Multiple sclerosis at 22: This Bremen woman wants to ride an art bike again

picture: DPA | Eye fovea / dung

Janina Mews plays sports and participates in tournaments. But all of a sudden she always falls. The diagnosis comes as a shock. On World MS Day she tells her story.

It all started with technical cycling, as Janina Mews explains. The 22-year-old speaks softly and, unlike four weeks ago, hardly notices that her mouth does not utter the words very clearly. The young woman remembers a training session in mid-February when she couldn’t ride her bike to the right anymore. “I had balance problems,” she says. The teammates are also surprised.

An experienced athlete, who has already participated in the German championships, is trying to dismiss the inexplicable as a “bad day”. And it keeps falling, every time you turn right. Until she descends sad and tears the ligament in her ankle. What Janina Moss doesn’t know yet is that her balance problems are the first symptoms of multiple sclerosis (MS). A week later, she had her first severe attack.

Speech disorders and paralysis

Janina Moyes has participated in the German Championships, the art of the bicycle is more than just a hobby.

Photo: Janina Moyes

The course is typical, says Professor Thomas Dunning, chief neurologist at the Bremen-Ost Clinic. An attack of MS builds up slowly, and patients develop their first symptoms over several days. Multiple sclerosis is a brain and autoimmune disease. “The immune system attacks the body’s tissues because they are misdirected. In MS, this usually happens in the brain, and the nerves become inflamed.” This creates scar tissue and these areas no longer function.

Janina Moyes studies and lives in Bremerhaven. Because it is her semester break, she visits her parents in Xuanweed a week after she continued to fall and injure herself during training. There she wakes up one morning and can no longer move her right hand. “I thought I lay on it and fell asleep,” she says. Because the situation was not improving, she called her mother and realized that she could not speak properly. “I couldn’t say the words I wanted to say. It was scary.” Speech disturbances, paralysis – parents are afraid of a stroke and call an ambulance.

A quick diagnosis should prevent damage

Janina Mües comes to the Bremen-Nord clinic. Now a quick diagnosis is important, says neurologist Dunning. “Because once the neurons are destroyed, it is almost impossible for them to regenerate.” Therapists want to avoid this and start treatment as soon as possible. The patient is immediately taken to an MRI machine, where an image of her head is taken. “It happened very quickly,” she recalls.

In addition, a so-called lumbar puncture is performed, in which brain fluid is removed from the spinal cord. These methods can be used to detect inflammation in the brain. Janina Moyes definitely found out just a day later that she had MS.

I had to address that first. It is a chronic disease, and it is forever. At the moment you can not even imagine how it affects life and how it continues. I was shocked.

Janina Moyes, suffers from MS

Young women in particular suffer from MS

A portrait of Professor Dr.  Medical Doctor Thomas Dunning
Thomas Dunning is Professor of Neurology and Chief Physician of Neurology at the Klinikum Bremen-Ost.

Photo: Klinikum Bremen Ost

It’s no surprise to veteran neurologist Dunning that a young, athletic woman was diagnosed with MS. “This is a typical patient of this disease,” Denning says. Although MS is rare in the general population compared to other prevalent diseases such as diabetes and heart attacks, it is one of the most common neurodegenerative diseases. Also in Germany and Bremen, eight out of every 100,000 people are affected. “Men can also get MS, but women are three to five times more likely,” says the doctor. Especially in the 20-40 age group, “and especially in women in their twenties, the diagnosis is not uncommon.”

Once diagnosed with MS, treatment is given right away to stop the inflammation as quickly as possible. Janina Moyes gets cortisone. Because that doesn’t work as hoped, the blood is washed off, the plasma is exchanged, and it continues. “It was annoying, it was so much at once,” Moyes recalls.

After a week, the patient feels the first improvement and is discharged. But the right hand was still paralyzed, “I couldn’t walk either.” She also finds it difficult to speak and swallow: “I couldn’t eat well, or I often choked while drinking.” She works on these limitations with a speech therapist and physical therapist.

Significant advances in treatment in recent years

According to neurologist Dunning, the disease usually ends with acute treatment. However, due to the chronic course, new flare-ups and acute inflammation persist. In order to suppress this, high doses of cortisone are given, as is the case with Janina Moyes. But this is only enough for now. “You also need regular immunotherapy so your immune system doesn’t catch new infections as often,” the doctor says. So Moyes has to go to her neurologist every six weeks for an intravenous injection, through which she is given the multiple sclerosis drug that stops taking the new drug. Target explode.

There is no disease in which treatment has developed more dynamically in neuroscience than multiple sclerosis.

Thomas Dunning, Chief Physician at the Neurological Clinic Bremen-Ost

According to Downing, it is not possible to predict when a new payment will be made. “There are people with MS who have not had a relapse in years. There are other forms of progression that have new relapses every two or three weeks.” Although MS is unpredictable, drug treatment options have advanced dramatically in the past 10 years — and especially in the last five, explains the Bremen doctor. “There is no disease in which treatment has evolved more dynamically in neuroscience than multiple sclerosis.”

While the immune system used to be greatly suppressed, making patients more susceptible to infections, there are now a wide range of drugs that specifically suppress the immune system. This allows for a more targeted individual treatment: “Where are the lesions, how many are there, how old is the patient, does she still want children?” According to the doctor, these questions can now be incorporated into the treatment plan.

Another major advance in the treatment of MS is currently being researched: vaccination can reduce the risk of disease.

Vaccination against MS?

Technical cyclist Janina Moyes
Janina Moyes is feeling better today. She’s also riding a technical bike again.

Photo: Janina Moyes

The causes of MS are not clear. However, US researchers only published a possible trend-setting finding in January: the autoimmune disease “multiple sclerosis” appears to be caused by a virus, the Epstein-Barr virus. It is known as glandular fever and belongs to the herpes virus family and 95 percent of adults carry this device. The connection has long been suspected, explains a neurologist in Bremen-Döning. By now it should be clear: If you don’t have Epstein Barr, you can’t get multiple sclerosis. The length of the data is impressive, “the medical histories of millions of patients have been reviewed,” Denning said.

Of course, not everyone who carries the virus will develop MS. Other factors play a role. For example, MS occurs less frequently in countries around the equator than in Scandinavia. So links with sun exposure and vitamin D deficiency are suspected. There must be a readiness. However, the results have a significant impact: vaccination against the Epstein-Barr virus can significantly reduce the risk of contracting the disease.

“Then I’ll turn right again.”

Researchers have been working on this for decades because the virus may also lead to cancer, especially leukemia, explains a neurologist in Bremen Donning. Studies are currently underway and vaccines are being tested. However, there is still little data to predict when the Epstein-Barr vaccine will be available. Once the time is up, one can vaccinate nationwide.

It’s too late for Janina Moyes. But the 22-year-old is doing much better now. She looks full of energy and is back on her bike, buten un binnen reported on Sunday. However, with reservations: “To the right, this will have to wait,” says Janina Moyes. “When I feel safer, I’ll go right back.”

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