The Unpredictability of Multiple Sclerosis
What Is Multiple Sclerosis?
Multiple sclerosis is a chronic disease that affects the central nervous system. It’s a very unpredictable condition, and symptoms vary from person to person. For some patients, symptoms are so mild that they don’t require treatment. For others, even the simplest tasks are challenging.
A fatty, protective material called myelin surrounds nerve fibers in your body. MS occurs when your immune system attacks myelin. The resulting inflammation and scar tissue disrupt brain signals to other parts of your body. These vital signals are responsible for triggering movement, vision and other functions. Balance and muscle control may also be impacted.
There are several forms of MS, but the most common is relapsing-remitting MS. There is no cure yet, but potential treatments emerge all the time. If you’ve been diagnosed, your prognosis is very hopeful.
Signs and Symptoms
These are common symptoms of MS, but their presence, frequency and severity are highly erratic:
- Blurred vision, double vision, or loss of vision.
- Numbness or tingling in your face, arms, fingers, or legs.
- Pain or stiffness in muscles or joints.
- Involuntary spasms or jerking movements in your legs and back.
- Weakness and chronic fatigue.
- Difficulty walking.
- Dizziness and poor balance.
- Constipation, diarrhea, or loss of bowel control.
- Sexual dysfunction.
- Poor memory, shortened attention span, language problems, and difficulty staying organized.
- Slurred speech.
- Emotional disturbances such as depression, irritability, mood swings, excessive crying, or uncontrollable laughter.
Your symptoms may change by the day, month or even year. The greatest challenge to coping with this disease is its unpredictability.
During an attack or relapse, you may experience brand new problems such as hearing loss, seizures, shaking, difficulty breathing, or trouble swallowing. These could vanish as abruptly as they appeared.
When poor balance and difficulty walking are at their worst, you may need physical assistance or special equipment to help you get around. Be safe, and take advantage of any helps that could prevent serious injury.
Common Treatment Options
For optimal results, your treatment should be an ongoing, comprehensive process. Continue care even when symptoms are absent, and be mindful of your emotional health throughout the course of the disease. Most patients do very well with a strong, supportive network of family and friends.
There are centers devoted solely to the treatment of MS, but it’s more likely that a team of specialists in your community will coordinate care. A neurologist usually heads up the team and formulates a strategy.
Just 20 years ago, there were no medications at all for MS. Today, many drugs exist to reduce the activity of the disease and slow its progression.
Beta interferons, including Avonex, Betaseron, Extavia, and Rebif, modify and slow the disease by altering the immune system. They also reduce the accumulation of lesions in the brain and spinal cord. Beta interferons were the first approved drug therapy for RRMS. Peginterferon beta-1a, commonly known as Plegridy, debuted in 2014 and is longer-acting.
Other medications are effective for managing symptoms and treating relapses. There are dozens upon dozens of drugs to address everything from bladder-control problems to difficulty walking. All of them are specially designed to make you more comfortable and improve your quality of life.
Severe relapses, also called exacerbations, may interfere with your vision or mobility. They can last anywhere from 24 hours to several days, weeks or months. You may become so weak and dizzy that your safety is at stake.
For these severe attacks, neurologists turn to corticosteroids. A three- to five-day course at high doses usually stops symptoms more quickly than they would subside on their own. A regimen of slowly tapering prednisone may follow. Steroids also work well for exacerbations, but they do nothing to counter the disease itself.
In March 2017, a new drug called Ocrevus was approved. It shows promising results for RRMS and a rarer form of MS called primary progressive multiple sclerosis. In PPMS, function steadily declines from its onset without remission. Ocrevus is administered through intravenous infusion.
Other types of care are almost as important. A comprehensive plan that will get the best results includes the following as needed:
- Physical therapy.
- Occupational therapy.
- Cognitive rehabilitation.
- Vocational rehabilitation.
- Speech-language pathology.
- Counseling or therapy for emotional health.
The goal is to reduce fatigue, build strength, improve mobility, and restore cognitive abilities and other functions. The better you’re able to dress, drive, perform your job, and stay socially engaged, the better your quality of life will be.
Alternative methods to complement your medical treatment abound, but run them by your doctor before you try them. Many that initially showed promise were later found to make symptoms worse.
Do an Internet search, and you’ll come across everything from coenzyme Q10 to medical marijuana to herbal remedies. Again, the importance of discussing alternative treatments with your doctor can’t be overstated. After weeks of caring for you, the doctor will know your body and your disease better than anyone.
Exercise, relaxation techniques, and certain types of massage make a lot of patients feel better. With approval, you may try yoga, tai chi, or acupuncture. Yoga and tai chi will increase flexibility, energy, and balance. Exercise also reduces stress, and who’s not for that?
Acupuncture is the ancient practice of placing needles and applying heat or electrical stimulation to specific points throughout the body. In your case, it could be effective for muscle spasms, bladder-control problems and pain.
The best way to manage MS is to get high-quality, comprehensive care. Always keep the big picture of your overall health in mind.
For example, continue to see your regular physician and your dentist. If you benefited from seeing a therapist or marriage counselor before your diagnosis, by all means continue with your appointments. Stay in your bridge club. Keep attending your house of worship. Nurture your body, mind, and spirit.
You may not master MS, but you’ll keep MS from mastering you.