Learning that you have multiple sclerosis (MS) can be scary. Like many other chronic neurological diseases, MS can affect one's ability to walk, talk, see, and do other important things. MS is also unpredictable and progresses differently in different people.
MS occurs when immune system cells don’t function normally. Rather than guarding the body from viruses or bacteria, the cells attack the body's myelin, a coating that protects the nerve fibers. This can cause damage to the brain, spinal cord, or optic nerves and lead to problems with both physical and mental functioning.
Patients who come to my neurology practice want to know how their MS will affect their day-to-day life, both now and in the years to come. But individuals can experience MS differently, and symptoms can come and go over time. Sometimes symptoms can worsen to the point where a person experiences some level of physical disability — but not always. I strive to share as much information as I can with my patients, based on my experience treating the disease. Here are some of the most common questions that come up in our discussions and what I tell my patients.
Q: What symptoms can I expect?
The types of symptoms a patient has — and their severity — depend on what parts of the brain and nervous system are affected. And MS symptoms change over time.
Common early symptoms of MS include:
- Bladder control problems
- Blurred or double vision
- Dizziness
- Clumsiness
- Numbness or tingling
- Trouble balancing
As the disease advances, patients may also have:
- Depression
- Cognitive problems, such as having a harder time concentrating, multitasking, or remembering things
- Mental or physical fatigue
- Problems expressing or controlling their emotions
Q: How will my disease progress?
While every MS patient is unique, the disease tends to follow common patterns, depending on which type of MS a patient has:
Relapsing-remitting MS is the most common type. That means that, for most patients, symptoms tend to flare up and then get better. These MS flares — or exacerbations — can last for several days to several weeks. Then symptoms typically disappear or improve, although some may persist. This period of remission may last for months or years before the next exacerbation occurs.
Secondary progressive MS may develop about 10 to 20 years after a patient is first diagnosed with relapsing-remitting MS. With this condition, symptoms tend to persist and get worse over time. Patients may have symptom flares and periods of stability, when symptoms don’t change.
Primary progressive MS affects about 15% of patients. With this type, while patients have periods when their symptoms are stable, they slowly worsen over time.
MS is rarely a fatal disease. But it's possible for patients to develop life-threatening complications or other medical conditions, such as heart disease or stroke, which can make MS symptoms worse. The good news is that these are often manageable or preventable with a healthy lifestyle and good medical care.
Q: Will I ever be able to function like I did before?
With a number of highly effective medications available, most patients with MS are able to continue their day-to-day life without significant changes. Some people with MS might have to expend extra effort on certain functions, like staying balanced or remembering things. Overall, the majority of my patients are able to make simple adjustments and most do not become severely disabled as long as they stay on treatment
That said, I tell patients that there may be times, particularly during an exacerbation, when they simply aren't able to do the things they normally do. However, these exacerbations are becoming very rare with the new therapies. There are brief periods of time when they might feel weaker or more fatigued. This typically happens when they are sick, over-exert themselves, get overheated, or even when they are under physical or mental stress.
Unfortunately, people whose MS is advanced, not well-controlled, or progressive in nature may develop more serious problems that make it difficult to walk or stand or may cause paralysis. Should these problems occur, a patient may need to use a wheelchair or scooter to get around.
Q: How can I handle the emotional side of MS?
Many of my patients find that the uncertain nature of MS is its biggest challenge. Not knowing what to expect can cause intense stress, anxiety, and sometimes depression. And that stress can make symptoms more likely to flare up.
My patients often share the approaches to managing stress and other emotional challenges that work best for them. They include:
- Exercise, such as yoga, tai chi, or a favorite sport
- Journaling
- Making time for enjoyable or meaningful activities
- Mindful breathing or meditation
- Time spent with family and friends
- Treatment for depression, anxiety or other mental health conditions
Coping with MS can be challenging, but making time for self-care and seeking support from friends and family helps many patients manage stress and find ways to thrive. I remind my patients that they never have to go at it alone. At Temple, we’re here to support MS patients and their loved ones every step of the way.
Q: What should I be doing to manage my health and feel good?
Managing MS symptoms is the first step. Neurologists have advanced training to manage specific symptoms to help patients function at their best. It is also important to start treatment as soon as possible. Early MS treatment can lower the risk of long-term disability.
I like to work with patients to balance prescription medications and lifestyle changes. For example, adding stretching, water therapy, yoga, or physical therapy can help patients feel much better than medicine alone. I also make sure medications are updated with any symptom changes.
Problems like fatigue can be minimized with medications too. But I also encourage patients to engage in mild to moderate exercise, which can improve energy levels, and to avoid hot weather whenever they can since it can cause them to feel weaker.
Issues with bladder control and constipation are also common. Often I'll prescribe a medical treatment for bladder-related problems and encourage patients to adopt lifestyle changes to address any constipation, like eating a high-fiber diet or taking a stool softener.
Q: How likely is it that we'll find a cure for MS?
I believe that MS will be curable one day. But we're not there yet. That said, we have a number of new treatments that are very effective at controlling the disease, and we continue to get new treatments every year. We are also starting to understand what causes MS a little better, which can potentially help us stop it before it develops for future generations.
Take control of your MS
Temple has a comprehensive and advanced Multiple Sclerosis Program for patients with all types of MS. Click here to make an appointment with one of our neurologists who specialize in treating MS.
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