Multiple Sclerosis (MS)

As MS develops, individuals may get to a point where they need help that friends and family can’t give. Individuals may decide with friends and family what support is needed for them. For example, they may need a “nurse aide or a housekeeper” (How to Get Help for Multiple Sclerosis, 2021, para. 3).

Individuals with MS should start looking for in-home options when they can’t perform basic tasks of daily living (How to Get Help for Multiple Sclerosis, 2021, para. 3-4). 

These include:

Eating and swallowing

Bathing or showering

Dressing or grooming

Walking or sitting

Using the toilet (How to Get Help for Multiple Sclerosis, 2021, para. 4)

Arrangements can be made to have short term or permanent home care. Lists can be found for “private or public providers for nurse aides and social services on the websites of hospitals, nonprofit groups, and government agencies”(How to Get Help for Multiple Sclerosis, 2021, para. 6).

Having family and friends’ support can be a great impact on the daily living of someone with MS. For example, they may be able to assist with “household chores,” such as  (How to Get Help for Multiple Sclerosis, 2021, para. 2).

Cleaning

Laundry

Cooking

Grocery shopping and errands

Rearranging furniture, installing grab bars, and making other changes to make your house safer and easier to use

Driving to doctors’ appointments

Reminding you to take your medications

Paying bills (How to Get Help for Multiple Sclerosis, 2021, para. 2)

VTE takes place when a “blood clot travels through the bloodstream to a vessel, causing a blockage.”

A study done in 2014 “published by the MS Trust UK” found that individuals who live with MS are at a “2.6 times greater risk for having VTE” than the general populace. This is due to the fact that individuals that live with MS usually have the same risk factors as VTE (Kiefer, 2019, as cited in Multiple Sclerosis Trust 2014, para. 17)

Some of the risk factors include:

disability

spasticity (muscle stiffness)

lack of mobility

steroid use (Kiefer, 2019, para. 17)

Individuals who have MS can have “feelings of numbness or other physical sensations” (Kiefer, 2019, para. 15). One of these sensations is a painful condition called Dysesthesia (Kiefer, 2019, para. 15).

Dysesthesia can cause:

aching

burning

“Half of people” who go through day-to-day life with MS develop cognitive problems, such as amnesia and processing information at a slower rate. These problems may also result in diminished “problem-solving, verbal, abstract reasoning, and visual-spatial abilities” (Kiefer, 2019, para. 13).“Brain atrophy or lesions” Attributable to MS is the reason there are cognitive changes (Kiefer, 2019, para. 13).

Vision issues appear as MS develops. Individuals may either experience a few of these symptoms for a small portion of time,“ or they may become permanent” (Kiefer, 2019, para. 11).

Potential vision complications include:

blurry vision

diplopia (double vision)

nystagmus (uncontrolled eye movements)

vision loss (Kiefer, 2019, para. 11).

Possible treatments may concentrate on helping individuals deal with changes in vision (Kiefer, 2019, para. 12). This could potentially include:

wearing a eye patch if you have diplopia 

Individuals who live with MS suffer from higher levels of depression and bipolar affective disorder. The causes for these elevated levels are complex (Kiefer, 2019, as cited in MS Society of Canada n.d., para. 7).

The changes in the brain tissue due to MS may be attached to depression. Individuals’ “emotional challenges” while going through daily life with MS may play a factor as well. A few people with MS “may feel a sense of isolation, and face career, economic, and social challenges”  (Kiefer, 2019, para. 8).

The development of MS and specific medications (for example, corticosteroids) can cause bipolar affective disorder (Kiefer, 2019, para. 9).

MS causes an interference between signals of the brain, urinary tract, and bowel systems. This means that from time to time, the body “doesn’t receive a message that it is time to release waste.” Muscle functions in the body parts that release waste and nerve damage occasionally affect the signals to the brain as well.  (Kiefer, 2019, para. 5).

Bladder and bowel difficulty normally include:

constipation

diarrhea

incontinence (Kiefer, 2019, para. 5).

Corticosteroids (steroids): 

In the past corticosteroids were used as the “first line of defense against MS.” Due to side effects and “the development of more effective MS treatments,” corticosteroids are now only used for flare ups and to make the “attack go away quickly” (Kiefer, 2019, para. 3).

Short-term complications of corticosteroid use include:

high BP

fluid retention

pressure in the eyes

gained weight 

mood and memory problems (Kiefer, 2019, para. 3)

Individuals who take corticosteroids long-term are at a greater risk of complications (Kiefer, 2019, para. 4).

  Complications of corticosteroids Long-term include:

infections

high BP

thin bones and fractures

cataracts

bruises

(National Multiple Sclerosis Society, 2021) 

In many cases the first flair up of multiple sclerosis is diagnosed as clinically isolated syndrome (CIS) which is a neurological eopisede of smptoms. It happens when your immune system mistakes your immune system to attack the myelin. This causes scars or lesions on the sheath which makes the signals harder to travel. The most common symptoms of CIS are optic symptoms which causes damage in the nerves that connect your eye to yor brain. The other signs that occur as signs are pain, bowel problems, fatigue, depression, and difficulty thinking.  (Rush University Medical Center, 2021) 

There are two main MS symptoms that tend to appear early on. Optic neuritis and spinal cord inflammation. 

Optic Neuritis: Is the inflammation of the optic nerve. The inflammation may cause pain, blurred vision and headaches. When this symptom presents itself it is usually in one eye but can lead to partial or complete vision loss. 

Spinal cord inflammation: Spinal cord inflammation is also known as partial transverse myelitis. This causes numbness, tingling, weakness in the extremities, bladder problems, and walking difficulties.

In this image it is a visual representation of the damage that is done to the myelin sheath when someone has multiple sclerosis. You can clearly see the damage that occurs to the sheath which exposes the fiber. (Mayo Clinic, 2021) 

Myelin Sheath: The myelin sheath is the insulating layer found surrounding the nerve. Myelin covers the nerves in the brain and spinal cord. This layer is made of protein and fatty substances and its main function is to allow electrical impulses to happen along the nerve cell. (Adam, 2021)