Finding the Care for MS

Multiple sclerosis (MS) is a chronic and progressive disease that affects the central nervous system (CNS). In people with MS, the immune system mistakenly starts to attack myelin, which is the protective sheath or layer that surrounds your nerve fibers. This causes inflammation throughout the body along with the formation of lesions or scar tissue. This makes it challenging for your brain to send signals to the rest of the body, which causes a variety of symptoms.1

The symptoms of MS vary widely from person to person, and they can also change in severity from day to day, month to month, or even on a yearly basis. The most common symptom of MS is fatigue.2 Approximately 80% of people with MS have reported experiencing fatigue.3 Fatigue that is associated with MS can, in fact, become debilitating. It not only affects your ability to work, but it also makes it difficult to perform everyday chores.

Fatigue can happen in different forms, including:

  • Activity-related fatigue
  • Due to depression
  • Fatigue due to deconditioning, meaning not being in good shape
  • Lassitude – a condition commonly known as MS fatigue, which tends to get worse towards late afternoon.4

Some of the other common symptoms of MS include:

Difficulty Walking

Many people with MS experience difficulty in walking for a variety of reasons. These include:

  • Difficulty balancing
  • Numbness in the feet or legs
  • Muscle weakness
  • Difficulty with vision
  • Muscle spasticity

If you are having difficulty walking, it can also cause injuries due to an increased risk of falling.

Bowel and Bladder Dysfunction

Bowel and bladder dysfunction can be an intermittent or ongoing symptom with MS. Increased frequency of urination, waking up in the night to go to the washroom, and bladder accidents are some of the symptoms of bladder dysfunction. Bowel dysfunction can cause constipation, diarrhea, loss of control, bowel urgency, and irregular bowel habits.5

Weakness

Weakness in people with MS can either be an ongoing problem, or it can only happen during a flare-up or exacerbation of your symptoms.

Acute and Chronic Pain

Similar to the symptoms of weakness, pain in MS can either be chronic or acute. You can experience pain that may seem like a burning sensation. Or it can feel like you are getting an electric shock. This can happen either spontaneously or in response to being touched anywhere.6

Cognitive Changes

When it comes to cognitive changes related to MS, they can either be very subtle or quite obvious. Cognitive changes may include poor judgment, memory loss, difficulty reasoning and solving problems, and a reduced attention span.7,8

Depression

Both clinical depression and less severe emotional distress that is similar to depression are commonly observed in people with MS. In fact, it is estimated that nearly 50 percent of people with MS go through depression at some point during their disease.9

Muscle Spasticity

Muscle spasticity in MS can have an impact on your ability to move and be comfortable. Spasticity is defined as stiffness or spasms, and it may also involve discomfort and pain.10

Vision problems are also quite common in people with MS. This may include:

  • Prolonged double vision
  • Blurry vision
  • Partial or complete loss of vision, usually in one eye at one time. This is usually also accompanied by pain during eye movement.

Some other MS symptoms may also include:

Living with MS

There is no cure for MS, but there are many treatments that are used to manage the progression of MS. However, these treatments are also only partially effective, and over time, some people will find that their MS worsens in spite of following and doing everything they and their doctors have been doing to try and prevent the progression and worsening of the disease.

While many people ask themselves, “why did this happen to me? Did I choose the wrong treatment or the wrong doctor? Did I not exercise enough? Did I follow the wrong diet?” But no matter what, the disease continues to progress because it is the natural course of the condition.

Researchers have been trying to identify new and improved strategies to stop the progression of MS, but people who are experiencing that their MS is becoming more disabling, along with their family and friends, need to understand how to best care for MS and manage the challenges they are facing.11

For many people, MS progresses rapidly, while in others, it advances at a slower rate. It’s just that the rate of disease progression differs from one person to another. At the same time, the critical feature of this disease is its unpredictability – this means that your doctor cannot predict for sure how fast or how far your MS is going to progress and what will the final outcome going to be. At the same time, the various types of MS also determine how your disease will progress. Scans and other diagnostic tests for MS do not always give you the entire picture about disability.

Caring for Yourself with MS

There are many common everyday things that you can use to help yourself manage your condition. Here are some tips that will help you take better care of yourself with MS.

Get Plenty Of Rest

Everyone functions better after getting a good night’s sleep. The same is true for people with MS, in which case taking more rest becomes even more critical. When you live with MS, the one thing that is certain is that there will be days when things will just not go your way. You need recovery time, especially if you have had a flare-up. Needing time to rest and recharge yourself is vital for people with MS.

Getting quality rest is important for people with MS. For this, establishing a good bedtime routine can help ensure that you get restful sleep during the night. People with MS should try to get at least eight hours of uninterrupted sleep during the night.

It is important to remember that MS can cause debilitating fatigue, and while getting plenty of sleep can be beneficial, one of the symptoms of MS-related fatigue is that you may wake up from your sleep still feeling tired and unrefreshed.12 Patients with MS are also more prone to have sleep disorders and have a poor quality of sleep at night.13,14

You should not feel guilty for sleeping for a longer time. This is especially important before you are going to attend any type of demanding, draining, or stressful events. Sleeping will help you preserve your energy.

When you have a flare-up or relapse of your symptoms, you may need to sleep and rest more than you normally do. This is why it is a good idea to incorporate extra sleeping time at the end of the day.

Exercise Regularly, Even If Moderately

Regular, moderate, and simple exercises can go a long way in helping you take better care of yourself when you have MS. Exercise is a wonderful way to help improve your balance, strength, muscle tone, and coordination while living life with MS.

According to the World Health Organization (WHO), it is recommended that adults should do at least 150 minutes of exercise in a week.15 For those with MS, exercise becomes even more important because it can dramatically reduce the impact of MS symptoms and improve the overall quality of life in the following manner:

  • Exercises improve cardiovascular health.
  • Exercise reduces MS-related weakness.
  • Exercise improves your strength, allowing you to have better mobility.
  • Exercise help improves the functioning of the bladder and bowel.
  • Exercise can improve your mood.
  • Exercise can help reduce fatigue.
  • It can encourage better participation in social events and engagements.

There are some types of exercise, like yoga, that can help alleviate painful muscle spasms.16 Exercise also has a big role to play in countering MS-related fatigue, weakness, and it also helps boost your mood.

Watch Your Body Temperature

When you have MS, even a minor increase in your body temperature, like even just 0.5 degrees Fahrenheit, can wreak havoc on your symptoms. This can be caused by a variety of things, including warm weather, a heavy meal, exercise, and even hot showers.

However, heat-related symptoms are usually not harmful and tend to go away once you cool down. The reason why people with MS become sensitive to heat is that MS causes damage to the protective sheath around nerve cells in the spinal cord and brain. This slows down the nerve signals, and the body fails to respond in the manner it should. Heat tends to further slowdown these signals.

MS can also impact the part of the brain that regulates the body’s temperature. Common MS symptoms like fatigue, weakness, pain, and cognitive issues can flare-up, making it more challenging to do your everyday tasks. Some of the other MS symptoms that can worsen in the heat include:

  • Muscle weakness
  • Blurry vision
  • Trouble with memory and focus
  • Trouble with bladder and bowel
  • Problems with balance or walking, may lead to more falls.

In the summers, you can consider running the air conditioner all summer or stay indoors, avoid the gym, don’t wear too many layers, consider swimming in an unheated pool, and try wearing a cooling collar. A cooling collar is a lightweight device that is worn around the neck like a scarf. It cools down the body as the ice inside the collar melts.17

Avoiding exposure to heat and high temperatures can help you manage your condition better.

Watch What You Eat

People with MS need to take extra care about what they eat and try to follow a low-fat, high-fiber diet. Since MS is an inflammatory condition, ensuring that your diet is rich in anti-inflammatory foods can help you control your symptoms.

There are certain foods that are known to have specific benefits to support symptom management when you have flare-ups. Vegetables, whole grains, and fresh fruits that are high in fiber should be included in your diet and can also help with any bowel problems. Foods rich in omega-3 and omega-6 fatty acids are also known to reduce the symptoms of MS.18

Even though there is no special diet that doctors recommended for MS patients, you should try to include some of the following foods in your daily diet:

  • Berries
  • Leafy green vegetables like kale, spinach, and Romaine lettuce
  • Fatty fish like tuna, salmon, and mackerel
  • Coconut oil
  • Olive oil
  • Whole grains like brown rice, quinoa, and oats
  • Flaxseed and flaxseed oil
  • Dietary supplements like vitamin B12 and D may also provide benefits for some people with MS.19

However, the National Multiple Sclerosis Society advises against following any particular diet plan considering that there is no evidence to support that any diet is safe and effective for managing MS. However, the society does recommend that you consume sufficient omega-3 fatty acids and fiber.20

Manage Your Stress

Even though the research is mixed about the relationship between stress and relapses of MS, researchers think that managing your stress levels can play a huge role in decreasing the impact of MS on your daily life.21

Here are some tips on how to reduce your stress levels when you have MS:

  • Plan for dealing with a stressful or demanding situation. Bring a book or listen to music when in particularly stressful situations.
  • Reduce the pressure from your daily tasks and chores. Assess the importance of the task on hand and, if needed, ask for help to do the task. Remember that asking for help can also alleviate stress during a relapse.
  • Get done with the less pleasant tasks earlier in the day. This will help you maintain your energy levels for doing the more enjoyable activities and tasks.
  • Try to engage in at least one enjoyable activity every day.
  • Try out stress management techniques such as deep breathing, yoga, and guided meditation to relieve stress.

Conclusion

There are many ways in which you can help yourself take care of yourself and manage your multiple sclerosis or MS. Getting enough rest, exercising regularly, eating a balanced diet, and relieving your stress are some ways in which you can better care for yourself when suffering from MS. It is also essential to try and stick to a daily schedule for your activities and surround yourself with people you are close to. Your family and friends are the best people to have around you. There is nothing wrong with enjoying your life even if you have MS. Indulge in your old hobbies or find some new ones that keep you busy and interested.

It can also help you to join an MS support group. Sharing your feelings with other people who have MS and experience the same thing can help you deal with the disease. Joining a local support group or even one online can be beneficial for people with MS.

References:

  1. Goldenberg, M.M., 2012. Multiple sclerosis review. Pharmacy and Therapeutics, 37(3), p.175.
  2. Krupp, L.B., Alvarez, L.A., LaRocca, N.G. and Scheinberg, L.C., 1988. Fatigue in multiple sclerosis. Archives of neurology, 45(4), pp.435-437.
  3. National Multiple Sclerosis Society. 2021. MS Symptoms. [online] Available at: <https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms> [Accessed 13 March 2021].
  4. Schwid, S.R., Covington, M.M.S.B., Segal, B.M. and Goodman, A.D., 2002. Fatigue in multiple sclerosis: current understanding and future directions. Journal of rehabilitation research and development, 39(2), pp.211-224.
  5. Chia, Y.W., Fowler, C.J., Kamm, M.A., Henry, M.M., Lemieux, M.C. and Swash, M., 1995. Prevalence of bowel dysfunction in patients with multiple sclerosis and bladder dysfunction. Journal of neurology, 242(2), pp.105-108.
  6. O’Connor, A.B., Schwid, S.R., Herrmann, D.N., Markman, J.D. and Dworkin, R.H., 2008. Pain associated with multiple sclerosis: systematic review and proposed classification. PAIN®, 137(1), pp.96-111.
  7. Amato, M.P., Zipoli, V. and Portaccio, E., 2006. Multiple sclerosis-related cognitive changes: a review of cross-sectional and longitudinal studies. Journal of the neurological sciences, 245(1-2), pp.41-46.
  8. Amato, M.P., Zipoli, V. and Portaccio, E., 2008. Cognitive changes in multiple sclerosis. Expert review of neurotherapeutics, 8(10), pp.1585-1596.
  9. Siegert, R.J. and Abernethy, D.A., 2005. Depression in multiple sclerosis: a review. Journal of Neurology, Neurosurgery & Psychiatry, 76(4), pp.469-475.
  10. Hobart, J.C., Riazi, A., Thompson, A.J., Styles, I.M., Ingram, W., Vickery, P.J., Warner, M., Fox, P.J. and Zajicek, J.P., 2006. Getting the measure of spasticity in multiple sclerosis: the Multiple Sclerosis Spasticity Scale (MSSS-88). Brain, 129(1), pp.224-234.
  11. National Multiple Sclerosis Society. 2021. Progressive MS Research. [online] Available at: <https://www.nationalmssociety.org/Research/Research-News-Progress/Progressive-MS-Research> [Accessed 13 March 2021].
  12. Stanton, B.R., Barnes, F. and Silber, E., 2006. Sleep and fatigue in multiple sclerosis. Multiple Sclerosis Journal, 12(4), pp.481-486.
  13. Braley, T.J. and Boudreau, E.A., 2016. Sleep disorders in multiple sclerosis. Current neurology and neuroscience reports, 16(5), p.50.
  14. Lunde, H.M.B., Aae, T.F., Indrevåg, W., Aarseth, J., Bjorvatn, B., Myhr, K.M. and Bø, L., 2012. Poor sleep in patients with multiple sclerosis. PloS one, 7(11), p.e49996.
  15. Who.int. 2021. [online] Available at: <https://www.who.int/dietphysicalactivity/physical-activity-recommendations-18-64years.pdf> [Accessed 13 March 2021].
  16. Ensari, I., Sandroff, B.M. and Motl, R.W., 2016. Effects of single bouts of walking exercise and yoga on acute mood symptoms in people with multiple sclerosis. International journal of MS care, 18(1), pp.1-8.
  17. Flensner, G., Landtblom, A.M., Söderhamn, O. and Ek, A.C., 2013. Work capacity and health-related quality of life among individuals with multiple sclerosis reduced by fatigue: a cross-sectional study. BMC Public Health, 13(1), pp.1-10.
  18. National Multiple Sclerosis Society. 2021. Diet & Nutrition. [online] Available at: <https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Diet-Nutrition> [Accessed 13 March 2021].
  19. Nationalmssociety.org. 2021. [online] Available at: <https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-Vitamins,-Minerals,-and-Herbs-in-MS_-An-Introduction.pdf> [Accessed 13 March 2021].
  20. Bagur, M.J., Murcia, M.A., Jiménez-Monreal, A.M., Tur, J.A., Bibiloni, M.M., Alonso, G.L. and Martínez-Tomé, M., 2017. Influence of diet in multiple sclerosis: a systematic review. Advances in nutrition, 8(3), pp.463-472.
  21. Nationalmssociety.org. 2021. [online] Available at: <https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-Taming-Stress.pdf> [Accessed 13 March 2021].

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