Communion Of Dreams


Machado-Joseph Disease: bitch, bitch, bitch

OK, this is going to sound like I’m complaining. And I am, to the extent that if this wasn’t bothering me I wouldn’t write about it. But I’m mostly writing about it as documentation: documentation for when I get the neurological assessment in a week, documentation for how things are now as a baseline to compare in the future, and documentation for anyone who wonders what this weird and rare disease is like. The truth is, presently all these elements are mostly just annoying rather than being really painful or debilitating. I’ve been so sick that I can’t get out of bed, and this ain’t it. I’ve been in significant pain where I can’t think of anything other than hurting and trying to make it stop; this ain’t that, either.

A lot of people have experienced Restless Leg Syndrome, a fairly common minor neurological disorder that isn’t very well understood. For me, it comes with a kind of itch or burning sensation, mostly on the surface of my lower legs and feet, that just makes me want to move them to avoid an unseen irritant. Now, this is one of the earliest symptoms I can point to, and it goes back at least six or seven years. Was it an indication of MJD onset, or just due to something else? Who knows. I will say that it has become more noticeable in the last few months, and now happens every day or two.

It’s also, weirdly, spread to my arms. Yeah. Exact same kinds of sensations, mostly confined to my forearms and the area around my elbows. I’ve never heard of this before, but one of the sites I checked about RLS mentions it happening to some people. I guess I qualify.

Something that is kinda like RLS, but is more intense, is a sharp, spike-like pain. It really does feel like I just stepped on a nail protruding from a plank. A nice, rough & rusty one like the one I remember as a kid, going through some dilapidated old house, that went through the sole of my tennis shoe, through my foot, and then out the top. Graphic memory, eh? Yup. And that was the exact same kind of pain I get with these spikes. These are usually a one-off, can happen to either foot, ankle or calf, or in my hands. I’ve joked with my wife that it’s just memories of my crucifixion as a rebellious slave. These are kinda rare, occurring a couple of times a week.

More common are unexpected cramps in the foot, leg, or hands. These are classic “Charlie Horse” type, and just about anyone who has over-exerted themselves at some point has experienced them. One of these happen every couple of days, and can be so intense that it leaves my affected muscle aching the next day or two. I’ve got a couple of sore feet right now due to this (one the bottom of the foot from last night, one the side of the ankle from a couple of days ago). This can also be triggered by using my hands in a repeated motion, like I do when doing book conservation. Or typing.

Related, but not as intense, is a “tightening” of the muscles/ligaments on the back of my hand or top of my feet. Makes it feel like it’s pulling my hands back towards my forearm or my feet towards my shins. Usually happens to both hands or both feet at the same time. Not really painful, just weird.

Then there are the twitches. Like a tic, or a spasm. These tend to come in clusters, lasting for a few minutes at a time, and usually just hit one hand or the other. Again, not particularly painful, but an annoying reminder that my body is not entirely under my conscious control.

I’d mentioned recently the problems with balance. Random vertigo happens rarely, but balance problem are one of the more consistent symptoms I’ve noticed. It happens when it’s dark and I don’t have a visual reference to help stabilize. It also happens if I’m moving and turn my head quickly. Or if I twist to look up and behind me.

Another frequent symptom I experience I didn’t actually know was a symptom of MJD: frequent urination. Yeah, overactive bladder. This one I’ve had for a decade or more, though I attributed it to my blood pressure meds. Maybe that was the case, but it has definitely increased in recent months, to the point where just about whenever I get up from sitting I want to pee. TMI? Sorry.

While each of these are fairly minor, together they usually conspire to do one of the things that most people who have MJD complain about: sleep disruption. Yeah, it’s hard for me these days to actually sleep solidly more than about four hours. Typically I take my usual pain meds (for chronic problems) and crash, then wake about four hours later to have a pee and take the next round of pain meds. In the past I’d usually be able to get fairly soundly back to sleep quickly, and sleep another three or four hours. Now, almost always one or more of the above symptoms will either stop me from getting back to sleep, or wake me frequently for the next couple of hours. At best, I doze in a light and fitful sleep.

So, there we go: a nice summary of where things stand for me.

Of course, that’s the physiological stuff, not the psychological stuff. Because yeah, there are stresses involved with this disease. Knowing what it can do. Knowing what it means. Knowing that there is no cure, and only limited treatments that have been proven effective. Knowing that it is rare to the point of almost being unknown by those outside a few medical specialties and the other families that have the genetic disorder. I was startled the other day when I was on Reddit (a huge online community/news site) looking for something else, and thought to see what kind of support groups exist for people with MJD. There aren’t any. None.

But then, the best estimates are that only about 3-5,000 people in the US have MJD. About one person in a hundred thousand. I’m guessing that I won’t be able to find a local support group, either.

So, thanks for being there, dear reader.

Jim Downey



Machado-Joseph Disease: It’s all in my head

I’m in this curious grey zone currently. On the one hand, I’m about 99% certain that I have the onset of MJD, for all the reasons that I’ve mentioned. On the other, I don’t yet have a diagnosis or the results of the genetic test for the disease (which is definitive).

So there’s some small doubt in my mind sometimes as to whether I actually have the disease, or if I’m just concocting it from a variety of lesser symptoms of normal aging and my own rather rough & tumble life. And boy, wouldn’t that be embarrassing? I mean, I’ve told all my family and friends that I’ve got this happening, I’ve posted about it on Facebook, I’ve blogged about it. What if I’ve just imagined it all? What if I’ve got a case of hypochondria going on?

Think of it as an inverse version of imposter syndrome, and you’ll see what I mean. After all, the symptoms I have are currently episodic, lasting a few hours here or there, then disappearing for a day or three. When I’m not actually experiencing them, it’s almost easy to think that I was imagining it all. And not having the disease is how I’ve lived some 63 years of my life, so it’s the norm.

But then, there are days like yesterday.

We’d had some heavy rains, and I needed to go down into our crude basement to see how much flooding there was. It’s not a real basement, as most people think of such. Rather, there’s an area about 10×20′ that has a concrete floor, but then the floor slopes back to be just a crawlspace for the rest of the rambling structure. What passes for a foundation is a porous brick structure, and during heavy rain, it floods. Where there’s the concrete floor is where the boiler for the radiator system sits, and close by is the hot water heater. Such is the state of a 139 year old sprawling house that has seen multiple additions and changes.

Anyway, I’d installed a sump pump to deal with the worst of the flooding, and it works to do that reasonably well. But still, I usually go down and check when we have heavy storms. So that’s what I did yesterday.

After seeing that the concrete area was OK, I went further back just to look around at the rest of the crawlspace, using a flashlight. I had to crouch down a bit where the floor was rising. And the combination of bending over a bit and having a limited amount of light for visual reference triggered a quick and intense vertigo.

This is a classic MJD symptom. Because MJD is largely thought to cause disruptions in the cerebellum, people who have the disease are prone to balance and coordination problems. Without visual references to confirm my vestibular and proprioception, things got quickly out of whack.

Now, this never used to be a problem for me. I always had an exceptional sense of balance and awareness of my body in space, regardless of whether my eyes were open or closed, regardless of movement or orientation of my head. Having this happen is affirmation that my suspicions are likely correct, and I do have MJD and it’s not just my imagination/hypochondria.

I suppose either way, it’s all in my head.

Jim Downey



Machado-Joseph Disease: hands

This morning I’ve been experiencing a typical episode of one of symptoms of MJD (for me): hand weakness/spasm/pain. I’m writing about this to document the disease and to give people a sense of how odd it can be sometimes. At this point, the episodes I experience aren’t constant; they last for a few hours, then disappear for a day or three.

Now, normally I have very strong hands. Building on my basic physiology (large hands, good musculature), 30+ years of bookbinding have made my hands strong, as you would expect. But not this morning.

The first thing I noticed was a slight tingling was through my hands, extending into my forearms. Almost like they were ‘falling asleep’, or like I had held onto a vibrating machine like an orbital sander for too long.

Then there was a feeling of weakness. Like I had been handling bricks for hours, or using a heavy hammer to break blocks or beat metal. My hands were tired, though I hadn’t done any work with them. When I was making coffee, I was sincerely worried that I’d be able to hold onto the mug securely. Popping off the top of my Tramadol Rx pill bottle actually took effort.

Know how when a muscle (group) is particularly tired, it can develop a slight tremor or spasm? Like it has been over-worked and the nerve signals are getting wonky? Yeah, that’s also typical of these episodes. My hands don’t really shake like I have Parkinson’s or something. Rather, they just feel like if I demand anything much from them then they will spasm. The medical term usually applied to this is fasciculation, and is common in neuromuscular diseases like MJD. There’s an … uncertainty … or maybe an unreliability to using my hands. Motions aren’t fluid, graceful, confident. I question whether I am holding the coffee mug securely enough. My typing suffers (the number of corrections I’ve made while typing this is rather startling).

Actual pain isn’t too bad today. It’s more like an ache. But there is a memory of pain there. A hint of things to come. More than just muscle pain, but different than arthritis pain. Almost like the pain from a broken bone, partially healed. In some ways it sounds like peripheral neuropathy, though I’ve never had a diagnosis of that.

None of this is debilitating. I’ve been able to make breakfast. Get showered. Run an errand. Feed the cats. Get lunch. Even get a little bit of work done at my bench. It’s mostly just annoying. And it will likely pass in a few more hours.

But it is tiring and distracting.

I’m looking forward to seeing if there’s something we can do to help manage it, and the other symptoms.

Jim Downey