Multiple sclerosis is an immune-mediated disorder which occurs in a progressive state. What this means is that your body is mistakenly attacked by the same system that’s meant to keep you healthy. What is bad about it is that MS attacks the vital organs. The functions of the spinal cord and the brain are diminished due to damage of nerve cell covering.
Multiple sclerosis symptoms are not only unpredictable, but their intensity can also be very severe which can result in diminished brain function, loss of vision and paralysis. However, some people will only experience numbness and fatigue.
Some of the common early signs of MS are:
- Balance problems or dizziness
- Cognitive problems
- Visual problems
- Sexual dysfunction
- Tingling and numbness
- Bladder issues
- Pains and spasms
- Weakness and fatigue
The optic nerve is affected due to inflammation and this ends up disrupting the central vision. Loss of vision, double vision, and blurred vision may also happen because of this. Due to slow degeneration of clear vision, it may not be easy to notice the problem immediately. Vision loss is usually accompanied by pain when you look to one side or look up.
Vision problems related to this illness can be handled in various ways.
Tingling and Numbness
Multiple sclerosis affects nerves in the spinal cord and the brain. These two make up the message center of the body. Mixed signals can, therefore, be sent around the body. Sometimes, signals may not be sent at all resulting in numbness in the fingers, arms, legs and the face. Numbness, coupled with tingling sensations, are some of the most common signs of the illness.
Pain and Spasms
The National Multiple Sclerosis Society conducted a study which showed that chronic pain was a common symptom in half the people suffering from the disease. Involuntary muscle spasms and chronic pain are common multiple sclerosis symptoms. Muscle stiffness, also known as spasms, is also common. Your joints and muscles may sometimes become stiff. Your extremities may also go through some uncontrollable and painful jerking movements. Though back pains are common, legs are more affected by these painful symptoms.
Fatigue and Weakness
This particular problem affects approximately 8 out of 10 people in the less advanced stages of the illness. Once the nerves wear out in the spinal column, chronic fatigue occurs. The fatigue is sudden and it may last for weeks before finally improving. Once again, the legs will be affected first.
Balance Problems and Dizziness
These two problems usually decrease the ability to move around for people with multiple sclerosis. Doctors usually refer to them as gait problems. People suffering from the illness will feel as if their surroundings are spinning and lightheaded. This is commonly referred to as vertigo. The symptom usually occurs when you are on your feet.
Bladder and Bowel Dysfunction
This problem may happen in different ways including strong urges to urinate, inability to hold urine in and frequent urination. It usually occurs in 80% of the people living with this chronic illness.
Loss of bowel control, diarrhea and constipation may also occur though less often. Symptoms related to urinary problems are manageable.
Some symptoms of multiple sclerosis affect the central nervous system. Sexual arousal may be a problem since this is where it all begins.
About 50% of multiple sclerosis patients have a problem with cognitive functions. This may include language problems, memory problems, and difficulty staying organized. Patients may also experience shortened attention spans.
Other common problems include depression and poor emotional health.
Changes in Emotional Health
People with multiple sclerosis usually go through major depression. Mood swings and irritability may be caused by the stress of the illness. The PseudoBulbar Affect, a condition which involves bouts of uncontrollable laughing and crying, may also occur.
Emotional disorders and depression may become more severe if they are coupled with family and relationship issues.
The same symptoms may not appear in everyone with multiple sclerosis. During attacks, different symptoms may manifest.
Besides the ones mentioned above, the disease also causes:
- Slurred speech
- Trouble swallowing
- Hearing loss
- Uncontrollable shaking
- Breathing problems
Is Multiple Sclerosis Hereditary?
Not exactly. However, if you have a relative suffering from the condition then your chances of developing multiple sclerosis are higher. This is according to the National Multiple Sclerosis Society.
If your parents or sibling have MS, then you have a 2.5 to 5% chance of developing multiple sclerosis. The general population has only a 0.1% chance.
This disease is not determined by the heredity factor only. A twin has just about 1 out of 4 chances of developing the disease if their identical twin is suffering from it. Though it’s not the only one, genetics is most certainly a factor that may lead to the disease.
Several tests have to be performed by a doctor, most likely a neurologist.
The tests include the following:
- Neurological Exam – The doctor will look for any impaired nerve function in the body.
- Magnetic Resonance Imaging – Cross-sectional images of the spinal cord and brain will be created via radio waves and a powerful magnetic field
- Spinal Tap – A sample of the fluid that circulates your spinal cord and brain is extracted by inserting a long needle into your spine
- Eye Exam – Several tests are carried out in order to check for eye diseases. It also involves an evaluation of your vision.
These tests are used to look for any damage to the CNS in two distinct areas. At least one month must have passed between the episodes that caused the damage. Other conditions are also ruled out through these tests.
Because of how much the disease varies both in the ways it can affect patients and, in its severity, doctors are continuously confused. Some attacks can manifest for just a few weeks after which they disappear. Relapses, on the other hand, are more unpredictable and they can become worse progressively. They also come with different symptoms. Quick progression of multiple sclerosis can be prevented with early detection.
A recent study reports that over the past one year almost 75 out of 100 surveyed multiple sclerosis specialists had come across at least 3 misdiagnosed patients.
Types of Multiple Sclerosis
This chronic illness usually involves the CNS. The layer that protects nerve fibers, myelin, is attacked by the immune system. This results in lesions, or scar tissues, and inflammation. The brain thus finds it hard to send messages to the rest of the body.
The types of multiple sclerosis include:
- Relapsing-Remitting Multiple Sclerosis. It involves remissions which are preceded by clear disease activity relapse. There’s usually no disease progression during remission periods. Symptoms are also absent. If present, they are mild. At its onset, RRMS manifests itself more than any other type of multiple sclerosis.
- Clinically Isolated Syndrome. It involves a 24-hour period during which symptoms manifest themselves. They usually occur due to a demyelination in the central nervous system.
There are two types of episodes commonly known as monofocal and multifocal. For the monofocal episode to occur one lesion has to cause one symptom. On the other hand, multiple lesions have to cause multiple symptoms for a multifocal episode to occur.
However, these episodes don’t have enough effect to require an MS diagnosis. You are more likely to receive an RRMS diagnosis if these lesions are close to those that manifest themselves with multiple sclerosis. If not, however, your chances of developing multiple sclerosis are less.
- Primary-Progressive Multiple Sclerosis. If you are suffering from PPMS, your neurological function can become increasingly worse once symptoms start showing. Short moments of stability can, however, occur. Progressive-relapsing MS was previously used to refer to multiple sclerosis that has clear relapses. This is now referred to as PPMS. Disease activity is usually described using the terms ‘active’ and ‘not active.’
- Secondary-Progressive Multiple Sclerosis. Other than experiencing worsening of disabilities or functions, noticeable relapses may also be present. Once RRMS moves on to the more aggressive form, the SPMS occurs.
Treatment for Multiple Sclerosis
There are multiple treatments for this disease, though no cure is currently available
RRMS medications are specifically designed to lower the rate of relapses and slow down disease progression.
Beta interferon’s and glatiramer (Copaxone) are some of the disease-modifying drugs.
They are usually self-administered and include:
Medications for oral ingestion include:
- Fingolimod (Gilenya)
- Dimethyl fumarate (tecfidera)
- Teriflunomide (aubagio)
RRMS treatments for intravenous infusions include:
- Alemtuzumab (lemtrada)
- Natalizumab (Tysabri)
- Mitoxantrone (Novantrone) this one is for severe cases of MS only
It’s not advisable to treat progressive MS with disease-modifying drugs since they are not very effective.
Prednisone (Deltasone) and methylprednisolone (Medrol) are some of the drugs that your doctor can prescribe for your relapses.
Due to the diversity of the ways in which MS attacks different people, treatment is usually based on your symptoms. A flexible approach is usually best. There are some treatments which will improve your life quality by easing the effects of your symptoms
Living with Multiple Sclerosis
A good number of patients living with multiple sclerosis usually live well by finding ways to manage their symptoms. Different people encounter different challenges which may change with time. Online and in-person support groups are the most common ways through which multiple sclerosis patients share their struggles.
If you have multiple sclerosis, you will need to see an experienced doctor.
Adhering strictly to the prescribed schedule for taking your medication is necessary if you are using disease-modifying drugs. Other symptoms will be treated through medication that your doctor will prescribe.
You will also need to manage your overall health by eating a balanced diet. Make sure it’s high in fiber and nutrients and also low in calories.
Physical and mental health can be improved via regular exercise. Disability shouldn’t prevent you from exercising.
Undertaking exercises in a swimming pool or actually swimming can help if physical movement is not possible. There are also some yoga classes that are specifically designed for people living with multiple sclerosis.
Though studies about them are scarce, complementary therapies can also be helpful
The following activities can help lower your stress levels and increase relaxation:
- Music therapy
Since multiple sclerosis usually lasts a long time, communication with your doctor should be constant. Strive to discover the things that make you feel good. Learning a lot about multiple sclerosis can also be helpful.
Though it has no impact on the disease itself, a proper diet can help ease some of the challenges associated with multiple sclerosis. For instance, carbohydrates and fats will not help if you’re constantly feeling fatigued.
A good diet will determine how good your health will be. In addition to creating a firm foundation for a healthy life, feeling good in the short term is also an added advantage.
The main components of your diet should be:
- A lot of water and other fluids
- Sources of fiber and whole grains
- Dairy products (low fat)
- Fruits and vegetables
- Skinless poultry, fish and other sources of protein
Make sure to avoid:
- High sugar beverages and foods
- High sodium foods
- Highly processed foods
- Red meats
- Trans- fats
Low nutrient and high-calorie foods will only worsen your condition. A healthier weight can also be maintained by doing protein control. Food labels usually have some instructions. If you have any other conditions, seek advice from your doctor on whether you need to change your diet or use special dietary supplements
Statistics About Multiple Sclerosis
- Multiple Sclerosis (MS) affects more young adults than any other neurological condition in the world.
- Though the number may be higher, there are about 400,000 people living with MS in the United States. The higher number may be due to accurate diagnosis and longer life spans.
- The National MS Society says that since1975 there has been a well-planned scientific study on MS prevalence in the US.
- Women have a higher tendency of developing MS compared to men by 2 or 3 times. Over the last five decades, the difference has continuously grown.
- Most diagnoses are made when one is between 20-40 years of age
- People living close to the equator have fewer chances of contracting the condition mostly due to vitamin D abundance. Relocation before one reaches the age of 15 could mean that you may develop the factors in the new location.
- While $60,000 per year is the current cost of disease-modifying drugs, the figure used to be between $8,528- $54,244 from 1998-2008.
Effects of Multiple Sclerosis
Lesions arising from MS can occur anywhere in the central nervous system. They may affect any body part.
While fatigue may be one of the most prevalent symptoms of MS, others may include:
- Some extent of cognitive impairment
Some disabilities from mobility issues become more visible as you age. Matters can be complicated even further by other conditions such as osteoporosis, arthritis.
Sexual function can be affected by mobility issues and fatigue. Other health problems can also arise from mobility issues, such as reduced physical activity.
What’s the Outlook for MS Patients?
Predicting how multiple sclerosis will manifest in a single patient is almost impossible.
Benign multiple sclerosis may only manifest in about 10 to 15% of people living with MS. This could mean that 10 years after diagnosis, patients will have a minimal disability and rare attacks.
RRMS generally advances slower than multiple sclerosis. Progressive RRMS may remain in an idle state for many years. If there’s still no disability after 5 years then the future is bright.
The disease progresses faster in people whose relapse rate is high. It’s also the same case for people aged 40 and above. Its progress rate is slower in women than in men.
Using a cane is common among people who have lived with multiple sclerosis for 15 years. Patients may also use other forms of assistance to move around. These may include wheelchairs or other techniques for support. At 20 years, however, just about 60 percent remains ambulatory.
Those who need special care are less than 15 percent. Depending on your response to the treatment and your symptoms, the quality of your life might vary. Due to its high unpredictability, the course of the disease can drastically change without warning, leading to more severe conditions.
Most people, however, continue to lead full lives without severe disability.
Foods to Avoid
Foods such as low-fat protein, low-fat dairy, vegetables and fresh fruits may help reduce relapse. Overall health will also be promoted. A study that was published in 2015 in Nutrition Neuroscience showed that disease activity can be increased by poor diet. It also showed that a healthier outlook can be maintained by a healthy diet.
It is advisable to avoid these foods:
- Saturated Fats. Full-fat dairy products and red meat are some of the major sources of fats. Foods containing coconut oil and palms also contain saturated fats. Saturated fats usually raise LDL or even worse, cholesterol. Arteriosclerosis which may lead to stroke and heart attacks is caused by high cholesterol.
In 2013 the journal Multiple Sclerosis published a study showing that the chances of heart attacks, heart failure, and flutters (or atrial fibrillation) were higher in women living with multiple sclerosis.
- Trans Fats. Consuming trans-fats may lead to inflammation inside the blood vessels which could cause cardiovascular problems according to Amie Jamieson-Petonic. She works at the Academy of Nutrition and Dietetics as a spokesperson. She also works at the Cleveland Clinic Wellness Institute of Ohio as the director of wellness coaching. It’s important to stay away from packaged foods that contain trans-fats. These include pies, baked cookies, and crackers.
- Cow’s Milk. The Autoimmune Disease published a report in 2016 saying that cow’s milk contains specific nutrients which could lead to more complications for people living with multiple sclerosis. Some other experts, however, think that the link is not strong enough to prove that you should stay away from these nutrients. If you feel the risk is too high, make sure you have alternative sources of vitamin D, protein and calcium before turning away from milk.
- Sugar. Taking in too much sugar can increase weight which will, in turn, reduce your mobility and ability to carry out daily activities. The journal Multiple Sclerosis recently revealed in a report that you will be able to tolerate the symptoms that occur once you are injected with interferon if you eat a healthy diet. This should be enough motivation to drop sugar from your diet.
- Sodium. Studies have shown that too much intake of salt can lead to heart problems. Also, relapses tend to increase if you consume too much salt while suffering from multiple sclerosis.
In 2015, Neurology published a study which stated that lesions have a high tendency of appearing if one consumes too much salt. If you have heart problems, try to consume under 1,500 mg of salt per day. However, if you’re healthy, 2,400 mg will be fine.
- Refined Grains. The Archives of Internal Medicine published a study in 2010 showing that processed carbohydrates have a tendency to increase blood sugar levels. This can lead to heart problems, especially in women. Coronary heart disease may also occur in people who eat a lot of these processed carbohydrates.
Jamieson Petonic says that it would be detrimental to your health if you have to deal with MS and other diseases such as diabetes and heart failure all at the same time.
- Gluten. This is a protein present in rye, barley, and wheat. BMS neurology published a study in 2011 showing that celiac disease, whose most common symptom is gluten intolerance, was more prevalent in people living with multiple sclerosis. Gluten usually causes intestinal damage so it should be avoided by people living with celiac disease.
Jamieson Petonic says that reducing the amount of gluten intake might be a great solution if other things are not working for you. That is if it makes you feel better.
Triggers to Avoid
MS is associated with unpredictable episodes of numbness, pain, imbalance or dizziness.
This can, however, be limited by doing certain things. Certain behaviors that trigger the relapse or MS flare-ups can be avoided by taking certain steps. This is especially for those with relapsing-remitting multiple sclerosis.
The following 8 triggers may lead to flare-ups or relapse and they should be avoided at all cost.
- Stress. Stress worsens multiple sclerosis symptoms. Common ways to avoid stress include yoga, psychological counseling, and medications. You can also try making decisions that will help you avoid stress.
- Smoking. Smoking is one of the major factors that lead to the progression of MS. So, try to stop it as soon as possible.
- Heat. How heat affects multiple sclerosis symptoms may vary from one patient to another. Some are susceptible to heat while others are not.
- Certain Medicines. These medicines may worsen your condition. It’s important to always check if your medications will lead to more complications. The particular ones that you will want to avoid are those that are used to treat Crohn’s disease or rheumatoid arthritis.
- Too Many Medicines. It’s very important to consult with your doctor in order to determine which medication is not necessary and which one you must take. Taking too much of them may lead to many complications when they interact inside your body.
- Stopping MS Medicines. People stop taking medications for various purposes. Some say that they don’t feel better while others say that they are worried about the side effects caused by the medication. However, Dr. Rae-Grant says that it’s what you don’t get that’s of importance. He means lesions and relapses and compares them to blood pressure treatment. You will not feel anything when you take the medication but the chances of having a stroke or a heart attack certainly reduce.
- Fatigue. Plenty of sleep is necessary if you want to fight the symptoms that occur from MS. This is because the low reserves of energy have to be compensated for. Doctors recommend a well-balanced nutrition diet and regular exercise.
- Infection. Any minor infection can lead to an increase in the number of flare-ups. Reduced bladder function may cause infection in the urinary tract. The immune system can also be weakened by infections.
Doctors offer the following advice.
- Get your annual flu shot
- Stay away from ill people
- Wash your hands regularly
When Should You Treat MS Flare-Ups?
Once the trigger is removed, some minor symptoms such as slight confusion, fatigue and tingling stop appearing.
Others like loss of vision and serious weakness will need treatment. More severe symptoms might be treated by taking steroids for short period of time. You should live a healthy lifestyle and avoid triggers. This will help you lead a comfortable life even with multiple sclerosis.
Causes of Flare-Ups
Flare-ups happen when the nerve cell covering is damaged by an inflammation in the nervous system. This stops signals from getting to the target organs. For those with relapsing-remitting multiple sclerosis, relapses may be followed by periods where no symptoms occur. These periods are referred to as remissions. For a relapse to be considered as real, the symptoms should manifest for 24 hours, and it should set-off after a 30-day period has passed since you had your last flare-up.
What Happens During a Flare-Up?
Flare ups-vary depending on the patient. Some could be severe while others could be mild.
When it happens, the symptoms you already have might get worse or new one might occur.
The following problems might arise:
- Blindness in one eye
- Blurred vision
- Balance problems
- Needle feeling.
How to Prevent Flare-Ups
Once again, the triggers for relapse are different for different patients. It’s important to find out what triggers your flare-ups so that you can avoid them.
- Take your medicines. Taking your prescribed medications helps prevent relapses and slows the progression of multiple sclerosis. Should any side effects occur, consult with your doctor. Don’t stop taking the medication.
- Maintain your health. You should avoid infections as even the minor ones can set off flare-ups. For example, flu, bladder infections, and bouts of cold. Always take your yearly flu shot, clean your hands with soap and warm water and avoid sick people. For bladder infections, ask your doctor how to avoid them.
- Quit smoking. As earlier stated, smoking is among the factors that trigger multiple sclerosis symptoms. Consult with your doctor on ways to quit the habit.
- Attend yoga classes, meditate and engage yourself in activities that will help you relax.
- You need to rest and get a lot of sleep each day. There are some medicines that may interrupt your sleep and symptoms that will keep you away from your bed also. These include muscles spasms and pain. Adjusting your medicine might help if they don’t let you sleep.
What to Do After a Flare-Up?
If you’re lucky you might have a full recovery after the relapse. It may also take months for all symptoms to disappear. If there’s extensive nerve damage, some symptoms may persist for longer periods. A rehab program might help you get your life back on track.
Your rehab specialist will assist you with:
- Thinking and memory problems
- Personal care and dressing
- Home chores