxic movement, while the buoyancy aids in upright balance.

Swimming and shallow water calisthenics have shown to be effective in improving strength, decreasing muscular fatigability and increasing endurance. Furthermore, the use of moderate or cool water temperature may help moderate spasticity. In general folks with ataxia do better in low stimulus environment that allows them to concentrate more fully on their movements. They benefit from augmented feedback (verbal cuing of knowledge of results, knowledge of performance, biofeedback) and repetition to improve motor learning.