Multiple Sclerosis - Article Example

Title: Case Study - Multiple Sclerosis Student’s Name: Instructors Name: Course Code and Name: Institution: Date Assignment is due: Case Study: Multiple Sclerosis I am a 32 year old male living in St.George, Queensland. I live with my wife and one small daughter aged 2 years. My home is lowest with three steps. It has two levels inside with my bathroom on the upper level, and bedroom on the lower level. I suffer from multiple sclerosis, the relapsing and remitting subtype. My MS is causing significant challenges to my daily living. This is because it has caused muscle numbness in almost my entire body. The muscle numbness has made it remarkably difficulty for to walk, or to eat. For the last 16 months, I have not had any conjugal intimacy with my wife. I have not been able to hold my baby in my hands. If I have to continue living in my present home, I will have to encounter insurmountable difficulties. I will have to continue having difficulties emptying my bladder and my bowels. This is because it is difficult for to climb the two steps to my bathroom. The numbness in my leg and body muscles makes it almost impossible for me to climb those two steps. My wife is a teacher at local elementary school and it means that I am let at home alone most of the day. I have problems with my speech so I can not call for help from my neighbors. I cannot feed my self. My wife has to come and feed me at lunch times, and sometimes she does not make it because the school she teaches is far. So if I have to continue to live in my present house, I will have to continue to suffer hunger. Also because I have to lie alone most of the time, I continue to suffer periods of depression. This is because I can not call my neighbors for chat. This depression also comes with unstable moods. So if I have to continue living in my present abode, I will continue to have difficulties in bathing and performing other related toiletry acts. My depression and unstable moods will only have to increase. Disability Awareness Effects of Multiple sclerosis on the body The disease has several negative effects on my body. It also impairs day to day living. MS has led to the loss of sensitivity or numbness. It has led to the loss of the pricking sensation in my body. This is because doctors explain this loss of sensitivity as a neurological impairment. This is known in scientific terms as hypoesthesia, and also as paraesthesia (Ascherio & Munger 2007, p.43). Another effect experienced because of MS is muscle weakness. The patient experiences muscle weakness, or muscle spasms. This results in moving difficulties. There are also difficulties in coordination, and balance. This author has been having difficulties coordinating simple movements and also standing even with the help of walking sticks. Visual problems have also been rampart with the author of this paper. This is because it is difficult to see more than three meters. Vision is impaired, and objects assume an unnatural shape. Objects seem to be moving all the time even when they are stationary. This means that I cannot watch television. I cannot also be left with my small daughter because I cannot see her properly. Driving is out of the question, as vision is central to driving (Ascherio & Munger 2007, p.43). MS comes with difficulties in bowel and bladder. This has caused a lot of pain in my body. This is because it takes sometimes up to three days to have a normal bowel movement. The pain of a full bladder is excruciating. MS also comes with difficulties in swallowing. The pain of eating is untold. This is because the throat passage is blocked by inflammations. Another difficulty experienced is constant fatigue. Sitting on the sofa bed fatigues me. Lying on bed also fatigues me. Trying to play with the little girl is remarkably difficult because fatigue sets in quickly. The most depressing moments come when emotions begin to fluctuate. These fluctuations in moods also come with depression. The depression is of a most diabolical nature because it stays for close to three weeks in a row. During this depression period it is difficulty to communicate with my wife. It is saddening to sit down with Danielle, my wife, and see her crying. This only increases the depression. It even more difficult to watch my little daughter play with her uncle’s when they come visiting on the weekend (Barbellion 1919, p.67). Effects on immediate and Extended family MS makes an individual an invalid. The worst kind of MS is the relapsing remitting Subtype. The author suffers from such a disease. Living with an individual with the disease is the worst kind of nightmare ever. The most affected individuals are those that are closely related to the invalid. The person who has borne the burden of my disease is my wife. As the paper has said elsewhere Danielle teaches elementary school. The job of teaching those young children is difficulty enough. One of the effects on my wife is that she has suffered stress because of living with me. The stress ahs been to strong and several weeks back she was diagnosed with ulcers. The ulcers are a direct result of the pressure she bears in living with me (Barbellion 1919, p.67). She has also become depressed of late, and keeps shouting at our daughter. Looking at her, one sees that she is fatigued. This is because she handles a lot of work. Her salary is the one that keeps the house running (Cohen 2009, p.825). She has become jumpy, and is frequently agigated. Her body is thin and gauntly because of the stress of living with me. The little girl is too young to know what really is happening. Looking closely, one can see that she misses a father figure that she can relate to well. My mother like Danielle has come down with depression because of my sickness. On top, she is the one who foots the bill that come with the management of the disease. Her blood pressure has gone up, and she has to receive medication every now and then. This is because the disease is also eating her economically on top of relationwise. She has become subdued, and refuses to come and she me. This is because she is emotionally upset. My two brothers remain aloof and it is difficulty to tell what they are experiencing (Cohen 2009, p.825). There is always pain in their eyes. International organizations that provide relevant Information In my country Australia, the organization that provides support and information about the condition is an international organization. This is the multiple sclerosis federation. Through its website, the multiple sclerosis international federation website, it provides information as to where help can be got. The Baptist church provides spiritual help to MS patients. Daily Living Time/Activity Ease of doing an activity or participating (0-4) 0= no difficulty 4= complete difficulty. Barriers or Facilitators you have encountered Your solution/s to overcome the barriers Approximate financial cost to you 7am: Getting out of bed 3 No railing to use Electronic bed would help US$400 7.15am: Going to the toilet 4 Unable to stand Required personal assistance US$700 7.45am Taking a shower 4 Unable to bend or stand Required PA 8.15 am Breakfasting 2 Unable to hold cutlery properly Required PA As shown above 8.45.going to the bus stop 3 Unable to walk Wheel chair required US$600 9.30am going to see the doctor 3 Cannot drive/walk Wheel chair and PA required 10.am seeing the doctor 3 Difficulties in speaking PA required 12.pm taking medication 4 Unable to read the prescription Nurse needed US$700 1.00pmTaking a nap 3 Difficulties in climbing the bed, seeing the way to the bedroom PA needed 3.00pm going shopping 4 Unable to see,walk,count money PA needed 4.30pm picking Michelle 4 Cant drive or walk PA required Social Restrictions It has been extremely difficulty to maintain family and friend relationships. This is caused by the fact that most of the time I cannot be able to control my bladder. This means that the control of the bladder is difficulty. The desire to urinate comes at odd moments with friends and family. It is so overpowering that most of the times I wet my self. This habit of incontinence has been of profound embarrassment to me and my wife. This way, most old-time friends have severed the relationship. The reason why they have severed the relationship is because they do not want to se me embarrassed before them (Koprowski 2008, p.328). Another social restriction that has been brought by this disease is the fact that I have been experiencing sexual disorders. In other words, I have lost my potency. This is too embarrassing for me as I cannot be able to meet my wife’s conjugal needs. We have tried using Viagra, but it has been of no help because of the numbness in my muscles. It becomes painful for me to see couples visit me. I try to imagine them together in bed and feel that I have let my wife down. I am sexually inhibited, and this is a huge familial roadblock (Brañas et al 2000, p.98). It has been extremely difficulty to maintain family and friends relationship because I cannot communicate well with them. The disease has brought with it speech impairment that has almost destroyed my ability to communicate (Brañas et al 2000, p.98). When family members come to visit me, we only sit down and keep silent. Alternatively they try to talk about the subjects that used to make me happy in the past. What they are doing is that they are talking to themselves. In a little while, most of them grow tired. Although they do not say so, it is obvious that my presence tires them. Most of those friends who visit me never return. I will never forget one of my friends who tried to call me immediately the condition worsened. For an hour, he tried to talk to me, but he could not. He later hung up and never called me again. Because of the disease, I cannot go to church as often as before. Before the condition, I was a Sunday school teacher with a large Baptist congregation in the neighborhood. Now I cannot go to church because walking is impossible and I do not want to tire my wife beyond her capacity. I cannot attend familial ceremonies like weddings, and graduations. Only recently one of my nephews was getting married but I could not attend the function. The disease has put a lot of social limitations on me (Gilden 2005, p.195). Environmental challenges There have been many environmental challenges that I have had to face in the course of my illness. One of the challenges is that it is difficulty to cross busy roads as in my residential area. This is because even with a wheelchair sometimes the arms fail to manipulate the handles properly due to muscle failure (Gilden 2005, p.195). Another challenge has been to climb uphill and stairs in storey buildings. This is because movement s difficulty. Another environmental challenge is the lack of sunshine in especially in winter. This makes the condition I am suffering from to become worse. The joints become painful. Because of the environmental challenges faced, I have had to make several changes. One of the changes that I initially made was the acquisition of walking sticks. These were made to make me walk on my own. I realized that my condition was more severe and the walking sticks could not help me. Thus, I switched to a manual wheel chair. This proved to be helpful for a short time. The relapses incapacitated their use. This is because I do no have the strength to push the wheel chair down the street. The ultimate solution was the purchase of an automatic wheel chair. This has proved to be of help to me although a personal assistant is needed to help me in busy environments like the town centre (Patel 2007, p.1549). Also, the personal assistant is needed to help with the wheel chair during rush hours. There are some ways in which the community can participate in helping people with multiple sclerosis cope with the condition in the enviroment.One of the ways would be the construction of ramps. Ramps would ease the movement of MS patients especially those with wheelchairs. They would also help those MS patients who are not afflicted with the serious subtypes of the disease. Ramps would provide a way for these people to move by themselves (Zamboni et al 2009, p.397). Thus, the construction of ramps would one way in which the community can help MS patients like me. Another way that can involve community participation is buying wheel chairs for patients of MS.Wheel chairs help in the movement of MS patients. This is because they have to move like any other person. They have to go to work. They need to go shopping. They also need to go to church, or other social places. The community can thus help MS victims by buying them wheel chairs. Another significant way that the community can help people like me is by building gymnasiums. These gymnasiums can be used by the MS patients to exercise. This is because exercise is of utmost importance to MS patients. The building of ramps, gymnasiums and providing wheel chairs are ways through which the community can help MS patients (Zamboni et al 2009, p.397). Reactions to my disability Having Ms has been a challenging development to me. This is because MS having is very incapacitating. It has made me leave my work as supervisor in a paint factory. The fact that today I cannot walk and I was the quarterback right from high school to college has been devastating. Before my eyes went bad, I used to watch football on television and cry. My worst reaction to my disability was the realization that I could no longer function sexually as a man. I felt incapacitated. I felt useless. This feeling of incapacitation continues to linger. This is especially so after my wife tries to rouse me sexually using all the tricks in the book. Taking medication to alleviate the sexual condition has not been helpful (Polman 2005, p.845). This leaves me felling unworthy. I have felt the desire to commit suicide. This is especially so during the worst depression periods when I imagine that my wife is seeing someone else. Because I cannot walk and do other manly chores in the house I feel powerless. The feeling of awkwardness as I try to play with my daughter is ever persistent. Having grown up in church, I feel let down by God. I feel that that this disease should have come to those people who have not been active in church. The fact that I cannot see properly is very painful to me. I have severally tried to pretend that it was not me that as experiencing this healthy problems. I know doctors would call that denial. I have been angry with myself, thinking that the fact that I used to work in a paint factory could have contributed to the disease. I have been angry with my former company thinking that they are responsible for my condition. My self esteem has been completely destroyed by this condition. This is especially with the fact that my wife pays the bills and meets any other financial obligations for the family (Pittock & Lucchinetti 2007, p.48). My self image is in taters. I feel irresponsible towards our daughter. Since she was born, her mother has been the one providing for her every need. I often wonder how I will face her when she is grown up, and school going. How will I tell that I cannot go for her prize giving days? My self concept and self image is completely shattered. In summary what can be said of my self concept, self image and self esteem is that those three aspects of my life have been shattered. I feel less of a man. The feeling of incapacitation is ever with me. I feel angry with my self that I cannot provide for my wife and daughter. I feel unworthy to continue living. Pity and paternalism by Healthcare professionals Multiple sclerosis (MS) has no known treatment. This means that the condition is managed by means of therapy. It falls in the same class with other conditions like rheumatoid arthritis that have no cure .The same conditions leave their patients disabled. Those patients who are disabled suffer a lot of pity from the healthcare professionals. This is especially so if the disability occurred late in life like in my case. Mixed with pity is the mannerism of paternalism that is exhibited by the healthcare professionals towards the disabled. This pity and paternalism is mostly exhibited by nurses and physical therapists (Johnson 2007, p.35). Most physical therapists are prone to be paternalistic in their attitude towards the physically disabled patients. This category also includes doctors. A health professional of this caliber tends to provide a therapathetic environment that is well rounded for the management of the disability. The health professionals adopt a father-like attitude to their disabled patients. The health professional provides prior consideration of the patient’s personal and social well being. They are given to help their physically disabled patients in small ways i.e. intimate ways that they cannot help other patients. They become like some sort of guardians to their physically disabled patients (Johnson 2007, p.35). This makes the patients to have good communication. The patients provide feedback for the management of their conditions. This feedback is used for the improvement of the management process. It leads to the alleviation of the feeling of inadequacy, and inferiority that accompanies most physically disabled patients. The patients develop trust in their health professionals (Sheean et al 1998, p.969). Health professionals cultivate the habit of self efficacy in their patients. This is the belief that one can achieve a certain goal by effort. They cultivate this belief so that most disabled people can become independent in most things in life. For example, most disabled people are able to do the personal things that they used before the disability. They can shave, shop, and even go to work. They start to live life to the full without the emotional disability that shackles so many disabled people (Rammohan et al 2008, p.180). All in all, disabled people have learned to positively live with their disability. They have learned that the popular cliché, that disability is not inability is true. They have taken a positive outlook towards living the rest of their lives in a productive way. This is because a good number of the persons who are disabled got disabled when they were adults (Polman et al, 845).They got diseases like multiple sclerosis, rhemautoid arthritis and other disabled diseases. They also could have got their disability through accidents. The female health professionals give their patients who are disabled. Pity is counterproductive. It motivates the disabled and also demotivates them. References Ascherio, A, Munger, KL, 2007, "Environmental risk factors for multiple sclerosis. Part II: Noninfectious factors". Ann. Neurol. 61, pp 43. Barbellion, 1919, The Journal of a Disappointed Man, New York, George H. Doran, pp 67. Brañas et al, 2000, Treatments for fatigue in multiple sclerosis: a rapid and systematic review. Health Technology Assessment; 4(27), pp 98. Cohen, JA, 2009,”Emerging therapies for relapsing multiple sclerosis". Arch. Neurol. 66 (7): pp 825. Koprowski, H, 2008, "Role of uric acid in multiple sclerosis ". Curr. Top. Microbiol. Immunology. 318: pp 328. Gilden, DH, 2005, "Infectious causes of multiple sclerosis ". The Lancet Neurology 4 (3): pp 195. Patel, PN, 2007, "Low-dose naltrexone for treatment of multiple sclerosis: clinical trials are needed". Ann Pharmacotherapy 41 (9): 1549. Pittock, SJ and Lucchinetti, CF, 2007 "The pathology of MS: new insights and potential clinical applications". Neurologist 13 (2): 48. Johnson, KP, 2007 "Control of multiple sclerosis relapses with immunomodulating agents". J. Neurol. Sci. 256 (Supply 1): S23 (8) pp 35. Rammohan, KW, Rosenberg JH et al 2004, Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: A two centre phase 2 study. Journal of Neurology, Neurosurgery, and Psychiatry 2002; 72:180. Sheean GL, Murray, NM, et al 1998 An open-labeled clinical and electrophysiological study of 3, 4 diaminopyridine in the treatment of fatigue in. multiple sclerosis Brain 1998; 121(5):969. Polman, CH, Reingold, SC, Edan, G et al. 2005, "Diagnostic criteria for multiple sclerosis 2005 revisions to the "McDonald Criteria"". Ann. Neurol. 58 (6): 845. Zamboni P, Galeotti R, Menegatti E, et al. 2009 "Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis". J. Neurol. Neurosurg. Psychiatry. 80 (4): 397. Read More