"Typical" of an MS flare?

[Andria]

Hello All,

I've been diagnosed with RRMS for 13 years. Been on Copaxone since 2003 and have only had two flares since (knock on wood). My most recent flare was last week and the other in 2012 after giving birth.

On the 22nd of April I got dizzy, nauseous and weak on my left side. I couldn't type or grasp things correctly. My balance was off. It felt like my arm and leg were "light" and non existent. Hard to explain. This lasted a week and a half and went away. I was fine for another week with no symptoms other than lhermittes sign and eye pain upon movement but no vision issues. Out of the blue, the weakness on the left side came back. I went to my neuro and he sent me for an MRI. I have one active lesion that is fading on the right side of my brain causing this flare. However, from my experience and from what I've read, symptoms don't disappear completely for a week and come back during a flare. Am I correct? I am so nervous this is going to come back again since I've been OK for the last 4 days. Is this normal for a flare? To be completely fine after a week of symptoms and then the symptoms to come right back? I still have the lhermittes but I've had that on and off for the last 13 years. It is pretty constant right now though, for at least 2 months.

My neuro wants me to switch meds because he said it's "clear the copaxone isnt working" because I have a lesion. But two flares out of 11 years is a good thing, no? I am so confused and depressed by this. TIA for any advice.

[Marco]

Hi Andria,
I'm sorry you are having a hard time and this medication business is causing you extra stress. It is not uncommon for symptoms to weaken and strengthen during the course of a flare up. A flare up is defined as new or worsening of symptoms that last at least 24 hours -and- must be proceeded by 30 days of remission. You say your symptoms went away for a week before coming back. By definition, this would be considered the same flare up since 30 days had not passed.

As for Copaxone, many neurologists use the “RPM” scale to determine the effectiveness of your DMT for you. RPM stands for Relapses, Progression and MRI. In general, your current RPM situation will be compared to your past medical history (or baseline). Let's compare your history with the RPM scale.

• From 2001-2012 (11 years) you had 0 flare ups. You did not indicate new lesion activity or disease progression.
• From 2012-2014 (2 years) you had 2 flare ups, disease progression, and new & active lesion activity.

Copaxone kept your MS 'well-controlled' for 11 years, but it appears that is no longer the case. Based on your recent RPM activity is makes complete sense that your doctor would want you on a different medication. If you do change medications, I hope it serves you as well, and as long, as Copaxone did.

Please continue to let us know how you are doing.

[AriD]

I agree with Marco. May be time for a new DMT. In the years since you started copaxone there are new options. It's great that copaxone helped for so long but it does sound like your MS has broken through.
My symptoms have shifted some during a flare with some days worse than others until things finally settle down not always to baseline though. It is scary especially so close to a flare. The worry of what each day will bring. Hopefully things will calm down for you and as they do hopefully the constant worry will settle too
Take care. I hope for another many years of quiet for you