Mark Twain

"Keep away from people who try to belittle your ambitions. Small people always do that, but the really great make you feel that you, too, can become great."

- Mark Twain

Wednesday, September 24, 2008


Multiple Sclerosis
Minding the body
As with any illness that causes physical disability, keeping the body safe from physical safety can become a concern. If you find you're getting weak or having problems with balance, falls or injuries such as fractures can be a worry. Through awareness of this possibility and through taking precautions, these dangers can be minimized. The most important factor - as difficult as it might be - is to accept that these safety measures are necessary. By welcoming needed help and adapting when necessary, you can help maintain your independence for as long as possible.

Home safety tips include:

installing a bench in the shower so you can sit while showering; this can prevent slipping
having hand-bars installed in the bath or shower stall to help you stand and sit safely
avoiding placing scatter rugs around the house, especially in the bathroom, as they're a real tripping hazard
not locking the bathroom door (so that others can get into the room should you fall)
using a cane or wheelchair if needed - even in the house
Occupational therapists can offer more suggestions to make your home safer and may be able to help you get special equipment if needed. Information is also available from the Multiple Sclerosis Society of Canada

Navigating life with multiple sclerosis

Life with a chronic illness like MS involves learning how to manage the symptoms while adapting your lifestyle to accommodate them. Some daily activities can stay the same while others may need to be changed or replaced due to physical limitations (for example, degree of fatigue or mobility).

A diagnosis of MS can seem devastating but, with the help of your health care team, you can continue to live a fulfilling life by making a few adjustments.

Here are some strategies that can go a long way to easing the effects of MS:

Lower your stress level. Anxiety and tension seem to make MS symptoms worse, so stress management is often recommended. This can mean job changes, counselling, yoga, or anything that helps you relax.

Eat a healthy diet. Eating well helps you maintain good body function and provides the vitamins and nutrients we all need to help fight off infections.

Get physical. Exercise has a lot of benefits: it's a stress reliever, it can firm up your muscles so that you'll maintain a good range of motion, and it increases bone density to keep osteoporosis at bay. Pool exercise is highly recommended; because water helps support your weight, there's less wear and tear on your joints.

Keep comfortable. Summer heat is usually welcome, but people with MS can get easily overheated. Air conditioning offsets this discomfort. If air conditioning isn't available, dressing lightly, using fans, and avoiding strenuous activities can all help.

Ask for assistance. Although friends and family are most often willing and able to lend a hand, many people with chronic illnesses don't want to feel as though they're imposing on people. No problem: outside sources like support groups and clinics can offer respite to you and your family and friends, and they can also provide support by giving you the chance to express your feelings to people who understand.

Don't overdo it. You can still travel, go out for dinner, or see a show, but pace yourself, allowing for rests and plenty of time to enjoy the activities that make your life more fun.

The low-down on multiple sclerosis
Multiple sclerosis (MS) is a neurological disorder that was described as far back as 1868. It affects twice as many women as men and is one of the major causes of disabilities in adults under the age of 65. Canada has one of the highest rates of MS in the world - 50,000 Canadians - with three new cases diagnosed every day. Symptoms usually first show up in people between 20 and 40 years of age but can appear earlier or later. No one yet knows what causes MS.

The symptoms of MS appear when the body's immune system begins to break down the myelin sheath that protects nerve cell fibres. Myelin is wrapped around these fibres like insulation around electrical wiring. When this protective sheath is damaged, nerve impulses from the brain to the muscles can no longer be effectively transmitted. Symptoms can range from very mild and barely noticeable to debilitating. Because they can be so varied and can come and go, diagnosis isn't always easy.

There are four main types of MS:

relapsing-remitting MS (RRMS): the most common form of MS, which involves "flareups" where symptoms get worse, followed by "remissions" where symptoms decrease or disappear
primary progressive MS (PPMS): this type of MS develops slowly but continuously and gets worse over time
secondary progressive MS (SPMS): this type of MS starts out like RRMS, but then steadily gets worse over time
progressive relapsing MS (PRMS): this rare type of MS shows a steady worsening of the disease plus flare-ups

Some symptoms of MS include:

lack of coordination
muscle spasticity (tightness or stiffness)
difficulty controlling bladder or bowels
altered sensation (tingling, numbness, or a burning feeling in a part of the body)
double vision
slurred speech
There's no definitive way to test for MS, and a neurologist will usually only make a diagnosis after someone has had a second "attack" of symptoms. However, treatment may be started after the first attack if an MRI scan shows damage that suggests MS. In this case, treatment may help delay the development of MS. Still, certain types of tests can be done to rule out other neurological disorders or to look for signs of the disorder in the brain, usually lesions. Your doctor may order investigations to check how quickly impulses travel along the nerve fibers, use MRIs (magnetic resonance imaging) or CT scans (computed tomography, for patients who cannot undergo MRI) to look for affected areas, or even do a spinal tap to rule out other diseases.

MS isn't fatal, although people with MS do have a slightly shorter life expectancy. People usually don't die from MS, but often do

MS description from Prevention:

Multiple sclerosis (MS) is a chronic, sometimes disabling, disease of the central nervous system affecting between 350,000 and 500,000 people in the U.S. according to the Multiple Sclerosis Society. If affects twice as many women as men. MS develops more often in Caucasians than in other races. About 200 new cases of MS are diagnosed in the U.S. every week.

The cause of MS is still unknown. Some researchers believe it could be caused by a virus, although it is unlikely that there is just one virus responsible for triggering the condition. Researchers do know that MS is not contagious. And while it is not an inherited disease, genetic susceptibility plays a role. There is a higher risk for MS in families where it has already occurred. The average person in the U.S. has about a two in 1,000 chance of developing MS. Children or siblings of a person with MS have a four in 1,000 chance of developing the disease if they're female; and a two in 1,000 chance if they're male.

It is believed that MS is an autoimmune disease. In MS, the immune system-for reasons still not understood -- attacks and destroys myelin and the oligodendrocytes (oligo-few, dendro-branches, cytes-cells) that produce it. Though the body usually sends in immune cells to fight off bacteria and viruses, in MS they misguidedly attack the body's own healthy nervous system, thus the term autoimmune disease. Rheumatoid arthritis and lupus are other types of autoimmune diseases.

In multiple sclerosis, these misdirected immune cells (certain types of lymphocytes, T-cells and killer cells) attack and consume myelin, damaging the myelin sheath -- the fatty insulation surrounding nerve cells in the brain and spinal cord. Myelin acts like the rubber insulation found in an electric cable and facilitates the smooth transmission of high-speed messages between the brain and the spinal cord and the rest of the body. As areas of myelin are affected, messages are not sent efficiently or they never reach their destination.

Eventually there is a build up of scar tissue (sclerosis) in multiple places where myelin has been lost; hence the disease's name: multiple sclerosis. These plaques or scarred areas, which only are a fraction of an inch in diameter, can interfere with signal transmission. The underlying nerve also may be damaged, further worsening symptoms and reducing the degree of recovery experienced. The disease can manifest itself in many different ways. Sometimes the diseased areas cause no apparent symptoms and sometimes they cause many; this is why the severity of problems varies greatly among persons affected with MS.

Multiple sclerosis usually strikes in the form of attacks or exacerbations. This is when at least one symptom occurs, or worsens, for more than 24 hours. The symptom(s) can last for days, weeks, months or indefinitely.

The most common type of multiple sclerosis is relapsing-remitting MS. It is characterized by periods of exacerbation followed by periods of remission. The remissions occur because nervous system cells have ways of partially compensating for their loss of ability. There's no way to know how long a remission will last after an attack-it could be a month or it could be several years. But disease activity usually continues at a low, often almost indiscernible level, and MS often leads to disability over time as the signal-transmitting portion of the cells-the axons-are damaged.

Most commonly, multiple sclerosis starts with a vague symptom that disappears completely within a few days or weeks. Temporary weakness in a limb can be a first sign. Ataxia (general physical unsteadiness), temporary blurring or double vision, difficulty urinating and slurred speech are also symptoms which can appear suddenly and then vanish for years after the first episode, or in some cases never reappear.

The symptoms of MS vary greatly, as does their severity, depending on the areas of the central nervous system that are affected. Most people suffer minor effects. The disease can, however, completely disable a person, preventing him or her from speaking and walking in the most extreme cases. The bodily functions that are commonly affected by MS are:





speech and swallowing

bladder and bowel control


cognitive function (thinking, concentration and short-term memory)

A varying degree of dysfunction may occur within these general areas. For instance, one person may suffer blurred vision while another may suffer double vision. Or one person may suffer from tremors while another will experience clumsiness of a particular limb.

Specific symptoms associated with MS can include:

Fatigue: a debilitating kind of general fatigue that is unpredictable and out of proportion to the activity; fatigue is one of the most common (and one of the most troubling) symptoms of MS

Cognitive function: short-term memory problems and difficulty concentrating and thinking, but typically not severe enough to seriously interfere with daily functioning for most people with MS. Judgment and reasoning may also be affected

Visual disturbances: blurring of vision, double vision (diplopia), optic neuritis, involuntary rapid eye movement, (rarely) total loss of sight

Balance and coordination problems: loss of balance, tremor, unstable walking (ataxia), dizziness (vertigo), clumsiness of a limb, lack of coordination

Weakness: usually in the legs

Spasticity: altered muscle tone can produce spasms or muscle stiffness, which can affect mobility and walking

Altered sensation: tingling, numbness (paresthesia), a burning feeling in an area of the body or other indefinable sensations

Abnormal speech: slowing of speech, slurring of words, and changes in rhythm of speech

Difficulty in swallowing (dysphagia)

Bladder and bowel problems: the need to pass urine frequently and/or urgently, incomplete emptying or emptying at inappropriate times, constipation, and loss of bowel control

Sexuality and intimacy: impotence, diminished arousal and loss of sensation

Pain: facial pain and muscle pains

Sensitivity to heat: this often causes symptoms to get worse temporarily

Though these are a few of the symptoms commonly associated with MS, not all people with MS will experience all of them. Most will experience more than one symptom, however. There is no typical case of MS. Each is unique.

Today, life expectancy for those with MS is close to normal.

Most people with MS begin experiencing symptoms between the ages of 20 and 40. But initial symptoms may be vague, may come and go with no pattern or be attributed to other factors or conditions. For instance, a woman who experiences sudden bouts of vertigo once every few months may explain away the symptom by linking it to her menstrual cycle. Or, perhaps, someone who suddenly has a bit of blurry vision may blame too many hours at the office.

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