Laurie Diangson, RN, MSCN
 "Importance of Early Diagnosis and
staying on track with treatments"
December 14, 2006

DeanOP:  The topic will be "Importance of Early Diagnosis and staying on track with treatments" I expect our guest to type for 20 mins or so and then a Q&A for as long as we can until 9 pm

DeanOP: Tonight we are using Protocol. Please type a ? or ! to ask a question or make a comment. When the presentation is over you will be called on in order.

Our Guest tonight is Laurie Diangson, RN, MSCN

Laurie Diangson is a Multiple Sclerosis Certified Nurse. She began her nursing career at UCLA Medical Center and has worked in surgical, post anesthesia recovery, outpatient surgery and intravenous homecare nursing.

She is currently part of the MS clinic at the University of California, Irvine where she established an infusion therapy center with Dr. Stanley van den Noort eleven years ago. Laurie was diagnosed with Relapsing-Remitting MS in 1990 and has been on interferon therapy since 1993.

Laurie's passion is working as a patient advocate drawing from her knowledge in MS Nursing and her experience as a patient with Multiple Sclerosis. She especially enjoys providing education and support to newly diagnosed patients, their families and well partners.

Laurie has shared her expertise as a speaker at numerous programs throughout the United States as well as the 2005 Scientific Nurses Meeting in Europe.

Laurie serves as a member on the Betaseron Patient Advisory Board, Betaseron Peer Mentor Program and Volunteer with MS Friends. She is a member of California Nursing Association, International Organization of Multiple Sclerosis Nurses, and is currently the president of the Orange County Chapter of the American Association of Neuroscience Nurses.

Laurie will be telling us about the importance of early treatment and staying on course with therapy.

DeanOP: Laurie, the floor is all yours!

Laurie Diangson, RN, MSCN,
THANK YOU FOR INVITING ME TO YOUR CHAT! SINCE THIS IS MY 1ST TRUE CHAT, I APPRECIATE YOUR PATIENCE WITH ME IN ADVANCE!

I'M GOING TO TALK FOR A WHILE AND THEN TAKE QUESTIONS...

I WAS A NURSE FOR MANY YRS BEFORE MY MS DIAGNOSIS... AT THE TIME OF MY DIAGNOSIS I WAS DOING IV HOMECARE AND ALSO WORKED IN OUTPATIENT SURGERY...

I DIDN'T REALLY UNDERSTAND THE DISEASE EVEN THOUGH I CARED FOR PATIENTS WITH MS,IT WAS ONLY TO GIVE THEM IV STEROIDS BEFORE OR AFTER SURGERY.

MS WAS HARD TO COMPREHEND UNTIL I EXPERIENCED IT FOR MYSELF....

AND EVEN NOW, SOMETIMES I DON'T UNDERSTAND IT....

HOW DO YOU EXPLAIN THAT PHANTOM PAIN, TINGLING, NUMBNESS, LEGS WEIGHING 200#’S EACH OR "HOT SPOTS"?

HOW DO YOU EXPLAIN THE FEAR OF NOT KNOWING IF YOU'LL BE ABLE TO FEEL THE FLOOR WHEN YOU GET OUT OF BED TOMORROW MORNING, OR BE ABLE TO DRIVE AT NIGHT WITH BOTH EYES WORKING!

AND MOST OF ALL "HITTING THAT WALL WITH OVERSHELMING FATIGUE"!

AFTER MY 1ST IV STEROID TREATMENT AND BEING DISSATISFIED WITH THE CARE I RECEIVED....

THE NURSES NOT UNDERSTANDING MY SYMPTOMS AND BEING MORE CONCERNED WITH THE ONCOLOGY PATIENTS... I TOLD MY DR HE NEEDED TO HIRE ME TO DO THE IV'S IN THE MS CLINIC WHERE ALL THE PATIENTS HAD MS...

AND I COULD RELATE TO THEM.

2 YRS LATER HE DID....AND THIS IS MY 11TH YEAR.

5 YRS AGO MS BECAME A NURSING SPECIALTY AND I WAS CERTIFIED AS A MS NURSE

SO I'M HERE PRESENTING FROM THE PERSPECTIVE OF A NURSE/PATIENT

I'M TALKING TO YOU AS A MS NURSE.... AND WITH YOU AS A FELLOW MS PT!

MY TOPIC IS ABOUT THE BENEFIT OF STARTING TREATMENT SOON AFTER BEING DIAGNOSED AND THEN STAYING THE COURSE ONCE YOU'VE STARTED. HOPEFULLY MOST OF YOU ARE TAKING ONE OF THE ABCR'S IF APPROPRIATE.

THEY'RE ALL PROVEN TO BE EFFECTIVE IN SLOWING THE PROGRESSION OF THE DISEASE ALONG THIS LINE....

MOST MS PRESENTATIONS REFER TO WHAT IS CALLED: THE "NATURAL HISTORY OF MS"

THIS STATES THAT MS IS A PROGRESSIVE DISEASE. WE KNOW THAT MS IS ALWAYS THERE....

ALWAYS SMOLDERING,,,,BUT MAY NOT BE OBVIOUS.

DON'T WE WISH IT WAS NEVER OBVIOUS TO US OR ANYONE ELSE!!!!

THE FACT IS, THAT THE TERM RELAPSING/REMITTING....WHICH 85% OF MS PATIENTS HAVE, DOES NOT TRANSLATE TO WITH OR WITHOUT THE DISEASE.

WHEN YOU ARE IN THE "REMITTING" PHASE, THE DISEASE IS NOT GONE OR DORMANT YOU ARE REALLY JUST WITH OR WITHOUT SYMPTOMS.

THE DISEASE IS EVER PRESENT AND "COOKING"! REMISSION MY MEAN NO SYMPTOMS....BUT WE ARE NEVER WITHOUT THE DISEASE - I CAN'T STRESS THAT ENOUGH!!

THE NATURAL HISTORY OF MS IS BROKEN INTO 3 PHASES....THE 1ST IS THE PRE-CLINICAL PHASE
'THIS IS THE TIME WHEN YOU WEREN'T AWARE OF HAVING THE DISEASE ACTIVITY WAS "SILENT"

THIS IS THE TIME BEFORE THE EVENT THAT TOOK YOU TO THE DR FOR THE 1ST TIME.
IN THIS PHASE AN MRI MOST LIKELY WOULD HAVE SHOWN MS LESIONS OR PLAQUES....BUT YOU WEREN'T AWARE OF THEM...

THIS PHASE ENDS WHEN YOU GO TO THE DR WITH YOUR VERY 1ST SYMPTOM AND RECEIVE THE DIAGNOSIS OF MS

YOU ARE THEN IN THE RR OR CLINICAL PHASE, FOR ME... THAT PRECLINICAL PHASE WAS 18 YRS!

WHEN I WAS TAKING MY RN BOARDS IT WAS 2 DAYS OF WRITTEN EXAMS (TODAY... THE EXAM IS GIVEN BY A COMPUTER AND TAKES A FEW HRS)

YOU CAN IMAGINE THE STRESS AND SLEEPLESS NIGHTS LEADING UP TO THE EXAM.... THEN DRIVING 60 MILES EACH WAY ON DAY 1, AND BACK AGAIN ON DAY 2....

WELL, ON DAY 2....MY LEFT LEG BECAME TOTALLY NUMB AND WEAK.

IT LASTED FOR ABOUT 2 WEEKS. MY DOCTOR TOLD ME I HAD "HYSTERICAL PARALYSIS"

WELL...18 YRS LATER.... WHILE ON A FAMILY TRIP TO THE PHILLIPINES, I WENT ALMOST TOTALLY BLIND IN ONE EYE OVER A 24 HR PERIOD WITH UNBELIEVABLE FATIGUE...

I COULDN'T STAY AWAKE FOR THE LIFE OF ME. THE DR'S THERE TOLD ME I HAD CORNEAL EDEMA (SWELLING OF MY EYE) DUE TO EATING TOO MUCH CHOCOLATE AND SALT!!!

DON'T THEY KNOW CHOCOLATE IS A FOOD GROUP!

WHEN I RETURNED TO THE STATES, AN OPTHALMOLOGIST SENT ME TO A NEUROLOGIST SUSPECTING MS... BUT AT THAT TIME I HAD A CLEAN MRI AND NO OTHER SYMPTOMS

8 MO LATER,... AFTER I THOUGHT I HAD PINCHED A NERVE IN MY BACK, THE "HYSTERICAL PARALYSIS" RETURNED AND I RECEIVED THE DIAGNOSIS OF MS....

THIS IS VERY COMMON.

I WAS FORTUNATE TO BEGIN INTERFERON THERAPY 3 YRS AFTER BEING DIAGNOSED WHEN BETASERON WAS APPROVED IN 1993.

PREVIOUS TO BETASERON I REC'D IV STEROIDS ABOUT EVERY 3 MONTHS FOR EXACERBATIONS...
SINCE BEGINNING INTERGERON THERAPY I'VE HAD ABOUT 5 EXACERBATIONS REQUIRING IV STEROIDS...

NOT BAD FOR 13 YEARS!!!!

NOW... THE DEGREE OF MS IS DIFFERENT FOR EVERYONE... EXACERBATIONS MEANS FLARE UPS

AND I BELIEVE IT'S THE "LUCK OF THE DRAW" HOW EACH PERSON IS AFFECTED

BUT THE ABCR'S HAVE BEEN PROVEN TO REDUCE THE FREQUENCY AND INTENSISTY OF RELAPSES ND MOST IMPORTANTLY...SLOW THE PROGRESSION OF THE DISEASE


AND THE HIGH DOSE INTERFERONS HAVE BEEN PROVEN MORE EFFECTIVE OVER LOW DOSE

MOST RECENTLY... BETASERON COMPLETED A STUDY CALLED THE "BENEFIT" STUDY. HERE PATIENTS WERE STARTED ON BETASERON AFTER ONLY 1 EVENT...IN THE PAST, YOU NEEDED TO WAIT AND HAVE AT LEAST 2 DIFFERENT OCCURANCES SEPARATED INTIME AND SPACE. (2 DIFFERENT AREAS OF THE CNS AT 2 DIFFERENT TIMES)

THE OUTCOME OF THE STUDY PROVED THAT STARTING ON INTERFERON THERAPY IMMEDIATELY, DELAYED THE DEFINITE DIAGNOSIS OF MS BY ONE YEAR.

THIS WAS THEN FOLLOWED UP BY AN ADDITIONAL YEAR OF STUDY.... AND CONTINUED TO PROVE THE BENEFIT OF BEGINNING TREATMENT IMMEDIATELY

BETASERON THEN RECEIVED THE RECOMMENDATION BY THE FDA TO PRESCRIBE TREATMENT WITH THE VERY FIRST INCIDENT OF A MS EVENT. WHAT COULD THIS MEAN OVERALL?

IT COULD MEAN THAT IF IT POSTPONES THE DEFINITE DIAGNOSIS BY ONE YEAR..... IT COULD PREVENT THE PROGRESSION OF THE DISEASE IN THE LONG TERM!!

WE ALSO KNOW.... ONCE DAMAGE IS DONE TO OUR CENTRAL NERVOUS SYSTEM, IT CAN'T BE REVERSED.

FOR THIS REASON, IT IS ENCOURAGED TO BEGIN TREATMENT ASAP AND STAY ON TREATMENT IN STAYING THE COURSE.... MANY PATIENTS CHANGE ABCR'S ALL THE TIME.... THEY GO FROM ONE TO ANOTHER.... PATIENTS THINK IF THERE IS NO DIFFERENCE THE DRUG ISN'T WORKING....

IF THERE IS NO CHANGE, AND YOU'RE NOT PROGRESSING THEN THE DRUGS ARE DEFINITELY WORKING!!!

I TELL PATIENTS TO THINK OF IT MUCH LIKE USING A SKIN CARE PRODUCT.... YOU DON'T THINK IT'S DOING ANYTHING UNTIL YOU RUN OUT OF IT AND THE SEE THE DIFFERENCE....

"OH....THAT STUFF REALLY WORKED"!!!!
YES..THE DISEASE MODIFYING DRUGS REALLY DO WORK!!!!

IT'S IMPORTANT TO CONTINUE TREATMENT UNLESS STOPPED BY YOUR DR THOUGH....I'VE EXPERIENCED THAT SOME DRS WHO DON'T HAVE A LARGE # OF MS PATIENTS MAY NOT BE AS AWARE OF ALL THE TREATMENT OPTIONS OR OUTCOMES - I ENCOURAGE PATIENTS TO HAVE A CONSULT WITH A MS SPECIALIST TO MAKE SURE YOU'RE ON THE RIGHT TRACK

DON'T BE AFRAID TO GET ANOTHER OPINION IF YOU'RE NOT HAPPY WITH YOUR TREATMENT OR LACK OF IT. IT'S IMPORTANT TO HAVE SOMEONE YOU CAN TALK WITH AND WILL SPEND TIME ANSWERING YOUR QUESTIONS

I MEET MAY PATIENTS IN MY TALKS WHO ARE TOLD THETRE IS NO TREATMENT FOR MS,.... THEY USED TO TERM THIS AS "DIAGNOSIS AND ADIOS"!

WHEN BETASERON WAS FIRST INTRODUCED IN 1993....WE TOOK THE DRUG FULL STRENGTH WITHOUT TYLENOL OR OTHER MEDS TO HELP WITH THOSE AWFUL SIDE EFFECTS.... SINCE THEN WE'VE LEARNED TO "TITRATE" OR START WITH A SMALL DOSE AND WORK OUR WAY UP TO FULL DOSE OVER TIME.

FOR SOME IT TAKES A MONTH OR 2 TO REACH MAXIMUM DOSE. BY DOING THIS YOU REDUCE THE SIDE EFFECTS OF HEADACHE, FEVER OR MUSCLE AND BODY ACHE. THESE SYMPTOMS RESOLVE VERY QUICKLY AND THE DRUG IS WELL TOLERATED

TODAY, WE HAVE "HELP LINES" AS CLOSE AS OUR PHONES FOR SUPPORT AND GUIDANCE. THROUGH THE SUGGESTIONS OF NURSES AND PATIENTS WE ARE CONSTANTLY RE-EVALUATING WAYS TO ENSURE PATIENTS CONTINUE ON THEIR PRESCRIBED THERAPIES.

WE DON'T WANT TO STOP OUR TREATMENTS AND LEAVE OUR CENTRAL NERVOUS SYSTEMS UNPROTECTED. MS IS JUST LIKE REAL ESTATE.... LOCATION, LOCATION, LOCATION!

WHERE WILL THAT NEXT PLAQUE BE? WILL IT FURTHER DISABLE US? WILL A VITAL AREA BE HIT?

'M THE FIRST TO ADMIT THAT I'N TIRED OF THESE INJECTIONS EVERY OTHER DAY..... AND I'VE TRIED THE OTHER DRUGS OT THERE TOO,.... BUT I CAME BACK TO THE EVERY OTHER DAY BECAUSE IT WORKS BEST FOR ME

JUST BECAUSE I'M A MS NURSE, IT DOESNT MEAN I HAVEN'T STOPPED TREATMENT WITHOUT CONSULTING MY DR!!

I'M HUMAN FIRST AND A NURSE 2ND!!!!

BUT THE RESULT WAS NOT WORTH IT.....AND REQUIRED ROUNDS OF IV STEROIDS

IN CLOSING... I ENCOURAGE YOU TO BE YOUR OWN ADVOCATE. ATTENDING THESE CHATS AND SEEKING OUT INFO IS THE FIRST STEP AND I COMMEND YOU FOR THAT

I ENCOURAGE YOU TO SEEK HELP AND SUPPORT IF NEEDED TO STAY THE COURSE AND RECEIVE THE OPTIMUM TREATMENT AVAILABLE - DON'T GIVE UP HOPE....I BELIEVE THE CURE IS OUT THERE....

AND LET'S BE IN THE BEST POSSIBLE SHAPE WHEN THAT CURE ARRIVES! THANK YOU....

DeanOP: ARE YOU READY FOR QUESTIONS LAURIE?

Laurie:YES

MEMBER #1: I JUST WANTED TO SAY I RELATE TO THE PINCHED NERVE THING. WENT NUMB FROM MY NECK DOWN ON MY RIGHT SIDE. IF I WOULD OF HAD A CLUE BACK THEN. INSTEAD I WENT TO A CHIROPRACTOR. THANK YOU FOR YOUR VISIT! WHAT'S AN ABCR BY THE WAY?

Laurie: MANY OF US HAVE EXPERIENCED THE SAME SYMPTOMS ALONG THE WAY

Laurie: ABCR'S ARE THE DRUGS AVAILABLE FOR TREATMENT; A-AVONEX; BETASERON;C- COPAXONE; AND R- REBIF

MEMBER #1: NOT ME, I FEEL SO NOT ALONE. THANKS AGAIN FOR YOUR TIME AND ANSWERS!

MEMBER #2: BIOGEN IDEC MAKERS OF AVONEX IS CHANGING FROM A LUER-SLIP NEEDLE TO A LUER-LOCK NEEDLE IN 2007. CAN YOU TELL ME THE DIFFERENCE BETWEEN LUER-LOCK AND LUER-SLIP NEEDLES.

Laurie: LEUR LOCK IS WHERE THE NEEDELE LOCKS ONTO THE SYRINGE

MEMBER #2: THANK YOU

MEMBER #3: MY HANDS R NUMB. NO FEELINGS AT ALL. WILL THE FEELING EVERY COME BACK? IT’S BEEN THIS WAY FOR 1 YR.

MEMBER #4: WHAT IS THE DIFFERENCE BETWEEN LOW DOSE AND HIGH DOSE?

Laurie: AVONEX IS LOW DOSE. LOW DOSE IS GIVEN ONCE A WK AND HIGH DOSE IS GIVEN SEVERAL TIMES A WK. BETASERON AND REBIF ARE HIGH DOSE

MEMBER #4: I HAD ONE LESION 3 YEARS AGO AND THEN IT HEALED ITSELF THEN ANOTHER SHOWED UPAFTER 3 YEARS OF A FEW MRIS AND BEING TOLD I HAD A STROKE THEY FINALLY DID A SPINAL TAP AND DIAGNOSED ME WITH MS...MT SYMPTOMS ARE NUMBNESS AND TINGLING IN THE LEFT FACE HAND AND CALF...IT COMES AND GOES...ON BETASERON FOR A MONTH AND A HALF BUT A FEW DAYS AGO MY SYMPTOMS FLARED UP AGAIN...WHAT SHOULD I DO?

Laurie: ALL I CAN EVER DO IS TELL YOU TO CALL YOUR DR

MEMBER #3 WOULD U ASK YOUR QUESTION AGAIN PLEASE?

Laurie: BUT SYMPTOMS WILL COME AND GO. EVEN BEING ON BETASERON YOU MAY EXPERIENCE SYMPTOMS. WHAT WE WANT TO DO IS POSTPONE PROGRESSION OF THE DISEASE

MEMBER #4: SO THIS DOESN'T NECESSARILY MEAN YOU ARE GETTING WORSE, JUST THAT YOU ARE HAVING A FLARE UP?

Laurie: RELAPSING- REMITTING IS JUST THAT. YOU CAN FLARE AND THEN COME BACK TO NORMAL OR NEAR NORMAL<

MEMBER #3: MY HANDS R NUMB,NO FEELINGS AT ALL. BEEN THAT WAY FOR 1 YR. SO DO U THINK I WILL EVERY GET FEELING BACK?

Laurie: THAT'S HARD TO SAY.... IN OUR PRACTICE WE GIVE STEROIDS FOR FLARES, DEPENDING ON THE FLARE ITSELF

MEMBER #3: I HAD STEROIDS 3 DAYS

Laurie: A SYMPTOM WILL USUALLY RESOLVE ON IT'S OWN, BUT STEROIDS CAN HURRY THE PROCESS
HERE AGAIN, DEPENDING ON THE SYMPTOMS, WE GIVE STEROIDS FOR 3 - 5 DAYS SOME, PTS GET THEM EVERY MONTH

MEMBER #3: OK THANK U

DeanOP: (Dec 14, 2006 9:01:57 PM) LAURIE, IT IS 9 BUT WE HAVE A FEW MORE QUESTIONS...CAN YOU STAY A BIT?

Laurie: YES

MEMBER #4: MY STRENGTH IS STILL THERE BUT HAVE PAIN NUMBNESS AND TINGLING...WHAT IS THE TYPICAL LENGTH OF AN EXACERBATION?

Laurie: BY DEFINITION: AN EXACERBATION IS A NEW OR RETURNING SYM PTOM THAT LASTS FOR MORE THAN 24 HRS. IF YOU'VE HAD IT FOR MONTHS...I WOULD THINK IT IS THEN SOMETHING THAT WILL STAY

MEMBER #5: I DID AVONEX FOR FIVE YEARS NEVER GOT RID OF SIDES DOC SAID I WAS GETTING MORE LESIONS ASKED ME TO TRY REBIFFSO I DID FOR 6MTHS SIDE REALY KICK MY REAR SWITCHED TO COPAXONE FOR A YEAR THEN HE ASKED ME TO DO NOVANTRONE BEEN ON IT FOR A YEAR N HALF DO SIDES SEEM COMMON LIKE THAT WITH INTERFERONS SOME N HAVE U EVER HEARD OF GLYCONUTRIENTS OR DO U THINK JUST SNAKE OIL?

Laurie: THAT IS A DIFFICULT ANSWER TO TACKLE... SORRY


MEMBER #6: ever heard of any seizure meds causing a person with ms to feel like they are progressing the actual med is zonegram?

Laurie: I'M NOT FAMILIAR WITH THAT

MEMBER #7: If you find you are allergic to one of the interferons, does that mean you are allergic to them all?

Laurie: I KNOW OF PTS WHO HAVE TRIED ALL THE INTERFERONS AND CAN'T TAKE ANY. IT DEPENDS WHAT "ALLERGIC" MEANS TO YOU

MEMBER #7: AFTER MORE THAN 1 YEAR I HAD A SEVERE REACTION THAT LASTED SEVERAL HOURS

Laurie: WAS IT FROM AN INTERFERON?

MEMBER #7: REBIF I AM SURE. WITHIN 15 SECONDS OF A SHOT

Laurie: I DON'T KNOW THE ANSWER TO THAT....YOU MIGHT CHECK WITH YOUR DR TO TRY A DIFFERENT DRUG.

MEMBER #8: I AM ON AVONEX FOR 5 WEEKS NOW, I HAVE READ THAT IT ATTACKS THE IMMUNE SYSTEM, DOES THIS MEAN I WILL BE GETTING EVERY ILLNESS OUT THERE?

Laurie: MOST MS PTS DON'T GET THE "USUAL" ILLNESS, BECAUSE OUR IMMUNE SYSTEMS ARE WORKING SO STRONG. THE DRUGS HELP TO QUIET THE ATTACK ON OUR NERVOUS SYSTEM

MEMBER #9: LAURIE, ARE YOU ALLOWED BY LAW WITHOUT LOSING YOUR LICENSE TO GIVE ANY INPUT CONCERNING NATUROPATHIC MEDICINES SUCH AS PROTOCEL FOR THOSE WITH RRMS. THERE ARE STUDIES THAT SHOW THIS MEDICINE WILL REBUILD THE MYELIN SHEATHS. JUST CURIOUS SINCE ALTERNATIVE MEDICINE SEEMS TO BE A NO-NO WHEN COMPETING WITH CONVENTIONAL CURES AND THE AMA.

Laurie: I CANNOT COMMENT ON THAT.

MEMBER #10: IS THE PATHWAYS HELP LINE GOOD? NEW TO THIS SO I HAVEN'T USED IT YET BUT NEED SOMEONE TO TALK TO AND ANAWER MANY QUESTIONS.

Laurie: YES, THE LINE IS GOOD. PATHWAYS...HAS RN'S AVAILABLE 24/7 - THEY ARE ALL EDUCATED IN MS AS THEIR SPECIALTY. YOU DON'T HAVE TO BE ON BETASERON TO CALL THEM. THEY ARE AVAILABLE TO PATIENTS AND FAMILY.

MEMBER #11: MY DOC TOLD ME TO TAKE FLAX SEED OIL TO HELP REBUILD THE MYELIN SHEATH.

Laurie: I CANNOT COMMENT ON THAT. TO MY KNOWLEDGE WE TELL PTS TO STAY AWAY FROM ANYTHING THAT CLAIMS TO REBUILD MYELIN OR BOOST THE IMMUNE SYSTEM.

MEMBER #12: Why is avonex considered low and u only give 1x a week and others are high dose giving more x a week?

Laurie: YOU ARE TAKING THE DRUG JUST ONCE A WK. THERE IS WHAT IS TERMED" THE LAW OF INTERFERON" IT STATES: THAT INTERFERONS ARE NOT THERAPEUTIC (EFFECTIVE) AFTER 48 HRS WITH THE HIGH DOSE BETASERON AND REBIF, YOU ARE TAKING THEM EVERY 48 HOURS.

MEMBER #13: HOW IMPORTANT ARE ABCRS FOR 2NDARY/PROG MS PTS? I HAVE BEEN ON C FOR 6 YEARS BUT HAVE TO QUIT FOR A YEAR I AM 2NDARY RPOG AND MY DOC SAYS OK, BUT WHAT DO YOU KNOW?

Laurie: I KNOW THAT BETASERON WAS APPROVED FOR THE 2ARY FORMS OF RELAPSING MS

MEMBER: THANK YOU FOR COMING LAURIE, PLEASE COME CHAT WITH US ANYTIME

DeanOP: WELL LAURIE, I DO THANK YOU ON B-HAF OF MSWORLD. IT WAS A GREATLY INFORMATIVE PRESENTATION

MEMBER: THANK YOU SO MUCH LAURIE FOR YOUR TIME AND KNOWLEDGE..IT IS NICE TO HEAR FROM A PROFESSIONAL THAT IS IN THE SAME BOAT...BEING A PATIENT TOO, BECAUSE AS YOU KNOW IT IS HARD TO EXPLAIN THE SYMPTOMS OF MS ESPECIALLY TO PEOPLE THAT THINK YOU LOOK JUST FINE...THANKS AGAIN