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Here are four memories from 1990 and 1991. 1. I was having trouble urinating. I just couldn’t get started. I’d feel like I had to go but nothing would come out. Another problem was I’d urinate and 5 minutes later I wanted to go again. 2. One weekend in the summer of 1990 the whole right side of my face went numb for two days. Then the numbness went away as fast as it came. 3. In softball, when a fly ball was hit to me the ball would disappear for about 4 seconds as I looked up into the sky. It would just disappear! Then it would reappear in time for me to catch it. 4. I also remember hating heat in the summer, hot tubs and saunas. My skin would start crawling. I remember saying to myself, “all these problems can’t be connected, can they?”
Well…I found out they can be connected! A person with Multiple Sclerosis can suffer almost any neurological symptom including loss of sensitivity, tingling, numbness, muscle weakness, clonus, muscle spasms or difficulty in moving.
There are also difficulties with coordination, balance, problems in speech, swallowing, visual problems, fatigue, acute or chronic pain, bladder and bowel difficulties. Cognitive impairment of varying degrees, depression and mood swings are also common.
When I finally went in to see a neurologist in 1991 I was unsure what the heck was wrong with me. I had eyesight problems, numbness and tingling all over my body, I was having trouble urinating, I wasn’t sleeping too well, I had a slight limp and a myriad of other little problems happening to my body. What could be wrong with me, I asked? It had taken me a year to get in to see an eye doctor and it would be another 3-6 months before I finally had the diagnosis I was looking for.
Believe it or not by the end I was actually relieved that I had MS! I didn’t know what course it would take but at least I had a name for all my symptoms. I also knew that I didn’t have a stroke, cancer, ALS or any other kind of major problem. I had been on a roller coaster ride for over a year wondering what was wrong but now I knew!
Uhthoff’s phenomenon is the worsening of neurologic symptoms in multiple sclerosis (MS) and other neurological and demyelinating conditions. When the body gets overheated from hot weather, exercise, fever, saunas and hot tubs can lead to problems. Lhermitte’s sign is an electrical sensation that runs down the back when bending the neck and is are particularly characteristic of MS although not specific.
The main clinical measure of disability progression and symptom severity is the Expanded Disability Status Scale or EDSS. Symptoms of MS usually appear in episodic acute periods of worsening called relapses, exacerbations, bouts, attacks or “flare-ups”. In a gradually progressive deterioration of neurologic function or in a combination of both. Multiple sclerosis relapses are often unpredictable, occurring without warning and without obvious inciting factors with a rate rarely above one and a half per year.
Some attacks however are preceded by common triggers. Relapses occur more frequently during spring and summer. Viral infections such as the common cold, influenza, or gastroenteritis increase the risk of relapse. Stress may also trigger an attack. Pregnancy affects the susceptibility to relapse with a lower relapse rate at each trimester of gestation. During the first few months after delivery however the risk of relapse is increased. Overall, pregnancy does not seem to influence long-term disability. Many potential triggers have been examined and found not to influence MS relapse rates. There is no evidence that vaccination, breast feeding, physical traumaor Uhthoff’s phenomenon are relapse triggers.
Most likely MS occurs as a result of some combination of genetic, environmental and infectious factors, and possibly other factors like vascular problems.
Severe stress may be a risk factor although evidence is weak. Smoking has also been shown to be an independent risk factor for developing MS. Association with occupational exposures and toxins—mainly solvents—has been evaluated but no clear conclusions have been reached.
Vaccinations were investigated as causal factors for the disease however most studies show no association between MS and vaccines. Several other possible risk factors such as diet and hormone intake have been investigated. The evidence on their relation with the disease is “sparse and unpersuasive”.
Gout occurs less than would statistically be expected in people with MS and low levels of uric acid have been found in people with MS as compared to normal individuals. This led to the theory that uric acid protects against MS, although its exact importance remains unknown.