Multiple Sclerosis can be Managed and Treated - Essay Example

Multiple Sclerosis can be Managed and Treated Abstract It was a day like others in school during which I visited the student health center because of the extreme fatigue that had made it difficult for me to get out of bed for my morning studies. In addition, my left leg had become numb. The physician considered this a composite case and therefore referred me to a neurologist who carried out magnetic resonance image, MRI scanning of my spinal cord and brain which led to suspected multiple sclerosis, MS, infection thus my journey with the disease began. Borrowing from my experience and supported by various scholarly sources, this paper seeks to enlighten on MS, giving its pathophysiology and diagnosis. It would be shown that indeed, with early detection, MS is manageable and treatable. Introduction MS is a chronic neurologic disease that comments on Experience Project indicates commonly affects the young adults aged between 25 and 35, targeting the central nervous system, CNS encompassing the optic nerve, spinal cord and the brain (Gelfand, Gelfand and Goadsby 73). It has been considered as an autoimmune disease which causes severe neurological disability due to demyelination, thus the reason for my numbness and fatigue. According to Amor and Noort (1), the massive amount of white blood cells that go into the tissue would cause swellings and consequently damage the tissue around the nerve fibers. Since these nerve fibers play a critical role in transmitting signals around the body, the damage could affect the functioning of the whole body. The female to male ratio of distribution has been documented as 3:1 (World Health Organization 17). One out of one thousand people suffer from MS in the Western world and the proportion keeps growing. In Europe, the disease affects about 400,000 people with the global figure standing at 2.5 million people according to Scolding and Wilkins (1), costing the EU economy approximately €9 billion every year. This disorder has been greatly associated with genetic factors, an argument that Scolding and Wilkins (4) use to explain the difference in its spread among different populations, notably the low prevalence among the Chinese and the Asian communities compared to the high prevalence in North America, the UK, Germany and Norway. Additionally, WHO (15) argues on the higher prevalence of the disorder in families that have a member who has been a victim, than in the general population. But to the best of my knowledge, no one in the family had suffered this disorder. As such, other factors could have played a greater role in causing the disorder. According to Brodkey, Ben-Zacharia and Reardon (42), with increase in latitude in some regions, there tends to be an increase in MS prevalence, where regions nearing the equator record lower prevalence rates as contrasted to those farther away, due to what could be attributed to reduced sunlight in the northern climates associated with increased susceptibility. Additionally, the African American men have been noted to be 40% less susceptible when compared to their American counterparts, which indicates the role of ethnicity in the disorder’s susceptibility. Diagnosis MS has no single way of development over time but it would mostly set in at ages between 25 and 35 as indicated by Gelfand, Gelfand and Goadsby (73). In my case, it began as episodic and then became progressive over time. The reason the physician could not easily recognize my MS condition could be attributed to the difficulty in its diagnosis because according to Amor and Noort (1) and Stachowiak, persons with MS would have the immune reactions occur at different parts of the CNS at varied intensities. The neurologic examination report indicated that my right eye visual acuity had reduced to 20/80. Together with my history and MRI scans, the neurologists confirmed to me that I had MS. As indicated by Brodkey, Ben-Zacharia and Reardon (42), there exists no known tests that confirm the diagnosis of MS. The practice has been to consider factors like medical history, symptoms, MRI scans on spinal cord and brain, neurologic findings and results from laboratory tests. Furthermore, since other over 100 conditions encompass symptoms resembling those of MS including subclinical stroke, lupus, vitamin B12 deficiency and Lyme disease, MS diagnosing would largely be an exclusion process, a fact that gave me the understanding as to why the physician could not summarily point out MS as the disorder I suffered with a single observation. Initially, the symptoms would include gait disturbance, blurred vision, numbness, bowel complaints and tingling. Examination would reveal signs of neurologic abnormalities including muscle group weakness, decreased sensation to vibration or pinprick and decreased visual acuity (Brodkey, Ben-Zacharia and Reardon 42; Gelfand, Gelfand and Goadsby 73). Of critical significance in MS diagnosis has been noted to be the spinal cord and brain MRI scanning which would show new lesions, tissue destruction, atrophy and inflammation. Recent developments have made it possible to determine the extent of MS disorder through a simple eye scan, a technology based on findings from Johns Hopkins studies which according to BBC indicate that MS patients with relapses exhibited faster retina thinning as opposed to their counterparts without relapses. Accurate diagnosis should be emphasized as it provides the patient with information to determine whether such a patient would adopt disease-modifying therapies or therapies for symptom management in addition to sourcing for education and related support services. Treatment According to Amor and Noort (1), there would be times when brain and spinal cord tissues fail to recover from the associated damage. It discouraged me that once it sets in, it never goes away though it could remain mild in some people. Even so, various treatment approaches gives hope as it modifies the course of the disease and manages symptoms, appreciating that MS cases differ considerably from each other. Various non-drugs options and drugs have been used to treat the symptoms associated with MS, be they primary symptoms directly caused by axonal loss or demyelination, secondary symptoms resulting from primary symptoms complications or tertiary symptoms which encompass the psychosocial challenges as noted by the National Multiple Sclerosis Society, NMSS. Dalfampridine (Ampyra), an oral medication improves conduction in the nerve fibers that have been demyelinated. In my case, the neurologist recommended ibuprofen and amantadine which according to the U.S. Food and Drug Administration, FDA reduce acute pain in eye muscles and treat fatigue respectively. This was to be consumed simultaneously with nonpharmacologic strategies of scheduled naps, regular exercise, eating protein-rich foods and minimizing the intake of caffeine. Occupational and physical therapies, energy conservation, bowel regimen and counseling are forms of non-drug alternatives. In case of disease modifying therapies, FDA recommends eight therapies: an oral preparation, one monoclonal antibody, one immunosuppressant and five immunomodulators. All these target CNS inflammation with the aim of reducing rates of relapse and slowing down progression of disease by minimizing the formation of emergent and active lesions as indicated on MRI scans. According to WHO (18), beta interferons would reduce 80% of inflammatory lesions. Glatiramer acetate, mostly recommended to patients with difficulties in tolerating beta interferons would mimic and compete with the basic protein of myelin and enhance antiinflamatory cytokines production, reducing relapses by about a third. The NMSS advocates for indefinite continued use of immunomodulators unless it yields no clear benefits. Conclusion and Recommendations My experience with MS indicates the complexity of the CNS disorder, first with diagnosis and then its treatment. Even so, various pharmacological and non-drug approaches have been used to manage the associated symptoms and modify the course of the disease. But with this complexity, there could be many other patients who continue to suffer from the disease unknowingly. As such, it would be critical to organize educational forums where members of the public would be sensitized on the disorder and empowered with management knowledge. Moreover, healthcare professionals would need to be trained regularly to be effective in diagnosing the disorder and advising on effective treatment approaches. Mutual support groups would be critical in providing the much needed support to those suffering from the disorder. Works Cited Amor, S. and H. Noort. Multiple Sclerosis. Oxford, OX: Oxford University Press, 2012. BBC. “Simple Eye Scan can Reveal extent of Multiple Sclerosis.” BBC, 25 Dec. 2012. Web. 25 Mar. 2013 http://www.bbc.co.uk/news/health-20836082 Brodkey, M. B., A. B. Ben-Zacharia and J. D. Reardon. “Living Well with Multiple Sclerosis.” American Journal of Nursing, 111.7, (2011): 40 – 48. Experience Project. “I Have Multiple Sclerosis.” Experience Project, 2013. Web. 25 Mar. 2013 http://www.experienceproject.com/groups/Have-Multiple-Sclerosis/99 Gelfand, A. A., J. M. Gelfand and P. J. Goadsby. “Migraine and Multiple Sclerosis: Epidemiology and Approach to Treatment.” Multiple Sclerosis and Related Disorders, 2.2 (2013): 73 – 79. National Multiple Sclerosis Society. “About MS.” NMSS, 2013. Web. 25 Mar. 2013 http://www.nationalmssociety.org/index.aspx Scolding, N. and A. Wilkins. Multiple Sclerosis. Oxford, OX: Oxford University Press, 2012. Stachowiak, J. “Solu-Medrol: The Good, The Bad and The Ugly.” About.com, 2013. Web. 25 Mar. 2013 http://ms.about.com/ U.S. Food and Drug Administration. “News & Events.” FDA, 12 Sept. 2012. Web. 25 Mar. 2013 http://www.fda.gov World Health Organization. Multiple Sclerosis Resources in the World 2008. Geneva, Switzerland: Author, 2008. Read More