Public Speaking: Writing has always been something that comes easily to me, whereas speaking in front of groups causes me to completely lose my shit, freeze up and babble incoherently. I typically do okay if you hand me a flute or sit me down at a piano in front of a group (assuming I've practiced a little bit), but make me talk in front of people? No can do. I stink at it.

As I've mentioned before, I've been going to Toastmasters meetings and as part of this I've given short, 1-2 minute impromptu speeches (and I've lived! Every time! Seriously a miracle.) But last night an idea sprung to mind and I actually started putting together my first speech! It's quite amazing how this works, really: you put your name down to give a speech at a certain time on a certain day and - lo and behold! - inspiration strikes!

The first speech is called the "ice-breaker" speech, which means I have to talk about myself for 4-6 minutes. Well, as everyone knows, people are not just one-sided automatons and I am no exception - however much my blathering on about my dog might lead you to disagree. There are a variety of angles you can take with your first speech and the objective is to get yourself speaking in front of people in order to learn what your strengths and weaknesses are. (Hint: my weaknesses include an inability to form thoughts and/or communicate them while in front of other people. And also, I say "um" a lot. Apparently.)

Um...anyway: my first speech is scheduled for Thursday, August 28, and so far I have an opening anecdote! Huzzah! I will be brilliant, I am sure. After all, I have 27 days to prepare the remaining 5 minutes and 30 seconds. (Wish me luck!!)

Tysabri: I got an email from a reporter at the Boston Globe this morning asking me if I'd be willing to be interviewed for an article on Tysabri. If I'd been home today (I had to go into the office to interview a couple of potential new hires) I'd probably have gotten the email and spoken to the reporter but as it is, I got home around 9 p.m. eastern time; far too late to make his deadline. I responded to let him know I'd be happy to talk to him if he was working on a follow up article to this piece, which posted today: Biogen: 2 patients get brain disease.

Bad news, my friends. Bad news.

Bloomberg, the Associated Press, and BusinessWeek also have stories on the topic. Looks like Biogen/Elan are not planning to pull Tysabri from the market as yet, according to the reports.

So what does this all mean? I'm still not entirely sure and, like most things, I'll be taking a wait-and-see approach for a little while. In thinking about my own treatment, though, here's what I'm going to be weighing:
1) There's a very real but still moderately low possibility of contracting PML (especially given both these two patients were using it as a mono-therapy.) General consensus seems to be that odds of contracting PML while on Tysabri were about 1/1000. I did a little bit of poking around just now and ran across this diagram. According to this chart, the odds of a person dying from heart disease (1/5), having a stroke (1/24), as the result of a fall (1/218) or by getting hit by a car (1/626) are all greater than the odds that someone would contract PML.

Something to ponder: walking out my front door (or, indeed, eating a cannoli and clogging my arteries) is still more dangerous than taking Tysabri.

2) The drug is more than twice as effective as the other available "first line" drugs: Tysabri has been shown to be ~67% effective at reducing relapses and disease progression, versus 30-ish percent for the CRAB drugs.

3) Given that my MS is still in the fairly early stages, my goal is to keep myself as symptom-free as I can and delay disease progression as much as possible. The better the drug I'm on, the more likely it'll be that I stay symptom-free.

4) I have a really hard time tolerating the other drugs. Now that my thyroid problems appear to be back under control I probably could tolerate the Copaxone again, but the interferons? NO THANK YOU. Those drugs are just awful. Blech. And even the Copaxone involves daily injections accompanied by itchy red welts. Compared with the Tysabri, which makes me tired for about a day and then I feel great, there's almost no comparison!

So for now, as long as my doctor is okay with it, I guess I'll be staying on Tysabri.