Stem Cells

I am so excited that President Obama is lifting the ban on stem cell research! Stem cells have the remarkable potential to develop into many different cell types in the body. Serving as a sort of repair system for the body, they can theoretically divide without limit to replenish other cells as long as the person or animal is still alive. When a stem cell divides, each new cell has the potential to either remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell. Stem cell transplants have helped several people with scleroderma improve their quality of life. I have always thought that a stem cell transplant would be my saving grace. But, according to my doctors, this is not to be. Pulmonary Hypertension has made a stem cell transplant impossible for me. My next option, I thought, was a heart/lung transplant. I am not sure I would go through the process, but I did think it was an option. But my doctors say that my age, pulmonary hypertension and other things make a heart/lung transplant not an option for me. It is possible that I may be able to undergo a lung transplant. Lung Transplants, in most cases, are the last resort. This is due to it being a very invasive procedure and requires a lung donor. This procedure is also extremely expensive compared to other treatments. Patients with pulmonary insufficiency due to scleroderma have long been considered suboptimal candidates for lung transplantation. In recent studies, patients with scleroderma who are recipients of lung transplantation experience similar rates of survival 2 years after the procedure compared with those with IPF or IPAH. In carefully selected patients with scleroderma who have end-stage lung disease, lung transplantation may be a valid life-saving therapeutic option. My dose of Letaris has been upped to 10mg as of last week. After five months on Letaris, I haven’t seen any relief from my breathing problems. This is discouraging as results can usually be seen after three months. I have a sinus infection that may be the result of a side effect of letaris (sinusitis, nose congestion) or a cold I had two weeks ago. I have emailed my doctors to see what they think. Brian is doing better with his depression. The hope that a cure will be found is fueling his optimism now and I keep encouraging that hope as it is very real.

Brian's day

Brian lost his balance this morning and fell. He had a hard time getting to the bathroom and then came back to bed. Later, when we got up, he was ok. He had a mild earache the other day that aspirin cleared up easily, so I thought his loss of balance might be from an inner ear infection. But inner ear infections usually are accompanied by dizziness and Brian wasn’t dizzy. Loss of balance and muscle weakness is a problem with Alzheimer’s so I have to assume this is another symptom that Brian is experiencing. The past month or so, Brian has also been experiencing rapid jerking movements of different parts of his body as he is going to sleep. This lasts twenty minutes and longer. They are called myoclonic jerks and often develop in patients with multiple sclerosis, Parkinson's disease, Alzheimer's disease, or Creutzfeldt-Jakob disease. Myoclonic twitches or jerks usually are caused by sudden muscle contractions, called positive myoclonus, or by muscle relaxation, called negative myoclonus. It isn’t painful and doesn’t seem to bother him. It is interesting to watch as the jerks occur several times a minute in different places. There are many different types of nyoclonus and Brian seems to have the Sleep myoclonus that occurs during the initial phases of sleep, especially at the moment of dropping off to sleep. Some persons with sleep myoclonus are rarely troubled by, or need treatment for, the condition.
The specific mechanisms underlying myoclonus are not yet fully understood. Scientists believe that some types of stimulus-sensitive myoclonus may involve overexcitability of the parts of the brain that control movement. These parts are interconnected in a series of feedback loops called motor pathways. These pathways facilitate and modulate communication between the brain and muscles. Key elements of this communication are chemicals known as neurotransmitters, which carry messages from one nerve cell, or neuron, to another. Neurotransmitters are released by neurons and attach themselves to receptors on parts of neighboring cells. Some neurotransmitters may make the receiving cell more sensitive, while others tend to make the receiving cell less sensitive. Laboratory studies suggest that an imbalance between these chemicals may underlie myoclonus. This is understandable since Alzheimer’s is a disorder that attacks the brain's nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes. Brian is depressed tonight as he told me he wonders why this had to happen to him. When he gets this way, I remind him that a cure is just around the corner. I only hope it is a short block.