Managing MS

Currently, there's no cure or vaccine for MS. However, by learning how to cope with the disease and using available treatments for symptoms of the disease progression, a person can still try to stay well.

Staying healthy is important for everyone, but people with multiple sclerosis (MS) have to pay extra attention to their health. Symptoms of MS, and sometimes the drugs used to treat the disease can have an impact on a patient's mobility, energy level, eating habits, and feelings, thereby compromising their overall well-being.

Currently, there's no cure or vaccine for MS. However, by learning how to cope with the disease and using available treatments (medical and complementary) for symptoms of the disease progression, a person can still try to stay well.

This disease affects people differently, and how it affects MS patients cannot be predicted. However, improvement of the aspects of health that we have some control over often improves quality of life.

Physical fitness and diet are two aspects of our lives over which we have some control. Studies have shown that for people with multiple sclerosis, regular aerobic exercise (exercise that raises the pulse and respiration rate) and a healthy diet have many benefits, including the following:

• Increased or at least maintained muscle strength
• Decreased fatigue (tiredness)
• Increased energy levels
• Increased endurance
• Increased bladder and bowel control
• Reduced feelings of depression
• Protected bone mass

A doctor or health care professional may refer a patient with MS to a nutritionist or physical therapist to help determine an appropriate diet and exercise plan.

Drugs used for the treatment of multiple sclerosis include:

• Corticosteroids: These affect immunologic actions, such as inflammation (swelling) and immune responses associated with multiple sclerosis may help expedite the recovery (but not necessarily reduce the severity) from multiple sclerosis attacks.
• Immune-modulating drugs: These decrease the ability of the immune cells to cause inflammation.
• Immunosuppressants: These are stronger medications that also interfere with the function of the immune system and can reduce inflammation.

Some people with MS explore alternative forms of therapy and treatments, including many who are already taking drugs for the disease. Because most people who have the disease should be using prescription medication under the supervision of their doctor or health care professional, alternative therapies usually are used as complementary therapies, meaning that these therapies complement the traditional medical therapy prescribed by your doctor or health care professional.

Some people report that acupuncture may help reduce the severity of their multiple sclerosis symptoms, for example:

• Pain
• Numbness
• Fatigue
• Anxiety
• Depression

Although no definitive studies exist showing that vitamin supplements help MS symptoms, their use is not contraindicated unless they are taken in excess. Before taking any vitamin supplement, however, be sure to check with the doctor or health care professional. Certain supplements are not recommended for people with the disease. For example, a supplement that is supposed to boost immune function may be dangerous for people with MS because an overactive immune system is likely the cause of symptoms in the disease. A brief overview of some supplements that may, in theory, be beneficial include:

• Vitamin D: It has been questioned if multiple sclerosis is more prevalent in the most northern latitudes because of decreased exposure to sunlight, which is necessary for the body's production of vitamin D. This vitamin may help maintain bone density. Some people with multiple sclerosis have low bone density as a side effect of corticosteroid treatment and are at an increased risk for osteoporosis; vitamin D helps strengthen bones.
• Vitamin E: Vitamin E could, in theory, help decrease the damage caused by substances called oxidants that may be involved in the multiple sclerosis disease process.
• Vitamin A: Vitamin A is necessary for vision, and people with multiple sclerosis often experience visual problems. Intake of vitamin A likely helps people with multiple sclerosis that also have a vitamin A deficiency.
• Vitamin C: Vitamin C can reduce the risk of urinary tract infections (UTIs). Because people with multiple sclerosis who also have bladder problems tend to have an increased risk of UTIs, vitamin C may be beneficial.
• Ginkgo biloba: This herb claims to boost memory, but it may also cause clotting problems. Ginkgo biloba should be used in caution or not at all if the patient with MS is also taking aspirin-containing drugs or other blood thinners.
• Vitamin B-12: Vitamin B-12 is required for the proper function of the nervous system and the production of red blood cells. People with B-12 deficiency may have signs and symptoms that may resemble multiple sclerosis. For people with multiple sclerosis who do not have a low B-12 level, no strong evidence exists that shows taking vitamin B-12 supplements is beneficial.

Multiple sclerosis rehabilitation helps to increase function, improving physical skills and thereby quality of life. Rehabilitation usually focuses on problems with walking and balance, using aids such as a cane or wheelchair, dressing and other personal care, and performing everyday tasks. There are two types of rehabilitation:

• Restorative rehabilitation seeks to restore lost function. This type of rehabilitation is especially helpful after an multiple sclerosis relapse (attack of symptoms). For people with severe disabilities, rehabilitation tries to make the most of the strengths and abilities that are still there.
• Maintenance, or preventive, rehabilitation seeks to preserve current function even as multiple sclerosis gets worse. For people who have been recently diagnosed with multiple sclerosis, rehabilitation can establish knowledge and patterns that will be in place in case problems arise later.

For friends and family, a rehabilitation program can teach these people how to adapt to changes, alter home and work environments for ease of mobility and tasks, and show how they can help others give assistance to their loved ones.

Every person with multiple sclerosis is unique, and a rehabilitation program is best when designed for each particular person. A doctor, neurologist, or other health care professional can recommend a rehabilitation therapist.

Being diagnosed with multiple sclerosis, as with any chronic illness, is difficult. You may experience the following emotions, which may vary at different points of the disease.

• Fear: Fear of disability, pain, the unknown, and losing control0
• Denial: Thoughts of "this can't be happening" or "it's not possible"
• Grief: Grief over what you think you may lose and how that loss may affect your life
• Depression: Loss of interest in what you used to enjoy, depression is present in about half of people with multiple sclerosis
• Guilt: Feelings of guilt because of the inability to perform usual tasks and do all that you were once able to do

It also has aspects that are particularly stressful:

• The unpredictability of the disease: MS is challenging to diagnose because of the variability of symptoms and the absence of a conclusive blood test that can establish the diagnosis. Then, once the diagnosis is made, no doctor can predict its course. Doctors will likely know statistics of the disease and give general predictions, but cannot predict with certainty in an individual case whether symptoms will get better or worse, change in nature, or reappear in other parts of the body.
• Invisible symptoms: Some symptoms of the disease, such as mild weakness and fatigue, are invisible. You can have these symptoms, and others would not know that you are experiencing them.
• Mental ability: Almost half of the people with MS have changes in their mental function. They may have trouble remembering things, processing information quickly, or solving problems that involve sequential tasks.
• Mood swings: Almost all people with the disease occasionally experience mood swings, periods in which emotions, such as crying or laughter, are exaggerated or reappear with little notice.

Managing your emotions and the extra stress brought on by multiple sclerosis may mean making a few adjustments in your life, but stress can be managed.

• Understand that you may not be able to do all the things you once did, or at least not as well. Perhaps it is possible to find new activities that are more feasible for you. In the early stages, however, it is possible for many people with the disease to lead a normal life.
• Maintain your relationship with loved ones. It may be hard for your loved ones to talk with you about the disease, but opening up with them and staying close to them will help both you and them to adjust to the changes multiple sclerosis brings. When you need their support, being specific about what you need will help them to assist you.
• If you cannot talk with loved ones about some things, find someone you trust and can talk with. This may be a counselor, a spiritual advisor, or someone else with multiple sclerosis.
• Keep healthy. Exercise and diet benefit your mental health as they do your physical health.
• Find a doctor you are comfortable with. This should be someone who knows about multiple sclerosis and who is able to encourage and educate you. Also, follow your doctor's suggestions about diet, medications, and activities.
• Relax. Meditation, yoga, massage, and other relaxation techniques can help reduce the tension you face every day. Simplify your life by cutting out activities you really do not need to do.
• Participate in fun activities. Social activities can reduce stress by making you laugh and by helping you "let off steam." If you enjoy yourself, you are likely to feel better about yourself and more in charge of your life.
• Help yourself. Carry a notebook to remind yourself of meetings and other things you need to do or go to. Feel free to say no to someone if you are feeling too tired or weak to do something. Try out a walking aid if you think that may help. Take several naps during the day if you are experiencing extreme fatigue.