Understanding Your MS Diagnosis
Just diagnosed with MS? If so, you aren't alone. Every hour of every day, someone in the United States is diagnosed with multiple sclerosis (MS), a chronic and progressive disease of the central nervous system. While severity, symptoms and the course of the disease vary from person to person, one thing remains the same: a diagnosis of MS is not the blow that it used to be.
It's true there's still no cure for MS, but recent advances have dramatically brightened the futures of the 400,000 people in the nation diagnosed with the disease. "When I started treating multiple sclerosis 20 years ago, there were no medications to slow progression of the disease, so the natural course of MS was often very disheartening," says Edward J. Fox, M.D., Ph.D., director of the MS Clinic of Central Texas in Round Rock. "Now there's a much greater likelihood of early diagnosis and early treatment, which means the prognosis is a lot better."
If you have been diagnosed with MS, educate both yourself and your family about the condition; working together makes it easier to cope with multiple sclerosis. Here's what you need to know about MS.
MS: Nerves Under Siege
In MS, your immune system mistakenly attacks myelin, a fatty substance that insulates your nerves and helps them communicate. Over time, this can lead to scarring (known as scleroses or lesions) and hardening of nerve tissue in the spinal cord, brain and eyes. These lesions can cause symptoms such as pain and weakness in the extremities, among other issues.
"Without therapy, after about 15 years, half of MS patients need some kind of device, such as a cane, to help them walk. After 20 years, it may be up to 80 percent," says Bianca Weinstock-Guttman, M.D., director of the Baird MS Center of the Jacobs Neurological Institute, University at Buffalo in New York.
Know the Risk Factors for MS
Women are two to three times more likely to develop MS than men. And most people are diagnosed between the ages of 20 and 50. The prime cause of MS remains a mystery, but risk factors may include:
- Ethnicity—Studies suggest that people in some ethnic groups are more susceptible to MS. For instance, the disease is most common among Caucasians of northern European ancestry. But Southeast Asians, for instance, are much less likely to develop MS.
- Family History—If you have a relative with MS, your chances of developing the disease may be as high as 2 percent. No family history? Your risk is .13 percent.
- Climate—MS occurs in only one of 1,000 people in tropical climates, but twice as often in people who grow up in temperate regions, which have a moderate change of seasons.
- Viruses —One outbreak of shingles, a painful rash caused by the chickenpox virus, can nearly quadruple the risk of developing MS the following year, finds a Journal of Infectious Diseases study. Plus, exposure to the Epstein-Barr virus, which is responsible for mononucleosis, may boost risk.
- Vitamin D—African Americans with MS have significantly lower levels of vitamin D than those who don't have the disease, notes a study in the journal Neurology. Researchers suspect that low levels may increase your likelihood of developing MS. Clinical trials are under way to test whether supplements can actually reduce disease activity in people who already have MS.
MS Symptoms and Complications
MS can be unpredictable, and one person's experience with the condition may be quite different from another's. You may face periods (days to months) of intensifying symptoms, known as flare-ups (these are also called relapses or exacerbations). It's also possible to have a gradual but regular increase in physical and cognitive symptoms over time. Or, you may go for years and years with only mild reminders of your MS.
In the early stages of MS, common signs include
- vision problems
- muscle weakness, stiffness and spasms
- limb numbness and tingling
- problems with coordination and balance
Many people notice certain situations, such as a hot bath, feeling stressed or being feverish, can trigger a flareup. As nerve damage progresses, you may develop other issues, such as:
- Eye pain, sensitivity to light and blind spots, which may worsen over days or weeks, then gradually subside.
- Depression, possibly triggered by the debilitating nature of the disease. Some experts believe the biology of MS may predispose you to depression as well.
- Cognitive problems, such as memory and concentration difficulties
- Swallowing trouble and slurred speech—up to 40 percent of people with MS may have speech problems.
- Urinary and bowel issues, including constipation and urinary incontinence
- Sexual difficulties with arousal and orgasm due to nerve damage, fatigue, muscle spasms and mood changes
Your MS Diagnosis: What Type of MS Do You Have?
There are 4 varieties of MS
- Relapsing-Remitting MS—You have clear flare-ups, often followed by partial or complete recovery periods that can last for months or years. This form accounts for up to 85 percent of all MS cases at diagnosis.
- Primary-Progressive MS—Distinct flare-ups and remissions are rare. Instead, symptoms slowly, continuously worsen over time. Unlike relapsing forms, this type of MS affects men and women equally. This variety accounts for some 10 percent of all MS cases.
- Secondary-Progressive MS—You experience a consistent worsening of symptoms. Flare-ups may occur, but are less frequent than in relapsing-remitting MS. Recovery is more difficult and symptoms may become chronic. Before disease-modifying drugs were available, half of people with relapsing-remitting MS transitioned to this form after 15 to 20 years with the disease.
- Progressive-Relapsing MS—You experience a steady worsening of symptoms punctuated by clear flare-ups. Bouncing back after flare-ups, however, is more challenging than with relapsing-remitting MS.
From our sister publication, RemedyMD (Fall 2011)