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MULTIPLE SCLEROSIS




By: Maria Love
06/2011

~ Thank you Amaray for all of your help ~
http://www.nytimes.com/2008/03/04/health/04brod.html
Genetics of MS
   “The genes a person inherits help determine whether that person is
    at increased risk for developing MS. MS does not follow the
    traditional gene inheritance patterns of autosomal dominant and
    recessive or sex linked. While there is evidence from studies that
    this genetic component exists, it appears to be only one factor
    among several that determine who gets MS. Most likely, an
    individual’s genetic blueprint ultimately determines if that
    individual will be susceptible to a triggering factor in the
    environment, which in turn initiates the autoimmune process that
    leads to the development of MS.”
   http://www.nationalmssociety.org/about-multiple-sclerosis/what-
    we-know-about-ms/who-gets-ms/genetics/index.aspx
Physical Manifestation
 BRAIN LESIONS
    http://www.health.com/health/library/mdp/0,,
zm6056,00.html




 STRIPING OF MYLIN SHEETH
    Being that MS is a type of autoimmune
     disease , the body attacks the Mylin Sheeth
     (protective coating of the nerve) or its own
     body.
     health.howstuffworks
    MS exacerbation is caused by inflammation in
     the central nervous system. The inflammation
     damages the myelin sheeth (white, fatty
     substance that covers and protects a part of the
     nerve cells) and delays or short circuits
     transmission of nerve signals which causes the
     symptoms of MS.
Symptoms
MS exacerbation or Relapse is a sudden worsening of 1 or more MS symptoms or the
appearance of new symptoms.
Depression can be a direct result of MS damage within the brain.
Motor System Symptoms:
   Muscle weakness, Mild paralysis
   Spasticity or stiffness
   Slurred speech
   Involuntary contraction
Sensory System Symptoms:
   Tingling sensation, Partial numbness
   Feeling excruciating pain without a cause
   Feeling electric shocks in head or throughout the body
   Affects the sense of touch
   Cognitive issues ~ Which becomes delayed due to loss of the Myelin Sheeth in the
    brain
   Heat sensitivity
Coordination/balance issues:
   Vertigo
   Loss of coordination
   Shaking while performing precision actions
Diagnosis
They must find evidence of damage in at least two separate areas of the central
nervous system (CNS), which includes the brain, spinal cord and optic nerves.
Referred to as White Matter or Lesions in the brain.


Doctor’s (Neurologist) look for these signs:
   The physician also performs a variety of tests to evaluate mental, emotional
    and language functions, movement and coordination, balance, vision, and the
    other four senses.
   MRI is the best imaging technology for detecting the presence of MS plaques
    or scarring (also called lesions) or (multiple scars) in different parts of the
    CNS.
   Evoked potential (EP) tests are recordings of the nervous system's electrical
    response to the stimulation of specific sensory pathways (e.g., visual,
    auditory, general sensory).
   Analysis of the cerebrospinal fluid, which is sampled by a spinal tap,
    detects the levels of certain immune system proteins and the presence of
    oligoclonal bands.
   While there is no definitive blood test for MS, blood tests can rule out other
    conditions that cause symptoms similar to those of MS, including Lyme
    disease, a group of diseases known as collagen-vascular diseases, certain rare
    hereditary disorders, and AIDS.
Frequency & History of MS
 The number of cases of Multiple Sclerosis range between
   2 to 150 in one thousand people
 Onset/symptoms begin in young adults
 MS occurs predominantly in women
 Jean-Martin Charcot first described MS in 1868


How many people have MS?
 Approximately 400,000 Americans have MS, and every week
  about 200 people are diagnosed. World-wide, MS affects about
  2.5 million people. Because the Centers for Disease Control and
  Prevention (CDC) does not require U.S. physicians to report
  new cases, and because symptoms can be completely invisible,
  the numbers can only be estimated.
 MS affects every ethnic group but is more common in
  Caucasians of northern European ancestry.
Varieties of MS
There are (3) three types of MS:

(1)Relapsing-Remitting MS (RRMS) - The most common
   disease course, a person experiences attacks (also called
   relapses or exacerbations) of worsening neurologic
   functioning followed by periods of remission in which partial
   or complete recovery occurs. This type people say,
   “ But you look so good”.
(2)Secondary Progressive MS (SPMS) – While technically a
   form of progressive MS, this type acts more like a relapsing
   form of MS in its early-to-mid stage with relapses and
   remissions being quite common.
(3)Progressive MS (PRMS) – This type shows no relapses, but
   over a period of years, there is gradual loss of physical
   cognitive functions.
Treatment/Therapy
Can MS be cured?
   Not yet. There are now FDA-approved medications that have been shown to "modify" or slow
    down the underlying course of MS. In addition, many therapeutic and technological advances
    are helping people manage symptoms. Advances in treating and understanding MS are made
    every year, and progress in research to find a cure is very encouraging.


Types of Medications:
Immunomodulating Medications (injection therapy)
*Avonex    - $3,526.59
- Once a week injection intramuscular (into the muscle)
*Betaseron -$4,129.69
- Every other day injection subcutaneous (under the skin)
*Copaxone -$4,345.29
- Every day injection subcutaneous (under the skin)
*Rebif      -$3,180.19
- Three times a week injection subcutaneous (under the skin)
Tysabri
- Every four weeks by IV infusion


Immunosuppressant drug
Novantrone – Four times a year by IV infusion


* Monthly cost of medications without insurance per Walgreens
A Sample day with Multiple Sclerosis (MS)
               for me, it is RRMS

   Good morning, did you sleep well?            Had a great night’s sleep.
   I didn’t. Been thinking about you all        I can do all things through Christ who strengthens
    night.                                        me (Phil. 4:13).


   So what’s your plans for today?              Going fast walking this morning.
   Got a surprise for you….                     Wow, struggling on my last round of my 2nd mile.
                                                  75 degree temperature @ 7:00 a.m., yikes, the
                                                  heat. Walking funny, man my head ...


                                                 Got to listen to my body, got to go home and rest.
   Hey, I’m b-a-c-k.                            I thought you were gone?


   Oh, who you talkin’ to?                      “Hey lady, I just c-c-came from the c-ca-ca store”.


   Let’s cook.                                  Ouch! I forgot to use the pot holder to take out the
                                                  hot food out of the oven again.


   I’m your stunt double today.                 I didn’t know that there was an art to falling.


   Hey, while your relaxing, let me thrill      What the heck? Feels like I’m short circuiting all
    you. How about some electrical shocks?        through my body.


   Remember me , Paralysis?                     Woke up this morning , where is my arm?
What I have learned thus far:
   Though Neurologist are specialist, I have learned that there are
    specialist in that field as well. My Neurologist is an MS Neurologist.
    I strongly urge you to seek out one in your area.
   I have learned not to get overwhelmed, but to get informed (my
    advice to the newly diagnosed).
   Get connected: Find a good support group in your area. Join the MS
    Society’s blog where you can get encouragement, answers to your
    questions, share a new way of eating, or inquiries on a drug, an
    exercise program and of course the jokes, got to love the jokes. I
    am sure there are other sites out there as well.
   I have learned that MS has many faces. It does not discriminate.
    And it comes around when you least expect it. I had no idea how
    many people were affected with MS.
   Something that I’d like to stress is that one should rule out any
    ailment or sickness before assuming it is MS related.
   I manage MS, it does not manage me.
!
                    ~ UNDERSTAND ~ (A Poem)

    If you don’t understand MS, could you just trust me?

    If you don’t “get it", can you just love me?

    If you can’t see what I’m going through, can you just believe me?

    If you can’t understand my pain, can you just comfort me?

    If you can’t find a way to fix it,

    Can you find an ear to lend?

    If you don’t know why this happened, Can you help my spirit mend?

    I love you for trying,

    Don’t ever forget.

    The effort you’ve put forth,

    Please don’t regret.

    I have this disease And I have confusion.

    Just don’t ever think MS is some illusion.

    Can you love me anyway?

    Can you be my friend? You may never understand it, But MS is a
    part of me in the end.

    ~By Tammy Malkowski, 7/26/10
Resources♣
nationalMSsociety.org
www.nationalmssociety.
org/about-multiple-
sclerosis/what-we-know-
about-ms/who-gets-
ms/genetics/index.aspx


www.nytimes.com/2008
/03/04/health/04brod.ht
ml
www.health.com/health/
library/mdp/0,,
zm6056,00.html
www.acthar.com
Wikipedia

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MS FACTS

  • 1. MULTIPLE SCLEROSIS By: Maria Love 06/2011 ~ Thank you Amaray for all of your help ~
  • 3. Genetics of MS  “The genes a person inherits help determine whether that person is at increased risk for developing MS. MS does not follow the traditional gene inheritance patterns of autosomal dominant and recessive or sex linked. While there is evidence from studies that this genetic component exists, it appears to be only one factor among several that determine who gets MS. Most likely, an individual’s genetic blueprint ultimately determines if that individual will be susceptible to a triggering factor in the environment, which in turn initiates the autoimmune process that leads to the development of MS.”  http://www.nationalmssociety.org/about-multiple-sclerosis/what- we-know-about-ms/who-gets-ms/genetics/index.aspx
  • 4. Physical Manifestation  BRAIN LESIONS  http://www.health.com/health/library/mdp/0,, zm6056,00.html  STRIPING OF MYLIN SHEETH  Being that MS is a type of autoimmune disease , the body attacks the Mylin Sheeth (protective coating of the nerve) or its own body. health.howstuffworks  MS exacerbation is caused by inflammation in the central nervous system. The inflammation damages the myelin sheeth (white, fatty substance that covers and protects a part of the nerve cells) and delays or short circuits transmission of nerve signals which causes the symptoms of MS.
  • 5. Symptoms MS exacerbation or Relapse is a sudden worsening of 1 or more MS symptoms or the appearance of new symptoms. Depression can be a direct result of MS damage within the brain. Motor System Symptoms:  Muscle weakness, Mild paralysis  Spasticity or stiffness  Slurred speech  Involuntary contraction Sensory System Symptoms:  Tingling sensation, Partial numbness  Feeling excruciating pain without a cause  Feeling electric shocks in head or throughout the body  Affects the sense of touch  Cognitive issues ~ Which becomes delayed due to loss of the Myelin Sheeth in the brain  Heat sensitivity Coordination/balance issues:  Vertigo  Loss of coordination  Shaking while performing precision actions
  • 6. Diagnosis They must find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves. Referred to as White Matter or Lesions in the brain. Doctor’s (Neurologist) look for these signs:  The physician also performs a variety of tests to evaluate mental, emotional and language functions, movement and coordination, balance, vision, and the other four senses.  MRI is the best imaging technology for detecting the presence of MS plaques or scarring (also called lesions) or (multiple scars) in different parts of the CNS.  Evoked potential (EP) tests are recordings of the nervous system's electrical response to the stimulation of specific sensory pathways (e.g., visual, auditory, general sensory).  Analysis of the cerebrospinal fluid, which is sampled by a spinal tap, detects the levels of certain immune system proteins and the presence of oligoclonal bands.  While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including Lyme disease, a group of diseases known as collagen-vascular diseases, certain rare hereditary disorders, and AIDS.
  • 7. Frequency & History of MS  The number of cases of Multiple Sclerosis range between 2 to 150 in one thousand people  Onset/symptoms begin in young adults  MS occurs predominantly in women  Jean-Martin Charcot first described MS in 1868 How many people have MS?  Approximately 400,000 Americans have MS, and every week about 200 people are diagnosed. World-wide, MS affects about 2.5 million people. Because the Centers for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, and because symptoms can be completely invisible, the numbers can only be estimated.  MS affects every ethnic group but is more common in Caucasians of northern European ancestry.
  • 8. Varieties of MS There are (3) three types of MS: (1)Relapsing-Remitting MS (RRMS) - The most common disease course, a person experiences attacks (also called relapses or exacerbations) of worsening neurologic functioning followed by periods of remission in which partial or complete recovery occurs. This type people say, “ But you look so good”. (2)Secondary Progressive MS (SPMS) – While technically a form of progressive MS, this type acts more like a relapsing form of MS in its early-to-mid stage with relapses and remissions being quite common. (3)Progressive MS (PRMS) – This type shows no relapses, but over a period of years, there is gradual loss of physical cognitive functions.
  • 9. Treatment/Therapy Can MS be cured?  Not yet. There are now FDA-approved medications that have been shown to "modify" or slow down the underlying course of MS. In addition, many therapeutic and technological advances are helping people manage symptoms. Advances in treating and understanding MS are made every year, and progress in research to find a cure is very encouraging. Types of Medications: Immunomodulating Medications (injection therapy) *Avonex - $3,526.59 - Once a week injection intramuscular (into the muscle) *Betaseron -$4,129.69 - Every other day injection subcutaneous (under the skin) *Copaxone -$4,345.29 - Every day injection subcutaneous (under the skin) *Rebif -$3,180.19 - Three times a week injection subcutaneous (under the skin) Tysabri - Every four weeks by IV infusion Immunosuppressant drug Novantrone – Four times a year by IV infusion * Monthly cost of medications without insurance per Walgreens
  • 10. A Sample day with Multiple Sclerosis (MS) for me, it is RRMS  Good morning, did you sleep well?  Had a great night’s sleep.  I didn’t. Been thinking about you all  I can do all things through Christ who strengthens night. me (Phil. 4:13).  So what’s your plans for today?  Going fast walking this morning.  Got a surprise for you….  Wow, struggling on my last round of my 2nd mile. 75 degree temperature @ 7:00 a.m., yikes, the heat. Walking funny, man my head ...  Got to listen to my body, got to go home and rest.  Hey, I’m b-a-c-k.  I thought you were gone?  Oh, who you talkin’ to?  “Hey lady, I just c-c-came from the c-ca-ca store”.  Let’s cook.  Ouch! I forgot to use the pot holder to take out the hot food out of the oven again.  I’m your stunt double today.  I didn’t know that there was an art to falling.  Hey, while your relaxing, let me thrill  What the heck? Feels like I’m short circuiting all you. How about some electrical shocks? through my body.  Remember me , Paralysis?  Woke up this morning , where is my arm?
  • 11. What I have learned thus far:  Though Neurologist are specialist, I have learned that there are specialist in that field as well. My Neurologist is an MS Neurologist. I strongly urge you to seek out one in your area.  I have learned not to get overwhelmed, but to get informed (my advice to the newly diagnosed).  Get connected: Find a good support group in your area. Join the MS Society’s blog where you can get encouragement, answers to your questions, share a new way of eating, or inquiries on a drug, an exercise program and of course the jokes, got to love the jokes. I am sure there are other sites out there as well.  I have learned that MS has many faces. It does not discriminate. And it comes around when you least expect it. I had no idea how many people were affected with MS.  Something that I’d like to stress is that one should rule out any ailment or sickness before assuming it is MS related.  I manage MS, it does not manage me.
  • 12. ! ~ UNDERSTAND ~ (A Poem) If you don’t understand MS, could you just trust me? If you don’t “get it", can you just love me? If you can’t see what I’m going through, can you just believe me? If you can’t understand my pain, can you just comfort me? If you can’t find a way to fix it, Can you find an ear to lend? If you don’t know why this happened, Can you help my spirit mend? I love you for trying, Don’t ever forget. The effort you’ve put forth, Please don’t regret. I have this disease And I have confusion. Just don’t ever think MS is some illusion. Can you love me anyway? Can you be my friend? You may never understand it, But MS is a part of me in the end. ~By Tammy Malkowski, 7/26/10