ROLLER COASTER RRMS EACH DAY

[Thomas Jackson]

DOES ANYONE FEEL LIKE THEY RELAPSE AND REMIT THROUGHOUT THE DAY? I NEVER KNOW HOW TO ANSWER IF I'VE HAD ANY RELAPSES WHEN I REORDER BETASERON. I CAN GO FROM BEING TOO WEAK TO WALK TO OK IN THE SAME DAY. BACK AND FORTH ALL DAY EVERY DAY WITH PAIN ETC. THANKS FOR YOUR TIME.

[jazzgirl]

I used to LOVE the roller coaster, but this was one I'd never have gotten on!

It sounds like you're just dealing with the disease playing footsie with you. A true flare-up is new symptoms showing up, or old symptoms re-surfacing, that lasts more than 24 hours.

I'm sorry...not much help, I know.

[Redwings]

Hi Thomas:
It's pretty common for symptoms to wax and wane throughout the day. It's caused in part by the normal diurnal changes in body temperature and internal chemistry, in part by environmental factors and fatigue, and in part... just because.

But it's important not to confuse the ebb and flow of daily symptoms with relapses and remissions. There are some people who call this variability "mini-relapses" (even people who should know better), but there's really no such thing. Using the word "relapse" for usual, recurrent symptoms is kind of a bad habit that can lead to some other errors in thinking, all of which can get confusing later.

In MS terminology, a true relapse/exacerbation/attack is an inflammatory event that manifests as an onset of new, or worsening of existing, symptoms that lasts at least 24 hours and is separated from the start of a previous relapse by at least 30 days. A true relapse (and its effects) lasts days to weeks to months. So, in comparison, it's evident why symptoms that come and go in a single day aren't a relapse, or even a "mini-relapse." A relapse is a "big," noticeable event that people usually recognize and remember because it's worse and longer lasting than the daily symptoms.

In between the regular daily ups and downs of symptoms and a true relapse is the pseudoexacerbation. It's a "false" relapse because it isn't an inflammatory event. Instead, it's an episode of increased symptoms caused by an increase in body temperature. Because it's temperature dependent, a pseudoexacerbation can come on and go away in a short time (say, within an hour), as soon as body temperature cools down.

This phenomenon can be part of what makes those daily symptoms come and go. But the term "pseudoexacerbation" is used mostly to refer to a distinct event, like what happens when someone is working out in the yard on a warm day and they overheat, their vision gets dim and their legs turn to jelly, but everything goes back to normal when they go indoors and cool down.

When you're renewing Betaseron, the relapse question refers to big, true relapses, not daily symptoms that come and go.

[jbell2435]

Wow, thanks Redwings! I didn't know this myself as this is so new to me still...

I was just prescribed DMD's but didn't really know if I had a flare. A 'big' episode, I really didn't notice, but a gradual increase or new symptom, not horrible, but noticeable!!

My neuro just told me this morning that he documented 2 distinct flares...one in 2010, the mother of all charlie horses which resulted in foot drop, and Dec 2011 with hug sensations lasting about a month.

I'm learning to try to recognize these things so this was extremely helpful, thank you.

[Redwings]

Thank you, jbell. Noticeable is a good word when it comes to identifying a flare. Or maybe noticeably different. (Now, there can be episodes of inflammation that causes damage without a person being acutely aware of them, but they're outside the scope of the question of how to tell the day-to-day stuff from a true relapse.) "Big" doesn't have to mean a screaming 10 on a scale of 10. Relapses can be mild, but they're still noticeably different than the day-to-day ups and downs. Big can mean that there's more going on, either in number of symptoms or severity. I think your description is good -- not necessarily horrible, but noticeable.

[Thomas Jackson]

Thanks jazzgirl,Redwings & jbell. most of all for not telling me to call 911. Oh tee hee.

[laker54]

laker54

I'm 68 and thankful for a mild case of RRMS...but have so many small but noticeable symptoms coming and going it makes me feel like a hypochondriac...is it just MS or is it something else? Now I'm having stomach discomfort, bloating, nausea, changes in bowel habit...anyone else experiencing this or should I see a Gastro doc?

[Thomas Jackson]

I'm 68 and thankful for a mild case of RRMS...but have so many small but noticeable symptoms coming and going it makes me feel like a hypochondriac...is it just MS or is it something else? Now I'm having stomach discomfort, bloating, nausea, changes in bowel habit...anyone else experiencing this or should I see a Gastro doc?

Laker54 , I have all you mentioned but only lasts a day or two. So far I just ride it out. I'm 58 with RRMS. I get this 2 or 3 times a month. Sorry I couldn't help.