A Medical Zebra, a Post for Rare Disease Day 2018

Where it all began

When I was in hospital two years ago I became a medical guinea pig. Most of the time I didn’t mind, it was a teaching hospital and the young doctors needed to learn. I was a rare case and difficult to diagnose.

When I first arrived at the hospital the first words uttered by a doctor were Multiple Sclerosis. My symptoms were very similar to MS but the doctor made a classic mistake of looking for horses when in fact I was a zebra. It’s a strange medical term but basically it means that most doctors will go for the obvious diagnosis (horses) which are more common, but some cases are not so obvious (zebras) and more rare. My condition is very rare, one in a million worldwide!

At the time, after days and days of testing, podding a poking to an extreme extent, my diagnosis was Transverse Mylelitis, another rare condition. This was later changed after more podding and poking and blood tests to Stiff Person Syndrome with PERM, but more about that later.

An MRI Scan had ruled out MS as I had no problem with my brain (although some may disagree with that but they are not doctors.) A Lumber Puncture had ruled out further, more obvious conditions. I had my legs pricked with little pins so many times that I looked like a pin cushion. The defining test had been the planter reflex, or in laymans terms, the tickling of my feet. When an object, usually a pen but they did have ‘proper’ tools for this, was brushed up the soles of my feet I didn’t feel a thing, but my toes shot upwards. This, my friends, is not normal. I had no control over my little tootsies, and still don’t but tickle my feet and they’ll shoot up. This is called the Babinski sign and is supposed to indicate a problem with the spine and that’s where my diagnosis of Transverse Myelitis came from and it means inflammation of the spinal cord. There is also a test on the hand, the Hoffman Sign, which is indicated by an involuntary flex of the thumb or forefinger when your middle finger is flicked. Oh, it’s all very technical you see.

Back to the student doctors. They were there every day and most times I agreed to let them take a pod and poke of my poor lifeless legs. Some days I was not so willing and I’d tell them to piss off. Well, I’m sorry, but when you are ill you just don’t care. On one particular day I had ten, yes TEN, students around my bed, with the curtains drawn it felt very claustrophobic. My consultant had visited me beforehand and asked me to stay quiet unless I was asked any questions. I think he had become a little fed up of my saying, no, you don’t do it like that, or try doing this, because I believed I’d become quite an expert in all the tests. Well, you would do if they were performed on you several times a day for a fortnight. Not only that but as soon as a doctor had performed a test and left I’d be on google finding out why. That’s how come I know about the Babinski and Hoffman signs.

So, I’m lying there like a good little guinea pig while these students do their tests and basically they haven’t got a clue what they are doing…but I did as promised and stayed quiet. I tried to concentrate on things like how smooth my legs looked considering they hadn’t been shaved for two weeks. I put up with having my legs lifted and dropped, I think this was fun for them because they all seemed keen to have a go, and they pricked me with pins, tested my reflexes (they got the Hoffman’s completely wrong) and pinched me after asking me to shut my eyes, oh they were mean! Then the consultant asked them what they thought was wrong with me and pointed to them one by one for their diagnosis. The first guy said Transverse Myelitis, but the second say Guillain Barre, after that the rest of them said Guillain Barre, talk about a pack of sheep. I so wanted to congratulate the first guy but I stayed quiet.

I stopped allowing students after that, there is only so much you can take and I’d had enough. Plus, I was starting to feel better, it’s one thing being poked, prodded, pricked and pinched while you are immobile and numb, but once I was feeling more I just couldn’t take it.

I left hospital with my Transverse Myelitis diagnosis and the assurance that I would be recovered in a couple of months, if not, then six months at most.

The New Diagnosis

So when I went back to my consultant eight months later with no recovery at all then I was sent for more tests. I had more blood tests then a EMG and NCS.
The EMG, or Electromyography, involves long needles pushed into the muscles to record any evidence of abnormal activity. Some people hate this procedure, but I didn’t feel a thing. Then came the NCS or Nerve Conduction Study, this is where they electrically stimulate the nerves to see if they react correctly. Again, I didn’t feel anything in my legs but apparently they behaved appropriately. Then they did my arms and boy did I feel that, it was just like having electric shocks…don’t touch a plug with wet hands! But, I was distracted from the pain as each shock made my fingers move like a robot, it was really fascinating.

Once all the results where collated my consultant decided that I had a form of Stiff Person Syndrome, Progressive Encephamyelitis with Rigidity and Myoclonus. I’m still not hundred percent sure that he’s right, I talk to other people with the condition and I can’t relate entirely with them…but then they don’t relate to each other, it seems each one of us is different but we are all diagnosed by anti bodies found in our blood. I guess if the condition was not so rare then there would be more similarities between patients, who knows?

Back to the Present

Since my diagnosis of Stiff Person Syndrome I have been trying out treatments that could make a difference. First I was given a big dose of steriods, intravenously for a week then in tablet form. The only thing they did was make me blow up like a balloon. So my consultant put me forward for IVIG, (Intravenous Immunoglobulin) which I’ve been having for nine months now. The first couple I only had a minor improvement but the third one was much better. I think mostly because I stopped expecting a miracle and settled for improvement instead. I have a LOT of symptoms which I won’t bore you with now (well done if you’ve got this far!) I have to be grateful for the lessening of any of these symptoms and the IVIG does help. It just doesn’t make me walk again and that is my biggest wish, my dream. I won’t give up on it, ever. I know my condition is progressive, but I’m not going to give in just yet.

Rare Disease Day 2018

28th February is Rare Disease Day, when those of us with rare medical conditions shout out loud, look at us, we are ill too. Find us a cure!

I’m one in a million. I’m a medical zebra!

I wish I was a horse!