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söndag, augusti 17, 2014

About MS on Swedish wireless

In a Swedish radio channel they have a program called Kropp och själ – Body and Soul. Last time it dealt about multiple scherosis and the development in the therapy which has happened during the last decades. Today there are persons who have been treated with interferon for 25 years (Medscape ). The immune modulaters have changed how we look at MS.
The first autologous hematopoietic stem-cell transplantation in Sweden happened some 10 years ago. The patient's name was Ida Berner. She had a very aggressive MS with great limitations in what she could do and the progress was very fast. After the autologous hematopoietic stem-cell transplantation she regained health rather quickly and she is now ten years later without symptoms ( sometimes she can feel something in a toe).
Jan Fagius who was her doctor said that today there have been 60 similar procedures in Sweden with good results. The majority has no symptoms and among those who have had one relapse nothing has happened after that so the result for them is also good.
Jan Fagius says that he looks att autologous hematopoietic stem-cell transplantations almost as a cure for MS. He says that the procedure is so safe that you could now start doing this to the next category of patients in the pyramid. Those people who today are treated with Tysabry. It is the same risk today. The difference is that with autologous hematopoietic stem-cell transplantation the complications happen immediately but with the immune modulators the complications could come later on. Thomas Olson professor att the Karoliska Institute said that one could handle the risks with the immune modulators for example Tysabri better today.

In parethesis – from a scientific point of view- it is an interesting phenomenom how they look att autologous hematopoietic stem-cell transplantation . There are no controlled studies but still they talk about it as a cure. If you compare it with professor Swank's studies with diet and MS. There you have a little bigger group and a control group but still most MS specialist take no notice of it. To do double blind with Swank's diet and autologous hematopoietic stem-cell transplantation are impossible- but of course. You could hardly hide from people what they eat for a long time and from an ethical point of view you cannot make a sham procedure with autologous hematopoietic stem-cell transplantation . What you can compare are people who have had another therapy or no therapy at all. ( but not placebo).
I also miss a holistic view. The life style factors matter. I have written about international wellknown MS specialists who have talked about that, among others Patricia Koyle, when she talked about progressive MS. It is also a little outdated information when they say that the immune modulators do not help if you have a progressive form of MS. The truth according to Koyle is that you cannot find that informations in the studies. They are too short and you do not have good method do measure the progression. Many specialist say that you have progressive MS with inflammation and progressive MS without inflammation. And those with inflammation could be treated with immune modulaters with a good effect

The program left the persons with a progressive MS without hope but as far as I know there is a lot of research about new and old drugs and progressive MS. And the life style factors are important here. Physical activity, diet, excercise, weight reduction, no smoking, stress reduction are important. If one follows Jelineks Overcoming MS programme it seems to help people with progressive forms of MS at least according to the book Recovering from MS. And some of those people are possible to reach with the modern communication means.
Thomas Olsson talked about genes and MS. People in Northern countries has specific genes which make them biased to develope MS. But this declaration does not wipe away the vitamin D hypothesis. The same relation to the exposition of sunlight exists in Australia.

The patient association of people with neurological diseases talked about the differences in the possibilities to get medications in Sweden. Sweden is divided in some districts where local governments decides what sort of therapy you get. And this can be very different. One of the Swedish parties the Christian Democrats have proposed that all health care should be run by the state. This is a good idea- at least it should be controlled by the state.

4 kommentarer:

  1. Anonym1:44 em

    Hej! Du skrev tidigare om osteoporos. Symtom och kroppsundersökning, hos läkare borde kunna räcka för att ställa en diagnos. När det syns på röntgen, kan det vara för sent.
    Min fråga är då, stämmer detta? De läkare jag hittils har träffat på tex. vårdcentral verkar inte vara särskilt skarpögda, och har inte mycket kroppskännedom. Och, det är de som ska ställa diagnos. En sjukgymnast, massör, kiropraktor som ofta har kroppskännedom -har ju ingen tyngd, i sjukvården, som det ser ut i dag, tyvärr. De får inte skriva remiss eller ställa diagnos. Vad lär sig läkare på sin utbildning kan jag undra, i bland? Det blir teoretiska kunskaper mycket, och allt går inte att mäta, i kroppen. Som patient blir jag frustrerad. Jag blir aarrggh...
    /C

    SvaraRadera
    Svar
    1. Det var om artros jag skrev detta. Det mesta är inspirerat av läkartidningens temanummer om artros: http://www.lakartidningen.se/Klinik-och-vetenskap/Klinisk-oversikt/2014/05/Dags-for-en-modern-syn-pa-artros/
      sune överhagen

      Radera
    2. Du undrar också vad läkare lär på sin utbildning. Visst blir det mycket teori-givetvis. Idag är utbildningen annorlunda än då jag gick men min utbildning innehöll mycket patientkontakt och jag tror inte det har minskat idag, snarare får man börja tidigare idag. Problematiken som du nämner har nog andra orsaker.
      hälsningar
      sune överhagen

      Radera
  2. Anonym11:41 fm

    Ok, det var kanske artros du skrev om. Min poäng var dock, att många yrkesgrupper som är bra på kroppskännedom; tex. kiropraktor, sjukgymnast, massör etc. -inte har någon tyngd, i den svenska sjukvården. Och jag tycker att det är fel. Det är fyrkantigt i sjukvården, och läkarna känner sig antagligen bakbundna av myndigheters regler etc. Jag vet inte, vad det är för andra orsaker, du syftar på?
    /C

    SvaraRadera