Sleuthing My MS: What Dunit?
You know when some entirely unrelated medical condition you have gets treated and the treatment makes your MS symptoms better? I love it when that happens. I do! But I can rarely sit back and enjoy the bliss for very long. I just gotta find out why it happened.
As I mentioned in one of my previous essays titled “Moving into Menopause with MS: Double Your Pleasure, Double Your Fun”, starting hormone therapy for my menopausal hot flashes greatly relieved my MS heat intolerance and cog fog. And that is still the case. After that, however, something really interesting happened.
I started bleeding in July, eleven months into menopause. My gynecologist scheduled a hysteroscopy. I received I.V. sedation and general anesthesia. He found and removed a uterine polyp and performed a D & C. But that is not the interesting thing that happened.
I had surgery in the morning; for the rest of that day and for several days thereafter, I felt like a million bucks. Not only did I have zero post-surgery pain, my MS symptoms dramatically improved. I had more energy and stamina, my balance improved and I could walk better. The double foot drop I’d been fighting all summer disappeared. No more spine and abdominal pain. Leg spasticity smoothed out, freeing my left hip. I could stay on my feet longer and complete a task all at once without taking rest breaks.
Naturally, my first question was: What did they put in that sedation cocktail? I told my neurologist what happened and she wondered if they’d given me a steroid. I called anesthesiology and was told no, only fentanyl and Versed. What’s more, they’ve seen MS patients come out of surgery with either worsened or improved disease symptoms. “You have relapses and remissions. It’s just the nature of your disease,” the doctor surmised.
Momentarily, my gumshoe investigation came to an abrupt end. Wouldn’t it be nice if solving the mystery of our strange ups and downs could be as easy as playing a game of Clue? By the end of the game you know the butler killed Colonel Mustard in the library with a candlestick. But so many of our MS crime investigations will go unsolved. We are all cold cases, the mysteries solved only after we make it to the autopsy table.
Of course, my brain didn’t stopped working this through. Quickly I abandoned my sedation drug hypothesis for a new one. Did having the surgery spike my serotonin and dopamine levels? If so, can I recreate that effect by taking an SSRI antidepressant such as citalopram? My neurologist was open to that, but she wanted to backtrack first. “Let’s start you on prednisone and see if that makes your symptoms better.” Yes, I thought, we were definitely on the same page. I suspected that I might have been in a mild relapse prior to surgery.
I started on 80 mg, and after taking the very first dose, my energy bloomed once again, leg spasticity quieted, and I became more productive. I enjoyed this improvement throughout the 80 mg and 70 mg days, but when I reduced the dose to 60, my energy began to flag, and increased leg spasticity had me doing the palsied rooster walk to the bathroom every morning once again. At 40, 30, and 20 mg, headache and abdominal pain sent me to the Tylenol bottle once or twice a day and I fought the urge to nap in the afternoon. I struggled to focus on the tasks at hand and chattered incessantly out loud about anything and everything. I wasn’t quite back to square one, though; some symptoms remained improved.
I’ll soon see my neuro for a follow-up appointment after the taper is finished. We will be discussing antidepressants and other ideas as we continue to gather clues, follow leads, and try meds that will up my game as much as possible.
I’m grateful to be sleuthing with a partner. My neurologist is my trusted sidekick. I’m not sure which detective I am, though. Certainly not Hercule Poirot. He relies on his little gray cells to solve mysteries. Mine probably look a lot like Swiss cheese at this point. We may never determine what happened, but between my neuro’s healthier little gray cells and my tenaciousness, we’ll probably find some ways to make Kim feel a little more comfortable.
And so, as Sherlock Holmes often says: “Watson, the game is afoot.”