By RICK COUSINS Correspondent
Imagine living in a house where the electrical insulation is failing. At first the lights might blink, the air conditioning might go intermittent, but as the wires became more and more exposed everything from the phone and computer to the dishwasher would slowly, but surely quit working altogether.
Multiple Sclerosis is something like this. The nerves of the human body carry electrical signals, and since they are immersed in the salt water that composes most of the body’s interior, they are well insulated with a waxy coating called myelin.
Multiple Sclerosis slowly erodes that coating, essentially shorting out critical nerve signals that crisscross the body like the wiring of a house.
Dr. Xiang Fang, medical director of the University of Texas Medical Branch’s Health Clinics, is an expert on this debilitating and progressive disease.
He noted that the diagnosis of Multiple Sclerosis is often delayed, resulting in additional problems.
“Often, patients with MS are either considered healthy due to invisible symptoms of MS such as poor memory, fatigue and numbness, or they are misdiagnosed due to other, different neurological symptoms over various periods of the time,” Fang said. “These misconceptions often cause delays of the diagnosis and treatment of MS and results in poor social and family support in the care of these patients.”
Diagnosis is complicated by the fact that Multiple Sclerosis presents no unique symptoms. Some patients will show a number of signs, but few will show all of the possible indicators. Any of the symptoms listed for Multiple Sclerosis can be caused by some other ailment. A Multiple Sclerosis diagnoses is not a death sentence; most of the patients are doing well with appropriate therapy even for a long term.
Still, there are symptoms worth watching for. When a number of these occur simultaneously, a doctor’s visit might be advisable.
“Common symptoms include sensory disturbance, muscle weakness, vision changes, bladder problems, unsteady gait and heat sensitivity,” Fang said. “The lack of consistent and unique clinical symptoms makes the diagnosis of MS very difficult. However, if a person between the ages 15 to 50 who experiences such neurological symptoms, and these symptoms are not explained by other known underlying medical conditions, then MS should be suspected and an appropriate work up is warranted.”
Fang also noted that it is impossible to predict how aggressive and severe Multiple Sclerosis will be in any given patient.
“A variety of factors have been identified as possible prognostic indicators in MS that may modify the disease course or predict exacerbations,” he said. “However, none have been established as reliable, and our ability to accurately predict outcome for individual patients with MS is quite limited. The duration of the MS is exceedingly variable, and no environmental, dietary or activity-related changes are known to alter the course of the illness.”
So what can patients, their loved ones and caregivers do?
The current treatment for flare-ups or attacks is to administer steroids which reduce the body’s autoimmune response.
Multiple Sclerosis, along with some types of arthritis, Crohn’s disease and a number of other serious conditions, is generally regarded as autoimmune in nature. That is, one where the body attacks its own workings, such as nerves, joints and organs.
Steroids can limit the symptoms of an attack, but there is an additional line of treatment available.
“Several different medicines, called ‘disease-modifying therapy,’ reduce the chance that symptoms will flare up,” Fang said. “Unfortunately, they also do not cure the disease. At the moment, it’s not clear whether these medications slow the development of MS. Many of these medicines come in shots, but some newer medicines come as pills or capsules that you can swallow.”
The long-desired goal then is to reteach the body to make its own myelin insulation, restoring the body’s electrical systems.
“Eventually, the hope is that these treatments will restore the functional integrity of neurons,” Fang said. “Currently, stem cells therapy looks promising in experimental, MS animal models. Other medications that can facilitate the re-myelination process are also under investigation.”
There’s no way to prevent the onset of Multiple Sclerosis. Risk factors may include genetics and previous exposure to certain viruses or toxins, but the only common-sense advice available along this line is to get an appropriate amount of outdoor activity while maintaining adequate vitamin D levels.
For those afflicted, Fang advised them to be religious about taking their prescribed medicines, staying in overall good health otherwise and being especially careful about personal hygiene, such as hand-washing. In addition, he advises yearly flu shots and avoiding contact with the sick.
Lastly, both patients and family members should realize that Multiple Sclerosis is a bit like riding a roller coaster. They are many unexpected ups and downs and little if any notice of what’s coming around the corner.
“Relapsing-remitting is the most common type of MS,” Fang said. “This type accounts for approximately 85 to 90 percent of MS cases at onset. Relapsing-remitting means the symptoms of MS come and go.
“When the symptoms flare up, it is called an attack. These attacks can last for days to weeks and usually get better slowly. In between attacks, people often feel pretty normal. Factors such as a bladder infection, a cold or flu, and stress can trigger a relapse.
Support groups can be found at www.nationalmssociety.org. Help with the cost of medications is also available from a number of major pharmaceutical companies.
Rick Cousins can be reached at rick.cousins@galvnews.com.