Focus – Multiple Sclerosis

For a person living with MS, the road to wellness involves more than treatment of the disease. Equally important are health advancement and prevention strategies, satisfying personal relationships, a strong support network, fulfilling work, relaxation and a meaningful place in the community.

Planning for the future

Although MS is a progressive disease, the rate of progression differs from one person to another. No one can predict with any certainty how far or fast a person’s MS is going to progress or what the outcome is likely to be. However, there are some factors that can help you and your family plan more effectively for the future:

Identifying options

The key message to anyone living with advanced MS is that there is always more that can be done to improve the current situation. Find a MS doctor who will partner with you and other members of the health care team to manage your symptoms and maintain your quality of life.

Rehabilitation

Rehabilitation programmes focus on function – they are designed to help you improve or maintain your ability to perform effectively and safely at home and at work. Rehabilitation professionals focus on overall fitness and energy management, while addressing problems with accessibility and mobility, speech and swallowing, and memory and other cognitive functions.

Learning to redefine control and independence

Sometimes MS symptoms can progress to the point that they significantly interfere with daily activities. Changes like this can threaten your self-confidence and feelings of self-worth. When this happens, remember that maintaining control and independence in everyday life doesn’t necessarily mean doing everything the same way you did it before.

By allowing yourself to do things differently, you gain access to the world of assistive technology (AT) and labour-saving tools and devices that allow you to stay active and productive. Rehabilitation professionals can help you navigate the world of AT and modify your environment at home and at work to optimise control and independence.

Dealing with emotional ups and downs

Depression and other mood changes are common in MS and grief is a normal reaction to the changes and losses that can accompany advanced MS. Remember that your physical health can affect your mental health. A counsellor or therapist may help you put things in perspective, as well as teach you coping skills and relaxation techniques that may be helpful.

A positive approach is to join a support group where you can share experiences and feelings with other people who have similar concerns.

Avoiding complications

People with more advanced MS are at greater risk for certain kinds of complications, such as osteoporosis, pressure sores, aspiration pneumonia and bladder or kidney infections. Schedule regular check-ups with your MS doctor to reduce your risk of complications and report any unusual fevers or changes in your symptoms.

Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to know more about living with multiple sclerosis.

Benefits of a well-balanced diet

The effects of MS vary from person to person and can change from one day to the next. MS fatigue, steroid therapy and depression can all lead to unwanted weight gain. You can improve your quality of life and sense of well-being by focusing on aspects of health that can be controlled and changed – such as diet. A well-balance diet, combined with appropriate exercise, has the following benefits for the person with MS:

• Controls weight
• Decreases fatigue
• Maintains regular bowel and bladder function
• Minimises the risk of skin problems
• Keeps bones healthy and strong
• Maintains healthy teeth and gums
• Strengthens the heart
• Improves muscle strength and range of motion
• Increases flexibility.

What makes up a healthy well-balanced diet?

A healthy diet contains a balance of the major food groups:

• Proteins – for growth and tissue repair
• Carbohydrates and sugars – for energy
• Fats – to absorb certain vitamins and for essential fatty acids
• Fibre – for healthy digestion
• Vitamins and minerals – for numerous processes in the body, including tissue repair, bone strength and the absorption of other nutrients
• Fluids – for optimum working of the body.

Maintenance of general good health is very important for persons with MS. A well-balanced and carefully planned diet will help you to achieve this goal. MS specialists recommend that people with MS follow the same low-fat, high-fibre diet that is recommended for the general population. Some MS researchers firmly believe that people with MS would greatly benefit from a low-fat vegetarian diet.

Exercise

A good exercise programme in combination with a healthy diet can help to develop the maximum potential of muscle, bone and respiration, thereby avoiding secondary complications. Regular aerobic exercise may offer some benefits if you have mild to moderate MS. Benefits include improved strength, muscle tone, balance, coordination and help to fight depression. Swimming is a good option for people who are bothered by heat. Activities such as yoga, tai chi, massage, meditation or deep breathing may help to relieve stress and improve your sense of wel-being.

Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to know more about multiple sclerosis and your diet.

Relapsing-remitting MS (RRMS)

RRMS is the most common disease course. It is characterised by clearly defined attacks of deteriorating neurologic function. These attacks, which are called relapses, flare-ups, or exacerbations, are followed by partial or complete recovery periods (remissions) during which no disease progression occur. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.

Primary-progressive MS (PPMS)

PPMS is characterised by a continuous, gradual decline in a person’s physical abilities from the beginning with no distinct relapses or remissions. A person with PPMS does not experience acute attacks. The rate of progression may vary over time, with occasional stability and temporary minor improvements. Approximately 10% of people are diagnosed with primary-progressive MS.

Secondary-progressive MS (SPMS)

Following an initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, with or without occasional flare-ups and minor recoveries. Before disease-modifying medications became available, approximately 50% of people with relapsing-remitting MS developed this form of the disease within ten years. Long-term data are not yet available to determine if treatment significantly delays this transition.

Progressive-relapsing MS (PRMS)

Approximately 5% of people diagnosed with MS appear to have PRMS. The course is characterised by a steady decline in abilities accompanied by sporadic attacks. They may or may not experience some recovery following these relapses, but the disease continues to progress without remissions.

How is MS diagnosed?

MS may not be diagnosed for months or even years after the onset of the disease due to the broad range of the symptoms. Neurologists record detailed histories and make use of the following tests to determine the presence of the disease:

• Magnetic resonance imaging (MRI) scans help to identify lesions in the brain
• An electro-physiological test examines the impulses traveling through the nerves to determine if the impulses are moving normally or too slowly
• An examination of the fluid that surrounds the brain and spinal cord may identify abnormal antibodies or cells that suggest the presence of MS.

Prognosis

Although the disorder is chronic and incurable, life expectancy can be normal or almost normal. Most people with MS continue to walk and function at work with minimal disability for 20 or more years.

Females and people who were young (less than 30 years of age) when the disease started, as well as those with a relapsing-remitting pattern who experience infrequent attacks, have the best outlook.

Most people return to normal or near-normal function between attacks. Over time, there is greater loss of function with less improvement between attacks and many require a wheelchair to get around. People with a support system are often able to remain in their homes.

Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to know more about the four courses of multiple sclerosis.