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Something Seemed to Be Blocking Signals to Her Brain. What Was It?

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“You may’t see the ceiling, are you able to?” the person requested his 31-year-old spouse. She grimaced, then shook her head. She was mendacity in mattress wanting towards the acquainted shadows and shapes forged by the wintry morning solar. However she couldn’t see them. It was as if a dense white fog lay between her and people day by day shifting patterns. Squinting didn’t assist. Opening her eyes as broad as she might didn’t, both. All her life she had excellent imaginative and prescient. It was a secret supply of pleasure. She’d by no means even seen a watch physician. However that morning modified every thing.

She first observed the difficulty in her eyes six months earlier. She is knowledgeable violinist and a trainer and that summer time took her college students to Italy to expertise the sacred music and artwork. As she gazed up on the frescos adorning the ceiling of a favourite cathedral, a shimmering form with jagged, irregular edges appeared out of nowhere. The factors appeared to twinkle because the starlike picture slowly enlarged. Contained in the glittering define, the colours had been jumbled, just like the crystals in a kaleidoscope. It was stunning and terrifying. She dropped her head, closed her eyes and rubbed her aching neck.

When she opened her eyes, the star burst, with its glimmering edges, was nonetheless there, distorting all that lay past it. It grew so giant that it was nearly all she might see. Then slowly it started to fade; after practically a half-hour, the world began to renew its acquainted look and form. There had been comparable, if much less extreme, experiences: Now and again, when she would stand up shortly after sitting or mendacity down, she would really feel an intense strain inside her head, and when it launched, every thing briefly regarded light and pale earlier than returning to regular hues. These spells solely lasted a couple of seconds and occurred solely a handful of occasions over the previous few years. She wrote it off to fatigue or stress. After that day in Italy, these glistening star bursts appeared weekly, then day by day.

Stranger nonetheless, straight traces developed bizarre lumps and bumps when she checked out them out of the nook of her eye. Doorways, curbs and desk edges appeared to waver, rising bulges and divots. When she regarded on the object full on, it will obediently straighten out however resumed its aberration as soon as it was on the sidelines once more.

Days after her morning whiteout, the younger lady went to an optometrist in close by Fort Lee, N.J., Dr. Paul Shahinian. If the star bursts had been worrisome to the younger lady, Shahinian’s response to her examination was terrifying. She wanted to see a neuro-ophthalmologist, he advised her — a specialist in eyes and brains — and he or she wanted to see one quickly. All the data collected by sight is transmitted to the mind by a thick cable of fibers in the back of the attention referred to as the optic nerve, the physician defined, and the nerve in her left eye was massively swollen. As she sat in his workplace, Shahinian referred to as the specialists himself. The primary two workplaces he referred to as had the identical reply: She couldn’t get an appointment for months. Then he reached out to a neuro-ophthalmologist who was new to the realm, Dr. Kaushal Kulkarni, and, after explaining the urgency, organized for the affected person to be seen the next week.

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Kulkarni listened to the affected person describe her unusual visible abnormalities. Though her imaginative and prescient was nonetheless 20/20, the intermittent star bursts and the bent traces seen in her peripheral imaginative and prescient — a phenomenon often known as metamorphopsia — advised one thing was incorrect with the way in which the mind was getting and processing her visible data. Kulkarni shined a slender vivid gentle into the younger lady’s proper eye. As anticipated, each pupils constricted. He moved the sunshine over to the left, and each pupils instantly dilated. Shifting it to the appropriate, her pupils once more constricted; returning to the left, once more they all of a sudden widened. Clearly the sign on the left wasn’t getting by. The swelling was slicing off the move of knowledge from the attention to the mind. It gave the impression to be a one-way downside, nevertheless: The truth that the left pupil constricted when the sunshine was shined in the appropriate eye indicated that data from the mind was nonetheless getting by.

There are numerous causes of this sort of optic-nerve harm. Shahinian had thought that, given the affected person’s age, this was prone to be a number of sclerosis, an autoimmune dysfunction during which the immune system mistakenly assaults nerve fibers that hyperlink the mind to the physique. Kulkarni agreed that was a chance and ordered an M.R.I. to search for proof of that or different abnormalities. Was this a tumor? Or a stroke? Different autoimmune ailments additionally needed to be thought of. It is also the results of an an infection: Lyme illness might do that; so might cat-scratch fever, an an infection brought on by the bacterium Bartonella henselae; even syphilis, usually referred to as the good imitator due to its capacity to manifest in so some ways, might trigger this sort of harm.

He despatched the affected person to the lab for testing. The outcomes of the blood assessments got here in shortly. It wasn’t Lyme or Bartonella or syphilis. Not one of the inflammatory markers suggestive of an autoimmune illness had been elevated. It was the M.R.I. that held the reply. Kulkarni didn’t see the brilliant white smattering of dots and dashes that will recommend M.S. As a substitute, a big spherical object, a mass in regards to the measurement of a plum, dominated the center portion of the left facet of her mind.

Kulkarni referred to as the affected person and advised her that the M.R.I. was irregular. She got here again a few days later. He couldn’t inform her based mostly on the images simply what sort of tumor she had. The commonest can be a meningioma, a tumor of the tissue that traces the mind. An acoustic neuroma was rarer but in addition potential. This can be a slow-growing tumor originating within the tissue that connects the ear to the mind. She was a bit younger for that; these tumors normally seem in women and men over 40, they usually normally trigger issues in listening to and steadiness quite than in imaginative and prescient. No matter it was, the tumor was so giant that it blocked the circulation of the spinal fluid by the mind, inflicting the nerve to swell. It must be eliminated.

Kulkarni knew the affected person didn’t have medical health insurance. He referred to as round to the neurosurgeons he knew, attempting to determine the best way to get this lady the care she wanted. The one reply gave the impression to be for her to get in by the emergency division. Because of a legislation referred to as the Emergency Medical Remedy and Labor Act, all emergency departments are required to offer stabilizing remedy to any affected person who is available in, no matter insurance coverage standing or capacity to pay. The care offered isn’t free; sufferers are billed, however they must be handled.

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She went to the emergency division at NewYork-Presbyterian Hospital/Columbia College Medical Middle, and the mass was eliminated. The pathologist confirmed that the tumor was an acoustic neuroma. Studying up on such a development, the affected person famous that listening to loss is a typical symptom. She had listening to loss in her left ear, however she hadn’t made a connection between that downside and the one together with her eyes. She thought that the fixed publicity to the sound from her violin might need prompted a bit injury. She figured it was simply the value of doing what she cherished. After the surgical procedure, her listening to didn’t change, however the unusual star bursts utterly disappeared. Straight traces nonetheless have the tendency to buckle in her peripheral imaginative and prescient, although.

Earlier than her hair had even grown sufficient to cover the scar, the payments started to roll in. The numbers had been much more scary than the pictures of the tumor. The last word accounting totaled round $650,000. She and her husband frightened that they must declare chapter. That they had some cash — they had been saving for a wet day, however this was a tsunami. Salvation got here, unexpectedly, when a pal of a pal requested if they’d talked to the hospital about monetary assist. It turned out that Columbia Presbyterian did have a financial-aid program. Actually, all nonprofit hospitals are required to offer monetary help to individuals who want it; it’s mandated by the Inexpensive Care Act. They didn’t must bankrupt themselves. They’re grateful that the ordeal ended properly. And, two years after the surgical procedure, they’re starting to rebuild their financial savings — since you by no means know when it would rain once more.


Lisa Sanders, M.D., is a contributing author for the journal. Her newest e book is “Analysis: Fixing the Most Baffling Medical Mysteries.” When you have a solved case to share, write her at Lisa.Sandersmdnyt@gmail.com.

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Young girl survives cancer thanks to little sister’s lifesaving donation: 'A perfect match'

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Young girl survives cancer thanks to little sister’s lifesaving donation: 'A perfect match'

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A young girl in the U.K. is in cancer remission thanks to her sister’s lifesaving bone marrow donation.

Ruby Leaning, 10, was diagnosed with acute lymphoblastic leukemia after collapsing on the school playground in Jan. 2020, according to SWNS, the British news service.

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The rare blood cancer required an urgent bone marrow transplant to keep the 6-year-old alive.

AI COULD PREDICT WHETHER CANCER TREATMENTS WILL WORK, EXPERTS SAY

After several tests, Leaning’s then 2-year-old sister, Mabel Leaning, came up as a “perfect match.”

The Leaning sisters’ grandmother, Amanda Fawcett, confirmed to SWNS that Ruby Leaning received treatment with Mabel Leaning’s stem cells.

Sisters Mabel Leaning, left, and Ruby Leaning hold hands in the hospital. The younger sister saved the older one with a bone marrow transplant. (Amanda Fawcett via SWNS)

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Ruby Leaning was declared cancer-free in 2022 — meaning Mabel Leaning “saved Ruby’s life for sure,” Fawcett said.

“She’s a happy, normal and healthy 10-year-old who loves swimming, dancing and piano lessons.”

“We [weren’t] expecting her to be a match at first, but thankfully she was, so we just couldn’t believe our luck,” she said. 

“It was amazing – we were so thankful.”

SOME BREAST CANCER PATIENTS COULD BE AT RISK OF ANOTHER TYPE OF CANCER, STUDY REVEALS

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Fawcett recalled the moment her granddaughter was diagnosed with cancer at Sheffield Children’s Hospital.

“It’s just every parent and grandparent’s nightmare,” she said to SWNS.

Ruby Leaning in the hospital

Ruby Leaning, pictured in the hospital, was diagnosed with acute leukemia in 2020. (Amanda Fawcett via SWNS)

“I was in the room with her mom when we found out, and you just can’t take anything in at all. It was all just heart-shattering.”

Fawcett described her granddaughters as “so close,” telling SWNS that they are “amazing girls.”

“They’ve got a great relationship between them,” she said.

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“But Mabel will be asking to borrow Ruby’s shoes when she realizes [she saved her life] – and we do laugh about how it will be fun and games.”

Fawcett said Ruby Leaning has been “doing fantastic” in remission and is “back to her normal self.”

Ruby Leaning and Mabel Leaning

Ruby and Mabel Leaning have “a great relationship between them,” grandmother Amanda Fawcett said. (Amanda Fawcett via SWNS)

“She’s a happy, normal and healthy 10-year-old who loves swimming, dancing and piano lessons,” she said.

The grandmother is currently raising money for the Parents Association of Children with Tumors and Leukemia (PACT), which supported the Leaning family, according to SWNS.

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“None of us could be there for Ruby, which was horrendous for us, because of the pandemic,” Fawcett shared.

“But they were an amazing support.”

Fox News Digital reached out to Sheffield Children’s Hospital for additional comment.

For more Health articles, visit www.foxnews.com/health.

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Alan Hale Jr: 16 Facts About the Skipper from 'Gilligan's Island'

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Alan Hale Jr: 16 Facts About the Skipper from 'Gilligan's Island'



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Alzheimer's drug embrace slows down as US doctors' reluctance grows

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Alzheimer's drug embrace slows down as US doctors' reluctance grows

Nine months into the U.S. launch of the first drug proven to slow the advance of Alzheimer’s, Eisai and Biogen’s Leqembi is facing an unexpected hurdle to widespread use: an entrenched belief among some doctors that treating the memory-robbing disease is futile.

Alzheimer’s experts had anticipated bottlenecks due to Leqembi’s requirements, which include additional diagnostic tests, twice-monthly infusions and regular brain scans to guard against potentially lethal side effects.

And those issues have played a role in slow adoption since the drug was approved by the U.S. Food and Drug Administration, according to interviews with 20 neurologists and geriatricians from rural, urban, academic and community practices in 19 states.

FDA FULLY APPROVES ‘NOVEL’ ALZHEIMER’S DISEASE DRUG LEQEMBI, WILL BE COVERED BY MEDICARE

In interviews with Reuters, seven doctors treating patients for Alzheimer’s attributed their own reluctance to prescribe Leqembi to concerns about the drug’s efficacy, cost and risks. 

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The use of the FDA-approved Alzheimer’s drug, Leqembi, has slowed down as doctor’s skepticism increases, while patients like Lyn Castellano in St. Louis continue to use the drug as it offers a sense of hope for her future. (Joe Castellano/Handout via REUTERS)

“I don’t think it’s a good Alzheimer’s drug. I think that’s the problem,” said Dr. James Burke, a neurologist at the Ohio State University who has been an outspoken critic of Leqembi. “It’s certainly nothing like the home run that we’re looking for.”

Another six scientists, all leaders in the field, said “therapeutic nihilism” – the belief that Alzheimer’s is a hopelessly intractable disease – was playing a bigger role than anticipated in suppressing demand from primary care doctors, geriatricians and neurologists who could be sending patients to memory specialists for treatment.

Dr. Reisa Sperling, a neurologist and Alzheimer’s researcher at Mass General Brigham in Boston, likens some doctors’ skepticism to Leqembi to fatalistic attitudes about cancer treatment 30 years ago: “You can’t really do anything about it, so why would you even want to get tested?”

Alex Scott, Eisai’s chief administrative officer, acknowledged that skepticism has weighed on the launch along with slower-than-expected adoption by large health systems.

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He suggested that some of the doctors’ hesitancy could be a holdover from the decades-long journey to prove that removing the Alzheimer’s protein beta amyloid from the brain could slow the course of the disease. Before Esai released the promising results of its Leqembi trial, some thought that area of research “a fool’s errand,” Scott said.

“We are beginning to make more and more progress every single month. So we’re still quite encouraged,” Scott said. “This is a new journey, and I think it takes some time for providers to figure it out.”

‘SIGNIFICANT RISKS, MARGINAL BENEFIT’

Leqembi was the first amyloid-targeting drug granted full FDA approval after it slowed the decline in cognition in people in the early stages of Alzheimer’s by 27% in a clinical trial.

Of the 10,000 Americans the companies hoped to treat by the end of March, Eisai announced only a couple thousand had begun treatment as of the end of January. An Eisai spokeswoman declined to provide updated numbers.

Even for treatments that do not require dramatic changes to medical practice, adoption of new drugs is notoriously slow. Several studies have estimated that it can take 17 years on average for clinical research to be translated into routine practice.

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The disease is estimated to affect more than 6 million Americans, according to the Alzheimer’s Association.

NEW DEMENTIA DRUG ‘HAS GIVEN ME HOPE’: ALZHEIMER’S PATIENTS REVEAL THEIR STORIES

Fewer than half of U.S. neurologists recommend Leqembi to patients, according to a January survey by life sciences market researcher Spherix Global Insights.

Dr. Michael Greicius, a professor at Stanford University’s Center for Memory Disorders, said there is little evidence that Leqembi benefits patients in a meaningful way.

“If we take the trial result at face value, the differences between placebo and treatment are likely small enough as to be undetectable by patients and family members or physicians,” said Greicius, who does not recommend Leqembi to patients.

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He said the long wait for an Alzheimer’s drug has put doctors in the position of feeling obligated to offer a treatment “even if the evidence for it is very slim.”

Other doctors have raised concerns about the risk of brain swelling and bleeding associated with Leqembi as well as the costs associated with the $26,500 annual drug, frequent MRIs and twice-monthly infusions.

“There are significant risks associated with these drugs, there are significant costs, and I would say there is marginal benefit,” said Dr. Eric Widera, a geriatrician and professor at University of California San Francisco, referring to amyloid-lowering treatments.

In an editorial published in November in the Journal of Gerontological Nursing, Donna Fick, president of the American Geriatrics Society, advised doctors that the group recommends caution in the use of lecanemab, which is sold under the brand name of Leqembi. 

“It is not yet clear whether treatments such as lecanemab that remove amyloid from the brain produce clinically important slowing of cognitive decline in Alzheimer’s disease.”

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‘YOUR ENEMY IS NIHILISM’

Dr. Jonathan Liss, a neurologist from Columbus, Georgia, who serves on Eisai’s scientific advisory board and has tested Leqembi in clinical trials, said he first warned about nihilism at a November 2022 conference following a presentation of Leqembi’s breakthrough study.

Eisai had asked its scientific advisors how the drug might fare against future rivals. Liss cautioned that rivals were not the enemy; “your enemy is nihilism,’” he recalled. “All of the neurologists around the table started applauding.”

FIRST DRUG PROVEN TO SLOW ALZHEIMER’S WON’T BE AVAILABLE TO MOST PATIENTS FOR SEVERAL MONTHS

Dr. Nathaniel Chin, a geriatrician with the University of Wisconsin’s Alzheimer’s Disease Research Center, said he was the target of negative comments on social media after he urged geriatricians to embrace such treatments in the Journal of the American Geriatrics Society.

Geriatricians, geriatric social workers and nurses objected, arguing that the drug’s statistically significant benefit was not clinically meaningful to patients, especially given the risks, he said.

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“I would ask the question, ‘Is it ethical to withhold a medication that is FDA-approved and covered by insurance from someone who knows the risk and is willing to take it?’” Chin said.

Dr. Priya Singhal, executive vice president and head of development at Biogen, acknowledged some apathy among physicians about the treatment but said that infrastructure and lack of access to neurologists have been bigger issues.

Singhal said the companies are working with physician and patient advocacy groups and developing educational programs and materials aimed at diagnosing early-stage patients, managing side effects and understanding the drug’s benefits.

The companies said they intend to increase their salesforce by 30% as they aim for 100,000 patients by 2026.

For the moment, Leqembi is the only Alzheimer’s drug on the market designed to slow the course of the disease. A decision on Lilly’s donanemab has been delayed until the FDA convenes an advisory panel.

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Lilly neuroscience president Anne White said in an interview that she sees doctor hesitancy as an issue that the company hopes to address by making clear which patients benefit from such treatments.

In the early stages of Alzheimer’s, many patients are still independent, and to be able to remain so for longer is very meaningful, she said.

‘PEACE AND QUIET’

Lyn Castellano, 64, who founded and ran a St. Louis breast cancer charity for 20 years and trained therapy dogs, started taking Leqembi last September, nearly a year after she found herself struggling with keeping track of appointments and was diagnosed with mild cognitive impairment.

Castellano said the prospect of bleeding in the brain – a possible side effect of the drug – was her biggest concern, but her family believed the drug may offer a chance at slowing the disease.

She is one of more than 140 patients being treated by physicians from Washington University in St. Louis, and has had 13 infusions and two MRIs without incident.

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Dr. Suzanne Schindler, an Alzheimer’s researcher who is treating Castellano, said Leqembi “forces clinicians to completely change the way they have practiced medicine for many years.”

She said she is candid about Leqembi’s modest benefit as well as the risks. About 80% of those she believes are good candidates have opted for the treatment, she said.

While Castellano can’t tell if Leqembi is helping, she says the treatment has given her hope, and she doesn’t mind the twice monthly infusions.

“I get to go, sit back in a nice chair, have my dog with me and read a book for a couple hours. It’s about the only place I get some peace and quiet.”

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