Coping with MS is a multistep process that requires a good
strategy and a strong support network of family and friends. In
this section of multiplesclerosis.com you will find information
on workplace issues, and learn about assistive devices that can
make day-to-day activities more manageable.The key in
continuing to live well following a diagnosis of MS is to take a
proactive approach to managing the disease. Managing MS
means carefully monitoring progression and actively managing
symptoms. Strict adherence to treatment protocols increases
the likelihood, and degree, of treatment effectiveness. Learn
the advantages of, and tips for, being consistent with treatment
compliance.In addition to medications described in detail in the
treatment section, there are many strategies and lifestyle
adjustments that can help people with MS manage their
symptoms. Some symptoms may be minor annoyances, while
others may be quite debilitating. Taking control and learning
more about management strategies is key to leading an
independent and healthy life.
It is often difficult to tell if symptoms are disease related,
treatment related, or something entirely unrelated to MS.
Keeping a daily diary can help uncover factors that trigger
symptoms, what makes them better, and what makes them
worse.
When a person with MS experiences new symptoms, or has a
recurrence of old ones lasting more then 24 hours, he or she is
experiencing an exacerbation, or attack. These symptoms vary
from person to person and from time to time in the same
person. No two patients have the same complaints and no one
develops all of the symptoms.
Pain can have many causes and take on many forms. Not all
pain, however, can be attributed to MS. People with MS still
have normal aches and pains of everyday life, including
headaches and joint pain. In people with MS, pain may be
caused by muscle spasms, cramps, and injury to sensory nerve
fibers. Some people experience excruciating facial pain on one
side that feels like a knife stab. Increased sensitivity to touch
and tight muscles can also cause pain.
Most people with MS have a pattern of attacks and remissions
throughout the course of their disease. Symptoms may go away
completely, leaving no residual effects, or partially, leaving
some degree of permanent damage. Sometimes the lesion
produces no symptoms at all because it is located in a relatively
insignificant region of the central nervous system.
Symptoms depend on the location of the MS lesions in the brain
and spinal cord.
The main areas of the central nervous system where MS lesions
are located include:
Cerebrum and cerebellum in the brain - Lesions located in this
area cause problems with balance, coordination, tremor, eye
movement, speaking, and comprehension.
Motor nerve tracts off the spinal cord - Lesions in this area are
responsible for muscle weakness, paralysis, uncontrolled
tightening of muscles, double vision, bladder problems, and
bowel problems.
Sensory nerve tracts off the spinal cord - Lesions in this area
may result in numbness, tingling, burning, pain, and problems
with knowing body position and perceiving vibration.
Optic Nerves - Lesions located in the optic nerves and other
visual pathways can result in a decrease in or loss of visual
acuity.
Spasticity
When the nerve pathways to muscles are disrupted, movement
can become stiff and slow. The control of movement relies on a
delicate balance between muscles contracting and relaxing. In
spasticity, there is an increase in muscle tone, with certain
muscle groups tending to be more affected than others. This is
an initial symptom in 30 to 40 percent of people diagnosed with
MS, and it occurs in 60 percent of people with progressive
disease.
People with this symptom complain of heaviness, stiffness, and
pain in the arms and legs. Muscles feel tight and limb
movements are slower. Over time, range of motion can be lost,
and spasms can also occur. It requires more work and energy to
walk and perform everyday activities.
Fatigue
Fatigue is the single most common complaint in people with MS
and is often one of the most debilitating of all possible
symptoms. It occurs in as many as 80 percent of people with MS
and interferes with most activities of daily living. Fatigue can
be associated with an increase in activity, but it can also appear
without cause. Although most people look normal during
episodes of fatigue, they in fact feel unusually exhausted.
Fatigue generally surfaces late in the afternoon when body and
outside temperatures rise. Fatigue often subsides in the
evening when temperatures fall. It can also occur after periods
of intense activity, such as after a long walk, and is often
relieved by a cooling down period and rest.
Sometimes, low energy in MS patients can be due to
depression, which needs to be treated differently than does
fatigue.
Vision Problems (optic neuritis)
Vision problems are caused by damage to the myelin
surrounding the nerves that supply the eyes (optic nerves). It is
the first symptom in 15 to 20 percent of people diagnosed with
MS. It rarely involves both eyes at the same time, but can
appear on one side followed by the other. Eye problems usually
begin with blurred vision, followed by vision loss in one spot.
Sometimes the entire field of vision is affected.
Common vision complaints include:
Dimming of vision
Sensitivity to light (photophobia)
Decrease in clear vision (visual acuity)
Poor light contrast
Problems distinguishing colors
Jerky eye movements (nystagmus)
Pain that is aggravated by eye movement
Some people experience vision problems after exercise, which
is caused by a sudden increase in body temperature (a type of
Uthoff's phenomenon). Vision usually returns to normal once
the body has cooled down.
It may take a while for vision to return to normal, if recovery
occurs. However, vision loss is usually mild and can return to
normal even though the damage to the optic nerve does not
heal completely. Damage to the optic nerve can occur alone or
in combination with other symptoms. It is not uncommon for
people to have one attack of optic neuritis and be diagnosed
with MS many years later. Twenty percent of people who have
vision problems develop a "definite" diagnosis of MS within two
years and 45 to 80 percent within 15 years.
Bowel Problems
Constipation is common in people with MS, and is often
aggravated when people with MS don't drink enough fluids in
an effort to avoid urine accidents. Leakage of stool (fecal
incontinence) and diarrhea are not usually reported. Hard
stools that are difficult to pass can cause pain and discomfort.
Constipation is easily controlled with medication, increasing
fluid intake, increasing fiber in the diet, and maintaining a
regular bowel schedule.
Bladder Problems
Bladder problems are commonly associated with MS. People
with MS may have to urinate frequently, often with little
warning. Some people find it hard to control the stop and start
of the urine stream (hesitation) or have difficulty emptying the
bladder completely (urinary retention). Some urine may
inadvertently leak out uncontrollably (incontinence). There is an
increased risk for urinary tract infections in people who are
unable to empty the bladder completely. In most cases urinary
problems can be controlled with medications. In rare cases the
urine must be removed manually using a small tube inserted
directly into the bladder (catheter).
Balance and Coordination
Problems with walking (gait) and balance are common in people
with MS. It is the first sign of the disease in 13 percent of
people diagnosed with MS. About half of people with
progressive disease report shaky movements, unsteady gait or
intention tremors, or uncontrollable shaking when trying to
touch a target. Muscle weakness, numbness, dizziness, and
vision problems can all contribute to problems with balance and
coordination.
People with balance problems may or may not have dizziness
(vertigo). Sometimes people become dizzy when they change
their position, such as when first standing up. Such episodes of
dizziness may make people with MS feel nauseated or cause
them to fall. Balance problems without dizziness tend to be
more constant, causing people with MS to sway or stagger while
walking.
Coordination problems and shaking tremors may affect the
hands or feet, causing clumsiness. Specialized walking aids
(assisted devices) may be needed when simple tasks, such as
walking heel to toe, become difficult.
Psychological Effects
Cognitive and emotional changes may be related to the stress
of being ill or the direct result of lesions located in thinking
areas of the brain. More then half of all patients with MS
experience changes in thinking, memory loss, difficulty in
processing information, and mood swings. Forty percent of
people diagnosed with MS report mild problems, and 10
percent, severe problems. Many physicians inexperienced in
diagnosing MS often dismiss cognitive and emotional symptoms
as "psychological," and this is more likely to happen to women
then men. But clearly, cognitive problems frequently occur in
MS patients as a result of brain lesions.
*****MOM,, I LOVE YOU FOR BEING YOU,,****
WITH ALL MY LOVE,,, TAMMY''''
FOR MORE INFO, CONTACT THE MS SOCIETY.
www.nationalmssociety.org.
