Tuesday, March 07, 2006

What, no cef boost?

I think it's clear that we have not seen an immediate improvement in my metrics such as occurred the very first time I used ceftriaxone. That first jump was evinced by the increase in grip strength on the local neurologist's hand dynamometer. Yes, this data can be called into question given that I had used his dynamometer so few times, and was feeling slightly off on the day of the measurement used as my baseline. However, I'm willing to treat the data as valid. That first dramatic increase seems consistent with the article in the 1/6/05 issue of Nature. I thought that perhaps, after having gone more than six months with no ceftriaxone infusion, excess glutamate would have had a chance to build up in my motor neurons, and the recent drug application would flush it out, leading to improved grip strength. Improvements described in the study occurred within 48 hours. It's been over 96 hours since I was dosed with ceftriaxone in the hospital, and I believe that I have recovered from the stress of surgery. My wound seems healed. The lack of a sudden increase in grip strength seems to mean that either:

  1. The initial improvement was valid, but excess glutamate takes longer to build up than just six months.

  2. The initial improvement was measurement error.

These two possibilities speak to whether I have classic ALS, just Lyme disease, or some form of ALS brought on by Lyme.

The first possibility (1) seems unlikely, given the great loss in functionality I have experienced in the last six months. The second (2) possibility seems more likely, despite how valid I feel the initial improvement was. The second would tend to support the idea that I am suffering primarily from Lyme. That bodes well for my prognosis.

I got an email from Dr. Quack:

Plan is to make sure you tolerate Rocephin (about 5 weeks) then go to 2x a day 4 days a week. You will have 3 days off. This should persist about 15 months if you tolerate well.

Left grip is 28 pounds (24, 28, 27), right grip is 73 pounds (63, 64, 73).

Wishing to compare my current energy level and physical prowess the last time I had left and right grips comparable to today's, I looked back in the metrics data. On October 28, 2005 I had a left grip of 29 and a right grip of 74. That compares well to today's 28 and 73. Back then I was blogging that I was letting my wife do all the kid work, though I had surprised myself by doing two loads of laundry, and that I was unsteady enough fall over sometimes when on all fours. That sounds about exactly where I am now, so it's not as though my grip strength has improved but my overall functionality has declined.

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