Thursday, August 25, 2011

Faulty Lines


At first, it was a patter-patter. Then a trembling. Finally, a full-out shake-n-shatter. Like many East Coasters, Tuesday's earthquake shook me from my seat. I was in a coffee shop in Northern Virginia. Some people ran outdoors. Others dropped under tables. 

I can't say how long it lasted, but for the last few violent seconds - I thought it may all be over. My most steady grounding - the earth - was steady no more.

Californians, laugh all you want at my dramatic description! This was my first quake and a fairly big one.

Afterwards, my fingertips tingled and my back felt twisted. I tried to re-concentrate on work, but something had shifted - I was floating like a buoy in choppy waters.  About six hours later, I finally washed ashore, returning to solid ground. Or was it solid? I couldn't be sure.

My appetite for others' earthquake stories is insatiable. While collecting stories, a powerful analogy came to mind.

People always ask me what cataplexy feels like. As the author of a memoir about narcolepsy, I relish in trying to convey the surreal sensation of being conscious inside a paralyzed body. 

Tuesday's earthquake felt a lot like cataplexy. Not necessarily in the physical shaking, but in the sudden loss of certainty.

During an episode of cataplexy, my eyes flutter, my jaw drops, my arms and legs jerk and spasm on their own volition. Sometimes, the paralysis is complete and my body falls to the ground - despite me "telling" it not to!

Cataplexy is actually the pathological equivalent of the muscle paralysis everyone experiences during dream sleep (to stop us from acting out our dreams). However, I experience dreamer's paralysis, inappropriately, while wide-awake. Why? Faulty lines under the surface. 

So what does cataplexy have to do with the earthquake? In both experiences, there's a quick erosion of trust.  Your sense of grounding shifts out of your control.  All that you know to be solid turns to dust.  The consequences are unsure - will I hurt myself? And then, the world returns to normal.

Yoga teaches me that there are no certainties. Life is always shifting. The earthquake and cataplexy are bold reminders of this, shaking me awake to the moment. 

Now that I know what it feels like to lose grounding, I can truly cherish the simple steadier times. I will breathe deeply and smile.  For better or worse, we're all dancing on fault lines.

Monday, August 22, 2011

Influenza A (including H1N1 infection) May Trigger Narcolepsy

What causes narcolepsy? I wasn't born with narcolepsy but developed it in my late teens to early 20's.

Evidence continues to suggest that influenza A (including H1N1) and other winter airway infections play a significant role in narcolepsy onset. However, the role of H1N1 vaccination is a different story, suggests a recent study led by Dr. Emmanuel Mignot.

About 3 million people worldwide have narcolepsy today.  Dr. Mignot's latest study explores the connection between influenza and narcolepsy in China.

The study examined the time of year that patients developed cataplexy and sleepiness, finding that the symptoms usually occurred about 5 to 7 months after the peak flu/cold or H1N1 infection season. The least number of cases developed in November and the most in April.  Researchers believe the seasonal onset pattern is significant. 

"Together with recent findings, these results strongly suggest that winter airway infections such as influenza A (including H1N1), and/or Streptococcus pyogenes are triggers for narcolepsy," reports the study published today August 22 in Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society.

In  2009, Mignot and colleagues confirmed that narcolepsy is an autoimmune disease, caused when patients' immune systems kill the neurons that produce the protein hypocretin.

Why does this happen to some people but not others? Scientists believe that  an individual may have a "genetic predisposition to the disease, and some environmental factor kicks his or her immune system into action leading to narcolepsy." In Caucasians, Streptococcus pyogenes infections, such as strep throat, have been shown to precede narcolepsy onset, similarly indicating that upper airway infections play a role.

"Last year, several European countries reported new cases of narcolepsy in children who had been vaccinated for the H1N1 strain of influenza; children who received the Pandemrix H1N1 vaccine in Finland, for example, faced a ninefold increased risk of narcolepsy," describes Stanford University's School of Medicine's news article today.  "The World Health Organization led an investigation and determined that something about this particular vaccine acted in a 'joint effort' with 'some other, still unknown factor' to increase risk in those already genetically predisposed. (Pandemrix contains two adjuvants to invoke a stronger immune response; these additives are not included in the H1N1 vaccines used in the United States and China.)"

Importantly, this paper suggests a connection between the onset of narcolepsy and H1N1 infection, as opposed to H1N1 vaccination.  In the patients interviewed, very few (about 5.6%) remembered receiving the H1N1 vaccine.  

Dr. Mignot believes that there may be a significant difference between the Pandemrix vaccine used in Europe and those used in the United States and China.  More research is underway to determine if and why Pandemrix causes a strong autoimmune reaction and increases the risk of narcolepsy. 

However, Dr. Mignot still believes that receiving a H1N1 vaccination (not Pandemrix) is important for personal safety and public health, explaining, "It's very possible that being vaccinated with a mild vaccine, one without the adjuvants in question, blocks you from getting a big infection that could increase your risk of narcolepsy."

Certainly no one wants to see an increase in narcolepsy cases worldwide as we've seen these past few years.  However, the wizard of narcolepsy is hopeful that we are narrowing in on why this is happening, stating, "We're much closer to understanding what's happening in the autoimmune destruction of hypocretin cells." 

For more information, please read the news report: "Stanford study draws connection between narcolepsy and influenza," Stanford University School of Medicine, August 22, 2011.

See also: Donald McNeil Jr., A Surge in Sleepiness in China Appears to Have Been Caused by Flu. New York Times, August 22, 2011.
Martin Beckford, Swine Flu infections trigger narcolepsy, not vaccine, says study. The Telegraph, August 22, 2011.

Thursday, August 18, 2011

Wake Up Nashville--and Dream Big!

A songwriting contest and music legend concert in support of narcolepsy? Now that's music to my ears!

I'm excited to feature Wake Up Narcolepsy's "Wake Up Nashville -- and Dream Big" event on my narcolepsy blog today.

Dave Gibson, Daisy Dern and Bob Saporiti of Savannah Music Group review song contest submissions in their Music Row studio.
Enter the Contest:
This is a unique opportunity for aspiring songwriters to be heard. Music Row's major recording label, Savannah Music Group will review songs sumbissions and winners will be invited to perform alongside music legends on Sept 29th, 2011 at Nashville's Country Music Hall of Fame & Museum. (Click here for submission details)

Support the Concert:
Country Music Hall of Fame & Museum
Reserve your tickets today to attend the first ever "Wake Up Nashville --- and Dream Big!" concert on September 29th, 2011 from 7-10pm at Nashville's Country Music Hall of Fame & Museum.  Music Row's Savannah Music Group artists will perform alongside contest winners.

Yours truly REM Runner will be in attendence! I'm thrilled to visit Nashville for the first time and to support this ground-breaking narcolepsy fundraiser.

In closing, a short video with some of the initiative's leaders:



My sincere thanks to the leaders who've come together from various industires and across the country to make this dream a reality: including doctors, muscians, publishers, generous sponsors, and families of those with narcolepsy.

For more information, visit:
Press Release "Not for Profit Event 'Wake Up Nashville' to Raise Awareness and Research Funding for Narcolepsy."
Wake Up Narcolepsy
Awaken The Cure
Saint Thomas Health
Savannah Music Group
Jazz Pharmaceuticals

Thursday, August 4, 2011

Roanoke Valley Awakens to Narcolepsy

Mother Diantha with daughters Haven and Seanna
On the last day of school, when a 4th grader passed a hat around the classroom, no one blinked. Instead, each 4th grader reached into their pockets and gave what they had – mostly coins. Together, they proudly collected about $15, believing that small change could lead to something bigger.

Another 4th grader, Margaret helped her aunt in the garden – planting squash and zucchini. Margaret’s aunt gave her $20 for her work. Instead of spending the money on herself, she brought it into school to add to the collection.

These 4th graders at Halifax Academy in the Roanoke Valley were determined to help their friend and classmate, who, just a few days into summer vacation, would board a plane for California to meet the Wizard of Narcolepsy.

A Fateful Nap:
This story began five months earlier, in February 2011, when Diantha, a high school teacher at Halifax Academy, brought her two daughters along to a weekend conference in Greensboro, NC.  The girls, Haven, age 10 and Seanna, 7, looked forward to mini-golf and the indoor pool.

On Saturday, Feb. 5th, Haven told her mom she needed a nap. “This was unusual,” Diantha recalls, “she’s always energetic. I thought she might be coming down with something.”

Haven’s sleepiness only worsened. Back home, she slept on the way to school, during school and after school.  Ranked high in her class, Haven’s sudden change was obvious.  She also began waking from vivid hallucinations in the night.  Around the same time, Haven’s knees started buckling under her.

Diantha brought Haven to her primary care doctor, who ran tests for everything under the sun.  “We live in an old house so lead poisoning was a possible concern,” Diantha explains, “We were grasping at straws in the dark.”

Haven’s knee-buckling progressed rapidly and before long, she collapsed to the floor of her classroom. Shaken by the incident, Haven’s teacher, Lindy cried as she brought Haven to her mother in the high school.

That’s when things got eerie, as this small private school had recently lost a student.  A young boy named Dylan had passed away after fighting a heroic battle with an incurable illness called Fanconi anemia. During this difficult time, the community had come together to support Dylan and his family.

Dylan had been a grade younger than Haven in school. With his memory still fresh in everyone’s mind, worst-scenario thinking was only natural.

Next, Diantha and Haven traveled to a hospital in Greenville, NC for a MRI.  While in the waiting room, Dylan’s mother, Betsy walked in.  “She drove an hour and half to be with us,” Diantha describes, “her support was incredible!” 

Yet, while waiting for the MRI results, the doctor instructed them not to leave the premises and mentioned the cancer ward across the street.   An assistant pulled Diantha aside to tell her she’d already reserved a room for Haven in the cancer ward.  “We were terrified.”

When Haven’s MRIs showed no cancerous abnormalities, there was a big sigh of relief, but still so many questions. Haven was falling out all the time by now.

From here, they traveled to various doctors at the best hospitals within driving distance - from Pitt to Duke.  They checked for epilepsy and everything else imaginable, yet still no answers.

Finding Narcolepsy:
It was Haven’s 4th grade teacher, Lindy who first found narcolepsy with cataplexy and called Diantha. “I’d heard of narcolepsy,” Diantha recalls, “but didn’t know it was such a serious illness.” She read more online and quickly thought this may be it.  

Soon thereafter, Haven helped her mom cook breakfast sausage one morning.  Haven enjoys cooking and this was her first attempt at sausage.  As she lifted the first cooked sausage from the pan, the link fell to the floor.

“I didn’t think much of the first fallen sausage,” Diantha explains, “but watching her drop link after link on the floor, I couldn’t take it anymore.”

Diantha drove Haven to Duke Emergency Room that morning. During this visit, she suggested narcolepsy with cataplexy.

The doctor responded, “How do you spell cataplexy?” 

The interaction was unsettling, but the doctor was honest. “I don’t know much about narcolepsy, I’m going to research it tonight.”

From here, Diantha, following advice from her sister-in-law Mable, self-referred Haven to UNC Chapel Hill’s sleep center for a sleep study.  A few weeks later, Haven was diagnosed with acute onset “narcolepsy with cataplexy” at age 10.

Once diagnosed, Haven began treatment with a sleep specialist at UNC Chapel Hill. However, in 3 visits, Diantha and Haven never met the doctor whose care Haven was technically under.  Instead, they met only with the Physician’s Assistant. “If I am going to give my 10 year old daughter such serious medications, I’d like to meet the doctor,” Diantha rightfully reflects.

Dr. Mignot
Diantha researched online and found that Stanford University was conducting narcolepsy research.

“I saw a number and called,” she describes, “Mali answered.”

Mali is the head coordinator of Stanford’s Center for Narcolepsy. She supports Dr. Mignot and works tirelessly on behalf of people with narcolepsy.

Speaking with Mali, some of the missing puzzle pieces started coming together for Diantha.  Both parties agreed it would be best for Haven to receive care with Dr. Mignot at Stanford.

Dr. Mignot is the Wizard of Narcolepsy.  Not only is he an internationally prominent narcolepsy specialist, but he is also a leader in our understanding of childhood acute onset cases like Haven’s (and the possible connections to H1N1 vaccine/virus). 

Traveling to California would be very expensive and Diantha was unsure how she would afford this.  Yet, she was not alone.

From Pancakes to Chicken Plates:
One Saturday morning, 15 high school students from Halifax Academy’s Beta Club rolled out of bed around 5am to meet at a local Applebee’s by 6:30am. They volunteered to work at the Flapjacks Breakfast Fundraiser for Haven, organized by Dylan’s mother Betsy and the biology teacher Carla.

Flapjacks Breakfast Fundraiser Kitchen
The kitchen was sweltering hot. Some students flipped pancakes while others carried heavy trays of food to tables.  It was hard work, a lot harder than the teenagers imagined but well worth their efforts. The breakfast raised over two thousand dollars for Haven.

On Field Day, students purchased $2 stickers for their cellphones, allowing them to use their phones and raising more funds for Haven.  There was a car wash led by the computer teacher, Ashley and collections taken at various local churches.  As previously mentioned, there was a hat passed around a classroom and Margaret’s gardening earnings.

Together, these funds allowed Haven to make the trip across the country to receive personalized attention and expert care from Dr. Mignot.  

Now, Haven has returned from California and started a new treatment plan, hoping to improve her sleepiness and cataplexy.  Challenges remain, but her community’s support endures as well. 

Unbeknownst to Diantha, other faculty members donated their sick days to her, so that she would not lose her already meager income during this challenging time.  In addition, the school awarded partial scholarships to reduce Haven and Seanna’s tuition for next year.

Going from doctor to doctor, Haven had missed a lot of school but worked extremely hard to keep up her good grades. Haven's little sister, Seanna received support from her teacher Sandra, who stayed after school to help Seanna with her work. Diantha’s mother and friend Lee provided invaluable care for Seanna as well. 

Most recently, a local chicken plate dinner honored Haven. A young man named Matthew, a past student in Diantha’s Spanish class, organized the event.  Matthew’s chicken plate dinner raised an impressive $1400 to further support Haven.

If you live in the Roanoke Valley, you already know this story, because it’s yours. Your efforts are invaluable and extend much farther than you imagined.  Thank you to Haven, Seanna and Diantha for allowing me to share your experience with the world.  

A few months ago, many people in Roanoke Valley had never heard of narcolepsy.  Others had heard of it, but believed it meant you were just a little extra sleepy or lazy.

Now these same people have led by example that narcolepsy is neither a silly joke nor something to be ashamed of – but something we can honor in the light of day with love and compassion. They’ve proven that small change makes big change. Thank you.

Photos from the Flapjacks Breakfast Fundraiser:
Applebee's Booths Filled for Fundraiser
Fundraiser Volunteers: Mary Beth, Victoria and Kimberly

Aunt Mable and Haven
Fundraiser Volunteers: Drew and Kristin
Preparations in the Kitchen
Diantha, Haven and Seanna
(Photographs curtosy of Victoria, thank you for sharing!)

For more information about narcolepsy, please visit Stanford's Center for Narcolespy website.

Please feel free to send me a message or join my mailing list on my Author's Website.

For more on Haven's story, click here.

Tuesday, August 2, 2011

Follow Your Dreams: REM Sleep, Intuition and Oprah Magazine

I've learned to trust my "gut feeling" in sticky situations. Yet how is it that my body's natural response is smarter than my well-educated rational mind?!

This month, O: The Oprah Magazine answers this question in a fascinating article, "The Science of Intuition: An eye-opening guide to your sixth sense," by Annie Murphy Paul (August 2011).  Turns out, there are legitimate scientific reasons why our gut is a smarty-pants!

More than meets the eye:
Did you know that our eyes see a lot more than we can conciously process? In a study, individuals viewing fearful images for 33 miliseconds didn't have enough time to consciously process the images, yet their amygdalas (the area of the brain resonpsible for emotional processing) were activated none-the-less.

If you feel nervous but don't know why, you may have spotted something of concern so quickly that you didn't even realize it!

Dreams know best:
The article gives big props to sleep and dreaming - explaining that REM Sleep plays a big role in problem solving and decision making.

During the day, we take in a TON of thoughts and emotions. REM Sleep is believed to help sort through the junk-yard of stimuli for the hidden gems.  REM Sleep activates the emotional part of the brain so "things that are most important on a gut level are prioritized."

Have you ever awoken from a dream and had an "aha" moment? In a recent study, two groups of people performed a gambling experiment with a hidden underlying rule. One group previewed the task, got a full night's sleep and returned the next morning. The other group previewed the task, went about their day and returned 12 hours later (without sleep).  Twice as many people who'd "slept on it" figured out the hidden trick than the group that stayed up.

It is believed that dreams help us prioritize what's important and disloge things stuck in our conscious brains.  REM Sleep helps us to see solutions that are unapparent to our logical minds.

So, if you're stuck on a problem, try sleeping on it. To help foster a dream-solution connection, researchers suggest writing down the problem before bed, to increase chances of your intuintion addressing the problem in your dreams.


Brain Bugs:
Most fascinating for my narcolepsy blog, the article warns that the subconscious is flawed too, because our brains are old!

"Our brains run on what amounts to a 100,000-year-old operating system," explains Dean Buonomano PhD to Oprah Magazine, "The results? Our intellectual equipment has it's flaws. For example,we're more afraid of being killed by strangers (rough odds: 1 in 100,000) than by cars (1 in 10,000)."

Scientists believe our brain's ancient impusles haven't caught up to modern times, resulting in some mental glitches or "brain bugs."

As a person with vivid dreams (a symptom of narcolepsy), this so fascinating because I often dream about an intruder breaking into my house/bedroom. I hardly fear this possibility when awake, but once asleep and dreaming, my 100,000 year old brain rewinds time to address the very primitive scenerio passed down from our earliest ancestors.