July 5, 2017 | Two years ago, Josh Martin wouldn’t have believed he could walk down the aisle at his own wedding.
Or easily navigate his classroom as an elementary school music teacher.
Or play disc golf with his friends.
Martin was diagnosed with multiple sclerosis in 2006, when he was a junior in high school. Every MS patient is different, but for Martin, the potentially debilitating disease that attacks the brain and spinal cord was stable at first, but about two years ago, it started having a big impact on his mobility.
“He’s been in a wheelchair, he’s been in a walker,” said Laura Barganier, a nurse practitioner at UAMS who has worked with Martin for several years. “Most of the time when he came, if he could walk, he could not stand up straight. His muscles were so tight in his legs that he couldn’t stand up, and he was dependent on the cane.”
Because of the signs that Martin’s condition was advancing despite his treatment regimen, Barganier recommended to Lee Archer, M.D., professor and interim chairman of the Department of Neurology, that they consider him as a candidate for Lemtrada, one of several new treatments to come on the market in the last few years that have greatly expanded physicians’ ability to tailor care to the individualized struggles of treating MS.
They have used Lemtrada to treat some of their MS patients with the most severe symptoms.
Martin began his Lemtrada treatments in March 2016. In the first year, he took five days of infusions. This year, he took three days of infusions. He will continue to return to UAMS for bloodwork once a month for five years to check for the potentially harmful side effects of the drug, but otherwise, the drug protocol calls for no further treatments. Before, he was taking daily injections or pills.
Martin said he tried not to get his hopes up going into the treatment – after all, he had already had to readjust his mental image of what his future might look like several times in his young life.
“Knowing exactly what to expect, you still have a little bit of doubt in the back of your mind,” Martin said, “saying, ‘OK, well, I’m been in a wheelchair for over a year now, and then this is coming up, so try not to get too hopeful.’ But then it worked!
“I felt it the day of,” Martin said. “And then that next week it got better and better, and then over the whole year, I started to see more stability in my legs, get my strength back, and that was year one. It just kept on going through this year.”
It wasn’t long before Barganier was getting happy emails from Martin with pictures of him enjoying outdoor activities.
“It’s great to see him get back to the life he had planned,” Barganier said.
Martin said he was better able to function at his job teaching music and the physical agility that comes along with it. And then there was the added joy of being able to walk at his wedding to his wife, Reva, when they got married in November 2016.
“In the back of my mind,” he said, “and I think hers, too, I was constantly thinking, ‘well, am I going to have a cane walking down the aisle with my wife? Am I going to be able to dance with her at my wedding?’ And so that was something that weighs on you. And more her, I think, than me, cause the wedding’s a big deal. But even me, too, because you want to be able to do these things.
“And then when this treatment came through and I was walking without the cane, I was able to walk Reva down the aisle, and I was able to share my first dance with her. That’s a milestone, and we got pictures and videos of that, and I’ll always be able to look at it and remember that we beat MS at this time in my life and we’re able to do these things.”
Archer and Barganier said that Martin is one of about 40 people who they have treated with Lemtrada so far at UAMS. While the strong treatment won’t be a good fit for every patient, they’re optimistic about the responses they’ve seen to the drug and the other treatment options available. Also, with the addition of Carolyn Mehaffey, M.D., who is finishing her time as UAMS’ first MS fellow, getting advanced training in treating MS and other neurological conditions, the MS Clinic at UAMS is taking new patients.
“I just really have been thrilled,” Archer said. “In the last few years, we have gotten these really good options to start treating patients. It’s really gratifying to be practicing at this time.”