My Tysabri experience is vastly different than Tisha’s. I feel that I am getting more than cursory medical attention. I am about to get my 25th infusion. I get a full battery of blood tests each month as well as visiting a hemotologist before every infusion. I see my neuologist every three months as well. They do yearly MRI’s as well as yearly lumbar punctures. Before Tysabri, I never went more than 10-12 months between relaspses, and over the last 12 years, have been on all of the ABC drugs with little results. I am now over 28 months without an exacerbation. I feel normal. I am aware of the risks of PML but I could just as easily get into a car accident on my way to the store.
In healthy individuals, especially athletes, bradycardia, Mobitz I AV block, and sinus pauses up to 2 seconds are common during sleep and require no intervention 5 . Cardiac rhythm is controlled primarily by autonomic tone. NREM sleep is accompanied by an increase in parasympathetic, and a decrease in sympathetic, tone. REM sleep is associated with decreased parasympathetic tone and variable sympathetic tone. Bradyarrhythmias in patients with OSA are related to the apnoeic episodes and over 80% are found during REM sleep. During these periods of low oxygen supply, increased vagal activity to the heart resulting in bradyarrhythmias may actually be cardioprotective by decreasing myocardial oxygen demand. This may be important in patients with underlying coronary heart disease.