STORY BYThis Saturday, John Rittman will join more than 14,000 cyclists riding 150 miles from Houston to Austin in the MS 150. The popular bike tour raises millions annually for Multiple Sclerosis research.
It's a cause the 36-year-old former bike messenger knows all too well. Three years ago, Rittman was diagnosed with a debilitating and progressive form of MS. But buoyed by hope and treatment, he plans to cross the finish line.
"When I was first diagnosed, I didn't think I would ever ride a bike again," Rittman says. The disease affected his vision and gave him vertigo and muscle weakness, making cycling too dangerous. Rittman needed a cane to walk.
Now, treatment with the drug beta-interferon enables Rittman to resume a part of his life he thought he would have to leave behind.
"Not being able to ride a bike was the one thing that really killed me with my diagnosis," Rittman says. "With treatment, eventually I started to ride again. Biking gives me a mental freedom that I really enjoy."
Bit by bit, or all at once, MS takes away a person’s physical freedom. The disease can cause vision problems, affect a patient's ability to walk and cause loss of bladder control. Some patients experience symptoms as attacks, and later go into remission and have periods with no symptoms at all. For other patients, the disease is progressive, and their symptoms will worsen over time. An estimated 400,000 people in America have MS.
What causes MS is still somewhat of a mystery. Researchers think that it may be an autoimmune disorder, in which the body attacks its own nervous system. A virus may trigger the disorder in certain people who have a genetic sensitivity to MS. However, there is no evidence that the disease is directly inherited.
Rittman says support was an essential part of
his dealing with his diagnosis. He recommends
participating in support groups and activities for
MS patients.
"When I was first diagnosed and had to walk
with a cane, I was very upset," Rittman says.
"So I got involved with an MS art group that
offers art therapy. It was nice to talk to other
people and share with people like me, because
it is not a very common disease. I also took an
MS yoga class. That really helped me relax and
the exercise is good treatment for your body."
For information on support groups or MS
related activities in your area, contact the Lone
Star Chapter of the National MS Society at
1-800-FIGHT-MS or visit the chapter's website
at:
http://www.nationalmssociety.org/txh/home/.
What we do know is that the disease damages the myelin sheath, the covering that protects the nerves from damage. In some cases, MS damages parts of the nerves themselves. MS can affect almost any part of the body.
"Just imagine, anything that the central nervous system controls is fair game to MS and loss of function," says Dr. Jerry S. Wolinsky, a professor of neurology at The University of Texas Medical School at Houston. "So, vision, balance, walking, sensation, bladder control -- a whole variety of things can be affected. Because MS hits part of the nervous system in a random fashion, the symptoms can be quite variable from one episode to another."
Attacks can come seemingly from out of the blue. Rittman was relishing his hard-riding, harder-partying lifestyle, when his first attack stopped him cold.
"I had felt some tingling in my legs and thought my knee had problems, but I ignored it," Rittman says. "Then one day I just fell over while walking."
While there is no cure for MS, treatment with "disease-modifying drugs" can help reduce the number of days a person with MS might have an attack. The drugs can also help reduce or eliminate damaged areas of the central nervous system, called lesions. Treatment works best when started soon after a patient is diagnosed, and before the disease has a chance to cause much damage.
Three classes of drugs are currently approved by the U.S. Food and Drug Administration to treat MS. Beta-interferon (Avonex, Betaseron and Rebif), and Copaxone (glatiramer acetate) modulate the immune system. Patients can inject the drugs themselves. Mitoxantrone (Novantrone) suppresses the immune system. The chemotherapy drug was originally developed to treat cancer patients. Patients receive the drug through an IV infusion in a medical setting.
Researchers are studying whether using a combination of both beta-interferon and glatiramer acetate may be more effective than using one drug alone. The two drugs modulate the immune system differently, so the hope is that they will complement each other. To find out, Wolinsky is recruiting patients for an 80-center study on the drug combination. The study is funded by a $30 million grant from the National Institutes of Health, with the lead center at Mt. Sinai Medical Center in New York in collaboration with the University of Alabama at Birmingham and here at UT Medical School. The goal is to enroll 1,000 patients in the study. Wolinsky is co-principal investigator.
Study centers will also collect DNA samples from participants to find genes that are regulated by both medications. This information can help doctors determine which treatments for MS will work best on individual patients. Finding the right drug and proper dosage is a process of trial and error that can take years of tweaking.
New classes of drugs are also being developed to treat MS. Unfortunately, one of the more promising new drugs, Tysabri, was taken off the market in February because of safety concerns. The loss of Tysabri was, "a disappointment," Wolinsky says. But he is hopeful about the future of MS treatments.
"There are eight different classes of drugs which are orally active, that are coming down the pipeline," Wolinsky says. "It is a very exciting time for MS research. When I started treating MS, the big debate was whether to even tell patients that they have the disease, because there was nothing we could do about it."
Though realistic about the physical challenges MS still has in store for him, Rittman is also hopeful for the future. He looks forward to more cycling, but most of all to watching his 9-month old daughter grow.
"MS is not a death sentence," Rittman says. "It is just something you have to learn to live with. You've got to live life while you've got it."
UPDATED: 4-12-2005
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Dr. Jerry Wolinsky is a professor of neurology at the UT Medical School.
See Dr. Wolinsky also at:
Food Irradiation
and Safety
On August 22, 2008, the Food and Drug Administration (FDA) published a final rule that allows the use of irradiation to make fresh iceberg lettuce and fresh spinach safer and last longer without spoiling.
Irradiating fresh iceberg lettuce and spinach will help protect consumers from disease-causing bacteria such as Salmonella and Escherichia coli O157:H7 (E. coli). Illnesses from these bacteria range from uncomfortable symptoms to life-threatening health problems.
The foods affected by the final rule are
Irradiation (also sometimes termed "ionizing radiation") is a process of treating products with a measured dose of radiation. Food irradiation is not new. FDA has conducted irradiation safety evaluations for more than 40 years and has determined the process to be safe for use on a variety of foods.
After studying the safety of irradiating fresh iceberg lettuce and fresh spinach, FDA has determined that these greens, when irradiated under the conditions specified in the final rule, retain their nutrient value and are safe to eat.
FDA considers irradiation a complement to, not a replacement for, proper food-handling by producers, processors, and consumers. Irradiation is just another tool to reduce the levels of disease-causing microorganisms on fresh iceberg lettuce and fresh pinach.
Irradiation does not take the place of washing. FDA continues to recommend that consumers wash fresh and bagged produce before eating unless the packaging specifically states that the product has been pre-washed.
For more information, go to: http://www.fda.gov)
