A multiple sclerosis overview

Finding out you have multiple sclerosis (MS) is scary and overwhelming. But this nerve disorder can often progress very slowly – or not at all. Here's what you should know to help you manage living with the disease.

Your central nervous system—including your brain and spinal cord—is a jumble of 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 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.

Problems 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.
• If the damage is too great, residual symptoms can persist. These may include weakness, fatigue, sensory loss, visual changes, dizziness, tremors, speech difficulties, trouble swallowing, urinary and bowel problems, and mood swings.
• Eventually, if MS continues unchecked, some people can lose the ability to walk as their muscles become increasingly difficult to control.

Some 50,000 Canadians have multiple sclerosis, which affects twice as many women as men. The five types of MS are:

1. Benign MS
   About 20 percent of cases are called benign MS. You have a single attack, which is never repeated.
2. Relapsing-remitting MS
   Most people (up to 75 percent) have relapsing-remitting MS. With this type, you may be symptom-free between attacks, and months (even years) can go by before another flare-up, or relapse.
   
3. Secondary progressive
   With this much more serious form of the disease, years of relapsing-remitting MS changes to continuous deterioration.
4. Primary progressive
   Another serious form of MS in which deterioration is slow but constant, with no remission.
5. Progressive-relapsing
   This is a very rare (and also serious) form of MS. People with this type of MS experience continuous deterioration and sudden episodes of new symptoms—or worsened old ones.

Being diligent about taking medication as prescribed will be important.

• Take medications to bring an acute attack under control and delay the onset of another attack.
• Once an attack is under control, make lifestyle changes to prepare you, mentally and physically, for the challenge of living with MS.

• Consider taking part in a clinical trial
  New and potentially better medications depend on clinical trials to get Health Canada approval before they can be marketed. You can search online or call the neurology department of any local teaching hospital to find studies that might be appropriate for you. What's more, your physician may be able to direct you to one.
• Don't ignore pain
  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 shot
  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 nerve damage in the brain.

• Make sure you stay abreast of the latest treatments for MS. One of the best sources for information is the Multiple Sclerosis Society of Canada.
• Find the chapter, division or support group nearest you by logging on to their website: www.mssociety.ca.