FDA Approves Boosters for Immunocompromised
Welcome to the newest edition of The Hunker Games. Dave and his wife Laura of ActiveMSers are hunkering down in isolation for the duration of the coronavirus pandemic—these are their stories (cue the L&O dong-dong) ... along with helpful advice, necessary levity, and, most crucially, hope.
Greetings, overnight the FDA approved coronavirus booster shots for immunocompromised people who have already taken the Pfizer and Moderna vaccines (there is insufficient data on the J&J vaccine). Within the past hour, the federal advisory panel for the CDC also gave the boosters their full endorsement. This is a big deal for many MSers, as the vaccine’s effectiveness is tenuous in people like us, particularly because some popular multiple sclerosis therapies can blunt the vaccine’s intended immune response. It's important to note that the third shot appears to be "moderately effective" in boosting resistance to Covid-19 in immune-compromised patients, including providing protection from the more contagious and deadly Delta variant. For that reason, "patients should be encouraged to continue following social distancing and other safety steps to reduce their chance of becoming infected with the coronavirus." More critical items of information concerning the booster:
  1. To minimize barriers to vaccination, NO prescription or doctor's note is needed. Your word that you have an impaired immune system is good.
  2. Unless unavailable, the CDC recommends to stay with the same vaccine manufacturer you originally received (e.g., if you got the Moderna vaccine, your booster should be from Moderna).
  3. Timing of the booster vaccine may matter depending on the type of MS medication you are currently taking. In general, "patients should talk to their doctors about the severity and duration of their immune issues, and whether they are taking medicine or doing other therapies that can lower their body’s response to vaccines."
  4. The CDC is NOT recommending antibody testing before and after the shots to see if the inoculations boosted immunity.
I recommend you discuss all of this with your neurologist without delay, as boosters could be available as soon as Saturday. Alas, those on anti-CD20 meds (Ocrevus, Rituxan, Kesimpta) and S1P modulators (Gilenya, Mayzent, Zeposia, Ponvory) are still in a murky, gray zone. A respected MS neuro breaks down the challenges of taking these MS DMTs with regard to vaccinations. There are no easy or clear answers (sorry!). As you digest this latest news, it’s time for the latest edition of The Hunker Games!
// REVIEW: The IndeeLift—Safely Get Off the Floor, Every Single Time
Fear of falling on the floor and being unable to get up without the help of the fire department (or heavy lifting from caregivers and friends) may be a thing of the past for MSers. ActiveMSers reviewed the innovative IndeeLift—a patient lift and versatile people picker upper—putting it through a rigorous, months-long testing process. That process? Falling. And getting promptly righted, repeatedly. Read the laugh-out-loud review, which could save your figurative bacon, not to mention an extra $250 in real bacon.
TIP: Discussing the Vaccine. After my last vaccine special edition newsletter, I got a few more angry unsubscribes. One fave: “David, I never read your emails. But I did this once in the hope that you might have an ounce of sense … but no, you’re probably being paid too to promote this experimental injection. Good luck with that poison.” I wrote a lengthy but cathartic response that included feigned disappointment at being unread (the nerve!), an amusing quarter-pounder-with-cheese Pulp Fiction reference (re: “ounce” of sense), a comparison of my robust annual compensation to a single night of teenage babysitting duties (I should seriously consider babysitting), and breezy Covid factoids (4.59 billion vaccine doses administered, zero zombies). “Feel better?” Laura asked. Then she cut it all, reminding me that snarkiness is a poor tool to sway minds. That I should be “professional.” That I am above that. “Wait, who, me?!” I started to protest, but… oh, fine.
// MS NEWS: Exercise Studies Leave Little Doubt
Researchers have found a potential key as to as to why exercise is so beneficial in neurodegenerative disorders, especially in MS. That was explained by this study, which found that the combination of aerobic and resistance training improves MS inflammation-associated markers. But which is most effective for improving leg function and MS fatigue? Researchers in this study made this nonconclusive conclusion: either one! (In yet another study, resistance training improves sleep quality in MSers, bonus.) And finally, a new MS study teases that exercise promotes "remarkable" remyelination, neuroprotection. Why the tease? It was seen in mice! 
// LAUGH: Dave Goes to the Dentist ... After 18 Months
So I had my first dental appointment after forever, and it went, well, hmm (that’s code for another signature palm-to-forehead Dave adventure). Since I neglected to inform the practice in advance of my wheelchair usage, my station was a touch too cozy to snug up to the dental seat to transfer. As I stared at posters littering the walls about the cataclysmic hazards of gum disease, tooth decay, and forgetting to floss for even a night, my heart sank as visions of root canals danced in my head. So many canals. BUT WAIT! My dentist assured me that they have completed exams, cleanings, and full-on procedures with people staying in the "comfort" of their wheelchairs. So I boldly volunteered to stay in my wheelchair and get my first cleaning in a year and half. What could possibly go wrong? 
Why do I ask myself these questions when I know the preordained answer? The dentist appointment unfolded predictably. The occasional neck kink. Drool. The hygienist trying to have a conversation with me even though her entire hand was in my mouth. ("Planning any trips the summer?""Ahph dphlh knphl, mphhhbe.") But no issues whatsoever with my teeth! She said everything looked super fantastic. Even after a year and a half. And that was that. Except. Yeahhh. Two days later I woke up with the spins. VERTIGO! Benign paroxysmal positional vertigo (BPPV). Sticking my head in positions it wasn’t supposed to be stuck in for extended periods of time couldn't have dislodged those darn balance crystals in my ear, right? Re, the Mayo Clinic: "Less common causes of BPPV include disorders that damage your inner ear or, rarely, damage that occurs during ear surgery or long periods positioned on your back, such as in a DENTIST CHAIR." Or, duh, stubbornly doing a dental exam in your wheelchair instead of just delaying your appointment! I eventually reset those darn crystals (Eply maneuver). 

Before I sign off, a heads up (not back, re: vertigo!). My summer of being underwater finally is coming to a close, and soon I’ll be able to catch you up on all the hijinks, including Laura’s haiku-laden 50th birthday, our first meal out during this pandemic, and an ill-fated attempt by my health insurer to deny me a new MS treatment (oops!). Until then, be active, stay fit, and keep exploring!

Dave Bexfield

p.s. In addition to ActiveMSers, I also write for my local community, contributing a regular column to our village’s bi-monthly magazine. The articles often discuss my challenges with MS, including this latest one about being immunocompromised. Also, my words have attracted a bit of a following (overlooking the aforementioned person who never reads them), so much so that New Mexico magazine took notice, even snapping an epic pic of me on my new handcycle!
be active - stay fit - keep exploring