It can be frightening and bewildering to hear that you multiple sclerosis (MS). But often this nerve disorder progresses very slowly--or not at all. And now even the more aggressive forms of MS can be treated to delay the disease's progress.
Your central nervous system--including your brain and spinal cord--is a jumble of wires, or nerves that transmit messages all over your body. To prevent short circuits, all nerves are covered with an insulation called a myelin sheath. When you develop multiple sclerosis (MS), your immune system attacks the myelin, possibly mistaking it for a virus. Nerves then get injured and your symptoms will depend on where the damage occurs. The problems associated with MS range from vision abnormalities and fatigue to poor coordination and tingling sensations.
While the course of MS is unpredictable, an acute flare-up is usually followed by a remission, which can last for months or even years before another episode occurs. After an acute attack, your nerves begin to heal, forming scars, or plaques over areas of myelin damage. (This means hard, and 'multiple sclerosis' is from the Greek skleros, which means hard, and 'multiple scelorsis' connotes hard, patchy scarring along the nerves.) If this acute damage is too great, residual symptoms can persist. These may include weakness, fiatique, sensory loss, visual changes, dizziness, tremors, speech difficulties, trouble swallowing, urinary and bowel problems and mood swings. Eventually, if MS continues unchecked you can lose the ability to walk as your muscles become increasingly difficult to control.
It is estimated that some 15,000 Australians and between 1000 and 3000 New Zealanders have MS, which affects twice as many women as men. About 20 percent of cases are called benign MS, where you have a single attack, which is never repeated. However, most people (up to 75 percent) have relpasing-remitting MS, where you may be symptoms-free between attacks, and months (even years) can go by before another flare-up, or relapse. Then there are the more serious forms of the disease: secondary progressive, in which years or relapsing-remitting MS changes to continuous deterioration; primary progressive, in which deterioration is slow but constant with no remission; and (very rarely) progressive-replasing, in which continuous deterioration is interpresed with sudden episodes of new symptoms or worsened old ones.
LIKELY FIRST STEPS
The goal of MS treatment is to stave off acute attacks (when nerve damage is likely to occur) as long as possible and then to manage all your symptoms effectively. Your success is likely to depend on the type of MS you have.
MEDICATIONS
-----------------------------------------------------------------------------------------------------------------------------------------
Interferon Limits nerve damage; may slow progression.
------------------------------------------------------------------------------------------------------------------------------------------
Glatiramer acetate Protects myelin sheath to limit nerve damage.
------------------------------------------------------------------------------------------------------------------------------------------- Corticosteroids Reduce inflammation; control immune system
-------------------------------------------------------------------------------------------------------------------------------------------
Baciofen Reduce muscle spasm.
--------------------------------------------------------------------------------------------------------------------------------------------
Other drugs For spasms, urinary problems, depression.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Exercise diet Keep muscles strong; good nutrition helps.
----------------------------------------------------------------------------------------------------------------------------------------------
Keep control Overheating can make symptoms worse.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Supplements Antioxidants, magnesium, essential fatty acids.
-----------------------------------------------------------------------------------------------------------------------------------------------
Acupuncture Helps reduce symptoms.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Plasma exchange Blood processing to reduce myelin damage.
--------------------------------------------------------------------------------------------------------------------------------------------- Therapy Physio, occupational and psychological.
Only since the 1960s have any effective treatments for MS existed at all. Since them, doctors have continued to develop treatments for making life with MS easier to manage.
TAKING CONTROL
There are many pharmacuetical options treating both the cause of MS and its symptoms. These medications are available only through prescription so you'll have to keep in close contact with your doctor, detailing what's working and what isn't. And if a drug doesn't work, don't despair. There's usually something else to try.
For treating the disease itself, evidence suggests that interferon medications, if used early enough, can limit irreversible nerve an initial attack and are not on inteferon, ask your doctor if it make sense to start. Drugs often prescribed include interferon beta-1a (Avonex, Rebif) and beta-1b (Betaferon). Studies have found that all reduce flare-ups for relapsing-reemitting MS by 30 percent, and make attacks less severe if they do occur. Interferon works by suppressing inflammatory mechanisms in the immune system and blocking molecules that target myelin for attack. These drugs also have antiviral properties, which could be potentially beneficial because many experts believe that a virus may be one cause of MS.
Another helpful drugs is glatiramer acetate (Copaxone), a synthetic molecule similar to a protein found in myelin. It works by tricking your immune system into attacking the drug instead of myelin sheath. It's most beautiful if started early in the disease and its effectiveness increases the longer you take it.
What is happening
Your central nervous system--including your brain and spinal cord--is a jumble of wires, or nerves that transmit messages all over your body. To prevent short circuits, all nerves are covered with an insulation called a myelin sheath. When you develop multiple sclerosis (MS), your immune system attacks the myelin, possibly mistaking it for a virus. Nerves then get injured and your symptoms will depend on where the damage occurs. The problems associated with MS range from vision abnormalities and fatigue to poor coordination and tingling sensations.
While the course of MS is unpredictable, an acute flare-up is usually followed by a remission, which can last for months or even years before another episode occurs. After an acute attack, your nerves begin to heal, forming scars, or plaques over areas of myelin damage. (This means hard, and 'multiple sclerosis' is from the Greek skleros, which means hard, and 'multiple scelorsis' connotes hard, patchy scarring along the nerves.) If this acute damage is too great, residual symptoms can persist. These may include weakness, fiatique, sensory loss, visual changes, dizziness, tremors, speech difficulties, trouble swallowing, urinary and bowel problems and mood swings. Eventually, if MS continues unchecked you can lose the ability to walk as your muscles become increasingly difficult to control.
It is estimated that some 15,000 Australians and between 1000 and 3000 New Zealanders have MS, which affects twice as many women as men. About 20 percent of cases are called benign MS, where you have a single attack, which is never repeated. However, most people (up to 75 percent) have relpasing-remitting MS, where you may be symptoms-free between attacks, and months (even years) can go by before another flare-up, or relapse. Then there are the more serious forms of the disease: secondary progressive, in which years or relapsing-remitting MS changes to continuous deterioration; primary progressive, in which deterioration is slow but constant with no remission; and (very rarely) progressive-replasing, in which continuous deterioration is interpresed with sudden episodes of new symptoms or worsened old ones.
- Medications to bring an acute attack under control and delay the onset of another attack.
- Once an attack is under control, lifestyle changes to prepare you mentally and physically for the challenge of living with MS.
QUESTIONS TO ASK
- Does my condition merit seeing an MS specialist?
- How long will I be able to continue with my usual activities?
- Do you know of any clinical trials that might be appropriate for me?
- How do I know if a particular product or program is bogus?
- Are there support groups that my family can join?
- Do any of the special MS diets work?
Treatments
The goal of MS treatment is to stave off acute attacks (when nerve damage is likely to occur) as long as possible and then to manage all your symptoms effectively. Your success is likely to depend on the type of MS you have.
Treatments Options
MEDICATIONS
-----------------------------------------------------------------------------------------------------------------------------------------
Interferon Limits nerve damage; may slow progression.
------------------------------------------------------------------------------------------------------------------------------------------
Glatiramer acetate Protects myelin sheath to limit nerve damage.
------------------------------------------------------------------------------------------------------------------------------------------- Corticosteroids Reduce inflammation; control immune system
-------------------------------------------------------------------------------------------------------------------------------------------
Baciofen Reduce muscle spasm.
--------------------------------------------------------------------------------------------------------------------------------------------
Other drugs For spasms, urinary problems, depression.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Exercise diet Keep muscles strong; good nutrition helps.
----------------------------------------------------------------------------------------------------------------------------------------------
Keep control Overheating can make symptoms worse.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Supplements Antioxidants, magnesium, essential fatty acids.
-----------------------------------------------------------------------------------------------------------------------------------------------
Acupuncture Helps reduce symptoms.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Plasma exchange Blood processing to reduce myelin damage.
--------------------------------------------------------------------------------------------------------------------------------------------- Therapy Physio, occupational and psychological.
Only since the 1960s have any effective treatments for MS existed at all. Since them, doctors have continued to develop treatments for making life with MS easier to manage.
TAKING CONTROL
- Consider taking part in a clinical trial (there are usually a number of trials for MS going on at any one time). New and potentially better medications depend on clinical trials to get Therapeutic Goods Administration (TGA) approval before they can be marketed. Check out the website www.ctc.usyd.edu.au to find studies that might be appropriate for you.
- Don't let pain get ignored. Pain is the 'hidden symptom' of MS and it may not get adequately treated. Because pain can really affect the quality of your life, be sure your doctor knows that you're experiencing it, and treats it accordingly.
- Get a flu injection. Flu-related fever means overheating and that worsens MS symptoms.
- De-stress. Too much stress is usually harmful to people with MS. One study found a connection between increased levels of stress (both everyday hassles and major life events) and new never damage in the brain.
Medications
There are many pharmacuetical options treating both the cause of MS and its symptoms. These medications are available only through prescription so you'll have to keep in close contact with your doctor, detailing what's working and what isn't. And if a drug doesn't work, don't despair. There's usually something else to try.
For treating the disease itself, evidence suggests that interferon medications, if used early enough, can limit irreversible nerve an initial attack and are not on inteferon, ask your doctor if it make sense to start. Drugs often prescribed include interferon beta-1a (Avonex, Rebif) and beta-1b (Betaferon). Studies have found that all reduce flare-ups for relapsing-reemitting MS by 30 percent, and make attacks less severe if they do occur. Interferon works by suppressing inflammatory mechanisms in the immune system and blocking molecules that target myelin for attack. These drugs also have antiviral properties, which could be potentially beneficial because many experts believe that a virus may be one cause of MS.
Another helpful drugs is glatiramer acetate (Copaxone), a synthetic molecule similar to a protein found in myelin. It works by tricking your immune system into attacking the drug instead of myelin sheath. It's most beautiful if started early in the disease and its effectiveness increases the longer you take it.
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