Hello and thanks for joining us. We’ll be kicking off the chat in just a few minutes, but if you have a question, you can go ahead and get it in queue.
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So glad to have you with us, Stephanie!
Hello everyone! It's a pleasure to be here, and I look forward to our discussion!
Also joining us is Michelle Cameron, MD, PT. Dr. Cameron is a neurologist and physical therapist specializing in MS. She is an assistant professor in the Department of Neurology at Oregon Health & Science University and is a staff neurologist at the VA Portland Health Care System. Dr. Cameron is one of the foremost researchers on balance and falls in people with MS. She teaches courses on mobility and rehabilitation in MS to providers around the world.
Please note that the views expressed in this chat are those of the individual experts and do not represent those of their employers – OHSU, the VA Portland Health Care System, or any other organization.
Welcome, Dr. Cameron!
A pleasure to be here with you.
Let’s start with some questions from readers.
Unfortunately there is not test for MS. However, if you are concerned that you are at high genetic risk, we do know that those living a healthy lifestyle with a healthy diet and not smoking, and with adequate vitamin D levels, seem to be less likely to develop MS.
If you are feeling unsteady on your feet at times I would recommend asking your doctor for a physical therapy referral. A physical therapist can watch you walk, work on your balance, and if needed they can tell you what kind of assistive device you should use. Being proactive now will hopefully help to improve your balance, and prevent you from falling at home in the future!
MS lesions enhance when they formed recently. So you can have MS with or without enhancing lesions. However, without enhancing lesions it is less likely that new symptoms are due to MS.
During pregnancy women with MS have up to a 70% reduced risk for having a relapse, especially during the second and third trimester. However, after giving birth the risk of having a relapse is increased by 20-40%. Therefore it is very important to involve your neurologist in your care during pregnancy and immediately after giving birth.
RE: your medications. It can take a few months for any of the MS disease modifying medications to work but we generally don’t recommend taking two medications together. This doesn’t seem to help people any more and can result in more side effects.
Overheating can cause your MS symptoms to worsen temporarily, so it is very important to keep well hydrated and to stay cool when it is hot and humid outside. Many people find that using cooling devices like vests and towels work well, and carrying ice water with you is also a great strategy for staying cool. If at all possible try to avoid going outside during the hottest points in the day, and plan your activities for the mornings or evenings when it is a bit cooler.
Diane, CIDP is not a form of MS. CIDP affects your peripheral nerves, MS affects your central nerves. I suggest you discuss this more with your doctor.
Stretching exercises can definitely be helpful for spasticity. A physical therapist can help identify what groups of muscles are affected, create a tailored stretching and exercise routine, and show you one-on-one how to safely perform that routine. If you haven’t already consulted a physical therapist, I recommend asking your neurologist for a referral.
Norma, I recommend you talk with your doctor about this. For some patients with MS it can be OK not to be taking MS meds because they don’t work for all types of MS, but doctors don’t completely agree about which patients won’t benefit from MS meds.
Eye twitching, or blepharospasm, is a spasm of the muscles around the eye and can definitely be caused by MS. There are medications and other interventions available to stop the twitching, so I would recommend contacting your neurologist to discuss your options.
It is possible to have MS with a negative spinal tap, although this is rare. I suggest you be checked out for other possible causes of your symptoms before anyone decides you have MS. MRI of your brain and spine may help clear this up.
Judy, I suggest that you get evaluated by a neuropsychologist. This will help you best understand both your strengths and possible weaknesses which should help you decide if you should keep teaching. This will also give you a baseline to compare to in the future and could help you get disability if needed.
In relapsing-remitting MS (RRMS) there are times when you will have new or worsening symptoms, known as relapses, followed by periods where things are relatively stable. People with RRMS will still have symptoms between relapses because of damage done during MS attack, which can be confusing at times. This is why it is important to report any new or worsening symptoms to your neurologist so that they can decide if you are having a relapse or not. In contrast people with Progressive MS have steady worsening, or progression, of their symptoms despite treatment and without any periods of remission.
Many people are working on remyelination therapies for MS. Some of these potential therapies are in human studies already so we’re very hopeful that at least one of them will work.
Although MS does not go away or disappear it can vary a lot between individuals. Some people have many relapses and other people may go years, or even decades, between relapses.
All stem cell therapies for MS are still experimental, and there are lots of different versions of stem cell therapy. We really don’t yet know for sure which are effective and safe. I suggest you talk with your neurologist about this.
As of now no studies have demonstrated that specific foods help with MS. However, we do know that eating a heart healthy diet can improve some symptoms such as fatigue, and will keep your body healthy by preventing other health conditions such as diabetes and heart disease. You could also speak to your doctor about adding supplements to your diet. Many people with MS are deficient in Vitamin D, and recently a study demonstrated that Biotin may also be beneficial for people with MS.
Yes, in people with MS, weakness and fatigue can get progressively worse without new lesions on MRI. This usually happens with progressive MS but can also be caused by deconditioning.