Nerve 'recovery'.

As one would presume and hope, the nerves do recover after initial damage, well kind of. In the initial stages of the disease, the damage can be repaired to a near 100% state. Unfortunately, the reality is that once a nerve is damage, under the current understanding and treatments, it never recovers completely again. Hope you've already had the kettle boiling as here we go again!

I will try to explain my makeshift graph below, after the first 'attack' the nerve may be repaired but to about 98%, so an MSers will look 'better' and perhaps feel 'better' too, but as the disease activity continues, the symptoms will remain and almost stagnate to a certain degree. Over time, the repair work will decline in terms of productivity, I like to see it a bit like something like the Atkins diet and many others which are offered to those seeking weight loss, after going through a repetitive  cycle of improvement then a relapse ( back to step 1) psychologically we'd easily give up. The human body kind of does the same, the repair will only ever be done to a certain extent till the more secondary stages of the disease will take over ( secondary progressive multiple sclerosis) which as stated - a very long time ago I know- stereo typically takes the body and its' functions downhill! And with this there are currently no treatments available other than one's that offer 'relief' of symptoms that an MSer may be finding difficult to cope with.

The bars showing an estimate of the recovery after each relapse ( numbered)

I think the generals of MS have been discussed, if anything is misunderstood so far or even in the future, please leave a comment or leave a message. Hopefully We will now be jumping in the deep end with the symptoms, I suggest you keep the kettle, mugs and tea/ coffee nearby for next week! And packet of biscuits! See you then!

The first of cliff hangers; Dignosis.

Obviously to all medical  abnormalities in a human body, there is stereotypically a study then a solution and then treatment. MS also follows the same pathway, as easy as it may seem it can be very difficult for a definite diagnosis of Multiple Sclerosis. There are many possibilities to the initial complaints of an MSer in their more 'baby' days of the disease. Therefore certain forms of 'research' are carried out to eradicate any possibilities and find the concluding answer.

There are a handful of tests carried out which I'll go through below. Grab a nice warm drink and get comfortable!

Neurological examination: This being one of the easy ones, a neurologist ( a doctor specialising in nerve related or neurological conditions) will carry out a short assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. Simply put this can be things like matching your finger between your nose and their finger to see whether your perceptions are a bit 'off', give it a go with someone to see how it goes. Another could be when they pull out their medical hammers to give you a bit of a whack and see the automatic response the body will carry out.

Magnetic resonance imaging (MRI): This one being the scan that scares a lot of people hearing about it! Where the body is placed in an oven like machine which is very loud and in the case of MS the brain and spine is scanned, this shows healthy and unhealthy nerve cells ( see the example below). Either by first look or scans carried out over a period of time which show more/ worsened or odd looking nerve cells and linking them to complaints of the patient, it shows the medical team the likelihood of it being MS, it sometimes taking discussion with a team of even world renown neurologists (like in my case!) and radiologists (those who do the scans and know how to read the pictures that come out. Majority of MSers are diagnosed via the use of MRI scans.

Evoked potential test: electrodes being placed on the brain or spinal cord and the electric potential ( as the messages sent across nerves are a bit like electric currents) are analysed (the speed of the reaction) in response to a stimulus like loud noise or so.

Lambur puncture/ spinal tap: The brain and spinal cord are bathed in fluid. A spinal tap, also called a lumbar puncture, is a procedure doctors use to remove and test some of this liquid, called cerebrospinal fluid (CSF). If there is an abnormal amount of WBCs present this can be used as a cue to their being autoimmune activity. Just a warning to anyone who may have this procedure done, it is quite scary but professionals are so for a reason! Unlike the advice I was given beforehand about it being like an epidural given in childbirth and it hurting for the rest of my life ( a load of rubbish!). When told to rest after, really make the most of it, I jumped up after a few minutes only to almost pass out at home time and be given medical advice to go ahead and drink lots of coke, to which my dad had requested six cans of coke to be left at my bedside at home!

Blood tests: Last but not least, simple blood tests may be carried out, to eradicate the small possibilites like diabetes, because of my skin colour and genetic liking to diabetes, this was the initial thought by my GPs, but as the saying goes ; jack of all trades but masters of nothing!

The white dots on the brain indicating damaged nerves.

This is making me a bit 'nervous'. Nerve communication.

As MS is a condition affecting the nervous system, I thought I should clarify a few further things about the NS( nervous system).

Back to how they communicate with each other and send 'signals' to one another; when the action potentials (the initial signals) are passed over to another nerve, they must pass a small gap called the synaptic cleft, for this to occur they are transferred via chemicals called neurotransmitters. Take a deep breath!

These neurotransmitters play a huge role in physical, mental and emotional factors in a body. For example; levels of serotonin have been associated with affecting mood, social behavior, appetite, digestion, sleep, memory and sexual desire/function and things like excercise or erm chocolate showing to increase the levels of serotonin, that's why chocolate is loved very much! And excrcise more in others.

Thus why along with the turbulence MS may cause on a physical and cognitive playing field, there are also many mental issues easily associated with the condition and the treatments used for dealing with it also affecting or resulting in a further imbalance, which is a thought to why most known mental illnesses arise or why even families with a genetic make up resulting in neurotransmitter imbalance tend to have family histories of mental illnesses.

Just to clarify how the speed difference of signals make massive implications, I thought the pictures below would enlighten how it may do so and to show why MSers can be a bit 'slow'.

I know this is very sciency but it is needed, if you think MS is very long and confusing, just wait for the diagnoses process!

An 'autoimmune' condition.

What is the turmoil in a body that results in a sclerosis ( abnormal hardening of body tissues) in multiple places one may ask? To put things in context, the human body has two types of blood cells, white and red. Red being the obvious one, cut yourself and you'd probably see a lot of them if you're unsure! No don't do that just kidding, the other type being white (WBC) and these are part of the 'immune' system of a body, there being a specific one named the ' T killer cell' which attacks to kill foreign cells that enter the body presuming they would be things like bacteria which would lead to infections,viruses or the flu, not too sure if the infamous 'man flu' would count here but regardless that's the job of this group of white blood cells in the body and the immune system.

As by consensus MS is deemed an autoimmune condition by the this simply meaning the immune system is attacking the body it is in. It is thought that WBCs wrongly cross the blood brain barrier ( where the central nervous system is - the brain and spinal cord-  in the body) which is somewhere they are not really meant to be. Seeing many nerve cells which are 'foreign' to them as thinking back to school days, normal cells are a lot more simpler than nerve cells so the WBCs pretty much wage war and thus attack these cells, whichever of the billions that they may encounter, attacking the myelin sheath thus slowing or stopping signals that would've been sent across that specific nerve.

It being classified as an autoimmune condition has opened up the door to many conspiracies about things that cause these such conditions, from a reaction to gluten consumed, mercury in teeth fillings, genetically modified foods orvaccines given at their respective moments in our lifespan. Just to point, I'm on the fence with this, neither promoting or ridiculing any of these suggestions that have been or are being made!

I don't think the science would stop with me but I'll try not to cause an overload, have fun with this weeks one!

The nature of the nerve.

So yes I'm back, had an unfortunate passing in the family which kept me away.

So let's get started with the nerve, what does it do and how does it work? Well to make it easy, take the example of somebody touching you, that initiates a signal ( known as an action potential) from the sensory neurons, going to the brain via the spine then a response ( the realisation that someone touched me!).

In our body there are nerves which are myelinated ( the fatty layering around the nerves) and non- myelinated ( obviously, no myelin). This speeds up the signal in large quantities, like an formula one car to a baby crawling. A human body would naturally have these where needed.

When the myelin is damaged, it becomes the root of all the symptoms experienced with such neurological disorders like MS. Thinking of it to be like a electric cable, the rubber coating being the myelin and the copper beneath being the nerve fiber(s) where the signals are transferred. When the signals can't travel properly a 'short charge' would occur and the signals may jump to the wrong nerves just like a charge would transfer current to anything nearby that conducts electricity, and If the damage is to an extent the nerve cell is completely dead then as you'd expect nothing is registered or picked up so it is pretty much left like a vegetable.

Now as MS affects the brain and spinal cord, the nerves damaged are the ones based there which would be responsible for transferring messages to the 'peripheral' nerves leading to normal bodily responses.

I like to see a body with MS a bit like a game of minecraft by someone who wouldn't know how to play it, so metaphorically speaking, bombs sites all over the nervous system which are expected to worsen over time.

How this is all thought to happen we will wait till this science lesson is digested!