Symptoms Of MS That Most People Ignore
MS might not be as unpredictable as we think
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I guess that we should preface this piece by saying that statistics are much like percentages… you can’t put either in the bank! Last weekend, I had the privilege to be asked inside the multiple sclerosis neurology “Inner Sanctum” for an evening. My local chapter of the National MS Society hosts an annual summit of doctors, researchers, and other MS healthcare providers from around the region. It’s really become quite the gathering over the years and I was honored to be invited.
Our keynote speaker for the event’s kickoff dinner was Dr. Brian Weinshenker, of the Mayo Clinic. If you haven’t heard of Dr. Weinshenker before, he’s very well respected and we all (doctors included) felt honored by his attendance and time in giving us a very interesting message. Seems multiple sclerosis might not be as “unpredictable” as we’ve all been lead to believe.
That’s a very general statement and must be precluded by the fact that this type of science is evolving and not very practical in its present state. Still, for those newly diagnosed, this could be very significant news.
Dr. Weinshenker proffered slides of information and well over an hour of facts which seem to suggest that a number of factors that can be ascertained upon diagnosis (and in the first three years following diagnosis) which can, to a certain extent, forecast what a person’s MS will look like 10-plus years out.
The specifics of this process are best left with the professionals to go over with people facing a new (or prospective) diagnosis of MS, but I’ll venture to encapsulate what I remember from the talk:
The type of symptom (sensory/motor verses optic neuritis) at diagnosis, age, length of symptoms prior to diagnosis, and the number/severity of MS attacks in the ensuing couple of years can place a person into one of three likely scenarios a decade out from the day we hear those words, “You have MS.”
Those three groupings are: nearly benign MS, moderately progressing MS, and likely severe disease.
In general (and I cannot emphasize “in general” enough because these are mostly what are called “natural history” studies at this point), a person presenting with optic neuritis will be better off than someone who’s first symptoms are of the motor/sensory sort. Diagnosis earlier seems to be a better harbinger. Contrary to what one might think, sudden onset seems to foreshadow a better outcome than years of come and go MS symptoms.
There were something like seven factors, but I’ll have to admit that I don’t remember them all (hey, I’m not a medical professional and I’ve been making the rounds with my MS symptoms of late).
If a person is on the “bad” side of only one or two of these, Dr. Weinshenker may not even start his patients on disease-modifying drugs (a fact that he readily admitted was not an “industry” standard). Three or four unfavorable signs and a person was in that “no man’s land” of unpredictability we all know so well, while more than five did not bode well for the future.
I could see folks with or close to MS doing some quick figuring when the doc put that slide up on screen.
Of course, at the edge of each group were the odd ones out, but for the patients the Mayo Clinic has been following for the past several years, there seems to be some pretty good science happening here.
There’s more to this than the old question of “Would you want to know?” Think of the money a person who might not need to be on therapy could save by not taking expensive drugs. If we're in the not-so-good end of the prediction, at least we can better prepare for what looks like is headed our way.
More research is assuredly in order on such topics. In the end, Dr. Weinshenker admitted that the answer to his question, “Is MS still an unpredictable disease in 2009?” was both yes and no.
We’re used to that kind of answer in the world of MS. Still, it was encouraging to me to see that some people are asking that question and working toward a more solid answer.
Seems like sometimes that’s all I really want -- a simple “yes” or “no.”
Wishing you and your family the best of health.
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