Multiple Sclerosis

WHAT YOU SHOULD KNOW

Causes

Signs/Symptoms

• Numbness or tingling in the arms, legs, or face
• Muscle cramps or weakness
• Muscle spasms that may make walking difficult and interfere with sleep
• Blurred or double vision
• Slurred speech
• Problems swallowing

Care

WHAT YOU SHOULD DO

• Take any medicine the doctor prescribes exactly as directed. If it doesn't seem to help, let the doctor know, but keep taking it until told otherwise. If you've been prescribed antibiotics, be sure to use them up, even if you're feeling better. If a medicine makes you drowsy, avoid driving or using dangerous machinery.
• Steroids are often prescribed to speed recovery from a relapse. Although they reduce swelling and inflammation, they can eventually have troubling side effects. It's important to continue taking them, however, until the doctor tapers them off. Stopping suddenly on your own can cause additional problems.
• Ask your doctor about the side effects of each medicine you're prescribed. Some drugs can make you nauseous or interfere with sleep. If any side effects develop, inform your doctor immediately.
• Eat healthy foods from all 5 food groups: meat and fish, fruits, vegetables, breads, and dairy products. This may help you feel better and increase your energy level.
• You may find it easier to eat small meals frequently. To avoid swallowing problems, cut your food into small pieces and use a straw to drink liquids. Mealtime should be relaxing; don't try to hurry.
• To avoid constipation, eat foods high in fiber, such as high-fiber cereals, beans, vegetables, and whole grain breads. Prune juice is a natural stool softener. Your doctor may also recommend an over-the-counter product.
• Unless instructed otherwise, drink 6 to 8 large glasses of liquid, such as water, juices, and milk, each day. Limit caffeinated beverages, such as coffee, tea, and soda. Healthy fluid intake can help prevent bladder infections.
• Ask your doctor to help you plan an exercise program. Start exercising slowly; do more as you get stronger. Exercise when you have the most energy, which for many people is in the morning.
• Your doctor may recommend physical therapy to strengthen affected muscles. These special exercises can keep you active and stave off disability. Do them faithfully.
• Your physical therapist may encourage you to try hydrotherapy, a gentle water exercise program that can strengthen muscles undamaged by MS.
• Body massages can help prevent contractures---permanent shortening of muscles that make it hard to walk or use the hands.
• If the muscles in your hands or ankles get too weak, you may need to wear splints for support.
• To reduce the risk of falling, remove loose carpeting from the floor. You may feel safer if you use a 4 prong cane or a walker. Use chairs with side arms and hard cushions to make getting up easier.
• MS may cause voice changes and problems with talking or swallowing. A speech therapist can be helpful if this occurs.
• Occupational therapy can help you care for yourself as long as possible by teaching you special skills for bathing, dressing, eating, and driving. The therapist can also help you choose special equipment for home and work, and can suggest ways to make them safer.
• To help prevent a relapse:
• • Get flu and pneumonia shots, and avoid people with these diseases.
  • Stay inside in very hot or cold weather. Temperature changes can make your symptoms worse.
  • Take warm---not hot---showers or baths. Hot water can aggravate your symptoms.
  • Fatigue can also make your symptoms worse. Match your activity to your energy level. Rest or nap when needed. Going to bed early and getting up late may also help.
  • Stress is another culprit. Since it is hard to avoid it, learn to control it with such techniques as deep breathing, relaxing muscles, meditation, and biofeedback. When feeling stressed, talk to someone and get your feelings off your chest.
• Grab bars on the walls beside toilets and inside showers and bathtubs will help you get up---and reduce the risk of falling. A special stool for the shower is another option to consider.
• Try to urinate every 3 hours while awake. To avoid trips to the bathroom during the night, stop drinking liquids 3 to 4 hours before going to bed and urinate just before bedtime.
• If you cannot urinate on your own, you may need to learn how to catheterize yourself by threading a soft rubber tube up your urethra into the bladder.
• MS can make parts of the body numb, so you won't feel irritation from unrelieved pressure. To help stop sores from developing in these areas, check them often to make sure the skin is healthy. Keep the skin clean and dry to prevent infection.
• MS is a life-changing disease for you and your family. Accepting it is hard. See support from doctors, friends, and family. Joining an MS support group can also help. For more information call or write:
• • Multiple Sclerosis Association of America
    706 Haddonfield Road
    Cherry Hill, NJ 08002
    Phone: 1-800-532-7667
  • National Multiple Sclerosis Society
    733 Third Avenue
    New York, NY 10017-3278
    Phone: 1-800-FIGHT-MS

Call Your Doctor If...

• You develop chills.
• You are running a high temperature.
• You notice burning or pain when urinating.
• You become constipated.
• You feel weaker than usual.
• You develop swallowing problems.
• You begin to feel you cannot cope with your illness.

Seek Care Immediately If...

• You develop a high temperature while taking steroids.
• You have breathing problems.
• You begin to think of suicide.