Multiple Sclerosis, Iguanas and Wrong Foot

In the summer of 2005 I read a rather compelling story in Hospital Doctor. The headline was: “Ignoring the Evidence: Diagnosis of his wife’s progressive multiple sclerosis would not have taken so long had doctors taken a proper history, says Dr David Wheldon.”

It was an extremely well written article. It had to be, as Dr Wheldon’s hobby is poetry writing. He is a microbiologist by profession.

His wife is an accomplished painter and a violin restorer and dealer. As early as 2000, she noticed that she was dragging her right foot on a walking holiday in the Auvergne. She was referred to an orthopaedic surgeon. “Congenital spinal stenosis,” he confidently diagnosed. She got worse. In 2003 she was referred to a neurologist but during the months when she was made to wait for an MRI (why was it not done immediately?) she deteriorated rapidly and was soon unable to walk unaided and had a multitude of other neurological symptoms.

“Progressive multiple sclerosis,” proclaimed the neurologist. "No treatment is available. Just let the disease evolve."

Dr Wheldon at this point commented that a proper history would have allowed for the diagnosis to be made earlier, as his wife had had two transient episodes of weakness of an arm and dimmed vision in one eye.

There was no time to waste and having been given a “no hope” verdict, Dr Wheldon thought that alternatives had to be found. How often have we found patients seeking alternative treatment and sometimes very very alternative treatments once they were told what was thought to be the “truth”? Luckily I learned early on in my medical training that one should “never say never” (as mentioned in the chapter “Miracles” in my book.)

He found the Vanderbilt University work on Chlamydia pneumoniae. The rest, so to speak, was history. His wife was put on two antichlamydial agents and later metronidazole. After some typical reactions his wife started to recover. Eighteen months later, she was able to paint and walk a mile or so.

Some may argue that the recovery had nothing to do with the treatment, but was just one of those rare spontaneous recoveries. I am aware that this is only an isolated case, but there is ongoing research in this area.

Iguana iguana, Costa Rica

So what is the iguana doing in today’s blog? Many iguanas kept as pets are wild, truly wild caught and they carry various bacteria including Chlamydia pneumoniae, which also infect and cause diseases in Koalas, snakes, chameleons, frogs, and green turtles.

There are now concerns that Chlamydia pneumoniae might be implicated in other human diseases including atherosclerosis and acute coronary syndromes, and a variety of prostate conditions.

According to National Geographic, one of my favourite reads,

“Green, or common, iguanas are also among the most popular reptile pets in the United States, despite being quite difficult to care for properly. In fact, most captive iguanas die within the first year, and many are either turned loose by their owners or given to reptile rescue groups.”

Perhaps we should leave them to stay in the wild.

Dr Zhang should have checked if Tommy, his Wrong Foot patient, kept an iguana. His mother was diagnosed with multiple sclerosis.

Chlamydia pneumoniae site: CPNHELP.ORG

Other Posts on Multiple Sclerosis:

Old and New: Multiple Sclerosis & Elgar

Multiple Sclerosis Treatment – an Update

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