Introducing My ‘MS Popeye-Spinach Hypothesis’

For any younger readers, and by that I’m guessing 45 and under, may I present the cartoon character Popeye the Sailor Man.

He got himself out of scrapes by downing a can of spinach, which supercharged his muscles. There was none of that nonsense of de-stalking raw young leaves and adding a drizzle of walnut oil and a pinch of sea salt before tossing it into a crunchy, yummy side salad. That would have taken far too long when he was being-a-battered!

A 2018 study published in the journal Scientific Reports noted that ”approximately three out of four MS subjects are affected by bilateral upper limb dysfunction.” Mine began the moment I had my first infusion of Lemtrada (alemtuzumab) five years ago.

Overnight, my right hand immediately started cramping up. This continued to spread until my entire arm was affected.

My left arm, which I use for everything now, is, err, flaccid. (Photo by Jane Davies)

The inexorable demyelination of my neurons has now put my arm into a constant state of flex. Without an inordinate quantity of drugs to relax it, I would be in incessant screaming agony. I know this because I was, until all of the following drugs were prescribed.

Here goes.

Gabapentin: I’m now on the maximum dose, due to it also working on one of my other comorbidities induced by MS, trigeminal neuralgia. This is a bonus for both conditions.

Similarly harmonious is baclofen.

Finally, I also have diazepam, which is perhaps better known by its older brand name, Valium. This drug was originally prescribed to deal with the regular spasms of my arm, which reduced me into a weeping mess. Then I found that if I took the maximum dose every night, my right arm would become somewhat useable the next day.

Actually, this occurred during a recent hospital stay. I no longer had control of my drugs, and they kept offering me two capsules every night. This was real bliss, as the constant shouting of a few of the distressed and confused patients simply faded into the darkness.

At this point, diazepam no longer reduced me to a puddle the next morning. I was becoming used to it, or technically, “tolerant.” However, I’d only been prescribed the maximum dose of two 5 mg capsules in extremis (such as during a spasm).

I phoned my doctor, as it was about time to fess up.

Immediately, my behavior changed, and I started taking just one dose every second day, at most. A warning of possible dementia as a side effect was enough for me. Diazepam is also supposed to be habit-forming; if you enjoy nights of total oblivion, it’s the drug for you. I prefer having dreams in which at least I get to walk, or even run, around; never flying, though, which is a tad prosaic!

So why the Popeye reference?

I got quite morose — OK, depressed — last weekend when I tried to put a stocking and foot wraps on my left leg. This is for another of my MS-derived comorbidities, lymphedema. A few months ago, I could just about do this. Well, I managed this time, but only barely.

Then I realized that I was no more disabled than before. It’s just that my right arm could no longer bend as far, because its muscles were in an even greater state of flex. Because I can hardly use that arm, my gun should have shrunk. But I realized that it actually was bigger than I ever had managed in all my years of sport.

This bulge in my right arm is the only part of me that isn’t fat or lymph fluid! (Photo by Jane Davies)

That’s my “MS Popeye-Spinach Hypothesis”: that the constant constriction of my arm is building up the muscle. There’s plenty of references on the internet to MS causing muscles to shrink, but I couldn’t find any causing the opposite effect.

I like spinach, but I really don’t down cans of it!

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