Tuesday 10 January 2017

Blog platform change

The latest blog has been done on wordpress as I was told they have a better service,  the blog can be found here: http://wp.me/p8gzfX-F

Thanks,

Sunday 1 January 2017

Speech and swallowing

I start off this post with an apology to those who were looking forward to this post last week, sorry to have disappointed you but I was making the most of the holiday season! With which I wish my 'fan group' happy holidays and a new year! And to those who may not be celebrating anything, happy Sunday!

So to start off, speech from a physical and a mental viewpoint. There are two noted down types of speech issues with MS: Speech dysarthria and speech dyphasia. 
Speech dysarthria is an issue with speech caused by damage to one part of the brain which can affect the muscles of the tongue and lips so making it difficult to pronounce precise sounds. Damage to another part can weaken the diaphragm which can affect breath control and volume.
The connecting part of the body between the brain and spine, the brainstem is an area particularly important for control of speech and if this is damaged there may be speech issues. The typical speech issues caused by dysarthria in MS are:
  • slurred, imprecise or slower speech
  • low volume or weak voice
  • difficulty with resonance and pitch control
  • sounding like you're speaking through the nose
  • long pauses between words, or between syllables
Moving on to speech dysphasia, it is a more rare issue but can make it hard to understand what an MSer is trying to say ( receptive dyspharia) or find the right way to say something ( expressive dyspharia). The way I like to see this side of the symptom ( not intending to cause any offence!) is Mr. Bean giving a talk. 

Along with these symptoms, side effects of drugs used to treat other symptoms may cause things like a dry mouth resulting in more issues with speech.

The first time I developed this symptom with the speech, I wasn't really aware of this issue in this context or that I even had any speech problems and I remember harshly being told to stop acting like a 'baby' as I was mid relapse, very fatigued and hungry asking for something to eat at the time. It is something awkward when talking to people as there are further cognitive issues that can affect speech which are still to be discussed! It has left me being grateful to those people who in a gentle manner ask me to repeat myself rather than the more common response of ' I can't bloody hear you' or ' speak properly' and all things such along them lines. I also remember having to practice speech in the different languages I know of to rehabilitate my speech abilities, with their being difficulty with the pronunciation of letters in Arabic which still last with me till today. Although when I was young, I was the kid who the teacher chose to read the passage being studied and also being the one chosen to be the lead in a group singing project or play ( not trying to 'big' myself up just mentioning!) but now I am grateful if I can successfully speak to a person comfortably!SwallowingThe ability to swallow is another thing we wouldn't really think about and it can be one that occurs with the speech issues after the relevant damage, these issues can occur at a relapse stage and go away and never return but can also occur and remain for a lasting period of time. The swallowing issues may include:
  • Changes in your speech (which go hand in hand with small changes in swallowing)
  • Problems chewing
  • Food sticking in your throat
  • Food or drink coming back up
  • Sluggish movement of food going down, or difficulty moving food back through your mouth
  • Coughing and spluttering during and after eating
  • Excessive saliva, which may cause dribbling
These symptoms are all dealt with by speech and language therapists when spotted, exercises and general tips can be given to try and deal with these symptoms. Speech issues can cause abnormal social issues and swallowing ones can be more dangerous, like chocking on something from even a bit of water to something a bit 'heavier' than that. I remember having to use a straw for breakfast and still till today told to slow down drinking anything even though I am now very cautious with consuming any liquid. but I am grateful I was never accused of being drunk due to speech symptoms with MS as I think that would have been a more difficult matter! 

The swallowing symptoms can result in foods 'going down the wrong pipe' and in severe cases patients would be fed via a tube through their nose to their stomach. If food goes down the windpipe by accident due to these symptoms it can lead to things like infections which can induce pseudo relapses ( still to be discussed!) and weight loss due to being unable to eat properly can be an issue.

That's this post done but I just wanted to mention, the further posts will be discussing symptoms mainly sourced at the cognitive side of MS and perhaps matters that are taboo or awkward will be discussed, so in a time where many serious things are almost laughed at I do ask for maturity with the coming content as yes it has unfortunately been a bit of a 'joke' to some when I felt stating the reality of things was the best way to go!

Sunday 18 December 2016

More than just a pain in the butt! Pain and MS.

Pain and multiple sclerosis, really is a bit of a pain in the head wondering how to put this forward (just to mention metaphorically speaking!). Like many things in MS they sound like things normal, average, healthy, living being thing would go through but with MS there always is that little extra bit of spice.

Like all the symptoms there are different avenues to their cause and they vary in severity but all are due to damaged nerves, pain in MS can be in different ways and forms which will be discussed below. But to start, a few ways in which an MSer may describe the pain they feel: Squeezing or crushing, Cold,Hot or burning, Sharp, Dull, Like ants under my skin or ‘creepy crawlies’, Like a build up of pressure, Stabbing, Creeping, Like an electric shock, Aching, Pins and needles. Those are the few that are noted down!

Optic neuritis again for starters; when the optic nerve or any nerve in that matter is damaged it is known to be 'inflamed'. Due to this symptom, an MSer may not even realise a vision loss but they will most definetely complain of the pain, especially immediately after damage episode starts. Simply put when we move an eye to change direction or look at something else or in some cases look to your far left or right/ up or down, there is an extreme burning like feeling like your eye is being pulled out by a hook from the side.

Next being trigeminal neuralgia pain,the trigeminal nerve is the nerve that is responsible for the sensation your face. If this nerve is inflamed it can leave a sharp stabbing pain on your face, it has been described as one of the worst types of pain a human can face. Damage to the brain stem can also result in this symptom, this type of pain can lead to an MSer thinking there's something wrong with their teeth or jaw and in my case being a bit of a yo-yo between the dentist and the GP.

Then there's the 'MS hug', it is everything but as nice as your normal hug. A feeling of being crushed or squeezed due to damage in the spinal cord, a lesion on the spine leading to a painful band around the chest. At first an MSer may get very worried thinking it's due to issues with their heart and thus get sent for ECG scans to make sure their heart is beating properly! Especially being of an Asian heritage known for our food fancies and heart issues it can be even more worrying!

Lhermitte's pain, Lhermitte being a European guy that is dead. But the Lhermittes phenomenon is something that is seen in MS and related spinal injuries. This is when an MSer were to move their neck, to look up, left or right and a quick zip ( electric shock type) from the neck down to the toes, so people who may have this symptom may do whatever it takes to keep their neck straight and not move it.

Burning limb pain; not a specific pain but due to damage anywhere on the sensory pathways, it can lead to abnormal weird, ' ouchy' feeling. Something that is hard to describe, sometimes best describe as a leg not feeling right and being really painful.

Only few more to go! With the recently mentioned spasticity symptom when the muscles may be almost at war with each other  ( one part wanting to relax and the other contract) it can lead to a type of pain. To put things in context if anyone ever wanted to get an idea of this type of pain and had 5 hours or so to spare, clinch a fist for 5 hours and try to open your hand or click your fingers and a similar type of pain can be felt, this would also cause painful cramps in an MSer but it is somewhat a normal thing for an MSer with this symptom.

Almost done now! Due to the nerve damage in the brain, it can cause random migraine like pain and this may be the only type in which the 'cure for all conditions' for people of the subcontinent (stereo typically!) may be helpful for, yes Paracetamol!

More secondary pain may be knock on effects of other symptoms, like bruises or cuts on the body from falling over or a limp in the walking pattern ( due to symptoms like foot drop or 'gait' issues [still to be mentioned don't be frightened!]) resulting in pain in joints due to an abnormal 'rubbing' on the knees or hips whilst walking ( see for video for example below).

This would probably sum up the pain related symptoms of MS: Neuropathic pain is caused by MS nerve damage in the brain and spinal cord. Nerve damage might cause a range of sensations, from minor irritations to intense sharp or burning pains.
Musculoskeletal pain is the pain in muscles and joints that comes from living with the stresses and strains MS places on the body. For example, difficulties with balance, fatigue or muscle weakness could lead to problems with posture, putting a strain on joints, ligaments or other muscles.

 Lastly, I promise! The drugs used for these symptom can have very severe side effects, though I won't go into too much depth now but for neuropathic pain which can be anywhere there is damage, a very common and vouched for 'homeopathic' or complementary treatment that is used is marijuana, I was approached by a 'dealer who somehow heard of me and MS and told me he had a lot of customers with MS and offered me his details. I will be unfortunately or fortunately have to be a  a killjoy so marijuana, drugs and MS will be saved for a sunny day hopefully! I apologise if this does hurt to read, but this is multiple sclerosis!

https://www.youtube.com/watch?v=CuuNtaLvwA8

Sunday 11 December 2016

Fatigue and sleep.

Why are you tired, you didn't do anything today? What do you mean you're tired, it's not like you go to work or anything? Just a few statements me and perhaps others with MS receive on a regular basis when we are trying to deal with life under fatigue because of MS!

You may think tiredness yes but fatigue is something far from just basic tiredness. One may think all that is needed to deal with tiredness would be a good nights sleep right? Anything but when it comes to MS.

Getting more into things, fatigue can be described as an overwhelming sense of tiredness with no obvious cause. This may have a mental, cognitive or physical exacerbation of symptoms for a period of time that the fatigue is lingering. This could be heavy limbs, balance or sight issues or concentration problems. Fatigue can also leave an MSer having a nice long and fruitful 8 hour sleep only to wake up feeling as gruggy as you did beforehand. And along with other symptoms fatigue can help slow down the process of waking up in the mornings, so for example the mind being fresh but the legs forever taking whatever means to wake up a bit later.

Fatigue affects people in different ways, and it may change from week to week, day to day, or hour to hour. The reason for fatigue in MS is still fairly unknown but there are a few slightly proven theories ( proven by scientific study but not completely identifying a certain cause). Primarily a result of damage caused by MS, a thought that damage to certain areas of the brain are associated with fatigue in MS. Another being that fatigue is caused by the way in which the brain adapts to the damage, simply put the way I saw and thought of it, the extra work required to send signals over damaged pathways leading to fatigue. MRI scans have shown MSers who suffer from fatigue ( the majority just to note) that larger areas of the brain are used for carrying out  activities than people who don't suffer with this symptom.

Fatigue like all MS symptoms vary from person to person, some are exhausted (in the MS sense!) by going to the shop, some by preparing something to eat and some by merely standing up. Fatigue is a symptom that isn't very tangible, many times I am asked by people if I feel fatigued, but usually the fatigue would result in a difficulty giving a yes or no answer! Past the usual comments I would receive like I shouldn't have slept/ woken up so late or should've completed my meal, a lot of the time fatigue can halt or cause problems in carrying out small 'normal' and 'basic' actions. To add further, after I tiresome day of doing 'nothing' sometimes, fatigue can stop an MSer from falling asleep properly! It can induce other symptoms like pain, spasms, bladder issues, spasticity or heat intolerance ( ignore the ones not yet discussed!) and thus leave a pretty double sided sword if anything, and to mention further; psychological impacts also affecting the sleep and fatigue, things like depression or anxiety which could be another thing caused by MS in more abnormal ways ( still to be discussed and I do look forward to it!) that could result in feeling more fatigue and not being able to fall asleep. 

I know for many, sleep is the best part of the day ( or night) along with the above mentioned things that affect sleep, there are further symptoms that may disrupt the quiet time we get in our days, everything but checking Facebook or Twitter before bed! Restless leg syndrome being an overwhelming, irresistible urge to move the legs ( or arms in some cases), this due to the short circuit effect because of damage, this isn't restricted to the night but it obvioisly would make sleeping harder.Lastly sleep apnea, where the regular breathing pattern of a human is 'off chord' whilst asleep, this affects the amount of oxygen that enters the blood, this may wake a person up mid sleep with a choke feeling to get the airways working again or occur without notice, but it can have an effect on the person the following day, the accomplished sleep feeling isn't felt due this symptom.

I think I've went on a bit too long today, would try lie down but I don't think I'd fall asleep so easily, but honestly, as fatigue can impact the whole bodily systems working, it has made me forget the more entertaining parts of my blog but hey, just one of the joys of MS!


Sleep apnea: https://www.youtube.com/watch?v=TgC_S09Xea4

RLS: https://www.youtube.com/watch?v=Pqke9lRn1h8

Sunday 4 December 2016

Muscle spasticity/ stiffness and spasms

Before we start, a video explaining MS in a few seconds I forgot to add in a long time ago ( If videos don't play see the links below):


I'm sure you would know by now especially it is far from beng a monkey scrotum! Muscles, muscles, muscles. What would we do without them? Or what if they didn't work as we plan to use them? The final more specific muscle related symptoms to be discussed, though just like our nerves, muscles are involved in most things in life and another part of the body that is an avenue to the long list of symptoms associated with MS!

Muscle spasticity/ neuro spasticity being an increased tone (resistance or tension in the muscle) due to the damaged or dead nerves along the signal pathway(s) to area involved. But simply meaning when the muscles are used, there is more resistance to the movement and the muscles feel more rigid.

Stiffness being pretty much a similar thing where due to muscle resistance they are slower to relax so simply put it can make fine movements more difficult to perform, like lifting your leg up to get in or out of a car or straightening your legs to stand up from a chair. Other more explicit movements like walking can also be affected by the stiffness, as you can probably imagine it would lead to walking a bit like a robot in the sense that the muscles would keep straight and not follow a normal walking pattern.

To give more of a understandable example; if a healthy person were to lift their fist towards their shoulder almost like to show off your muscles, the muscles on the front of the arm will tighten and the ones on the back would relax. However a person suffering with spasticity did the same when this is done the muscle in the whole arm would tighten and the same time, so the muscle thus is very 'rigid'.

Another example to show the effects of this symptom, if a person where to stretch for a training session, when stretching the tendon ( the muscle on the other side of the shin [the back] they would be able to feel a stretch happening so to speak, but with this symptom the motion can be carried out but there be no feeling of any changes at all.



Spasms being random jerks in uncontrollable ways, somewhat similar to tremors however a different bodily function involved and more random than that of the tremors. These can be minor like a constant tapping of the foot which is known as 'clonus' or quite major where the whole limb or two may suddenly jerk resulting in a bit of pain and embarrassment if around other people! Though me being me, I have warned a few of my close friends that if they do frustrate me, I'd give them a good slap and blame it on the spasm effect!

Clonus:



Though thankfully I do not suffer so severely this symptom but recalling a discussion in a meet up group of MSers, where a gentleman with SPMS and his wife, told us their stories of the wife waking him up at 3am in the morning to tell him off for giving her a hurtful kick whilst fast asleep!

Spasm examples: 



A lot more extreme example. watch with caution: 



Sunday 27 November 2016

Tremor, ‘butter fingers & more manual dexterity issues.

Back when I was in my second year of college ( sounds like a long time ago but feels like yesterday!) I mentioned to a fellow classmate in Biology that I have MS, his response? How come you're not shaking! I still don't really understand what he meant but the obvious symptom that did come to mind was that of the 'tremors'.

On first thought tremor just means a bit of shaking somewhere literally right? But as I'm sure you'd know by now things are never so simple with anything related to multiple sclerosis. Tremors aren't the only reason there may be a bit of 'shaking' occuring but the first and main one I reckon would be the tremors.

So, a tremor would be described as a trembling or shaking movement that can't be controlled in the affected muscle. Usually in a rhythmic shaking either fine small movements or larger more explicit ones. This would be due to a damaged nerve(s) somewhere along the neurological pathway to the muscle that is concerned. 

Furthermore, there are two types of these tremors. An intention tremor where an MSer is intending to do something like switch a light on and the tremor worsening as the hand gets closer to the object. Postural tremor, where the muscles are trying to hold part of the body still against the force of gravity and just has the odd wiggle because of the main reason of most symptoms, the short circuit reaction.

Ataxia is a term for a group of disorders that affect co-ordination, balance and speech thus the tremor, along with the tremors and the previous loss of sensationor any other related symptoms, this leaves an MSer with the infamous butter finger trait, so it would make sense if things don't last long in our hands, we miss the hand when reaching for a handshake, turning a page or untangling your headphones becoming a bit like an Olympic sport!

With me it just happened to occur in its more severe state ( post relapse) at the ending of winter, so I had a lot of people telling me to bring a pair of gloves, or wear extra clothing next time I left the house! But when I did have these tremors it was difficult to hold the phone straight or bring a cup of tea to the table, it almost frightened a few folk around me resulting in them grabbing my hand to hold it straight, which reminded me of something that's done whenever there is a mouse, spider or lizard ( yes in India and so these are common household guests! Though a stick or brush is used!) and a rush movement to grab them or hit them is usually the typical response now displayed when my hand couldn't stop dancing around!

These two videos below showing examples of the tremors and their effects:

https://www.youtube.com/watch?v=6dmZMK6FNps
https://www.youtube.com/watch?v=01ojuCnMonM

Sunday 20 November 2016

Balance problems and dizziness (vertigo, drunkard disease)

Most people with MS are regularly perceived to being drunk and having ' a bit too many'. This is all due to the balance problems that can be seen and the effect of 'dizziness' that is experienced. Something we would hardly realise or even think about is the complexity of our balance and our human ability to stand up straight without wobbling over. MS at a time was known as the 'drunkard disease' because of symptoms based on these points below.

For normal balance (just to clarify, on two legs not one!) there are different parts of the human body that work together; Information your brain receives and the replies it sends out can be late, incomplete or misleading. The messages being passed inside your brain can also be disrupted, which affects the way it processes balance information. we can put this into three groups to make things that tiny bit easier to understand! The input, processing and the output, not as simple as baking a cake unfortunately but regardless, here we go!

The input consists of three avenues and these are; vision - the symptoms left by ON can give confusing information to the brain that would try to understand incomplete or disrupted signals - the inner ear - which updates our brains of the angle and position of our heads, disruption or missing information can lead to balance issues- and sensory changes - if you can't feel things properly then signals needed by the brain to make us stay straight aren't received properly or at all - thus MSers tend to wobble around or remain completely stagnant for our own safety ( on a wheelchair, or using walking aids to help us walk straight, well just about).

Processing of the messages sent by the NS are vital for our brains to process the right information. Damage to the cerebellum ( at the base of the brain, see picture below) or the brain stem can lead to symptoms like vertigo ( slight movements making your body feel like it is on a rollercoaster) or nausea. Similar to the way a person who gets travel sick or sea sick would feel as their body finds it hard to process the information of being stable but moving ( on water or road) at the same time.

Output, as already stated the muscles respond in a delayed manner or not at all due to neurological damage and more specific symptoms ( which we still have to discuss) the muscles aren't able to respond to messages from the brain properly so the MSer with the damaged system thus looks drunk if anything. I look drunk all the time; I have an excuse for walking into things/ people or tripping to my right when taking a left in the corridor but I've never had a 'drink' in my life!

Usually when I do seem to be toppling over, something very much expected with MS I'm told I didn't eat enough food or told to slow down, it has been a very long time since I've rushed to do anything believe me!

Unfortunately, I try my best but all posts can't be so funny and entertaining, some like this have to be just plain and boring! Till next week guys!