How Multiple Sclerosis Works

When the immune system mistakes the tissue covering neural connections as foreign invaders, the result can devastate the body. There is hope, however, in a new radical treatment that resets the immune system.

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Episode Transcript

Speaker 1 (00:01):
Welcome to Stuff you Should Know from how Stuff Works
dot com. Hey, and welcome to the podcast. I'm Josh Clark.
There's Charles w Chuck Bryant, Sherry's over there. Their finger
on the button, and this is stuff you should know.

(00:22):
Not the button. Okay, well it's a button. She doesn't
have the nuclear suitcase. It's the button. As far as
we're concerned, that's our nuclear suitcase. Yeah, because we're dropping
bombs every time we drop an episode. That's right. How
are you feeling pretty good? I am. I'm a little, uh,

(00:43):
a little apprehensive about this one. Well, I've been avoiding
this one for years because my uh, one of my
very best friends died from complications of MS oh man
just last year. You failed to tell me that when
I said this one over your way as a suggestion. Well,
you'd sent it before before he died, and I didn't

(01:04):
think I could do it, and I just kind of
feel like, now it's the time, you know. And weirdly,
yesterday was his birthday and no would have been his birthday,
and you did not know that and had sent it
over and it was just kind of one of those
eerie things where I was like, all right, this is
this has got to happen. What's your friend's name, Billy, Well,
this one's for Billy. Yeah, and this will be we'll

(01:27):
pepper his story throughout this. It's very sad stuff. Man. Well,
I'm right here with you. Man. Thank you. Just lead
on me when you need it. I appreciate it. Okay. Uh.
So we are talking multiple sclerosis, or m S as
it's called. UM, and I knew very little about this.
I guess you probably are a lot more familiar with
it than I am. Then, huh yeah, I mean obviously

(01:49):
personally his journey with it, but as we will see, UM,
everyone's journey with MS is different. It is UM. Depending
on what kind you have, and depending on you as
an individual, it can progress in different ways, very slowly,
very quickly. Can be devastating, it can be not it
can be very manageable. Um. He have one of the

(02:10):
worst kinds. So yeah, from what I understand, it's very
fairly rare for someone to die from complications of MS. Right, Yeah,
I mean, I don't know if rare is the word,
but it's definitely not the common outcome. I got you
somewhere between rare and common. I think I got you,
but it's already a fairly rare disease. I think something

(02:32):
like four hundred thousand people in the United States and
I think two million worldwide have it, which I mean
it's a substantial number of people, but in the context
of the larger global and national population, it's not that many.
It is rare, I would guess. Yeah, it's um, just
a little bit of an overview. I guess, um they

(02:53):
call it the prime of life disease. Uh, and it's
very cruel in that way because, um, it most often
likes people between twenty and fifty, but I think even
usually in in you're like twenties. Uh, and that's when
Billy was hit with it, and um, it's uh. I
think more women than men get it, Yeah, by far,

(03:16):
because it's an autoimmune disease, and more women get autoimmune
diseases more, which I didn't know. More Caucasians get it,
and apparently Caucasians of Northern European descent or more likely
to get it. And it's really there's a lot of
mystery about why people get this, Yeah, like, for example,
why Caucasian people more than people with darker skin um

(03:41):
or Also I think part of the same coin why
people who live, you know, away from the equator more
than people who live in the tropics. That suggests that
the sun might have something to do with it. Or
I think one of the things that they've been looking
into lately is vitamin D, which you produce through exposed
sure of this on Yeah, it's really, um a mystery

(04:04):
in a lot of ways. Um. Some people have have
brought up the idea of there are clusters of areas.
Other people have said, you know that's not the case,
uh clusters or bs um you're reading you know your
your reverse engineering a what do you call it? A cause?
I guess stop bringing up clusters basically, h environmental or um,

(04:30):
whether it's environmental or hereditary, don't know for sure. That
would that would suggest that clusters could exist, right, But
the fact that they're not sure if it is environmental
or not, I would think that leaves that cluster thing
open to debate. Yeah, but whether or not you can
it's hereditary, it's up for debate too, because I think

(04:51):
it says the risk for people with parents, siblings, or
children who are diagnoses between one and twenty and one
and forty, whereas it's what one and seven fifty for
the general population. UM obviously got something to do with
heredity or or it could be that you tend to
live with your parents and your siblings, so you would

(05:12):
share the same environments them too. So there's a lot
of mystery surrounding the underlying causes, there really is, and
so much so that they don't even know what is
going on. Well, they do know generally what's going on
on the biological level, but not specifically, right. So, multiple
sclerosis is like you said, it's an autoimmune disease where

(05:34):
your body's immune system attacks your own body. So there's
a number of different ones, Like there's Crohn's disease is
one UM, there's inflammatory bowel syndrome, and they all have
in common that the body is mistaking, or the immune
system is mistaking some part of some normal natural part
of the body as a foreign invader and is attacking

(05:57):
it as such. And in the case of multi pull sclerosis, UH,
the body is mistaking what's called the mile in sheath,
this fatty substance that protects the axons that UM neurons,
that nerve cells communicate between UM. They attack that sheath,

(06:17):
and as they attack that sheath, they start to break
it down, and a basically what amounts to scar tissue
and a type of plaque starts to develop and those
form lesions, and it can happen anywhere on your brain
or your central nervous system. Yeah, that's that's essentially what
multiple sclerosis is. Yeah, those plaques, um, those are that's

(06:39):
called the sclerosis. So literally, multiple sclerosis means you have
multiple plaques this hardened tissue at places on your body. Uh.
And like you said, you know you have the neurons,
which are the nerve cells themselves, and the axons or
the fibers that connect everything wrapped in that sheath and
that sheath it's really it's very basic and cruel how

(07:01):
it acts. You know, any autoimmune disease is just devastating because, uh,
there's just something about the body making a mistake and
turning on it's on an otherwise healthy self. That's just uh,
I don't know, it's hard to hard to wrap your
head around it. It really is, um And one of
the reasons why it's so tragic it is because we

(07:22):
have really no idea how to make the body stop
doing that. And in the case of multiple scores, you
you have a body that's attacking the mile in sheath,
But researchers aren't quite sure exactly what part of the
mile in sheath is triggering the attack, so they can't
tailor drugs to stop the body from doing that. They

(07:43):
just know it's going after milin. Yeah, and the milin
can repair itself if there's damage. But um, the problem
with MS is this, they call it de milonization. It's
happening to too fast basically. Uh. And sometimes it can
be so severe that that those nerve fibers are severed
outright right exactly. It's kind of like if you clear

(08:03):
cut a forest and then before you let the forests
come back, you start cutting down saplings. It's never gonna
come back. Same thing with the mile in chief. Um.
It is difficult to diagnose it first because the early
signs or things like you know, maybe a little dizzy
and may be fatigued. Um, maybe my vision is blurry occasionally. Um.

(08:27):
And it kind of comes and goes to where people
you know think like, oh, maybe it's migraines, maybe it's
some you know, something minor and um. Because it is
not the most common thing, I don't think doctors immediately
are like, well, we need to get you into a
spinal tap, right, And because it doesn't necessarily follow a
strict set of symptoms, you know, you can get those

(08:50):
lesions anywhere, and since their nerve um, they're disrupting or
affecting the nerve signals, they can present in all sorts
of different ways. Right. So, yeah, doctors are frequently stumped
when you present with MS symptoms. Should we take a
break and talk a little bit about the history and
then get back into it. Oh yeah, sure, all right,
let's do it. So historically, ms UM, although it is

(09:37):
new on the described disease front um, obviously it's been
around for a long time and people just didn't know
what the heck was going on. Yeah, there's a saint
that had it, they think, Yeah, back in the Middle Ages,
Saint Ledwena, who's Dutch. And because she was Dutch, she
was ice skating once back in the fourteen the fifteenth century, Yeah,

(10:01):
fourteen thirties, she was ice skating and she fell, and
after she fell she developed um excruciating pain, headaches, trouble walking, paralysis, UM.
And apparently there would be periods where she didn't have
these symptoms and then they would come back. And it
would get worse and then she would not have them again,

(10:23):
which are hallmarks of multiple sclerosis. As we'll see. Yeah,
these attacks are flare ups followed by periods of remission. UM. Yeah,
that's a specific type of MS. Well, yeah, which we'll
get to that. But UM. King Georgia third apparently had
a grandson who had a very extensive diary about his
health until he died, and most people think like he

(10:45):
clearly had ms UM and I believe that. Uh. There's
a couple of decades after that that UM, a doctor
Jean Martin Charcot became the first person at least it
got credit with with describing the disease itself UM, identifying
it and describing it. He's known as the father of

(11:05):
modern neurology. He's popped up in some of our other stuff.
He sounded familiar because he had a woman, a patient
that UM had these symptoms. She eventually died. He dissected
her brain, discovered these lesions and called it scleros en plaque.
And then the malin was UM was discovered after that,

(11:28):
But they didn't they didn't put two and two together
at a time with the island, but it was discovered
after that. So the the plaques in the effect on
the milin um was really first discovered or demonstrated by
Scottish doctor James Dawson, who, thanks to UM better microscopes
than previous researchers that had, he could see, Oh yeah,

(11:51):
these lines of communication between nerve cells and brain cells
are basically being worn down to nothing and in some
case this is broken and um, this is the basis
of MS. I'm James Dawson, goodnight. Yeah, we should do
one on the microscope because it seems like time and
time again we've had like just literally because the being

(12:15):
able to see things smaller has gotten more advanced, like
every time that has taken a leap forward medical science
as Oh, sure, it's really interesting. Plus we'll get to
say Anton von leven hook that bunch. Yeah, we've talked
about him before, right. Yeah. So Dawson, uh described the inflammation,
but they thought it was like a virus or a

(12:36):
toxin running through the bloodstream at the time. Um, they
did for a long time. Actually well yeah, and ironically
in the thirties, UM there were lab mice going hey,
it's autoimmune, right, and doctors were like, oh, don't listen
to the lab results from the slee mice. No, it's
clearly a blood toxin that's doing that. Yeah, So they

(12:57):
sort of were not looking at the evidence right in
front of their faces for a little while until the
nineteen forties, when I think at Columbia University they found
that um these weird protein byproducts and their and their
cerebro spinal fluid. And that was seven and that's kind
of when that's kind of when the doors really opened
and they said, Oh, I think we know what's going on,

(13:18):
and I think we know how we can test for
this right. Right, that established one of the big tests
for for um MS, which is they're looking for so
they go do a spinal tap, right, which is where
they draw a sample of um cerebro spinal fluid from
between your vertebrate um and when they're testing for MS,

(13:39):
they're looking for high levels of I G G immunoglobin,
G antibodies, and something called oglio clonal bands, which are
another type of protein that are immunoglobins. And then they're
also looking for these protein by products that are the
results of myle in being broken down in the cerebro

(14:00):
spinal fluid, which is not supposed to happen. So when
they find all this stuff, they can say this is
probably multiple sclerosis. And since the forties they've they've had
that test, and then starting in about the eighties or nineties,
they also introduced m R I. And when you compare
those two things together and they both suggest MS, you've

(14:22):
got a pretty good MS diagnosis. Yeah, but it, like
you know, like I said, it's a slow process. I
remember Billy, it took a while until they finally landed
on MS for him, and that just kind of seems
to be the way it goes. What were his initial symptoms?
Do you do you remember? You know, like we didn't.
He was a college roommate and we didn't. Um. He

(14:44):
ended up moving to the Billy was. He was a
very unique guy. He he lived life to the fullest
and did not really follow the rules of uh modern man.
Where did he move? He kind of dropped out. He
went to Boone, North Carolina, which is a great place
to drop out and lived in a one room shack

(15:05):
like cabin in the middle of the woods. It's a
great place to do that with the toilet just sort
of in the room, a toilet or a bucket that
was a toilet, had running water and electricity, but it
was a one room thing and I went up there
a few times and stayed with him. But um, we
would like, you know, drink whiskey and shoot guns and
a cross streams on the toilet probably so like Ghostbusters.

(15:29):
So Billy kind of dropped out, and um, this was
before MS. You know, he just did that. You know,
as a he was like a river guide, a whitewater
river guide, and live the life that those dudes live,
which is to say, not being responsible for a lot
and kind of spending a lot of time on the river. Yeah,
it's been a lot of time on the river and
hanging out. Um, so he dropped out, and you know,

(15:52):
didn't have a phone. This was pretty cell phone, so
we weren't in the best touch. This is when I
was post college living in New Jersey. So the memories
of his exact early diagnosis or a little foggy, but
I think I remember like fogginess and uh, dizziness kind
of be in his first warning signs. But he wasn't

(16:13):
the kind of like, oh, well, you know, I need
to run right out to the doctor and see what's
going on. No, And it certainly wasn't the Billy way,
so he you know, he didn't do himself any favors
in the early years, and then when he finally did
find out, he didn't do himself any favors because he
didn't take care of himself and he didn't rehab and

(16:34):
take his medication like you should have and sort of
fell down into a spiral of alcohol and drug abuse
and um which did not help. Like you know, they say,
if you get a diagnosis, you want to you want
to live as clean as you can and work out
and be as physical as you can and really try
and take care of your body to stave off these

(16:56):
physical symptoms. And he didn't do any of that stuff.
And plus the early thing is a really big part
of it too, because again, what's happening is the mile
in sheets around your entire central nervous system or subject
to attack. And so if you can catch this earatly,
you can kind of stave off some of those successive
attacks where if you just ignore it or don't pay
attention to it, it will just get worse and worse

(17:19):
and worse. It's a it's what's called devastating progressive disease. Yeah,
and there's you know, a lot of people keep it
a secret at first because it can um some of
the physical side effects can be embarrassing. I know that
this article mentioned and at Funicello waited for years to
come out, you know, former Disney Mouseketeer, And she didn't
come out until I think there were reports that she

(17:40):
was an alcoholic because they see your stumbling around. Uh,
and it can be confused with things like that publicly
and um and then she said, actually, tabloids, I have MS.
Oh sorry and that and the same with Richard Pryor.
He kept his MS diagnosis a secret for a little while. Yeah,
I remember everybody's Richard Pryor's got tremors because he used

(18:02):
to free base. Yeah, no, turned out MS. Yeah totally.
Muhamma Ali didn't have MS. But I remember people when
Ali's condition got worse, We're like, oh, yeah, that you
know see what that's what happens with boxing. Well, I
think they might be right about that. One was by boxing. Yeah.
I think he had brain plaques from too many from

(18:24):
uh CTE. Okay, for some reason, I thought, I mean
I could be mistaken, but I'm pretty sure that's why
he Uh, he had Parkinson's. I think it was brought
on by all the punches he took. I think, yeah,
I didn't research any of this, so I'm speaking off
the cuff same here, all right, That's that's what we

(18:46):
do well. At any rate. UM people can kind of
keep it a secret for a little while because it
can be a diagnosis can be scary at first when
you get diagnosed with MS because of the unpredictability, and
you sort of have to I remember with Billy, they
were kind of like, we gotta kind of see how
this goes before we know what kind you have, right,

(19:06):
which is fairly primitive as far as medicine goes. So Chuck,
there's UM, there's this article has four kinds. What I
saw is that it's been pared down to basically two. Yeah.
Our article says that there's progressive, relapsing, relapsing, remitting UM,
there is primary progressive, and then secondary progressive. And basically

(19:28):
what I saw is that UM, there's an umbrella group
called UM remitting or relapsing UH multiple sclerosis r MS,
and then there's another kind that is UM, sorry, it's
relapsing multiple sclerosis. And then the other kind is called
primary progressive. Right, And with relapsing MS. You are, you

(19:53):
have MS symptoms, you have basically what amounts to an attack,
right where your symptoms come on and then they subside
after a while. And during the time that they subside,
you're in what's called um remission, right, and then they
come on again, so you're in relapse phase. But during
those two times, your disease is not getting worse, right,

(20:17):
it's not progressing. That's the relapsing type of multiple sclerosis.
The other kinds primary progressive, and they used to call
that one UM yeah, and they kind of folded all
those together. But the one that survived is primary progressive.
And that's basically, like you are, your diseases getting worse

(20:40):
pretty much constantly, and it might be happening fast, it
might be happening slowly, but you have a disease progression
that can be noted by the people in charge of
taking care with care of you. But then during that
you may have small periods where you don't have symptoms,
so you've got a remission, or you have periods where

(21:00):
they come on really strong and it gets really cute,
so you have a relapse. But during this time, during
like say a year or five years or ten years,
your MS is getting worse, you know by the year. Yeah,
which that was what Billy had got you. That's what
it Yeah, that's what it sounds like. I have the
impression that, um, the any kind of progressive type of

(21:22):
of most polt clerosis is the worst of the two
because you're you're you have it like basically all the time,
and it's getting worse as it goes along. Yeah, and
his would come together, his would come and fits and
starts for the first period of years. Um, and it
was that classic thing, I think where his flare ups
would be like not so bad at one point and

(21:44):
then kind of calmed down and then be really bad
and then calm down. But the whole time there was
a progressive thing going on to where he was. He
was obviously worst case scenario, um, like couldn't walk in
a wheelchair, couldn't talk, um, and that poor guy. Yeah,
you know, the muscles fasticity is a big um hallmark

(22:05):
of a kind of the worst kinds And that's when you're, um,
you know, your body is just not communicating anymore, like well, no,
that mile in sheath is exposed and so the the
electrical impulses are going Hey, wires. So the muscles they're
commanding are going hey wired too. Yeah, so he he,
like I said, he walked with a cane for a
little while, but eventually like just had to go, you know,

(22:28):
lost tons of weight, eventually ended up in a wheelchair,
and was his body was almost constantly in a state
of muscle tension. You know. The ironic part about that
is it sounds like his immune system was super healthy,
which is how it was able to stage those massive
attacks on on his poor mile in sheaths. Maybe you know, yeah,

(22:50):
because you think if you had a weakish immune system,
your MS wouldn't be quite as bad. Yeah, I guess
I do, remember he thought about that. Yeah, it's really
interesting and it's super cruel to see, um, like the body,
like I said, the body turn on itself like that
because Billy was very athletic and he was a good singer,
and like it took away his ability to do all

(23:10):
this stuff. Um, and it got so bad where he
would um and it mentions it in this article about
like even when you're eating, you have to be really
careful because you can choke on your tongue or choke
on food. Um. When he would get cracked up and
laugh at us. It would like it would be you know,
it would be good for him, but it would also
be a little bit scary because he would his laugh

(23:31):
would get out of control such where you had to
worry about if you know, he had taken a sip
of water or something, you could choke on it. Yeah,
apparently that's one of the ways that people do die
from complications of MS is choking because they have swallowing problems. Yeah,
that was definitely, I mean, I don't remember the exact
like literal cause of death at the end, but um

(23:54):
you know, it just ravaged his body basically, so the
other ones I saw where that your lung function, weakend.
Muscle activity is one of the other main ways um uh,
like an infection from a sore due to immobility can
if not treated correctly, those things can lead to say
like a blood infection and you can die from sepsis

(24:17):
and then sadly, suicide is another leading cause of death
among people who have MS. Something like six percent of
fourteen percent of people with MS commit suicide. And one
of the reasons why that's much higher than the population
at large um is because one of the comorbidity ease
of multiple sclerosis is depression, and it's apparently, from what

(24:40):
I saw in my research, one of those things that's
not widely recognized and therefore not widely treated enough as
far as m S goes. That it's a it's apparently
a big problem with it, and it can come from
just being depressed that you have MS, because again the
strikes you in the prime of your life, so you
think about all the stuff you're missing out on because

(25:01):
you have debilitating MS, or just the the mile in
sheath coding regions of your brain. If you get legion
lesions in the parts of your brain that regulate your mood,
you can become Um, the physiology of your brain can
lead to depression because of the changes there. Well yeah,
I mean it does originate in the central nervous system,

(25:23):
but um, it can in some cases affect like your memory, uh,
your speech, your problem solving, and your higher brain function.
I think it's it says in here like five have
severe impairment of higher brain functions. So yeah, of course
depression is gonna go along with that, you know, so
we should we should say that for the most part,

(25:43):
it's from what I saw, the vast majority of patients
with multiple sclerosis don't die from it, they don't suffer
major cognitive impairment as a result of it, and um,
a lot of them don't even exhibit major symptoms for
the most part. Yeah, I don't want to freak people
out with Billy's story because he had the worst case scenario.

(26:06):
But the diagnosis doesn't mean you're headed towards that. No. No,
I just wanted to make sure that we were saying that.
You know, I don't want to scare anybody, but we
gotta get information out there, right because I mean, if
there's one thing that would be really great if we
could do with this episode, is if there's somebody out
there right now who is starting to have migraines are
tinkling in their arm, that they'll go to the doctor

(26:29):
and catch it early. You know, absolutely, So let's talk
about a treatment and stuff after your break. Huh, okay, alright.

(26:58):
One of the things you can do one to you
are diagnosed is get on drugs. Um. They've come a
long way to do drugs, that's right. Uh. The drugs
that they use to help treat them as have come
a long way over the years. They're called disease modifying agents,
and um, you know, they don't cure anything. But what
they're trying to do is slow the progression or alter

(27:21):
or suppress that immune system in such a way that
it helps. Yeah. Yeah, and um, there's a lot of
ways out there to actually treat the symptoms that are
drug based and non drug based, but those disease modifying
agents are the ones that actually alter the course of
the multiple sclerosis. But like you said, they don't actually

(27:42):
cure it. Although it is possible that there is a
cure for it out right now, but it's new enough,
it was just started in the late nineties, and it's
so not so radical, um that it just hasn't been
proven as a cure, but it's kind of looking like
it might be. Yes, should we go ahead and talk
about that. Yeah, So it's based on stem cells. Yeah,
I mean, it's basically what they're doing is completely replacing

(28:06):
your immune system, right, it's nuts. So back in the nineties,
two doctors from Ottawa, Um, what provinces Ottawa in do
you remember the Ontario, Well, let's just say Ottawa, Canada
like Atlanta, USA. Uh. These doctors, Mark Friedman and Henry Atkins.

(28:26):
They had this idea of basically reducing your immune system
to nothing, so that when they managed to keep you alive,
if they managed to keep you alive, when they restarted
your immune system again by reintroducing some of your stem
cells your hemeo poetic I want to say, stem cells,

(28:48):
ye your own right, um, that it would build your
immune system up again, and then they could watch the
immune system restart MS and they'd be able to watch
the disease progression from square one. But as one of
them said in an interview, they failed miserably. But it's
great that they did, because what they found was that
when they devastated the immune system, brought it to zero,

(29:10):
wiped it out, and then reintroduced your blood stem cells
to the patient again, the MS didn't come back. In
most of the people they tried this on. Yeh six
remained relapse free for three years after three years and counting,
and almost showed no sign of progression of the disease.

(29:30):
Which is and then in that original I think UM
study that Friedman and Atkins carried out, something like twenty
three of the twenty four UM the disease was stopped
in its tracks. And apparently these people had like a
pretty bad bad cases of MS. This wasn't it wasn't
a lightweight case of MS. Yeah. There's something called the

(29:50):
Expanded Disability Status Scale, which basically kind of ranks how
bad they are in terms of walking, dexterity, cognition. And
they all had to rate between a three and a
five point five on that scale, which is, you know,
fairly severe, right, And so some people for twenty three
out of twenty four in the original study, and I think,
like you said, six and later studies, Um, the disease

(30:13):
just stopped, that did not get any worse, even though
these were progressive cases of MS. And in something like
six of the twenty four they actually there the disease
was walked back. So like the permanent damage apparently there's
a rule of thumb among people with multiple sclerosis or
doctors that if you have a symptom that doesn't get

(30:35):
better or go away after a year, you can consider
it permanent damage. That permanent damage was actually reversed in
six of the twenty four patients by this incredibly radical
procedure that seems to work. Yeah, like that they one
of the doctors is, like, no one likes using the
C word and he was like, but I'm gonna go
ahead and say it, like, these people are cured. Yeah,

(30:57):
some of these people have been in remission for four
teen years and for all intents and purposes, that's that's cured.
It's amazing, it is. It's pretty great. But again it's
also a very very risky procedure. What they're using in
UM and I think the most current incarnation, i think
it's called halt MS is the process, but it's based

(31:19):
on those Autawa doctors discovery that you use five different
kinds of chemotherapy to kill your immune system. And so
obviously you have to be kept in isolation and everyone
has to wear a crazy bio hazard suit around you,
and they have you on anti microbials and it kills
everything UM and they are trying to fight off any

(31:43):
infection in Anyone who's ever stayed in the hospital knows
the best place to get an infection is a hospital.
So it's extraordinarily dangerous. But if you can survive, and
if you have like a pretty bad case of MS,
I'm guessing you'd be willing to try this UM it
can cure you. Yeah, Billy would have tried this in
a second. I guarantee it. Uh. They had twenty four

(32:05):
volunteers initially between two thousand and six and two thousand
and ten. For the first study, I think, oh no, no,
this one was um, this was in Denver, So I
guess are they doing follow up research? Yeah, this is
a difference. So the one that you're talking about, that's
the Halt study. UM. I'm not sure exactly what Freedman
and Atkins called their technique, but as far as I know,

(32:25):
they're the pioneers of wiping out your immune system and
then replacing it to get rid of MS. Yeah. So
I think I might have mixed together some of the
stats for these two studies. But let's just say they're
both very promising. Um. And you know who knows, like
I don't. I don't know the procedure. I know we've
talked about doing shows on medical testing and stuff, and
the procedure like the stepping stones from here to like

(32:49):
all right now, when is this going to be a thing? Um?
But I mean it's so kind of dangerous and frought
with complications. I don't know if they this can be
super widespread, you know, I from what I'm seeing in
the research, though, it has such positive backing. I think
kind of across the spectrum that it's I think people

(33:13):
are gung hollo about it, Like people should be able
to decide if they want to take that risk, Like
Billy was certainly in a position where he's like, it's
not gonna get any worse for me, right, Yeah, Like
I'm willing to take this chance and maybe die. Right. Uh.
It's basically I guess what these volunteers are saying to
make my life better. Yeah. I think one of the

(33:35):
things that's probably staying in most people like that's way
is the cost associated because I supposedly there's really just
stupid loopholes that you have that regarding um stem cell therapies.
Like like the article I sent you UM talked about
a guy named Dave Bexfield and he was UM accepted

(33:58):
to the study, willing to take the risks, and UM
his insurance company was like, yeah, that's great, it's a
stem cell um study, but we only cover stem cells
that are that come from donors, and this study has
stem cells that come from you, So you're gonna have
to pay the two thousand dollars yourself. And he did.

(34:19):
This guy got together, he's scraped together like a hundred
and eighties six grand, which is what it costs to
to carry out this trial for him specifically, And um,
I guess afterward he went after his insurance company and
got not only that money back, but like another two

(34:39):
thousand dollars or something in interest and he's cured. So boom,
I should say, and he's c worded. That's right. Uh.
There are UM some other diseases that are sort of
like MS, and there is debate in the medical community
whether or not they want to actually classify them. There's

(35:02):
something called clinically isolated syndrome, which means you can have
an attack or a flare up or an episode UM
from this de milonization. But it's just like one lesion.
And sometimes you might develop MS, but not always. Sometimes
it's just c I D. Yeah. I thought that was weird,

(35:22):
and to me it is kind of suggests how incomplete
and understanding science has of MS. Well, yeah, and like
I said that, some people say, well, you shouldn't even
call this MS, and some people say no, it's like
maybe the mildest form you can get. Uh. What else,
There's something called Marburg m s H shoulders diffuse sclerosis

(35:46):
Belo concentric sclerosis and devits disease. They are all sort
of in that UM range of what's called ideopathic inflammatory
demylinating diseases. And children can get it too, even though
it's pretty rare. Yeah, eight thousand cases in the US.

(36:09):
And remember there's like four dred thousand of MS, but
of pediatric multiple sclerosis UM, there's eight thousand of them,
which is I mean talk about prime of life disease. Yeah,
and I think it's even harder to diagnose in kids
because that's certainly not something they're looking for, right, And
we're like the drugs that they're using, it's it's like

(36:32):
what we don't know what effects are going to have
on kids. You know, it is the career worse than
the disease because there's you know, we said that there's
some disease altering drugs. There's a new one called O
Crivous that is UM pending approval from the FDA but
looks like it's going to go through, which is I
think the first UH disease modifying agent that is shown

(36:53):
to treat both progressive and relapsing forms of multiple sclerosis UM.
And it goes after the immune system. I think it
tries to suppress your B cells in the immune system.
Um So, there's there's plenty of treatments that go after
the disease, but there's also a lot of treatments that

(37:13):
treat symptoms, right, and um one of the ones that
are used are antidepressants and anti convulsants. And so there's
a lot of questions like, should we be giving those
two kids even though they have MS. What's the long
term effect of giving antidepressants to a child whose brain
chemistry is still in the beginning stages of development. Yeah,

(37:34):
I mean, drugs can be wonderful, but there there's not
a drug you can take that doesn't have some sort
of other effect. And um, the benefits outweighing the side effects,
Like you gotta take all this into consideration for anything,
you know. One of the other things I saw about antidepressants, Chuck, was, um,
they have figured out that they can use it to

(37:55):
treat chronic pain. And one of the outcroppings from m S.
So again, MS is like your body going haywire and
really unique ways for each person with multiple sclerosis. Um So,
it kind of in a way provides researchers ways to
whenever the body does something it is not supposed to.

(38:17):
It's a great place for researchers to go study the
normal processes of the body. And one of the things
they figured out is that in treating chronic pain with
multiple sclerosis, um, you can use antidepressants. And the reason
why is because apparently chronic pain and depression use a
lot of the same neural pathways and create a lot

(38:37):
of the same changes to the plasticity of the brain
as one another, and that chronic pain and depression maybe
in a lot of ways more related at least neurologically
than chronic pain and acute pain, which seemed to be
kind of different animals. Yeah, fascinating, I think so too.

(38:58):
Have you got anything else? Uh? Yeah, you know, I
think I would just advise anyone. And it's not just MSS,
but like if you got a I wasn't the friend
to Billy that I should have been towards the end,
and it's fraught with regret, uh. And part of that

(39:23):
is because life gets in the way, uh. And part
of it is just you know, it's not the easiest
thing to face as a friend. And I think what
I did was I let myself off the hook too easily.
For that stuff, which I feel really crappy about now,
like try to overcome that. If you have something like

(39:44):
this going on. That's good advice, man, That's what I
will say. I swore I wasn't gonna do this. Are
you missing? Yeah, it's it's It was very hard and
I wasn't the friend I should have been. And my
friend Eddie was great and stood by Billy, and uh,
I went and saw him at the end in the hospital,

(40:05):
but it was you know, I had a lot of
regret about the final years and not going to see him.
You should have and it's understandable. Man. Yeah, I think
you just did some sort of absolution though. Well we'll see. Well,
if you want to know more about multiple sclerosis, you
could type those words into the search part how stuff
works dot com and it will bring up this article. Um.

(40:29):
And since I said that and Chuck is missing, it's
time for listening mail. That means it's Wednesday. Uh, this
is on empathy a little bit too. Um. Hey, guys
listening to empathy right now. I had a pause to
say thank you when you were talking about the study

(40:50):
relating to autism and alex athemia. Uh, you listed four
groups studied as individuals with autism and alexothemia, individuals with autism,
um uh without alexithemia, individuals with alexithemia but not autism,
and then people who didn't have either one. Growing up
as a sister of a guy with autism, I can

(41:10):
tell you how many times I've heard people describe individuals
without autism as normal people. It's such a lazy way
to describe a group who doesn't exhibit just one of
a multitude of other characteristics, and frankly, it's demeaning and rude.
So thank you for not being those guys. You're always
careful in your wording, so I shouldn't be surprised, But
having thirty years plus experience hearing normal people condition me

(41:33):
to brace myself when you started the list inclusive language
for the wind keep up the great work. That is
from Megan is isgin in Indianapolis? And she said, psh,
Indianapolis is no Seattle, but maybe come to the Circle
City sometime. Oh nice, up uh, and we I think
we have been batting around the idea of in Indianapolis show,

(41:55):
so yeah, hopefully it will happen. Thanks a lot, Megan.
That was very nice of you. We appreciate the kudos.
Um And if you want to get in touch with this,
like Megan and tell us to come to your city,
you can tweet to us We're at s Y s
K podcast or josh um Clark Uh. You can hang
out with us on Facebook dot com slash stuff you
Should Know or Facebook dot com slash Charles W. Chuck Bryant.

(42:17):
You can send us an email stuff podcast at how
stuff Works dot com, and as always, join us at
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