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Bedside Thoughts

Blog Summary

I write this from my wife’s bedside in an acute respiratory rehabilitation unit in a South Florida hospital. We are beginning our 7th week of hospitalization. You may ask yourself, “What does the journey of this couple have to do with MS?” The answer is: everything.

The purpose of this blog is more than a source of therapy for a spouse caregiver and greater than the need to rant about the inequities of life. The sole purpose of this article is to shine a very bright light on the difference between MS-related fatigue that may accompany an exacerbation and the ever so subtle presence of coronary disease and how it may present itself in women...

How becoming a patient made me a better physician

Blog Summary

The year I finished my residency in obstetrics and gynecology and began to practice medicine, life was intense, fast-paced and very exciting. The odd feelings of numbness and pain in my back and legs just seemed to be something that came with the long wakeful nights and hard working days. I did not take the time to seek medical care myself because I was too busy and besides, I thought to myself, I was working through it, wasn’t I? Once I had time I would attend to myself. For now I had night call, babies to deliver, surgeries to perform and books to study. I knew my symptoms were strange and hard to understand. I would probably be told they were stress-related and that things would just get better or that they simply did not know what was wrong. That had happened years before when I had first felt the numbness in my legs.

Dragged to the curb

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When it got dragged to the curb, my good friend and neighbor Michelle, walked across the street and remarked, “Aren’t you embarrassed that everyone will know you have furniture like that in your house?”  We burst out laughing as my favorite recliner was now perched upon a frozen snow bank, full of stains, the wood frame showing through the rips of upholstery that Flash, our cat, created. The replacement was delivered, it was the perfect color, updated style and it swiveled. It was this feature that landed me in rehab with a broken leg. Getting there was more painful than the break...

The Unspeakable Bits from a Life with MS: Conspiracy Theories

Blog Summary

In the profit-driven, 24/7 news cycle of a world in which we live, it’s amazing the number of outrageous theories about multiple sclerosis one hears. I believe that the internet has become the most powerful tool people living with MS have at our disposal. The access it allows us to previously hard to find research, historical data and others living with the disease around the globe is an informed patient’s dream. To paraphrase Newton’s Third Law of Motion, however: For every action there is an equal and opposite reaction...

Flu shots

Blog Summary

I got my annual flu shot the other day. It was relatively painless, and I always feel better once that task is checked off my to-do list.   But each time I fill out the paperwork (or, in this case, the questionnaire on the registration kiosk at my pharmacy) to get the influenza vaccine, I pause at one question: “Do you have cancer, leukemia, AIDS, or any other immune-system problem?”  

Shared Decision Making

Blog Summary

Do you and your health care team employ a shared decision making process?   Shared decision making (SDM) is a process in which clinicians and patients work together to select tests, treatment and disease management based on clinical evidence and the values and preferences of the patient. I learned a great deal today during a teaching course at ECTRIMS 2013, entitled “Shared Decision Making for Multiple Sclerosis Treatment.”   I am a huge fan of a shared decision making approach. Besides the simple fact that it results in more dignity for the patient, I believe it is crucial to increasing adherence.  When people are prescribed treatments that they don’t want (either because they think they don’t need them or are afraid of some of the side effects), there is a very good chance that they will not use the medications correctly – or at all.

What else ails you?

Blog Summary

I write for a living, so I really value the full use of my fingers for typing and for scribbling notes during interviews. When I was diagnosed with multiple sclerosis more than a dozen years ago, one of the things I worried about most was that I might develop spasticity in my hands, making it hard or even impossible for me to type and write. That, thank goodness, hasn’t happened, at least not yet.

Death from ‘Complications’ of Multiple Sclerosis: The Unspeakable Bits from a Life With MS

Blog Summary

When we first started writing the “Unspeakable Bits” blog, I resolved not to candy-coat the difficult parts of living with multiple sclerosis. I’d always intended to open the conversation about end-of-life and MS. I decided to broach the subject now, in the wake of the recent passing of our fellow “MSketeer,” Annette Funicello. Social media sites erupted with kind words and remembrances of the actress. Soon, however, confusion began to set in as Disney’s press release attributed her death to “complications from multiple sclerosis.”  When a Canadian television video of her last days was broadcast as a remembrance, confusion became fear and concern.

Empathy

Blog Summary

“I feel pain when I see young people in wheelchairs.” This statement appeared on an empathy test given to medical students, the Balanced Emotional Empathy Scale (BEES), presented at a Medicine and Writing conference I attended last year. The test-taker was to assign each statement with a number on a scale from +4 (highly agree) to -4 (highly disagree). This was presented as a reliable assessment of empathy. I wrote -4 next to the statement. I do not feel pain when I see young people in wheelchairs. Nor do I feel pain when I see one using a cane or a walker/rollator.  I feel a sense of kinship, compassion, respect; I have been using a cane off and on since my mid-20s, and I know how helpful it can be. I know wheelchairs aren’t objects to which people are bound; they offer freedom when legs won’t carry people where they need to go.

Don’t ignore the rest

Blog Summary

When my husband, Khoren — who has secondary-progressive MS — complained of excruciating pain down both arms and something that felt like a toothache, he took some ibuprofen. Just when we started to become familiar with his usual MS-related aches and pains, a new symptom seemed to be coming on to the scene. Great. I didn’t want to make a big deal of it, but I’d never seen that look of distress on his face before. When he sat up in bed, it gave him some relief, but that strategy soon stopped working. He took a muscle relaxer and another drug for nerve pain that he typically skipped. He decided to head out to the living room so one of us could sleep. I told him I’d turn our noise machine off in the bedroom so I could hear if something went wrong. As it turns out, that was the smartest fluke of a decision I’d ever made in my life.

Planning for the Long Term: Taking Action Today

Blog Summary

I was diagnosed with primary-progressive multiple sclerosis in 1997. "Progressive" means that the disease, well, progresses. I am now functionally quadriplegic, having only partial use of one arm. To write this I am using speech-to-text software on my iPad. I also use my iPad to control the lights, heat, music and door locks in my house. I have been a wheelchair user for 12 years. I am unable to perform any of the activities of daily living (for instance washing, dressing, toileting, eating, etc.) and am completely dependent on home aides to help me with everything. Yet I continue to live alone in my own house.