Tag Archives: muscle biopsy

I Have Mitochondrial Myopathy

Day by Day with a Movement Disorder Posted on January 12, 2012 by 2

I finally got the results of the muscle biopsy I had back on Dec. 8th! And the Neuromuscular Specialist from UAB told us that I had a significant number of ragged red fibers in my muscle tissue, with a diagnosis of Mitochondrial Myopathy. He had suspected that, based on the level of muscle weakness I have plus my complete medical history and family history.

Mitochondrial Myopathy is classified as a Rare Disease by the National Institute of Health, affecting about 1 in 5,000 people. The Mitochondria are found in all human cells except for mature red blood cells, and they are the engines that provide energy to the cells to function properly. When they are defective in some way the cells cannot properly use the food fuel to provide that energy needed for normal cell activity. Exactly how this disease affects a person depends on which type of cells are most significantly affected by mutated Mitochondrial DNA. I was born with this disease, and the doctor says the mutations have been building up in my body my whole life until now I have a significant number of muscular tissue cells with defective Mitochondria. My symptoms have finally progressed to a point that it was possible to make an accurate diagnosis, confirmed by the muscle biopsy.

Adult onset MITO is not a life threatening disease, and for that we are extremely thankful. It certainly does affect my quality of life, however. The specialist does not think I will ever end up in a wheelchair, which is wonderful news. There is no cure and no real treatment, however. That’s the bad news.

There are some vitamins and cofactors I can try taking, but I’ll basically have to experiment on myself to see which ones, if any, will possibly give me more energy. He suggested I try Coenzyme-Q10, so I started taking it last night. Antioxidants may also be helpful. I had stopped taking all but the most essential meds and supplements early in 2011 when my liver enzymes were first elevated and the weakness became pronounced. Now that we know what I have I plan to start taking Turmeric, Vitamin E, Omega 3, and Lutein, again, as well as the CoQ10. I already eat a diet rich in green leafy vegetables, nuts, and fruits, as well as consciously eating high quality proteins and limited complex carbohydrates – all recommended for Diabetics and people with neurological disorders.

When I see my own Neurologist next time I’ll probably ask for a prescription for Physical Therapy again, so they can help me build up a safe exercise routine based on this diagnosis. In the mean time I’ll try to increase my activity level VERY gradually.

I’ve joined the United Mitochondrial Disease Foundation, MitoAction, and the Muscular Dystrophy Association, and I’m studying all the information on this disease they provide.

So I feel like I’m developing a plan of action and have hope that I will be able to slow the progression of this disease with supplements and good nutrition. I’m thankful to God for our close proximity to such a world renowned research hospital as UAB and for the specialists there. Waiting so long to get these test results has been extremely hard on both of us, but now we have an enemy with a name and can deal with it emotionally and physically.

My Open Muscle Biopsy Experience

Day by Day with a Movement Disorder Posted on December 17, 2011 by 7

I had my muscle biopsy last Thursday after what seemed like an eternity of waiting for the appointment to finally come. It turned out to be in my deltoid muscle, not my leg, which suited me just fine, considering how difficult walking is for me already. They numbed me up with Novacaine so I couldn’t feel anything, and since it was right near my shoulder I really couldn’t see what the doctor was doing, either.

The doctor, whom I had found so difficult to understand when we saw him back in October, did the biopsy, and he and I chatted quite a bit during the hour plus procedure. I’m glad he was the one who did it, because it gave me a chance to develop some rapport with him and get used to his speech. I feel MUCH better about having him as my doctor at UAB now.

I told him about how much pain my neck had been giving me since the 3 hours of lying flat during all the tests in November, and he gave me a prescription for a muscle relaxer that has helped a lot. As weak as my muscles are it never occurred to me to ask for such a prescription, but I’m glad he offered it! I’m still using the cervical collar while in the car and when I’ll be out of the house for extended periods of time, but my neck and back are definitely less painful at home.

I was pleased that he had been impressed with my complete medical history printout I gave him back in October.

We have had extensive experience as care givers for our parents, and we learned quickly that doctor’s appointments were much more productive if I brought complete and easy to read information to each appointment.

So as soon as I was diagnosed with Parkinson’s back in 2006, I started keeping a journal and also created a Word document in table form detailing all my medical history from birth to the present. Thank goodness I had copies of our life insurance application forms, or I would never have been able to resurrect all the dates of my surgeries and life events. It’s very easy to update the document with any new test results, prescriptions, drug reactions, etc. So I print out a new copy each time I go to a doctor and always give them the front sheet with the most pertinent information on it. If they need a full current copy I have that for them, too.

I had done a good bit of online research about how the biopsy would be done, but somehow I didn’t realize just how big a sample they would be taking out. I had an open biopsy, rather than a needle biopsy. He took a piece of muscle tissue from my upper arm about the size of the last knuckle of my little finger. I was able to keep my knees bent the whole time, so I didn’t end up with as much back pain as I did last time.

Since I’m diabetic I have to wait 10 days to have the stitches removed. I was sent home with antibiotics to take, as well as pain meds. And I really was in a great deal of pain, which surprised me, too. I guess if I had realized what a big hunk of me he was going to take out I would have realized I was going to be very uncomfortable. I’ve been off prescription pain meds for several days now, but still use Tylenol sometimes.

I was also surprised by how little I was able to use my arm – almost nothing at first, but still difficult even now after 8 days. I’ve pretty much lived in sweat pants now since the biopsy, even wearing them when we go out Christmas shopping. I had no choice. The first trip out after the biopsy to get a sandwich and do a small amount of shopping I didn’t stop to think and wore my elastic waist jeans, as I normally do. That was stupid, because hubby had to help me get INTO them.

Well, I had to use the restroom while we were out – and I couldn’t pull my pants down one handed! I’ve done my share of going into the bathroom with my father-in-law, who had Alzheimer’s, but this was the first time someone ever had to go in a public bathroom to help ME. Hubby helped me of course, but he understandably wasn’t comfortable being in the women’s restroom, even though we made sure it was empty. It really makes you appreciate businesses that provide Family Restrooms for situations such as this.

I was told not to lift anything heavier than a plate of food. I’ve learned to do a lot of things left handed and am gradually using my right arm more and more. Hopefully when the stitches are out and the heavy bandage is gone I will be able to quickly get full range of motion back.

As for test results – it will take 3 weeks to get that back, so we’ll just enjoy Christmas and possibly New Years before we hear the results.

This is an expensive invasive test that is not performed if there is any other way to obtain a diagnosis, but I’m glad I decided to have it done. I’ve said it many times while my diagnoses kept changing that I can deal with the Devil I know much better than I can the Unknown.

If you’ve read this far it may be because you are considering having a muscle biopsy. I pray that you get definitive results that will help your medical team provide a beneficial treatment regimen for you. And we pray for that for me as well, that the Neuromuscular Specialist will be able to determine what type of Myopathy I have. We are praying that it will be one of the types for which a treatment has been developed.

May you have a Blessed Christmas!

Test Results??

Day by Day with a Movement Disorder Posted on November 12, 2011 by 6

The Neuromuscular Specialist called the other day – 2 days after I had called his office and left a message asking for an update on the test results. He was rattling off a lot of medical terms I wasn’t familiar with, and his thick accent didn’t help in understanding what he was telling us. But from what I could understand he thinks I have Mitochondrial Myopathy, which is a genetic disorder involving DNA mutations. I questioned him about that, as it would seem logical to a lay person that if it were genetic I would have had symptoms my whole life. He said symptoms often didn’t show up until a person’s 50’s or 60’s, and my first movement disorder symptoms did show up in my late 50’s. And I was what people used to call a sickly child.

From what I’ve read it’s actually called Adult Onset Mitochondrial Myopathy. I did find a very good information source online at the UMDF, United Mitochondrial Disease Foundation . Once I joined with a free membership I was able to read quite a few helpful articles.

There’s a long list of possible symptoms associated with MITO, as it’s abbreviated, depending on which organs are affected by the gene mutations. But I do recognize myself in the list. Even the Type II Diabetes is on the list, as well as the Myoclonus.

He is scheduling me for a muscle biopsy for a more conclusive diagnosis, although even then it won’t be definitive. But I’ll feel better knowing we’d tried everything we can to pin down the diagnosis and what type of MITO I might have. I handle the Devil I Know much better than an unknown enemy. There’s just something about being able to read about the disease that helps me deal with it – even if there is no real treatment for it.

There are some articles I’ve read that suggested there are some vitamins and supplements that may help to delay the progression of the mutations, but these articles caution not to take them without medical supervision, as some can actually make variations of MITO worse, rather than delay progression.

So it’s still a waiting game, as I continue to be very weak and find walking to be difficult and slow and holding up my head very tiring and painful.

3 Hours of Tests Today

Day by Day with a Movement Disorder Posted on October 27, 2011 by 4

The Bradykinesia (slow walking) continues, so today I went to UAB in Birmingham and had a Nerve Conduction Velocity Test, a complete Jolly’s Test, and an EMG (Electromyogram). It took 3 hours to complete all the testing, and that involved some fairly uncomfortable electrical stimulation in the Nerve Conduction Test and some very uncomfortable electrical shocks during the Jolly Test. The EMG is mildly uncomfortable, but they did that last, and by then I was so stressed and tired that it was not pleasant, either.

I’ve had variations of these tests before, so at least I knew about what to expect. I’m glad I didn’t realize ahead of time that I was having the Jolly Test, as it was extremely painful last time. It still wasn’t easy, but it wasn’t as bad as it was the first time I had it done. This test was more complete than the other Jolly Test I had, testing the eyelid muscles, the neck muscles, as well as the hand and arm muscles. The NCVT was done on my right leg and arm, as was the EMG.

A technician did the NCVT and Jolly Test, but two doctors did the EMG. They said the NCVT and Jolly Test looked normal, but the EMG showed signs of polyphasia. I tried researching that, but couldn’t tell much about what that meant, and of course they didn’t elaborate. They said it would be up to the Neuromuscular Specialist to decide if I needed a muscle biopsy, based on the results of these tests.

So, we still don’t know anything, but maybe in a couple of weeks we’ll get some indication of what the specialist thinks might be going on. We sure hope so.