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How Multiple Sclerosis Works · Stuff You Should Know

0:01
Speaker 1: Welcome to Stuff you Should Know from how Stuff Works
0:04
Speaker 1: dot com. Hey, and welcome to the podcast. I'm Josh Clark.
0:13
Speaker 1: There's Charles w Chuck Bryant, Sherry's over there. Their finger
0:18
Speaker 1: on the button, and this is stuff you should know.
0:22
Speaker 1: Not the button. Okay, well it's a button. She doesn't
0:25
Speaker 1: have the nuclear suitcase. It's the button. As far as
0:28
Speaker 1: we're concerned, that's our nuclear suitcase. Yeah, because we're dropping
0:34
Speaker 1: bombs every time we drop an episode. That's right. How
0:39
Speaker 1: are you feeling pretty good? I am. I'm a little, uh,
0:43
Speaker 1: a little apprehensive about this one. Well, I've been avoiding
0:47
Speaker 1: this one for years because my uh, one of my
0:50
Speaker 1: very best friends died from complications of MS oh man
0:55
Speaker 1: just last year. You failed to tell me that when
0:58
Speaker 1: I said this one over your way as a suggestion. Well,
1:01
Speaker 1: you'd sent it before before he died, and I didn't
1:04
Speaker 1: think I could do it, and I just kind of
1:07
Speaker 1: feel like, now it's the time, you know. And weirdly,
1:10
Speaker 1: yesterday was his birthday and no would have been his birthday,
1:14
Speaker 1: and you did not know that and had sent it
1:16
Speaker 1: over and it was just kind of one of those
1:18
Speaker 1: eerie things where I was like, all right, this is
1:21
Speaker 1: this has got to happen. What's your friend's name, Billy, Well,
1:24
Speaker 1: this one's for Billy. Yeah, and this will be we'll
1:27
Speaker 1: pepper his story throughout this. It's very sad stuff. Man. Well,
1:30
Speaker 1: I'm right here with you. Man. Thank you. Just lead
1:32
Speaker 1: on me when you need it. I appreciate it. Okay. Uh.
1:36
Speaker 1: So we are talking multiple sclerosis, or m S as
1:40
Speaker 1: it's called. UM, and I knew very little about this.
1:43
Speaker 1: I guess you probably are a lot more familiar with
1:45
Speaker 1: it than I am. Then, huh yeah, I mean obviously
1:49
Speaker 1: personally his journey with it, but as we will see, UM,
1:54
Speaker 1: everyone's journey with MS is different. It is UM. Depending
1:58
Speaker 1: on what kind you have, and depending on you as
2:00
Speaker 1: an individual, it can progress in different ways, very slowly,
2:04
Speaker 1: very quickly. Can be devastating, it can be not it
2:07
Speaker 1: can be very manageable. Um. He have one of the
2:10
Speaker 1: worst kinds. So yeah, from what I understand, it's very
2:13
Speaker 1: fairly rare for someone to die from complications of MS. Right, Yeah,
2:20
Speaker 1: I mean, I don't know if rare is the word,
2:22
Speaker 1: but it's definitely not the common outcome. I got you
2:27
Speaker 1: somewhere between rare and common. I think I got you,
2:29
Speaker 1: but it's already a fairly rare disease. I think something
2:32
Speaker 1: like four hundred thousand people in the United States and
2:35
Speaker 1: I think two million worldwide have it, which I mean
2:39
Speaker 1: it's a substantial number of people, but in the context
2:43
Speaker 1: of the larger global and national population, it's not that many.
2:47
Speaker 1: It is rare, I would guess. Yeah, it's um, just
2:51
Speaker 1: a little bit of an overview. I guess, um they
2:53
Speaker 1: call it the prime of life disease. Uh, and it's
2:57
Speaker 1: very cruel in that way because, um, it most often
3:00
Speaker 1: likes people between twenty and fifty, but I think even
3:03
Speaker 1: usually in in you're like twenties. Uh, and that's when
3:07
Speaker 1: Billy was hit with it, and um, it's uh. I
3:11
Speaker 1: think more women than men get it, Yeah, by far,
3:16
Speaker 1: because it's an autoimmune disease, and more women get autoimmune
3:19
Speaker 1: diseases more, which I didn't know. More Caucasians get it,
3:24
Speaker 1: and apparently Caucasians of Northern European descent or more likely
3:28
Speaker 1: to get it. And it's really there's a lot of
3:31
Speaker 1: mystery about why people get this, Yeah, like, for example,
3:35
Speaker 1: why Caucasian people more than people with darker skin um
3:41
Speaker 1: or Also I think part of the same coin why
3:45
Speaker 1: people who live, you know, away from the equator more
3:49
Speaker 1: than people who live in the tropics. That suggests that
3:52
Speaker 1: the sun might have something to do with it. Or
3:54
Speaker 1: I think one of the things that they've been looking
3:56
Speaker 1: into lately is vitamin D, which you produce through exposed
4:00
Speaker 1: sure of this on Yeah, it's really, um a mystery
4:04
Speaker 1: in a lot of ways. Um. Some people have have
4:08
Speaker 1: brought up the idea of there are clusters of areas.
4:11
Speaker 1: Other people have said, you know that's not the case,
4:15
Speaker 1: uh clusters or bs um you're reading you know your
4:19
Speaker 1: your reverse engineering a what do you call it? A cause?
4:23
Speaker 1: I guess stop bringing up clusters basically, h environmental or um,
4:30
Speaker 1: whether it's environmental or hereditary, don't know for sure. That
4:35
Speaker 1: would that would suggest that clusters could exist, right, But
4:39
Speaker 1: the fact that they're not sure if it is environmental
4:41
Speaker 1: or not, I would think that leaves that cluster thing
4:44
Speaker 1: open to debate. Yeah, but whether or not you can
4:48
Speaker 1: it's hereditary, it's up for debate too, because I think
4:51
Speaker 1: it says the risk for people with parents, siblings, or
4:55
Speaker 1: children who are diagnoses between one and twenty and one
4:57
Speaker 1: and forty, whereas it's what one and seven fifty for
5:00
Speaker 1: the general population. UM obviously got something to do with
5:05
Speaker 1: heredity or or it could be that you tend to
5:09
Speaker 1: live with your parents and your siblings, so you would
5:12
Speaker 1: share the same environments them too. So there's a lot
5:15
Speaker 1: of mystery surrounding the underlying causes, there really is, and
5:18
Speaker 1: so much so that they don't even know what is
5:22
Speaker 1: going on. Well, they do know generally what's going on
5:25
Speaker 1: on the biological level, but not specifically, right. So, multiple
5:31
Speaker 1: sclerosis is like you said, it's an autoimmune disease where
5:34
Speaker 1: your body's immune system attacks your own body. So there's
5:39
Speaker 1: a number of different ones, Like there's Crohn's disease is
5:42
Speaker 1: one UM, there's inflammatory bowel syndrome, and they all have
5:47
Speaker 1: in common that the body is mistaking, or the immune
5:50
Speaker 1: system is mistaking some part of some normal natural part
5:54
Speaker 1: of the body as a foreign invader and is attacking
5:57
Speaker 1: it as such. And in the case of multi pull sclerosis, UH,
6:01
Speaker 1: the body is mistaking what's called the mile in sheath,
6:05
Speaker 1: this fatty substance that protects the axons that UM neurons,
6:11
Speaker 1: that nerve cells communicate between UM. They attack that sheath,
6:17
Speaker 1: and as they attack that sheath, they start to break
6:20
Speaker 1: it down, and a basically what amounts to scar tissue
6:24
Speaker 1: and a type of plaque starts to develop and those
6:28
Speaker 1: form lesions, and it can happen anywhere on your brain
6:32
Speaker 1: or your central nervous system. Yeah, that's that's essentially what
6:36
Speaker 1: multiple sclerosis is. Yeah, those plaques, um, those are that's
6:39
Speaker 1: called the sclerosis. So literally, multiple sclerosis means you have
6:43
Speaker 1: multiple plaques this hardened tissue at places on your body. Uh.
6:48
Speaker 1: And like you said, you know you have the neurons,
6:50
Speaker 1: which are the nerve cells themselves, and the axons or
6:53
Speaker 1: the fibers that connect everything wrapped in that sheath and
6:56
Speaker 1: that sheath it's really it's very basic and cruel how
7:01
Speaker 1: it acts. You know, any autoimmune disease is just devastating because, uh,
7:06
Speaker 1: there's just something about the body making a mistake and
7:09
Speaker 1: turning on it's on an otherwise healthy self. That's just uh,
7:14
Speaker 1: I don't know, it's hard to hard to wrap your
7:16
Speaker 1: head around it. It really is, um And one of
7:19
Speaker 1: the reasons why it's so tragic it is because we
7:22
Speaker 1: have really no idea how to make the body stop
7:25
Speaker 1: doing that. And in the case of multiple scores, you
7:29
Speaker 1: you have a body that's attacking the mile in sheath,
7:32
Speaker 1: But researchers aren't quite sure exactly what part of the
7:36
Speaker 1: mile in sheath is triggering the attack, so they can't
7:40
Speaker 1: tailor drugs to stop the body from doing that. They
7:43
Speaker 1: just know it's going after milin. Yeah, and the milin
7:46
Speaker 1: can repair itself if there's damage. But um, the problem
7:50
Speaker 1: with MS is this, they call it de milonization. It's
7:53
Speaker 1: happening to too fast basically. Uh. And sometimes it can
7:57
Speaker 1: be so severe that that those nerve fibers are severed
8:00
Speaker 1: outright right exactly. It's kind of like if you clear
8:03
Speaker 1: cut a forest and then before you let the forests
8:06
Speaker 1: come back, you start cutting down saplings. It's never gonna
8:10
Speaker 1: come back. Same thing with the mile in chief. Um.
8:13
Speaker 1: It is difficult to diagnose it first because the early
8:18
Speaker 1: signs or things like you know, maybe a little dizzy
8:21
Speaker 1: and may be fatigued. Um, maybe my vision is blurry occasionally. Um.
8:27
Speaker 1: And it kind of comes and goes to where people
8:29
Speaker 1: you know think like, oh, maybe it's migraines, maybe it's
8:32
Speaker 1: some you know, something minor and um. Because it is
8:38
Speaker 1: not the most common thing, I don't think doctors immediately
8:41
Speaker 1: are like, well, we need to get you into a
8:42
Speaker 1: spinal tap, right, And because it doesn't necessarily follow a
8:47
Speaker 1: strict set of symptoms, you know, you can get those
8:50
Speaker 1: lesions anywhere, and since their nerve um, they're disrupting or
8:55
Speaker 1: affecting the nerve signals, they can present in all sorts
8:58
Speaker 1: of different ways. Right. So, yeah, doctors are frequently stumped
9:01
Speaker 1: when you present with MS symptoms. Should we take a
9:05
Speaker 1: break and talk a little bit about the history and
9:07
Speaker 1: then get back into it. Oh yeah, sure, all right,
9:09
Speaker 1: let's do it. So historically, ms UM, although it is
9:37
Speaker 1: new on the described disease front um, obviously it's been
9:43
Speaker 1: around for a long time and people just didn't know
9:45
Speaker 1: what the heck was going on. Yeah, there's a saint
9:47
Speaker 1: that had it, they think, Yeah, back in the Middle Ages,
9:50
Speaker 1: Saint Ledwena, who's Dutch. And because she was Dutch, she
9:55
Speaker 1: was ice skating once back in the fourteen the fifteenth century, Yeah,
10:01
Speaker 1: fourteen thirties, she was ice skating and she fell, and
10:04
Speaker 1: after she fell she developed um excruciating pain, headaches, trouble walking, paralysis, UM.
10:15
Speaker 1: And apparently there would be periods where she didn't have
10:18
Speaker 1: these symptoms and then they would come back. And it
10:20
Speaker 1: would get worse and then she would not have them again,
10:23
Speaker 1: which are hallmarks of multiple sclerosis. As we'll see. Yeah,
10:26
Speaker 1: these attacks are flare ups followed by periods of remission. UM. Yeah,
10:31
Speaker 1: that's a specific type of MS. Well, yeah, which we'll
10:33
Speaker 1: get to that. But UM. King Georgia third apparently had
10:36
Speaker 1: a grandson who had a very extensive diary about his
10:41
Speaker 1: health until he died, and most people think like he
10:45
Speaker 1: clearly had ms UM and I believe that. Uh. There's
10:50
Speaker 1: a couple of decades after that that UM, a doctor
10:54
Speaker 1: Jean Martin Charcot became the first person at least it
10:58
Speaker 1: got credit with with describing the disease itself UM, identifying
11:03
Speaker 1: it and describing it. He's known as the father of
11:05
Speaker 1: modern neurology. He's popped up in some of our other stuff.
11:09
Speaker 1: He sounded familiar because he had a woman, a patient
11:12
Speaker 1: that UM had these symptoms. She eventually died. He dissected
11:16
Speaker 1: her brain, discovered these lesions and called it scleros en plaque.
11:24
Speaker 1: And then the malin was UM was discovered after that,
11:28
Speaker 1: But they didn't they didn't put two and two together
11:31
Speaker 1: at a time with the island, but it was discovered
11:32
Speaker 1: after that. So the the plaques in the effect on
11:36
Speaker 1: the milin um was really first discovered or demonstrated by
11:42
Speaker 1: Scottish doctor James Dawson, who, thanks to UM better microscopes
11:47
Speaker 1: than previous researchers that had, he could see, Oh yeah,
11:51
Speaker 1: these lines of communication between nerve cells and brain cells
11:55
Speaker 1: are basically being worn down to nothing and in some
11:59
Speaker 1: case this is broken and um, this is the basis
12:03
Speaker 1: of MS. I'm James Dawson, goodnight. Yeah, we should do
12:08
Speaker 1: one on the microscope because it seems like time and
12:11
Speaker 1: time again we've had like just literally because the being
12:15
Speaker 1: able to see things smaller has gotten more advanced, like
12:19
Speaker 1: every time that has taken a leap forward medical science
12:22
Speaker 1: as Oh, sure, it's really interesting. Plus we'll get to
12:24
Speaker 1: say Anton von leven hook that bunch. Yeah, we've talked
12:29
Speaker 1: about him before, right. Yeah. So Dawson, uh described the inflammation,
12:34
Speaker 1: but they thought it was like a virus or a
12:36
Speaker 1: toxin running through the bloodstream at the time. Um, they
12:40
Speaker 1: did for a long time. Actually well yeah, and ironically
12:43
Speaker 1: in the thirties, UM there were lab mice going hey,
12:47
Speaker 1: it's autoimmune, right, and doctors were like, oh, don't listen
12:52
Speaker 1: to the lab results from the slee mice. No, it's
12:54
Speaker 1: clearly a blood toxin that's doing that. Yeah, So they
12:57
Speaker 1: sort of were not looking at the evidence right in
12:59
Speaker 1: front of their faces for a little while until the
13:00
Speaker 1: nineteen forties, when I think at Columbia University they found
13:04
Speaker 1: that um these weird protein byproducts and their and their
13:08
Speaker 1: cerebro spinal fluid. And that was seven and that's kind
13:13
Speaker 1: of when that's kind of when the doors really opened
13:16
Speaker 1: and they said, Oh, I think we know what's going on,
13:18
Speaker 1: and I think we know how we can test for
13:20
Speaker 1: this right. Right, that established one of the big tests
13:23
Speaker 1: for for um MS, which is they're looking for so
13:28
Speaker 1: they go do a spinal tap, right, which is where
13:31
Speaker 1: they draw a sample of um cerebro spinal fluid from
13:34
Speaker 1: between your vertebrate um and when they're testing for MS,
13:39
Speaker 1: they're looking for high levels of I G G immunoglobin,
13:44
Speaker 1: G antibodies, and something called oglio clonal bands, which are
13:49
Speaker 1: another type of protein that are immunoglobins. And then they're
13:53
Speaker 1: also looking for these protein by products that are the
13:57
Speaker 1: results of myle in being broken down in the cerebro
14:00
Speaker 1: spinal fluid, which is not supposed to happen. So when
14:03
Speaker 1: they find all this stuff, they can say this is
14:06
Speaker 1: probably multiple sclerosis. And since the forties they've they've had
14:10
Speaker 1: that test, and then starting in about the eighties or nineties,
14:15
Speaker 1: they also introduced m R I. And when you compare
14:19
Speaker 1: those two things together and they both suggest MS, you've
14:22
Speaker 1: got a pretty good MS diagnosis. Yeah, but it, like
14:26
Speaker 1: you know, like I said, it's a slow process. I
14:28
Speaker 1: remember Billy, it took a while until they finally landed
14:30
Speaker 1: on MS for him, and that just kind of seems
14:33
Speaker 1: to be the way it goes. What were his initial symptoms?
14:37
Speaker 1: Do you do you remember? You know, like we didn't.
14:40
Speaker 1: He was a college roommate and we didn't. Um. He
14:44
Speaker 1: ended up moving to the Billy was. He was a
14:48
Speaker 1: very unique guy. He he lived life to the fullest
14:50
Speaker 1: and did not really follow the rules of uh modern man.
14:55
Speaker 1: Where did he move? He kind of dropped out. He
14:57
Speaker 1: went to Boone, North Carolina, which is a great place
15:01
Speaker 1: to drop out and lived in a one room shack
15:05
Speaker 1: like cabin in the middle of the woods. It's a
15:08
Speaker 1: great place to do that with the toilet just sort
15:11
Speaker 1: of in the room, a toilet or a bucket that
15:15
Speaker 1: was a toilet, had running water and electricity, but it
15:18
Speaker 1: was a one room thing and I went up there
15:19
Speaker 1: a few times and stayed with him. But um, we
15:22
Speaker 1: would like, you know, drink whiskey and shoot guns and
15:25
Speaker 1: a cross streams on the toilet probably so like Ghostbusters.
15:29
Speaker 1: So Billy kind of dropped out, and um, this was
15:32
Speaker 1: before MS. You know, he just did that. You know,
15:34
Speaker 1: as a he was like a river guide, a whitewater
15:37
Speaker 1: river guide, and live the life that those dudes live,
15:41
Speaker 1: which is to say, not being responsible for a lot
15:44
Speaker 1: and kind of spending a lot of time on the river. Yeah,
15:47
Speaker 1: it's been a lot of time on the river and
15:49
Speaker 1: hanging out. Um, so he dropped out, and you know,
15:52
Speaker 1: didn't have a phone. This was pretty cell phone, so
15:55
Speaker 1: we weren't in the best touch. This is when I
15:56
Speaker 1: was post college living in New Jersey. So the memories
16:00
Speaker 1: of his exact early diagnosis or a little foggy, but
16:03
Speaker 1: I think I remember like fogginess and uh, dizziness kind
16:09
Speaker 1: of be in his first warning signs. But he wasn't
16:13
Speaker 1: the kind of like, oh, well, you know, I need
16:16
Speaker 1: to run right out to the doctor and see what's
16:18
Speaker 1: going on. No, And it certainly wasn't the Billy way,
16:22
Speaker 1: so he you know, he didn't do himself any favors
16:26
Speaker 1: in the early years, and then when he finally did
16:28
Speaker 1: find out, he didn't do himself any favors because he
16:31
Speaker 1: didn't take care of himself and he didn't rehab and
16:34
Speaker 1: take his medication like you should have and sort of
16:38
Speaker 1: fell down into a spiral of alcohol and drug abuse
16:42
Speaker 1: and um which did not help. Like you know, they say,
16:45
Speaker 1: if you get a diagnosis, you want to you want
16:48
Speaker 1: to live as clean as you can and work out
16:50
Speaker 1: and be as physical as you can and really try
16:52
Speaker 1: and take care of your body to stave off these
16:56
Speaker 1: physical symptoms. And he didn't do any of that stuff.
16:59
Speaker 1: And plus the early thing is a really big part
17:01
Speaker 1: of it too, because again, what's happening is the mile
17:04
Speaker 1: in sheets around your entire central nervous system or subject
17:08
Speaker 1: to attack. And so if you can catch this earatly,
17:10
Speaker 1: you can kind of stave off some of those successive
17:13
Speaker 1: attacks where if you just ignore it or don't pay
17:16
Speaker 1: attention to it, it will just get worse and worse
17:19
Speaker 1: and worse. It's a it's what's called devastating progressive disease. Yeah,
17:23
Speaker 1: and there's you know, a lot of people keep it
17:24
Speaker 1: a secret at first because it can um some of
17:27
Speaker 1: the physical side effects can be embarrassing. I know that
17:31
Speaker 1: this article mentioned and at Funicello waited for years to
17:34
Speaker 1: come out, you know, former Disney Mouseketeer, And she didn't
17:38
Speaker 1: come out until I think there were reports that she
17:40
Speaker 1: was an alcoholic because they see your stumbling around. Uh,
17:44
Speaker 1: and it can be confused with things like that publicly
17:46
Speaker 1: and um and then she said, actually, tabloids, I have MS.
17:52
Speaker 1: Oh sorry and that and the same with Richard Pryor.
17:55
Speaker 1: He kept his MS diagnosis a secret for a little while. Yeah,
17:59
Speaker 1: I remember everybody's Richard Pryor's got tremors because he used
18:02
Speaker 1: to free base. Yeah, no, turned out MS. Yeah totally.
18:07
Speaker 1: Muhamma Ali didn't have MS. But I remember people when
18:10
Speaker 1: Ali's condition got worse, We're like, oh, yeah, that you
18:12
Speaker 1: know see what that's what happens with boxing. Well, I
18:15
Speaker 1: think they might be right about that. One was by boxing. Yeah.
18:20
Speaker 1: I think he had brain plaques from too many from
18:24
Speaker 1: uh CTE. Okay, for some reason, I thought, I mean
18:30
Speaker 1: I could be mistaken, but I'm pretty sure that's why
18:33
Speaker 1: he Uh, he had Parkinson's. I think it was brought
18:38
Speaker 1: on by all the punches he took. I think, yeah,
18:41
Speaker 1: I didn't research any of this, so I'm speaking off
18:43
Speaker 1: the cuff same here, all right, That's that's what we
18:46
Speaker 1: do well. At any rate. UM people can kind of
18:50
Speaker 1: keep it a secret for a little while because it
18:52
Speaker 1: can be a diagnosis can be scary at first when
18:54
Speaker 1: you get diagnosed with MS because of the unpredictability, and
18:58
Speaker 1: you sort of have to I remember with Billy, they
19:00
Speaker 1: were kind of like, we gotta kind of see how
19:02
Speaker 1: this goes before we know what kind you have, right,
19:06
Speaker 1: which is fairly primitive as far as medicine goes. So Chuck,
19:11
Speaker 1: there's UM, there's this article has four kinds. What I
19:15
Speaker 1: saw is that it's been pared down to basically two. Yeah.
19:19
Speaker 1: Our article says that there's progressive, relapsing, relapsing, remitting UM,
19:25
Speaker 1: there is primary progressive, and then secondary progressive. And basically
19:28
Speaker 1: what I saw is that UM, there's an umbrella group
19:32
Speaker 1: called UM remitting or relapsing UH multiple sclerosis r MS,
19:40
Speaker 1: and then there's another kind that is UM, sorry, it's
19:44
Speaker 1: relapsing multiple sclerosis. And then the other kind is called
19:47
Speaker 1: primary progressive. Right, And with relapsing MS. You are, you
19:53
Speaker 1: have MS symptoms, you have basically what amounts to an attack,
19:56
Speaker 1: right where your symptoms come on and then they subside
20:00
Speaker 1: after a while. And during the time that they subside,
20:03
Speaker 1: you're in what's called um remission, right, and then they
20:08
Speaker 1: come on again, so you're in relapse phase. But during
20:12
Speaker 1: those two times, your disease is not getting worse, right,
20:17
Speaker 1: it's not progressing. That's the relapsing type of multiple sclerosis.
20:23
Speaker 1: The other kinds primary progressive, and they used to call
20:27
Speaker 1: that one UM yeah, and they kind of folded all
20:31
Speaker 1: those together. But the one that survived is primary progressive.
20:34
Speaker 1: And that's basically, like you are, your diseases getting worse
20:40
Speaker 1: pretty much constantly, and it might be happening fast, it
20:43
Speaker 1: might be happening slowly, but you have a disease progression
20:47
Speaker 1: that can be noted by the people in charge of
20:50
Speaker 1: taking care with care of you. But then during that
20:53
Speaker 1: you may have small periods where you don't have symptoms,
20:57
Speaker 1: so you've got a remission, or you have periods where
21:00
Speaker 1: they come on really strong and it gets really cute,
21:03
Speaker 1: so you have a relapse. But during this time, during
21:06
Speaker 1: like say a year or five years or ten years,
21:09
Speaker 1: your MS is getting worse, you know by the year. Yeah,
21:13
Speaker 1: which that was what Billy had got you. That's what
21:15
Speaker 1: it Yeah, that's what it sounds like. I have the
21:17
Speaker 1: impression that, um, the any kind of progressive type of
21:22
Speaker 1: of most polt clerosis is the worst of the two
21:26
Speaker 1: because you're you're you have it like basically all the time,
21:29
Speaker 1: and it's getting worse as it goes along. Yeah, and
21:31
Speaker 1: his would come together, his would come and fits and
21:34
Speaker 1: starts for the first period of years. Um, and it
21:38
Speaker 1: was that classic thing, I think where his flare ups
21:42
Speaker 1: would be like not so bad at one point and
21:44
Speaker 1: then kind of calmed down and then be really bad
21:47
Speaker 1: and then calm down. But the whole time there was
21:49
Speaker 1: a progressive thing going on to where he was. He
21:53
Speaker 1: was obviously worst case scenario, um, like couldn't walk in
21:56
Speaker 1: a wheelchair, couldn't talk, um, and that poor guy. Yeah,
22:02
Speaker 1: you know, the muscles fasticity is a big um hallmark
22:05
Speaker 1: of a kind of the worst kinds And that's when you're, um,
22:09
Speaker 1: you know, your body is just not communicating anymore, like well, no,
22:12
Speaker 1: that mile in sheath is exposed and so the the
22:16
Speaker 1: electrical impulses are going Hey, wires. So the muscles they're
22:20
Speaker 1: commanding are going hey wired too. Yeah, so he he,
22:24
Speaker 1: like I said, he walked with a cane for a
22:25
Speaker 1: little while, but eventually like just had to go, you know,
22:28
Speaker 1: lost tons of weight, eventually ended up in a wheelchair,
22:31
Speaker 1: and was his body was almost constantly in a state
22:34
Speaker 1: of muscle tension. You know. The ironic part about that
22:38
Speaker 1: is it sounds like his immune system was super healthy,
22:42
Speaker 1: which is how it was able to stage those massive
22:44
Speaker 1: attacks on on his poor mile in sheaths. Maybe you know, yeah,
22:50
Speaker 1: because you think if you had a weakish immune system,
22:53
Speaker 1: your MS wouldn't be quite as bad. Yeah, I guess
22:55
Speaker 1: I do, remember he thought about that. Yeah, it's really
22:59
Speaker 1: interesting and it's super cruel to see, um, like the body,
23:03
Speaker 1: like I said, the body turn on itself like that
23:05
Speaker 1: because Billy was very athletic and he was a good singer,
23:08
Speaker 1: and like it took away his ability to do all
23:10
Speaker 1: this stuff. Um, and it got so bad where he
23:13
Speaker 1: would um and it mentions it in this article about
23:16
Speaker 1: like even when you're eating, you have to be really
23:18
Speaker 1: careful because you can choke on your tongue or choke
23:21
Speaker 1: on food. Um. When he would get cracked up and
23:24
Speaker 1: laugh at us. It would like it would be you know,
23:27
Speaker 1: it would be good for him, but it would also
23:28
Speaker 1: be a little bit scary because he would his laugh
23:31
Speaker 1: would get out of control such where you had to
23:33
Speaker 1: worry about if you know, he had taken a sip
23:35
Speaker 1: of water or something, you could choke on it. Yeah,
23:38
Speaker 1: apparently that's one of the ways that people do die
23:42
Speaker 1: from complications of MS is choking because they have swallowing problems. Yeah,
23:46
Speaker 1: that was definitely, I mean, I don't remember the exact
23:50
Speaker 1: like literal cause of death at the end, but um
23:54
Speaker 1: you know, it just ravaged his body basically, so the
23:57
Speaker 1: other ones I saw where that your lung function, weakend.
24:01
Speaker 1: Muscle activity is one of the other main ways um uh,
24:07
Speaker 1: like an infection from a sore due to immobility can
24:11
Speaker 1: if not treated correctly, those things can lead to say
24:14
Speaker 1: like a blood infection and you can die from sepsis
24:17
Speaker 1: and then sadly, suicide is another leading cause of death
24:19
Speaker 1: among people who have MS. Something like six percent of
24:23
Speaker 1: fourteen percent of people with MS commit suicide. And one
24:28
Speaker 1: of the reasons why that's much higher than the population
24:31
Speaker 1: at large um is because one of the comorbidity ease
24:35
Speaker 1: of multiple sclerosis is depression, and it's apparently, from what
24:40
Speaker 1: I saw in my research, one of those things that's
24:43
Speaker 1: not widely recognized and therefore not widely treated enough as
24:49
Speaker 1: far as m S goes. That it's a it's apparently
24:51
Speaker 1: a big problem with it, and it can come from
24:53
Speaker 1: just being depressed that you have MS, because again the
24:56
Speaker 1: strikes you in the prime of your life, so you
24:59
Speaker 1: think about all the stuff you're missing out on because
25:01
Speaker 1: you have debilitating MS, or just the the mile in
25:07
Speaker 1: sheath coding regions of your brain. If you get legion
25:10
Speaker 1: lesions in the parts of your brain that regulate your mood,
25:14
Speaker 1: you can become Um, the physiology of your brain can
25:18
Speaker 1: lead to depression because of the changes there. Well yeah,
25:20
Speaker 1: I mean it does originate in the central nervous system,
25:23
Speaker 1: but um, it can in some cases affect like your memory, uh,
25:27
Speaker 1: your speech, your problem solving, and your higher brain function.
25:31
Speaker 1: I think it's it says in here like five have
25:34
Speaker 1: severe impairment of higher brain functions. So yeah, of course
25:38
Speaker 1: depression is gonna go along with that, you know, so
25:41
Speaker 1: we should we should say that for the most part,
25:43
Speaker 1: it's from what I saw, the vast majority of patients
25:47
Speaker 1: with multiple sclerosis don't die from it, they don't suffer
25:52
Speaker 1: major cognitive impairment as a result of it, and um,
25:57
Speaker 1: a lot of them don't even exhibit major symptoms for
26:00
Speaker 1: the most part. Yeah, I don't want to freak people
26:02
Speaker 1: out with Billy's story because he had the worst case scenario.
26:06
Speaker 1: But the diagnosis doesn't mean you're headed towards that. No. No,
26:10
Speaker 1: I just wanted to make sure that we were saying that.
26:12
Speaker 1: You know, I don't want to scare anybody, but we
26:14
Speaker 1: gotta get information out there, right because I mean, if
26:16
Speaker 1: there's one thing that would be really great if we
26:19
Speaker 1: could do with this episode, is if there's somebody out
26:23
Speaker 1: there right now who is starting to have migraines are
26:26
Speaker 1: tinkling in their arm, that they'll go to the doctor
26:29
Speaker 1: and catch it early. You know, absolutely, So let's talk
26:33
Speaker 1: about a treatment and stuff after your break. Huh, okay, alright.
26:58
Speaker 1: One of the things you can do one to you
27:00
Speaker 1: are diagnosed is get on drugs. Um. They've come a
27:05
Speaker 1: long way to do drugs, that's right. Uh. The drugs
27:08
Speaker 1: that they use to help treat them as have come
27:10
Speaker 1: a long way over the years. They're called disease modifying agents,
27:14
Speaker 1: and um, you know, they don't cure anything. But what
27:17
Speaker 1: they're trying to do is slow the progression or alter
27:21
Speaker 1: or suppress that immune system in such a way that
27:24
Speaker 1: it helps. Yeah. Yeah, and um, there's a lot of
27:30
Speaker 1: ways out there to actually treat the symptoms that are
27:33
Speaker 1: drug based and non drug based, but those disease modifying
27:36
Speaker 1: agents are the ones that actually alter the course of
27:39
Speaker 1: the multiple sclerosis. But like you said, they don't actually
27:42
Speaker 1: cure it. Although it is possible that there is a
27:45
Speaker 1: cure for it out right now, but it's new enough,
27:47
Speaker 1: it was just started in the late nineties, and it's
27:51
Speaker 1: so not so radical, um that it just hasn't been
27:54
Speaker 1: proven as a cure, but it's kind of looking like
27:57
Speaker 1: it might be. Yes, should we go ahead and talk
27:59
Speaker 1: about that. Yeah, So it's based on stem cells. Yeah,
28:02
Speaker 1: I mean, it's basically what they're doing is completely replacing
28:06
Speaker 1: your immune system, right, it's nuts. So back in the nineties,
28:11
Speaker 1: two doctors from Ottawa, Um, what provinces Ottawa in do
28:15
Speaker 1: you remember the Ontario, Well, let's just say Ottawa, Canada
28:20
Speaker 1: like Atlanta, USA. Uh. These doctors, Mark Friedman and Henry Atkins.
28:26
Speaker 1: They had this idea of basically reducing your immune system
28:31
Speaker 1: to nothing, so that when they managed to keep you alive,
28:35
Speaker 1: if they managed to keep you alive, when they restarted
28:38
Speaker 1: your immune system again by reintroducing some of your stem
28:42
Speaker 1: cells your hemeo poetic I want to say, stem cells,
28:48
Speaker 1: ye your own right, um, that it would build your
28:51
Speaker 1: immune system up again, and then they could watch the
28:54
Speaker 1: immune system restart MS and they'd be able to watch
28:57
Speaker 1: the disease progression from square one. But as one of
29:02
Speaker 1: them said in an interview, they failed miserably. But it's
29:04
Speaker 1: great that they did, because what they found was that
29:07
Speaker 1: when they devastated the immune system, brought it to zero,
29:10
Speaker 1: wiped it out, and then reintroduced your blood stem cells
29:14
Speaker 1: to the patient again, the MS didn't come back. In
29:17
Speaker 1: most of the people they tried this on. Yeh six
29:21
Speaker 1: remained relapse free for three years after three years and counting,
29:25
Speaker 1: and almost showed no sign of progression of the disease.
29:30
Speaker 1: Which is and then in that original I think UM
29:35
Speaker 1: study that Friedman and Atkins carried out, something like twenty
29:39
Speaker 1: three of the twenty four UM the disease was stopped
29:42
Speaker 1: in its tracks. And apparently these people had like a
29:44
Speaker 1: pretty bad bad cases of MS. This wasn't it wasn't
29:48
Speaker 1: a lightweight case of MS. Yeah. There's something called the
29:50
Speaker 1: Expanded Disability Status Scale, which basically kind of ranks how
29:55
Speaker 1: bad they are in terms of walking, dexterity, cognition. And
29:58
Speaker 1: they all had to rate between a three and a
30:00
Speaker 1: five point five on that scale, which is, you know,
30:03
Speaker 1: fairly severe, right, And so some people for twenty three
30:07
Speaker 1: out of twenty four in the original study, and I think,
30:09
Speaker 1: like you said, six and later studies, Um, the disease
30:13
Speaker 1: just stopped, that did not get any worse, even though
30:15
Speaker 1: these were progressive cases of MS. And in something like
30:19
Speaker 1: six of the twenty four they actually there the disease
30:24
Speaker 1: was walked back. So like the permanent damage apparently there's
30:28
Speaker 1: a rule of thumb among people with multiple sclerosis or
30:31
Speaker 1: doctors that if you have a symptom that doesn't get
30:35
Speaker 1: better or go away after a year, you can consider
30:39
Speaker 1: it permanent damage. That permanent damage was actually reversed in
30:43
Speaker 1: six of the twenty four patients by this incredibly radical
30:47
Speaker 1: procedure that seems to work. Yeah, like that they one
30:50
Speaker 1: of the doctors is, like, no one likes using the
30:52
Speaker 1: C word and he was like, but I'm gonna go
30:54
Speaker 1: ahead and say it, like, these people are cured. Yeah,
30:57
Speaker 1: some of these people have been in remission for four
31:00
Speaker 1: teen years and for all intents and purposes, that's that's cured.
31:05
Speaker 1: It's amazing, it is. It's pretty great. But again it's
31:08
Speaker 1: also a very very risky procedure. What they're using in
31:12
Speaker 1: UM and I think the most current incarnation, i think
31:15
Speaker 1: it's called halt MS is the process, but it's based
31:19
Speaker 1: on those Autawa doctors discovery that you use five different
31:23
Speaker 1: kinds of chemotherapy to kill your immune system. And so
31:30
Speaker 1: obviously you have to be kept in isolation and everyone
31:33
Speaker 1: has to wear a crazy bio hazard suit around you,
31:35
Speaker 1: and they have you on anti microbials and it kills
31:38
Speaker 1: everything UM and they are trying to fight off any
31:43
Speaker 1: infection in Anyone who's ever stayed in the hospital knows
31:46
Speaker 1: the best place to get an infection is a hospital.
31:49
Speaker 1: So it's extraordinarily dangerous. But if you can survive, and
31:53
Speaker 1: if you have like a pretty bad case of MS,
31:56
Speaker 1: I'm guessing you'd be willing to try this UM it
31:59
Speaker 1: can cure you. Yeah, Billy would have tried this in
32:01
Speaker 1: a second. I guarantee it. Uh. They had twenty four
32:05
Speaker 1: volunteers initially between two thousand and six and two thousand
32:08
Speaker 1: and ten. For the first study, I think, oh no, no,
32:10
Speaker 1: this one was um, this was in Denver, So I
32:13
Speaker 1: guess are they doing follow up research? Yeah, this is
32:15
Speaker 1: a difference. So the one that you're talking about, that's
32:18
Speaker 1: the Halt study. UM. I'm not sure exactly what Freedman
32:22
Speaker 1: and Atkins called their technique, but as far as I know,
32:25
Speaker 1: they're the pioneers of wiping out your immune system and
32:28
Speaker 1: then replacing it to get rid of MS. Yeah. So
32:30
Speaker 1: I think I might have mixed together some of the
32:33
Speaker 1: stats for these two studies. But let's just say they're
32:35
Speaker 1: both very promising. Um. And you know who knows, like
32:40
Speaker 1: I don't. I don't know the procedure. I know we've
32:42
Speaker 1: talked about doing shows on medical testing and stuff, and
32:45
Speaker 1: the procedure like the stepping stones from here to like
32:49
Speaker 1: all right now, when is this going to be a thing? Um?
32:52
Speaker 1: But I mean it's so kind of dangerous and frought
32:55
Speaker 1: with complications. I don't know if they this can be
32:58
Speaker 1: super widespread, you know, I from what I'm seeing in
33:03
Speaker 1: the research, though, it has such positive backing. I think
33:08
Speaker 1: kind of across the spectrum that it's I think people
33:13
Speaker 1: are gung hollo about it, Like people should be able
33:15
Speaker 1: to decide if they want to take that risk, Like
33:18
Speaker 1: Billy was certainly in a position where he's like, it's
33:21
Speaker 1: not gonna get any worse for me, right, Yeah, Like
33:24
Speaker 1: I'm willing to take this chance and maybe die. Right. Uh.
33:28
Speaker 1: It's basically I guess what these volunteers are saying to
33:31
Speaker 1: make my life better. Yeah. I think one of the
33:35
Speaker 1: things that's probably staying in most people like that's way
33:38
Speaker 1: is the cost associated because I supposedly there's really just
33:43
Speaker 1: stupid loopholes that you have that regarding um stem cell therapies.
33:50
Speaker 1: Like like the article I sent you UM talked about
33:53
Speaker 1: a guy named Dave Bexfield and he was UM accepted
33:58
Speaker 1: to the study, willing to take the risks, and UM
34:01
Speaker 1: his insurance company was like, yeah, that's great, it's a
34:04
Speaker 1: stem cell um study, but we only cover stem cells
34:09
Speaker 1: that are that come from donors, and this study has
34:13
Speaker 1: stem cells that come from you, So you're gonna have
34:15
Speaker 1: to pay the two thousand dollars yourself. And he did.
34:19
Speaker 1: This guy got together, he's scraped together like a hundred
34:23
Speaker 1: and eighties six grand, which is what it costs to
34:26
Speaker 1: to carry out this trial for him specifically, And um,
34:32
Speaker 1: I guess afterward he went after his insurance company and
34:37
Speaker 1: got not only that money back, but like another two
34:39
Speaker 1: thousand dollars or something in interest and he's cured. So boom,
34:47
Speaker 1: I should say, and he's c worded. That's right. Uh.
34:53
Speaker 1: There are UM some other diseases that are sort of
34:56
Speaker 1: like MS, and there is debate in the medical community
34:59
Speaker 1: whether or not they want to actually classify them. There's
35:02
Speaker 1: something called clinically isolated syndrome, which means you can have
35:06
Speaker 1: an attack or a flare up or an episode UM
35:09
Speaker 1: from this de milonization. But it's just like one lesion.
35:14
Speaker 1: And sometimes you might develop MS, but not always. Sometimes
35:18
Speaker 1: it's just c I D. Yeah. I thought that was weird,
35:22
Speaker 1: and to me it is kind of suggests how incomplete
35:27
Speaker 1: and understanding science has of MS. Well, yeah, and like
35:31
Speaker 1: I said that, some people say, well, you shouldn't even
35:33
Speaker 1: call this MS, and some people say no, it's like
35:36
Speaker 1: maybe the mildest form you can get. Uh. What else,
35:40
Speaker 1: There's something called Marburg m s H shoulders diffuse sclerosis
35:46
Speaker 1: Belo concentric sclerosis and devits disease. They are all sort
35:51
Speaker 1: of in that UM range of what's called ideopathic inflammatory
35:58
Speaker 1: demylinating diseases. And children can get it too, even though
36:05
Speaker 1: it's pretty rare. Yeah, eight thousand cases in the US.
36:09
Speaker 1: And remember there's like four dred thousand of MS, but
36:12
Speaker 1: of pediatric multiple sclerosis UM, there's eight thousand of them,
36:18
Speaker 1: which is I mean talk about prime of life disease. Yeah,
36:22
Speaker 1: and I think it's even harder to diagnose in kids
36:25
Speaker 1: because that's certainly not something they're looking for, right, And
36:29
Speaker 1: we're like the drugs that they're using, it's it's like
36:32
Speaker 1: what we don't know what effects are going to have
36:34
Speaker 1: on kids. You know, it is the career worse than
36:36
Speaker 1: the disease because there's you know, we said that there's
36:39
Speaker 1: some disease altering drugs. There's a new one called O
36:42
Speaker 1: Crivous that is UM pending approval from the FDA but
36:46
Speaker 1: looks like it's going to go through, which is I
36:49
Speaker 1: think the first UH disease modifying agent that is shown
36:53
Speaker 1: to treat both progressive and relapsing forms of multiple sclerosis UM.
37:00
Speaker 1: And it goes after the immune system. I think it
37:02
Speaker 1: tries to suppress your B cells in the immune system.
37:06
Speaker 1: Um So, there's there's plenty of treatments that go after
37:11
Speaker 1: the disease, but there's also a lot of treatments that
37:13
Speaker 1: treat symptoms, right, and um one of the ones that
37:17
Speaker 1: are used are antidepressants and anti convulsants. And so there's
37:21
Speaker 1: a lot of questions like, should we be giving those
37:23
Speaker 1: two kids even though they have MS. What's the long
37:26
Speaker 1: term effect of giving antidepressants to a child whose brain
37:30
Speaker 1: chemistry is still in the beginning stages of development. Yeah,
37:34
Speaker 1: I mean, drugs can be wonderful, but there there's not
37:38
Speaker 1: a drug you can take that doesn't have some sort
37:40
Speaker 1: of other effect. And um, the benefits outweighing the side effects,
37:46
Speaker 1: Like you gotta take all this into consideration for anything,
37:49
Speaker 1: you know. One of the other things I saw about antidepressants, Chuck, was, um,
37:53
Speaker 1: they have figured out that they can use it to
37:55
Speaker 1: treat chronic pain. And one of the outcroppings from m S.
38:00
Speaker 1: So again, MS is like your body going haywire and
38:04
Speaker 1: really unique ways for each person with multiple sclerosis. Um So,
38:10
Speaker 1: it kind of in a way provides researchers ways to
38:14
Speaker 1: whenever the body does something it is not supposed to.
38:17
Speaker 1: It's a great place for researchers to go study the
38:20
Speaker 1: normal processes of the body. And one of the things
38:23
Speaker 1: they figured out is that in treating chronic pain with
38:26
Speaker 1: multiple sclerosis, um, you can use antidepressants. And the reason
38:30
Speaker 1: why is because apparently chronic pain and depression use a
38:34
Speaker 1: lot of the same neural pathways and create a lot
38:37
Speaker 1: of the same changes to the plasticity of the brain
38:41
Speaker 1: as one another, and that chronic pain and depression maybe
38:45
Speaker 1: in a lot of ways more related at least neurologically
38:49
Speaker 1: than chronic pain and acute pain, which seemed to be
38:52
Speaker 1: kind of different animals. Yeah, fascinating, I think so too.
38:58
Speaker 1: Have you got anything else? Uh? Yeah, you know, I
39:04
Speaker 1: think I would just advise anyone. And it's not just MSS,
39:09
Speaker 1: but like if you got a I wasn't the friend
39:14
Speaker 1: to Billy that I should have been towards the end,
39:18
Speaker 1: and it's fraught with regret, uh. And part of that
39:23
Speaker 1: is because life gets in the way, uh. And part
39:27
Speaker 1: of it is just you know, it's not the easiest
39:29
Speaker 1: thing to face as a friend. And I think what
39:32
Speaker 1: I did was I let myself off the hook too easily.
39:35
Speaker 1: For that stuff, which I feel really crappy about now,
39:40
Speaker 1: like try to overcome that. If you have something like
39:44
Speaker 1: this going on. That's good advice, man, That's what I
39:48
Speaker 1: will say. I swore I wasn't gonna do this. Are
39:54
Speaker 1: you missing? Yeah, it's it's It was very hard and
39:57
Speaker 1: I wasn't the friend I should have been. And my
39:59
Speaker 1: friend Eddie was great and stood by Billy, and uh,
40:04
Speaker 1: I went and saw him at the end in the hospital,
40:05
Speaker 1: but it was you know, I had a lot of
40:08
Speaker 1: regret about the final years and not going to see him.
40:12
Speaker 1: You should have and it's understandable. Man. Yeah, I think
40:16
Speaker 1: you just did some sort of absolution though. Well we'll see. Well,
40:20
Speaker 1: if you want to know more about multiple sclerosis, you
40:23
Speaker 1: could type those words into the search part how stuff
40:25
Speaker 1: works dot com and it will bring up this article. Um.
40:29
Speaker 1: And since I said that and Chuck is missing, it's
40:32
Speaker 1: time for listening mail. That means it's Wednesday. Uh, this
40:43
Speaker 1: is on empathy a little bit too. Um. Hey, guys
40:45
Speaker 1: listening to empathy right now. I had a pause to
40:47
Speaker 1: say thank you when you were talking about the study
40:50
Speaker 1: relating to autism and alex athemia. Uh, you listed four
40:54
Speaker 1: groups studied as individuals with autism and alexothemia, individuals with autism,
41:00
Speaker 1: um uh without alexithemia, individuals with alexithemia but not autism,
41:06
Speaker 1: and then people who didn't have either one. Growing up
41:09
Speaker 1: as a sister of a guy with autism, I can
41:10
Speaker 1: tell you how many times I've heard people describe individuals
41:14
Speaker 1: without autism as normal people. It's such a lazy way
41:18
Speaker 1: to describe a group who doesn't exhibit just one of
41:20
Speaker 1: a multitude of other characteristics, and frankly, it's demeaning and rude.
41:24
Speaker 1: So thank you for not being those guys. You're always
41:27
Speaker 1: careful in your wording, so I shouldn't be surprised, But
41:29
Speaker 1: having thirty years plus experience hearing normal people condition me
41:33
Speaker 1: to brace myself when you started the list inclusive language
41:36
Speaker 1: for the wind keep up the great work. That is
41:39
Speaker 1: from Megan is isgin in Indianapolis? And she said, psh,
41:44
Speaker 1: Indianapolis is no Seattle, but maybe come to the Circle
41:47
Speaker 1: City sometime. Oh nice, up uh, and we I think
41:52
Speaker 1: we have been batting around the idea of in Indianapolis show,
41:55
Speaker 1: so yeah, hopefully it will happen. Thanks a lot, Megan.
41:58
Speaker 1: That was very nice of you. We appreciate the kudos.
42:02
Speaker 1: Um And if you want to get in touch with this,
42:04
Speaker 1: like Megan and tell us to come to your city,
42:06
Speaker 1: you can tweet to us We're at s Y s
42:08
Speaker 1: K podcast or josh um Clark Uh. You can hang
42:12
Speaker 1: out with us on Facebook dot com slash stuff you
42:14
Speaker 1: Should Know or Facebook dot com slash Charles W. Chuck Bryant.
42:17
Speaker 1: You can send us an email stuff podcast at how
42:19
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