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Each month I have this unique opportunity to share my MS story. Years ago I chose to be "enabled" by MS rather than "disabled," and I believe that each one of us has the opportunity to make that same choice. My task is to help you believe that also. I believe my body is designed to be self-healing, and that my challenge is to learn how to "listen" to my body and to help it turn on that innate self-healing process. Everything I have learned and recommend is to help all of us do exactly that. Whether you are new to Journey to Wellness, or you have been with me for years, I warmly welcome you to our world-wide network of readers. Thanks to the Internet and the continuing rapid rise in "social networking," it seems that we are all becoming more aware of how truly alike and connected we are. I hope something included in this issue "speaks" to you and challenges you to move ahead in your own journey to wellness. Enjoy.
___________________________________ Happy Valentine's Day to all. I hope I never outgrow my enthusiasm for this holiday. Will you be my Valentine? It is fun to remember those long ago days when we were in elementary school, and how we wanted to get a valentine from that certain boy or girl we really liked. Those activities were important in our development, and I believe they are important today - it is just that the circumstances have changed as we have aged. Won't you join me, whether you are single like me, or you have a mate, show someone how much you love them. The sentiment applies universally. Showing love is very important in our emotional life. I tend to believe that it is not so much about the other person, but rather what it does for us. I hope you have a lovely Valentine's day with those you care about. This month I am pleased to welcome reader Mardy Wilson as a contributor to Journey to Wellness and the food section. Please don't miss her contributions this month. If you would like to communicate with Mardy, you may send e-mails to me and I will forward them on to her. I continue to work at learning how to use Facebook and Twitter more effectively. You can help by clicking on these links. Thank you very much.
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addresses, please fill in this request to join the list Do you enjoy reading this free on-line newsletter? Do you appreciate the fact that there are no sponsoring commercial ads cluttering the pages of the newsletter and website? Then please consider making a contribution to help sustain them. I have always wanted Betty's house to be commercial free, and that is still my intention. And I never wanted the newsletter to be paid subscription only. But be that as it may, everything connected with the website and newsletter costs money, and over time I learned that I could not do it alone. The costs continue to escalate. I cannot say strongly enough how appreciative I am for those of you who help make the newsletter and Betty's House possible. Thank you just doesn't seem adequate to express how grateful I am. For any reader who makes a $25.00 contribution, I will say "thank you" with a motivation video. I produced these videos myself and I call them LifeDesign Videos. I continue to receive glowing reports from those who continue to use them. If you are familiar with "vision boards," which feature photos which support goals, then you will understand how the videos work. Your response has been very gratifying. Each video is from 3-1/2 to 5 minutes in length and incorporates affirmations and appropriate images, backed up with motivation music. The two videos currently available are: Health and Weight Loss, and Spirituality. Next month I'll be introducing a new Health video.You may mail your contribution to Iams House, 139 Inner Circle, Davis, CA 95618, or use credit card or Pay Pal at my on-line shopping cart here. When making your contribution through the shopping cart, please indicate under "shipping instructions" which video you would like to receive. The on-line shopping cart makes it very easy. If you send a contribution by mail, please be sure to include your e-mail address. YOU make the website and this newsletter possible. → YOU MAY WATCH A SHORT SAMPLE VIDEO BY CLICKING HERE. ← THANKS FOR SHOPPING AT MY AMAZON STORE: Just click on this Amazon link, then when it opens bookmark it in your "favorites" and it will be easy to always use it. Each order you place using this Betty's House Amazon link means a few cents is returned to Betty's House to help pay the monthly expenses for the website. It doesn't amount to very much, but every little bit helps. Thanks so much. IAMS HOUSE AMAZON STOREPLEASE NOTE:
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Bon
Appétit
- Healthy Food Tips and Recipes
Primary Progressive MS has been part of her life for a lot of years, although she was officially diagnosed in 1992. Mardy believes that her active lifestyle and love of good food, has helped keep her "on the more fortunate side of PP MS."
During our e-mail and telephone exchanges we have agreed for Mardy to provide recipes for the newsletter, along with sharing her philosophy of creating health through a healthy food plan. Mardy shares that, "Food and cooking are my passion." In the months to come Mardy will share more of her philosophy of healthy food preparation. This month she shares three recipes. The first is a special Valentine's recipe. I'm sure all chocolate lovers (which includes me!) will love this. I can't wait to try it.
DARK CHOCOLATE BARK WITH NUTS AND DRIED CHERRIES
1 1/2 c. walnut halves or whole almonds
Preheat oven to 350°. Spread nuts on a baking sheet and toast for approximately 8 minutes, or until golden and fragrant. Watch closely; don’t burn them. This may also be done in a heavy skillet on med. low heat. Toss nuts frequently. When nuts are cool, coarsely chop. Line a baking sheet with parchment or wax paper. In a glass bowl, heat two-thirds of chocolate in a microwave oven at high power in 30-second bursts until just melted. Stir until smooth. Add remaining chocolate and stir until melted. Note: When melting chocolate in a microwave oven, be sure to give the chocolate a quick stir between each 30-second burst to prevent it from scorching. Stir in nuts, cherries, salt and crystallized ginger until evenly coated.
Working quickly, scrape mixture onto prepared baking sheet, spread it into an approximate 12-by-8-inch rectangle, making sure all additions are coated with chocolate. Refrigerate for 10 minutes, or until firm enough to cut. NOTE: this mixture will set quickly outside of the refrigerator.
Cut or break bark into small to medium size pieces. Try serving with cold, sliced pears and a glass of Port for an easy, sophisticated desert.
Make bark ahead, keep in an airtight container, refrigerated for up to 2 weeks.
For gifts, layer pieces in a clear container, if possible. Tie cloth ribbon around container, make a ribbon. Chocolate lovers will love this and you!
*Bittersweet Chocolate: Very dark, but a little sweeter than unsweetened. It is unsweetened chocolate to which sugar, more cocoa butter, lecithin, and vanilla has been added. It has less sugar and more liquor than semisweet chocolate but the two are interchangeable in baking. Bittersweet has become the sophisticated choice of chefs. It contains a high percentage (up to 75%) of cocoa solids, and little (or no) added sugar.
MARDY’S QUICK, EASY, BASIC MARINARA SAUCE
1 lg.-32 oz. can chunky tomato sauce-the best you can find; this is your star ingredient. 2 to 3 lg. garlic cloves mashed and minced 1 T dried oregano 2 T dried basil 5 T olive oil or to taste 1/2 c. white wine (approx.) or red wine for a heartier taste
In a large, deep pot, 2 Tbs. of olive oil on med. low heat. Add minced garlic, stir constantly until lightly golden-about 1 minute.
Add chunky tomato sauce, stir into garlic. Slowly heat sauce over med. low heat, stirring occasionally-do not let it burn. It will bubble and splatter a bit as it reaches a high simmer. Lower heat to a slow simmer for about 10 minutes.
Add oregano, rub in your hands, over pot, completely stir into sauce. Add basil, rub in hands over pot, completely stir into sauce. Let simmer for about 5 min. Taste. It may be a bit harsh. This sauce will be on the thick side for a sauce.
Add 1/2 or so of the wine and taste. Add 2 more T of olive oil and taste. Consistency will now be a bit thinner and taste will be mellower. Add rest of wine.
Keeping heat low, simmer for about an additional 15 min., stirring enough to keep from scorching. Taste, add more of anything you think it needs. If too thick, add more wine. Stir in remaining 1 T of olive oil, off heat, right before serving
Prep time start to finish about 30 min. This basic sauce freezes well.
Other seasoning options: Add 1 t. ground cinnamon or 1 T hot red pepper flakes, try 1 T ground cumin, or olives, meat balls, mushrooms, etc. This is wonderful over fish or shrimp, many veggies.
STEAMED CHICKEN, MUSHROOMS & ONIONS Serves 4
You will need a steamer basket, metal or bamboo, a deep pot with a lid, wide enough to accommodate metal steamer basket opened flat.
SUGGESTION: Please taste each cooked component separately; each piece will have an interestingly intense, wonderful flavor; which, hopefully, you will love without too much additional seasoning.
4 whole chicken breasts cut in half, length wise-boned & skinless ¾ lb. of small button or crimini mushrooms-washed, stemmed and quartered 1 lg. white or yellow onion-peeled, cut into 1/8 segments or sliced 2 lg. lettuce leaves 2 lemons, seeded and sliced 2 fresh or dried-whole bay leaves 1 T dried Tarragon 1 piece star anise, or 1 t. anise seeds
NOTE: if you do not have Anise, add another tsp. of dried Tarragon—then buy the Star Anise and the anise seeds. They are powerful seasoning agents with many uses . . . and your home will smell lovely.
Fill your pot with water to a level under the base of your steamer basket; water should not be coming into the basket. At this point, do not put basket into your pot with water.
Add 3 slices of lemon; bay leaves, tarragon and anise to water. Bring water to a boil; take off heat, let steep for about 10 minutes.
While herbs are steeping, cut away any stray fat and skin from chicken. rinse, pat dry
After 10 minutes, place steamer basket into pot, line steamer with lettuce leaves, then layer 3 or 4 lemon slices over lettuce. Arrange chicken on top of lemon slices. Layer 4 more lemon slices on top of chicken. Overlap breasts if necessary. Layer onion slices over chicken and lemon slices; arrange mushroom quarters over your onion slices. Put lid on pot, bring water back to a boil, turn heat to medium low, or just enough heat to keep water steaming.
Steam for 10 to 20 minutes; depending on thickness of your chicken breasts. Check chicken for doneness by cutting into thickest part. If pinkness remains, take pot off of heat, keep lid on, let chicken sit for another 5 min. Be careful to not steam too long or chicken will become a bit tough.
It is my pleasure to become a small part of Betty's newsletter. Recipes shared here are, for the most part, basic & simple versions. You adapt them to fit your tastes. Try adding a salad to your steamed chicken, and dark chocolate bark for desert.
Until next month, I encourage you to " Play With Your Food" and eat well!
Mardy
What I Know for Sure:THE ANSWER TO HEALTH IS SIMPLE ― WHY DO WE MAKE IT SEEM COMPLEX? I ask myself that question every day as I attempt to help the people who struggle with their disabling physical challenge, whatever it may be. I always outline in very KIS (keep it simple) terms how to get yourself on a healthy lifestyle program, whatever physical problem you may have. Please remember that the "name" of whatever physical challenge you may have only matters to doctors. I love the Chinese medicine approach wherein every physical problem is merely the body demonstrating a biochemical imbalance somewhere in the body, which they label only as dis-ease. These imbalances are our body's response to all kinds of stressors. They may be physical, psychological, environmental, etc. Which brings us back to how to create health, which simply (KIS) means how to bring our body back into perfect balance. In medicine/science that state is known as homeostasis. Again the steps are simple:
FIRST STEP: I do not believe one needs a drastic diet. Unless you have known allergies, just start be cleaning up your diet, eliminating processed sugar and white flour, and making your diet predominantly of fresh fruit and vegetables, fish and poultry. We know today that the very best medicine there is we can find in fresh fruit and a rainbow of different colored vegetables. That is a very easy dietary change to make. Once you have accomplished that simple revision, then you can determine if you need any further revision.
SECOND STEP: I do not believe we can be healthy without a consistent exercise program. If you can walk, that is a simple answer. Walking 30 minutes daily is ideal. Qi Gong and/or Modified yoga are ideal. Yoga primarily maintains and rebuilds muscles, while Qi Gong (which translates into English as Energy Work) comes from ancient Chinese medicine and works to move and enhance the body's own energy to correct imbalances. I am a walking example of the efficacy of these programs.
THIRD STEP: Learning to listen to your body is a great skill to have. Some communications from our body, like a bad headache, etc., jar us into attention. But learning to recognize more subtle communications is an acquired skill and I write frequently about how to develop that skill.
FOURTH STEP: Meditation is equally as important. It may seem the most challenging, but I assure you that it is not. You are simply teaching your mind a new skill ― SILENCE. Meditation is such a powerful tool, studies have shown that regular meditation can even strengthen your immune system and help you ward off illness and infection! All you have to do is learn to quiet your mind. You'll find a simple, easy-to-learn meditation report HERE.
These four steps, all built on a foundation of a belief in yourself and your body's self-healing ability, are all you really need to know. That's it. It truly is not complicated, and anyone who reads this newsletter for one year will become an expert in self-healing. The what and how I cover in detail my e-book, Four Steps to Overcoming Multiple Sclerosis.
And please don't pay attention to statistics. Don't accept as "fact" what someone tells you or predicts, including your physician. Once you accept that it is your body, and your life, and you - and only you - determine how everything related to you turns out, then you can get down to creating your life.
Focus on Exercise
You cannot overcome any health challenge without keeping your body fit. Through the 17 years since I was diagnosed with PP MS, I have studied diligently how to help my body heal itself.
The first important thing I discovered is that healthy exercise need not involve jumping about as we commonly think of "aerobic" exercise. All it takes is increasing the flow of oxygen in our body. The easiest way to accomplish that is through breathing exercises. When I discovered that my (at that time) obvious limp was greatly improved by my daily Qi Gong exercise routine (Tai Chi/Qi Gong for Seniors routine by Mark Johnson featured in this newsletter) I began to seriously explore how that could be.
I learned that our chi is an innate creative spark of life-force energy with which every one of us was born. When that energy is blocked for any of various reasons we create an unhealthy body reaction or dis-ease. I also discovered that I could physically feel the movement of the chi in my body, and that was/is the reason for that early experience of reversing my right leg limp.
I have now been a serious student of Qi Gong for the past 16 years and still make this practice part of my daily routine. Qi Gong is the healing form of Tai Chi, developed by ancient Chinese medicine practitioners. Still today it is practiced all over the world. I continue to study this theory of dis-ease, and how the flow of chi in our body is involved in creating a healthy healing environment. I have learned that deliberate breath exercises and very simple self-massage increase the flow of our chi.
In Mark Johnson's Tai Chi/Qi Gong for Seniors routine he teaches proper breathing techniques, and one section is devoted entirely to self-massage. It is so incredibly effective and easy. AND ANYONE CAN DO IT, EITHER STANDING, SITTING, OR LYING DOWN. This self-massage is both external (on the face, ears, arms, legs, and hands and feet), as well as massage of the internal organs by massaging the abdomen.
You can do a two to three minute massage break, anytime and anywhere, during the course of your day. If you do nothing else but massaging your arms and legs, following the pattern of how the energy flows in your arms (down the inside, up the outside), and legs (down the outside and up the inside) you will immediately experience increased energy. Begin and end your self-massage by inhaling deeply and exhaling as slowly as possible.
It is not my intent to negate the power of Yoga for MS. If you are looking to build or rebuild strength, Shoosh Crotzer's DVD program is the best. I discovered Shoosh's video program a couple of years after beginning my Qi Gong practice, and for quite a few years I did both. At this stage of my life I must be selective and I personally cannot do floor exercises without nausea. I have always and still do consider the Yoga for MS routine to be best for strength building or rebuilding, and for stress reduction, and Tai Chi/Chi Gong for healing. Both have been profoundly effective for me.
If this is a new concept to you, I suggest you begin with the Qi Gong routine, and then later add the Yoga for MS program.
Every body will benefit from the simple, easy-to-learn Tai Chi/Qi Gong Mark Johnson teaches. I encourage you to get started living in the moment, stop procrastinating, and get with the program. You ̶̶ and your body ̶ will be glad you did. After all, the house you live in , YOUR BODY, is the only one you are going to get in this lifetime. Doesn't it make sense to take good care of it?
I absolutely know for sure that your body will thank you!
"Stuff" From Here and There
ABC News Special Report - THE END OF ILLNESS
I recently heard a well-known ABC physician and medical advisor, in a Special Report called The End of Illness, say:
"Your body is always talking to you, giving you signals of what is going on with it."
He went on to say that the skill of recognizing these subtleties is the secret to longevity.
This is exactly what I have been teaching for years as our Internal Guidance System (IGS). Examples of the subtle messages our body's innate intelligence gives us include such things as excessive tiredness, perhaps a cough or sneezes, maybe an itch that doesn't go away, or perhaps indigestion, etc. I suggest we need to learn to look for causes rather than remedies. Remedies that do not effect a change in the underlying condition are merely band aids.
Actually our body is in a constant dialog with us all the time. When you don't feel well, whatever you are feeling is your body talking to you. Unfortunately most of the time we are too busy to listen. We just need to learn to listen to its subtle messages. I urge you to practice listening to your body and learn to determine what it is telling you, instead of reaching for a "band aid."
THE SECRET
OF YOUR SUCCESS IS YOU?
That’s right Y-O-U. Everything you’ve ever wanted, everything you’ve ever dreamed about and every conceivable success, talent, skill, that you've ever imagined is completely and totally within your grasp. You have an awe-inspiring ability to literally create your own reality and then create it again if you choose to do so. And this fantastic ability doesn't require any college degrees. You needn't have a Mensa IQ or possess super-human strength. In fact, the only thing you need to turn your desires into reality is a mind and a little intent.
Okay, maybe a lot of intent but intent is easy to come by, so that shouldn't be a problem. Just as humankind evolved from the caveman into the intelligent beings we are today, we can take the next leap on our evolutional ladder and discover the real magic of the Universe. Everything you need to have, everything you want is in your possession right now. You just need to learn how to use it. And that's why we've started this series with Meditation.
In order to create and construct your perfect reality, you'll need a focused and intentful mind. But you can't reach this state without first removing the chaos that is bouncing around inside your head. I need to pay this bill, I need to stop at the store. Oh, I forgot to call him...
Yikes! What time is it? I need to pick her up! At any given time of the day, most of us are bombarded by an array of unrelated and random thoughts. It is a byproduct of our lifestyle, our multi-tasking, always on the go existence that demands we cram as much as we possibly can into every single second. The result is a constant state of confusion, marked by memory lapses, stress and the feeling of being overwhelmed.
You can't create in this state of mind for the simple fact that you can't concentrate on your intentions long enough to get anything done. There's too many other thoughts flying in, all demanding your attention and pulling you away from the peace you're so desperately seeking. And so, I invite you to meditate with me.
IS YOUR MIND A PLACE OF STRESS OR A PLACE OF PEACE? Do you need some help in managing your stress? Answer these questions and find out!
In fact, meditation is such a powerful tool, studies have shown that regular meditation can even strengthen your immune system and help you ward off illness and infection! All you have to do is learn to quiet your mind.
GRATITUDE (From the Gratitude Journal)
The beauty I see in you is:
* That you have a great gift to share with this world * That the more you love and accept yourself, the more you make other people light up and smile
One of the most transformative exercises I have ever done was in a seminar where we sat across from total strangers and told them, "The beauty I see in you, is..."
It was a very powerful exercise and it instantly made me realize how wonderful everyone is and what a tremendous gift everyone has to share with the world.
It also made me realize that compliments, even from a perfect stranger are very powerful. I'm sure that everyone of you is loved and appreciated by many people in your life. I suggest you make a list of the people in your life for whom you are grateful. If you do this exercise seriously, you will surely become more grateful, and thereby blessed.
Everyone loves to feel appreciated. Tell someone - anyone - how much you appreciate them. You'll be glad you did!
"Your vision is the promise of what you shall one day be." - Author James Allen
"The thoughts we think, the
words we speak, the beliefs we accept, - Author Louise Hay
Is the Way You Breathe Bad for Your Health?
One of the best things you can do for your well-being? Change the way you inhale and exhale. By Mark Matousek From the November 2011 issue of O, The Oprah Magazine
It's among the most important physical functions our bodies perform. We do it about 20,000 times a day. And still, somehow, most of us get it wrong. "If I had to limit my advice on healthier living to just one tip, it would be to learn to breathe correctly," says Andrew Weil, MD, a well-known pioneer in the field of integrative medicine.
Chinese and yogic traditions have long extolled the importance of chi or prana—the life forces associated with breath—and science is finally catching up. "Medicine is just recognizing the importance of energy to health," says Richard P. Brown, MD, an associate clinical professor of psychiatry at Columbia University. "And our most critical source of energy is oxygen."
It turns out that getting more oxygen—by simply changing the way we breathe—can facilitate healing from a startling number of serious conditions, including chronic pain, atrial fibrillation, asthma, digestive issues, depression, and a wide range of stress-related illnesses. The secret is to return to a more natural pattern of respiration: Newborns come into the world breathing deeply, but as we age, stress can alter that pattern, and many of us start to breathe more shallowly. By adulthood, on average, we're taking 15 to 20 breaths per minute—three to four times faster than is optimal.
That's where the trouble can start. "Rapid, shallow breathing sends a message to our adrenal glands that we're in fight-or-flight mode, and they begin pumping out stress hormones like cortisol," explains Brenda Stockdale, director of mind-body medicine at the RC Cancer Centers in Atlanta. And when the body is stressed, it's weakened. Our immune cells normally function like "little Pac-Men," Stockdale explains, "patrolling for and destroying bacteria and diseased cells before they can multiply. But when cortisol levels are elevated, those immune cells slow down drastically, allowing pathogens and diseased cells to slip by."
Fortunately, there are simple methods to reverse our faulty inhale-exhale habits. To get started, try these three exercises:
Diaphragmatic Breathing What it is: Breathing that involves expanding the belly, which gives the lungs room to take in more oxygen. How it can help: Improves circulation; eases stress-related and anxiety disorders; speeds recovery from chemotherapy. How to start: 1. Lie on your back with your knees bent. Place one hand just below your rib cage and the other on your upper chest. 2. Breathe in slowly through your nose so that your stomach pushes against your lower hand. 3. As you exhale through pursed lips, tighten your abs and let them fall inward. (Throughout inhalation and exhalation, the hand on your chest should remain as still as possible.) Do this exercise three times a day for five to ten minutes, then gradually increase that amount. With enough practice, you should begin to breathe this way automatically.
Alternate-Nostril Breathing What it is: A yogic technique designed to promote relaxation. How it can help: Reduces blood pressure; may have an anti-obesity effect; boosts cognitive function on spatial tasks. How to start: 1. With your right thumb, close your right nostril and inhale slowly through your left nostril. 2. Now close your left nostril with your pinky and ring fingers, release your thumb, and exhale slowly through your right nostril. 3. Keep the right nostril open, inhale, then close it; open the left nostril, and exhale slowly through the left. That's one round. Start with three rounds, and add a round each week until you are up to five. Then practice whenever you're feeling stressed out.
The Bellows Breath What it is: An exercise aimed at increasing alertness. How it can help: Provides a boost in energy comparable to the high you feel after a workout. How to start: 1. With your mouth closed, inhale and exhale quickly and evenly through your nose. Aim for three in-out cycles per second, but stop after 15 seconds on your first attempt. 2. Keep practicing, increasing your time by five seconds, until you reach a minute. When you feel your energy dipping, try this technique for 60 seconds.
Pasted from www.oprah.com/spirit/Deep-Breathing-Methods-How-Breathing-Reduces-Stress
Hi Heather,
Thanks for your lovely note. If I help anyone to get in touch with their own personal healer within, then it makes all the hard work worthwhile. Welcome to Journey to Wellness. Best wishes for a Happy, Healthy, and Prosperous 2012.
Thank you for all you share. It is great to have someone to look up to who has defeated this thing you call your "uninvited guest." May you have many more years to help us all see the light. /s/ Margaret M.
Thanks Margaret for your thoughtful note. And to all my many readers who sent holiday greetings. I consider you all my extended family and very much like to hear from you.
Thanks for your note John. Dr. Wahls' story is certainly inspiring. She is another example of someone who decided to change her MS story and set out to find a way to do that. I salute anyone who successfully reverses dis-ease.
Featured Books,
DVD Exercise Programs and VideosPlease, everyone, do not sit around and wait for testing and treatment if warranted for CCSVI. Even if that becomes the standard MS treatment down the road, you need to get moving and improve your quality of life NOW. Even those who have the corrective procedure done still have to work to recover their quality of life. How do you do that? I suspect that you already know. Start a simple daily meditation ritual, and move your body with healthy exercise and breathing exercises. Oh you say you can't exercise? Excuse me, but that is rubbish. There is no such thing as a person who can't exercise. You can do a very effective exercise program sitting in a wheelchair, or even lying in bed. You just begin with some simple deep breathing and very simple arm movements. EVERYBODY CAN IMPROVE HIS/HER BODY WITH A COMMITMENT TO EXERCISE. If you don't have them, order Yoga for MS (for strength) and/or Tai Chi/Qi Gong for Seniors (for healing) or Gentle Fitness (for overall fitness) and get moving. PLEASE DO NOT WAIT! Then pick two or three things from one or two of these programs and get started. Soon you won't believe what a tremendous improvement you will experience. The only thing hindering you is your own lack of enthusiasm and passion. There is no person who cannot improve the quality of his or her life with exercise. Just get moving! I absolutely know that one of the primary reasons I live a normal, healthy life today is because of these exercise programs. Come on. Get started today!
CHECK OUT THE DETAILS OF THESE
EXERCISE
Research NewsSource: Neurology
Venous drainage in multiple sclerosis: a combined MRI and ultrasound study
Doepp F, Würfel JT, Pfueller CF, Valdueza JM, Petersen D, Paul F, Schreiber SJ; Neurology 77 (19), 1745-51 (Nov 2011)
BACKGROUND: Chronic cerebrospinal venous insufficiency (CCSVI) was proposed as the causal trigger for developing multiple sclerosis (MS). However, current data are contradictory and a gold standard for venous flow assessment is missing.
OBJECTIVE: To compare structural magnetic resonance venography (MRV) and dynamic extracranial color-coded duplex sonography (ECCS) in a cohort of patients with MS.
METHODS: We enrolled 40 patients (44 ± 10 years). All underwent contrast-enhanced MRV for assessment of internal jugular vein (IJV) and azygos vein (AV) narrowing, graded into 3 groups: 0%-50%, 51%-80%, and>80%. ECCS analysis of blood flow direction, cross-sectional area (CSA), and blood volume flow (BVF) in both IJV and vertebral veins (VV) occurred in the supine and upright body position.
RESULTS: MRV identified 1 AV narrowing. IJV analysis yielded 12 patients for group 1 (30%), 19 patients for group 2 (48%), and 9 patients for group 3 (22%). By ECCS criteria, 4 patients (10%) presented with venous drainage abnormalities. Jugular BVF was different only between groups 1 and 3 (616 ± 133 vs. 381 ± 213 mL/min, p = 0.02). No other parameters in supine position and none of the parameters in the upright body position, apart from the IJV-BVF decrease in groups 1 and 3 (479 ± 172 vs. 231 ± 144 mL/min, p = 0.01), were different.
CONCLUSIONS: Our ECCS data contradict the postulated 100% prevalence of CCSVI criteria in MS. MRV seems more sensitive to detect IJV narrowing compared to ECCS. A measurable hemodynamic effect only exists in vessel narrowings>80%. Our combined data argue against a causal relationship of venous narrowing and MS, favoring the rejection of the CCSVI hypothesis…
EMA Begins Investigation Into the Cardiovascular Effects of Fingolimod
LONDON -- January 20, 2012 -- The European Medicines Agency (EMA) has begun a review of the benefits and risks of the multiple-sclerosis medicine fingolimod (Gilenya). This follows concerns over the effects of the medicine on the heart after the first dose.
The review was started following reports of heart problems in patients taking fingolimod, as well as the death of 1 patient in the United States less than 24 hours after the first dose. The exact cause of this patient’s death is still unexplained.
Fingolimod has been authorised in the European Union since March 2011 for the treatment of relapsing-remitting multiple sclerosis in patients whose disease has failed to respond to a beta-interferon or is severe and getting worse rapidly.
While the review is ongoing, the Agency’s Committee for Medicinal Products for Human Use (CHMP) is advising doctors to increase their level of monitoring of patients after the first dose of the medicine. This includes electrocardiogram (ECG) monitoring before treatment and then continuously for the first 6 hours after the first dose, and measurement of blood pressure and heart rate every hour. After 6 hours, any patients with clinically important heart-related effects, such as bradycardia or atrioventricular block, should continue to be managed and monitored until their condition has improved.
The risk of bradycardia after the first dose of fingolimod was known when it was authorised. The medicine’s product information already includes recommendations to observe patients for signs and symptoms related to this side effect for at least 6 hours after the first dose.
Fingolimod’s marketing-authorisation holder, Novartis, has committed to supplying the Committee with the results of its ongoing investigations into the cardiovascular effects of this medicine. The Committee will take this information into account while carrying out its full review of the balance of benefits and risks of the medicine.
The Committee expects to finalise its review by the time of its plenary meeting in March 2012.
SOURCE: European Medicines Agency
Tysabri (natalizumab): Drug Safety Communication - New Risk Factor for Progressive Multifocal Leukoencephalopathy (PML)
AUDIENCE: Neurology, Gastroenterology
ISSUE: FDA notified healthcare professionals that testing positive for anti-JC virus (JCV) antibodies has been identified as a risk factor for progressive multifocal leukoencephalopathy (PML). PML is a rare but serious brain infection associated with use of Tysabri (natalizumab) for the treatment of multiple sclerosis (MS) or Crohn's disease.
A patient's anti-JCV antibody status may be determined using an anti-JCV antibody detection test that has been analytically and clinically validated, and has been ordered by a healthcare professional. The Stratify JCV Antibody ELISA test2 was cleared by FDA on January 20, 2012. Testing positive for anti-JCV antibodies means that a person has been exposed to JCV in the past.
BACKGROUND: Tysabri (natalizumab) is in a class of medications called immunomodulators. It works by stopping certain cells of the immune system from causing damage to the body. Tysabri is approved for the treatment of relapsing forms of multiple sclerosis since November 2004 and for the treatment of moderately to severely active Crohn's disease since January 2008.
RECOMMENDATION: The risks and benefits of continuing treatment with Tysabri should be carefully considered in patients who are found to be anti-JCV antibody positive and have one or more of the other known risk factors for PML. Patients with all three known risk factors have an estimated risk of PML of 11/1,000 users. See the Drug Safety Communication Data Summary section for additional information.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:
• Complete and submit the report Online: www.fda.gov/MedWatch/report.htm • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178 Read the MedWatch safety alert, including links to tht eFDA Drug Safety Communication and News Release, at:
Screening for chronic cerebrospinal venous insufficiency (CCSVI) using ultrasound - Recommendations for a protocol
Zamboni P, Morovic S, Menegatti E, Viselner G, Nicolaides AN; International Angiology 30 (6), 571-97 (Dec 2011)
That's all for this month. Please help me keep Journey to Wellness interactive. I really do want to hear from you. If you have an interesting question or story to share, please don't hesitate to write to me. And please don't worry about editing. I'll do that for you. If you have a photo, send it along and I'll share it with your e-mail.
Have a great January, and remember to keep smiling ̶ the alternative isn't a whole lot of fun! Betty PLEASE NOTE: I AM NOT A MEDICALLY TRAINED PERSON, AND I DO NOT GIVE MEDICAL ADVICE. BUT I HAVE BEEN A VERY SERIOUS STUDENT OF MULTIPLE SCLEROSIS FOR MANY YEARS, AND I HAVE DEVELOPED A PROGRAM THAT HAS KEPT ME SYMPTOM FREE FOR A LOT OF YEARS NOW SINCE PRIMARY PROGRESSIVE MS FIRST MADE ITS APPEARANCE IN MY LIFE.
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