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Date Posted: 14:54:27 01/25/08 Fri
Author: doc
Subject: This is getting way off base, but there are a number of accepted treatments for multiple sclerosis. (inside)
In reply to: lska 's message, "Because, not even having seen the scene, it tells you a lot about the character. It tells you that he's not willing to sit alone and in pain in a dark room without doing something about it. He hasn't given up on easing his symptoms. And it tells you he's willing to go outside normal boundaries to do it. From the writers' perspective, they were able to get across a lot of info with a simple action." on 13:49:27 01/25/08 Fri


Disease Modifying Agents
Interferon-beta
Glatiramer (Copaxone)
Mitoxantrone INovantrone)
Natalizumab (Tysabri)


Acute Exacerbations
Steroids (including, dexamethason, prednisone, ACTH)


Treatment of Spasticity &/or Tremors
Baclofen
Dantrolene
Clonazepam
Diazepam
Tizanidine
Isoniazid



There are also recommended treatments for other symptoms, including: bladder dysfunction, urinary retention, urinary frequency, erectile dysfunction, constipation, depression, fatigue, dizziness, nausea, vomiting, and pain.

The visual problem most often associated with MS is Optic Neuritis. It is an inflammation or demyelination of the optic nerve and may result in blurring of vision or temporary loss of vision. There may be pain, but not necessarily. The only potential treatment of possible benefit is steroids (methylprednisolone). Although the steroid my shorten the course, there’s no evidence to substantiate that steroids change the outcome over non-treatment. The usual course of the exacerbation is 1-3 months, with maximal vision loss in the first few days. Vision improves with or without treatment.

There are multiple research studies currently being conducted both by the NIH and The National MS Society. The National MS Society is currently funding a placebo-controlled study of marijuana related to the effectiveness of oral marinol vs. inhaled cannabis vs. placebo in improving MS-related spasticity. The important word there is placebo-controlled. Unless you study a treatment in a defined, blinded and controlled manner, there is NO reliable efficacy. Testimonials don not count as research! Medical literature is resplendent with ‘treatments and therapies’ that huge deleterious side effects (including death), when therapies are not adequately studied for effectiveness and safety.

On the other hand, a HUGE amount of money is being invested in research related to immune mediation, cell replacement therapy, metabolic changes in the brain & spinal cord, repairing myelination, inducing cells to rebuild damaged tissues, etc. THIS IS THE FUTURE OF TREATMENT ON MULTIPLE SCLEROSIS! Problem is…this isn’t sexy and alluring when seen on TV! And ‘Hollywood’ tends to ‘glorify’ controversial therapies, which they wish to portray as ‘mainstream’.

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Replies:

[> [> [> [> [> Oh, and just in case you think this is irrelevant…you have no idea how much time healthcare providers spend trying to convince patients that the treatments they see on TV or on the internet are not efficacious, and may in fact be dangerous. It’s scary how trusting the ‘public’ is in TV/internet personalities, rather than trained medical professionals. Especially, when you’re talking about terminal illness, people tend to grasp at straws. -- doc, 15:01:05 01/25/08 Fri [1]


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[> [> [> [> [> [> WOW, doc, thanks for all the thorough info. You are right on the money when you say that we probably won't see any of this correct, state-of-the-art MS related therapy portrayed anytime soon. I'm afraid the mj-smoking David might crop up a bit more than the moon-faced (from steroids) David. Fortunately, though, I do think most people do get that 'reel life' approaches to illnesses and real life are not to be confused. Internet mis-info is a whole other travesty and frustration, but a good doctor/nurse quickly dispels any incorrect and/or false notions, without too much precious time wasted. -- mj, 15:27:05 01/25/08 Fri [1]


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[> [> [> [> [> [> doc, Since I'm going off the reservation Inside: -- mkim Didnt mean to go here, but since I am, what the heck!, 15:32:02 01/25/08 Fri [1]

I dont have the base of knowledge that you have, but because of my own medical history one of the things that really bother me, when I see a character dealing with long term pain or a chronic illness, is that the only answer seems to be doing things the wrong way.

I dont have MS, I have no idea how they feel, but I do know about pain, and about disability. Staying (high) on anything, doesnt really help, if you truly mean to 'live' with whatever disease process you're dealing with. Long term use of some pain meds or I assume mj make you lose huge blocks of time, you are totally disconnected from the world, and I have always hated that. I'll take a bit of pain, and know what the hell is going on, thank you.

This is one reason I never was able to warm up to House. It seems to be a great show, with interesting characters, but then you have House, popping Vicodin and generally treating everyone like crap because he hates his life. All because he had this surgery on his leg, that apparently did some nerve damage?? I always think, hey buddy, try six surgeries!
I did need pain meds for a long time,especially after surgery before last, when my prosthesis failed, but it was no life, and I never felt better than when I was finally off.

No kidding though, I just think there have to be other ways to deal with long term pain or the onset of illness.

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[> [> [> [> [> Thank you, doc, I learnt something new from a person that I trust, don't ask me why I can say that, since I've never met you, but it's true :) -- gigi - who is partly good partly lucky in chosing people in which she can trust., 15:03:13 01/25/08 Fri [1]


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[> [> [> [> [> [> Oh! My "Thank you doc" was written *before* your post right above, we spoke about trust and our posts seem to be related more than it was in our own intention, I guess, or, we have to admit there are some "connection" across the internet, a big smile to you, doc :) -- gigi, 15:10:45 01/25/08 Fri [1]


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[> [> [> [> [> Well, I don't know enough about the character or his story to know whether the medical marijuana is a last resort, or if he's choosing to use it instead of other treatments. I think mkim is right that he's just a fundamentally different kind of character than Harm. But since this is a situation that happens in real life, hopefully they will show all sides of it -- the potential drawbacks as well as benefits. -- lska, 16:13:38 01/25/08 Fri [1]

I've had friends of friends that did benefit greatly from medical marijuana. I'm not from BC, but I'm also from the "left coast" ;) and so I know very well that there are people who abuse the availability of medical marijuana out here. But there are others who use it responsibly -- you don't need to use, um, a "recreational dose" to get the benefits -- and for some of them it has been a godsend. *shrug*

Sorry for helping push this so OT, mkim. LOL!

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