Showing posts with label Hemoglobin. Show all posts
Showing posts with label Hemoglobin. Show all posts

Wednesday 28 February 2018

Winter Olympics

Today’s post is about the non-academic benefits of treating classic autism, which mainly seem to come from raising cognition (IQ).

Our reader Liz from Australia, whose five year old daughter has been using Bumetanide for two years, was telling us recently in her comments how her daughter can now go surfing with her four brothers.
While we do all want success at school and mastering practical skills like doing up shoe laces, the importance of being able to actively participate with siblings should not be underestimated.
Some siblings may be angels, but quite often there is resentment about having a sibling with special needs. One way to compensate is to have cool talents like surfing, skiing, fencing - something you can do well.

When I started this blog I was contacted by an Australian doctor who has a son with autism, she went to the same university as me. Her son was diagnosed early with severe autism with MR/ID, but progressed remarkably well and attended a mainstream school. His chosen sport at school was fencing (sword fighting). At that time Monty’s big brother was also having fencing classes and had all the equipment. I recall at the time thinking there is no way Monty could ever do that. Five years later though, Monty and his big brother are fighting together with homemade swords.
Fencing can look very impressive and certainly seems to count as a cool activity by modern day teenagers.

The main sport of Monty, now aged 14 with autism, is swimming - particularly underwater. While people with classic autism are at a greatly elevated risk of drowning, that is no longer something we have to worry about. Monty is more likely to be the rescuer than the one in trouble. If we lived in Australia, he too would be going to the beach to surf.
We did have swimming lessons, but only post-Polypill did Monty get competent. Now he swims really well and can swim a very long way underwater.

I do think that things that improve exercise endurance may be helpful to those with a neurological condition like autism. Just look what Nordic skiers, cyclists and tennis stars get into trouble for taking - much relates to getting more output from your mitochondria.  High altitude training is not an option for us, but swimming underwater may have a similar effect. There actually is research about what changes biologically in endurance divers (holding their breath) and people who train at high altitude. I suspect that moderate diving may improve brain perfusion, extreme diving is different because they are functioning when a typical person would have lost consciousness due to lack of oxygen. Moderate diving, like high altitude training, should increase how much oxygen your blood can carry.
Native Andean and Himalayan populations have better oxygenation at birth, enlarged lung volumes throughout life, and a higher capacity for exercise. Tibetans demonstrate a sustained increase in cerebral blood flow, but a typical hemoglobin concentration, whereas in the Andes they have significantly elevated levels of hemoglobin. Hemoglobin/haemoglobin is the protein in your blood that transports the oxygen around your body.  How do the Tibetans manage without extra hemoglobin?

“The Tibetan hemoglobin distribution closely resembled that from a comparable, sea-level sample from the United States whereas the Aymara (Andes) distribution was shifted toward 3-4 gm/dl higher values.”

The performance-enhancing effect of altitude training appears not to be due to increased red blood cell count or increased hemoglobin, as thought until recently, but rather something called Red Blood Cell (RBC) Hypoxic Metabolic Reprograming.
In essence, the hemoglobin becomes better at holding on to oxygen. Perhaps this is what Tibetans do.
Lay people suggest that:
More hemoglobin = More oxygen delivery.
It appears that you do not need more hemoglobin, you just need to make your existing hemoglobin work better.  And for that you need to give it a challenge; perhaps regularly swimming a long way on a single breath counts?

When scientists examined the oxygen-carrying proteins, known as hemoglobin, in volunteers’ red blood cells, they found multiple changes affecting how tightly it hung onto its oxygen load. Roach says a simplistic analogy is comparing this to what happens when baseball players loosen their grip on a mitt. “If I relax my hand, it will let go of the ball,” he says. Such changes had been observed before in the lab, but never in humans, and never at high altitude, the team reports this month in the Journal of Proteome Research. The scientists also found that the metabolic processes producing these changes were considerably more complex than suspected. And because red blood cells live for about 120 days, the changes last as long as the cells do.

Skiing is popular where we live and most children from our school go once a year, either with school or with their family. 

Unless you live in the mountains, skiing is not a sport people do very often and so you could question whether it is worth all the expense. 
Monty started skiing when he was five with a couple of instructors who had recently started a ski school in Zell am See in Austria, just for children with disabilities like autism.

In the beginning just putting on all the equipment and riding up the mountain in the cable car was a big challenge.  It certainly was a case of stepping out of his comfort zone.  Having started we did persevere, in part so that big brother also had his chance to learn to ski.
2018 was the first week of skiing without any lessons.

This year big brother was concerned that he would have no one to ski with and was planning to make new friends on the slopes.
He did agree that he would ski with little brother, but much to his surprise spent the whole week skiing with him. It was not at all what he had expected. They could ski all over the resort using multiple types of ski lift. Who lost his ski while on a chair lift and had it fall into the trees? Not Monty, who had to ski by himself to the bottom of the slope while big brother retrieved his ski.
Being left alone at the top of the mountain, might have been a cue for one of those old-time “meltdowns”, but much to big brother’s surprise, Monty just skied alone down the mountain and waited for him, once he had found his missing ski. No awkward explaining to parents what had happened to Monty was required.
So then big brother decided to teach Monty how to do ski jumps, just like any regular teenager.
Both have been skiing for 8 years. Monty skis on red slopes (medium difficulty), whereas his brother would also go on the black slopes (the hardest).

Regarding myelination from a recent post, many people (like me) who learn skiing in adulthood often never myelinate their “skiing neuronal pathways” and so each year you come back as a near beginner. This is clearly not the case with Monty, he now retains his skiing skills, even though he has not used them for a year. 

Other Sports
Trampolining is something remarkably popular among people with severe autism. I suppose this is all about seeking sensory stimulation. Monty loves water slides and we used to know twins with autism/Asperger’s who were obsessed with roller coasters.

There is a common view that if you have a mental disability you must have a physical disability. Monty’s new teachers at high school were surprised when they learnt he skis just like a regular boy. Of course he showed the ski jump video to his classmates.

While you can ski with an IQ less than 70, as in Down Syndrome and most Classic Autism, it goes even better when you boost IQ.
I imagine the same applies to surfing and other water sports like sailing.
Clearly raising IQ means parents have far less safety issues to worry about.
Music of course is another great potential area for people with autism and Asperger’s. I wrote a post a long time ago about talents and savants, suggesting that people with autism really should be encouraged to use their abundant free time to develop such skills. Many people already do. Most of the Asperger’s people I have come across are now very talented musicians, practising hours every day. One is also an excellent skier on black slopes.