Eva, ARE YOU MS FREE? 
UPDATE June 7, 2011.

I am symptom free since 1991, and very well and active. See videos.

I celebrate my 67th birthday next week and it is now 441/2 years since diagnosis.

FROM - ASK THE EXPERT MS Canada Winter 2007 page 13    www.msanswers.ca

Q: Does the absence of new plaques over a long period (five or ten years) mean that MS has been cured? In other words, it’s said that MS is an incurable disease but is there a chance that the disease can disappear?

A: Plaques don't always show up on a brain MRI and many plaques can form in the spinal cord, which is usually not imaged. I would be very careful about over interpreting either what seems like a good MRI or a bad one. It is a 'picture in time' and may not be reflecting the fact that lesions come and go. It gets even more complicated when two small plaques come together
to form a slightly bigger single plaque; here it might seem like there are fewer plaques, when clearly this  was not the case. Bottom line: your physician can probably tell you if your disease is truly stable. Such a conclusion is often reached by an in depth history and repeated neurological exams. The MRI results are of course taken into consideration but only after the clinical evaluation.By Dr. Mark Freedman, currently professor of medicine in the field of neurology at the University of Ottawa, as well as director of the MS research unit at the Ottawa Hospital, General Campus.

NOTE FROM EVA:My MRI, 1995, has too many spots to count and is interpreted to mean that I require 24 hour care. See MAYO comment.

Q: How did you strengthen your foot to overcome toe-drop?

A: As an undergraduate student at McMaster University, I was privileged to join the neuroscience research team  led by Dr. Alan McComas. On page 228, I write about our project to investigate the strength of the foot. Published articles are:

Marsh E, Sale D, McComas AJ, Quinlan J (1981) Influence of joint position on ankle dorsiflexion in humans.

J Appl Physiol: Respirat Environ Exercise Physiol 51:160-167.

Sale DG, Quinlan J, Marsh E, McComas AJ, Belanger AY (1982) Influence of Joint Position on Ankle

Plantar flexion in Humans. J App Physiol: Respirat Environ Exercise Physiol 52(6):1636-42.

The long extensors of the toes, and four muscles act to dorsiflex (turn up) the ankle, and turn out the foot. 
The tibialis anterior, TA muscle was found to contribute a large portion of turning force of the ankle. 
The TA runs along the outside of the shin, below the knee. 

To strengthen these muscles, 
FIRST, I sit comfortably and stimulate circulation by massaging my foot and ankle. 
Then I sit with my feet flat on the floor, and gently, raise my heels, putting a bit of weight over my toes, then raise my toes. Then I relax. I can do this anytime I am sitting. 

A simple way to strengthen the TA is to sit and drop a tissue on the floor. With bare feet, I crunch up the tissue. My girls and I used to have "crunching" contests. Hilarious!! These simple maneuvers, along with walking, strengthened my feet and ankles. 

The next stage is to stand at the kitchen sink, hang on, and lift one heel, then the other. Then I lift both heels, and rise to my toes. 

In our project it was observed that joint position has an effect on the excitability of nerve cells that convey motor impulses. As I walked, my foot and ankle went through the whole range of positions, and the rough edges of my gait smoothed out. 

Q: DO YOU THINK THAT YOU HAVE CURED YOUR MS? 

A: I have not cured the ms virus. I have familiarized myself with virus history, and how to live with it until it mutates itself into a state of "permanent arrest."  I am symptom free, and do not use energy monitoring something that will come and go according to it's own timetable. I take care not to stress myself by pushing too far beyond my personal limit.
My body knows how best to use its resources for self healing. 
My experience demonstrates that there is an alternative to chronic decline. We can take advantage of remyelination (self healing), and recover from the damage caused by disease activity with persistent movement. 
We can direct our energy to recovery with clarity of intention, factual information and strategies for recovery.

One important strategy is visualization. 
The brain is working just as hard when we visualize, as when we make physical effort. Brain pathways must be refreshed as we work to make physical pathways operational.  
Recent advances prove the power of our thoughts and intention to initiate the healing process.  

With insights from NeuroLinguistic Programming NLP, I am mindful of the power of words and although doctors reviewed my symptoms and attached the label ms, I do not claim ownership of ms with the phrase "my ms;" I say that doctors have confirmed the diagnosis of ms, suggesting I have made a different choice. This may seem like a small point, but the effect is significant.

Q:  WHY is MS different for everybody? 

A: The damage in the brain and spinal cord can be in different locations and of greater or lesser extent. Even though many people appear to have similar symptoms, the course may be drastically different for each of us. 
Many authors observe that individual reaction to the disease is the prime factor in modifying its course.  See LETTERS FROM READERS 

Many people just give up. Others make a determined effort and still decline. Having determination is admirable; we also need information and ideas to design strategies for recovery, and we need to take action! Help is only helpful when it enables a person to recover or extend the limits to his or her own ability. Caregivers must take care not to interfere in the self healing process. It's all too easy to justify taking over in the misguided belief that

"It's all for the best". 

It has been suggested that ms is caused by a virus. 
McAlpine writes that if we consider a virus as the cause of ms, we must broaden our view to recognize not only the acute stage, but also subclinical, or 'mild' forms. 
This could explain what appear to be different "kinds" of ms. The natural course of a virus is often characterized by lesions, and may terminate in recovery with the total disappearance of evidence from the body. 
Some animals and people are naturally immune to a virus. Some cannot be re-infected by the causative agent, a condition called natural acquired immunity. This process of self-immunization has been redefined as auto-immunity, leading to the description of ms as an autoimmune disease, with a twist to suggest that somehow, the body "attacks" itself.

Q: What is an episode?

A: In my case, episodes(cycles of disease activity/damage/repair) have been quite distinct because of the obvious bouts of damage followed by complete recovery. 
Definitions of an episode depend largely on the patient/observer/interpreter and doctor/observer/interpreter. Changes in symptoms do not necessarily indicate disease activity. Research has always shown that episodes of damage/repair at the cell level often occur without noticeable clinical symptoms, and there can be serious decline, with no evidence of disease activity. Many people regard changes in symptoms as more trouble, when in fact, they may be indications of healing, that has yet to be properly reconnected and "retrained" to do the job we want. On p152, I write about muscle spasms and and "burning pain." These symptoms did not indicate a new problem, but were related to the smoothing the process of retraining nerve pathways related to the episode of November  1972.

Think of an inexperienced telephone repairman incorrectly hooking up wires after storm havoc. This process of rewiring to 'fix connections' never ends. 

Canadian Behavioural Psychologist Donald O Hebb 1949 proposed that neurons that fire together connect more strongly.

Neuroscientist Carla Shatz:Neurons that fire together, wire together.

However we experience episodes, or whether we can even distinguish episodes, in the microscopic universe, ms runs its course and arrests itself. Please draw consolation in that fact. That incidentally, is the classic course of a virus ... 

As disease activity continues, it sometimes results in symptoms we experience, and sometimes it does not. We still do not have the techno sensitivity to see the whole picture. WE also need to keep in mind, that only 3% of cells stimulated by magnetic waves of an MRI actually respond! See latest research on unreliability of MRI scans.  http://www.evamarsh.net/research_ms.php

Q: What can I do? Many things have improved but my walking just gets worse ...

A reader reported that he had been doing exercises and walking with some success since reading my book. He described a blip of tremendous energy and walking 10 or even 20 times as far as usual, when he was particularly happy, or relieved about life's demands. 
All the while, he was under the stress of a bad living arrangement, a search for new accommodations, and finally a move. This reader's gait and stamina got gradually worse. It occurred to him that he might not have been getting enough rest and asked how many hours I slept. 

A: The amount of sleep we require depends on many factors. Our physical condition, lifestyle, and stress all deplete our energy reserves. 
With large muscle movement, positive attitude and laughter, the body produces a flood of healing peptides called endorphins. This produces a natural high, and can act as a painkiller leading us to ignore signs of overwork! After physical activity,we need to relax and recuperate our energy. 
This pause allows endorphins to do their real job - strengthening the immune system. If we go too far beyond our personal body limit, we deplete our resources and re-gress, not pro-gress. 

Yoga impresses the importance in listening to our body language. In yoga, as well as sports training, we are advised to go to our limit + 3 seconds more - then relax and recuperate energy . 
Just a small added effort extends the limit safely. 
Pushing too far uses up the energy and stamina we have worked to build. It's like trying to drive on fumes, instead of refilling the gas tank.