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On the Road Again STORY BY

Anissa Anderson Orr

This Saturday, John Rittman will join more than 14,000 cyclists riding 150 miles from Houston to Austin in the MS 150. The popular bike tour raises millions annually for Multiple Sclerosis research.

It's a cause the 36-year-old former bike messenger knows all too well. Three years ago, Rittman was diagnosed with a debilitating and progressive form of MS. But buoyed by hope and treatment, he plans to cross the finish line.

"When I was first diagnosed, I didn't think I would ever ride a bike again," Rittman says. The disease affected his vision and gave him vertigo and muscle weakness, making cycling too dangerous. Rittman needed a cane to walk.

Now, treatment with the drug beta-interferon enables Rittman to resume a part of his life he thought he would have to leave behind.

"Not being able to ride a bike was the one thing that really killed me with my diagnosis," Rittman says. "With treatment, eventually I started to ride again. Biking gives me a mental freedom that I really enjoy."

Whole Body is Fair Game

Bit by bit, or all at once, MS takes away a person’s physical freedom. The disease can cause vision problems, affect a patient's ability to walk and cause loss of bladder control. Some patients experience symptoms as attacks, and later go into remission and have periods with no symptoms at all. For other patients, the disease is progressive, and their symptoms will worsen over time. An estimated 400,000 people in America have MS.

What causes MS is still somewhat of a mystery. Researchers think that it may be an autoimmune disorder, in which the body attacks its own nervous system. A virus may trigger the disorder in certain people who have a genetic sensitivity to MS. However, there is no evidence that the disease is directly inherited.

Support is Key to Success


Rittman says support was an essential part of his
dealing with his diagnosis. He recommends
participating in support groups and activities for
MS patients.

"When I was first diagnosed and had to walk with
a cane, I was very upset," Rittman says. "So I
got involved with an MS art group that offers art
therapy. It was nice to talk to other people and
share with people like me, because it is not a
very common disease. I also took an MS yoga
class. That really helped me relax and the
exercise is good treatment for your body."

For information on support groups or MS related
activities in your area, contact the Lone Star
Chapter of the National MS Society at 1-800-
FIGHT-MS or visit the chapter's website at:
www.nationalmssociety.org.

What we do know is that the disease damages the myelin sheath, the covering that protects the nerves from damage. In some cases, MS damages parts of the nerves themselves. MS can affect almost any part of the body.

"Just imagine, anything that the central nervous system controls is fair game to MS and loss of function," says Dr. Jerry S. Wolinsky, a professor of neurology at The University of Texas Medical School at Houston. "So, vision, balance, walking, sensation, bladder control -- a whole variety of things can be affected. Because MS hits part of the nervous system in a random fashion, the symptoms can be quite variable from one episode to another."

Attacks can come seemingly from out of the blue. Rittman was relishing his hard-riding, harder-partying lifestyle, when his first attack stopped him cold.

"I had felt some tingling in my legs and thought my knee had problems, but I ignored it," Rittman says. "Then one day I just fell over while walking."

Treatments Limit Attacks

While there is no cure for MS, treatment with "disease-modifying drugs" can help reduce the number of days a person with MS might have an attack. The drugs can also help reduce or eliminate damaged areas of the central nervous system, called lesions. Treatment works best when started soon after a patient is diagnosed, and before the disease has a chance to cause much damage.

Three classes of drugs are currently approved by the U.S. Food and Drug Administration to treat MS. Beta-interferon (Avonex, Betaseron and Rebif), and Copaxone (glatiramer acetate) modulate the immune system. Patients can inject the drugs themselves. Mitoxantrone (Novantrone) suppresses the immune system. The chemotherapy drug was originally developed to treat cancer patients. Patients receive the drug through an IV infusion in a medical setting.

New Research Efforts

Researchers are studying whether using a combination of both beta-interferon and glatiramer acetate may be more effective than using one drug alone. The two drugs modulate the immune system differently, so the hope is that they will complement each other. To find out, Wolinsky is recruiting patients for an 80-center study on the drug combination. The study is funded by a $30 million grant from the National Institutes of Health, with the lead center at Mt. Sinai Medical Center in New York in collaboration with the University of Alabama at Birmingham and here at UT Medical School. The goal is to enroll 1,000 patients in the study. Wolinsky is co-principal investigator.

Study centers will also collect DNA samples from participants to find genes that are regulated by both medications. This information can help doctors determine which treatments for MS will work best on individual patients. Finding the right drug and proper dosage is a process of trial and error that can take years of tweaking.

New classes of drugs are also being developed to treat MS. Unfortunately, one of the more promising new drugs, Tysabri, was taken off the market in February because of safety concerns. The loss of Tysabri was, "a disappointment," Wolinsky says. But he is hopeful about the future of MS treatments.

"There are eight different classes of drugs which are orally active, that are coming down the pipeline," Wolinsky says. "It is a very exciting time for MS research. When I started treating MS, the big debate was whether to even tell patients that they have the disease, because there was nothing we could do about it."

Though realistic about the physical challenges MS still has in store for him, Rittman is also hopeful for the future. He looks forward to more cycling, but most of all to watching his 9-month old daughter grow.

"MS is not a death sentence," Rittman says. "It is just something you have to learn to live with. You've got to live life while you've got it."

Last Updated: 4-12-2005