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Twinsburg -- Cindi Ramirez said she wasn't surprised when her son, Twinsburg High School graduate Anthony Ramirez, 24, told her he wanted to get a tattoo.
Cindi had never been particularly fond of tattoos, and Anthony knew that, always telling her in jest he was a moments away from putting ink to skin.
"I'd always say I was going to get one, because it would frustrate her," Anthony said July 28. "I needed a good reason to do it. Now I had one."
On a recent afternoon, Anthony, who was diagnosed with multiple sclerosis Aug. 24, 2015, sat at the kitchen table in his Van Oaks Drive home, next to his 17-year-old brother, Mikey, and across from his father, Jesse.
The tall, slim and quick-witted Anthony threw out several one liners during a half-hour conversation, keeping the mood light.
Months before his diagnosis, while living in Cincinnati, Anthony said he was playing softball when he took a nasty fall, hitting his head on the ground. He was diagnosed with a concussion.
"My head hurt and it didn't get better," he said.
The recent University of Cincinnati graduate was working for the Cincinnati Reds baseball team in ticket operations at the time, and it wasn't a great time to have a non-stop headache.
A Cincinnati neurologist ordered tests to check for brain swelling. Instead, the doctor found lesions consistent with MS, a chronic, incurable disease that affects the nervous system.
"After the diagnosis, [my parents] packed me up and moved me back home," Anthony said. "It is unexpected to be home. I am eating better and exercising."
Shortly after he returned home to Twinsburg, Anthony saw a Cleveland Clinic doctor for a second opinion.
"It's nothing against the doctors in Cincinnati, but look what we have here," Cindi said. "We wanted a neurologist who was a specialist to confirm that diagnosis."
Dr. Mary Rensel, a neurologist at the Cleveland Clinic's Mellen Center for Treatment and Research, explained that there are two kinds of MS.
"One is progressive and the other is relapsing that starts very suddenly," she said.
Anthony's MS is progressive, which begins with small changes that may not be noticed, especially in one's gait.
"It kind of becomes your normal," Rensel said.
Many people diagnosed with MS have other diseases, such as high blood pressure or obesity, Rensel said.
Many are smokers, and most are between the ages of 20 and 40 when MS is diagnosed -- although it can occur in young children and older adults.
Except for his age, the tall, thin and consistently healthy Anthony didn't fit the profile, Rensel said.
"What's challenging about MS is we don't know what causes it or why people get different forms," Rensel said.
She called Anthony a "special kind of kid."
"He does approach it with a lot of humor," she said. "It's a tricky kind of MS and it snuck up on him when he was trying to be an adult and live his life."
When Anthony told his parents in January that he wanted a tattoo, he said it was to symbolize his "new normal."
As his parents let the request settle, knowing he was serious this time, Anthony dropped another bombshell.
"I said, 'Do you think you could all get one?'" Anthony said.
Mikey, his younger brother, offered an enthusiastic "yes."
Mikey said he always wanted a tattoo anyway, and now he wouldn't have to wait until he turned 18. That he could design a tattoo that would support his brother was a bonus.
Jesse and Cindi also on got on board with the idea. But unlike the men in the family, getting a tattoo was the last thing Cindi thought she would ever do.
"It's just not my personality," she said. "Wild and crazy for me is a double-pierced ear."
For Anthony's parents, it was something they could do at a time when they felt their son could do nothing.
"He's my son," Jesse said. "I try to give him whatever he needs. We try to help him as much as we can."
Between January and May, the four members of the Ramirez family got their tattoos. Jesse's is "ram4fam," for the Ramirez family of four, with an orange ribbon hanging off of the four, signifying MS. It is on his upper right arm.
Mikey chose a cross, to symbolize hope, draped with an orange ribbon.
Cindi chose a butterfly, with an orange ribbon as the body.
"I wanted something feminine and classic," she said.
Anthony got his last, a multi-colored ribbon that includes the MS orange.
"I wanted to make sure [my family] was going to go through with it," he joked. "[The tattoo] symbolizes a lot of ailments and diseases that have affected friends, family and myself ... I'm not completely selfish."
Since his diagnosis a year ago, Anthony has begun using a walker to steady himself. He's living at home. Jesse quit his construction job so that he can take his son to therapy and acupuncture appointments.
While the family waits for a cure, Cindi and Jesse, with help from Dr. Rensel, are doing everything they can to slow down the progression.
"They have every right to be hopeful because there will be more treatment options for him and people like him," Rensel said. "There are finally studies that show there's hope and new products to be tested."
"We're not leaving any rock unturned," Cindi said. "That's why we spent a week at [the] Mayo [Clinic], and we've got some other rocks to turn over. We're going to continue down the path to help him."