Archive2019

Merry Christmas

Barts-MS would like to take this opportunity to wish all our readers a very Merry Christmas. The Children’s Ward of the London Hospital at Christmas. Image from The Graphic, 30 Jan 1886. Whitechapel Workhouse, Christmas 1874 Scrooge: “Bah, humbug!” Narrator: “Oh! but he was a tight-fisted hand at the grindstone, Scrooge! A squeezing, wrenching, grasping, scraping...

Slip-sliding away – do I have secondary progressive MS?

Barts-MS rose-tinted-odometer – zero stars We have been running a campaign that #MS_is_1_not_2_or_3_diseases for sometime. This is based on the biology of MS and not what we see clinically. The pathology that underpins so-called progressive MS is the loss of axons, loss of neurons and loss of synapses, which are the chemical connections between neurons. All three of these processes begin...

To botox or not to botox

That is the question: Whether ’tis nobler in mind to sufferThe slings and arrows of bladder instability,Or to take arms against a sea of troubles,And by opposing end them? –Shakespeare a’la NDG Bladder botox treatment If you suffer from bladder dysfunction, ask yourself why put with the dry mouth from Vesicare and Co., when a few injections of botox per year will do? It works...

Diagnose and Treat Early

As you know, I don’t like CRAB drugs becuase I don’t think they are effective enough for most people, Never have never will. but obviously I respect people’s choice for these agents. However if you go down this route , this is yet another example of treat early, wait too long and damage is done, meaning that it is less likely that you can get disease undercontrol. Early...

How much do you weigh?

Barts-MS rose-tinted-odometer  ★ When last have you weighed yourself and calculated your BMI (body mass index)?  BMI = body mass (kg) / the square of the body height (m) [kg/m2]; to save you time and effort you can simply use the NHS BMI calculator, which takes imperial measurements as well.  I am not sure if you are aware that childhood and adolescent obesity is an important risk...

Do you have high blood pressure?

Barts-MS rose-tinted-odometer  ★ ★ ★ ★ ★ Who knows their current blood pressure? If you have MS you should know your blood pressure, your BMI (body mass index), your lipid status and whether or not you have impaired glucose tolerance or diabetes. In other words, all pwMS should have an annual health check outside of their MS clinic appointment to be screened for comorbidities. We know that pwMS...

High Dose Biotin study fails to reach the mark

High dose biotin has led to many people to be chomping on loads of low dose biotin pills. But dooes it work? According to this report not very well. High-dose biotin in progressive multiple sclerosis: A prospective study of 178 patients in routine clinical practice. Couloume L, Barbin L, Leray E, Wiertlewski S, Le Page E, Kerbrat A, Ory S, Le Port D, Edan G, Laplaud DA, Michel L.Mult Scler...

Sorry to disappoint

Many of you who have requested an opinion from Barts-MS, and don’t live in the Barts-MS catchment area, have discovered that your referral to our service has been rejected. I have a handful of complaints from patients wanting to see me in the last week or so. The reason is that we can’t cope and we are now putting our existing patients at risk! We have just completed a review of our...

Methotrexate in progressive MS

ProfG has argued that if hand-function was the major endpoint of clinical trials then you would have had an approved treatment for progressive MS over a decade ago. In this study they look at the influence of intrathecal methotrexate. Methotrexate is an anti-proliferative agent Safety of long-term intrathecal methotrexate in progressive forms of MS. Stark JW, Josephs L, Dulak D, Clague M, Sadiq...

Antibodies are important for some people with MS

Yesterday I was whinging about studies looking for anti-CNS antibodies and suggesting that they may be effect rather than cause, but are antibodies important. I would say almost certainly for some individuals and this post shows you why. Some people have circulating antibodies that are damaging and these can be removed from the blood. In this study people who did not respond well to a dose of...

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