Use Multiple Strategies to Manage Multiple Sclerosis - dummies

Use Multiple Strategies to Manage Multiple Sclerosis

By Rosalind Kalb, Barbara Giesser, Kathleen Costello

It wasn’t very long ago that treatment options for people with multiple sclerosis (MS) were nonexistent. Patients diagnosed with MS were told to just go home and learn to live with it. Dr. Labe Scheinberg — acknowledged by many to be the father of comprehensive MS care — referred to that unfortunate time as the “diagnose and adios” era of MS treatment.

Fortunately, the world of MS care has come a long way since then. Today, management strategies for MS fall into five main categories, as discussed here. As you and your healthcare team work to manage your MS, you’ll be using some or all of these strategies.

MS treatment strategy: Modifying the disease course

Even though doctors still don’t know how to cure MS, they now have several medications that have been shown to reduce disease activity. These medications help control the disease by:

  • Reducing the number, frequency, and severity of acute relapses (which are also called attacks or exacerbations)

  • Reducing the number of new brain lesions as shown on magnetic resonance imaging (MRI)

  • Possibly reducing or delaying future disability

The National MS Society’s Disease Management Consensus Statement, which reflects the opinions of the recognized experts on the Society’s National Clinical Advisory Board, makes the following recommendations about early treatment:

  • Treatment with one of the disease-modifying therapies should be considered as soon as possible following a diagnosis of MS with active disease (for example, recent relapses or new lesions on MRI). Treatment may also be considered for some patients with a first attack who are at high risk of developing MS (this situation is known as clinically isolated syndrome).

  • Treatment should be continued unless the person is no longer benefiting from it, the side effects are intolerable, or a better treatment becomes available.

MS treatment strategy: Managing acute relapses

Even though the disease-modifying therapies have been shown to reduce the number of relapses, they don’t stop them completely. Because some relapses will still occur, managing them is an important aspect of MS care. When you have a relapse, you and your doctor can decide whether to treat it (usually with high-dose corticosteroids) or let it resolve itself.

Depending on the kinds of symptoms you experience during a relapse and the number of symptoms that remain after the relapse is over, you may also be referred for rehabilitation to help speed your recovery.

MS treatment strategy: Taking charge of your symptoms

Symptom management is a key element of MS care. The process begins with your first visit to the MS doctor’s office and continues for the rest of your life. Because MS doesn’t significantly alter your life span, you and your doctor will be working together over the long haul to manage whatever symptoms you experience.

In order to manage your symptoms effectively, both you and your doctor have certain duties to fulfill: Your job is to keep the doctor informed of the symptoms and changes you experience, follow the treatment regimen he or she recommends, and report back on the outcome. Your doctor’s job is to listen to the information you provide, suggest management strategies, and tweak those recommendations based on your feedback.

MS treatment strategy: Enhancing function through rehabilitation

Rehabilitation is a branch of medicine that focuses on a person’s ability to function. The job of rehabilitation specialists, including physiatrists, physical therapists (PTs), occupational therapists (OTs), and speech/language pathologists (S/LPs), is to help you maintain the highest possible level of function, comfort, and safety, given whatever impairments MS may cause.

From the get-go, these specialists can explain how to manage your energy supply so that you can function optimally at home and at work, and help you develop a personalized exercise regimen. Over the course of the disease, the rehab folks are the creative problem-solvers. They’re the ones who help you identify the strategies and tools you need to keep doing the things that are important to you.

Their ingenuity and know-how, combined with your determination and willingness to try new and different approaches to your daily activities, make for a dynamic duo.

MS treatment strategy: Engaging psychosocial support

Living with a chronic illness isn’t anybody’s idea of fun. And some days, your MS may ask more of you than you have to give. Fortunately, you don’t have to go it alone. You have access to lots of support from MS organizations and from mental health professionals who specialize in helping individuals and families adapt to life with a chronic illness.