Husband DX'd today w/MS, but hasn't shown symptoms

[zahra]

Hello,

My husband had his first migraine back in May and another in October. The first migraine was mild, but the 2nd involved visual impairment, confusion and dementia. I take this as fairly common with migraines.

Due to my husband's medical history, his brother was DX's with MS around the age of 38, the doc sent him to an epilepsy center. First of all, why refer him to an epilepsy center when MS is already in question, but oh well at this point. They did an EEG, MRI and Spinal Tap. The EEG was normal, MRI showed 2 small spots and Spinal Tap showed a few O rings.

We don't think he has had any symptoms. Sometimes his feet go numb, or feel like they fall asleep. He says it does not happen often at all. He says one of his hands tingles occasionally, but its where he cut himself with a knife while cooking and thinks its from that.

Is there medication he can take now to stave off the effects of MS? Especially if he follows the MS diet, continues to exercise and starts to strengthen his muscles? What if he starts brain exercises like the Luminosity site?

Thanks for listening and if you share.

[Jules A]

Hi and welcome,
The migraine symptoms you describe are not unheard of but unusual could be MS symptoms and the paresthesia is very common in MS.

It does sound like he has had MS symptoms which combined with the MRI and LP would likely equal a MS diagnosis, especially with a family history. He is fortunate to have been diagnosed quickly as some people go on for years without a diagnosis and the option to start treatment.

I'm sorry that you have to be here but glad you found us. Thankfully there are many medication options now for people with MS. Check out the National MS Society for information. Best wishes as you embark on this journey.

http://www.nationalmssociety.org/Tre...MS/Medications

[Marco]

Hi Zahra,
Welcome to MSWorld! Hopefully, you will get a lot of great answers. As a "caregiver" of a MS patient, you may be treated like a VIP around here. We love people that love people like us. My long wind up and long-winded answers are below:

When diagnosing MS, the doctor's should review your husband's medical history, perform blood tests, MRI, and other diagnostics to rule out other diseases, and then compare the remaining results to the McDonald criteria. Unfortunately, every MS symptom can be caused by one or more other ailments. His foot going numb is a potential sign of MS. His hand tingling is a potential sign of MS.

Depending on who you talk to, the MS diagnosis has a number of potential stages:

• Radiological Isolated Syndrome (RIS) is where diagnostics show MS, but there are no symptoms, or documented flare ups.
• Clinically Isolated Syndrome (CIS) is where there is a documented flare up, but insufficient diagnostic evidence to diagnose MS.
• Clinically Definite MS (CDMS) is where there is sufficient diagnostic evidence to confirm MS, according to the 2010 McDonald Criteria (Revised)

If your husband has not been officially diagnosed, they are lacking evidence, but he would probably fall in the CIS category. Other terms used for this category could be probable or possible MS. The numbers of possible terms are superfluous, and they simply mean your husband may have MS, and they will continue to evaluate him over time to see if he crosses over from possible to clinically definite MS. This could take the form of additional MRIs with new lesion activity, a flare up, a second spinal tap, etc.

A flare up is either new symptoms or the worsening of old symptoms,that last for at least 24 hours, and most be proceeded by 30 days of stability. A flare up may also be called an exacerbation, an attack, or a relapse. Examples of a possible relapse:

• Your husband having numbness in his left leg that he hasn't had before, it lasts 2 weeks.
• Your husband has intermittent foot numbness, but now it's 24/7 and lasts 3 days.
• Your husband wakes up with crushing fatigue and it lasts for several days.

Before being diagnosed, minor flare ups may be easy to overlook. You wake up and your foot seems to be numb. You notice it, but don't want to go to the doctor. You say, if Monday the problem still exists you'll go to the doctor. The problem goes away Sunday and you forget about it. In addition to flare ups, MS patients may experience a psuedo-flare. A psuedo-flare is often caused by a specific trigger, but once the trigger is removed the symptoms begin to subside. Examples of triggers would include: overheating, being fatigued, stressed or infection. For example: your husband is running a fever, and his foot goes numb. Once the fever breaks the foot wakes back up.

Once confronted with the possible diagnosis of MS, both patient and loved ones will often start the grieving process. The 5-stages of grief are: denial and isolation, anger, bargaining, depression and acceptance. A good counselor or minister can help you navigate this process. During this often prolonged process, you will need to extend extra grace to one another.

Is there medication he can take now to stave off the effects of MS?
The National Multiple Sclerosis Society (NMSS) recommends patients in the CIS category start a MS drug. MS drugs are often called disease modifying therapies/agent, but may be called any number of terms. These medications are believed to reduce the chance of new lesion development, calm any disease activity, and potentially delay, or even prevent, the full onset of MS. Additional medication information can be found here: http://www.msworld.org/forum/showthread.php?t=129748. In addition to a medication that attempts to modify the disease course, MS symptoms are treated by medications indicated for specific symptoms.

Potentially even more important than MS medications is your husband's Vitamin D level. Researchers are still trying to determine exactly how Vitamin D wards off MS, but many MS patients are deficient in Vitamin D. Under the direction of a physician, your husband should supplement Vitamin D to maintain a normal level. Too much Vitamin D can be toxic, but a normal range should be maintained.

Especially if he follows the MS diet, continues to exercise and starts to strengthen his muscles?
There are no diets scientifically proven to delay the onset or progression of MS. Many doctors simply suggest you follow the American Heart Association Diet. There will be many others that swear by a specific diet or supplement regimen, but most have no scientific evidence to support these claims. Instead of going off the deep end, I would strive to simply be healthier.
Exercise programs are great for both the body and mind. This will also help him maintain a healthy stress level. Exercise programs should be tailored to build endurance rather than bulk muscle. Stretching is also important to maintain flexibility and combat spasticity. While these items may not directly impact the disease; healthier bodies are better suited to deal with symptoms and flare ups.
What if he starts brain exercises like the Luminosity site?
That's a great idea. Exercising the brain can delay, or offset, the cognitive challenges that many MS patients face. There are a number of free websites, applications and activities that could save you the monthly Luminosity fees. Even learning a new language is a wonderful way to engage the mind, but maybe in a more entertaining way.

Along the way, you may need the assistance of additional medical professionals. These may include psychologists, urologists, pain management, and a variety of therapists. When possible, I would encourage you to use these specialists to help you along the way. A physical therapist can help design a tailored exercise program for your husband. An occupational therapist can help him develop strategies to conserve energy, or help him with activities of daily living. They can also visit your home and make recommendations to remove safety hazards or help him more efficiently live in the space. A speech therapist can help develop a plan to help with speech related issues, or memory related issues. Too often, MS patients do not maximize the use of these professionals that can help them live a more successful life.

Please feel free to ask any follow up questions. Again, I would like to welcome you to MSWorld, and I wish you and your husband well!

[22cyclist]

It sounds like your husband meets the McDonald Criteria for diagnosing MS. One of the thing required is 2 or more lesions in the brain or spinal cord, which he has. The other is 5 or more O-banding that is only in the spinal cord, not in the blood. So that along with your husbands symptoms: tingling hand off and on; numb legs, all point to a definite diagnosis of MS not CIS. Either way he can stat treatment, just with more options than if he just had CIS.

It is always a shock to get diagnosed both for the patient and the family. The more you read about it, the more informed you are, the less scary it becomes.

Take care
Lisa

[zahra]

Thank you

I want to thank you all for your kind responses and sharing of information.