Raise your hand if you've fallen. I bet you didn't have to think long to come up with that answer. Most of us cannot remember what we ate for dinner yesterday without thinking about it a little while, but, boy, those falls are permanently imprinted on our memory and often come to mind at unexpected moments like other embarrassing situations that we have endured.
Most MS symptoms can be covered up. Bladder accidents can usually be hidden. If you have problems with your speech, you can simply participate in conversation with one-word answers. People with tremor often keep their hands clasped when not using them. However, a fall is public and obvious. And humiliating. If it happens when one is alone, it can be scary.
Falls separate us from "healthy" people in a very literal way. We are completely alone in that moment when we hit the floor, no matter who we were standing with seconds before. As we struggle to get up, our first instinct is to reassure everyone, including ourselves, that the fall was "no big deal," that we are "just fine."
However, often we are not "just fine." Among adults with MS who experience difficulty walking, 60% report that they have fallen. These are usually not isolated incidents, either – typically those who have experienced falls report having fallen about three times in the prior six months. Beyond psychological and emotional impact of falls, there is a very real physical danger, as one-third of the people who report falling say that a fall resulted in an injury.
This data comes out of a study presented at ECTRIMS 2011 by Dr. Nicolas LaRocca, Vice President for Health Care Delivery and Policy Research at the National MS Society. The survey, entitled, "The Frequency and Impact of Walking Impairment in MS," shines a light on a subject that often gets overlooked by researchers and docs, and often goes unmentioned by patients. In fact, although the majority of people with MS report difficulty walking or maintaining balance, 40% of people discuss this symptom with their doctor "rarely" or "never."
According to the survey findings, younger people with MS are less likely to bring up their walking difficulties with their doctor - on average, people with MS aged 41 or younger who do discuss trouble walking with their doctor initiate the conversation only 46% of the time, compared to 54% of people who are 61 or over.
As a person living with MS myself, I can imagine some of the reasons for this. Maybe people are afraid that their docs will immediately decree that they need an assistive device, when the patient may not be ready for such a move. Perhaps there are other symptoms that are bothering them more at the moment. Maybe they are waiting for the doctor to start this difficult conversation or perhaps they are too intimidated to bring it up.
However, it is important to discuss walking or balance issues with your doc, especially if you have fallen or afraid that you might. There are many things that can be done to address these difficulties. As Dr. LaRocca stated in his presentation, "The basic activities that constitute life are seriously disrupted by difficulties walking." If there is a way to reduce unnecessary stress and challenges around this symptom, we owe it to ourselves to look into our options.