During  her August 2008 speech at the Democratic National Convention, Michelle Obama shared her experiences with multiple sclerosis (MS): Mrs. Obama’s father was diagnosed with the disease when he was in his early thirties.  Last week rock legend Captain Beefheart, 69, died after struggling with MS for many years.

As Mrs. Obama said in her speech: “My Dad was our rock. Although he was diagnosed with multiple sclerosis in his early thirties, he was our provider, our champion, our hero. But as he got sicker, it got harder for him to walk, it took him longer to get dressed in the morning. But if he was in pain, he never let on. He never stopped smiling and laughing — even while struggling to button his shirt, even while using two canes to get himself across the room to give my Mom a kiss. He just woke up a little earlier, and worked a little harder.”

Michele Obama is, of course, only one of many people whose lives have been touched by MS.  Here’s a partial list of entertainers with MS: actors Terri Garr, David “Squiggy” Lander, TV personality Montel Williams, Annette Funicello, singers Lena Horne and Clay Walker, comedian Richard Pryor. MS affects an estimated 300,000 people in the United States and is the most common cause of neurological disability in young adults.

Last week, it was reported that Don Van Vliet, otherwise know by his rock legend persona Captain Beefheart passed away at the age of 69 from complications of MS after many years with the disease. According to Rolling Stone, “… the incomparable Captain Beefheart who, together with his Magic Band, rose to prominence in the 1960s with a totally unique style of blues-inspired, experimental rock & roll. This would ultimately secure Van Vliet’s place in music history as one of the most original recording artists of his time. After two decades in the spotlight as an avant-garde composer and performer, Van Vliet retired from performing to devote himself wholeheartedly to painting and drawing. Like his music, Van Vliet’s lush paintings are the product of a truly rare and unique vision.”

Below President Obama is shown holding Captain Beefheart’s 1969 album Trout Mask Replica.

Photo credit: Oscars Wild Years
 

UPDATE 21-Oct-2011
According to Xconomy:
“Weston, MA-based Biogen Idec (NASDAQ: BIIB) announced today that it has received conditional approval from the European Commission to market the long-acting version of fampridine (Fampyra) to adult patients with multiple sclerosis (MS) who have walking disability. The drug was developed and commercialized in the United States by Hawthorne, NY-based Acorda Therapeutics (NASDAQ: ACOR). As part of the approval, the agency has asked Biogen to perform a study to assess the drug’s benefits beyond improving walking speed—a request that’s consistent with post-marketing research plans already in place, the company says.”

Paul Giamatti, who played Pekar in the 2003 film adaptation of his classic, autobiographical work American Splendor said: “Harvey was one of the most compassionate and empathetic human beings I’ve ever met. He had a huge brain and an even bigger soul. And he was hilarious. He was a great artist, a true American poet, and there is no one to replace him.” Mr. Pekar, 70, was found dead in his home in Cleveland Heights, Ohio today. He is said to have been suffering from multiple medical problems including prostate cancer, asthma, high blood pressure and depression. Mr. Pekar had previously survived non-Hodgkins lymphoma and, in collaboration with his third wife Joyce Brabner, wrote about their experiences in the graphic novel Our Cancer Year.

Veteran TV reporter and The View c0-host, Barbara Walters, made a surprise announcement today on The View.  The 80 year-old TV personality told viewers that she will be undergoing heart valve surgery later this week. Walters said that she was to have heart valve replacement to repair a heart valve that had become  “tighter and smaller.” She said that she has known about the condition for a while, but has kept it a secret, even from her co-hosts. Walters said that she was not having any symptoms, however her doctors and she decided that the timing was right to do the surgery now, as she could take the rest of the summer off.

There are four heart valves which help direct the flow of blood through the heart. The mitral valve lies between the left atrium, which receives oxygenated blood from the lungs, and the left ventricle, which pumps this blood to the rest of the body. The aortic valve lies between the muscular left ventricle (the side of the heart which pumps blood to the rest of the body) and the aorta (the body’s main artery out of the heart). The pulmonary and tricuspid valves are the valves of the right side of the heart. The pulmonary valve lies between the right ventricle and the main blood vessel to the lungs, and the tricuspid valve directs blood flow from the right atrium to the right ventricle.

Valves may be either too tight (called  stenosis) or too loose or floppy (regurgitation or insufficiency).  Either problem can cause abnormalities in the way the blood flows through the heart and, if severe enough, cause symptoms of shortness of breath,fatigue, congestive heart failure, stroke, or even sudden death.   An open heart operation is required to perform total valve replacement. In this case, the diseased valve is surgically removed and a new one (either a manufactured valve or a natural valve removed from pig) is put in its place.

Biologic replacement valve (left) and mechanical valve (right)

For more information:

Resounding Health(tm) Aortic valve disease

Resounding Health(tm) Heart Valve Disease

Legendary author, Jerome David Salinger died yesterday of natural causes in his home in Cornish, New Hampshire were he lived in self-exile for decades. Mr. Salinger was 91. His most famous novel, The Catcher in the Rye, was required reading in high school English courses for generations of students.

Natural causes is a frequently given cause of death, particularly in the elderly, but what specifically does it mean? Specifying a cause of death is required by law in all states. Death certification provides public health statistics and prevents cover-ups of murder. A death certificate requires two pieces of information:

• A cause of death: a disease or injury directly related to the death (such as heart attack, AIDS, kidney failure) or the circumstances of death (gun shot wound, hanging)
• The manner of death: natural,accidental, suicide, homicide, unknown, pending

In practice, “natural causes” is a loosely-defined term used by coroners describing death when the cause of death was a naturally occurring disease process, or is not apparent given medical history or circumstances. As long as a physician familiar with the patient agrees to sign the death certificate, no autopsy in required.

At Mr. Salinger’s age, the most likely cause of death is heart failure. Even when a patient has no heart problems or other conditions, a body’s key cells and tissues can just wear down. It’s not so much a disease process, as a natural biological condition – the body just doesn’t last forever.

Dr. B and I are just wrapping up a week in Brussels and today we toured an art museum devoted exclusively to the great Belgian surrealist Rene Magritte (1989-1967). Among the things we learned was that, early in his career, he did commercial advertising work, creating film posters and covers for musical scores, to support himself financially. As part of the exhibition, there is a biographical movie about Magritte. In 1965, two years before his death from pancreatic cancer, he was visited and photographed in his Brussels’ home by American photographer Duane Michals (b. 1932). At one point in the film, Michals described times when he would have lunch with Magritte and his wife, Georgette. According to Michals, the “fourth person” at the table was a television set and Mr. Magritte’s favorite TV show was the western drama Bonanza. One of the four principle actors in the series was Michael Landon who, like Magritte, died from cancer of the pancreas (Landon in 1991 at the age of 54).

Related story: Patrick Swayze and the apparent “epidemic” of pancreatic cancer among public figures

Artist Jeanne-Claude, who along with her husband Christo, created the 2005 Central Park installation “The Gates” and other large scale “wrapping” projects around the globe has died at age 74. Her family reports that she died from complications of a brain aneurysm (otherwise known as a cerebral aneurysm).

What is a Cerebral Aneurysm?

A cerebral aneurysm (also known as an intracranial  aneurysm) is a weak or thin spot on a blood vessel in the brain that balloons out and fills with blood. It is estimated that one in fifteen people in the US will develop an aneurysm during their lifetime. The bulging aneurysm can put pressure on a nerve or surrounding brain tissue.  It may also leak or rupture, spilling blood into the surrounding tissue (called a hemorrhage).  Some cerebral aneurysms, particularly those that are very small, do not bleed or cause other problems.  Cerebral aneurysms can occur anywhere in the brain, but most are located along a loop of arteries that run between the underside of the brain and the base of the skull.

Symptoms depend on what structure the aneurysm pushes on, but may include:

* Double vision
* Loss of vision
* Headaches
* Eye pain
* Neck pain

A sudden, severe headache (often described as “the worst headache of your life”) is one symptom that an aneurysm has ruptured.

Other symptoms of an aneurysm rupture may include:

* Confusion, lethargy, or sleepiness
* Eyelid drooping
* Headaches with nausea and/or vomiting
* Muscle weakness or difficulty moving any part of the body
* Numbness or decreased sensation in any part of the body
* Seizures
* Speech impairment
* Sudden onset of irritability, impulsiveness, or loss of temper control
* Vision changes (double vision, loss of vision)

NOTE: A ruptured aneurysm is a medical emergency. Seek immediate medical help.

Treatment of unruptured aneurysms may be one of two ways- depending on size, shape and location:

1. An open skull procedure, with placement of a clip to cut off the aneurysm
2. An endovascular procedure, where a catheter is threaded into the artery and small metal wires are inserted into the aneurysm. These wires coil up into a mesh ball and encourage the formation of a blood clot, which prevents the aneurysm from rupturing. This is a less invasive procedure, but is not appropriate for all types of aneurysms.

For more information:

Resounding Health(tm) Cerebral Aneurysm