Saturday, April 11, 2015

Multiple Sclerosis

  This is my essay for school this week on MS.  As I continue to deal with many symptoms of relapsing-remitting MS, I pray that I will be able to get an answer soon... one way or another.  My next steps are an MRI and if there are lesions on my brain, a spinal tap to confirm.  At this point I just want an answer.  I am continuing to treat it the best way I know how and to consume all the information I can get.  Learning about the Nervous System in Anatomy this week, has been very helpful in my quest towards healing.  
     Multiple Sclerosis (MS) is a disease of the central nervous system (CNS) the disrupts the flow of information in the brain and between the brain and the body. MS is considered to be an immune-mediated disease in which the body's immune system attacks the central nervous system. Some MS experts believe it is an autoimmune disease but this is debated by the scientific community. Autoimmunity means that the immune system is reacting against normally occurring antigens (or proteins that stimulate an immune response) in the body, as if the antigens were a foreign object. Because no specific antigen has been identified in MS, it has not been classified as an autoimmune disease at this time.
     Multiple Sclerosis occurs as the immune system attacks myelin, which is the protective coating around nerve fibers in the central nervous system. The damaged myelin forms scar tissue called sclerosis, which gives the disease its name. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing a wide variety of symptoms. The disease is thought to be triggered in a genetically susceptible individual by a combination of one or more environmental factors.
People with MS typically experience one of four disease courses, which can be classified as mild, moderate or severe. They are as follows:

1. Relapsing-remmitting MS (RRMS) is the most common. It is characterized by clearly defined attacks of worsening neurologic function. The attacks are defined as relapses, flare-ups or exacerbations. They are followed by partial or complete recovery periods or remissions when symptoms improve partially or completely and it doesn't seem like there is progression of the disease. Approximately 85% of people with MS are diagnosed with RRMS.
2. Secondary-progressive MS (SPMS) comes from the fact that it follows after the relapsing-remitting course. Most people who are initially diagnosed with RRMS will eventually transition to SPMS, which means that the disease will begin to progress more steadily (although not necessarily more quickly), with or without relapses.
3. Primary-progressive MS (PPMS) is characterized by steadily worsening neurologic function from the beginning. Although the rate of progression may vary over time with occasional plateaus and temporary, minor improvements, there are no distinct relapses or remissions. About 10% of people with MS are diagnosed with PPMS.
4. Progressive-relapsing MS (PRMS )is the least common of the four disease courses. It is characterized by steadily progressing disease from the beginning and occasional exacerbations along the way. People with this form of MS may or may not experience some recovery following these attacks; the disease continues to progress without remissions.
No two people have exactly the same MS symptoms, and each person’s symptoms can change or fluctuate over time. One person might experience only one or two of the possible symptoms while another person can experience multiple symptoms.

     The more common symptoms of MS are, Fatigue (80%), Numbness or tingling (one of the 1st symptoms), Weakness, Dissiness & Vertigo, Sexual Problems, Acute or Chronic Pain, Emotional Changes, Walking or Gait difficulties, Spasticity, Vision Problems, Bladder & Bowel Problems and Cognitive changes.
     Less common symptoms include; Speech problems, Tremors, Breathing difficulties, Headaches, Swallowing problems, Seizures, Itching and Hearing loss. Even though chronic headaches and migraines are considered a less common symptom of MS, it can be one of the first signs you have the disease.
     In the early stages of MS, symptoms may be subtle or “invisible” to those on the outside. You can look perfectly normal to those on the outside. The worst part is when others don't believe you or question the reality of your symptoms.
     According the the National MS Society, there are currently no symptoms, physical findings or laboratory tests that can, by themselves, determine if a person has MS. Several strategies are used to determine if a person meets the long established criteria for a diagnosis of MS, and to rule out other possible causes of whatever symptoms the person is experiencing. These strategies include a careful medical history, a neurologic exam and various tests including magnetic resonance imaging (MRI), evoked potentials (EP) and spinal fluid analysis.
     Currently, there is no cure for MS but there are several medications used to modify the disease course, treat relapses and manage symptoms. These medications help people manage their MS and enhance their comfort and quality of life. For a list of these medications, here is a great link:  http://www.nationalmssociety.org/Treating-MS/Medications.
     Complementary and alternative medicine (CAM) for MS includes a wide variety of interventions, from diets and supplements to meditation and T’ai Chi. Vitamin D, exercise, acupuncture and cooling strategies are establishing their role in comprehensive care through scientific study and clinical trials.
     The American Academy of Neurology recently released a guideline on the use of complementary and alternative medicine (CAM) in MS. CAM therapies with sufficient evidence to support practice recommendation in MS include:
  • Cannabinoids: OCE, Synthetic THC, Sativex oromucosal spray & smoked cannabis
  • Ginkgo Biloba
  • Lofepramine plus phenylalanine with B12
  • Reflexology
  • Bee Venom
  • Magnetic Therapy
  • Lowfat diet with Omega 3 supplementation
     There are many treatments and resources available for those suffering with MS. I recommend visiting the National Multiple Sclerosis Society's website for more detailed information and support.

Namaste,  Beci 

References:
     A World Free of MS. (2015, March 6). Retrieved April 5, 2015, from       http://www.nationalmssociety.org/
     Yadav, MD, MCR, V., Bever, Jr., MD, MBA, FAAN, C., Bowen, MD, J., Bowling, MD, PhD, A., -Guttman, MD, B., Cameron, MD, PT, M., . . . Narayanaswami, MBBS, DM, FAAN, P. (2014, March 24). Summary of evidence-based guideline: Complementary and alternative medicine in multiple sclerosis. Retrieved April 5, 2015, from http://www.neurology.org/content/82/12/1083.full.pdf html