Your breath and your thoughts are the keys that open the door to your IGS.  I'm sure that may be news to some of you, but please stay with me. You may call it your intuition, or perhaps your higher self or spirit guide, but it is an innate internal knowing that every human being has. When I began my own MS journey I had known I had that intuitive internal voice, but didn't understand that it was always available to me and that I could learn to activate and/or enhance it. I also learned activation tools, as well as ways to recognize my IGS. Now I consciously use them every day.

In Four Steps to Overcoming MS I introduced this subject with the following:

. . . Energy medicine is your body's innate self-healing mechanism. More and more it is being recognized by well-known allopathic medical doctors. The challenge for us is learning how we turn on that mechanism.

With each succeeding year of life I become more and more aware of the importance of what I call our personal Internal Guidance System (IGS). Oh yes, we all have one. It is somewhat like a Global Positioning System for our body. It is how we communicate with our body's self-healing ability.

We all need to cultivate a relationship with this IGS and seek to do that. We have talked a lot about the body’s innate energy system, that energy we call chi, prana, or life force . . . In the Tai Chi/Qi Gong video Mark Johnson refers to the ability to feel the chi energy. It is the recognition and "feeling" of that energy which is the basis for our IGS. Actually, it was through working with Mark's video that I first realized I could physically feel the energy.

I can just hear some of you saying, "OK Betty, I accept that you can feel that energy, but I sure can’t." If you will stay with me for a few minutes, I’ll share with you how to begin to feel and recognize your own IGS.

The first step is to feel the energy in your hands. Sitting quietly, arms bent at the elbow, hands somewhat elevated, notice the slight tingling in your hands. Once you place your attention and intention on your hands, it is easy to feel that inner energy.

Now just close your eyes and concentrate on feeling that energy as it courses through your hands. Do this first step only every day for a few minutes, for about a week.

The second step is to learn to also feel the energy in your feet. Just sit in a chair, totally relaxed with your shoes removed, and allow your attention and intention to focus not only on your hands but also on your feet. You will begin to feel the same slight tingling in your feet. Again, practice this for at least a week. Move at your own pace, and if it takes a month before you "feel" the energy in your hands, that’s OK. Remember that your attention and intention are very important.

Your ultimate goal is to learn little by little to increase your awareness of the life force energy in your entire body. Add your arms to your hands, then add your legs to your feet, then the upper body and then the lower body. Soon you will be able to feel that energy throughout your entire body.

You will soon begin to recognize the subtle physical aspects of your personal Internal Guidance System. Remember that your personal IGS is your guide to self-healing of any aspect of your life.

"You are not your thoughts; you are the awareness of your thoughts."

                                                                                                                       - Eckhart Tolle

Eckhart Tolle's masterful book, A New Earth, Awakening to Your Life's Purpose (published by Plume), is a very insightful guide to understanding who we truly are, through increased awareness. Each of us has an innate source within that is the ultimate IGS. It is the essence of who we are.

EVERYONE’S body has this energy force, which is the source of all life, and which powers our personal IGS. It enters our body the instant we are born and breathe our first breath, and when it leaves our body, we call that death. As we learn to recognize and feel that energy, we will begin to develop a relationship with our IGS.

Spend a little time each day practicing feeling your body’s inner energy before moving on.

Four Steps then goes into great detail about recognizing and working with your IGS. It truly is a very powerful healing tool that resides in each one of us. If you do not have Four Steps to Overcoming MS, I encourage you to order it today.

  From My Mailbox

   Hi Betty,

Thanks for writing about the effects of heat and humidity on the person with MS.  I am newly diagnosed, live in Florida, and have no insurance.  I have been suffering terribly this summer.  Thanks so much for your assurance that the increased weakness when it is hot does not mean that my MS is worse.  Bless you for all that you do. /s/ Robin D.

Hi Robin.  I'm so glad you found the heat-related information helpful.  I always try to include the things I found helpful when I first started my MS journey.

   Dear Betty, 

Thank you for not giving up on getting those of us who are still lagging behind with exercise.  I have finally learned to get my duff off the couch and into exercising, and I can't believe how much better I feel.  Thanks again Betty for not giving up on people like me.  The short 5-minute routine you gave last month got me to moving, and I can't believe how much better I feel.  Now I have dusted off my Yoga for MS DVD and I love it!  Thanks for all that you do. /s/ David D.

Thanks for writing David.  You are so correct; that routine is a great first step to beginning a regular exercise program.  When we quickly feel a benefit from exercise, it is easier to make the commitment necessary to follow through with a program.  I personally love that short 5-minute routine that gets me moving in the morning.  I'm glad it is working for you also.

  MS Research News 

Gentle Touch May Aid Multiple Sclerosis Patients

Science Daily (Oct. 17, 2009) — While gripping, lifting or manipulating an object such as drinking from a cup or placing a book on a shelf is usually easy for most, it can be challenging for those with neurological diseases such as multiple sclerosis or Parkinson's, or for people who had a stroke. For them, the tight gripping can cause fatigue, making everyday tasks difficult.

A team of University of Illinois at Chicago physical therapists report this month in the journal Neurorehabilitation and Neural Repair that persons with multiple sclerosis use excessive force when they are lifting objects. In an earlier finding reported in the journal Clinical Neurophysiology, they reported that regaining control and coordination may be as easy as applying a gentle touch to the affected hand from a finger of the opposite hand.

"We studied how this light touch application changes the way people apply force to an object they want to grip," said Alexander Aruin, professor of physical therapy. The study compared eight adults with multiple sclerosis to eight without the disease, gender-matched and of comparable age. "In each case, the grip force required to lift an object decreased," said Aruin.  He found similar results in an earlier study he did of people with arm weakness caused by a stroke.

Why the simple light finger touch application works so well is not fully understood, but Aruin offers a hypothesis.  "It could be due to auxiliary sensory information from the contra-lateral arm," he said. "When we use our second hand and touch the wrist of the target hand, available information to the central nervous system about the hand-object interaction may increase. Without the touch, the information needed to manipulate an object comes only through vision and sensory input from just the target arm and hand."

Aruin and his colleagues tested subjects griping and lifting a variety of objects that they moved in several different ways, directions and velocities. The gentle finger touch always helped to reduce grip force, making the task easier. The UIC researcher said he and his colleagues plan to test the approach on those with other neurological and muscular diseases to examine the effects.

"We look forward to developing training and rehabilitation procedures on how to use this," said Aruin. "We know that MS patients are prone to fatigue and muscle weakness. This finding may enable them to perform daily activities more independently to improve their quality of life."

The papers' lead author was Veena Iyengar, a former master's student of Aruin's now at Advocate Lutheran General Hospital in Park Ridge, Ill. Other authors were Marcio Santos, a former UIC postdoctoral fellow now at Santa Catarina State University in Brazil, and Michael Ko, a neurologist with Loyola University Chicago's medical center.

Juggling Enhances Connections In The Brain
Jan Scholz of FMRIB centre juggling. (Credit: Image courtesy of University of Oxford)

Science Daily (Oct. 17, 2009) — Learning to juggle leads to changes in the white matter of the brain, an Oxford University study has shown. The research, funded by the Welcome Trust and Medical Research Council and published in the journal Nature Neuroscience, appears to show improved connectivity in parts of the brain involved in making movements necessary to catch the balls.

‘We tend to think of the brain as being static, or even beginning to degenerate, once we reach adulthood,’ says Dr Heidi Johansen-Berg of the Department of Clinical Neurology, University of Oxford, who led the work. ‘In fact we find the structure of the brain is ripe for change. We’ve shown that it is possible for the brain to condition its own wiring system to operate more efficiently.’

The researchers at the Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) set out to see if changes in the white matter of the brain could be seen in healthy adults on learning a new task or skill.

White matter consists of the bundles of long nerve fibres that conduct electrical signals between nerve cells and connect different parts of the brain together, while the grey matter consists of the nerve cell bodies where the processing and computation in the brain is done. Changes in grey matter following new experiences and learning have been shown. But enhancements in white matter have not previously been demonstrated.

Measuring changes in white matter relied on assessing diffusion MRI images using new methods pioneered by the FMRIB centre at Oxford. The methods are able to compare anatomical features of white matter between individuals or over time. ‘We have demonstrated that there are changes in the white matter of the brain – the bundles of nerve fibres that connect different parts of the brain – as a result of learning an entirely new skill,’ explains Dr Johansen-Berg. A group of young healthy adults, none of whom could juggle, was divided into two groups each of 24 people. One of the groups was given weekly training sessions in juggling for six weeks and asked to practice 30 minutes every day. Both groups were scanned using diffusion MRI before and after the six-week period.

Juggler, postgraduate student at FMRIB, and first author on the paper, Jan Scholz (left), said: ‘We challenged half of the volunteers to learn to do something entirely new. After six weeks of juggling training, we saw changes in the white matter of this group compared to the others who had received no training. The changes were in regions of the brain which are involved in reaching and grasping in the periphery of vision, so that seems to make a lot of sense.’

After the training, there was a great variation in the ability of the volunteers to juggle. All could juggle three balls for at least two cascades, but some could juggle five balls and perform other tricks. All showed changes in white matter, however, suggesting this was down to the time spent training and practising rather than the level of skill attained.

‘This exciting new result raises a lot of questions,’ says Dr Johansen-Berg, ‘MRI is an indirect way to measure brain structure and so we cannot be sure exactly what is changing when these people learn. Future work should test whether these results reflect changes in the shape or number of nerve fibres, or growth of the insulating myelin sheath surrounding the fibres.’

Dr Johansen-Berg says: ‘Of course, this doesn’t mean that everyone should go out and start juggling to improve their brains. We chose juggling purely as a complex new skill for people to learn. But there is a ‘use it or lose it’ school of thought, in which any way of keeping the brain working is a good thing, such as going for a walk or doing a crossword.’ ‘There are potential clinical applications of this work, although they are a long way off,’ adds Dr Johansen-Berg. ‘Knowing that pathways in the brain can be enhanced may be significant in the long run in coming up with new treatments for neurological diseases, such as multiple sclerosis, where these pathways become degraded.’

Adapted from materials provided by University of Oxford.

University of Oxford (2009, October 17). Juggling Enhances Connections In The Brain. ScienceDaily. Retrieved October 20, 2009, from http://www.sciencedaily.com /releases/2009/10/091016114055.htm

BUFFALO, NY – Neurologists at the University at Buffalo are beginning a research study that could overturn the prevailing wisdom on the cause of multiple sclerosis (MS).

The researchers will test the possibility that the symptoms of MS result from narrowing of the primary veins outside the skull, a condition called "chronic cerebrospinal venous insufficiency," or CCSVI. CCSVI is a complex vascular condition discovered and described by Paolo Zamboni, M.D., from Italy's University of Ferrara. In the original Italian patients, CCSVI was found to be strongly associated with MS, increasing the risk of developing MS by 43 fold. This narrowing restricts the normal outflow of blood from the brain, causing alterations in the blood flow patterns within the brain that eventually causes injury to brain tissue and degeneration of neurons.

"If we can prove our hypothesis, that cerebrospinal venous insufficiency is the underlying cause of MS," said Robert Zivadinov, M.D., Ph.D., UB associate professor of neurology, director of the Buffalo Neuroimaging Analysis Center (BNAC) and principal investigator on the study, "it is going to change the face of how we understand MS."

Michael Cain, M.D., professor and dean of the UB School of Medicine and Biomedical Sciences, said a positive outcome from this trial would have enormous implications for the treatment of MS. "Being able to identify those at risk of developing MS before symptoms take their toll could change the lives of millions of persons who now face inevitable lifestyle restrictions."

Margaret Paroski, M.D., executive vice president and chief medical officer of Kaleida Health, parent of Buffalo General Hospital where the BNAC is located, commented: "Will Rogers once said, 'It isn't what we don't know that gives us trouble, it's what we do know that ain't so'. Challenging basic assumptions about diseases has lead to some very important discoveries.  "When I was in medical school, we thought peptic ulcer disease was due to stress. We now know that 80 percent of cases are due to a bacterial infection. Dr. Zivadinov's work may lead to a whole different way of thinking about multiple sclerosis."

The preliminary findings were based on a pilot study at the BNAC headed by Zivadinov, and at the Universities of Ferrara and Bologna, Italy, directed by Zamboni and Fabrizio Salvi, M.D, respectively. The study showed that several abnormalities affecting the predominant pathways that return venous blood from the brain to the heart occurred more frequently in MS patients than in controls.

This research, supported by the Hilarescere Foundation of Italy and the BNAC, was conducted to replicate the findings of the Italian investigators.  "Results of this preliminary study, which involved 16 relapsing-remitting MS patients and eight age-and-sex-matched healthy controls, showed that all the MS patients, but none of the controls, had chronic insufficient blood flow out of the brain," said Zivadinov.

Bianca Weinstock-Guttman, M.D., UB associate professor of neurology and a co-principal investigator on the pilot study, added: "The images from this study were acquired using a method called Doppler ultrasound. The method identified anomalies in the venous blood flow associated with strictures, malformed valves and peculiar webs within the large veins of the neck and brain." Weinstock-Guttman directs the Baird Multiple Sclerosis Center at the Jacobs Neurological Institute (JNI), UB's Department of Neurology. The JNI and BNAC are located in Buffalo General Hospital of Kaleida Health.

Advanced magnetic resonance imaging scanning (MRI) of the MS study patients conducted at the BNAC also identified distinct areas of iron deposits in the brain, and showed that those deposits may be associated with the location of MS lesions and sites of impaired drainage. The scans also revealed increased brain atrophy and changes in the flow of cerebrospinal fluid in the MS patients. These results, which form the basis of the current larger investigation, were presented at the 25th Congress of the European Committee for Treatment and Research in Multiple Sclerosis held in September in Dusseldorf, Germany

The new study will involve 1,600 adults and 100 children. The cohort will be comprised of 1,100 patients who were diagnosed with possible or definite MS, 300 age-and-sex matched normal controls, and 300 patients with other autoimmune and neurodegenerative diseases. Enrollment in the study has begun and will continue for two years. MS patients from across the U.S. are eligible to participate in the study.

"The prevailing wisdom that central nervous system damage in MS is predominantly the result of abnormal immune responses against the patient's nervous tissue has been challenged by research findings, which have demonstrated a significant neurodegenerative component in MS and the progressive loss of neurons" said Zivadinov. However, these inflammatory and neurodegenerative processes occur concurrently in MS and vary considerably among patients, making it difficult to identify the cause, or causes of the disease. Consequently, the origin and development of MS remains poorly understood, and its cause remains elusive."

To determine if these preliminary findings can be repeated, Zivadinov and Weinstock-Guttman organized the present study, which will evaluate both the velocity of blood flow through both the brain's blood vessels and the extracranial veins, using Doppler ultrasound.

The technical name of the study is "combined transcranial and extracranial venous Doppler (CTEVD) evaluation in MS and related diseases."  All study subjects will undergo a general clinical examination and a Doppler scan of the head and neck to acquire images of the direction of venous blood flow in different body postures. Participants also will provide blood samples, and complete an extensive environmental questionnaire to identify potential MS risk factors. All MS patients will undergo MRI of the brain to measure iron deposits in lesions and surrounding areas of the brain using a method called susceptibility-weighted imaging. Iron findings on these images will be related to neuropsychological symptoms. The neuropsychological part of the study will be conducted by Ralph Benedict, Ph.D., professor of neurology and psychiatry at the JNI, UB's Department of Neurology.  A sub-cohort of 250 consecutive patients and controls will undergo MRI of the veins of the neck to confirm diagnosis of CCSVI.

Murali Ramanathan, Ph.D., associate professor in the Department of Pharmaceutical Sciences, UB School of Pharmacy and Pharmaceutical Sciences, will analyze blood samples for proteins and soluble factors associated with central nervous system injury. He also will be looking for other factors of interest in MS research, such as vitamin D metabolites and cigarette smoking, which have been linked to increased risk for developing MS as well as MS disease progression.

The data will be unblinded at three predetermined time-points, with the initial unblinding scheduled for November 2009. For more details on the study, send an email to ctevd@bnac.net. Zivadinov said results of the study may lead to a larger multicenter North-American trial that will evaluate the occurrence of CCSVI in MS.

A Clue in the Multiple Sclerosis Mystery
September 23, 2009

Scientists do not yet understand what triggers the attack on myelin. However, in the last two years a sea change has occurred in our understanding of the nature of the "self" attack after it begins. This new understanding, many of us believe, will lead to new therapies for MS.  In this resurging field, a molecule called interleukin-17, or IL-17, is a fulcrum. IL-17 first came on the scene in 1996 in the lab of Jacques Banchereau, this year’s winner of the American Association of Immunologists–Dana Foundation Award in Human Immunology Research.

The Banchereau team was not, at the time, focused on MS, but rather on molecules that drive inflammation more broadly. They reported in the Journal of Experimental Medicine their discovery of a new molecule— IL-17—which stimulated the production of phagocytes (white blood cells) to defend against infection.

Shortly thereafter, Jay Kolls, now at Louisiana State University, began to identify the helpful roles of IL-17. Kolls was trying to figure out how the body defends against a difficult pneumonia caused by the organism Klebsiella pneumoniae. In 2001, Kolls proved that IL-17 was needed to defend against this bug.

The IL-17 field has taken off in the years since. Scientists identified a major new pathway in which immune T cells—a subtype of white blood cells—commit to making IL-17. These "Th17" cells help our bodies resist not only Klebsiella, but other scourges such as Staphylococcus aureus and the fungus Candida albicans. Th17 cells and IL-17 are important; people with genetic deficiencies in the Th17 pathway suffer from corresponding infections.  That’s the protective role of IL-17. But what about the downside?  Thanks to more superb immunology from several quarters, we now realize that Th17 cells bring about certain types of autoimmunity, and MS is a leading example.

Much of current MS research on IL-17 is in a mouse model that has been vital for the development of most existing therapies for human MS. In addition, scientists already are looking for Th17 cells in samples from MS patients.  Notably, immunologists quickly figured out some key molecules that teach T cells to become Th17 in nature. They identified other interleukins, such as IL-6 and IL-23, that drive the Th17 cells.

Furthermore, the intricate genetic program of the Th17 cell is being illuminated. This program allows Th17 cells to make many products in addition to IL-17 whose relevance was previously obscure. Now there is great potential to develop agents to block the elements of the newly discovered Th17 pathway in people with MS and other forms of autoimmunity.  But what about the enigma? How does this Th17 pathway get triggered in the first place, especially to focus on the brain? Federica Sallusto and her colleagues identified a major clue in findings they published in the May Nature Immunology.  This Swiss team knew that Th17 cells had a special receptor called CCR6 that guides the cells’ movement to wherever an attracting molecule, CCL20, is made. Normally, CCR6 and CCL20 work together to direct Th17 cells to body surfaces to fight infections such as K. pneumoniae, S. aureus and C. albicans.

The downside is that parts of the brain, particularly the choroid plexus, are rich in CCL20 and thus also attract Th17 cells. The Nature Immunology research showed that if a mouse has Th17 cells, but these cells cannot get into the choroid plexus, MS is blocked. The step that enables Th17 to enter the brain looks like a pivotal one for figuring out how the autoimmune attack in the brain begins.

Clearly the research community is making significant discoveries in its longstanding commitment to figure out MS and to identify new treatments—beginning with steps toward understanding, once and for all, how it starts.

About Ralph M. Steinman, M.D.: Ralph M. Steinman, M.D., is the head of the Laboratory of Cellular Physiology and Immunology at Rockefeller University and a senior physician at The Rockefeller University Hospital. He investigates the fundamental mechanisms of cellular immunity, with the goal of developing immune-based therapies. He discovered a previously unknown class of immune cells, called dendritic cells, which control many of our early immune responses. For that discovery, he received the 2007 Albert Lasker Award for Basic Medical Research.

Copyright 2009 The Dana Foundation All Rights Reserved