Dystoniamatters! - The Dystonia Society
Transcription
Dystoniamatters! - The Dystonia Society
Dystoniamatters! Issue 58 ● Winter 2007 ‘Hello darlings...’ Also in this issue... ● ● Phyllis Yates’ first words in over 13 years... page 19 IA N O ST Y E* D U L ISS EA G L A N CI RY E A P L *S Alternative therapies, Connie’s way, page 15 A day in the life, New York diary page 39 Supported by an Unrestricted Educational Grant from Ipsen Ltd Issue 58 ● Winter 2007 The Dystonia Society exists to support people who have any form of the neurological movement disorder known as dystonia, and their families, through the promotion of awareness, research and welfare. THE DYSTONIA SOCIETY Registered Charity No. 1062595 Company limited by guarantee No. 3309777 1st Floor Camelford House 89 Albert Embankment London SE1 7TP Office: 0845 458 6211 Helpline: 0845 458 6322 Fax: 0845 458 6311 email helpline: [email protected] email other enquiries: [email protected] www.dystonia.org.uk Newsletter published at end of: February, May, August, November We welcome new ideas for the newsletter, please call the Editor to discuss your ideas. Items intended for publication should be submitted to the Editor, eight weeks before publication. 1 ROYAL PATRON HRH Princess Alexandra, KG, GCVO PATRONS Tom Beldon Sir Geoffrey Littler, KCB Lord Macdonald of Tradeston, CBE Derek Thompson CHAIRMAN Martin Cross VICE CHAIRMAN Fiona Ross, OBE TRUSTEES Mike Newbigin, Honorary Treasurer Graham Ashdown Sue Day Roger Edmonds Tony Flowers Moira Gwilliam Penny Richie-Calder Maureen Sheehan Alan Tamlyn CHIEF EXECUTIVE Philip Eckstein MEDICAL ADVISOR Dr Tom Warner, PhD, MRCP FOUNDER The late Joan Young Dystoniamatters! EDITOR Phil Baldy Dystoniamatters! DESIGN Sarah Davies Design (01726) 834833 Dystoniamatters! Society news Annual Conference Around 150 delegates attended the Dystonia Society’s AGM and conference at the Wellcome Conference Centre in London in early November. The members certainly appreciated the impressive new venue. ‘This was certainly the best conference I have attended’ and ‘I think this year’s AGM will take some beating’, were just two of the comments from attendees. Among the distinguished speakers at the Conference were Dr Paul Eunson from Edinburgh who spoke on ‘Children and dystonia’ and the importance of early diagnosis and support for children affected. ‘The potential of too many children with dystonia is not realised at school and beyond’, he said. Dr Peter Moore gave an interesting presentation on ‘Dystonia – focusing on the future’ in which he identified new directions for the Society and also suggested that members use opportunities to get involved with their local trusts and health services in order to raise awareness of dystonia. Alistair Newton spoke on the European Dystonia Federation and Peter Meager, National Manager for Scotland spoke about the physiotherapy project that has just started (see page 4). Issue 58 ● Winter 2007 From left to right: Neil Fairburn, Kate Foley Geoffrey Chem -Yee Tan ● Essay prize winners... The winners of the Jackie Deakin essay competition, which is run by the Society for 3rd, 4th and 5th year medical students, received their prizes at the conference. Geoffrey Chem-Yee Tan from the Royal Free and UCL Medical School was presented with his first prize by our patron Lord Macdonald and Keith Deakin. Kate Foley from Sheffield came second and other prize winners were Neil Fairburn, Tim Brock, Laura McWhirter, Musa Basir Sami and Christopher Groves. Copies of the seven winning essays are available to members directly on the web site www.dystonia. org.uk or as printed copies from UK Office. 2 Editorial One-to-One Welcome... A new support service ● PLANS FOR 2008 As we look to 2008, we are already planning next year for the following: ● Progress on our three research projects with at least one new project launched ● Our most successful Awareness Week yet using information gained via the members questionnaire ● New projects to help children affected by dystonia ● An improved web site with scope for membership involvement ● Staging five regional conferences ● Expansion of our One-toOne and Helpline services 3 You will notice some changes. Each newsletter will now feature a specific type of dystonia, starting with laryngeal dystonia. The February issue will focus on blepharospasm with the May 2008 edition highlighting cervical dystonia. We are sure you will find this approach more ‘substantial’ and useful. Let us know what you think. You will see another change too: we are no longer including a list of Area Contacts in the magazine. This comes about because our newly launched support service, ‘Dystonia One-to-One’ takes over that role. Now members can call us and tell us exactly the type of person they would like to speak to for an informal, supportive chat. We will do our best to match them against our list of One-to-One volunteers. We are hugely grateful to that special band of volunteers who made up our Area Contacts over the years. Happily, quite a number of them are still involved in the new service. We have very recently undertaken a mailing to around 1500 ex-members whose membership had lapsed at least three years ago and are delighted to welcome back around fifty readers already. Remember, the more members we have the more impact we can have on behalf of people with dystonia. An important new service is being launched in December to provide members with informal, positive support over the telephone or via email. A v to the Winter newsletter For an isolating and little known condition like dystonia, the support that members can give each other is vital. “We hear every week from members who would like to speak to others with the same experience”, says CEO Philip Eckstein. “This new service will enable us to match callers with a One-to-One volunteer who can share experiences in a supportive way”. Members will be able to call one central telephone number where they can discuss their requirements with a staff member. They will then be matched with a volunteer who has appropriate experience. For instance a member might find considerable benefit in speaking to someone with similar symptoms, or the same type of dystonia, or who has had a certain treatment, or who is also the parent of a child with dystonia. The new service is a refinement of our previous Area Contact service. But whereas previously it was not possible for members to easily find people with similar experience, this should now be possible. The service also offers better support and clearer guidelines for the volunteers themselves. How the One-to-One service works 1 Member calls our One-to-One number 0845 899 7111 You will be asked about what sort of person you would like to be ‘matched’ with and when you would like to be contacted. 2 We will identify a volunteer with suitable experience and make contact with them to see if they are able to call you. 3 You will then be called by the One-to-One volunteer. 4 We’d also like to follow up with users of the new service some weeks after the first call to get feedback about their experiences with the aim of making the service even better in the future. Philip Eckstein Chief Executive Dystoniamatters! Issue 58 ● Winter 2007 4 Local 2008 Conferences Society news Society news Research Update Awareness Week Next year we are planning four more regional Living with Dystonia days as well as the national conference. Don’t forget to put them in your diary. Each of the three research projects funded by the Society has made progress in the past three months: ● Bristol 29 March ● East Midlands (Nottingham) 17 May ● Liverpool 20 September ● AGM /conference (London) Early November ● South East Physiotherapy project Now that the full amount of £150,000 has been raised, the project to evaluate the benefits of physiotherapy for people with cervical dystonia has started! The project is being run at two centres in Scotland: Glasgow and Aberdeen. A physiotherapist has been recruited at each centre and they have both started their training in France. They’ll be starting their work with patients after Christmas. We are delighted to welcome Maureen Sheehan and Tony Flowers as new members of the Board of trustees. WEBSITE EXPERIENCE Childhood Onset Dystonia project NEW TRUSTEES We are planning big improvements to the website in 2008. Do you have ‘web experience’ or know anyone who does? If so, we would love to hear from you. The HELPLINE will break for Christmas on 21 Dec and resume on Monday 31 Dec. 5 If we are to work and lobby effectively on behalf of our members, we need the ammunition! The Society plans to send every member a questionnaire in January 2008 that asks about your treatments and the everyday challenges you face. We will also seek your opinions on the Society’s priorities and the local involvement you would like. The questionnaire will not take longer than 15 minutes to complete. Please do take the time to complete your copy. The more we know about your challenges, the more we can help. Oxford Blepharospasm device trial We are now at the last hurdle before the project can start! The final application to use the simple device that clips to spectacles is with the MHRA (Medicines and Healthcare Regulatory Agency). As soon as we receive approval, the project can finally begin. 6 December ASKING THE RIGHT QUESTIONS... Consultant Paediatric Neurologist, Dr Paul Eunson, will head a project to carry out a detailed audit of Scottish children and youngsters with dystonia (particularly the causes and treatments). An application is with the Ethics Committee, awaiting their approval. A positive decision is expected in the next few months. Dystoniamatters! Runners and riders If you have a place in the London Marathon or would like to run the race, please contact Joy Bourne on 020 7793 3654. Likewise if you would like to take part in an exciting cycle challenge in May 2008. GRANTS ● Why not see if you are eligible for a home insulation grant? Trustee Alan Tamlyn reports that if a member is on any of a number of benefits (including DLA), they may be able to apply for a grant covering up to 100% of the cost of insulating their home. Ring the Helpline for more details on 0845 458 6322. Thank you To Helen Barrow from Gateshead, Tyne and Wear for her splendid photography at our Annual Conference and to Lucy Laing for her contribution to My Story who kindly allowed us to reproduce the photographs. Good idea... Following suggestions from readers, we are planning to produce several items to help people communicate their dystonia to others. The first is a sticker about having writer’s cramp. It is designed to be stuck onto a letter written by someone with writer’s cramp. The other is a card (credit card sized) for people suffering from laryngeal dystonia. What do readers think? Please call the office if you are interested is either item. Let us know if you have any other good ideas on how to communicate your condition to others. Issue 58 ● Winter 2007 6 A Review Laryngeal dystonia – Special Issue Dystonia affecting the voice is known as laryngeal dystonia or spasmodic dysphonia. In this article, Dystonia matters! puts the questions to two eminent ENT surgeons who regularly treat people with laryngeal dystonia (LD): Mr Gerald Brookes and Mr Maurice Hawthorne. The statistics published by the renowned US Mayo Clinic suggest that about 52 people per million have laryngeal dystonia. This translates to 3,100 people being affected in the UK. Mr. Brookes feels this is almost certainly an underestimate: “As awareness of laryngeal dystonia grows, so are the numbers of people being diagnosed,” he says. There are two principal types of laryngeal ● Mr Gerald Brookes dystonia – one affecting the adductor muscles that pull the vocal cords together and the other affecting the abductor muscles pulling the vocal cords apart. LD of the adductor muscles results in a strained staccato-like speech while LD of the abductor muscles often results in a weak, breathy voice that can break in mid-word. It is very unusual to have complete voice loss as a consequence of laryngeal dystonia. The symptoms of LD such as strained speech or a breathy voice are thought to be caused by muscle spasms within the adductor or abductor muscles. In some patients, however, sudden changes in muscle tension may simply appear as spasms. Mr. Brookes suggests it is more useful to think of the symptoms caused by laryngeal dystonia as a problem of correctly sequencing the complex movements of the vocal cords. “Laryngeal dystonia is caused by faulty control signals from the brain to the laryngeal muscles”, Mr. Brookes says, “which results in disruption of the co-ordination of vocal cord movements.” 7 Dystoniamatters! Adductor LD is the commonest type of laryngeal dystonia, resulting in around 90% of cases of laryngeal dystonia while abductor LD is rarer and seen in around 10% of cases. However, there are variations on these conditions and physicians occasionally see patients who have a mixed pattern of dystonia with elements of abductor and adductor muscle spasms. “This is rare,” comments Mr. Brookes “and these mixed patterns are seen in less than 1% of patients”. There are a number of conditions which ● Mr Maurice Hawthorne have similar symptoms to that of LD such with his son Hugh as nodules or polyps or potentially tumours on the vocal cords. The diagnosis of LD must start by excluding these and other medical problems. “The diagnosis of LD is not always easy, as the patients’ efforts to compensate for their communication difficulties may cause additional voice distortion which can mask the underlying condition” says Mr. Brookes. Patients should also be cautious about assuming that every case of dysphonia is likely to be dystonia. “Around one third of the patients I see with initial symptoms of dysphonia, turn out not to have LD after further investigation”, says Mr. Hawthorne, “so it is very important therefore that the patient sees an ENT specialist who can make a careful assessment”. The main treatment for LD is injections of botulinum toxin into the muscles causing the abnormal vocal cord movements. Botulinum toxin can be very effective in lessening the spasms that distort the vocal cords. The vast majority of people with laryngeal dystonia get some relief with this treatment. “Around 90% of patients will usually find their laryngeal dystonia can be successfully treated using botulinum toxin. It is reassuring to patients to know that the symptoms can usually be well managed with a course of the drug” says Mr. Hawthorne. There are also other novel approaches that focus on the ‘reprogramming’ of the pathways in the brain by retraining the voice muscles, (see the article on Connie Pike’s regime, page 15). Issue 58 ● Winter 2007 8 A Review (continued) Laryngeal dystonia – Special Issue Mr. Brookes is also working on a technique using radiofrequency treatment to the neck muscles to ‘re-programme’ neural pathways. He thinks this causes a masking effect thereby improving regulation of the brain ‘control centre’. Typically treatment for adductor LD is given sitting up or lying down. Firstly the throat is treated with local anaesthetic after which a small injection is given into the affected laryngeal muscles. To guide the placement of injections, the patient must be attached to an electro-myography (EMG) “Laryngeal dystonia is caused machine that senses the electrical activity in the by faulty control signals from muscles. Normally each the brain to the laryngeal patient is offered treatment muscles... which results in with botulinum toxin type disruption of the co-ordination A following diagnosis. For those very few patients of vocal cord movements.” who develop a ‘resistance’ (ie. anti-bodies) against botulinum toxin type A that will negate the beneficial effects, there is a type B that is sometimes tried and can prove effective. However, the likelihood of a patient with voice problems developing a resistance to botulinum toxin is rare. Usually small side effects from injections last for one week while the benefits from the injections can continue for up to four months. “That is the gold standard,” says Mr. Brookes, “and we try to accurately adjust the dosage to achieve this. Some patients are ten times more sensitive to the effects of the toxin than others so careful evaluation of the patients’ response is necessary to decide the optimum dosage”. The toxin blocks activity at the nerve-muscle junction and is effective for a very long time. However, the sprouting of new nerve fibres to overcome the chemical blockade occurs, which is the reason for recurrent symptoms from re-innervation. 9 Dystoniamatters! Laryngeal dystonia normally affects people aged 30s onwards. It is very rare for the dystonic symptoms to spread to other areas of the body. “If the symptoms appeared to spread, I would question the original diagnosis of laryngeal dystonia,” said Mr. Hawthorne.The symptoms of laryngeal dystonia can go into remission. “However, this is very unusual” he comments. It is widely accepted that stress can make any type of dystonia worse and that relaxation can help to mitigate the symptoms. “While stressful situations can make the symptoms worse, the cause of dystonia is not stress”, says Mr. Hawthorne. ● Getting the treatment The principal treatment centres in the UK are listed on the following pages. To really make an impact on the patient’s quality of life, treatment needs to be available when it is needed – generally every three months at least. Some centres are flexible enough to allow the patients to change appointment times at a few days notice. “Every patient is given a three month appointment, but about 30% will call to vary these dates – either earlier or later, as their current situation dictates,” said Mr. Hawthorne of his weekly clinic in Middlesbrough and the monthly clinics in Penrith and Newcastle. However, not all patients are that lucky. We are now increasingly hearing from members about difficulties in getting timely treatment as the capacity at centres no longer matches the growing demand for the service. Appointments are being pushed to four month or even longer intervals. In other cases it is impossible for patients to get their treatment at a clinic that is reasonably close. The Dystonia Society thinks this is unacceptable. We recognise just how important it is to members to have access to treatments when they need it. Without it, family life will be hugely affected and one’s social life suffers. There is also the threat of losing one’s job. The Society will work with everyone directly affected to try and get improvements in the problem areas. If you are having problems, please contact Val Wells, Service Development Manager on 0845 458 6299. Issue 58 ● Winter 2007 10 Important note: This is a list of treatment centres we are aware of. Botulinum toxin clinics If you know of any omissions or amendments that should be made, or if you would like further information on any of these centres, please call the Helpline on 0845 458 6322. for laryngeal dystonia LOCATION ENT CLINIC CONSULTANT FREQUENCY OF CLINICS Birmingham Blackpool Bradford Bristol Canterbury Cumbria Huddersfield Liverpool Liverpool London (Grays Inn Road) London (Queen Square) London (Harley Street) Manchester Middlesbrough Newcastle-upon-Tyne Nottingham Oxford Plymouth Sheffield Northern Ireland, Belfast Scotland, Aberdeen Scotland, Dundee Scotland, Edinburgh Scotland, Glasgow Scotland, Melrose Wales, Swansea Wales, Wrexham Queen Elizabeth Hospital Blackpool Victoria Hospital Bradford Royal Infirmary St Michaels Hospital Kent and Canterbury Hospital Penrith Hospital Huddersfield Royal Infirmary University Hospital Aintree Royal Liverpool Hospital Royal Throat Nose and Ear Hospital The National Hospital for Neurology The Harley Street Voice Centre (1) Manchester Royal Infirmary James Cook University Hospital Walkergate Park for Neuro Rehabilitation Queens Medical Centre John Radcliffe Hospital Derriford Hospital Royal Hallamshire Hospital Royal Victoria Hospital Aberdeen Royal Infirmary Ninewells Hospital Edinburgh Royal Infirmary Glasgow Royal Infirmary Borders General Hospital Singleton Hospital Maelor General Hospital Mr D Proops Mr Nigam Mr Tucker Mr G Porter Mr D Mitchell Mr M Hawthorne Mr Newbeggin Mr A Swift Mr McCormick Mr J Rubin Mr G Brookes Mr G Brookes Mr Horner Mr M Hawthorne Mr M Hawthorne Mr J McGlashan Mr G J Bates Mr M Bridger Mr A Parker Mr Primrose Mr A Hussain Professor R Blair Mr M Armstrong Mr K MacKenzie Mr M Armstrong Mr C Fielder Mr J Coakley Monthly 2 – 3 times per year Every 6 weeks Every 2 months Monthly Every 2 weeks Every 2 weeks By appointment Weekly Every 3 weeks Monthly 2 – 3 times per year Monthly Varies Monthly 4 – 5 times per year (1) available for treatment of NHS patients with prior authorisation of their Primary Care Trust 11 Dystoniamatters! Issue 58 ● Winter 2007 12 Helpful hints Laryngeal dystonia Special Issue Below are excerpts from an information pamphlet produced by Norma Barer ● Dr Renata Whurr and William Vanderlinde of the National Spasmodic Dysphonia Association in the US. (www.dysphonia.org). They have been identified by Dr. Renata Whurr, Specialist Speech and Language Therapist at the National Hospital for Neurology and Neurosurgery, London as particularly useful to first time patients. 1. Benefits of botulinum toxin injections For many spasmodic dysphonia patients, injections provide the freedom to speak more easily. Although not a cure, most people note a marked improvement in the quality of their voice and in the effort required to speak. The benefits are temporary (lasting six weeks to six months) and can be repeated as required. The length of benefit will vary for each individual. 2. Your injection If this is your first injection, there is nothing to be nervous about. This is a safe and relatively simple procedure, taking no more than a few minutes to perform. Your doctor will use a local anaesthetic to minimise any discomfort associated with the injection. Most people do not find the experience painful. Before your injection, try to relax and breathe quietly. Focusing on the relief you will soon receive can help to diminish any anxiety. 3. After your injection After the injection, you are free to go about your regular routine. There are no immediate after-effects. The length of time for the toxin to take effect can vary from 24 hours to several days. Most patients experience a weakened voice for one to three weeks following the injection. Often, the voice becomes very soft or ‘breathy.’ 13 Dystoniamatters! The breathiness can last from several days to weeks, depending on the individual patient and the dose of toxin given. At first, you may not have the power to speak in a loud voice. Be patient and enjoy talking. Your voice will gradually become stronger. Voice rest is not necessary. As the effect of the toxin begins to wear off, you will experience various changes in your voice. This is normal and to be expected. Try to relax and enjoy these changes. 4. Post-injection side effects There are two minor discomforts sometimes associated with your injections, which can occur shortly afterwards. However, not all patients experience these discomforts. Both are temporary. One is the breathiness and the other is a slight difficulty in swallowing liquids. This is easily overcome by sipping slowly rather than swallowing quickly! Some patients report a rough or scratchy voice after their injection. This may be caused by a change in the tension of the vocal cords, resulting in diplophonia (two vocal cords vibrating at different frequencies). This scratchy voice tends to recover gradually over a period of one to three months. A few patients have reported occasional side effects such as difficulty swallowing, trouble clearing their throat, problem with swallowing too much air, etc. These side effects, which may vary from mildly to extremely annoying, are apparently due to the spreading of the botulinum toxin into the other muscles. The most severe side effects usually go away in one or two weeks. I have found that during my ‘breathy’ period, it is better not to force my voice to be louder than it is. In noisy situations, I try to move away from the centre of noise and explain that my voice is not very loud. It certainly gets the attention of your listeners! You will find that speaking over the telephone is not nearly as difficult as it was before the injection. Speak slowly, enunciate and remember to pause and breathe often. For me botulinum toxin injections are miraculous! After the injection, my voice may not always be perfect but the improvement is amazing. I am once again able to express myself without inhibitions and to once again be spontaneous. Issue 58 ● Winter 2007 14 Alternative therapies Connie’s way By Peter Meager Connie Pike is an American speech and language therapist. Around three years ago, she developed severe spasmodic dysphonia (SD for short – also known as laryngeal dystonia). As a result, she developed a non-drug, holistic programme to tackle her symptoms. Today you would not know she had a speech problem and she runs a clinic in her home near Tampa in Florida to treat others who suffer from SD. In June, Peter Meager had the opportunity of experiencing what Connie is advocating at first hand. While in London, I was able to sit in on a meeting Connie was having with English SD sufferers in the Society’s UK office. The kind of things she was saying made sense to me and I came home wondering if it could really work. Christine, my wife, said that she really thought I should go and agreed to go with me. So, we decided to dig into our savings and four weeks later were flying to Orlando en route for Tampa. There were six of us at the clinic, the other five being American ladies from various parts of the States. All of them had symptoms much worse than mine. I had been having botulinum toxin injections for over eleven years and when they worked my voice wasn’t too bad. But the last injections hadn’t worked and I was desperate to try anything which would get me out of this cycle of injections – waiting to see if they worked; struggling when the benefits (if any) wore off and then waiting for the date of the next injections so that I could get on with my life again. There are several elements in the five day clinic programme. First there is traditional speech and language therapy carried out by Connie Pike. Then there is optimal breathing with Mike White who, over the last thirty years, has developed a course to improve breathing. Although this is not primarily for people with speech problems it has been found to be of great benefit to many who have them. There is a psycho-social aspect 15 Dystoniamatters! (the Taylor-Johnson Temperament Analysis Profile) and also a spiritual element. As the symptoms of SD can be different for almost every individual, we learned many general ● Peter & Christine Meager principles and then, with Connie and Mike’s guidance, could pick out which might help us individually. One of the common characteristics is tension in the throat which causes the vocal cords to go into spasm. One of the main aims of the clinic is to take the focus away from the throat and bring it up into the front of the face. One way of doing this is by humming. Another is by singing, making ‘oo’ sounds. We were given a book called Set Your Voice Free by Roger Love. This has a CD with it with singing exercises which we practised as a group. We also had a PC programme called Voice Print, which allows you to check your voice quality and also that you are speaking at the correct pitch. The breathing exercises were very intensive and it was during a one-to-one session with Mike White that the breakthrough came for me. One second there was the tight, strained, rasping, breathy voice and the next there was a deep, free resonant sound, filling the room. I stopped and exclaimed, ‘Where did that come from?’ Then I cried. It was like meeting a long lost friend. I could hardly remember having been able to make that kind of sound. After that I had to start learning to use this new voice for speaking. By the end of the clinic each of us had seen an improvement in our voices. It is recognised that several things can affect the vocal cords and therefore might aggrevate SD symptoms. These were highlighted and we were advised to avoid them for at least six months to give us the best possible chance of maintaining any progress we had made. Issue 58 ● Winter 2007 16 Alternative therapies (continued) Connie’s way Comments & tips from members of the Laryngeal Dystonia group ” ”I spent a lot of time preparing for a job interview and sought advice from the on-line American spasmodic dysphonia bulletin board,” writes Debbie Skerrett. “I told people I had a muscle disorder that affected my voice – not a neurological disorder because I find people then assume I am going to keel over at any moment. I’m really pleased to say I was offered the job as a medical social worker!” ● The on-line SD Bulletin Board: www.dysphonia-bb.org/forums/sd/ Alcohol, caffeine and dairy products come into this category. We were also advised to try a diet which is at least 75% vegetarian. In addition, to help maintain our breathing efficiency, we were told to take at least three, thirty minute exercise sessions per week. After nearly three months the improvement in my speech has been maintained, despite two or three blips. My consultant observed that my voice was better than he had ever heard it. Is this a cure for SD, or is the brain learning a new pathway for speech – by-passing the malfunctioning part? Whichever it is, I’m glad I went and it’s working for me. Liz Hope explains: I tried The Journey – a mind, body and spirit organisation that brings together beliefs and experience, linked to psychological therapies. I can now speak without effort and have not had any effective treatment for nearly two years. Whilst I would love to know why things have changed, I am content with the result. ● For anyone interested, the web site is www.thejourney.com “It would be good to see much better availability of treatment for those with LD when we need it, within reasonable travelling distance from where we live,” comments Liz Armstrong. “Many patients are denied treatment they need to improve the quality of their lives, due to clinics being closed to new patients and longer waiting lists between appointments.” Essential Information Ivy Black says: “My first injection was Dec ‘88, making me the very first in the country to have botulinum toxin treatment for my condition. Since then, I’ve had 91 injections although my appointments now seem to have been extended to six months, so I may have lost my voice by Christmas!” Connie Pike: www.freetospeaktherapy.com Cost of clinic: US $3000 (from start of 2008) plus travel and accommodation Roger Love: Set Your Voice Free (ISBN 0-316-44158-9 / US $15.99) Optimal Breathing: www.breathing.com Voice Print: www.vocalinnovations.com Taylor-Johnson Assessment: www.tjta.com Free to Speak by Connie Pike costs £10 (including p+p) and a copy can be obtained by ringing Roz on 0845 458 6211 or emailing [email protected] 17 Notice board Dystoniamatters! “I am a professional trainer. I always start by explaining that I have spasmodic torticollis and dysphonia (it’s good publicity for a condition I’d never heard of until it was diagnosed) and I tell the ones at the back to shout out if they can’t hear so I can mime the rest,” reports Alec Sandison. ● National Spasmodic Dysphonia Association www.dysphonia.org ● To join the laryngeal dystonia group of the Dystonia Society, please contact Moira Gwilliam via the Dystonia Society. Issue 58 ● Winter 2007 18 My story Hello darlings... By Lucy Laing When Phyllis Yates lost her voice more than 13 years ago she despaired of ever being able to say hello to her beloved granddaughters... Ever since Leanne, ● Phyllis & granddaughters Donna (left) & Leanne 13, and Donna, 11, were born in 1994 and 1996, Phyllis has never been able to hold a conversation with them. She would play games with them as toddlers and give them cuddles, but has never been able to say ‘I love you’. Phyllis said: “It was wonderful to be a grandmother and I loved my granddaughters but I’ve had to watch my granddaughters being born and growing up without being able to talk to them. It has been so frustrating. All I wanted to do was talk to them; ask how they were doing at school, and just to tell them that I loved them. We had a great relationship and my son John explained to them why I couldn’t speak, so they were used to me being silent. But I really wished that I could speak to them and ask them about their friends and school. And most of all I just wanted to tell them that I loved them.” Phyllis, who is 73, lives in Lowestoft with husband George, a former crane driver. She had been able to speak perfectly normally until she went to a party at her sister’s house in 1993 and woke up the following morning unable to speak. She said: “I opened my mouth the following morning and no words came out. I couldn’t understand it. I had been able to speak perfectly the night before, yet now I couldn’t make a single word come out. 19 Dystoniamatters! It was terrifying. I couldn’t tell George what had happened, but he could see that I couldn’t speak.” Phyllis and George went to see her GP and were referred to an ear, nose and throat specialist at her local hospital, but neither could provide any answers. “No one could understand what had happened to my voice. I was treated by a psychiatrist as it was thought my problem was psychological but that didn’t work either. I was even given a bottle of indigestion remedy, but nothing worked. My voice never came back,” she added. She spent the next decade unable to answer the phone, answer the door to anyone or even go shopping. “It was just impossible. George had to do everything and I felt completely helpless. I couldn’t go shopping because I couldn’t ask for anything, or communicate with any of the shop assistants”, she said. “I got very depressed as I’d gone from living a normal life, to living in a shadow, without any independence. George got very good at lip reading. He could understand what I was trying to say just by reading my lips. So I didn’t have to resort to writing things down for him. He would always understand me. He was a rock of support – I couldn’t have done it on my own.” Issue 58 ● Winter 2007 20 My story continued “It seemed so strange hearing my own voice again. I’d almost forgotten what I sounded like. I was so thrilled and so was George.” ● George & Phyllis In October last year, she saw a specialist in Harley Street, London for a private consultation and, after years of not knowing what was wrong, Phyllis was finally diagnosed with laryngeal dystonia, a neurological voice disorder that involves involuntary spasms of the vocal cords, causing speech interruptions, or in the rare case of Phyllis, the complete disappearance of her voice. She said: “I was so shocked when I was diagnosed, but it was a relief too, after years of doctors just believing that it was all in my head. Finally I had some answers.” Phyllis underwent her first treatment in May this year where she was injected with botulinum toxin A into the voice box, which has released the muscle spasms. Her second injection resulted in some voice improvement. Then after her third injection two months ago, she finally got her voice back properly. She said: “It seemed so strange hearing my own voice again. I’d almost forgotten what I sounded like. I was so thrilled and so was George. My voice was wobbly at first as I’d been so out of practice, and I was only able to talk for a few minutes at a time. Also it came out very loud at first – I was almost shouting – as I didn’t have much control over my vocal cords. But the first thing I wanted to say was ‘hello darlings,’ to my granddaughters. They were so shocked when they heard me speak as they had never heard me before. Now I ask them all the things that 21 Dystoniamatters! I’ve always wanted to ask them and they tell me how they are getting on at school, which is wonderful.” Phyllis has now got her voice completely back, although she is still having the injections every four months. “The specialist didn’t know whether the treatment would work,” she added, “but it has been marvellous and I am very grateful. It has given me not only my voice back – but my life back too. The only thing is that I can nag George as much as I like now. He’s had a quiet life for 13 years – and I’ve got a lot of catching up to do!” The Harley Street ENT Clinic can be contacted on: 020 7224 2350 ● Phyllis’s treatment has taken place in the Harley Street Voice Centre at the Harley Street ENT Clinic in London by Mr Gerald Brookes, Consultant ENT Surgeon. The clinic’s ethos is that its state of the art diagnostic and treatment facilities should be available to all patients. Despite being a specialised unit in a private clinic, the Voice Centre also treats NHS patients for NHS tariff rates funded by their Primary Care Trust (PCT). Phyllis’s treatment has therefore been paid for completely by her local PCT. Mr. Brookes commented: “This lady’s voice result is as close to a modern day miracle as you can get. She has a severe form of a very uncommon type of laryngeal dystonia. Over the last 20 years I have only previously treated 2 or 3 similar dystonia patients with complete loss of voice in a personal series of nearly 700 cases. I am delighted with the outcome of Phyllis’s treatment and for the new lease of life it has given her.” Issue 58 ● Winter 2007 22 Your Questions & Answers... With thanks to Dr Tom Warner, Medical Director of the Society for responses to certain questions. Q. Following the question in the previous issue about neuroleptic drugs causing tardive dystonia, could you confirm that symptoms are likely to disappear if a person stops taking these drugs? ● It is important to distinguish between an acute dystonic reaction which is a response often to a single dose of a dopamine blocking drug and tardive dystonia. The latter usually comes on after chronic exposure to such drugs and is the dystonia most commonly seen in patients treated with neuroleptic drugs. Whilst in the great majority of acute dystonic reactions, the dystonia resolves once the drug is stopped, unfortunately for tardive dystonia this is rarely the case and the dystonia will persist. Furthermore, there are major risks of a relapse of the psychiatric condition if the drugs are stopped. It is vital that drugs used for treating psychiatric conditions are not just stopped if tardive dystonia develops. 27 The possible options need to be discussed with mental health professionals and sometimes neurologists. We also asked the mental health charity, MIND, for their opinion. Their response was: “When tardive dyskinesia develops in response to neuroleptic drugs, it may persist after the drugs are stopped, and indeed it may only appear after someone has stopped the drug, because the drug has disguised the effect. For this reason people may be advised to continue taking the drug in order to continue masking the dyskinesia. Psychiatric advice now is that if people begin to show signs of tardive dyskinesia when taking these drugs, they should stop taking them as soon as possible, to minimise the likelihood that this effect will continue. And in all cases, people should take the smallest possible effective dose for the shortest possible time. In spite of this advice. people are still often expected to go on taking these drugs at high doses, and indefinitely. Dystoniamatters! The longer you have been taking a drug, the more difficult you are likely to find withdrawal, and the longer you should expect it to take. However coming off neuroleptic drugs is not impossible providing it is done with care. Many people do manage to stop taking them, and to find other ways of resolving or coping with their psychotic experiences.” It is important that you liaise closely with your physician if you want to change your drug regime. Q. Does Erb’s palsy have any connection to spasmodic torticollis? ● There is no connection. Erb’s palsy can be due to birth trauma and is caused by damage to the brachial plexus as it runs through the axilla (armpit). The brachial plexus contains nerves that supply the arms. Erb’s palsy can lead to weakness and sometimes loss of feeling. It would be unusual to affect the neck muscles, particularly after a period of many years after the original insult. Q. Is there any connection between paroxysmal dystonia and periods of paralysis? similarities to another episodic disorder called periodic paralysis and I wonder whether there may be some connection. It is always difficult to speculate further without full clinical details. Q. In your fact sheet on paroxysmal dystonia you say: “during an attack, people do not lose consciousness, and are completely aware of their surroundings. Paroxysmal dystonias do not affect the mind or the sense.” I don’t believe this is correct. I have on a number of occasions lost consciousness especially when the pain gets bad and I wake up later not able to move. ● Dr Warner writes: The vast majority of people with paroxysmal dystonia do not lose consciousness. This correspondent has very unusual symptoms. Rarely paroxysmal dystonia is associated with epilepsy, although I am not convinced that this is the case with this individual. I can only suggest that he approaches his neurologist and suggest that if this is felt to be the case, then perhaps the neurologist could let us know so we can amend our records / literature. ● Dr Warner writes: I am not aware of any connection although paroxysmal dystonia has some Issue 58 ● Winter 2007 HELPLINE 0845 458 6322 28 Questions & Answers Q. I have cervical dystonia and was getting very positive benefits from botulinum toxin injections over the past 18 years, with small amounts injected monthly. Then recently my usual consultant was on leave and a covering consultant gave me the full amount in one injection and told me not to come back for 3 months. These injections resulted in terrible pain in eyes, neck and ear which I had not experienced before. How do I counter these negative effects? ● I am afraid there is not much to counter the effects other than the usual painkillers if the pain is a major problem, and time. The effects will wear off but may take several weeks. The majority of people receiving botulinum toxin for dystonia have injections every 3 – 4 months, rather than monthly. Q. I have been receiving botulinum toxin injections for four years without side effects. However, following my last injection, I developed an itch (not rash) which is unbearable. I was initially told that the itch was not related to injections but a new doctor has told me 29 (continued) that 1 in 2000 suffer from itch as a side effect. Can you comment? ● It would be surprising to develop an allergic response such as an itch after this time if the botulinum toxin preparation was the same. I am not aware of any other cases. If the preparation has changed then it is possible. It may also be possible to prevent further such reactions with the use of antihistamines. Q. My girlfriend and I have just found out that she has been diagnosed with paroxysmal dystonia. She has major back spasms at present and I was wondering whether medications and spasms may prevent her from having children, or if she may be advised not to have children. This is a concern for us both as we are both still young (under 25). Could you please help put our minds at ease, or let us know what the risks may be? ● It is important that your diagnosis is correct. If your do have dystonia then the type is important but unlikely to have major effect on pregnancy. It is possible that the dystonia may Dystoniamatters! be genetic and thereby there is a risk children could have the same. Drugs such Carbamazepine used to treat this could have the potential risk of increased foetal abnormalities. You and your girlfriend will need to discuss this with the physician supervising treatment when you are thinking about starting a family. Q. I am looking for a dentist with experience of working with people with neurological conditions. My anxiety is that my head moves and I suffer from facial spasms which makes it very difficult to hold my mouth open. ● Some Primary Care Trusts (PCT) have community dental services which treat people with particular needs: adults with special needs, those that are housebound, hospital long-stay patients or in-patients or those living with a physical or mental illness. In the case of housebound patients a domiciliary dental service can be provided. Referrals to the dental service have to go via a dentist or GP. In the case of a referral made by a GP they would need to Issue 58 ● Winter 2007 obtain a referral form from the priority / community dental service (as only referrals completed on appropriate forms will be considered). The number for this service can be obtained from the local PCT. People need to be aware that unfortunately at this time not all PCT’s have this facility and some people requiring this type of treatment may still have to pay privately. Q. I have just had my application for Disability Living Allowance turned down. What should I do now? I had a real problem explaining the variability of my dystonia experience on the form. Do you have any advice? ● The Society recently met with the Department of Work and Pensions who are responsible for the DLA. We have produced a fact sheet to help with this. The fact sheet is available on the website or you can contact the Helpline on 0845 458 6322. 30 Reader’s letters Have your say... ● Alison Bird, Essex Happy ending In August 2005 I was housebound. My head faced up and left, it was shaking tremendously and I couldn’t see to walk straight. I was in constant agony and I felt like a freak; that my life had come to an end. I was terrified that whatever I had was going to kill me. All this at the age of 31, with my life ahead of me. It was only then that I was finally diagnosed with spasmodic torticollis. It left me feeling frightened as I’d never heard of dystonia, but there was also a sense of reassurance that it wasn’t terminal, that I hadn’t imagined it, that it wasn’t depression or whiplash and there could be light at the end of the tunnel with treatment. Shortly before the torticollis had become severe, I had fallen in love with Fergus. I had moved to the countryside, near my parents and then the torticollis did its worst and I thought that Fergus would leave me. I had been too scared to tell anybody that something odd had been happening to my body and it was easy enough to hide the early symptoms by drinking copious amounts of wine with friends. A few months later Fergus proposed and I was determined to be able to walk myself down the aisle without my head facing up and shaking uncontrollably. After a year of injections, Clonazepam and some great physiotherapy and acupuncture, I achieved my goal and also raised £300 for dystonia from our wedding collection. With all the treatment and family support I was back to feeling normal most of the time and in May 2007 we had our first baby, Poppy. I have been in partial remission for some time but it’s still a battle to fight and keep on top of every day. 31 Dystoniamatters! ● Jim Howson, Kent Cure I am writing to comment on the inference, in recent articles published in our newsletter, that spasmodic torticollis can never be cured – only alleviated. In the early 1970s my wife developed this condition and, after the usual round of advice to try acupuncture, head massage, psychiatry etc, the situation was becoming desperate. Fortunately, I then heard of an operation being carried out routinely at Oldchurch Hospital in Romford, Essex. I persuaded my GP to refer us there and we saw a surgeon called Mr. Andrew. He was prepared to operate in this case but warned my wife that there was (a) a slight risk of permanent further disablement, (b) a virtual certainty of a small amount of slurring of the speech but (c) a good chance of a complete cure of the torticollis. She was verging on suicide and readily agreed to the operation. The surgeon carried out his procedure which involved brain surgery and the turning of the neck was completely eliminated! However, there was (and still is) a very slight impairment in speech. We were overjoyed of course and my wife remains in good health at the age of 72. ● Jan Lucas, Kent Passport renewal I have suffered from cervical dystonia for 16 years. My reason for contacting you is regarding the problems I had renewing my passport this year. My photographs did not comply with the new guidelines because my neck was slightly twisted to the side and my renewal was deferred. I contacted Belfast by telephone and offered to attend a face-to-face interview with the authorities who could see that this was my natural stance. I was advised that the only way around the issue, at my suggestion, was for them to receive confirmation from my GP, who willingly agreed to write a four line letter which cost me £32! Obtaining my passport was a very expensive exercise, not only financially but also coming up against an immovable authoritarian force that would not even meet me to confirm my situation. It upset and embarrassed me and highlighted a physical problem that I struggle so very hard to cope with in my everyday life and, where possible, to forget! Issue 58 ● Winter 2007 32 Reader’s letters... ● continued Janet Baird, East Sussex ● Vicki Bennett, Hants Iridology Sticker idea During the time when my symptoms of oromandibular dystonia began until I found the cause (a period of eight years), I consulted many complimentary and alternative therapists. Some were excellent, others were mediocre and a few who were plain weird! Finally in 1993, while studying to be a nutritionist and at my lowest point, I went on a course to study iridology, which is the examination and analysis of the coloured portion of the eye which determines factors that may be important in the prevention and treatment of disease. It was then I discovered the cause of my dystonia. On the left side of my mouth was a mercury filling. It had been leaking into my mouth for years. Many nerves pass via the temporomandibular joint in the lower jaw on their way to the brain and this was causing the dystonia. Following removal of the filling by a mercury free dentist, using the correct safety procedure to protect the patient (any other method is dangerous) and having chelation treatment to remove the mercury, I am now 95% cured. A trip to our local supermarket the other day got my partner and myself thinking. We were parked in the disabled bay and next to our car was a vehicle displaying a sticker briefly outlining their medical condition. It certainly caught our attention to an illness we were both unfamiliar with – pulmonary hypertension. ‘What a brilliant idea!’ I thought and wondered if the Dystonia Society had ever considered such a scheme. Not only would it back up the Blue Badge, but most importantly it would attract public awareness for our society. I appreciate this could be uncomfortable for some members, displaying their illness for all to see, but obviously that’s freedom of choice. Personally, it would give a boost to my flagging confidence, as many a time I’ve felt uneasy when I’ve parked in a disabled bay and got a disapproving look from an individual, the moment I’ve stepped out of the car despite the badge and the lopsided head! ● Helen Barrow, Newcastle upon Tyne ● New goals I have been diagnosed with spasmodic torticollis for over three years now and sadly the condition has progressed. The botulinum toxin treatment has had little effect. The spasms, twists and the pulls have gradually appeared in more areas of my body, affecting not only my neck but both shoulders, my arms and now stiffness in the hip. I am still learning to adapt to my new life, finding new hobbies, new goals and dreams which are a lot different to those I’d had even a few years ago. But I have discovered if you stay still and think of the things you have lost, you will be left behind and loneliness will be your only friend. I have learned it is vital to remain focused and to keep going, to keep seeking new goals or else you risk letting the condition take you over. It’s you who has to take control of it. That’s easier said than done, I know but then this is why an organisation such as the Dystonia Society is so important. 33 Editor’s note: That’s a good idea Vicki. What do other reader’s think? Dystoniamatters! Judy Reeves, West London Update I am writing to let you know how things are going with my injections. The first in May didn’t really make any difference and I was a little disappointed but was still hopeful. I had my second injection in September and am now experiencing a change in the movement in my neck. I am able to voluntarily control my neck. Generally things are better but if I’m a little tired and stressed, the spasms and twisting start again, if only for a short while. Since being in contact with the Dystonia Society and receiving so much support and encouragement from members, my self-esteem is slowly being healed. Please send all your letters to: The Editor 1st floor, Camelford House 89 Albert Embankment, London SE1 7TP Issue 58 ● Winter 2007 34 Top form Trustee Graham Ashdown travelled to Felpham near Bognor to collect a £2,500 cheque from the Community College. Students have raised funds for several charities through various activities and allocated this sum for the Dystonia Society. David Paske, a member of the Society from Bognor Regis, is a teacher at the college and his daughter has generalised dystonia and is now completely reliant on special care. David says that although students knew of his daughter’s condition, he had no influence on their choice of charity. Fundraising news and events ● Joanne Day ● Denise with her dad True grit Ritz style A total of £4,000 and awareness of dystonia were raised at Cannock Rotary Club’s Dragon Boat Race in August. There were 21 teams competing with two having been sponsored to raise funds for the Dystonia Society. Around 60 guests were invited to a garden party at the home of Denise Flowers in Feltham, West London and raised £780 with more expected from matched-funding by the Royal Bank of Scotland. The event was based on high tea served at the plush Ritz Hotel in the Strand, London and even had menus printed, along with a raffle and tombola stall. One of the rowers was our very own Joanne Day, who was the only disabled person rowing and she was awarded a special medal by the organisers for ‘True Grit and Determination’. Thanks also to Joanne’s brother, Richard, and RWE Systems. Heroic Hever Many thanks to Terry Newman and Pat Whitty for choosing us as one of the charities to benefit from their year of captaincy at Hever Golf Club. We have received the magnificent sum of £7,562 so far with the promise a little more will be added before the end of their captaincy year. ● 35 Fundraising news and events Recycling So far we have received £176 from Cartridges4Causes from the mobile phones, inkjet and laser cartridges recycling scheme. Recycling phones not only help the environment but is a fantastic way to raise money for the Society. If you or anyone you know receives a new mobile for Christmas, please consider recycling your old one by registering online at www.cartridges4causes.co.uk/recycling Or call 0845 466 7147 for your free mobile phone recycling bag. Club captain Terry Newman and ladies captain Pat Whitty Dystoniamatters! Issue 58 ● Winter 2007 On yer bike Make a note in your diary for Saturday, 10 May 2008. There will be a 25 mile sponsored bike ride around Rutland Water and we hope to recruit as many cyclists as possible to raise money and also help raise awareness. Free places are available to members, their families and friends. Further details from Joy Bourne: call her on 020 7793 3654 or email [email protected] 36 Thanks Helen! We are very grateful to Helen Curd (pictured above) who generously asked guests at her 80th birthday celebrations to make a donation to the Society in lieu of gifts. New heights... Val Wells had so much fun doing her first ever skydive in New Zealand that she plans to repeat the experience and raise £2,000 by falling out of a plane again in February. Please sponsor Val by visiting the website www.justgiving.com /valwells or send her a cheque via the UK office. 37 Fundraising news and events Fundraising news Every click So far, nearly thirty Rose Day Hindsight Congratulations to everyone who took part in the successful Alexandra Rose Day collections this year. Over £1,400 was raised. Just four groups took part but we hope that many more of you will join Rose Day 2008. The London street collection will take place on 18 June and the national collections on 21 June next year. If you take part in Rose Day collections, you can also apply to the Special Appeal fund for a grant towards a project or your running costs. You can find out more by looking at their website www.alexandraroseday.org.uk or call Mrs. Margaret Stock on 01252 726171. In October, a fundraising event, which ● Nikki Parkin (centre) was organised by Nikki Parkin, a dystonia sufferer, took place in London Colney, Hertfordshire. Guests danced the night away to music by rock band Hindsight, complete with nibbles and a free bar – thanks to a donation from Tesco and one of the guests. A raffle was drawn by the local Deputy Mayor, Councillor Geoff Harrison. Nikki said: “For me, the most important aspects of the evening were raising £600 for the Society and giving hope to another local sufferer who read my story in a local newspaper and came along to the event with her family.” Hydroactive Here are some of the runners who ran for us in the Hydro Active Women’s Challenge in Hyde Park, London in September (right to left Rosalind Fell, Coral Datta, Anne Chadwick and her two daughters). Well done to all! Dystoniamatters! ● ● Hilda collecting Issue 58 ● Winter 2007 of you are using Everyclick instead of your usual search engine and by doing so have raised £137.61. Using everyclick.com is a highly effective way for you to raise money for us. It’s really simple. Every search you make earns money for the Dystonia Society. Please log on to www.everyclick.com to find out how to make Everyclick your home page when you search the web or shop on-line. Trust boost The Lincolnshire support group were thrilled to receive the news of a grant from the John and Lucille van Geest Foundation for £1,500. The foundation offers support for medical research and welfare purposes. A day in the life... Our New York diary By Gus Macdonald, our patron Contacts Corner ✎ My grandson Dylan has a passion for New York. He also has generalised dystonia. Our challenge was to leave behind his normal support systems and find ways to explore Manhattan. If you would like to contact any of the following people, please ring Roz at central office, on: 0845 458 6211 or email: [email protected] ● Member with hemi dystonia, tardive dyskinesia and spasmodic torticollis, would like to contact others with a similar combination of symptoms. ● Member with spasmodic torticollis and spondylosis would like to contact others with similar symptoms. ● A member would like to contact any people with Meige’s syndrome or cranial dystonia. ● Member from Liverpool is interested in hearing from anyone with paroxysmal dystonia. ● A member who currently is not in need of treatment, following 7 years of botulinum toxin injections, would like to speak to another member who has experienced a long period without injections. ● A member in Tyne & Wear with multi-focal dystonia would like to make contact by email with other people with dystonia. Members in the North East with any neurological conditions who would like to join a local social group can also make contact with this member via email. ● A member who’s pregnant and has had Deep Brain Stimulation would like to contact other members who are going through / have gone through pregnancy and had DBS. Dylan and his father Paul started their search months ago on the internet. With a few clicks they found Silverjet, one of the new business class carriers flying out of London. Silverjet seats all convert to flat beds; their flights take only a hundred or so passengers and at £500 each way are much cheaper than business class on scheduled airlines. Another advantage is their Silverjet terminal at Luton where Dylan could drop off right outside the door, check in and speed with his wheelchair through security with no Heathrow hassle. The on board arrangements were spacious and the in-flight entertainment made time fly for Dylan on the seven hour flight. At Newark airport a wheelchair attendant whisked us through the immigration queues, helped with the luggage and dropped us at the Silverjet lounge just next to our taxi pick up point. By mid afternoon we were in our hotel room on the 43rd floor. Brilliant! Manhattan is like nowhere else with its breathtaking skyline and bustling canyons full of yellow cabs. Dylan found New Yorkers friendly, funny and generally helpful – special meal requests were ‘not a problem’. We wheeled through the grid pattern streets with sat-nav precision to take in all the sights. Wheelchair access to the top of the Rockefeller Centre and in the Museum of Modern Art was excellent. We also rickshawed through Central Park, sailed around the Statue of Liberty, helicoptered up the Hudson river and took a limo tour through Greenwich Village, Tribeca, Wall Street and over the bridge to Brooklyn. With world leaders in town for the United Nations summit, a particular thrill for Dylan was to find our hotel swarming with Secret Service agents talking into their lapels. As a precaution we had taken the full range of medication for dystonia and cerebral palsy, plus letters from Dylan’s doctors to consultants in New York should the need arise. Fortunately it did not. However, after we checked in at Newark for the flight back, US Customs must have broken open his suitcase for a closer look at his stash of drugs. Back in London, the damaged suitcase emerged swathed in security tape with a polite apology pasted on. For Dylan it was just a final memorable event in an unforgettable trip. 39 Issue 58 Dystoniamatters! ● Winter 2007 40 In my opinion... Dystonia Society by Kathy Bacchus Christmas gifts My name is Kathy Bacchus and I am a mother of three married children, from New Addington, Croydon. I can remember being affected by dystonia from a very early age and was treated at Great Ormond Street Hospital as a child because I couldn’t walk properly and had to have leg irons and special shoes. My condition is now diagnosed as spasmodic torticollis and generalised dystonia. I am undergoing botulinum toxin injections which do seem to help me. I have been regularly prescribed with a cocktail of drugs for most of my life to help ease the pain and discomfort of my condition. However, my major problem is with diazepam, in the form of ‘valium’, and how I can be weaned off such an addictive drug that has been almost a constant part of my life for the last 11 years or so. I can understand why I was prescribed the drug in the first place. The spasms had become so bad and uncontrollable as my head had began twisting violently towards the right and then upwards. It did “I am hooked on diazepam, and help to ease my condition at first, am getting little or no support...” along with steadying my balance. I feel resentful over my medical care as I really need someone to look at my medicine properly and monitor and control my drugs intake. I feel I am hooked on diazepam and am getting little or no support from those who should be caring and supporting me. It is like a nightmare and I am sure there are many others who must be affected by the way such drugs as diazepam are administered. My dosage has been reduced to 5mg – that hasn’t helped but has rather increased my problems. I find it difficult to sleep and often experience nightmares when I do. However I cannot finish this article of complaint without expressing grateful thanks to the Helpline support team, particularly Malcolm Freeman, who has been really helpful and given me encouragement and support when I needed it most. 41 Dystoniamatters! With the festive season nearly upon us, now is the time to think about gifts for family and friends. The Society has produced a limited run of teddy bears, roller ball pens and key rings with shopping trolley tags. Not only will they make lovely gifts – perfect for a Christmas stocking – but they will raise awareness of dystonia too. For branches and groups who would like to sell the items below themselves, special rates are available to ensure they can make a profit from their sales. Please call the UK office to discuss your order. How to order Send the completed form on the back cover to the UK Office, enclosing your cheque. Or you can phone or email us: [email protected] All items will be sent to you on a same day delivery basis. ● Please give me a new loving home! ● Pen with comfortable hold and key ring with disc for shopping trolley Hurry while stocks last! Issue 58 ● Winter 2007 42 DYSTONIA SOCIETY GIFTS ● ORDER FORM Items to order: Teddy Bears Price: £10.00 each Colour of ‘hoodie’ RED BLUE Number required: Pens Price: £2.00 each Number required: Key ring with shopping trolley tag Price: £1.50 each Number required: I enclose a cheque payable to The Dystonia Society for £ Name Address Post code Tel. no Quick turnaround: All orders will be sent out on the day received. Please send your order form to: Dystonia Society, 89 Albert Embankment London SE1 7TP or call us: 0845 458 6211
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Dystoniamatters! - The Dystonia Society
Dystonia Society, 2nd floor 89 Albert Embankment London SE1 7TP Office: 0845 458 6211 Helpline: 0845 458 6322 Fax: 0845 458 6311 email helpline: [email protected] email other enquiries: info@...
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