On the cover: Andy Vladimir, of Coconut Grove, Fla., has MMD and uses a wheelchair. This hardly slows him down. A travel writer and textbook author, he’s a frequent contributor to MDA Quest magazine’s “To Boldly Go” column. Dear Friends What is Myotonic Muscular Dystrophy? What causes myotonic muscular dystrophy? What happens in adult-onset MMD? Comparison of MMD1 and MMD2 What happens in congenital MMD? How is MMD diagnosed? How is MMD treated? Does it Run in the Family? MDA's Search for Treatments and Cures MDA is Here to Help You

Denise Balon

Dear Friends:

Myotonic muscular dystrophy (MMD) has been a part of my family’s life for many years. The symptoms for my siblings and me began in our 30s, and we believe the disease goes back at least two generations before us. Some of my nieces and nephews also are affected.

Like many of you, we were surprised to learn that such a wide range of symptoms — muscle weakness, involuntary clenching of hands and jaw, swallowing problems, eye problems, heart disorders, extreme fatigue and other difficulties — could be caused by a form of muscular dystrophy. With correct information about our disorder, we’re able to monitor and protect our health to a great degree.

This pamphlet has been prepared to give you the basic knowledge about MMD that you’ll need to make your life enjoyable and productive. With this information, you or your children can be prepared for changes to come and armed to minimize many effects of the disease.

By understanding how the disease affects me in different ways, I’ve been able to stay active while avoiding more physically demanding activities. I take pains to keep my stress level to a minimum and make sure I get plenty of sleep, because I’ve learned that stress and fatigue will exacerbate my symptoms rapidly. A pacemaker corrects the heart problems caused by my MMD.

I find that, with these precautions and forms of assistance, there’s little I can’t do in my personal life with my husband and extended family.

My sister and brothers have had to make similar adjustments to the effects of MMD. My nieces and nephews showed symptoms in childhood, and they’ve received expert medical guidance from the beginning for symptoms that include learning disabilities.

From this booklet you’ll learn some encouraging things about MMD: There are treatments and interventions for most of the symptoms and difficulties that arise with the disease. And MDA’s research program is constantly making strides toward better treatments and a cure. “MDA Is Here to Help You” introduces MDA’s many services.

In the meantime, it’s good to know that people with disabilities have more opportunities than ever before to develop and use their abilities, as well as legal rights to equalemployment opportunity and access to public places. Federal law guarantees children with physical and cognitive disabilities a public education with whatever supports they need.

My family’s greatest ally in living with MMD is MDA. So, as you face the challenges ahead, please remember: You’re not alone.

Denise Balon New Port Richey, Fla.

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