An MS relapse is an unfortunate reality for many people living with multiple sclerosis. During a relapse, new symptoms appear and/or usual symptoms worsen for at least 24 hours and up to several weeks. A relapse is also called a "flare," an "attack" or an "exacerbation."
Like most negative things, there's never quite a "good" time to have an MS relapse. Work, kids and chores don't stop even when you're not feeling your best.
While MS relapses are unpredictable, taking steps now to prepare can make your life easier for whenever a flare might occur.
What Causes a Relapse?
An MS relapse is triggered by inflammation that occurs in the spinal cord or brain. In a healthy person, myelin, a natural insulation, covers and protects every nerve in the body. It allows signals to flow between nerves that control muscle movement.
Think about how a blender whirls when electricity flows through a plug. In MS, immune cells attack myelin, provoking inflammation or a lesion. Now affected nerves delay or fail to conduct signals, causing muscle spasms and possibly a relapse of MS symptoms.
MS can affect different nerves in the body. During a relapse, a person might experience symptoms such as weakness, unsteadiness, bladder disturbance or double vision. Vision problems occur when the optic nerve is inflamed. Coordination and balance problems result when the cerebellum, a part of the brain, is affected.
If you think you're experiencing an MS relapse, see your doctor. Most times symptoms won't land you in the emergency room. Still, it makes sense to follow the mantra "believe the best, and plan for the worst."
Have the following information handy:
- Keep an emergency contact list that includes contact information for your doctors and close family members or friends.
- On a medical history sheet, make a list of other medical conditions you have in addition to multiple sclerosis.
- Complete a medication list: Gather your medications together and, for each one, write down the name of the medication, dosage and how long you've been taking it; there are several smart phone apps available for this purpose as well. Remember to include non-prescription drugs and herbal and nutritional supplements too (such as vitamins). Record if you are allergic to any medications.
By law, an employer cannot discriminate against you for having multiple sclerosis. If you feel comfortable revealing your diagnosis, you might ask your employer for accommodations in the event of a relapse.
Job accommodations may include things like taking a day off for medical testing or doctors’ appointments, working from home or asking for wheelchair access. It’s a good idea to ask for confidentiality, so your medical information stays private.
You may not be able to drive during a relapse if leg or arm strength is affected or you experience vision problems. It is a good idea to have a back-up plan just in case.
Recruit several close friends or family members to help you in the event of a flare. These individuals agree to drive you to doctors' appointments, errands, or work.
Your city may also provide a free, shared transport service for people with disabilities who are unable - all or some of the time - to use other public transport services. Check with your local transportation department or city office to inquire and apply.
If you haven't already, ask an occupational therapist to help you adapt your home and lifestyle to make living with MS easier - especially in the event of a flare. You want to incorporate tools and techniques that decrease the risk of injury and make common tasks easier.
Here's a room-by-room guide of modifications you might make:
It is generally a good idea to keep important and frequently used items at hip-level in your home so you do not have to do much reaching or bending over during a flare. These items could include hygiene items, toiletries, phones, medications and foods and anything else you use regularly.
- Get a set of lightweight pots and pans to reduce the chances of strain.
- Keep heavy cans and kitchen tools in easy reach.
- Consider using an adjustable chair on wheels to help you get around the kitchen. Ideally, this chair would provide lift when needed, so you could reach counters and cabinets.
- Install non-slip flooring or mats in your bathtub or shower.
- Install railings in the shower so it’s easier to enter and exit.
- Install a railing by the toilet or use a seat raiser so it’s easier to sit and stand.
- Lower or raise your mattress height so it’s easy to get in and out of bed.
- Use additional pillows to cushion your back.
- Keep your alarm clock and phone within arm’s reach.
- Sit in a sturdy chair with armrests instead of a soft couch, so it’s easier to get up.
- Keep a side table by the chair. It can hold the remote control, phone, a beverage and anything else you need. That saves you from leaning over to reach the coffee table.
- Consider installing a stairlift or a second banister to keep you steady when going up and down the stairs.
- Consider installing ramps instead of stairs near entrances and doorways.
By working with your doctor and your occupational therapist and gathering support from family and friends, you can rest easier during a flare and focus on getting better.
By: R. Elizabeth C. Kitchen
Multiple Sclerosis Society. How Do I Know if I am Having a Relapse? Available at: http://www.mssociety.org.uk/about_ms/relapses/symptoms_of_rela.html Accessed on June 28, 2011
Multiple Sclerosis Society. Managing a Relapse. Available at: http://www.mssociety.org.uk/about_ms/relapses/index.html Accessed on June 20, 2011
Multiple Sclerosis Society. What is an MS Relapse? Available at: http://www.mssociety.org.uk/about_ms/relapses/what_is_relapse.html Accessed on June 28, 2011
University of Maryland Medical Center. The Maryland Center for Multiple Sclerosis. Available at: http://www.umm.edu/ms/what_is_ms.htm Accessed on June 20, 2011
Yanofsky, C.S. MD. Understanding Multiple Sclerosis. Available at: http://www.pneuro.com/publications/ms/index.html Accessed on June 20, 2011