Dystonia Dialogue - Dystonia Medical Research Foundation
Transcription
Dystonia Dialogue - Dystonia Medical Research Foundation
MAGAZINE OF THE DYSTONIA MEDICAL RESEARCH FOUNDATION | SUMMER 2015 | VOL. 38 • NO. 2 Dystonia Dialogue & Cure Dystonia 5 DMRF Now Investigate New Treatment the Dystonia 8 Join Moves Me Campaign Military at 17 US Increased Risk of Dystonia Following TBI SUMM ER 201 5 2 Inside This Issue 5 DMRF & Cure Dystonia Now Collaborate to Investigate Possible Treatment Medication May Lessen Dystonia with Fewer Side Effects 7 Clinical Fellowships Announced for 2015 DMRF Program Provides Physicians with Special Training 14 Flexing Our Muscles Dystonia Advocates Urge Action from Congressional Leaders 20 Employees with Dystonia: Accommodation & Compliance Guidelines for Employers from the Job Accommodation Network 22 Personal Profiles Meet Wayne Erickson & Johnny McCoy What is Dystonia? Dystonia is a disorder that affects the nervous system. Improper signaling from the brain causes muscles to contract and twist involuntarily. Dystonia can affect a single body area or multiple muscle groups. There are several forms of dystonia, and dozens of diseases and conditions include dystonia as a significant symptom. For more information visit: www.dystonia-foundation.org On the Cover: The Dystonia Dialogue is the magazine of the Dystonia Medical Research Foundation (DMRF). It is published three times a year to provide information to individuals affected by dystonia, family members, and supporters of the DMRF. The Dystonia Medical Research Foundation (DMRF) is a non-profit, 501c(3) organization founded in 1976. The mission is to advance research for more effective treatments and a cure, to promote awareness and education, and to support the well being of affected individuals and families. Dystonia Medical Research Foundation One East Wacker Drive • Suite 2810 Chicago, Illinois 60601-1905 Phone: 312 755 0198 • 800 377 3978 Email: dystonia@dystonia-foundation.org Web: www.dystonia-foundation.org The Dystonia Dialogue reports on developments in dystonia research and treatments but does not endorse or recommend any of the therapies discussed. Individuals are urged to consult a physician with questions and concerns about their symptoms and care. Staff Janet L. Hieshetter Executive Director Debbie Durrer Director of Development Veronica Diaz Information Coordinator Jessica Feeley Editor and Special Projects Jennifer McNabola Director of Finance Martha Murphy Brain Bank Liaison Emma Pinto Development Associate Jody Roosevelt Science and Technology Manager Jan Teller, MA, PhD Chief Scientific Officer The DMRF is more than an organization— we are a community working tirelessly to better the lives of people and families living with dystonia today and in the future. Partial support of the Dystonia Dialogue is provided by educational grants from Allergan. Printed in the USA. © Dystonia Medical Research Foundation DY STON IA DIA LOGU E 3 Foundation Update Dear Friends, ART KESSLER As an organization, the DMRF owes its strength to the dedication of our supporters; as individuals impacted by dystonia, we find strength in each other. Together we have built a community that works tirelessly to better the lives of people and families living with dystonia today and in the future. PRESIDENT Although the dystonia experience can feel isolating at times, we hope each of you feels confident that the DMRF is fighting every day on your behalf. JANET L.HIESHETTER EXECUTIVE DIRECTOR In this issue of the Dystonia Dialogue we share how our community is continuing to make a difference with a special focus on legislative advocacy and the work of the Dystonia Advocacy Network (DAN). The DAN is the dystonia community’s voice on Capitol Hill, educating legislators and policy makers about dystonia and the needs of affected individuals and families. The DAN mobilizes volunteer advocates to take action when needed, and the results are inspiring. See page 14 to read about how advocates have significantly increased federal research funding opportunities for dystonia investigators. For years advocates have highlighted the increased risk of dystonia among US military service people and veterans due to traumatic brain injury. Read more about this important subject on page 17. You are a vital member of the DMRF family. There is no substitute for connecting with others who understand the realities of dystonia, and your experiences can help others. We encourage you to reach out to the nearest DMRF support group and/or online support groups. Support groups also offer opportunities to get involved in efforts to promote dystonia awareness and raise funds for medical research toward better therapies and a cure. We never lose sight of how much we appreciate and depend on our community. We welcome everyone who wishes to join us and be part of our efforts to make a difference. Thank you for your ongoing support. Art Kessler President Janet L. Hieshetter Executive Director Join the DMRF’s 2015 Awareness Campaign! See page 8 for details. SUMM ER 201 5 4 More Than a Day at the Zoo Zoo Walks Raise Awareness & Funds to Benefit DMRF Dystance4Dystonia Zoo Walks are happening throughout the US to raise dystonia awareness and research funds. Teams of participants gather for a day at the zoo in support of a local family that has been impacted by the disease. “It was awesome to see everyone get together, whatever kind of dystonia they have. I was able to meet families we connected with online,” explains Becky Shaughnessy who traveled from New Hampshire to attend the Providence Zoo Walk in June. “It’s amazing the bonds you make. I can’t wait for next year. I want to do whatever I can to raise awareness and funds for research so hopefully one day we’ll find a cure.” Becky’s son, daughter, and husband have dystonia. Maria Jeffries of Arizona traveled to Providence to attend the Zoo Walk. Her extended family in the area formed a team in her honor: “My family was happy to support me and they enjoyed being there with me, even though I couldn’t walk with them. We had a great time. My family grew that day: I have my blood family and my dystonia family.” Maria was diagnosed with cervical dystonia and focal torsion dystonia in 2009. Upcoming Zoo Walks scheduled for 2015 include: • August 30: St. Louis Zoo • September 12: Cincinnati Zoo • September 19: Cleveland Zoo • September 19: Binghamton Zoo, New York • September 27: Pittsburgh Zoo • October 4: Bronx Zoo Proceeds benefit the DMRF. Cost to attend is typically $25 per adult and $15 for children under 11. Fee includes all day admission to the zoo, t-shirt, and refreshments. Additional upcoming DMRF events include the Minnesota Dystonia Golf Classic (August 15), the Toss4Dystonia Cornhole Tournament (September 26), the Putnam, CT Dystance4Dystonia Walk (October 17), Team DMRF at the TCS New York City Marathon (November 1), and others. For more information and to register for scheduled DMRF events, visit www.dystonia-foundation.org/events. Zoo Walks bring the dystonia community together and support the work of the DMRF. DY STON IA DIA LOGU E 5 DMRF & Cure Dystonia Now Announce Collaboration to Investigate Possible New Treatment Medication May Lessen Dystonia with Fewer Side Effects than Existing Drugs The DMRF and Cure Dystonia Now (CDN) are collaborating to co-support a research investigation that may one day lead to a new dystonia drug. The medications most frequently prescribed to treat this debilitating disorder are ironically those with some of the highest incidence of intolerable side effects, which limit their use. A team of American and European investigators is exploring whether a drug called AZD1446, a.k.a. TC-6683, could potentially provide relief for dystonia patients without the unintended effects frequently caused by existing pharmacological therapies. ARTICLE AT A GLANCE • DMRF and Cure Dystonia Now are collaborating to co-support a research investigation that may lead to a new dystonia drug. • Investigators are exploring whether AZD1446 could potentially provide relief for dystonia with fewer side effects than existing medications. • The drug has been examined for treating attention deficit/ hyperactivity disorder and Alzheimer’s disease. The investigation is led by David Standaert, MD, PhD, Professor and Neurology Chair at University of Alabama and includes Antonio Pisani, MD, PhD, Associate Professor of Neurology at University of Rome Tor Vergata and DMRF Stanley Fahn Awardee. Art Kessler, President of the DMRF, explains: “This project addresses two important issues for the dystonia community: We need additional treatment options and we need to find new ways to offer treatment with minimal side effects. This project provides an important opportunity to investigate a possible new medication for dystonia while pursuing a better quality of life for patients.” Kessler developed an especially debilitating childhood onset form of dystonia at age eight and knows firsthand the challenges inherent in treatment. Marc Miller, Director and Co-President of CDN states, “Our priority is to work with the brightest and most motivated doctors and scientists, and our goal is to discover new treatments. This project is an exciting opportunity to do both.” Two generations of the Miller family are affected by dystonia. Dystonia treatment typically requires a combination of approaches including oral medications, botulinum neurotoxin injections, surgical interventions, and supportive therapies such as physical therapy. In some people, a class of drugs called anticholinergics (for example, Artane/trihexyphenidyl) may replace or compound the physical symptoms with equally disabling cognitive effects such as drowsiness, hallucinations, and memory difficulties. Striking a balance between controlling the dystonia and preserving the ability to function in daily life is a challenge for physicians and patients alike. Dystonia results from improper signals in the nervous system that instruct muscles to contract excessively. Experts do not yet fully understand the neurological mechanism that causes the abnormal muscle contractions, but the origins appear to stem from an imbalance of neurotransmitters in the brain and changes in brain cell synapses. Standaert and team are using a genetically engineered mouse with abnormal neuronal signaling to examine whether AZD1446 can correct the abnormal signaling and restore the balance of neurotransmitters. In separate studies, the drug has been examined for use in treating attention deficit/hyperactivity disorder and Alzheimer’s disease. SUMM ER 201 5 6 Stanley Fahn Honored for Life’s Work in Dystonia & Movement Disorders The DMRF joined Columbia University Medical Center and the Parkinson’s Disease Foundation to honor movement disorder pioneer Stanley Fahn, MD at the Stanley Fahn Symposium on April 18 at Columbia University in New York City. Dr. Fahn is the H. Houston Merritt Professor of Neurology and Director Emeritus of the Center for Parkinson’s Disease and Other Movement Disorders at Columbia. Goetz, Director of the Parkinson Disease and Movement Disorders Center at Rush University Medical Center; Mark Hallett, Chief of the Human Motor Control Section of the National Institute of Neurological Disorders & Stroke; Joseph Jankovic, Professor of Neurology, Distinguished Chair in Movement Disorders, and Director of Parkinson’s Disease Center and Movement Disorders Clinic at Baylor College of Medicine; Anthony Lang, Jack Clark Chair for Parkinson’s Disease Research at University of Toronto and Director of the Movement Disorders Centre at Toronto Western Hospital, and many others. In addition to being a pioneer in Dr. Stanley Fahn was recognized movement disorders research and for being a pioneer in research patient care, Dr. Fahn’s commitment and patient care. to training young physicians nurtured many—if not most—of the most influential names in Meeting support was provided by the Allergan movement disorders today. The symposium paid tribute to Foundation with additional support from Lundbeck Dr. Fahn for his contributions to the field and provided and US WorldMeds. a forum in which established and up-and-coming movement disorder experts discussed the latest in research and patient care for dystonia and other movement disorders. The Stanley Fahn Symposium was chaired by Drs. Mahlon Delong, William Timmie Professor of Neurology, Emory University School of Medicine; William Dauer, Associate Professor of Neurology, University of Michigan; and Un Kang, H. Houston Merritt Professor of Neurology and Chief of Movement Disorders Division, Columbia University. Additional speakers included prominent movement disorder experts Drs. Susan Bressman, Chair of the Alan and Barbara Mirken Department of Neurology at Mount Sinai Beth Israel and Interim Chair in the Department of Neurology at Mount Sinai St. Luke’s Roosevelt; David Eidelberg, Investigator and Head at the Susan and Leonard Feinstein Center for Neurosciences and Director of the NIH Morris K. Udall Center of Excellence for Parkinson’s Disease Research; Steven Frucht, Professor of Neurology and Director of Movement Disorders in the Robert and John M. Bendheim Parkinson and Movement Disorders Center at Mount Sinai Medical Center; Christopher Stay in Touch It's easy to keep informed of the latest DMRF events and news: • Renew Your Membership: www.dystonia-foundation.org/membership • Sign Up for Monthly Email Updates: www.dystonia-foundation.org/email • Text DYSTONIA to 90999 for Updates to Your Mobile • Find a Support Group: www.dystonia-foundation.org/supportgroups • Join an Online Group: www.dystonia-foundation.org/online • Find the DMRF on Facebook, Twitter, and Instagram DY STON IA DIA LOGU E 7 Mahlon DeLong Earns 2015 Taubman Prize for Excellence in Translational Medical Science The DMRF congratulates Scientific Director Dr. Mahlon R. DeLong for earning the 2015 Taubman Prize for Excellence in Translational Medical Science from the University of Michigan’s A. Alfred Taubman Medical Research Institute. Dr. Mahlon DeLong was honored for contributions to the treatment of Parkinson’s disease. He is being honored for his contributions to the treatment of Parkinson’s disease. Dr. DeLong will present the keynote address at the Taubman Institute’s annual symposium on October 16, 2015 at the Kahn Auditorium on the University of Michigan medical campus. The Taubman Prize was established to recognize outstanding translational medical research. It includes a $100,000 award and is presented each year to a clinician-scientist who has transformed laboratory discoveries into clinical applications for patients suffering from disease. Dr. DeLong is William Timmie Professor of Neurology at Emory University School of Medicine. Among his numerous awards, he earned the 2014 Breakthrough Prize in Life Sciences and the 2014 Lasker-DeBakey Clinical Medical Research Award. Clinical Fellowships Announced for 2015 Few things are more important to living well with dystonia than a knowledgeable doctor who is trained in the diagnosis and treatment of movement disorders. The DMRF is fostering the next generation of dystonia leaders by offering one-year fellowships to support clinical training of physicians in preparation for a clinical and/or research career in movement disorders with a special focus on dystonia. The training is patient-oriented and includes hands on experience in clinics as well as participation in professional meetings and workshops. The Clinical Fellowship Training Program is made possible by grants from Merz Pharmaceuticals and the Allergan Foundation. Congratulations to our 2015 Clinical Fellows and their mentors: Leonardo Almeida, MD University of Florida Mentor: Mike Okun, MD Jeffrey Ratliff, MD Mount Sinai Mentor: Rachel SaundersPullman, MD, MPH Kelly Andrzejewski, DO, PhD Laura Scorr, MD University of Rochester Emory University Mentor: Mentors: H. A. Jinnah, MD, Richard Barbano, MD, PhD PhD and Stewart Factor, DO Sophie Cho, MD National Institute of Neurological Disorders & Stroke Mentor: Mark Hallett, MD The impact of the Clinical Fellowship Training Program is reaching communities across the country. Past Clinical Fellows have earned positions in the movement disorder programs at prestigious institutions such as University of Pennsylvania, Brown University, and University of Texas Southwestern. Others are filling gaps in communities previously without movement disorder experts with special experience in dystonia such as Bakersfield, California. As future Clinical Fellows complete the program, additional communities throughout the country will benefit from these outstanding movement disorder clinicians. SUMM ER 201 5 8 Dystonia Moves Me: Show Me Your Moves DMRF Launches 2015 Awareness Campaign Dystonia Moves Me is the DMRF’s awareness campaign to take place throughout September. This year’s challenge is to promote dystonia awareness by ‘showing your moves’ and encouraging others to do the same. The Challenge Use photos, video, or live events to promote dystonia awareness by showing off your moves—whether through dance, sports, demonstrating a sensory trick, playing a musical instrument, or any favorite skill or hobby. Or simply share how dystonia, a movement disorder, impacts your life. Encourage family, friends, school mates, dance studios, fitness clubs, etc. to take part and challenge one another. The more people who participate, the greater the awareness. Get Started Today Download your free Dystonia Moves Me: Show Me Your Moves awareness kit, including an optional media kit, at: www.dystonia-foundation.org/ DMMkit. A supply of awareness materials including stickers and walletsized dystonia information cards will be mailed to you. To request an awareness kit by mail, contact the DMRF at 800-377-3978 or awareness@dystonia-foundation.org. Stay in Touch Be sure to keep the DMRF informed of your awareness activities. Submit your photos and images to the DMRF at www.dystonia-foundation.org/moves. Visit www.dystonia-foundation.org/dystoniamovesme and follow the DMRF on Facebook, Twitter, and Instagram for news and updates about the campaign. Look for a full report on Dystonia Moves Me in the next Dystonia Dialogue. Special Edition DMM T-Shirt Available While Supplies Last Promote dystonia awareness wherever you go with a limited edition Dystonia Moves Me t-shirt with stylish royal blue ringer detail for just $18. For details, go to: www.dystonia-foundation.org/DMMshirt. Help Researchers Find a Cure: Register as a Brain Donor Registering as a brain donor is a powerful way to contribute to dystonia research without cost to the donor or family. Important neuropathological studies are not possible without volunteers who chose in advance to donate their brains to research. Brain recovery does not alter the outward appearance of the donor or interfere with memorial services or remembrance practices. The DMRF partners with the Harvard Brain Tissue Resource Center (HBTRC) at McLean Hospital in Belmont, Massachusetts. The HBTRC accepts donations from the 48 states in the contiguous USA. (Contact the DMRF for more information if you live outside of those areas and wish to donate.) Individuals have the right to withdraw from the program at any time. Learn more about the program and begin the simple registration process at www.dystoniafoundation.org/brain. Or request information by mail by contacting Martha Murphy, Brain Bank Liaison, at brainbank@dystoniafoundation.org or calling 800-377-3978. DY STON IA DIA LOGU E 9 Return of the Fly Research Reality Check with Chief Scientific Officer Jan Teller It is not easy to catch a fruit fly. Scientists recently discovered that fruit flies react to threats as if they were fighter jets, elegantly using aerodynamic forces to perfection. So when you find one hovering around your kitchen, do not chase; it is pointless! Other scientists, probably less impressed with their flying abilities but captivated by their genetics and short life cycle, use fruit flies to study dystonia. Two recent scientific papers, published virtually simultaneously, provide unusually detailed insights into torsinA and the inner workings of the fly brain. In the first paper, a research team from South Korea, led by Dr. Young Ho Koh and helped by Canadian and US scientists, explored the role of abnormal torsinA in how neurons respond to stress. The researchers show that mutant The cellular torsinA is essentially toxic to the fly brain cells and induces a protein TorsinA stress response that causes excessive accumulation of cell proteins causes dystonia when that are misshaped, damaged, and not fully functional. Abnormal torsinA it becomes abnormal causes an increase in another protein identified by the team, which helps the due to a mutation neurons compensate for the harmful effects. As a result, flies that carry the in the DYT1 gene. human mutant torsinA have a shorter lifespan and accumulate different proteins in their brains. Here, a little fly has become a tiny model of dystonia that can be studied at the brain level to help researchers reconcile the conflicting results obtained in other cell and animal models. The second paper comes from a group well-known to our readers. In fact, this work was supported in part by DMRF. A team of investigators from Harvard and the University of Alabama led by Dr. Naoto Ito capitalized on the fact that fruit flies, unlike humans, have only one torsin-related gene. If this gene is removed, the insects cannot move normally. There is also a substantial drop in brain dopamine levels and reduction in the activity of a key enzyme in the dopamine pathway. The fly’s movement problems can be rescued by feeding the larvae dopamine. In the current study, the team showed that if you insert the human DYT1 mutant of torsinA into the fly, this also inhibits locomotion in larvae and adult flies as well as decreases levels of the enzyme. Furthermore, when both normal and mutated torsinA were present, there was a similar reduction in the movement and enzyme activities. This seems to support the hypothesis that mutated torsinA interferes with the activity of normal, ‘healthy’ torsinA. These studies are remarkable because they are clarifying the role of a known dystonia-causing protein and providing a superb model system to test molecular and cellular hypotheses. This is critical for developing new treatment strategies. The studies reinforce the value of the fly as a dystonia model while rodents and other models have recently attracted a great deal of attention. So, please, think twice before trying to swat a fruit fly—his cousins in the lab are busy helping us solve the mysteries of dystonia. Dr. Naoto Ito received funding for his work through the Department of Defense Peer Reviewed Medical Research Program. Learn more on page 14. SUM MER 2 015 10 PEOPLE ON THE MOVE The DMRF is deeply grateful for our grassroots volunteers who work year round to promote dystonia awareness and fundraise for medical research. Every effort and every volunteer makes a difference! For 15 years, DMRF supporters and support group leaders Janice and Len Nachbar of New Jersey have obtained annual dystonia awareness proclamations from the Township Committee of Freehold and Monmouth County. Governor Chris Christie has also acknowledged the need for increased dystonia awareness due to their efforts. Congratulations and thanks to Janice and Len for their tremendous contributions to improving dystonia awareness in New Jersey and beyond. Pictured from L to R: Freehold Township Mayor Tom Cook, Committeewoman Barbara McMorrow, Len Nachbar, Janice Nachbar, Committeeman David Salkin, Committeeman Anthony Ammiano, and Committeeman Lester Preston Jr. The 2nd Annual Multiple Sclerosis Meets Dystonia Golf Tournament took place June 14 at Sand Springs Golf Course in Drums. Pat Brogan and Dave Latoff teamed up to raise awareness and funds for two debilitating disorders: dystonia and multiple sclerosis. Pat is a former college basketball coach who developed dystonia after a hit-and-run collision while training for a triathlon. DMRF Past President Claire Centrella hosted an online Pampered Chef fundraiser. A second Pampered Chef fundraiser in honor of Crystal McCarthy also supported the DMRF. On May 10, Patrician Bergeron and the Verville family held the 10th Hands for Movement Freedom benefit piano recital in Vermont. Alexandre Verville, who has dystonia, inspired this annual concert and played piano along with 19 pianists—all students of Patricia. The event raised $450. In May, Denise Gibson completed the Lilac Bloomsday Run held in Spokane, Washington on behalf of the DMRF. Denise walked 7.46 miles and raised $1,200— all this despite multi-focal dystonia, ongoing deep brain stimulation programming, a weak neck, and a broken rib. The Baron family of Rhode Island organized the first-ever Providence Dystance4Dystonia Zoo Walk at Roger Williams Park on June 27. Approximately 400 people attended to support dystonia research and bring visibility to the disorder. Twenty-year-old Bryan Baron was diagnosed with dystonia as a teenager in 2007. Special thanks to Leadership Chair Paula Schneider for her role in supporting and organizing the Zoo Walk. DY STON IA DIA LOGU E 11 Members of the Phoenix and Prescott Dystonia Support Groups in Arizona, led by Bob and Virginia Spencer, represented the DMRF at the “Celebrate Life! Health Expo 2015” offered by Yavapai Regional Medical Center. Bob Spencer is affected by cervical dystonia and underwent deep brain stimulation surgery last year. Pictured support group members: Bob Sturdevant, Joelle Katan, Bob Spencer, Noreen Passmore, Jim Stobbs, Virginia Spencer, and Miyoshi McMurray. Sandra Aresta and Michael Katz threw a joint party to celebrate milestone birthdays. In lieu of gifts, they invited guests to make donations to the DMRF. Their daughter is affected by early-onset generalized dystonia. The Bono family of Connecticut generously shared their story with the TV series Diagnose Me on Discovery LIFE. The episode “Ballerina Interrupted” chronicles the process by which daughter Sullivan was diagnosed with dystonia after a serious misdiagnosis and unnecessary medical procedures. Sullivan Bono was also named an Everyday MVP by News 8 WTNH and Frontier Communications. Ashlyn Lacey, a 12-year-old from Missouri with dystonia, was presented with a new iPad by Matina KoronisKoester, president and CEO of St. Louis- based Digital Partners Incorporated (dpi), which recently created Move for Dystonia, a campaign to benefit the DMRF. Representatives from the Dystonia Support & Advocacy Group of San Diego, Paul Fowler and Martha Murphy, were once again interviewed on the UT Community Spotlight internet radio program to discuss dystonia and the upcoming, sold-out Dystonia Benefit Concert with recording artist Juice Newton in October. Leader Martha Murphy and Susi Pensel helped represent the DMRF at the 19th International Congress of Parkinson’s Disease and Movement Disorders in San Diego in June. Stay in Touch! Sign up for the DMRF's monthly e-newsletter for the latest updates and announcements: www.dystonia-foundation.org/email SUM MER 2 015 12 St. Philomena School in Portsmouth, Rhode Island hosted a bake sale for the DMRF in honor of Maddie Paolero and raised over $600. The funds were added to the total raised for Team Reno at the Dystance4Dystonia Providence Zoo Walk. Special thanks to teacher Karen Turner. Eagle Rare Kentucky Straight Bourbon Whiskey has named Melissa Phelps the winner of the 2015 Rare Life Survival Award. Eagle Rare donated $5,000 to her charity of choice, the DMRF. Many congratulations and thanks to Melissa—and to everyone who voted for her story. She is in the running again this year. Show your support by voting daily at http://www.eaglerarelife.com/ content/melissa-phelps. Long time DMRF supporters Linda and Roger Yerkey of Illinois raised $1,700 in support of the DMRF and a second charity by hosting a trivia fundraiser. Proceeds were split between the two organizations. Debbie Harris, Second Grade Teacher in the North Hills School District, Pittsburgh, hosted a District Denim Day for Dystonia fundraiser in honor of her sister. The first-time event raised over $560. The Westminster Choir of The First Presbyterian Church at Caldwell in New Jersey held a special collection for the DMRF in honor of Lydia Nathans at the Maundy Thursday service. The Nathans family hosted their 3rd Nathans Family Yard Sale in May, and raised over $2,200. The students of Katie Rosa-Martin’s Family Consumer Science I and II classes at Sullivan County High School in Laporte, Pennsylvania organized a sewing kit fundraiser in support of the DMRF. The DMRF extends our condolences and gratefully acknowledges the generous gifts received in memory of the following: Emanuel Batista Albert Foley Shirley Krusheski Phillip Schevetto Yvonne Berard Tommy Ford Jamie Lafferty Marvin Scobee Frances Borowsky Yvonne Marie Fross David Lewis Diane Shaw Willie Brown Frances Geraci Stevie Melamed Matthew Simmons Joyce Campbell Joseph Geraci Enid June Meltzer Anita Simon Rev. Ronald Channel Linda Geraci Chad Orison Selma Marie Skiba Janene Ann Conte Mario Geraci Doris Oster Bruce Slepian David Cullinane John Phillip Gunther Muriel Ostroff Martin Sloate Dorothy Dale Sara Harris Aleksandra Passarello Carol Stallions Michael DeCrescente Richard Ingebretsen Jyoti Patel Sophia Stanich Frankie Depanfilo Toby Iverson Richard Pollack Vincent Tabbachino Martha Ann Dufault Ara Johnston Morty Pomerantz Mike Underwood Teressa Duffey Don Kahn Terry Rafferty Elaine Weinberg Robert Easter James C. Kilik Bebe Rose James Wiles Bertha Eichler Mary Kolls Iris Salter Frank Wyeth DY STON IA DIA LOGU E 13 Not Just Any Body: Living Well with Dystonia Dystonia is a movement disorder that impacts the physical body, and it can also affect emotional and psychological health. Living well with dystonia includes treating the physical symptoms, protecting emotional and psychological well-being, and accommodating your unique treatment needs as an individual. There is no single strategy for living well with dystonia that works for everyone. The following suggestions have been compiled from individuals with dystonia, support leaders, and healthcare professionals. ; Seek Out Expert Healthcare Providers. It often takes a team of experienced professionals to diagnose and treat dystonia. This may include a movement disorder neurologist, physical therapist, psychiatrist, psychotherapist/ counselor, and others. Actively Participate in Your Treatment. Learn about dystonia. Make informed choices about your care with the input of your medical team. wqwq Develop a Multi-Layered Support System. Seek out supportive family and friends, local dystonia support groups, online support groups, community events, and self-help resources. Enlist the help of a psychotherapist or counselor to help navigate concerns and vulnerabilities. i Listen to Your Body. Respect and honor your individual need for sleep, rest, nutrition, exercise, relaxation, and time/scheduling. v Cautiously Explore Complementary Therapies. Talk to your doctor about non-traditional therapies that interest you. Different complementary approaches may work for different people, but keep in mind that numerous practitioners and outfits falsely claim to have a unique ability to treat dystonia. Exercise. The benefits of exercise can be profound. Consider working with a physical therapist to develop an exercise plan that works for you. Seek Help When You Need It. If you need assistance, reach out and be specific about what you are having trouble with. Accept help when offered—and without guilt. Treat Depression & Anxiety. Depression and anxiety can dramatically impact quality of life and the severity of motor symptoms. Consider being evaluated for depression and/or anxiety and, if symptoms are present, seek treatment. Be Mindful of Stress. Regular stress reduction and relaxation practices can have a positive impact on symptoms and overall well-being. Take Care of Your Relationships. Resist the temptation to isolate from other people. If family or love relationships are strained, consider enlisting the help of a therapist to bring you closer to those you care about. Remain as Active and Social as Possible. It may be physically and/or mentally demanding to go certain places or complete specific tasks. Plan ahead, pace yourself, and rest when needed. Embrace Awkward Social Situations. Your symptoms may flare at extremely inopportune times. Strangers may occasionally misinterpret your body language. Be forgiving with yourself in these moments. V Do Things You Enjoy. It can be easy to let pleasurable activities and fun fall by the way side. Create space in your routine for activities and experiences that invigorate you and keep you going. Contact the DMRF for Assistance. We can be reached at dystonia@ dystonia-foundation.org or 800-377-3978. Look for the DMRF on Facebook and Twitter. Special thanks to Steven Frucht, MD and Pichet Termsarasab, MD for reviewing the content of this article. SUM MER 2 015 14 Flexing Our Muscles: Strength through Advocacy On April 14–15, nearly 100 DOD Research Program Awards Millions in Funding for Dystonia Investigators volunteers representing the Dystonia Advocacy Network (DAN) gathered in Washington, DC on behalf of the greater dystonia Thanks to the tireless work of dystonia community. Following a day of advocates, in 2010 Congress began legislative training, advocates met to include dystonia in the Department with Members of Congress and of Defense (DOD) Peer Reviewed their staff on Capitol Hill to share Medical Research Program (PRMRP). their stories and educate Senators And each year, advocates must push and Representatives on the needs of affected constituents. DAN Chair Emma Mattes presented Congressman David Jolly of Florida with the Distinguished Public Service Award. Two of the most important requests dystonia advocates made to their legislators focused on federal funding of dystonia research: Advocates asked legislators to support a funding level of $32 billion for the National Institutes of Health (NIH) in the Labor-HHS-Education Appropriations Bill for Fiscal Year 2016. This level of funding will support the progress NIH has made on medical research. Right now, only 1 of 11 highly-scored research proposals are funded by the NIH. This means 10 out of 11 good studies are not funded. If this trend continues, researchers will likely be forced to look elsewhere for funding, including institutions in other countries, risking an evacuation of researchers from the US. Advocates also asked legislators to keep dystonia as a condition eligible for study through the Department to keep dystonia on the exclusive list of Defense (DOD) Peer-Reviewed Medical Research Program. As Congress drafted the Defense Appropriations Bill for Fiscal Year 2016, advocates urged them to include dystonia in this program so that investigators can apply for research funding—and they were successful. of conditions eligible for study. The US military personnel are at increased risk of traumatic brain injury and developing dystonia, especially those in combat operations. To date the DOD has funded over $3 million in dystonia research, and this work represents studies by top dystonia experts. Read more about dystonia and TBI among military personnel on page 17. 2014 A Novel Animal Model for Investigating the Neural Basis of Focal Dystonia Craig Evinger, PhD Stony Brook University School of Medicine $753,634 The DAN is comprised of five dystonia patient groups working collaboratively on behalf of the greater community: Dystonia Medical Research Foundation, Benign Essential Blepharospasm Research Foundation, National Spasmodic Dysphonia Association, National Spasmodic Torticollis Association (NSTA), ST/Dystonia, Inc. results have been game-changing; now both the National Institutes of Health (NIH) and the DOD invite dystonia researchers to apply for funding. The DOD PRMRP has funded the following dystonia investigations since 2010: Pathomechanisms of Dopamine Dysregulation in DYT1 Dystonia: Targets for Therapeutics Ellen Hess, PhD Emory University School of Medicine $1,200,000 (pending) DY STON IA DIA LOGU E 15 High School Students Organize “Stomp Out Dystonia 5K” 2013 Identifying Molecular Regulators of Neuronal Functions Affected in the Movement Disorder Dystonia Nobutoshi Harata, PhD University of Iowa $1,132,500 Developing Gene Silencing for the Study and Treatment of Dystonia Pedro Gonzalez-Alegre, MD, PhD Philadelphia Children’s Hospital $1,132,500 2012 Dopamine Dysfunction in DYT1 Dystonia Nutan Sharma, MD, PhD Massachusetts General Hospital $176,800 2011 Gene Expression-Based High-Throughput Screening (GE-HTS) To Identify Novel Therapeutics for Dystonia D. Cristopher Bragg, PhD Massachusetts General Hospital $131,126 2010 Creation of a Mouse with Stress-Induced Dystonia: Control of an ATPase Chaperone Kathleen J. Sweadner, PhD Massachusetts General Hospital $118,843 First-time Event Raises Awareness & Research Funds Seventeen-year-old high school seniors Caitlyn Connelly and Melanie Edwards organized the first-ever Stomp Out Dystonia 5K Walk in Bensalem, Pennsylvania on May 16. A crowd of 400 people attended, and the event raised $16,000 for urgently needed medical research toward a cure. Caitlyn Connelly and Melanie Edwards raised $16,000 in support of the DMRF. “It was a truly amazing day, and we are blown away by the amount of support we received,” says Caitlyn, who was diagnosed with dystonia approximately five years ago. At the event, Caitlyn and Melanie were presented with Certificates of Appreciation by Janice and Len Nachbar, area support group leaders and representatives of the DMRF. “Caitlyn and Melanie accomplished much more than many adults would be able to, and they did it while attending high school honors classes! Two unbelievable young women,” remarked Len. Caitlyn was born with cerebral palsy and developed generalized dystonia at age 12. “Imagine your muscles painfully contracting so severely that you can’t use your hands,” she explains. “Imagine being awake for days because excruciating spasms relentlessly grip your body. Imagine being unable to walk, swallow, speak, or brush your teeth because you can’t control your movements. This is the reality of dystonia for me and for many others.” Caitlyn has endured a number of treatments to try to reduce the powerful dystonic movements such as oral medications, botulinum toxin injections, and multiple surgeries. The surgical procedures include an implanted device that delivers medication directly into her spinal column and deep brain stimulation, which involves electrodes placed deep in her brain and powered by a pacemaker-like stimulator in her chest wall. She has undergone orthopedic surgeries to correct spinal curvatures caused by the dystonic muscle spasms and has a feeding tube for nutrition. Caitlyn uses a power wheelchair for mobility and augmentative communication. Caitlyn and Melanie celebrated graduation in June. SUM MER 2 015 16 Douglas Kramer Advocacy Award Recipients Recognized at Advocacy Day Rebecca Sharp advocates on behalf of her father who recently learned he had been The Douglas Kramer misdiagnosed with dystonia in 2008. From L to R: This year’s Douglas Kramer Young Advocate Award “Oddly enough,” she explains, “my Young Advocate Award recipients are heart and passion for the dystonia is presented to individuals Miyoshi McMurry, Joseph Buffa, community has only increased through Rebecca Sharp, Devin McClernan, committed to making a and Ginny Bryan. my father’s revised diagnosis. If more difference through had been known about dystonia, things legislative advocacy would be so different for him.” Rebecca At Dystonia Advocacy Day (April 14–15, worked with her parents to start a dystonia 2015), the DMRF was extremely proud to support group, authored a dystonia awareness announce the 2015 Douglas Kramer Young blog, and has been integral in recruiting runners for Advocate Award recipients: Virginia Bryan, Joseph the DMRF’s New York City Marathon team. Buffa, Devin McClernan, Miyoshi McMurry, and Rebecca Sharp. These exceptional volunteers are Before Devin McClernan’s film, Dystonia Devin, won working with the DMRF throughout the year on the American Academy of Neurology’s prestigious Neuro various initiatives at federal and state levels. Film Fest in 2014, he participated in legislative advocacy and presented at DMRF events. “Without the progress Joseph Buffa is a university student whose 11-year-old made through advocacy, I might have not been able to sister was diagnosed with dystonia at age three. Joseph’s undergo deep brain stimulation surgery, which alleviated first experience getting involved in the dystonia commuof almost all my pain, straightened my posture, and nity was attending last year’s Detroit Dystance4Dystonia considerably increased my speech intelligibility,” says Zoo Walk. This inspired him to create opportunities to Devin. “The behind-the-scenes advocacy for the dystonia promote dystonia awareness. “My sister does not let community has enhanced the lives of those afflicted by dystonia define her,” he explains. “Her fight makes the condition and turned my life around.” me want to fight with her.” Virginia (Ginny) Bryan has lived with dystonia as long as she can remember but was misdiagnosed for 26 years. Since being properly diagnosed with myoclonus-dystonia, Ginny has supported DMRF events such as the Toss4Dystonia Cornhole Tournament, contributed to the Dystonia Dialogue, and serves as a co-admin of the 20/30 Dystonia Group on Facebook. She says, “The dystonia community is at a turning point where it has all the necessary tools to be as advanced as the cystic fibrosis community or breast cancer, if we continue to fight this beast of a disorder.” Miyoshi McMurry is a US Air Force Veteran and aspiring counselor whose career was derailed by the onset of dystonia in 2012 coupled with additional service-related health conditions. She explains, “When I speak up and advocate for dystonia, it not only helps me cope with the stigma, but I hope it empowers those whose are self-conscious or struggling with acceptance— which I believe we all cycle through. I hid dystonia as best I could for as long as possible but last year I began to speak up.” Miyoshi created an online dystonia awareness campaign and partnered with local businesses to organize an awareness event. She also worked with her children’s schools to educate students. DY STON IA DIA LOGU E 17 US Service Members at Increased Risk of Dystonia Following TBI Dystonia is a chronic neurological movement disorder that can result from genetic mutations, exposure to certain medications, and brain injury. The frequency of traumatic brain injury (TBI) among US military service members puts them at increased risk for dystonia. Investing in medical research is needed to improve treatment and outcomes for US troops, veterans, and civilians. What is the Connection between Dystonia and TBI? Traumatic brain injury (TBI) occurs when a bump, blow, or jolt to the head or a penetrating head injury disrupts the normal function of the brain. TBI is a serious health issue for which military service members are at increased risk, whether on active duty or reserve status. The Department of Defense (DOD) describes TBI as one of the signature injuries of troops wounded in the Afghanistan and Iraq wars. US forces suffered 320,344 instances of TBI from 2000–2014. The link between brain trauma and movement disorders such as tremor and dystonia is well-established; studies date back to the late 1800s. The most well-known post-traumatic movement disorder is “punch drunk syndrome,” (i.e. chronic traumatic encephalopathy) marked by parkinsonism and other motor symptoms in professional boxers. Estimates to the frequency of movement disorders resulting from severe head injury vary from 13-66%. Dystonia is second only to tremor as the most common movement disorder to result from injury to the central nervous system. While a service member may recover from the original injury, the dystonia can leave him/her permanently disabled. Dystonia results not only from injury to the brain but also peripheral injury to a limb or body part. Based on the data available, dystonia is the most common movement disorder to occur from peripheral trauma. What Treatment is Available? Post-traumatic dystonia, whether due to central nervous system or peripheral injury, is often challenging to treat effectively. Available therapeutic approaches include oral medications, botulinum neurotoxin injections, intrathecal baclofen, and deep brain stimulation. These therapies attempt to alleviate pain and disability by suppressing symptoms, but do not correct the underlying disorder. Need for Research While researchers have long acknowledged the link between dystonia and trauma, much remains to be learned about the underlying pathological mechanisms. Further study is needed to improve therapies and outcomes for US troops experiencing dystonia resulting from TBI. Dystonia investigators have been funded every year dystonia has been included in the DOD CongressionallyDirected Peer Reviewed Medical Research Program (PRMRP) list of conditions eligible for study, demonstrating the strength of dystonia applications received. Dystonia studies funded by the PRMRP have been led by top dystonia experts whose work represents research on movement disorders and the fundamentals of human motor control. See page 23 for an interview with a veteran who developed dystonia from a service-related injury. SUM MER 2 015 18 Research Studies on Focal & Generalized Dystonia Need Volunteers The following clinical studies on dystonia at major movement disorder centers are recruiting volunteers. Sensorimotor Integration in Focal Hand Dystonia Researchers at the University of Rochester in New York are looking for adults with dystonia to participate in a research study on focal hand dystonia. You may qualify for this study if you: 1. Are a musician and have been diagnosed with focal hand dystonia. 2. Are not a musician and have been diagnosed with generalized or segmental dystonia affecting your hands. 3. Are over 18 years of age. You may not qualify for this study if you: 1. Have the inability to use your arms or hands for any reason. 2. Have had botulinum toxin injections within the past six months. 3. A history of neurological disease or disorders other than dystonia. This is a research study conducted at the University of Rochester Medical Center. You will be asked to perform finger-tapping tasks and complete some questionnaires. There are no blood draws or study medications. Compensation for time and travel will be provided. For more information: Visit http://goo.gl/a0VTYV or contact Molly Jaynes at 585-273-1005 or molly_jaynes@@umc.rochester.edu. Reproductive Factors & Cervical Dystonia Researchers at the University of Tennessee Health Science Center (UTHSC ) are conducting an online research study related to the correlation between various reproductive, hormonal, and environmental factors with cervical dystonia. Your participation will take approximately 30 minutes and will require the completion of an online questionnaire. To participate: • You must have been diagnosed with cervical dystonia. • You must be at least 18 years of age. • You must have access to the internet. • You must ask at least two biologically-unrelated individuals (such as friends or co-workers) of the same gender and approximate age as you to also complete the questionnaire as control subjects. Participation is entirely voluntary. Submissions are anonymous. No identifying information will be requested linking you to the information you provide. Access the survey at https://www.surveymonkey.com/s/7KY7FCF This study is being conducted under the guidance of Dr. Mark LeDoux, Professor of Neurology at UTHSC, and member of the Dystonia Coalition. DY STON IA DIA LOGU E 19 Dystonia 101 Dystonia can be a confusing disorder to understand. It never hurts to brush up on the basics: Efficacy of Levetiracetam in Oromandibular & Cranial Dystonia Researchers at the National Institute of Neurological Disorders and Stroke are looking for people with oromandibular (oral) or cranial dystonia to participate in a study exploring the effect of the drug levetiracetam in volunteers with these focal dystonias. You may qualify if you: • Are 18-80 years of age. • Are diagnosed with primary oromandibular or cranial dystonia. • Have never taken levetiracetam. • Are able to remain on your current doses of dystonia medications for four weeks prior to the study. • Have not had botulinum toxin injections within 12 weeks of starting this study. You may not qualify if you: • Know the cause of your dystonia. • Have balance problems, frequent falling, or severe dizziness. • Are unable to take medications by mouth. • Have abnormal kidney function. • Are pregnant, nursing, or planning to become pregnant in six months. • Have mental health problems. This outpatient study involves six visits, each of which may last up to two hours. All study-related tests and medications are provided without cost. Travel assistance will be provided. For more information: Contact Dr. Jung E. Park at 301-443-3475 or junge.park@nih.gov. • Dystonia is a neurological movement disorder. It affects the ability to control voluntary muscle movements. • Dystonia does not affect smooth muscles, such as the heart. • There are many forms of dystonia. It can affect a single body area or multiple muscle groups. • In cases of isolated (primary) dystonia, dystonia is the only movement symptom present, with the exception of tremor. • Dystonia may also occur in combination with other movement symptoms such as myoclonus or parkinsonism. • Inherited dystonias are those with a proven genetic origin, for example mutations in the DYTdesignated genes such as DYT1, DYT5, or DYT11. • Dystonia may be acquired (secondary) due to a specific life event or series of events, for example birth injury, drug exposure, brain injury, or infection, and other factors. • People with acquired dystonia often have other neurological symptoms, some of which may affect more than just muscle movement. • Treatment options include oral medications, botulinum neurotoxin injections, surgery, and less invasive methods such as physical or occupational therapy and relaxation practices. • Stress does not cause dystonia, but symptoms may worsen in stressful situations. For more information, visit www.dystonia-foundation.org SUMMER 2015 20 Employees with Dystonia: Accommodation & Compliance By Eddie Whidden, MA, Senior Consultant, Motor Team, Job Accommodation Network Employers are required, in certain circumstances, to provide reasonable accommodations for qualified employees and job applicants with disabilities. The Job Accommodation Network (JAN)’s Accommodation and Compliance Series is designed to help employers determine effective accommodations and comply with Title I of the Americans with Disabilities Act (ADA). This article addresses ADA information, accommodation ideas, and resources for additional information relevant to dystonia. Accommodations should be made on a case by case basis, considering each employee’s individual limitations and accommodation needs. Employers are encouraged to contact JAN to discuss specific situations in more detail (http://askjan.org/). Is Dystonia a Disability Under the ADA? The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. Therefore, some people with dystonia will have a disability under the ADA and some will not. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. Accommodating Employees with Dystonia People with dystonia may develop limitations in some of the areas discussed on the opposite page, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Not all people with dystonia will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist. Questions to Consider: 1. What limitations is the employee with dystonia experiencing? 2. How do these limitations affect the employee and the employee’s job performance? 3. What specific job tasks are problematic as a result of these limitations? 4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations? 5. Has the employee with dystonia been consulted regarding possible accommodations? 6. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed? 7. Do supervisory personnel and employees need training regarding dystonia? DYSTONIA DIALOGUE 21 ACCOMMODATION IDEAS General Accommodation Considerations: • Accessible work-site • Parking close to the work-site • Accessible entrance • Automatic door openers • Accessible restroom and break area • Accessible route of travel to other work areas used by the employee • Accessible workstation • Materials and equipment within reach • Workstation close to restrooms, break areas, and other common use areas • Alternative computer, phone, writing aids, and other assistive devices • Ergonomic workstation design • Sensitivity training to coworkers and supervisors Keyboarding and Using a Mouse: • Speech recognition software • Large-key keyboards and on-screen keyboard software used in conjunction with a mouse • Alternative mice including trackballs, touchpads, foot mice, head pointers, and programmable mice • Word prediction and alternative mouse software Writing: • Grip aids • Weighted pens • Writing cuffs • Orthotic devices • Soft grasp build-ups • Portable recording products • Clipboards • Desk slants Using the Telephone: • Speaker-phones • Telephones with programmable number storage • Phone holders • Telephone headsets Using Tools: • Grasping cuffs • Ergonomically designed tools and handles • Vibration dampening wraps and gloves • Vises • Work positioners • Foot controls • Pistol grip attachments • Orthotic devices Lifting: • Portable lift equipment • Hoists • Tilt-tables • Tailgate lifts Carrying: • Lightweight carts • Shoulder bags • Backpacks • Electrically powered carts or scooters with baskets Standing: • Sit/stand stools • Standing frames • Lumbar support stands • Anti-fatigue matting • Rest breaks as needed Climbing: • Stair-lifts • Wheelchair platform lifts • Rolling safety ladders with handrails • Work platforms • Step-stands • Hydraulic personnel lifts Walking: • Canes • Crutches • Rolling walkers with seats • Wheelchairs • Powered wheelchairs or scooters Driving: • Hand controls • Steering wheel knobs • Powered steering • Automatic transmission vehicles • Designated parking Housekeeping/Cleaning: • Lightweight vacuum cleaners • Back-pack vacuums • Grasping cuffs Speech: • Augmentative and alternative communication devices • Voice amplifiers JAN is one of several services provided by the US Department of Labor’s Office of Disability Employment Policy. The full-length Accommodation and Compliance Series on dystonia is available at http://askjan.org/ media/dystonia.html Special thanks to volunteer Roberta Senzel for directing the DMRF to JAN resources. SUMMER 2015 22 PERSONAL PROFILE Wayne Erickson Wayne Erickson is a retired bus driver who developed blepharospasm over 10 years ago. This year he is organizing the 7th Annual Dystonia Golf Classic to benefit the DMRF. His sister, DMRF Board Member Donna Driscoll, is affected by focal leg dystonia. How did your symptoms begin and how were you Wayne Erickson is affected diagnosed? by dystonia of the eye lid I was driving a bus and one muscles. day my eyes started to water and blink rapidly, and I started to yawn like I hadn’t had sleep in days. I went to the local eye doctor and he gave me some drops that didn’t work. After a while I went to an eye clinic and received botulinum toxin injections in my eyelids for about 18 months, one shot a month. That didn’t do any good. My sister Donna, who has dystonia, arranged for me to see a doctor at the National Institutes of Health [NIH]. I flew out there and was diagnosed with blepharospasm. The dystonia affects my eyelids. The shortest attack is a few minutes, the longest was about four hours. My eyelids go nuts, I get the deep yawning and my eyes water ferociously. It’s in both eyes, mostly the right. Over the past year it has taken a pretty big effect over my life. How do you manage the symptoms? After going to NIH, even though I was improperly treated with botulinum toxin before getting diagnosed, they said try it again. Nothing happened. I know it does help other people. One thing that does help me is that, when I feel a dystonia attack coming on, I douse my eyes with hot water. And that seems to stop the dystonia attack. The other thing I found is, when I feel an attack coming on, if I can’t get to hot water I get into a dark room and stay there until the attack goes away. So through trial and error I came up with those two things that definitely help me out. I also found that by wearing big heavy sunglasses, with shields on the sides, that does me a world of good too. What motivated you to get involved with the DMRF? While I was sitting in the waiting room at the NIH, this mother and her young daughter came into the room. The daughter had a bandage around her mouth. The mother took the bandage off and the girl’s jaw was about 2 ½ inches open. She could never close her mouth. And she had a big feeding tube stuck in her side. It was dystonia. I love working with kids, I’ve been doing that all my life. That’s when I decided that if there was anything I could do to get the word out about dystonia and try to find a cure, I was going to do it. And I’ve been doing it ever since. What advice do you have for others living with dystonia? When I was diagnosed with this thing the doctors told me it was something I was going to have to adapt to. That was the best advice I got, right then and there. We do adapt. Being able to talk to someone who has dystonia, or who knows about dystonia, is important. My sister and I have had many conversations about dystonia and the way it affects us. Talking to someone who can relate to what you are going through, that’s the best thing in the world. The people with dystonia here in Minnesota that I’ve talked to, almost all of them, have said they feel weird. They feel out of place and like they shouldn’t be here because they have dystonia. And I tell them that’s not even close to being true. You have a disorder, yes, there is nothing you can do about that. But you’re just as good as anybody else. Go out and live your life, and give it the best you can. And try to spread the word about dystonia and what it does to people so maybe we can stop this from affecting more people. For more information about the 7th Annual Dystonia Golf Classic on August 15 in Cannon Falls, Minnesota, visit https://www.dystonia-foundation.org/mndystoniagolf. DYSTONIA DIALOGUE 23 PERSONAL PROFILE Johnny McCoy Johnny McCoy is a US Army Veteran who acquired cervical dystonia after a service-related injury. He has participated in Dystonia Advocacy Day, participated in the Dystonia Moves Me campaign, and enlisted the help of his employer, Lowe’s, in promoting awareness. How did your symptoms begin and how were you Johnny McCoy developed diagnosed? cervical dystonia following In 1975 I was in the an injury. Tennessee National Guard. I was riding in a personnel carrier, which is like a small tank. The driver was not watching where he was going and drove into a 14-foot ditch, straight down. I had a helmet on which probably saved my life. I got slammed into the wall, and it knocked the helmet off. My shoulder took most of the impact but it definitely hurt my neck quite a bit. I didn’t have any use in my right arm for some time. Later on, I noticed my head was turning to the left. I went to the doctor and of course they didn’t know what it was. Time progressed and it started to get worse. My head was pulling to the left, which made it very difficult to drive a car. Sometimes I sat sideways in the seat to do so. I finally went to some neurologists locally and they diagnosed it as torticollis [cervical dystonia]. At that time there wasn’t a lot of botulinum toxin going around, so to speak, so they sent me to a center in Nashville. I tried botulinum toxin injections two or three times and then had a bit of a reaction. And it didn’t seem to help a whole lot. I was trying to get some benefits from the VA [Veterans Administration] to help me out. Of course I was denied for 10 years or so. People aren’t eager to hire you when you shake and your head turns to the side— they don’t know what’s going on with you. What motivates you to promote dystonia awareness? The more educated I got on dystonia the more I wanted to help not only myself but other people. One day someone at work asked me how long I’d had Parkinson’s [disease], and I said well I don’t have Parkinson’s. I explained my situation to them. They gave me a gentleman’s name at the VA and I started working with him. That’s when things started to improve—I was on the road to helping myself. I contacted the DMRF and they helped me tremendously too. People still say to me, what are you shaking your head for? How long have you had Parkinson’s? I don’t care what they say any more. They don’t understand until you tell them. So why not educate them. How do your symptoms affect your daily life? As we’re sitting here, I’m shaking and my head is turning to the left. The DMRF put me in touch with a movement disorder doctor in Memphis. He’s a fine guy. He has me on another kind of botulinum toxin. This stuff has helped me quite a bit, but it doesn’t solve the problem. It always comes back. The pain is in the morning or mainly at night. After a day of your head moving around, it kind of wears you out. What was it like to participate in Advocacy Day? I never imagined doing that. It was great. I was able to take my wife with me. My wife is very supportive. We met with the legislators from Tennessee, and I told my story. The experience of going to Washington for Dystonia Advocacy Day is something everybody needs to do at least once—I’d go every year if I could. I want to help everybody, and my emphasis is the veterans because there are going to be a lot of folks that have this. A lot of people don’t think a knock on the head can cause something like this. Any advice for people who are newly diagnosed? Find a good neurologist to start. Contact the DMRF. The help they offer is really good. For more information on dystonia and military service members, see page 17. Each spring, dystonia advocates travel to Washington, DC for Advocacy Day. Learn more on page 14. Dystonia Dialogue Dystonia Medical Research Foundation One East Wacker Drive • Suite 2810 Chicago, Illinois 60601-1905 PHONE 312 755 0198 • 800 377 DYST (3978) WEB www.dystonia-foundation.org UPCOMING EVENTS AUGUST 15 – Minnesota Dystonia Golf Classic AUGUST 30 – St. Louis Dystance4Dystonia Zoo Walk SEPTEMBER 12 – Cincinnati Dystance4Dystonia Zoo Walk SEPTEMBER 19 – Cleveland Dystance4Dystonia Zoo Walk SEPTEMBER 19 – Binghamton Dystance4Dystonia Zoo Walk (NY) SEPTEMBER 26 – Toss4Dystonia Cornhole Tournament, Buffalo, NY SEPTEMBER 27 – Pittsburgh Dystance4Dystonia Zoo Walk OCTOBER 17 – Dystance4Dystonia Walk, Putnam, CT OCTOBER 4 – Bronx Dystance4Dystonia Zoo (NY) NOVEMBER 1 – TCS New York City Marathon NOVEMBER 1 – Chicago Basket Bash For more information and to register for scheduled DMRF events, visit www.dystonia-foundation.org/events
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