Oral lipoic acid, a powerful antioxidant^">i, has been found to reduce the progress of brain atrophy in secondary progressive MSⁱ.

Here is a link to this fascinating paper. http://nn.neurology.org/content/4/5/e374.full.pdf<   The trial was a small one, but the authors hope to conduct larger multicentre trials in the future.

Here is a fascinating paper entitled “Neuroprotective mechanisms of astaxanthin: a potential therapeutic role in preserving cognitive function in age and neurodegeneration.” Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352583/<  The complete paper is available as a pdf. 

Astaxanthin supplementation sounds a good idea.

It is Sarah’s birthday.

She was born in November darkness at five o’clock in the morning in the Bristol Maternity Hospital, at the top of Black Boy Hill, where, coincidentally, I learned midwifery some years later. Five o’clock. The most awkward time of night. She was awkward in her origins. She is awkward now. I think I love her because she’s not compliant.

Anyway, for her birthday we ordered a CD of Conan the Barbarian. Though violent, it has a very fine music score, and the villain (Thulsa Doom) reminds both of us of her Neurologist.

I cooked the birthday-girl lamb’s liver and onions and roast tomatoes. She enjoyed it. Now she sits back with a glass of dry white wine.

David

                                                                                                                    4^th November 2015

Dr ---- -------

Consultant Neurologist

Bedford Hospital

Some people think that C. pneumoniae is just an innocent bystander. I think it is more like this: https://www.youtube.com/watch?v=XcxKIJTb3Hg< 

Doctor Manford Returned to his Chair.

‘I’m sorry: your wife is finished.’

‘Oh. What do you mean?’

‘She’s finished.’ He paused. ‘Get her

To a Nursing Home. I can recommend one.’

‘Thank you. She’s an artist.’

‘That’s all over,’ he said.

‘And now you have a fee to pay,’ he said.

Sarah drew out her cheque-book.

‘How much?’ ‘Sixty Pounds.’

Sarah wrote out the cheque

Somewhat laboriously.

‘You see,’ said the neurologist,

In the past I’ve had to make

Recourse to a debt-collecting agency.

We take our work habitus for granted and assume that others must understand it. I’ve come believe that this is not the case; in my own situation I find that people wonder whether I’m a real medical practitioner. Part of the problem is that the American MD degree is equivalent to a MB ChB in the UK. British MDs are rare. So I thought I would try to clarify matters on my web-page by adding a short resume of how I came to be a medical microbiologist and what the daily work of such a person entails. Please let me know if it can be improved.

I've updated my page on personality changes in persons with MSⁱ. I have often wondered whether these stereotypical changes were due to intoxication with volatile bacterial products behind the blood-brain barrierⁱ.

I've just put an update on my website. If I may I'll copy it here

Nine years ago this month the Consultant Neurologist to whom Sarah was referred, after a history and a thorough examination, took me to one side and told me to prepare for the worst. The disease, multiple sclerosisⁱ, was in a progressive mode and behaving very aggressively. He advised me to look round for a nursing home. Her career as a fine artist was over. He was very frank, and I respect this.

I've been writing a series of poems, which I hope have the mordancy of the artist Francisco José de Goya. Here is one of them:

Goyaesque: a cruel-faced neurologist

told me that my wife was dying, and
told me that I’d have to make arrangements:
he mentioned a nursing-home. He showed us

a stock scan which was not hers, and which
he carried with him. Well; events
turned otherwise. But he never liked her

getting better. She recovered. But he
he never liked her getting better. And when
she sent him images of her later work

he never responded. Ah, well.

As a registered medical practitioner my professional interest is in the treatment of persons with Multiple Sclerosisⁱ. That’s understandable; my wife, Sarah, had developed a very aggressive form of the disease, with the classical frontal lobe disturbances typical of severe illness. She was given a poor prognosis. I found the work of the Vanderbilt people (the patent of Dr Stratton and Dr Mitchell) and treated Sarah with a combination of oral doxycycline and roxithromycin; I later added pulses of metronidazoleⁱ, changing this to tinidazole as it was better tolerated. Supplementsⁱ including antioxidantsⁱ and vitamins B3, B12 and folate^">i were taken. After six months rifampicin was substituted for doxycycline. Sarah made a good recovery following a rather stormy course. C.

Well, I thought I should tell you that I'm retiring from NHS medical practice at the end of the month. I'm nearly sixty and wish to catch up with my writing. If I can find a consulting room for a few hours a week at not too much expense I'll continue to see and treat people with MSⁱ. I'll leave my webpages up, and also my email address.

To be absolutely honest I don't like the way that hospital medicine is going in the UK. Managers are being chosen for their obedience to central dictates, and their ability to enforce them, rather than any brilliance of character. This is saddening. Morale is poor.

I am constantly surprised how incompletely people recall their illness once they have begun to recover. Perhaps the most dramatic example I have come across was a young man in his twenties who was admitted to our Intensive Care Unit with a severe, life threatening soft-tissue infection of the floor of the mouth and the neck, with involvement of the mediastinum. He had classical necrobacillosis (link,<) caused by mouth anaerobes, notably the fusobacteria group. These bacteria produce powerful toxins which include a very potent endotoxinⁱ. We aspirated fluid from his swollen neck and immediately gave a combination of intravenous Co-amoxiclav and Metronidazoleⁱ.

MSⁱ is painted over in pastel shades: people with the early disease often have little idea about what might happen to them. The general population has a skewed notion of the illness as those with aggressive disease fall off the social map and vanish. Here is a medically reviewed quotation from the MS Society of the UK:

"MS is not a terminal illness. However, it is a lifelong condition, so once you have it, you have it for life. Like everyone else, you are most likely to die from natural causes and can expect to have a relatively normal life span."