Newswise — This Christmas, Marie McMillan can bake and decorate holiday cookies with her grandson -- and she won't take the holiday tradition for granted.
About two years ago, she couldn't bake. She couldn't walk, speak clearly, swallow or even keep her eyes open. McMillan suffered from myasthenia gravis, a disorder that blocks the impulses that go from the nerves to the muscle, resulting in muscle weakness. Patients end up developing weakness of the muscles of the eye, face, throat and even the breathing muscles, as well as arm and leg muscles.
"It was awful. Nobody could tell me what was wrong ... I just accepted it," says McMillan, who is now 65 years old. “I’d have days where words just didn’t come out right, you know and everybody would say ‘what’s the matter with you?’ And I said ‘I don’t know’ and I’d try to say it again and it didn’t matter how many times I tried, I just couldn’t say it right.”
McMillan came to the University of Michigan Health System and remembers that she didn’t even have the strength to keep her eyes open as she was wheeled into the hospital the first time. But her strength improved almost immediately after her first treatment from Kirsten L. Gruis, M.D., M.S., associate professor in the Department of Neurology.
Two days later, she could walk. Gruis began an unusual intravenous immunoglobulin treatment for McMillan that has continued to improve her health.
“Here at the University of Michigan we’re using a new class of medications called biologics, where the medication is infused directly into the vein. One of those medications is called intravenous immunoglobulin or IVIG,” says Gruis.
“In myasthenia gravis people produce too much of a rogue antibody that damages the connection between the nerve and the muscle. With the IVIG, the immune system is rebooted, like rebooting a computer system, so that rogue antibody is produced in smaller amounts and the neuromuscular junction can heal, and the signals can be sent from the nerve to the muscle properly to restore strength,” Gruis says.
McMillan’s condition has improved and she keeps gaining strength. Gruis says U-M physicians push the envelope and exhaust all possibilities in finding the right treatment. U-M physicians are familiar with IVIG treatment and have the expertise that comes along with handling complex cases like McMillan’s.
"Marie is a lovely grandmother and last December she moved me when she said it was the first time in two years she was able to go to her grandchild's Christmas program and bake cookies," says Gruis.
Myasthenia gravis is likely underdiagnosed in people over the age of 50, Gruis says. Symptoms can be intermittent, so patients may have times when they have normal strength and at other times be quite weak. They often can blame it on age and fatigue, when treatment could improve their quality of life greatly, Gruis adds.
Myasthenia gravis generally affects adults and is found in about 60,000 people in the U.S., Gruis says. For example, the University of Michigan stadium holds over 100,000 people so about 10 people could be affected with myasthenia gravis at a full stadium football game.
“Myasthenia gravis is an autoimmune disease and autoimmune diseases are not well understood,” Gruis says.
“Such conditions confuse the immune system, which instead of attacking an infectious agent, ends up attacking a part of the body. In myasthenia gravis it attacks the connection between the nerve and the muscle, also called the neuromuscular junction.”
Untreated, the disease will continue to progress and patients will develop fixed weakness, including difficulty talking or swallowing solid food, Gruis says. It can affect breathing muscles, make it difficult to walk and left untreated, can cause death.
McMillan’s prognosis is now good. She continues to get the IVIG treatments. The resident of Birch Run, Mich., says she got her life back – something she couldn’t imagine during those days when just talking was a struggle. She's back to her favorite activities like bowling and just bowled a 245 just a few weeks ago.
"I wouldn't go anywhere else for my care, I don't think twice about it. Dr. Gruis saved my life.”
To make an appointment at U-M’s neuromuscular clinic, call 734-936-9006.
About U-M’s Department of Neurology: The Department of Neurology treats a wide range of neurological disorders and provides a number of diagnostic services and treatments. In a 20-bed inpatient unit and a neuro-intensive care unit (shared with Neurosurgery) state-of-the-art inpatient care is provided in a referral University Hospital setting. Outpatient clinics oriented by subspecialty provide expert primary neurology care and referral consultation by qualified subspecialists. Special units include an 18-bed Sleep Laboratory, adult and pediatric inpatient epilepsy monitoring units, the EEG Laboratory, an EMG Laboratory and a referral stroke team.
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