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“Living with Multiple Sclerosis” by Piet Mesmer

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21. Children and Multiple Sclerosis

Though multiple sclerosis is most common in adults between the

ages of 20 to 50, it can also affect children and teenagers.

Children whose fathers have multiple sclerosis will, most likely,

inherit the disease.

Researchers say that there is twice the chance of men with multiple

sclerosis transmitting their disease to their offspring than women

that have the disease. This finding surprised researchers because

multiple sclerosis is more common in women than in men.

In one study, the researchers looked at 444 children that came from

206 different families and whose parents also had multiple sclerosis.

It was found that where the father had multiple sclerosis, the

children had a higher risk of being born with the same disease. In

other words, fathers with multiple sclerosis have more chance to

transmit the disease to their child rather than the mothers.

Children with multiple sclerosis experience similar symptoms as the

adults. The drugs for treating the children are similar to the drugs

used for adults.

Studies indicate that genes and perhaps some unknown

environmental factor is responsible for causing multiple sclerosis. To

understand how the disease works, research on parental inheritance

in multiple sclerosis inheritance might lead to some substantial

findings.

Researchers feel that, since men are less likely to develop multiple

sclerosis than women, those men who have this disease tend to

have a very strong multiple sclerosis-prone genes. The hypothesis is

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that the men are more resistant to multiple sclerosis; therefore,

their genes and the number of those genes are stronger and higher.

It is advisable for men and women with multiple sclerosis to get

guidance from a genetic counselor before planning a family.

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Part-V: Diagnosis and Clinical Aspects

22. When to Seek Medical Care

Multiple sclerosis does not have specific symptoms that always

occur the same in each patient. Some symptoms may not manifest

totally. They may occur at intervals or may not be serious enough

for you to notice and decide to visit your doctor. Some symptoms

could overlap with those of other ailments.

However, it is better to diagnose MS in the early stages and seek

necessary measures to combat the symptoms.

MS Symptoms that Require Medical Care

• Stiffness in limbs, causing involuntary dragging of legs

• Feeling of exhaustion and weakness in legs and hands

• Vision problems - blurred, hazy or foggy vision

• Loss of vision or double vision, or eyeball pain

• Walking problems and clumsiness in moving limbs

• Dizziness

• Intermittent tingling sensation or numbness in arms, hands

or legs

• ‘Electric shock’ sensations moving down your back or spine,

legs and arms

• Problems when trying to retain things in your memory or lack

of attention at times.

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• Problems with maintaining a daily routine

• Unable to communicate effectively, searching for the right

words to give voice to your feelings

• Inability to empty your bladder completely or to hold urine

• Unsteadiness

• Pain when you move your eyes

• A burning sensation while urinating

• Problems when swallowing

• Regular bouts of constipation

• Frequent attacks of cold, chills and high temperatures

• Slurred speech

• Excessive pain in forearms, fingers or neck

• Development of numerous rashes

• Vertigo or muscular spasms

• Excessive urination

If these symptoms occur with great regularity and frequency, it is

advised to consult a medical professional immediately or visit your

nearest health care center for a complete diagnosis.

Some symptoms, like excessive weakness, personality changes or

respiratory problems may signal the presence of other ailments like

strokes, severe infections or chemical imbalances. These symptoms

are also typical of MS.

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So, a medical analysis can help you arrive at the correct diagnosis

and make it easier for you to get appropriate treatment.

Painful eye movements may signal the presence of optic neuritis,

which is one of the earliest signs of MS. Early diagnosis and

appropriate treatment with corticosteroid medication may avert

development of more serious symptoms.

If, after starting with your treatment for MS, you develop

complications (like side effects of any medicines or injections) or if

you do not find any relief from your symptoms, consult your doctor

immediately.

Normally, injections require a minimum of two weeks to give you

any substantial relief. Sometimes, you do not feel your symptoms

while taking your medicine regularly. However, all symptoms come

back as soon as you stop your medications or after the effect of the

medication weans off. It makes sense to keep watch on your

symptoms and seek medical advice whenever appropriate.

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“Living with Multiple Sclerosis” by Piet Mesmer

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23. Diagnosis of Multiple Sclerosis

There is no single or simple test to diagnose MS.

Doctors examine you and study all the symptoms carefully.

There are international efforts to standardize and establish specific

criteria for diagnosis of MS by using clinical, radiologic, and

laboratory data. However, most symptoms and signs of MS are

similar to those of other nervous ailments like brain inflammation,

strokes, and Lyme disease.

They try to exclude symptoms that are connected to other

conditions.

They look for two episodes of damage to the myelin sheath on the

structures of the nervous system (termed demyelinating) that occur

at least thirty days apart.

If you have had two separate episodes of MS with characteristic

neurological symptoms and you display specific physical symptoms

or abnormalities, doctors may diagnose MS without further testing.

The first attack produces many possible causes - different

neurological disorders and symptoms according to where the

damage occurs. MS causes many lesions on your brain and spinal

cord. This attack could last for many hours or even days.

Some people have additional attacks while some others get medical

advice and treatment soon after the occurrence of the first attack.

Some people with mild MS could suffer from optic neuritis, which is

inflammation of their optic nerve. In such cases, if a brain scan is

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normal, you probably have a very low risk of developing MS. A

percentage of just 10%.

If your MRI discloses multiple lesions at the time of the single

episode, you have more than an 80% chance of developing MS.

Sometimes, the tests do not provide evidence for definitely

diagnosing MS. The case becomes more definite only if your age is

within the range for MS. You should show strong signs of recurring

symptoms too.

Neurologists often suggest a few more tests to confirm MS. Such

tests include:

Lumbar Puncture: This is a spinal tap test. Doctors take a sample

of your cerebrospinal fluid by inserting a needle between two

vertebrae of the spine. If you have MS, this fluid will contain high

protein levels, white blood cells and certain antibodies. This test

confirms the presence of immunoglobulin, which is normally present

as oligoclonal bands in the spinal fluid of people with definite MS.

MRI: MRI is Magnetic Resonance Imaging. Doctors conduct a scan

of the spinal cord and brain by using magnetic waves to create

pictures. Scanning can reveal damage to the spinal cord.

Additionally, such a scan can rule out any other symptoms too, like

abnormal pressure on the spinal cord. Chronic presence of

symptoms is essential to establish MS. This test can reveal previous

lesions, which may not have produced any clinical symptoms.

Neuropsychological tests: Doctors give you specific tasks to

check your abilities in arithmetic, judgment, memory, attention and

reasoning. These tests can show the functioning of your brain and

other sensory activities.

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Potential testing: Doctors stimulate brain functioning by passing

mild electric current through your legs or arms. Wires on your scalp

and legs or arms pass this current. It is then possible to measure

electrical activity in response to such stimulation. They can test your

hearing and sight abilities too. If you have MS, your brain will

respond less actively to such stimulations. This test helps locate the

widespread involvement of nerves needed to make a definite

diagnosis.

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24. Factors for Progression of Multiple Sclerosis

Multiple sclerosis causes severe impairment to your nervous

system as it disrupts functioning of your immune system. Most

treatments can slow down the progression of the disease. With

longer remission periods, you should experience fewer flare-ups and

complications.

Normally, your immune system produces many antibodies to fight

against the antigens. In MS, your immune system loses its normal

functioning abilities and turns against the healthy cells of your body.

Normally, MS patients progress into the chronic stages of the

disease. In the early stages of destruction of the myelin sheath by

your immune system, you suffer from various bouts of minor

illnesses like dizziness, vision problems and some others. Although

you are able to recover from these bouts quickly, you are

progressing into the chronic stages at the same time. There may

not be any specific treatment plan for these later stages.

In the early stages of MS, most symptoms are not prominent. They

come and go. They do not cause much impairment or disability.

Such random occurrences of symptoms could last for many years.

However, over time, all the symptoms of MS occur with increased

frequency and severity because many small attacks on your spinal

cord and brain have caused them to deteriorate.

Your nervous system is unable to bear the assault any more, so it

steadily loses its abilities to work properly for you.

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Some studies suggest that a particular substance, macrophage

migration inhibitory factor, that is made by your immune cells

might be responsible for the progression of MS.

Studies on mice indicate that the absence of this substance caused

occurrence of MS in initial stages. However, it apparently did not

develop into a serious form of the disease in those tests.

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25. Prognosis of Multiple Sclerosis

The cause(s) of Multiple Sclerosis is still being studied. The factors

affecting its progression vary in their effects too. Sometimes,

patients with MS continue to live full lives for more than 35 years

after their first attack.

In very rare cases, MS patients succumb to the disease within

weeks. In some cases, MS patients develop severe symptoms and

die due to numerous complications within five years.

The outcome of your multiple sclerosis may be serious if:

• You are a female

• You had the first symptoms at a young age of around twenty

• Your first symptoms were vision problems or decreased

sensation, and not of coordination or weakness

• You had long gaps of remission between relapses

• Your MS was the relapsing-remitting form

After diagnosis of MS, progress of the disease could be

slow if:

• There are long intervals between episodes

• You recover completely after an episode

• You suffer fewer attacks after your first diagnosis

• Your episodes are mainly sensory in nature and cause tingling

or numbness

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Your MS could progress very fast if:

• You have many frequent attacks

• You do not recover completely from your episodes

• You suffer more attacks after your initial diagnosis

• Initial symptoms disrupt your motor functions and disturb

your coordination

• Early MRI scans reveal many lesions

According to NINDS Multiple Sclerosis Information, the majority of

MS patients do not suffer extreme symptoms and have a normal life

expectancy. Usually, symptoms become a constant feature without

any great regression or progression.

MS may only make you unable to write, read, walk, or speak in very

severe cases. In extremely rare cases, it causes paralysis, blindness

and sometimes premature death.

However, most outcomes are unpredictable and therefore are not

authoritative. There are no clinically established and laboratory-

tested investigations to predict the outcome of most cases of MS

accurately.

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Part-VI: Treatment and Medications

26. Treatment and Medications

for Multiple Sclerosis

There is no conclusive evidence of the actual cause of multiple

sclerosis and no specific treatment available for an effective cure.

You need medical supervision and medications to provide some

relief for your symptoms.

Sometimes, MS patients recover completely and do not suffer any

relapse. Another extreme is that MS could cause severe damage to

your nervous system very early in the disease itself or even before

the MS symptoms show up.

Sometimes, the symptoms prove to be very mild and the patient

may not even notice them.

Medications for MS reduce the severity of the disease by:

• Reducing further damage to lesions

• Preventing accumulation of lesions

• Reducing the number of days you suffer from MS symptoms

• Slowing down all disabilities due to MS

• Preventing development of new symptoms

• Preventing relapses

Current medications can sometimes slow down the progress of the

disease and prevent its natural course.

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Available Medications and Treatments for MS

The most common drugs for treating MS symptoms are popular as

ABC drugs. They are Avonex, Betaseron and Copaxone. These

medications quieten the immune system through different biological

mechanisms. They reduce the intensity and frequency of your

attacks and the numbness, disability and severe fatigue. Each drug

needs a separate type of administration and provides different

effects.

Avonex: (Beta-interferon-1a): Administration of this drug is

through intramuscular injection. This drug effectively reduces

further inflammations of MS lesions by about a third. It also reduces

disabilities associated with MS like gait disturbance, weakness,

visual problems and cognitive impairments. It is best to use

ibuprofen (Motrin) or acetaminophen (Tylenol) before taking the

injection to reduce the severity of side effects.

Common side effects of Avonex are:

• Fever

• Muscle aches

• Chills

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Betaseron (Beta-interferon-1b): This drug is slightly stronger

than Avonex. It is more effective in cases of secondary progressive

MS. This type of MS registers steady progression of the disease

rather than recurrent remissions and exacerbations. It can help

reduce the appearance of new lesions on your nerves.

Common side effects of this drug are:

• Chills

• Fever

• Muscle aches

• Injection site reactions

Copaxone (Glatiramer acetate or Copolymer-1): Administration

of this drug is as a daily subcutaneous injection. This drug also

produces extensive reduction in the frequency of MS attacks. It

does not cause any flu-like symptoms of side effects.

Common side effects are:

• Tenderness, swelling, redness, or pain at the place of

injection

• Anxiousness for around twenty minutes after the injection

Steroids

Steroids prove effective at speeding the recovery process from an

episode. Steroids are not a permanent cure for MS. Steroids are

anti-inflammatory drugs that arrest further inflammation. These

drugs are only for very severe cases of MS. In such cases, MS could

affect your daily functioning like walking and vision.

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Steroids do cause severe side effects and therefore, you should

discuss the situation in detail with your doctor before using any

steroid treatment for your MS symptoms.

Doctors prescribe administration of these drugs by mouth or

through intravenous injections, depending on the severity of MS

attack. You can either administer injections at the nursing home or

at your home with the help of any nurse. Normally, doctors

prescribe steroid treatments for a few days to a week only.

Common side effects of steroidal treatments are:

• Insomnia

• Mood swings

• Weight gain

• Increasing glucose levels

All these side effects disappear once you stop your steroidal

treatment.

Medications to Reduce Stiffness

Muscular stiffness is a very common feature of Multiple Sclerosis.

Some doctors prescribe Baclofen (Lioresal) for treating such

stiffness. Although doctors prescribe many dosages during a day,

you can, with your doctor’s approval, adjust your dosages to take

them during severe attacks. You should start the drug at low doses

and thereafter increase in small increments to get relief from your

symptoms. This medicine relaxes muscles and reduces muscular

weakness. It can calm you.

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However, if Baclofen is unable to provide the necessary relief from

your muscular spasms, you can take tizanidine (Zanaflex) in

combination with it. This drug is very potent and therefore, you

have to start at low doses and increase them over time. This is very

effective at reducing spasms and does not cause much weakness.

Doctors sometimes use dantrolene (Dantrium) if both these

medications do not provide the necessary relief.

Medications to Reduce Neuropathic Pain

There are many medications to treat Neuropathic pain that occurs

due to MS. Most of these medications are similar to depression

medications. They include gabapentin (Neurontin) or

antidepressants like amitriptyline (Elavil), paroxetine (Paxil),

and sertraline (Zoloft). All these medications help relieve pain.

Medications to Cure Bladder problems

Medications to cure bladder problems are tolterodine (Detrol) and

Oxybutynin (Ditropan). These reduce excessive urination and

urgency in urination.

Medications to Combat Fatigue

Multiple sclerosis causes fatigue, a general feeling of weakness

where you feel very sleepy. Amantadine (Symmetrel) and

Modafinil (Provigil) can help improve these symptoms.

Medications for Treating More Chronic

and Progressive Forms of MS

There is presently no conclusive report of effective treatments for

treating chronic and progressive cases of MS. There are a few

reports of beneficial effects of some medications for some chronic

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cases. However, there is always a very high risk factor. Your doctors

needs to weigh the risks and benefits and decide accordingly.

Such treatments and medications include intravenous

immunoglobulin, intravenous steroids and plasmapheresis

(plasma exchange), use of chemotherapeutic agents like

azathioprine (Imuran) and methotrexate.

You normally need to be in the hospital for administration of

intravenous immunoglobulin and plasmapheresis.

All medications and treatments for MS produce different effects in

different patients with MS symptoms. Although none of them offers

any permanent cure, they help alleviate symptoms. Recent and

continuing research will offer newer therapies and medications.

Precautions

Avonex can cause serious problems for MS patients with existing

depression or any other type of psychiatric disorder. It is best not to

start Avonex medications if doctors are still unsure of your MS

symptoms and do not declare it a clear case of multiple sclerosis.

Avonex can worsen the symptoms. FDA and Avonex manufacturers

have issued a warning to this effect.

Extensive and long-term use of such medications could decrease its

effectiveness as your body produces many neutralizing antibodies.

There is no information at the time of writing about the risks of

long-term treatment.

There is no guarantee of any treatment. It is difficult to predict

effectiveness of any treatment in a person with MS symptoms.

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Treatment costs may be well above $10,000 per year.

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Part-VII: Alternative Therapies

Used for Multiple Sclerosis

27. Multiple Sclerosis: Alternative and

Complementary Therapies

Multiple sclerosis is one of the most widespread chronic diseases of

the central nervous system in which the brain, spinal cord, and optic

nerves can be affected. Despite much research, the cause of

multiple sclerosis is still unknown. Though there is no cure for

multiple sclerosis, many alternative and complementary therapies

are available that are claimed to ease the symptoms and modify the

course of multiple sclerosis.

Alternative therapy includes a wide variety of traditional medical

treatments that have not been documented scientifically. These

traditional interventions range from diet and exercise to mental

conditioning and changes in the attitude and lifestyle of the patient.

Alternative Therapies for MS

Positive Attitude: Living in depression and stress because of MS

will increase your pain. Believe in yourself and your willpower. A

positive attitude towards life will help you feel better. Keep away

from people and situations that increase stress and negative

thoughts.

Exercise: Exercise, like Yoga and Tai Chi, may strengthen your

immune system, reduce your stress and boost your energy. Though

exercise can help, you should consult your physician before starting.

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Diet: With MS, you should stick to a well-balanced and healthy diet.

You should eat plenty of whole grains for energy, fresh green leafy

vegetables and fruits for fiber. Make sure that you maintain an

appropriate fluid intake to avoid constipation, and look for

unsaturated fats. Reduce the intake of saturated fats.

MS patients are advised to stop smoking and drinking alcohol

immediately. They lower the energy level of body and weaken the

immune system.

Complementary Therapy

Complementary therapies are recommended by some people to

accompany the traditional treatments. As the name itself indicates,

they complement your medical treatment. But, you should always

discuss them with your own medical practitioner before you consider

starting with any of them.

Some Options of Complementary Therapy for MS

Massage: Our skin has countless nerve endings that respond to

touch. Massage relaxes the tense muscles of your body and soothes

the skin. Regular massage may help you to manage the muscle pain

in MS. However, massage is not considered safe for everybody with

MS. For example, it may prove harmful to people with osteoporosis.

So, be advised by your doctor first.

Acupuncture: Acupuncture is also believed by some to relieve you

of pain, muscle spasms, or bladder control problems in MS.

However, sterile needles should be used to avoid any kind of the

infection.

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Chiropractic: Terrific back pain intensified by damaged leg muscles

is a common symptom of MS. Chiropractic practice is believed by its

devotees and practitioners to be one of the most effective

treatments for back pain and injury. The spinal manipulation done in

chiropractic may help you lessen the musculoskeletal problems.

Make sure you get x-rays first and consult your doctor before

starting.

Meditation: Mental conditioning through meditation encourages a

relaxed and calm mind with heightened awareness. Meditation is a

popular stress management therapy.

Yoga: Yoga is promoted as an effective form of meditation. It is

associated with concentrating on postures timed with breathing.

Yoga improves the flexibility of muscles and reduces the stress.

Check with your doctor first that your body is fit enough to do yoga.

Use of evening primrose oil and fish oil: Oral supplements of

evening primrose oil and fish oil contain Linoleic acid, which some

believe has a positive effect on MS symptoms.

Despite noticeable success of these therapies, you should evaluate

them to avoid the negative results and wastage of money and time.

The following guidelines may help you to reach a decision about

these therapies:

1. You should never rely on the face value of a treatment. Check

with trustworthy organizations, support groups, doctors and your

family members to reach an educated and well-informed decision.

2. Consult your doctor about the therapy and likely interactions or

side-effects.

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3. Instead of relying on testimonials, talk to people with MS who

have used the therapy.

4. Research the background and credibility of each therapy or

product provider. Go for providers who are willing to work with your

doctor.

5. Get the estimated total cost of your treatment before spending

any money on it.

6. Be careful to ensure that you are getting the actual product from

the original manufacturer.

7. Make sure of the presence of all active ingredients.

I would like to mention few alternative therapies which have been

unsuccessful.

1. Replacing mercury dental fillings.

2. Use of Hyperbaric oxygen therapy in which oxygen is inhaled

under pressure.

3. Use of Vitamin supplements

4. Employing special diets

Even if there is no cure available yet for multiple sclerosis, proper

use of alternative or complement therapies with medical prescription

may take the edge off severe pain and MS attacks to a significant

extent with some patients.

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28. Acupuncture and Multiple Sclerosis

Acupuncture is one of the most common, traditional forms of

alternative therapy from China. With other medical interventions,

acupuncture may relieve various multiple sclerosis symptoms.

How It Works

An insulating layer called the myelin sheath protects the axons of

neurons that carry communications between the brain and other

parts of the body. MS damages this myelin and interferes with the

communication. In Acupuncture, certain key points in the body are

pierced with sterile needles. This is claimed to induce the release of

certain endorphins and peptides in the central nervous system,

which modulate sensory information between the body and brain. In

this way, acupuncture is claimed to reconcile some MS symptoms,

especially pain associated with facial neuralgias.

However, Chinese medical theory does not reflect on the concept of

the nervous system. It is based on the flow of energy through 14

main pathways called meridians that are believed by its

practitioners to control the functioning of body. Any disease is a

consequence of disrupted flow of energy. Acupuncture deals with

this disruption and relieves the body from imbalance and pain.

Studies and Surveys on MS

A small number of clinical studies and surveys have been conducted

to evaluate the success of acupuncture in people with MS.

Significant positive results have been found in some patients after

10 acupuncture treatments.

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A 53-year-old female had been suffering from MS for 15 years. She

was confined to a wheelchair. After 10 acupuncture treatments, she

was able to walk. She also improved her vision, bladder control and

general health.

The Washington Acupuncture Center has been tracking treatments

and the records of 10,000 patients for three years. They say that

they noticed up to 85% improvement in MS symptoms.

The MS Clinic at the University of British Columbia conducted a

survey on 566 patients with definite MS and declared acupuncture

as the most common and effective method used for relief of some

symptoms.

Two large surveys conducted on MS people in the United States and

Canada, reported some improvement in pain, muscle spasms, and

bowel or bladder function.

Acupuncture is not a scientifically documented treatment, but it is

reported to have proven helpful for certain MS symptoms in some

sufferers. Even if it is not effective, acupuncture is claimed to be a

harmless treatment. However, only qualified professionals should

use it.

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29. Herbs for Multiple Sclerosis

Living with multiple sclerosis is difficult and confronting every day.

It is not easy to deal with the MS symptoms. Recently, some herbs

have been claimed to be effective for relieving some of the

symptoms of this incurable disease.

Herbs are the plants that act upon the cells and produce changes in

the body. These herbs contain certain chemicals that are believed to

be responsible for the desired effect on different conditions.

Herbs Used to Treat MS Symptoms

Echinacea: Echinacea is an extremely popular herb. It is used by

many people to treat the common cold. As acute MS attacks are

associated with viral respiratory infections, Echinacea may be

helpful in treating a cold. However, it may stimulate the immune

system of MS people.

Cranberry: Cranberry is a herb used to treat urinary tract

infections. It is claimed to inhibit bacteria from sticking to cells that

line the urinary tract and may also kill bacteria. It contains two

medicinal compounds - Fructose and Proanthocyanidin. Because it is

claimed to have no side effects, it is widely used. It may be helpful

to people with MS as urinary tract infections can have serious

consequences.

Ginkgo Biloba: Ginkgo is obtained from one of the oldest tree

species. It acts as an antioxidant. It is also claimed to inhibit a

platelet activating factor (PAF) leading to a decrease in the activity

of certain immune cells. This reduced level of activity is claimed to

lessen MS attacks. Ginkgo may be effective in improving MS-related

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cognitive dysfunction to a some extent. However, Ginkgo may also

have some serious side effects, like inhibited blood clotting.

Therefore, it should be only ever be used under qualified medical

advice.

Valerian: Valerian is a foul-smelling root, normally used as a sleep

aid. MS people may suffer from troubled sleep, which increases MS-

related fatigue. Valerian may be very helpful to some people with

MS. However, Valerian is also associated with an enduring, sedating

effect, which limits its usefulness and safety for MS patients.

Asian Ginseng: Asian ginseng is believed to boost the energy and

strength of the body. It is also claimed to help resist stress and

aging. However, little, if any, evidence is available in support of its

effects. Ginseng may be some help to MS people experiencing

unbearable fatigue.

But, it is believed to be linked with the possibility of stimulating the

immune system which may prove fatal for people with MS.

St. John’s Wort: St. John’s Wort is commonly used as an

antidepressant. However, the trial conducted by the National

Institute of Mental Health, National Center for Complementary and

Alternative Medicine, and the federal Office of Dietary Supplements,

found St. John’s Wort, ineffective in treating major depression of

moderate severity. Although St. John’s Wort is claimed to be

tolerated and act without side effects on the immune system of MS

people, it displays a critical risk of interaction with other

medications. St. John’s Wort is not fit for people with severe

depression.

Check with your physician before trying St. John’s Wort.

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If herbs can improve your health, they can produce some harmful

effects too. Thus, herbs should only be used with appropriate

caution and qualified medical supervision. You should not start with

any herbal medication before consulting your doctor.

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30. Vitamins and Minerals for Multiple Sclerosis

Vitamins and minerals form an integral part of your diet;

irrespective of any ailments. MS patients need to maintain the

balance of vitamins and minerals necessary to combat MS

symptoms. You cannot store vitamins in your body. Therefore, you

should get the necessary requirements at appropriate intervals.

You can get your supply of all necessary vitamins and minerals from

your daily diet except for vitamin D. The essential vitamins consist

of antioxidant vitamins A, C, and E, vitamin B12, and vitamin D.

Necessary minerals include calcium, zinc, and selenium.

Vegetables and fruits are rich sources of antioxidants. Such

antioxidants can fight off free radicals and give you some necessary

relief from MS symptoms. You can get the essential amounts of

antioxidants by eating three to four servings of vegetables and two

to four servings of fruits daily. Only ever use antioxidant

supplements in moderation and with advice from your doctor.

MS patients often suffer from urinary tract infections. Although

some intake of vitamin C can reduce these infections, there is

controversy regarding its dosage and effectiveness. Vitamin E may

help prevent damage to cell linings and cell membranes. You can

get your supply of vitamin E from fruits, vegetable oils, nuts,

vegetables and meat.

It is best to restrict consumption of vitamin E to less than 1000 IU.

Low vitamin D levels cause low bone density and could increase

your chances of osteoporosis in addition to your MS symptoms.

Fortified breakfast cereals, fish and dairy products can provide

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vitamin D to you. Additionally, exposure to sunlight is also helpful in

accumulation of vitamin D in your body.

Vitamin B12 helps in the normal functioning of the nervous system

and production of red blood cells. Lack of such vitamin can cause

severe neurological symptoms that are common in MS. Vitamin B12

foods include poultry, meat, eggs, dairy products, and shellfish.

MS patients can get their necessary amounts of minerals from their

regular diet. Selenium rich sources include legumes, seafood, low-

fat meats, whole grains, and dairy products. Drinking milk can help

you maintain the necessary calcium levels in your body.

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31. Dietary Therapy for Multiple Sclerosis

Diet plays an important role for MS patients. MS symptoms often

cause excessive fatigue, constipation and incontinence. Your diet

may help you to reduce or overcome these symptoms by providing

all necessary nutrition.

Be careful about three main parts your diet:

1. Allergic reactions

2. Excess or deficiency of food

3. Toxic effects of foods

Suitable Diets for MS Patients

If you exhibit MS symptoms, you might look at trying the following:

Consume yellow, orange, and dark green vegetables. Five servings

of vegetables and include more of the dark green and leafy variety.

Two servings of fruits is necessary daily.

Consume a protein-rich diet consisting of seeds, nuts, and cold-

water fish.

Include many fibrous foods like brown rice, whole wheat, bran

flakes, oats, whole cornmeal, shredded wheat, grape-nuts and

whole grain corn. These carbohydrates can help to increase the fiber

content of your body.

Include more fish, poultry, lean meat, dried beans, low-fat or non-

fat dairy products, tofu and other plant proteins.

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Have at least six to eight glasses of water daily to flush out toxins

from your body and prevent constipation problems common in MS

patients.

Include polyunsaturated fats available in safflower, sunflower, Soya,

corn oils and oily fish.

Eat more prunes, raisins and figs.

Foods to Avoid

Some people advise MS patients to reduce their intake of the

following:

Full-fat dairy products and red meat, as they contain saturated fats.

Refined foods, caffeine, and additives like aspartame.

Often MS patients have an allergy to gluten foods and some of

these food allergens could be in dairy products, wheat, soy, eggs,

tomatoes, fish, chocolate, corn, or peanuts. Monitor your

consumption of these foods and check for any allergic symptoms

with your MS.

Stay away from alcohol and smoking. Alcohol in moderation may

not be very harmful. However, smoking erodes away the vitamin C

resources of your body. So, it proves very harmful in conjunction

with MS symptoms.

It is essential to maintain your body weight at a healthy level.

Excessive weight can strain your tense muscles, leading to further

damage and risk of falls.

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32. Yoga for Multiple Sclerosis

Multiple sclerosis is a chronic disorder that progresses steadily.

You may experience benefits through relaxation techniques like

yoga. This ancient Indian form of exercise and relaxation is an

option for those suffering from physical limitations. MS patients

often suffer from muscular disabilities due to poor and inefficient

coordination of their nervous system, brain and spinal cord.

Yogic postures may help to relax and relieve stiffness in the

muscles. It may be of great help to MS patients suffering from

balance and posture problems. The Mountain and Warrior poses

done against the wall are best for regaining your balance. You can

sit down and practice Eagle, Tree, and Triangle poses.

The library is a great source for books on Yoga.

Yoga can be restorative or adaptive. Restorative yoga poses prove

beneficial for recovering from illness, fatigue, and stress. These help

your body to gain strength and rejuvenate itself. It also calms down

the brain and restores normalcy in breath. This relieves stress

extensively, as you are able to breathe normally and freely.

Yoga is very useful in improving your range of motion. It boosts

your energy levels and makes your muscles more flexible. Practicing

yoga also improves flexibility of your joints. Yoga may not only

improve your MS symptoms, it may also be a great boost to your

general health. All parts of your body may benefit through better

circulation of air and blood.

MS patients often suffer from cognitive disabilities, like difficulty in

concentration. Yoga may bring a marked improvement in such

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disabilities. You need to concentrate on any particular yogic posture

while doing it. Regular practice of yoga may improve your

concentration levels immensely.

Yoga does not need any elaborate gear. You can do yoga

comfortably on the ground or on a thick rug.

Precautions

You should consult your medical practitioner before starting on your

yoga. You should not do yoga for long periods or until your muscles

ache. Overexertion can lead to destructive effects instead of

benefits. You could end up over-exerting your already-stressed

muscular system.

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Part-VIII: Coping with Multiple Sclerosis

33. Prevention for Multiple Sclerosis

Multiple sclerosis is a debilitating disease of the nervous system. If

you suffer from relapsing-remitting MS, glatiramer acetate or

interferon beta may delay any disability. Similarly, Mitoxantrone

or Interferon beta-1b may reduce some effects of progressive MS.

However, these provide temporary relief and do not offer any long-

lasting remedy.

There are many cases of people with relapsing-remitting MS

progressing into secondary progressive MS within a decade.

There are various conflicting claims about the occurrence of MS.

Some suggest shocks, injuries, vaccinations or even pregnancy. But

there is no conclusive evidence to support any of these claims. A

simple viral infection can aggravate your MS symptoms too.

Although pregnant women report fewer relapses of MS symptoms,

they may suffer from many frequent relapses after delivery. There

is still no conclusive evidence linking genetic causes for the

occurrence of MS.

Simple Control Measures

These measures may assist in controlling some of the effects of

your MS.

Excessive heat can aggravate MS symptoms, as high body

temperatures cause more harm to your affected nerves and reduce

their capabilities. Therefore, avoid overheating your body as much

as possible. Keep your home cool. Exercise indoors and in air-

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conditioned places during hot weather. Similarly, do not use really

hot baths and swimming pools. Avoid venturing out in hot weather.

Eat a healthy diet including many fruits, dark green vegetables,

vegetables of different colors, whole grains and other fibrous food.

Lower your intake of saturated fats and eat sufficient foods that

provide Omega-3 and Omega-6 fatty substances.

Maintain a regular exercise regimen. Physical exercises and mental

relaxation techniques may alleviate MS symptoms. However, consult

your doctor and discuss the exercise regimen in detail before

starting on any particular workout.

Provide adequate rest to your body and do not rush into things.

Maintain a steady rate without excessive stress.

Take regular medications as prescribed by your doctor. Do not make

changes in the medications without prior approval of your doctor.

Avoid any drastic changes in your weight, as excessive weight gain

and loss may be equally harmful.

Regular massage may reduce your stress due to MS.

Practice regular bladder regimen and hygiene to lower the intensity

of bladder complications due to MS symptoms.

MS affects a random section of people across the world. Therefore,

you cannot avoid its occurrence. You can only try to reduce MS

symptoms.

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34. Coping Skills for Multiple Sclerosis

If you are an MS patient, you may have to deal with many

instances and situations with severe emotional and social

consequences. It does not mean that you will lose your faith and

feel helpless. Medical science and Psychology can provide you with

some coping strategies that help you to fight the exhausting effects

of MS.

Coping at an Individual Level

Maintaining Physical Health

1. If multiple sclerosis reduces your ability to do things you take

pleasure in, ask your doctor about feasible ways to get

around the impediments.

2. Modify your home and adjust your work situation, where

possible, so that your daily routine is less stressful or tiring.

3. Eat a well-balanced diet with plenty of grains, cereals, fruits,

vegetables, fish, lean meats, legumes, poultry and low-fat

dairy products.

4. Do regular exercise, either on your own or with assistance.

5. Drink plenty of fluids. Plan your fluid intake and activities so

that bladder problems, like retaining or releasing urine could

be minimized.

6. If you having a problem in swallowing, consult your doctor.

7. Maintain your normal daily activities as best as you can.

8. Continue to practice hobbies that you enjoy and can do.

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Coping with Emotional Trauma

Your physical health can directly influence your mental health.

Anger, denial, and frustration are usual when you learn that life has

handed you something painful, unexpected and incurable.

MS is always associated with an increased risk of depression. You

may start feeling rejected. You may need to consult therapists or

behavioral psychologists who may be able to help you put things in

a clear, positive perspective.

Joining a support group where you can share your experiences and

feelings with other people is another good approach.

Do not let fear overtake you. Instead, focus on problem solving and

stay positive through your illness and rehabilitation.

Do not let MS deprive you of your feelings of self-worth or your

confidence. The MS Society has a great slogan, " You have MS. MS

doesn’t have you. ” Avoid thinking of what you cannot do. Instead,

focus on what you can do today.

Remember, children with MS generally deal with life better than

adults do, as most of them are hopeful about the future and keep

their high expectations. This optimism encourages and protects

them from being overwhelmed by anxiety about their illness.

Coping Socially

You need to find a few positive behaviors and characteristics that

will be useful in the psychological management of your MS:

1. Educate your family and partner about your illness.

2. Stay connected with family members and friends.

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3. Tell your partner about your MS at the right time; when you

feel relaxed and the two of you have a sense of trust and

mutual caring.

4. Be strong and avoid giving in to any feeling of rejection.

5. Find your faith in the higher power.

6. Participate in organized community activities.

7. Innovate, improvise and solve problems.

Your health is your wealth. Preserve it with proper diet, rest and

sensible use of your energy. You can cope well with this disease

with practical and emotional support from your family, friends and

doctor.

You must always have a positive attitude towards life and feel that

you will definitely win over this disease.

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35. Self-Care for Multiple Sclerosis

Multiple sclerosis requires many changes in your normal routine to

meet the physical and emotional demands of the disease. You can

adopt various self-treatment measures that are simple and easy to

practice at home to help you better combat the disease.

Some Self-Care Tips

Follow a regular exercise pattern, either by yourself or with the help

of a physical or occupational therapist.

Eat a balanced diet that includes different types of vegetables,

fruits, lean meat, poultry, legumes, cereals, grains, fish, and low-fat

dairy products.

If you have swallowing problems, try drinking thicker liquids like

juices in gelatin form or milk shakes.

Stay away from foods like cakes and crackers as these crumble

easily and could cause choking.

Use helper devices like reachers, long-handled shoehorns and

dressing sticks to help you balance yourself if you experience any

balancing problems.

Use lightweight pans and dishes. Use trolleys to carry heavier

dishes.

Urinary incontinence is a common symptom of MS. Plan your fluid

intake to complement your daily activities. You could also take a

prescription medication in consultation with your doctor.

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Take sufficient rest as fatigue is a common symptom of MS. Eat

many small meals in a day instead of three large ones to avoid

fatigue due to heavy meals.

Extreme heat can cause severe weakness in your muscles. Be

careful about having hot baths or sauna baths. If you experience

any excessive signs of heat-related symptoms, let your body cool

for a few minutes to bring you back to your original state.

Avoid stressful situations; specifically physical stress, as such stress

can aggravate your MS symptoms.

Do not allow any bacterial infections or fever to continue. Treat

them as soon as they occur.

Get professional and supportive psychological counseling where

available. This can help keep you in good spirits and reduce the

effects of any depression.

Schedule your working hours to suit your energy levels. If possible,

reduce your working hours to ease physical or mental stress.

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36. Professional Help for Multiple Sclerosis

Multiple sclerosis symptoms could make you need to get the

services of many different professionals. MS causes serious

symptoms that you cannot take care of by yourself.

You could need the services of some of these specialists:

MS Nurse: Your nurse teaches you self-care tips to manage your

daily routine. Also, she teaches you correct administration of

medications through injections etc and coordinates the services of

insurance agencies and other healthcare providers.

Neurologist: Your neurologist is often the first person to confirm

the MS diagnosis. Then, regular visits can help you understand how

to manage your MS symptoms. The neurologist will also suggest

remedial measures. They could also refer you to other specialists

like a psychiatrist, urologist, gynecologist, or pain specialist.

Occupational Therapist: Your therapist helps monitor your upper

body functions. They help you to use specific equipment that

compensates for your disabilities. Alternatively, they may consult

architects about various home adaptations or renovations to help

you retain independent movement within your home.

Speech/Language Pathologist: They analyze your speech and

swallowing problems. Then, they teach you to eat safely, swallow

food easily and, if necessary, show you how to manage your feeding

tubes. They also will help you learn how to use telephone aids,

speech amplifiers and other devices to help with your cognitive

problems.

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Physical Therapist: They help you learn and practice effective

exercise programs to reduce pain in your joints, limbs and other

muscles. Such exercises could also reduce instances of

osteoporosis, tremors or spastic movement problems. They also

teach you how to use equipment like hoists, wheelchairs, walkers,

braces and canes.

Counselor: A medical counselor helps you and your family

members to understand and adapt to changes in your lifestyle that

are due to your MS symptoms. You will be able to view any

disability in a more productive light. This helps to you rebuild your

self-esteem and develop various problem-solving skills to combat

your symptoms of MS.

Home care therapists: They can come to your home and

administer necessary treatments for your MS. This could be more

appealing than being confined to a hospital room.

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37. 20 Tips to Help Deal with Multiple Sclerosis

Multiple sclerosis could be a debilitating disease. But, this may not

restrict you from living a fairly full life. You just need to take a few

precautions and plan things well in advance.

Some tips that can help you deal with multiple sclerosis are:

Do not brood over your illness. Instead, set a goal in your life and

work towards it. This keeps you engaged and active.

Maintain a regular exercise regimen. Physical exercises help

maintain your emotional health and good moods. Exercise helps

release the stiffness of muscles. In some cases, exercise could

initially tire you. However, over time, your body will adapt to sustain

the strain and you will see improvements in limb functions.

Remove negativity from your life. Maintain regular contact with your

friends and colleagues. That interaction distracts your mind from

your illness and you will feel rejuvenated.

Practice mental relaxation exercises like meditation, yoga, massage,

tai chi and progressive relaxation. These reduce daily tensions and

stress in your life.

Some patients find relief by attending spiritual gatherings. Strong

religious beliefs could work wonders and be a pillar of support

during the trying times of your illness.

Form support groups with people that have similar illnesses or other

chronic illnesses. Taking active part in such support groups can help

increase your knowledge about MS health care options, treatment

options and other important information.

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Survey your medical situation and plan chores or other activities

accordingly.

Maintain strong bonds with family and friends for help or support in

times of need. A general feeling of being able to love and receive

love makes you happier.

Do not hesitate to ask for help.

Do not keep your feelings and symptoms or other doubts to

yourself. Instead, talk about and share concerns with friends.

Go for regular checkups and analyze your progress in dealing with

your MS.

Maintain close relations with your doctor so that you can more

easily discuss complex issues and other problems concerning your

ailment.

Take an active part in recreational activities, social activities and

related events that can help to reduce your stress.

Laughing aloud and enjoying humor can alleviate your MS

symptoms.

Wear an emergency call button on your ring, chain, or bracelet. This

helps or someone near you to call for emergency help at any time of

the day or night.

Pay attention to your diet as certain foods could aggravate your MS

symptoms or assist to reduce some of them.

Avoid any kind of physical or mental stress, as excessive stress can

deprive your body of essential rest and recuperative abilities.

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Drink adequate water, as it helps cleanse your body of impurities

and toxins.

Have a healthy diet to provide all necessary nutrients and

supplements for your body.

Talk to counselors if you feel unable to cope with MS and that it may

be getting the upper hand in your life.

Take adequate precautions while traveling. Carry your prescribed

medications, injections and special food.

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Part-IX: Multiple Sclerosis FAQ

38. Multiple Sclerosis

– Frequently Asked Questions

What is multiple sclerosis?

Multiple sclerosis (MS) is a permanent disease that causes

increasing disability. The outer covering of nerves in the spinal cord

and brain are attacked and this reduces their functionality.

Who are the most common victims of Multiple Sclerosis?

Incidence of the disease is higher in women than in men; around

three women for every two men.

Multiple sclerosis is more prevalent in the age group of 20 to 40.

People living in the temperate regions of northern Europe and North

America report higher incidences of the disease.

One in every 800 fall victim to this disease.

What are the causes of multiple sclerosis?

There is no clear, definite evidence of the specific cause(s) of

multiple sclerosis. Probable cause may include a combination of

genetic factors, a virus-like environmental trigger and possibly some

defects in patients’ immune systems.

What are the symptoms of multiple sclerosis?

Symptoms of multiple sclerosis differ from person to person. It can

attack any part of your nervous system.

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Common symptoms include:

• Inflammation of the optic nerves, causing pain and problems

with sight. Sometimes, vision becomes normal after few days

or there could be a permanent deficiency in vision.

• Loss of sensation in body limbs like legs, hands, and feet.

• Paralysis

• Urination problems like excessive urination, unable to hold

urine in bladder and a burning sensation while urinating.

How does diagnosis of multiple sclerosis take place?

The doctor interviews you and gathers information about your

neurological episodes. This can only make it a case for possible MS,

so your doctors conduct further tests to confirm whether you

definitely have MS.

Such tests include:

• MRI scanning of brain and spinal cord to reveal scarred nerve

tissues and their locations.

• Spinal cord examination identifies presence of antibodies.

• Neurophysiologic examinations reveal reduced rate of

conduction through your nerves.

Doctors also consider your medical history before making a final

diagnosis.

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What are the available treatments for multiple sclerosis?

Presently, there is no specific treatment for all multiple sclerosis.

Steroids, in the form of injections and tablets, can reduce the

duration of the attacks and their severity. However, there is not yet

a permanent cure.

But, active research indicates the possibility of development of

effective treatments in the future.

Available Medications for Multiple Sclerosis

Doctors prescribe various medications to reduce the intensity and

severity of the neurological attacks.

Common medications include muscle relaxants, painkillers,

antidepressants and medicines for preventing or reducing urinary

incontinence. Glatiramer acetate and interferon-beta help to

reduce the disease’s level of activity and attacks, thereby reducing

further damage. These medications are delivered as intramuscular

or intravenous injections. This is a long-term treatment option and

it can be very expensive.

Physiotherapy can help restore functionality of nerves to a

substantial level.

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