Sunday, March 13, 2011

Four Words 4 MS

Video can demonstrate different aspects of our lives than the written word.  I received an email asking me to tell you about a new program being launched by mslifelines.com called Words 4 MS(MS LifeLines is an educational support service for people living with MS and their families.  programs MS LifeLines is sponsored by EMD Serono, Inc. and Pfizer Inc.)

Below are portions of the email I received announcing this program, in the spirit of MS Awareness Week:

Words 4 MS has been created to empower and inspire people in the MS community by encouraging them to share their stories.  The program will share individual stories from people living with MS, or people who know someone impacted by MS – like you - through selected videos on mslifelines.com.  Video submissions should follow the theme of Words 4 MS and include four words to describe a personal achievement (examples:  Still Full of Hope, My Mom, My Hero). 

People can submit their video and access the full program guidelines and submission criteria at MSLifeLines.com/Words4MS. (Website will be live on Monday, 3/14) Video submissions will be accepted from March 14th through July 13th.

Will Never Stop Fighting
Still Full Of Hope
My Mom, My Hero

These are just a few examples of how to tell a story in four words about your personal experience with multiple sclerosis (MS).  Are there four inspiring, thought-provoking words that say how you feel, inspire you, or remind you of someone in your life who has helped you through your MS journey?

If so, MS LifeLines is asking you to share your story through video!

Through Words 4 MS, people living with MS or who have a loved one living with MS– like you – will be able to share their individual stories through video that might be revealed on www.mslifelines.com and other possible media outlets.  We encourage you to submit a video that showcases how your life has been impacted by MS.  Video submissions should follow the theme of Words 4 MS and include your personal, 10-second video depiction of how MS has impacted your lives using four words that describe this story (examples:  Still Full of Hope, My Mom, My Hero). 

We are asking you to help demonstrate how many people are touched by MS while also helping to raise awareness of this condition by sharing your four words today!  Please visit www.mslifelines.com for the official guidelines and submission criteria.

MS LifeLines is an educational support service for people living with MS and their families.  programs LifeLines is sponsored by EMD Serono, Inc. and Pfizer Inc.

Thursday, March 10, 2011

Carnival of MS Bloggers #83

Welcome to the Carnival of MS Bloggers, a bi-weekly compendium of thoughts and experiences shared by those living with multiple sclerosis.

What Does MS Equal To You?

By Mary K. Mennenga

Guilt as an emotion is what
People use to get what they want
The only way it's able to work is if you buy into it
Honestly only you can make yourself feel guilty
Of course people will use words to reinforce your interpretation
Of what they've said to help you in feeling guilty
It's more about your interpretation of what was said
Take great care whenever buying into guilt
Because if guilt is the reason behind your actions
Your actions will have little meaning
Because it's become something you have to do
Instead of what you want to do


By Lisa Emrich at Brass and Ivory

MS = a twisted roller coaster, spiraling and without brakes.

I can’t recall the last “real” roller coaster I rode.  Honestly, I’m trying to rack my brain.  Was it during a visit to Disney World in 1985?  Or could it have been in a car driven by a speed demon? (That would be a figurative roller coaster, of course.)

During one ride, the anticipation and excitement about being strapped into a seat and allowing your body to be whirled through the air is intoxicating.  During the other ride, eyes are closed, feet are trying to push the imaginary brake pedal in the passenger seat, and the adrenaline rush is exhausting rather than exhilarating.  (Can you tell I have vivid memories of a car ride which scared the living daylights outta me?)

Living with multiple sclerosis is a bit like a roller coaster ride.  Many different and ever changing roller coaster rides, in fact.

When first diagnosed, I think that the roller coaster is ridden in total darkness.  You can’t see what obstacles, loops, twists, or drops are to come.  The fear of the unknown can be overwhelming and you just want someone to turn the lights on.

When living with MS for a little time, you begin to see patterns which repeat.  You get to know your own roller coaster track.  If you have relapsing-remitting MS, this analogy may sound very familiar.  Perhaps each relapse is like a separate ride which eventually comes back to rest.  However each experience changes you a bit and you can never really go back to being a coaster ride “virgin.”


Dealing with life with MS can be an emotional roller coaster as well.  You may have learned about the “stages” of grief which can generally be applied to dealing with a new diagnosis - shock, denial, anger, bargaining, guilt, depression, detachment, acceptance.    Of course, no one has to go through these stages in any organized fashion.  There are no hard and fast rules. 
I have found each reminder that MS is a companion who will not leave sends me out on the roller coaster once more.  It doesn’t matter how many times I’ve ridden the ride, or how well I know that I will never truly fall from the rickety supports, or that I will once again learn how to live with the new post-ride me.  I still get strapped in for a bumpy ride complete with anger and tears, sadness and guilt, and finally resignation to the new normals of life with MS.

A third type of roller coaster which I envision is the one where you can see the rides of other travelers on this MS journey.  Your initial coaster may be like the gentle teacups which swirl in circles.  As you learn more about the disease, you may begin to see what types of rides others experience.  Maybe somebody else has graduated up to a wicked tower of a ride, complete with loopdy-loops and straight drops.  You know that you might be on that ride also at some point. 

It can be frightening simply knowing what others experience.  Knowing what you might experience.  Knowing what you have experienced and may again (or always).  This knowledge is a type of anticipation which no patient or medical professional wants to burden you with, however “knowledge is power.”  It seems better to know what the possibilities are rather than always riding with your eyes closed.  Right?

No matter what the ride entails.  Know that we do not have to ride alone.  Others have come to the amusement park with us.  Our friends, family, loved ones, caregivers.  And, honestly, we (those who live with MS) do not have exclusive access to the park.  People living with other chronic and acute diseases may be there as well.

In fact, life itself is like a roller coaster, never completely flat nor static.  We each move forward (whether we intend to or not) eventually.  Perhaps we have a bit of control over which ride to take, choosing to become the strongest and healthiest we can be, choosing to open our eyes and face the monster down, choosing to let another person take the seat next to us.  Choosing to never go this journey alone.

MS = a journey to destinations known and unknown

MS = a community of travelers who support each other

MS = the reason I am here, right now, reaching out to myself


by Tammy Malkowski from Pick Tammy's Brain
My hands shake as my words slur,
But it’s not what you think.
I trip and I sway,
Though I haven’t had a drink.

I could fall at any moment.
And this never leaves my mind
But I’m trying hard to manage
As I’m on this MS ride.

My legs look normal
But feel like rubber.
My arms look strong enough,
But melt like butter.

I have slept for hours,
But my eyes still droop.
I want to walk straight,
But my head loop-de-loops.

You think I’m paying attention,
But my mind has wandered away.
I want to speak clearly,
But I’m stuttering today.

I try to read your email,
But I am seeing double.
I want to come with you,
But walking gives me trouble.

I may need your patience
And your compassion too.
But never your pity
For all I have to do.

I need you to be kind.
And try to understand.
I’m living a new life
Doing the best that I can.

I am making an effort
To be someone who
Is making a difference
In my own life too.

Give me a chance
Be on my side
I am still me
Even with all the drama inside.

My body has changed
But my heart is the same.
I still have a beautiful life
Even when playing the MS game.

The thing I need the most
As you try to understand
Is the comfort and confidence
That I still have my friend.

by Tammy Malkowski (2/25/2011)

from Living! with MS by Denver Refashionista

Lately I have been feeling some creative inspiration again and I have been looking back at old poetry and journals I wrote at age 23. I found a couple of interesting things. Many things are the same and many are different. Many of the images in my writing are still the same. I still love to be dramatic, and I still am in love with the idea of love :)

I also see the way life has changed. Every day is not a drama. The hard days are not as hard. One of the benefits of age is that it lends perspective. There are still hard days but I guess now I know that the good also comes with the bad. While one day may be a trial, the pain passes quickly and great moments can follow right behind tough ones. Since this blog is "Living with MS!" let me state that I have found these observations to hold true after living almost three years with this diagnoses.

One observation I can share with the newly diagnosed (with relapsing remitting) is that relapses do have an end. Sometimes when you think that some function is irrecoverable, it comes back. It is also easy to get lost in the idea that it's all downhill from the time of diagnoses. Not true: the course of this disease is different for everyone.

My first year was the hardest physically and mentally. At age 34, I am in the best physical condition I have been in since about age 16. I practice yoga every day and physically, I can run circles around my 16 year old students. I have enough perspective on the disease at this point to know that this could also change at any time, but this knowledge is also a gift. When you truly face your mortality and realize that things could change at any time, it makes you value each day of health even more.

Joy is often about valuing what you have, not morning what you have lost or could lose.


This concludes the 83rd edition of the Carnival.

The next Carnival of MS Bloggers will be hosted here on March 24, 2011. Please remember to submit a post (via email) from your blog of which you are particularly proud, or which you simply want to share, by noon on Tuesday, March 22, 2011.

Thank you.

Comments for this post.

Tuesday, March 8, 2011

What Does MS Equal To You?

MS = a twisted roller coaster, spiraling and without brakes.

I can’t recall the last “real” roller coaster I rode.  Honestly, I’m trying to rack my brain.  Was it during a visit to Disney World in 1985?  Or could it have been in a car driven by a speed demon? (That would be a figurative roller coaster, of course.)

During one ride, the anticipation and excitement about being strapped into a seat and allowing your body to be whirled through the air is intoxicating.  During the other ride, eyes are closed, feet are trying to push the imaginary brake pedal in the passenger seat, and the adrenaline rush is exhausting rather than exhilarating.  (Can you tell I have vivid memories of a car ride which scared the living daylights outta me?)

Living with multiple sclerosis is a bit like a roller coaster ride.  Many different and ever changing roller coaster rides, in fact.

When first diagnosed, I think that the roller coaster is ridden in total darkness.  You can’t see what obstacles, loops, twists, or drops are to come.  The fear of the unknown can be overwhelming and you just want someone to turn the lights on.

When living with MS for a little time, you begin to see patterns which repeat.  You get to know your own roller coaster track.  If you have relapsing-remitting MS, this analogy may sound very familiar.  Perhaps each relapse is like a separate ride which eventually comes back to rest.  However each experience changes you a bit and you can never really go back to being a coaster ride “virgin.”


Dealing with life with MS can be an emotional roller coaster as well.  You may have learned about the “stages” of grief which can generally be applied to dealing with a new diagnosis - shock, denial, anger, bargaining, guilt, depression, detachment, acceptance.    Of course, no one has to go through these stages in any organized fashion.  There are no hard and fast rules. 
I have found each reminder that MS is a companion who will not leave sends me out on the roller coaster once more.  It doesn’t matter how many times I’ve ridden the ride, or how well I know that I will never truly fall from the rickety supports, or that I will once again learn how to live with the new post-ride me.  I still get strapped in for a bumpy ride complete with anger and tears, sadness and guilt, and finally resignation to the new normals of life with MS.

A third type of roller coaster which I envision is the one where you can see the rides of other travelers on this MS journey.  Your initial coaster may be like the gentle teacups which swirl in circles.  As you learn more about the disease, you may begin to see what types of rides others experience.  Maybe somebody else has graduated up to a wicked tower of a ride, complete with loopdy-loops and straight drops.  You know that you might be on that ride also at some point. 

It can be frightening simply knowing what others experience.  Knowing what you might experience.  Knowing what you have experienced and may again (or always).  This knowledge is a type of anticipation which no patient or medical professional wants to burden you with, however “knowledge is power.”  It seems better to know what the possibilities are rather than always riding with your eyes closed.  Right?

No matter what the ride entails.  Know that we do not have to ride alone.  Others have come to the amusement park with us.  Our friends, family, loved ones, caregivers.  And, honestly, we (those who live with MS) do not have exclusive access to the park.  People living with other chronic and acute diseases may be there as well.

In fact, life itself is like a roller coaster, never completely flat nor static.  We each move forward (whether we intend to or not) eventually.  Perhaps we have a bit of control over which ride to take, choosing to become the strongest and healthiest we can be, choosing to open our eyes and face the monster down, choosing to let another person take the seat next to us.  Choosing to never go this journey alone.

MS = a journey to destinations known and unknown

MS = a community of travelers who support each other

MS = the reason I am here, right now, reaching out to myself

Friday, March 4, 2011

Carnival Delay

Hi folks,

Did you notice?  The Carnival didn't go up yesterday.  Tuesday was extra busy.  Wednesday was normally day.  On Thursday after going and going and going non-stop from 10 am to past 7 pm, I gave myself an extra day to collect the posts.  Thought that I would take time today during an infusion of Rituxan to take care of getting the Carnival posted.

Today has not been a boring day, that's for sure.  And not really in a good way.  But things are going more smoothly now.  After having trouble getting an IV started this morning, me bending my elbow too far and causing the delicate IV we did get started to infiltrate, thus getting a dose of steroids and saline in my arm (not the vein), I was tired.  Silly arm of mine didn't let me know that there was a problem with the IV until I already had a HUGE bulge on my forearm (which was BELOW the IV insertion point).  I think I do know when the tube must have broken through the vein wall as I did feel a 'pinch' at one brief moment while I was adjusting myself in the chair and typing on the computer.

Then a different was brought in to check for veins with a doppler scan (and proceeding to miss three sticks herself, I think), I fainted.  My blood pressure seriously was measuring a systolic (the bigger number) pressure of 40 (I was told much later in the day).  I'm also told that I stayed lucid enough to talk a bit.  I just remember trying to continue to reach through the fog to stay connected with the kind nurses at this new-to-me infusion center.

Then there was talk of admitting me to the hospital so that another team could put an IV in my upper arm (which this outpatient department doesn't do).  But eventually pediatric nurses were called to help get another IV started.  (Yes, I did finally make this suggestion after the nudge of finding someone who might work with small and difficult veins didn't result in a successful IV.)

I honestly lost track of how many attempts to start an IV were as a number of them happened while I was almost blacked-out. I'm sure that it was at least eight.  However, my experience here is still better than the previous infusion location I must say.  The attitude and atmosphere made a huge differnce.  And Yes, the peds nurses (it took two of them working together) got a good IV going.  We were finally back in business.

But since the pre-treatment steroids didn't make it into my veins, I had the same infusion reaction at about one hour into the drip (and we were already going at a planned slow pace with the infusion rate).  We had hoped that my body was still processing the steroids which ended up sub-Q.  More IV benadryl and steroids were given, the drip stopped, and after 30 minutes we were ready to begin the infusion again.

That was several hours ago.  Since we are staying at a slow infusion rate, I still have a couple of hours to go.  But at least the medicine is flowing into my body now without difficulty.

As a result of all this drama, I haven't felt like writing, collecting, or creating any posts or articles (including the Carnival) today.  My apologies....but now you know what's been going on with me today (and this week, see P.S. below).  Thinking of most of the days this week, I've been on the go-go-go much more than usual and I'm exhausted.

Hope things are good with you.  Don't fret, the Carnival will indeed come (sometime).

P.S. I was able to spend a large chunk of time catching up with an old friend who was in town this past Sunday.  I taught as usual on Monday.  Tuesday evening I attended a concert and went out to eat after wards with a small group.  Wednesday was normal busy.  Thursday was gong to be somewhat busy, but became a hugely long 8 hour day away from home.  Today, I arrived at the hospital before 7am; I will probably finish close to 5pm.  Long days indeed.

Wednesday, March 2, 2011

FDA Wants More Info on Risks of Merck's Cladribine; No Approval for Use in MS (for now)

In the United States, we will continue to have only one oral option (Gilenya) for use as a disease-modifying drug in multiple sclerosis.  FDA rejects Merck's application for marketing approval of Cladribine oral tablets in the United States.  More information regarding risks and benefits is needed.  Additional studies are ongoing.

On January 21, 2011, the European Medicines Agency's or EMA Committee for Medicinal Products for Human Use (CMPH) - the European version of our FDA - rejected Merck's application for marketing approval of Cladribine (Movectro) for use in patients with MS.

Below is Merck's press release as published on Fierce Biotech.

Merck Receives Complete Response Letter From FDA on Cladribine Tablets New Drug Application

By Erica Teichert
Created Mar 2 2011 - 9:08am
Darmstadt, Germany, March 2, 2011 - Merck KGaA announced today that it received a complete response letter from the U.S. Food and Drug Administration (FDA) on the new drug application (NDA) for Cladribine Tablets, Merck's proprietary investigational oral formulation of cladribine, as a therapy for relapsing-remitting multiple sclerosis (MS).

A complete response letter (CRL) is issued by the FDA when the agency's review of a file is complete and the application cannot be approved in its present form. In the complete response letter, the FDA concluded that substantial evidence of Cladribine Tablets' effectiveness was provided by the CLARITY1 study. However, the FDA has requested the Company provide an improved understanding of safety risks and the overall benefit-risk profile either through additional analyses or by additional studies. Merck intends to request an end-of-review meeting with the FDA to clarify next steps and to identify whether data from completed and ongoing clinical studies can address the Agency's questions.

"Our commitment to transform the way people living with MS approach their therapy options remains steadfast," said Fereydoun Firouz, President and CEO of Merck's U.S. subsidiary EMD Serono, Inc. "We look forward to working with the FDA to address the safety issues in its letter and will continue to move toward identifying a potential path that provides patients and physicians the opportunity to have access to Cladribine Tablets in the treatment of MS."

Merck remains committed to completing the ongoing clinical trials with Cladribine Tablets. These trials, which are fully enrolled, will provide additional information on the efficacy and safety of Cladribine Tablets in MS. Top-line results from the CLARITY EXTENSION and ORACLE MS2 studies are expected by the end of 2011. Top-line results from the ONWARD3 study are expected in the first half of 2012.

Cladribine Tablets are approved and available under the trade name Movectro® in Australia and Russia as a treatment of relapsing-remitting MS and are under regulatory review in other countries.

1 CLARITY: CLAdRIbine Tablets treating MS orallY
2 ORACLE MS: ORAl CLadribine in Early MS
3 ONWARD: Oral Cladribine added oN to interferon beta-1a in patients With Active Relapsing Disease

About Cladribine Tablets
Merck Serono's oral formulation of cladribine (Cladribine Tablets) is an investigational treatment for patients with relapsing forms of multiple sclerosis (MS). Cladribine is a small molecule that may interfere with the behavior and the proliferation of certain white blood cells, particularly lymphocytes, which are thought to be involved in the pathological process of MS. Cladribine Tablets were approved in Russia in July 2010 and in Australia in September 2010 as a treatment of relapsing-remitting MS and are under regulatory review in other countries.

The clinical development program for Cladribine Tablets includes:

- The CLARITY (CLAdRIbine Tablets treating MS orallY) study and its extension: a two-year Phase III placebo-controlled trial designed to evaluate the efficacy and safety of Cladribine Tablets as a monotherapy in patients with relapsing-remitting MS and the CLARITY EXTENSION two-year Phase III study designed to provide data on the long-term safety and efficacy of extended administration of Cladribine Tablets for up to four years.

- The ORACLE MS (ORAl CLadribine in Early MS) study: a two-year Phase III placebo-controlled trial designed to evaluate the efficacy and safety of Cladribine Tablets as a monotherapy in patients at risk of developing MS (patients who have experienced a first clinical event suggestive of MS). This trial was announced in September 2008.

- The ONWARD (Oral Cladribine added oN to interferon beta-1a in patients With Active Relapsing Disease) study: a Phase II placebo-controlled trial designed primarily to evaluate the safety and tolerability of adding Cladribine Tablets treatment to patients with relapsing forms of MS, who have experienced breakthrough disease while on established interferon-beta therapy. This trial was announced in January 2007.

- The PREMIERE (PRospective observational long-term safEty registry of Multiple sclerosis patIEnts who have participated in CladRibinE clinical trials) registry: an eight-year observational safety registry of patients who have participated in Cladribine Tablets clinical trials, designed to support the evaluation of the long-term safety of Cladribine Tablets in MS.

About multiple sclerosis
Multiple sclerosis (MS) is a chronic, inflammatory condition of the central nervous system and is the most common, non-traumatic, disabling neurological disease in young adults. It is estimated that approximately two million people have MS worldwide. While symptoms can vary, the most common symptoms of MS include blurred vision, numbness or tingling in the limbs and problems with strength and coordination. The relapsing forms of MS are the most common.

Tuesday, March 1, 2011

How Are You Using Technology for Health?

If you are reading this, then you use technology (your computer) for health reasons.  Interacting on health-related blogs and in forums are ways in which people have been using online technologies for years. 

But do we know how people are using these and other technologies?  WEGO Health is conducting a study on people’s use of new technologies for health and they need your voice to understand the potential of technology to empower patients.

I completed the survey and suggest that you do the same (if you are interested).  The survey which closes on Friday, March 4, 2011 will take about 10 minutes (you can stop anytime & come back later).  

All completed survey responses will be entered into a drawing to win an iPad, one of three iPod Touches or one of 200 iTunes gift cards.  Everyone will receive a report on the survey findings.

This survey won’t be open much longer, so jump in now!

Take WEGO Health’s Health Technology Survey: http://svy.mk/eJvSow