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when do you call your Dr. about a relapse

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  • 22cyclist
    replied
    Pseudo-exacerbations can be caused by fever, viruses, bacterial infections, change in temperature (mostly hot), etc. It sounds like yours have come from viruses (stomach virus, then cold virus)

    A true exacerbation is not prompted by anything in general, it lasts >24 hours, the symptoms are constant (don't come and go), can last anywhere from 24 hours to 6 weeks or more, and have a break in them in RRMS for at least 30 days before the next set of symptoms (exacerbation) comes about.

    http://www.nationalmssociety.org/abo...ons/index.aspx

    http://www.google.com/url?sa=t&rct=j...k8xVjGo-WFI4og

    In any instance, call your doctor and ask him/her what they think about it. It never hurts to get their opinion. Depending on how long you have had symptoms no matter if it is a pseudo or real exacerbation, they may want to treat it.

    Good luck, let us know how you are doing.

    Lisa

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  • MSer102
    replied
    Originally posted by mcarter608 View Post
    So I may be having a relapse. I have had two viruses this month. Stomach bug the beginning of the month and nasty cold last week just started feeling half normal yesterday.
    Increases in symptoms due to illness are not considered to be true relapses. They are considered to be pseudorelapses. Since the symptoms are brought on by the "electrical malfunctions" that go along with increased body temperature - and not by an inflammatory attack - they are not treated with anti-inflammatory treatments.

    Pseudoexacerbations clear up when the illness that caused them clear up. That you are starting to feel better now that your cold is passing is typical of how pseudoexacerbations work.

    As far as calling your neurologist or other doctor, you should get medical attention if something extreme and unsual occurs, such as your reaction to being ill leaves you so weak that you can't breathe properly or you lose actual body functions. Then you should go to the ER and the ER will treat you and contact your neurologist.

    But otherwise, illness usually just brings on an increase in symptoms that makes us feel terrible but no more dysfunctional than just what goes along with being sick. You can report illness and a pseudoexacerbation to your neurologist, but it will probably be documented as an illness and the neurologist won't do anything but give you the standard advice about taking care of yourself when you are sick.

    Pins and needles in your feet probably won't get any special attention from your doctor. And again, the symptoms aren't inflammatory so should go away when your cold is better and your body temperature comes down.

    The McDonald diagnostic criteria even make a special notation symptoms that occur during illness or fever are not considered to be an attack.

    The onset of new symptoms or the worsening of existing symptoms when you are not sick can be considered to be a relapse. Not all relapses need to be treated. If you have an onset or worsening of symptoms, that's the time to call your neurologist. Then you and your doctor can discuss whether this episode should be treated.

    Here is what the NMSS says about exacerbations: http://www.nationalmssociety.org/abo...ons/index.aspx

    On that page, there's a sidebar on the right called "Is It an Attack or Not?" that gives more information about pseudoexacerbations that can clear up some of your questions.

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  • mcarter608
    started a topic when do you call your Dr. about a relapse

    when do you call your Dr. about a relapse

    So I may be having a relapse. I have had two viruses this month. Stomach bug the beginning of the month and nasty cold last week just started feeling half normal yesterday.

    So what happens? Of course the pins and needles in my feet that I havent had in years. So when do you call the Dr. about symptoms? And when do you decide if you need to be treated?

    On 2008
    dx'd May 2010
    Started Copaxone June 2010
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