Regular updates by our President, MHAUS staff, and guest contributors.
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At this joyous time of the year, I would like to wish all the friends and supporters of MHAUS best wishes for the holidays and the New Year. Your support and encouragement of our activities and programs motivates the entire team to continue to bring the latest information and educational programs to those with an interest in this complex, potentially fatal disorder first described over 50 years ago.
From the beginning descriptions of the MH syndrome in the 1960s it was noted that the animal model for MH, i.e. certain pig breeds would develop muscle breakdown, acidosis, and high body temperature with stress alone (“awake MH”, i.e. MH signs without exposure to anesthetic agents).
1981 was a rather important year in my professional life. On July first I assumed the Chairmanship of Anesthesiology at Hahnemann University in Philadelphia. In October 1981 the first meeting of what would turn out to be the founding Board of MHAUS met in my unfinished offices at Hahnemann. It is hard to believe that thirty years have gone by which witnessed the evolution of a patient advocacy organization from an unknown entity to one where anyone seeking information and guidance on MH turns first.
Surprising revelations concerning the association of MH with Drug induced muscle pain; muscle weakness with age; and an inherited syndrome of muscle weakness.
In this month’s blog, I have asked Dr. Stanley Caroff, Professor of Psychiatry at the University of Pennsylvania, a long time member of MHAUS and prolific author on the subject of Neuroleptic Malignant Syndrome (NMS) to summarize several drug related reactions that resemble MH in some ways but are generally thought to be unrelated to the mechanisms that lead to MH.
When an MH susceptible patient requires a general anesthetic one concern is whether he/she will be inadvertently exposed to potent gas anesthetics such as sevoflurane or isoflurane that may trigger an MH episode.
I was privileged to attend the 30th Annual European MH Group (EMHG) meeting in the town of Nijmegen, Holland from June 8-10 this year. The EMHG was developed in the early 1980s by a group of clinical anesthesiologists and researchers interested in advancing the understanding of MH and providing optimum care to MH susceptibles and their families. The EMHG has focused on testing for MH susceptibility, muscle biopsy contracture tests as well as genetic tests and their relation to biochemical and physiologic changes that underlie the MH syndrome.
On May 14, 2011 MHAUS sponsored the first ever day long retreat for our hotline and professional advisory consultants. 30 consultants, including one board member (Debra Merritt), a genetic counselor associated with the University of Pittsburgh MH DNA testing center (Deanna Steele) and Dr. Albert Urwyler, head of the MH testing center in Basel, Switzerland and member of the European MH group, met in a hotel near the Chicago O’Hare airport to discuss many perplexing issues related to MH.
As part of my “day job” I am in charge of graduate medical education (i.e. residency programs) as well as medical student education at a large academic medical center. In that capacity I and my colleagues who are supervising educational programs are required to keep up with the evolving standards that govern the training of the physicians of the future.
Last month I discussed the difficulty of understanding how MH susceptibility relates to heat stroke, muscle breakdown with exercise and MH without anesthesia. This is an exceedingly complex and murky topic.
On behalf of MHAUS, its Board, Staff, Professional Advisory Council, and Hotline Consultants I would like to wish all of you a Happy and Healthy New Year. Our hope for the future is to fulfill the mission of eliminating death and disability related to MH and MH-related syndromes.
Earlier this year I described what lies ahead for MHAUS. I laid out an ambitious program for the year. I am pleased to report that with one or two exceptions the goals were largely met. Here are some of the programs and accomplishments of 2010:
First, I would like to apologize for the somewhat technical blog I posted for October, 2010. I realize that not everyone would be familiar enough with the science of MH and cellular physiology to understand some of the information behind my reasoning. However, in basic terms what I was trying to do was separate MH into subcategories based on what is known of the molecular biology and biochemistry of the disorder. I realize too that not everyone would agree with my reasoning, but that is what a blog is for, i.e., theorizing and proposing some new ways of looking at things.
Malignant Hyperthermia (MH) is a life threatening syndrome characterized by hypermetabolism, hyperthermia, acidosis, muscle contraction, muscle membrane breakdown, hyperkalemia and rhabdomyolysis. The syndrome occurs as a result of exposure to certain drugs and /or environmental conditions.
On September 20, 2010 I had the privilege of being a visiting professor at the University of Colorado, Denver Medical School and delivering the annual Hermann B. Stein MD, endowed lecture. Dr. Stein practiced anesthesiology in Denver for many years in the 1920s, 30s and 40s. His son then became an anesthesiologist and practiced the specialty for close to 40 years. One of his daughters is now a practicing anesthesiologist in New England. Three generations of anesthesiologists. Pretty striking.