Tuesday, September 14, 2004

Incontinent giraffes?

We're getting ready for a trip out of state, so there are a lot of details to handle before we leave tomorrow. For example, I went to the local neurologist today to have him re-do some paperwork that someone else had goofed up.

I mentioned that he was much more sympathetic than the neurologist in the movie "Garden State," and he said he really liked the movie Eternal Sunshine of the Spotless Mind. With Kate Winslet, who, quite frankly, would make me hot if she were Gweneth Paltrow, but she's not. The idea in the movie is that they can erase unpleasant memories. Sounds fun. Comes out on DVD Sept 28th, which is good timing.

We talked again about superoxide dismutase. People with familial ALS show problems with their SOD, so he thinks that it might be a good idea to start taking it, if it is biochemically available (not destroyed by the stomach). It's available on the internet and in freak stores, so I plan to get some.

I mentioned to him that when people are telling me very serious things, awful things, even, I sometimes wind up smiling or grinning against my will. That's not what my feelings are, it's just as though my face does something on its own. I said I had read about uncontrollable laughing or crying in people with ALS, and wondered if this were related. He said my situation is not abnormal. He described a hierarchy of inhibition that is layered in vertical levels from the base of the spine up to the brain. I have a form of ALS which mostly resides in the brain and upper nervous system, he said, and the reflex inhibitors for laughter are located at the top of the vertical inhibitor system. Hence the hiccups I've been having more easily and more often. And my inability to control my facial expression. He says there is an awful term for it, but I love it, actually. They call it "emotional incontinence."

He said it can also happen in old age due to brain deterioration leading to disinhibition. Don't worry, it's not like I'm out of control, dancing around like Twyla Tharpe, weeping and laughing by turns. Hardly. Most of the time, I'm the same old poker-face.

"Disinhibition" is an interesting alibi. Hmmm...

Then we talked about how weird ALS is, that it effects only motor neurons and is globally sporadic. I asked him if there were any databases of ALS studies that I could access, just to assure myself that certain avenues of research had already been explored. He named a local medical school and said they have an excellent library, plus a great database. I'll see if I can get access to that, maybe even online.

He mentioned that the motor neurons are the longest and hardest-working structures in the body, and mentioned how much the nervous system consumes in blood and nutrients (the wee little two-pound brain just by itself takes 20% of our blood and glucose). He said that those nerves, particularly the motor nerves, have to engage in tremendous metabolic throughput. And so perhaps tiny amounts of trace toxins can be damaging. Regarding the case of extreme athletes, who, it is conjectured may have a tendency towards ALS (no studies have proven this), he said that perhaps they put so much water through their system in the course of their exertions that they filter and trap higher quantities of trace toxins. I don't want to bust this theory too badly, but you'd think it would show up, historically, in a class stratified way. The laboring classes would get it, and the idle classes would not.

Since we were talking about the relative length of the motor neurons being a possible factor, I said I wondered if giraffes get ALS. The doc looked at me with mild surmise and said he'd never thought of animal ALS incidence. (Obviously, we do have mice models, but he means other large animals.) He said it was a very good idea, and worth looking into.

Next stop, that research database.

By the way, today I noted (formally) that my left leg bows inward at the knee much more dramatically than my right leg when I squat on it, for example when compressing the ankle joint as a stretch. They've always had this tendency, since I was born pigeon-toed and had to be straightened with plaster casts and braces. This greater bowing of the left leg has been going on for a while, I just had never formally noticed it in comparison to the right.
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