You are walking down the street and suddenly you see a biker coming your way at full speed. You immediately step aside and pave way for the biker to pass you by. The speed and efficiency with which you coordinated this whole movement is due to a robust central nervous system (CNS) which causes an immediate response. In multiple sclerosis (MS), it is this very core of our being, the CNS, which consists of the brain and spinal cord that is affected.
Our nerves are covered by a fatty material called myelin that allows the nerve impulses to travel rapidly in response to a sensory input (biker coming your way) and dictates a motor response (stepping aside). In MS, this myelin is lost (demyelination) as a result of immune system’s attack on myelin proteins. It is replaced by hard, sclerotic (scarred) areas that result in the loss of coordinated movements. Because myelin is lost in many areas of the CNS, this disease is called multiple sclerosis.
Some of the symptoms of MS are
- Spasticity (stiffness)
- Muscle weakness
- Tremors, and loss of mobility
- Difficulty in bladder and bowel control
- Speech and swallowing difficulties
- Sensory impairment in vision, pain, or numbness, and
- Cognitive difficulties
The extent of MS damage depends on what areas of the brain and spinal cord are affected. There are various FDA approved medications that treat attacks, course of the disease, and symptoms and some drugs and procedures are still under investigation. No two individuals with MS will have similar symptoms. But what is common is that these people are able to have meaningful lives thanks to the advanced research and advent of drugs that reduce complications and disability often associated with MS.
Because MS affects different people in different ways, there can be no “one size fits all” exercise regimen too. It is important to have a set of exercises tailored to an individual’s needs that combats weakness and fatigue. Stretching and balance exercises, mild aerobic exercises, and relaxation exercises are some of the ways to improve overall condition without causing too much pain.
Rehabilitation therapies such as physical therapy, occupational therapy, speech and swallowing therapy, cognitive rehabilitation, or vocational rehabilitation are great tools in the fight against MS. Diet and nutrition may not play a huge role but eating sensibly and having a healthy lifestyle is required for higher order functioning. Eat a wide variety of foods that include complex carbohydrates, fruits, vegetables, low fat dairy products, and lean meat.
Adapting to MS is one of the most difficult aspects for the affected individuals. There is a decreased self-esteem, a fear of rejection by family and friends accompanied by re-evaluating life’s goals. All of this can lead to extreme stress and despondency. There are a number of ways of dealing with the emotional aspects of MS. Psychological counselling, modifying the environment, creating opportunities to step out of the house, taking support of close family and friends, and employing some relaxation techniques, like meditation, are some of the ways. This is easier said than done and clearly requires a huge effort. By acknowledging, adjusting, and adapting to the physical and psychological challenges involved, one can hope for an empowered and fulfilling life for those with MS.
In general, management of MS involves disease management, symptoms management, and patient/person management. A combination of these techniques is essential to ease the various symptoms. For more information on MS and how to deal with it, go to The National Multiple Sclerosis Society (NMSS) homepage. NMSS is a group of individuals that strives to provide resources to drive research for a cure and address the needs and challenges of everyone affected by MS.