Wednesday, December 10, 2014

Multiple Sclerosis Without Evidence of Demyelination?

People who are in the process of being tested for multiple sclerosis often have many questions. Some of the most common questions surround the subjects of MRIs and lesions. Magnetic Resonance Imaging (MRI) is a powerful tool used to help diagnosis MS as well as measure disease progression. Lesions are the scars caused by demyelination which can be detected by MRI scan.

There have been many occasions where people in the process of being diagnosed with MS ask whether it is possible to have MS and not have brain lesions. The short answer is an unequivocal YES.

When I first experienced blinding optic neuritis in 2000, the neurologist ordered MRI scans of my brain. The results showed inflammation of the optic nerve, but no detectable lesions in the brain. Thus I was not diagnosed with MS at that time.

Five years later, when I was undergoing MRI testing of both my brain and cervical spine, lesions were seen in my neck. But my brain was still clear from lesions or atrophy. We only had to wait a few months until additional lesions showed up in my cervical spine and an official diagnosis was made.

Eventually the smaller lesions in my spine grew together to form one large lesion that spanned from the C4 to C6 vertebras. At the time I switched from my original disease-modifying therapy (Copaxone) to a totally different treatment approach (off-label Rituxan), I was hoping to avoid developing even larger lesions in my spine as I was definitely experiencing increased symptoms and relapses.

After I had been on Rituxan for a year, my MRI report indicated stability in lesion load, meaning that I had not developed any new or larger lesions. Follow-up scans two years later were stable, without evidence of new or worsening lesions, once again.

Another two years have past and I’ve just recently undergone MRI exam to determine two things: 1) How is my MS is doing? and 2) Is my current treatment continuing to be effective? What follows are the radiologist’s reports following the recent MRIs.

Read this post in its entirety:
Living with MS: No Evidence of Demyelination

Tuesday, December 9, 2014

Winter Survival Tips

Surviving winter is about more than keeping warm taking extra pain medication with you live with RA, it is about being proactive and keeping ahead of the dangers and/or negative effects of winter.

Gloves vs. mittens. 
Avoid gloves that are too tight as they can restrict blood circulation and aggrevate Raynaud’s syndrome. Consider wearing mittens instead. Mittens allow your fingers to warm each other and provide extra room in which you can insert disposable “hand warmers” to keep arthritis joints warm and toasty.

Too easily, people can become less active during the winter months; however, immobility works against RA. Muscles contribute to the strength and stability of joints and need regular activity to stay healthy. Stretching and gentle range of motion exercises are essential. Exercise can decrease RA pain by keeping joints and cartilage healthy, while also helping to reduce symptoms of depression which are common during the winter months.

Heated pools are good.

Clear snow and ice.
To prevent frost from forming on your car’s windows, spritz the outer surface of the window with a mixture of 3 parts vinegar and 1 part water once you are done with errands for the day. To make snow shoveling easier, spray your shovel with aerosol cooking spray beforehand to help the snow glide right off.

Stay safe.
Wet conditions of winter can be treacherous and we want to avoid falling to reduce the risk of injury. Wear sturdy, supportive shoes with good tread (sometimes tennis shoes are the worse shoes to wear on slippery surfaces) and try to avoid walking on ice. You may be better off walking through fresh snow, providing natural traction. Also, ask your doctor about obtaining a ‘handicapped’ parking permit to allow you to park closer to your destination and consider using a mobility aid such as a walking cane for the added stability.

Rest up and relax.

Hydrate and moisturize.
Drink plenty of water to keep your body hydrated from the inside out. Protect your skin by keeping it moisturized. As a musician, it is important that I keep my lips, part of my playing instrument, soft and supple by locking in moisture. I like to use plain vaseline or A+D® Original Ointment as Chapstick makes my lips feel dry.

Avoid getting sick.

Take medication as prescribed.

Have fun and watch for longer days to come.

Read this post in its entirety:
Surviving Winter with RA