• anxiety,
• insomnia,
• fear,
• dizziness
• facial flushing
• headache; increased sweating
• mild nausea
• pain
• swelling, or redness at the injection site
• stomach pain or bloating
• vomiting (sometimes quite severe resulting in electrolyte imbalance)

Allergic reactions:

• anaphylactoid reaction
• anaphylaxis
• swelling beneath the skin.

Bradycardia,

• If you have bradycardia, your brain and other organs may not get the supply of oxygen they need. As a result, you may experience these bradycardia symptoms:
• Near-fainting or fainting
• dizziness
• weakness
• fatigue
• shortness of breath
• chest pains
• confusion or memory problems
• easily tiring during physical activity

Cardiac arrest,

• cardiac arrhythmias
• cardiac enlargement
• circulatory collapse
• congestive heart failure
• fat embolism
• hypertension
• hypertrophic cardiomyopathy  (associated with thickening of the heart muscle, most commonly at the septum between the ventricles, below the aortic valve. This leads to stiffening of the walls of the heart and abnormal aortic and mitral heart valve function, both of which may impede normal blood flow out of the heart.)
• myocardial rupture  (or heart rupture) is a laceration or tearing of the walls of the ventricles or atria of the heart) following recent myocardial infarction,
• pulmonary edema
• syncope
• tachycardia
• Formation in a blood vessel of a clot (thrombus) that breaks loose and is carried by the blood stream to plug another vessel.
• thrombophlebitis, (occurs when a blood clot causes swelling in one or more of your veins, typically in your legs. Rarely, thrombophlebitis (sometimes called phlebitis) can affect veins in your arms or neck

Vasculitis (Vasculitis is an inflammation of your blood vessels. It causes changes in the walls of your blood vessels, including thickening, weakening, narrowing and scarring.)

Allergic dermatitis

• burning or tingling (especially in the perineal area after intravenous injection),
• cutaneous and subcutaneous atrophy,
• dry scaly skin,
• ecchymoses (the passage of blood from ruptured blood vessels into subcutaneous tissue, marked by a purple discoloration of the skin)
• petechiae
• edema,
• erythema, (inflammation of the fat cells under the skin characterized by tender red nodules or lumps
• hyperpigmentation,
• hypopigmentation,  loss of skin color.
• Impaired wound healing,
• increased sweating,
• rash,
• sterile abscess striae,
• suppressed reactions to skin tests
• thin fragile skin,
• thinning scalp hair
• permanent baldness
• hives

Endocrine:

• Decreased carbohydrate and glucose tolerance,
• Development of cushingoid state, ( It includes a moon face, a prominent dowager’s hump at the lower neck and upper back, and purple streaks on the skin of the abdominal wall.)
•  Gycosuria (sugar in the urine)
• Hirsutism (excessive growth of thick dark hair in locations where hair growth in women usually is minimal or absent .)
• Hypertrichosis: ( abnormal amount of hair growth on the body
• increased requirements for insulin or oral hypoglycemic agents in diabetes
•  manifestations of latent diabetes mellitus
• menstrual irregularities,
• secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness),
• suppression of growth

Fluid and electrolyte disturbances: Congestive heart failure in susceptible patients, fluid retention, hypokalemic alkalosis, potassium loss, sodium retention.

Gastrointestinal: Abdominal distention, bowel/bladder dysfunction elevation in serum liver enzyme levels, enlarged liver, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease), ulcerative inflammation of the lining of the esophagus, esophagitis,candida infection.

Metabolic: Negative nitrogen balance due to protein catabolism.

Musculoskeletal:

• Aseptic necrosis of femoral and humeral heads: (bone death caused by poor blood supply to the area. It is most common in the hip and shoulder, but can affect other large joints such as knee, elbow, wrist and ankle. joint damage.)
• Loss of muscle mass
• muscle weakness
• osteoporosis
• pathologic fracture of long bones,
• postinjection flare
• steroid myopathy
• tendon rupture
• vertebral compression fractures

Neurologic/Psychiatric:

• Convulsions
• Depression
• emotional instability
• euphoria
• headache
• increased intracranial pressure
• mood swings
• neuritis
• neuropath
• paresthesia
• personality changes
• psychic disorders
• vertigo
• arachnoiditis meningitis
• paraparesis/paraplegia and sensory disturbances have occurred after intrathecal administration.
• You will no doubt be familiar with meningitis: well arachnoiditis is a sort of chronic meningitis of the middle layer. Arachnoid because the layer resembles a spider’s web in appearance. Basically this web becomes tangled when it is chronically inflamed. Scar tissue binds the nerve roots together and this causes pain and numbness/tingling in the parts of the body supplied by these roots(which are effectively the channels of information from the spinal cord to various parts of the body). Of course, this information is both incoming (sensations) and outgoing (movement information to muscles) so another problem is weakness.
• In fact arachnoiditis causes a wide variety of symptoms. The pain is the predominant feature. It is persistent, always there. Generally, sufferers describe it as an intense burning, and they often have intermittent electric shock sensations, as well as muscle spasms which can be very painful. Many people complain especially about burning feet or a feeling of walking on broken glass. Approximately two thirds of arachniacs experience problems with bladder control, sexual dysfunction and/or bowel control. This is obviously highly distressing.
• Another common problem is excessive sweating and intolerance of heat. In this respect (and others) arachnoiditis resembles Multiple Sclerosis.  This devastating condition is incurable. The pain it causes is severe and many sufferers take opiate drugs like morphine on a daily basis to try to gain some relief. Many need to take a whole cocktail of drugs to combat the pain and symptoms like muscle spasms.

Ophthalmic:

• Exophthalmos
•  Glaucoma
• increased intraocular pressure
•  posterior subcapsular cataracts
•  rare instances of blindness

Other: Abnormal fat deposits, decreased resistance to infection, hiccups, increased or decreased motility and number of spermatozoa, injection site infections following non-sterile administration, malaise, moon face, weight gain.

Seek medical attention right away if any of these SEVERE side effects occur when using Solu-Medrol Solution:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody, black, or tarry stools; changes in body fat; changes in menstrual period; chest pain; fainting; fever, chills, or sore throat; increased hunger, thirst, or urination; mental or mood changes (eg, depression, personality or behavioral changes); muscle pain, weakness, or wasting; seizures; severe nausea or vomiting; shortness of breath; slow, fast, or irregular heartbeat; slow wound healing; stomach pain; sudden, severe dizziness or headache; swelling of the feet or legs; tendon, bone, or joint pain; thinning or discoloration of the skin; unusual bruising or bleeding; unusual skin sensation; unusual weight gain; vision changes or other eye problems; vomit that looks like coffee grounds.

Due to the number of people in the area requesting information about CCSVI and “the Liberation Procedure” (their term, not mine), this eclectic group was put together to gain insight. Four of us were part of the same study who all had well documented diagnosis of Multiple Sclerosis and unbroken chains of medical records. I had been diagnosed earlier than the other three. I was also born well before the others. I have a recording of the entire proceedings but I wanted to share a couple of observations. After a brief presentation by DRs. James and Montalbano, one of the neurologists began to reduce the entire venous connection to MS as a pipe dream not based in any logical scientific study. I began to wonder why I was there. Apparently so did one of the doctors because he said, “your presence is not necessary as we have copies of your records, written by other physicians. We cannot expect “patients “to understand medical terminology.” The silence was deafening. After about an hour, in reality about 15 seconds, I said, “If I may, I would be most willing to explain why patients are important in making their healthcare decisions in concert with their own physicians. Have you read our records, sir?”  The hematologist of all people said she would be interested in asking some questions. Finally we were getting somewhere as all of us answered their concerns very well in my opinion.

After about 15 minutes, Dr. Ego felt he could conclude the session by dazzling us with his superior knowledge of Multiple Sclerosis. I have to admit it was impressive, though it didn’t appear that the other doctors understood half of what he said. Finally I said, “How can you discount what you see before you? Two of us are considered to have SPMS. Neither of us use a wheelchair or cane. You can see the remarkable difference in my records of two years ago and today, including all of my MRI’s and reports. Aren’t you even curious?” Someone said, “Would you submit to a neurological exam?” I agreed and she asked me to come up front. I was standing in the front of all the brass when I realized that the neurologist who wanted to examine me was one of my old neurologists. I had not seen her for at least 8 years. She was quite thorough, even having me take off my shoes and glasses. She never smiled. I was getting nervous. When she was finished, they all agreed that I “appeared” to have no clinical signs of MS. Finally Dr. Rivers said, ” I was this woman’s neurologist many years ago. She had RRMS. I read her chart and wanted to be here to see for myself. She went on to explain the MS symptoms I had as her patient. When there was an objection, she said,” I have never seen this level of improvement in an MS patient. After reading the doctor notes of successive physicians, and her severe level of disability two years ago, I concede that this dimension into the causal factors of MS demands more consideration.”

I went back to my seat, without my shoes. I would have to do something stupid! All in all, I think some progress was made. I mentioned Dr. Hubbard and his willingness to speak with them. I left them with contact information and website links. The young woman next to me ran and got my shoes.

Pharmaceutical companies run the most profitable business in the United States. It is the only Western country where direct to consumer advertising for drugs is allowed. They invent physical and mental illnesses to provide medications for them. Prescription drugs are now the first leading cause of accidental death, more than all automobile accidents combined. We consume 60% of the world’s prescription drugs. The use of depression medications has increased 400% in the past two decades. For all their protestations to the contrary, physicians are wined and dined to endorse the drug companies’ products. Kickbacks and under the table payments are made every day to the doctors whom we entrust our lives and that of our spouses and children.

Seraquel is the leading drug prescribed for Bi-Polar disorder yet it takes 49 seconds to list the possible side effects, some fatal. Yet it earned a whopping 4.4 Billion dollars last year. One in Five Americans take at least one prescription medication a day for mental disorders.
Adderall which technically is legal “speed” is prescribed daily to children for ADHD. Marijuana is far safer than Adderrall for adolescents .

In addition, the FDA sworn to protect us from Big Pharma are in their back pocket:

http://healthwyze.org/index.php/component/content/article/576-fda-blocked-suicide-warning-for-anti-depressants.html

The normal level of blood oxygen fluctuates between 95% to 100%, for any normal adult. Smokers can hover around 92%. Anything less than 85% to 90% means that you need to wear an oxygen mask.

In cerebral hypoxia, sometimes only the oxygen supply is interrupted. This can be caused by:

• Breathing in smoke (smoke inhalation), such as during a fire
• Carbon monoxide poisoning
• Chronic Cerebro-Spinal Venous Insufficiency
• Choking
• Diseases that prevent movement (paralysis) of the breathing muscles, such as  amyotrophic lateral sclerosis (ALS)
• High altitudes
• Pressure on (compression) the windpipe (trachea)
• Strangulation

In other cases, both oxygen and nutrient supply are stopped, caused by:

• Cardiac arrest (when the heart stops pumping)
• Cardiac arrhythmia
• Complications of general anesthesia
• Drowning
• Drug overdose
• Injuries to a newborn that occurred before, during, or soon after birth
• Stroke
• Very low blood pressure( Hypotension)

Brain cells are extremely sensitive to a lack of oxygen. Some brain cells start dying less than 5 minutes after their oxygen supply disappears. As a result, brain hypoxia can rapidly cause severe brain damage or death.

• Change in attention (inattentiveness)
• Poor judgment
• Uncoordinated movement

Symptoms of severe cerebral hypoxia include:

• Complete unawareness and unresponsiveness (coma)
• No breathing
• No response of the pupils of the eye to light

Chronic hypoxia,

• clinical depression

• Restlessness
• Anxiety
• Disorientation,
• confusion,
•  lassitude
• listlessness
• Headaches
• confusion
• short term memory loss

• persistent mental and physical fatigue
• sluggish mental responses
• loss of ability to perform physical tasks
• pulmonary hypertension (PH)
• right heart failure
• Polycythemia (High Red Blood Cell Count)
• interferes with endothelium-derived nitric oxide-dependent vasodilation
• Tachycardia (increased rate of heartbeats, more than 100 per min)

Our “progressive” society still attaches a stigma to people who suffer mental health issues. In truth, diabetes, cardiac problems, or any other major medical concern is caused by the same factors as major depressive disorder.

No laboratory test has been found to be diagnostic of this disorder. Sleep EEG abnormalities are evident in 40%-60% of outpatients and in up to 90% of inpatients with this disorder.

1. Major Depressive disorder can be hereditary and it is not uncommon for people with it having family members with major depression or bi-polar disorder. It is not caused by trauma, poor self esteem, lack of character or self perceived weakness. It took me many years to realize this in my own life. Patients who have a chronic disease can develop a reactive depression, but in the MS population the incidence is much greater than what you would expect, comparing it with other chronic-disease processes. It is a manifestation of the disease due to MS activity, which actually causes a chemical change that leads to depression. Clinical depression goes beyond a few bad days.  Technically defined one must have a number of these symptoms:

   -depressed (or irritable) mood most of the day nearly every day
   - diminished interest in pleasure and activities
   - significant weight loss or gain
   -  insomnia or hypersomnia
   - agitation or, alternately, sluggishness or complaints of fatigue
   -  feelings of worthlessness or excessive or inappropriate guilt
   - diminished ability to think, or an inability to make decisions
   - recurrent thoughts of death or interest in/plans for suicide

1. Stress is a major factor in depression. The stress of dealing with a diagnosis of a chronic disease and the possibility of disability can bring on depression.
2. The disease process of MS may cause depression. If MS damages areas of the brain that are involved in emotional expression and control, a variety of behavioral changes can result, including depression.
3. Depression may also be associated with MS-related changes that occur in the neuro endocrine or immunesystems.
4. .Depression can also be a side effect of some medications.

While MS is not depression, its consequences can certainly make people depressed. Depression can result from the personal and social losses that come with MS symptoms. Weakness, clumsiness, reduced mobility, restricted movement — all these things can cause depression. We value our capacity to move with energy and ease very highly.  Sometimes these changes cause other losses, like jobs, well-loved activities, hobbies, even friends, companions, or spouses who turn out to be less loyal and caring then we had hoped. Losing any one of these things can trigger depressed days that can escalate into a major depression. Even the threat of these kinds of losses is enough to depress many of the newly diagnosed.

PwMS often go through a period of grieving. They may grieve the losses they experience due to MS, such as walking or working. This mourning may look like depression. However, grief eventually goes away on its own.

Clinical depression is a serious condition that can last from at least two weeks to several months. It produces flare-ups known as “episodes.”

Symptoms of depression appear to be more common in people living with MS. Symptoms of depression may also be associated with some MS treatments. If you experience symptoms of depression or have thoughts of death or suicide, contact your doctor immediately.

Symptoms of a major depressive episode:

1. Sadness
2. Loss of interest or pleasure in everyday activities
3. Loss of or increase in appetite
4. Insomnia or sleeping too much
5. Agitation or slowing in behavior
6. Fatigue (feeling of tiredness)
7. Feelings of worthlessness or guilt
8. Problems with thinking or concentration
9. Ongoing thoughts of death or suicide

Depression does not mean that you are “weak, crazy, or unworthy” You should not feel ashamed about being depressed or feel the need to hide it. You cannot control or prevent depression, but it is very treatable.

1. Talk openly about your feelings so those close to you can learn how best to support you.
2. Allow for two-way communication. Regular family meetings are a good outlet for communication.
3. Reach out to a friend if you need help.
4. Spend time with others.
5. Connect with other PwMS/CCSVI
6. Get involved in the community.
7. Find time to relax.
8. Exercise
9. Be careful of eating comfort foods. They add empty calories, cause unneeded weight gain. If you are like me, comfort foods always include sugar and carbs which serve to worsen our vascular condition.
10. Laugh, and surround yourself with others who do. Facebook may not be the only place you need to weed through your “friend” list. Avoid toxic family members as much as possible. If your spouse, parent or other loved ones aren’t helpful in this area, educate them or make some hard choices.
11. Try to focus on the positive

Medication for depression in PwMS according to one study may not be as effective as it is in other chronic illnesses. Serotonin reuptake inhibitors like Zoloft, Paxil, and Prozac may help some. Older tricylic antidepressants like Imiprimine and Amitriptyline sometimes work better for those who don’t tolerate the others well. The drug companies refer to these as “dirty drugs” because they are no longer the profitable meds they once were. An added benefit for them is they often help with pain management; another by-product of serious depression. A sober talk with your doctor is crucial to find what combinations of treatment options will work best for you. Drugs are not a panacea for depression and are probably prescribed far too often for less serious forms of depression. There is no “happy pill”. However, there is no more reason to avoid them than their is avoiding insulin if you are diabetic. (For example, I am diabetic and also suffer from major depressive disorder.)

Episodes of this disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Stressors may play a more significant role in the precipitation of the first or second episode of this disorder and play less of a role in the onset of subsequent episodes. Chronic medical conditions like Multiple Sclerosis and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of this disorder.

Completed suicide occurs in up to 15% of individuals with severe Major Depressive Disorder. There is a fourfold increase in deaths in individuals with this disorder who are over age 55. Individuals with this disorder have more pain and physical illness and decreased physical, social, and role functioning.

A SPECIAL NOTE TO THOSE WHO HAVE BEEN TREATED FOR CCSVI:

Regardless of what improvements you may or may not have received due to your angioplasty and life style changes, you are still a prime target for depressive episodes. The damage done over the years with this condition does not magically disappear. It can take a long while for the brain to adapt to proper blood flow after suffering from hypoxia, medication and even lack of use. In my case, guilt has been a causal factor in depression. Some people mistakenly believe that I remain an advocate for PwMS/CCSVI for self promotion. Ginger McQueen and a few others as well as myself have talked about this in our blogs and posts. It DOES feel nice for people to say positive things about you. Everyone responds well to kind remarks. I hope that ego has not been a factor in my advocacy, but I am certain that guilt has prompted me to remain online and attend meetings, etc. It doesn’t seem fair that some people have spent an enormous amount of time money and emotional investments into getting well only to have little or no improvement. After talking with several dozen people who like myself have had substantial recovery in the quality of their lives, I see a common thread through all of them: Guilt. Feeling guilty for something over which you have no control is counter-productive and in itself can worsen depressed feelings.

One friend of mine was married for 20 years to a man who was able to support and love her throughout her increasing disability. They divorced about 6 months ago because they could not deal with her recovery. As supportive as my own family has been, the last year and a half has been a real struggle as I have tried to find my place in the family again. Chronic illness creates anger toward the ill person by spouses, parents, friends and children alike. It is a normal human reaction that many people refuse to acknowledge. The longer the disability as well as the severity has a profound effect upon relationships. My family and I never expected to see me out of a power chair again or be able to interact as I had before MS became a part of my life. We were resigned to what we had, period. Over the years they adapted to doing for themselves what I had done for them in the past. Now the tables have turned and it has taken time to adapt again to the more vibrant and healthy person I have become. As an A personality, I no longer want to be dependant. All of these things add to the stress that is so devastating to PwMS/CCSVI. It took 17 years for me to bottom out with my disabilities. Just as my body and brain are still healing, so is my emotional self.