Mystery Solved: Vitamin Di Deficiency
Just got my lab test results: Vitamin D, 25-Hydroxy Result: 27.6L ng/mL Normal Range: (32.0 - 100.0) Am probably suffering from Osteomalacia/Rickets, too. It explains all of my symptoms. Not MS relapse or pseudorelapse. Or even, peripheral neuropathy and porphyriai. Even the IV Rocephini that I was on depletes calcium. And the Dilantin and Prednisone were depleting calcium and Vitamin D, too. Had only been taking minimal amounts of cod liver oil, while on CAPi, from the start. And have been housebound for a year, now. Doctor had never tested my Vitamin D levels, so was probably deficient long before I started CAP. Why? Because he prescribes the Marshall protocol for some of his patients who claim that it is helping them. But as far as I'm concerned, I have now experienced years of needless suffering because of it.
Let recovery begin. Stopped the dilantin and steroids, a week ago. Symptoms were getting worse and worse, until then. Am now taking calcium Hydroxyapatite, 4 X daily. And am using this Vitamin D sublingual spray: LINK I hope that this will be enough and that it is effective. Am using 3-4 X/day. Not twice, since I am deficient.
Am already experiening significant improvement in symptoms, day by day. Can almost stand again and walk with my walker. It is said that it will take six months for recovery from Osteomalacia to occur.
Many thanks to Red for all he has researched and posted about Vitamin D. I think you just saved my life! And, to Dr. Aytan who just PM'ed me even more info for consideration. 
--Minai
--Can't type. Composing this via Speech Recognition RRMSi, diagnosed 2/04. NACi 4/06. Started Wheldon/Stratton regime 8/30/06. Doxycycline, 8/06, Azith, 10/06. Switched to Roxithromycin 11/06. Psuedo relapse/die-off with hospitalization 1/07. GAD-enhanced MRI of brain and spine shows NO NEW DISEASE ACTIVITY. LDNi 4/07. 1st Tinidazole Pulse, 8/11/07. Keflex 2/08. IV Rocephin 3/08. IV Clindamycin 5/08. Housebound with Neuropathy and increased spasticity and weakness since 6/08. Stopped CAP 3/09. USA
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Don't know if this is been
Severe Proximal Myopathy with Remarkable Recovery after Vitamin Di Treatment
Yousef A. Al-Said A1, Hiyam S. Al-Rached A1, Hussien A. Al-Qahtani A2, Mohammed M. S. Jan A1 A3
A1 Department of Neurosciences, King Faisal Specialist Hospital & Research Center
A2 Department of Internal Medicine, King Abdulaziz Medical City
A3 Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Abstract:
Background: Osteomalacia is an uncommon cause of muscle weakness. Our objectives were to describe features of myopathy associated with Vitamin D deficiency and examine the contributing factors leading to osteomalacic myopathy in our region. Methods: Patients identified retrospectively for the six year period ending in December 2006 with the diagnosis of osteomalacia and/or Vitamin D deficiency associated proximal muscle weakness were included. They were followed in three major centers in western Saudi Arabia. Clinical, biochemical, radiological, and electrophysiological findings were collected before and after Vitamin D treatment by chart review. Results: Forty seven female patients aged 13-46 years (mean 23.5, SD 4.5) were included. All were veiled and covered heavily when outside the house for social and cultural reasons. Only eight (17%) had adequate varied diet with daily milk ingestion. All patients presented with progressive proximal muscle weakness lasting 6-24 months (mean 14) prior to our evaluation. The weakness was severe in six (13%) patients leading to wheel chair bound states. Associated musculoskeletal pain involving the back, hips, or lower limbs was common (66%). Osteomalcia was the referral diagnosis in only 11 patients and the remaining 36 (77%) patients were misdiagnosed. All patients had metabolic and radiological profiles suggestive of osteomalacia. Remarkable recovery was documented in all patients following oral cholecalciferol and calcium supplementation. Conclusions: Vitamin D deficiency is an important treatable cause of osteomalacic myopathy in Saudi Arabia. The diagnosis is frequently delayed or missed. Screening for Vitamin D deficiency in patients with acquired myopathy is needed to identify this treatable disorder.
http://cjns.metapress.com/app/home/main.asp?referrer=default
Minai, I am so happy you
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On Wheldon protocol for MSi since April, 2006. doxyi 200 mgs daily, zithromax 250 mgs 3x/ week , Flagyli Pulses start end Sept., LDNi 2004. Gad-enhanced MRI of brain and spine shows NO NEW DISEASE ACTIVITY and one lesion diminishing in size on 9/30. Ma
Excellent news Minai!!
Excellent news Minai!! One thing though: osteomalacia yes, but not rickets. Only children got/get rickets because their bones are not yet fully formed. My best friend's father had severe osteomalacia, though, contributing to his early death and due to excess use of steroids before people knew much about dosage............Sarah
An Itinerary in Light and Shadow
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This is such good news
This is such good news Minai. I was also not getting enough D. My test was in the normal range but I found out through genetic testing that I have a deficit in one of my VDR genesi. So I upped my dosage to 10,000 iu a day. This is a range that feels good to me. I want to do a blood test soon but I would be very happy if I am in the 70-100 ng/ml range after an initial test result in the single digits.
I think my mother is also suffering bone and joint pain from low D. I think she is also infected with Cpni. She has had a terrible time with osteoporosis. I don't think she is taking enough and recently talked her into raising her D to 8,000 iu.
Keep us posted. You are on the track of something important.
Raven
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Feeling 95% well-going for 100. Still testing + for Cpni. CAPi since 8-05 for Cpn/Mycoplasma P.for MSi and/or CFSi. Also EBVi and HHV6. Amoxy,Doxyi, Azith, Tinii pulses. NACi, BHRT, MethyB12 injections
Hi Minai,This is wonderful
Hi Minai,
This is wonderful news! I'm absolutely thrilled for you. Keep the great news coming!
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Treatment for Rosaceai
With osteomalacia magnesium
With osteomalacia magnesium could also be an issue. When I first got my D tested it was only 20 (rr 30-150). After a year of supplementsi my D level is still only at 38. In Feb I had a bone density scan and it was considered "excellent" at +2.0 despite a somewhat low D level. I've never been one to take a lot of calcium supplementsi, either. So how do I have healthy bones? I think it's because I take magnesium supplements. From what I've read sufficient magnesium, which most modern diets do not contain, allows for a much lower calcium intake (which in turn requires less D) to keep bones healthy. This is because, with adequate magnesium, the calcium is used much more efficiently so less is needed. It makes sense since throughout most of human history we did not have domesticated cattle along side us and we did not consume dairy. So where did we got lots of calcium? We didn't. But our ancesters ate a lot more plants and nuts that were rich in magnesium. I'm rattling on now. Anyway, my point was that it would probably help if you added a good magnesium supplement to your regimen. I like Solgar's magnesium citrate as it does not cause digestive issues like magnesium oxide can.
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GFAi -
asthmai, sinusitis/rhinitis, tendonitis, low back pain, hypothyroid. Started abxi 1/9/08. Azi 250mg/day, doxyi, tinii, 5,000iu vitD, rhodiola, SAM-eI apologize for my
The neuralgia starts in my face and travels down my body to the tips of my toes. In occurs in wave-like patterns, with some relief in between the waves.
Yet, the bilateral spasticity is much better. And I can actually walk a little with the walker.
This was what the dilantin and prednisone were prescribed for. While the pain was eliminated, all other symptoms were getting worse and worse. I stopped the prednisone first, because it was giving me back pain. No way do I want to start them again. They are calcium channel blockers. And deplete calcium and D3, too. But I don't know what to do about the pain. As I can't tolerate NSAIDsi, either. I was given a a prescription for Elavil, for pain, but am afraid that it me make me too sedated. So, I have no idea what to do.
But will now attempt to respond to each of you.
Wiggy: Thank you. Am hoping that the spray is effective.
Sarah: I only mentioned rickets, because most people don't know what Osteomalacia is. Yet, they have heard of rickets. I wonder why doctors didn't realize that the steroids were what was killing your friend's father at the time?
Raven: I hope that you have been able to raise your D3 levels, in spite of those genetic deficits. I hope that your mother can successfully do so, too. Would type of calcium is your mother taking for osteoporosis?
Red: Thanks, again! Do you think Mercola's Vitamin Di might be effective?
Sunni: My magnesium levels tested within normal range. Have been taking the liquid mix Calm, recommended to me by my doctor. No other form of magnesium had been effective in helping with my bowels, either. My calcium tested within low normal range. But my doctor claims that it is very hard to test for. I had started the supplementsi a few days before I was tested. So it was the extracelluar blood levels, as opposed to the intracellulari that were measured. The osteomalacia diagnoses is primarily being made based on symptoms. Like you, I should have a bone density scan, too. Maybe you're right and I might be taking calcium, unnecessarily.
Hi Minai,Sorry to hear the
Hi Minai,
Sorry to hear the neuralgia has returned. Hopefully it will pass again soon!
As for different forms of Vit D3, I really think any form will do. I just use the powdered capsule form and it seems to work fine. Dr Cannell mentions that he doesn't believe the oil based forms are any more effective so really, just pick up a good cheap source:
http://www.cpnhelp.org/vitamin_d_and_fat_intake#comment-49252
I use this one, and like it because I can have allergies to oil based supplementsi. It's very inexpensive ($10 for @ 250 2,000iu capsules):
http://www.vitacost.com/NSI-Vitamin-D3-2000-IU-300-Capsules
They also have a very inexpensive 4,000iu capsule, btw:
http://www.vitacost.com/NSI-Vitamin-D3-4000-IU-300-Capsules
Anyway, hope this helps. Hang in there!
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Treatment for Rosaceai
Do any of you who live in
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Nelly (France-neuroLyme and ????)
Early days yet, re:
Early days yet, re: neuralgia but I do hope it goes soon. Actually the way you describe it sounds a bit like my reflex sympathetic dystrophy which I got for a couple of weeks during and after pulse five or six. It didn't start in my face but my right elbow, traveled down to the tips of my fingers then reversed, ending u in my right shoulder. I would only get the pain during the day, it seemed to go away when I went to bed. DW put it down to die-off, so maybe it is that with you.
AS for my friend's father, he was one of the first people given steroids soon after WW2. They were thought to be a wonder drug and were given before enough was known about the effects. It wasn't till years later that the full effects became obvious. Now people know much more, but mistakes are still made with other things, like Tysabri
Nelly, I get most things from Vitacost with no trouble from customs at the moment!.............Sarah
An Itinerary in Light and Shadow
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Thanks Sarah, French
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Nelly (France-neuroLyme and ????)
Minai, sorry to hear about
Minai, sorry to hear about your pain. You might give high dose niacinamide a try. Source Naturals has a 1500 mg tablet. Try one then work up to two a day--morning and evening--total of 3000mg. I have read studies online that is beneficial for nerve regeneration and pain. Check with your doctor first. My doctor recommended this to me and it works.
http://www.iherb.com/Source-Naturals-Niacinamide-B-3-Timed-Release-1500-...
Raven
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Feeling 95% well-going for 100. Still testing + for Cpni. CAPi since 8-05 for Cpn/Mycoplasma P.for MSi and/or CFSi. Also EBVi and HHV6. Amoxy,Doxyi, Azith, Tinii pulses. NACi, BHRT, MethyB12 injections
Well, the LDNi certainly
Well, the LDNi certainly seems to be playing a part. Had began taking it again, nearly a month ago. Was only taking 1.5 milligrams. Because I had been advised by pharmacist, Dr. Skip Lenz, that any less is not an effective dose. Last night, I'd tried taking 1.0. As soon as I did, the neuralgia increased. So tonight, will probably only take .5 mgs. The pain seems to get better as its effects wear off. Plus, I have always been one of the unlucky ones whose spasticity seems to have increased from starting it.
Red: Thank you for the links in the information. All very helpful to have and to know about! Mercola's spray is probably oil based.
Nelly: I have heard that France does limit American imports of various things. Yet, I can't blame them for some of those things. So, those supplementsi are not available in France? Am surprised as you French seem to be so much more healthier, than we Americans are, in so many ways. My dream is to visit France, someday :-)
Sarah: I do hope that this neuralgia will go. If it is reflux sympathetic dystrophy, it might not? If it is just die off, why has it lasted this long? Yes. As with Tysabri.
Raven: Was taking no-flush niacinamide when I came down with shingles. High in arginine, my doctor and I held it responsible in large part. But have wondered if I could use regular niacin. Maybe there is no arginine in it?
Minai, I think I am missing
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Feeling 95% well-going for 100. Still testing + for Cpni. CAPi since 8-05 for Cpn/Mycoplasma P.for MSi and/or CFSi. Also EBVi and HHV6. Amoxy,Doxyi, Azith, Tinii pulses. NACi, BHRT, MethyB12 injections
Hi Minai! I'm jumping in
Hi Minai!
I'm jumping in late because I just got home from the rehab facility. I'm delighted to hear of your solving the mystery of the disappearing muscles. My ankle broke because of severe osteoporosis. This after taking 1500 mg of calcium per day for over 10 years, taking 2000 iu per day of D3, Actonel for 3 years and magnesium for over 20. I've increased the D3 to 10,000 iu per day and I am trying Forteo instead of Actonel. You inject it each night (virtually painless) and it seems to have been successful with old folks with broken bones that won't heal as well as osteoporosis.
I hope the pain decides that you are too nice a person and goes to bite some nasty guy. Good luck and be well. I'm home (!) if you want to talk.
Nancy
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PPMSi-misdiagnosed 2001-diagnosed 2006. Also maybe Lyme. Minocycline 7 mos.- resulting bronchitis 5 months. Deserted by Hopkins neurology dept. and going to private m.d. out-of-plan. Wheldon CAPi 3/2/07 - Now (3/10) doing 100 doxyi; 125mg. azith; pulsing tin
Raven, I was wrong. It
Hi Nancy,So glad to know
Hi Nancy,
So glad to know that you are now home! Hope all is going as well for you as it possibly can. Thank you for the well wishes. You are taking calcium for over 10 years and you still have osteoporosis?! Maybe Sunnivara is right about magnesium (see above). Before I started CAPi, I was under the care of a doctor who believes the same about magnesium, rather then calcium, being the remedy. I hope that the Forteo will work for you. Apparently, D3 is oh so important for bone maintenance, too. You had reported earlier that you were taking fish oil. Maybe you should take the D3 supplementsi, in the doses recommended by Red (again, see above)?
I wouldn't wish this pain, let alone what you are going through, on my worst enemy. When is the best time to call you? While I have a trouble carrying on the simplest of conversations, my mother would like to call sometime. Again, am so glad to know that you are home!
Minai, So good to hear that
Minai, So good to hear that you are beginning to be up and moving again with your walker, that is the first step.
Vitamin D3 at 10,000IU seems to be a good daily dose for me based on my repeated blood levels. I have not made it to the 100ng/mL goal for me set by my MD and will continue on this dose at this time. I have been on the 10,000IU daily since late Oct 2008, that is 6 months now. I recently began taking the Calcium Hydryapatite Caps I had not been aware of it until last month when I was at my doctors appointment.
I also had a nutrieval drawn from Genova Labs to assess what my nutritional needs really are. I had to stop all supplementsi and it stretched out to a week off my methylation supports etc., then I had company and forgot my LDNi for several days and boom, I started to feel hints of my old afternoon fatigue and low mood and darker thoughts. Very amazing experiment that lets me know that I do need all the puzzle pieces to feel a somewhat normal level of energy and optimism.
I have started to have Meyers coctail IV's with glutathione and thanks to Joyce my MD is ordering the Readisorb reduced Glutathione oral supplement that I asked him about and he reasearched with the company. It is so wonderful to get useful information here from each other to bring to our MD's and possible add to our treatment supports. Almost every add on supplement and neutraceutical support as well as the adjunct LDN I would not have heard of if not reading here. Also I would not know the all important CPni protocolsi.
Minai, I look forward to hearing more about your progress. Best of blessings to you. Louise
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6-07WheldonCAP CFS20+yr
(11-29-07 started Cholestyramine HS PRNi x 7d for porphyrin+endotoxinsi removal)
Check out Louise's Blog at; http://www.cpnhelp.org/blog/louise for the details of my treatment adventure!
"Sarah, I do hope that this
"Sarah, I do hope that this neuralgia will go. If it is reflex sympathetic dystrophy, it might not? If it is just die off, why has it lasted this long?"
Well mine lasted about two weeks and has never returned: our kind of war is different from WW2 and we have different enemies. The die off can take a long, long time to go, though and I still get burning big toes from time to time............Sarah
An Itinerary in Light and Shadow
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Minai, you may have seen
Minai, you may have seen this write up about Vitamin K. http://articles.mercola.com/sites/articles/archive/2004/03/24/vitamin-k-part-two.aspx Seems it is important to bone support and perhaps as effective as fosamax?
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6-07WheldonCAP CFS20+yr
(11-29-07 started Cholestyramine HS PRNi x 7d for porphyrin+endotoxinsi removal)
Check out Louise's Blog at; http://www.cpnhelp.org/blog/louise for the details of my treatment adventure!
Minai,I would love to speak
Minai,
I would love to speak with both you and your mother (whose name I've forgotten). I am generally home at this point except for doctor's appointments. The therapists come to me. And I am actually going to the Poconos for Memorial Day weekend. We have planned a family reunion since November in honor of my parents' 65th anniversary. I'm still pretty tired but I'll sleep there.
In fact, my good fortune is adding to my fatigue: I saw the orthopedist today and he removed my cast. If it were not for the osteoporosis, I would be fully weight-bearing but he wants me to be 20% weight bearing, using a walker and wearing a boot, for another 4 weeks. My ankle looks nasty with 2 big scars. Anyway, the walking is pretty tiring right now.
Keep improving!
Nancy
I have been taking magnesium for at least 12 years as well as calcium with D. I am now taking about 6-10,000 iu of D3 daily and I aim for 12000. Plus I took Actonel for 3.5 years up until a few weeks ago. Still got osteoporosis. I have every risk factor except heredity -- plus some they don't list like lactose intolerance and msi (less exercise).
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PPMSi-misdiagnosed 2001-diagnosed 2006. Also maybe Lyme. Minocycline 7 mos.- resulting bronchitis 5 months. Deserted by Hopkins neurology dept. and going to private m.d. out-of-plan. Wheldon CAPi 3/2/07 - Now (3/10) doing 100 doxyi; 125mg. azith; pulsing tin
Minai,I would love to speak
Minai,
I would love to speak with both you and your mother (whose name I've forgotten). I am generally home at this point except for doctor's appointments. The therapists come to me. And I am actually going to the Poconos for Memorial Day weekend. We have planned a family reunion since November in honor of my parents' 65th anniversary. I'm still pretty tired but I'll sleep there.
In fact, my good fortune is adding to my fatigue: I saw the orthopedist today and he removed my cast. If it were not for the osteoporosis, I would be fully weight-bearing but he wants me to be 20% weight bearing, using a walker and wearing a boot, for another 4 weeks. My ankle looks nasty with 2 big scars. Anyway, the walking is pretty tiring right now.
Keep improving!
Nancy
I have been taking magnesium for at least 12 years as well as calcium with D. I am now taking about 6-10,000 iu of D3 daily and I aim for 12000. Plus I took Actonel for 3.5 years up until a few weeks ago. Still got osteoporosis. I have every risk factor except heredity -- plus some they don't list like lactose intolerance and msi (less exercise).
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PPMSi-misdiagnosed 2001-diagnosed 2006. Also maybe Lyme. Minocycline 7 mos.- resulting bronchitis 5 months. Deserted by Hopkins neurology dept. and going to private m.d. out-of-plan. Wheldon CAPi 3/2/07 - Now (3/10) doing 100 doxyi; 125mg. azith; pulsing tin
Minai,I don't know your
Minai,
I don't know your partiular situation but will relate my experience with Vitamin Di and hope you can use something from it.
My level was 20 ng/ml and I experienced significant improvement initially when I started vitamin D3. I actually experienced good improvement immediately after starting a lot of things that kill bacteria (Cat's Claw, Andrographis, etc...) I think the bacterial are initially shut down for a while and the symptoms disappear. Perhaps the liver is given a break from processing endotoxinsi long enough so you feel better.
Vitamin D produces a natural antibiotic
From: http://www.scientificamerican.com/article.cfm?id=cell-defenses-and-the-sunshine-vitamin&print=true
"Although these mapping studies did help us to better understand some of the anticancer actions of vitamin D, they also revealed VDREs lying close to two genesi that encode antimicrobial peptides called cathelicidin and defensin beta 2. These small proteins act as natural antibioticsi against a wide spectrum of bacteria, viruses and fungi."
Increasing your vitamin D levels will turn up the heat on bacteria in your system. It is good thing. Your vitamin D levels may have been slowly dropping for years, perhaps due to an unfriendly pathogen. By supplementing Vitamin D you will boost your body's natural defenses which will step up the fight against foreign invaders.
I have found thst taking things that counter the endo toxins help immensely. I found a combo recently that help me a lot (see my blog if you wish).
I am pushing hard to get my Vitamin D levels up. My last test 4-6 months after the first showed I was at 25 ng/ml. I have another test next week. I have been supplementing from 800-1400 IU per day. I went up to 3000 IU and got a bad herx from it so I backed off. I am also getting out in the sun as much as possible. If you read the article you can get 10,000 - 20,000 IU of vitamin D per day in the sun. I've actually got a nice tan right now which my wife likes very much. I will post the results of my test as soon as I get them
BH
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Doxyi 100mgx2, Azithromycin 250mg MWF, Probiotics: PB8, JarrowDophilus. CFSi since 2003. Last 5+ years lots of the usual research (Depression, Adrenal Fatigue, HPA, Mercury, Candida, Thyroid, etc.). iherb.com $5 coupon code: HAW103
Louise, Thank you for the
Louise, Thank you for the well wishes. I very much appreciate all of the info that you are sharing. My father, who has survived stroke and prostatei cancer, has been given the Meyer’s cocktail by one of his doctors who specialize in hematology. He looks forward to each IV session, because they make him feel so much better. I had started taking vitamin K supplementsi, to control bleeding during my menstrual cycle. But they didn’t seem to work, so I stopped them.
Sarah: I guess we are fighting a war based on unknowns. Always assuming that our enemy is Cpni, and not knowing what its tactics will be, I suppose.
BH: Thank you for sharing your story and for the article reference and a quote. I wish that I could get outside in the sun. But am unable to. This vitamin Di spray that I am using, twice a day, is 6000 IUs per serving. Am wondering if this is too much, yet it is the recommended amount on the bottle for normal use. It is interesting that your D3 levels are so low. I hope that you can successfully bring them up. I will read and watch your blog.
Don't know what's the matter
Don't know what's the matter with me, now!!! Took some time-released, 250 mg Niacini to start slowly. It triggered the Neuralgia.
It was some of the worst pain I have ever experienced. All I could do is hold my face and cry out, every time an icy wave strongly hit me. My husband carried me to the sofa and thought he should call 911 to have me taken to the hospital.
In between icy waves, I begged him not to. Instead, I had my mother give me 300 mg of Neurontin. The pain eventually went away, as my husband stroked my face and my mother, my legs and feet. I fell into a deep sleep and slept the day away. One of my cats was so worried, she squeezed up beside me and slept, too.
Why oh why did I have this reaction to niacin?!!! What could be wrong with me?!!!
Hi minai, Unfortunatly, I
Hi minai,
Unfortunatly, I have no idea as to why that would happen with the niacini. The first time i took niacin, i saw blotches and wavy green patterns in front of my eyes. Niacin is a blood thinner, maybe you have a compressed blood vessel to a nerve, or a blood vessel damaged or calcified by cpni? I dont know really, but i do hope you feel better, I think facial pain is very high on the unbareable scale, I wouldnt wish it on anyone
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MSi TMJ trigeminal neuralgia
cfsineutropeniaicystitisnephritisoptc-neuritissinusitis. Dox200 zith250 rif 600 daily. Treating cpn and TBI'sPoor baby! Things have got
Poor baby! Things have got to look up for you soon. Your husband and mother sound like they are being wonderful.
As for me, you got things a little bit backwards, but that's ok. I am 20% weight bearing on the broken ankle for 3 more weeks. And the walker will continue after that until I am ready for a cane. Which is a little confusing since I use a cane for the unbroken leg.
Anyway, yes we went to the Poconos and my walker walking improved greatly over the 3 days since it was a big hotel with long hallways. The highlight was the wheelchair dancing I did with my 26 year old son. We took over the dance floor as he kept spinning me in circles, throwing me out and pulling me back it. Most fun I've had in years.
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PPMSi-misdiagnosed 2001-diagnosed 2006. Also maybe Lyme. Minocycline 7 mos.- resulting bronchitis 5 months. Deserted by Hopkins neurology dept. and going to private m.d. out-of-plan. Wheldon CAPi 3/2/07 - Now (3/10) doing 100 doxyi; 125mg. azith; pulsing tin