Impact Of Loss Of Motion

If any of your joints whether your hips, knees, or shoulders are tight, you may find that the number of positions you can move into independently is limited. This, in turn, may limit the types of activities you can do for yourself. Tightness in your trunk and legs can affect your sitting or standing posture, especially when one side of your body feels tighter than the other. This can lead to a curving or twisting of your back and can throw your balance off. It also can interfere with cleansing...

Chemical Name Amitriptyline ameetriptileen

Brand Name Elavil (U.S. and Canada) Generic Available Yes (U.S. and Canada) Description Amitriptyline is a tricyclic anti-depressant used to treat mental depression. In multiple sclerosis, it is frequently used to treat painful paresthesias in the arms and legs (e.g., burning sensations, pins and needles, stabbing pains) caused by damage to the pain regulating pathways of the brain and spinal cord. Note Other tricyclic antidepressants are also used for the management of neurologic pain...

How To Minimize And Manage The Different Types Of Fatigue

Normal fatigue in people with MS can be managed by getting adequate rest at night and by napping at strategic times during the day. If you are experiencing insomnia, talk to your physician about medications that will help you sleep. In addition, training programs are available to help you relax and sleep. Many of these programs are offered through local medical centers and may require a referral from your physician. If sleep deprivation is caused by frequent awakening to...

Chemical Name Amantadine amantadeen

BrandName Symmetrel (U.S. and Canada) Description Amantadine is an antiviral medication used to prevent or treat certain influenza infections it is also given as an adjunct for the treatment of Parkinson's disease. It has been demonstrated that this medication, through some unknown mechanism, is sometimes effective in relieving fatigue in multiple sclerosis. The usual dosage for the management of fatigue in MS is 100 to 200 mg daily, taken in the earlier part of the day in order to avoid sleep...

Chemical Name Interferon interfeeron beta1a

Brand Name Rebif (U.S. and Canada) Generic Available No Description Rebif is a medication manufactured by a biotechnological process from one of the naturally occurring interferons (a type of protein). It is made up of exactly the same amino acids (major components of proteins) as the interferon beta found in the human body. A controlled clinical trial in relapsing-remitting MS compared three groups those receiving 22 mcg (micrograms) three times per week, those receiving 44 mcg three times a...

Respiratory System

The respiratory system consists of the windpipe (trachea) bronchi (respiratory tree), which connects to the lungs diaphragm (the main muscle of breathing) and the intercostal muscles (the muscles between the ribs that are used for coughing and deep breathing) (see Figure 14.1). Protected by the breastbone, ribs, and spine, the lungs function primarily in breathing and filtering air. Air, which consists of nitrogen, oxygen, water, carbon dioxide, and other particles, enters through the nose and...

The Fatigue Severity Scale

The Fatigue Severity Scale (FSS) is a method of evaluating fatigue in MS and other conditions. The FSS is designed to differentiate fatigue from clinical depression, since both share some of the same symptoms. Essentially, the FSS consists of answering a short questionnaire that requires the subject to rate his or her own level of fatigue. The obvious problem with this measure is its subjectivity. The FSS questionnaire on page 26 containing nine statements that attempt to explore severity of...

Stress Demon Of The Modern

Many people believe that stress plays an important role either in precipitating the onset of multiple sclerosis (MS) or in triggering exacerbations. Anecdotes abound of people who had their first attack right after a major emotional trauma. Many studies have investigated this possible link, with mixed results. It is therefore unclear whether stress plays a major role in MS disease activity. Immune dysregulation seems to be the major culprit in MS. There is plenty of evidence, mainly from...

Chemical Name Imipramine imzprameen

Brand Name Tofranil (U.S. and Canada) Generic Available Yes (U.S. and Canada) Description Imipramine is a tricyclic anti-depressant used to treat mental depression. Its primary use in multiple sclerosis is to treat bladder symptoms, including urinary frequency and incontinence. Imipramine is also prescribed occasionally for the management of neurologic pain in MS. To lessen stomach upset, take this medication with food, even for a daily bedtime dose, unless your physician has told you to take...

Medicationinduced Injection Site Reactions

Recent studies have shown that disease modifying therapies alter the natural course of MS and slow the progression of disability. These medications are injectable either sub-cutaneously or intramuscularly. So while it is important to stay on treatment for as long as your health provider recommends it, it is important to take care of your skin. Some people who are using disease modifying therapies such as interferon beta-1b (Betaseron ), interferon beta-1a (Avonex , Rebif ), and glatiramer...

C07

Feel your breast in overlapping areas. Some research suggests that many women do breast self-examinations more thoroughhly when they use a pattern of up-and-down lines or strips. Other women feel more comfortable with another pattern. The important thing is to cover the entire breast and to pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone and all the way over to your shoulder. Feel the...

The Future Of Multiple Sclerosis Treatments

Restoring normal immune tolerance to myelin without disturbing other functions of the immune system is the ultimate goal of therapy. As more is understood about the natural mechanisms for establishing and maintaining this tolerance, new drugs will be designed to treat MS. Our knowledge of immune regulation is built partly on the tremendous strides made in this century in augmenting with vaccines the immune system's ability to fight infectious diseases that once were uniformly fatal or...

Adaptive Devices

Although exercise helps maintain physical function and muscle tone, MS can cause loss of strength, spasticity, and incoordination. Many types of adaptive devices can help you deal with the problems in physical functioning caused by MS. These devices can be thought of as tools to promote safety and maximal function. The best way to determine which device is best for you is to consult a rehabilitation specialist a physia-trist, occupational therapist, physical therapist, or rehabilitation nurse....

Chemical Name Sertraline sertraleen

Brand Name Zoloft (U.S. and Canada) Description Sertraline is used to treat mental depression and certain types of anxiety. This medication should always be taken at the same time in relation to meals and snacks to make sure that it is absorbed in the same way. Because sertraline may be given to different individuals at different times of the day, you and your physician should discuss what to do about any missed doses. It may take 4 to 6 weeks for you to feel the beneficial effects of this...

SEXuAl Response Cycle

Two pioneering researchers, William Masters and Virginia Johnson, identified four stages of sexual response. These stages excitement, plateau, orgasm, and resolution are known as the human sexual response cycle. Two basic processes occur during sexual response vasocongestion and myotonia. Vasocongestion refers to the concentration of blood in the blood vessels and in the tissues of the genitals and breasts. In men, vasocongestion occurs when arterial blood flow to the penis increases and venous...

Immunomodulators The Abcr Drugs

Perhaps the most effective treatments currently available today deal with the autoimmune component of MS and work by regulating aspects of the immune system. Avonex , Betaseron , Copaxone , and Rebif have been approved to modify the disease in relapsing forms of MS Betaseron has been FDA-approved for use in people who have SPMS. Avonex is being used for worsening MS in people presenting with a clinically isolated syndrome (CIS) one neurologic attack with MRI evidence of demyeli-nation. A fifth...

Food and Drug Administration FDA

The U.S. federal agency that is responsible for enforcing governmental regulations pertaining to the manufacture and sale of food, drugs, and cosmetics. Its role is to prevent the sale of impure or dangerous substances. Any new drug that is proposed for the treatment of MS in the United States must be approved by the FDA. Foot drop A condition of weakness in the muscles of the foot and ankle, caused by poor nerve conduction, which interferes with a person's ability to flex the ankle and walk...

Chemical Name Venlafaxine venlafaxeen

Brand Name Effexor (U.S. and Canada) Generic Available No Description Venlafaxine is used to treat mental depression and certain types of anxiety. Unless your physician has instructed otherwise, this medication should be taken with food or on a full stomach to reduce the chances of stomach upset. If you miss a dose of this medication, take it as soon as possible. If, however, it is within two hours of your next dose, skip the missed dose and return to your regular schedule. Do not double dose....

Bladder Management

Proper treatment of urinary dysfunction is probably the greatest factor in increasing the life expectancy of people with MS and in reducing the number of MS-related hos-pitalizations. In addition to interfering with daily activities, bladder infections and other urinary complications can cause serious illness. The good news is that bladder symptoms can be controlled and complications prevented with proper assessment and treatment. Understanding how the urinary system works will help you to make...

Be A Wise Consumer

Although many people have reported positive experiences with alternative treatments, you need to be a wise consumer. When choosing an alternative therapy, ask these questions Is there any evidence that it is harmful Is there any evidence that it is helpful Is it too expensive for my budget Is it too difficult to access Is there a potential negative interaction with any of my current medications In addition, the following guidelines can Beware of alternative therapies that make hard to believe...

Chemical Name Prednisone prednisone

Brand Name Deltasone (U.S. and Canada) Generic Available Yes (U.S. and Canada) Description Prednisone is one of a group of corticosteroids (cortisone-like medicines) that are used to relieve inflammation in different parts of the body. Corticosteroids are used in MS for the management of acute exacerbations because they have the capacity to close the damaged blood-brain barrier and reduce inflammation in the central nervous system. Although prednisone is among the most commonly used...

Expanded Disability Status Scale EDSS

A part of the Minimal Record of Disability that summarizes the neurologic examination and provides a measure of overall disability. The EDSS is a 20-point scale, ranging from 0 (normal examination) to 10 (death due to MS) by half-points. A person with a score of 4.5 can walk three blocks without stopping a score of 6.0 means that a cane or a leg brace is needed to walk one block a score over 7.5 indicates that a person cannot take more than a few steps, even with crutches or help from another...

Chemical Name Mineral oil

Mineral oil is available in a variety of brands in the U.S. and Canada. Description Mineral oil is a lubricant laxative that is taken by mouth. It encourages bowel movements by coating the bowel and the stool with a waterproof film that helps to retain moisture in the stool. Laxatives are to be used to provide short-term relief only, unless otherwise directed by the nurse or physician who is helping you to manage your bowel symptoms. A regimen that includes a healthy diet containing roughage...

Maintaining Health Insurance

Maintaining health insurance is extremely important to people with chronic conditions or diseases such as MS. Many express fear that leaving the workforce or changing from full-time to part-time employment will result in loss of health coverage, not only for themselves but for their families. Concern is also expressed that people who change jobs may not be able to get health insurance coverage from their new employer because of their pre-existing condition. Two pieces of federal legislation...

Chemical Name Bisacodyl bisaoedill

Brand Name Dulcolax tablet or suppository (U.S.) Bisacolax tablet or suppository (Canada) Generic Available Yes (U.S. and Canada) Description Bisacodyl is an over-the-counter stimulant laxative that can be used in either oral or suppository form. Stimulant laxatives encourage bowel movements by increasing the muscle contractions in the intestinal wall that propel the stool mass. Although stimulant laxatives are popular for self-treatment, they are more likely to cause side effects than other...

Chemical Name Methenamine methenameen

Brand Name Hiprex Mandelamine (U.S.) Hip-Rex Mandelamine (canada) Description Methenamine is an anti-infective medication that is used to help prevent infections of the urinary tract. it is usually prescribed on a long-term basis for individ uals with a history of repeated or chronic urinary tract infections. Before you start taking this medication, check your urine with phenaphthazine paper or another test to see if it is acidic. Your urine must be acidic (pH 5.5 or below) for this medicine to...

Types Of Exercises

Coloring Dinosaur

The following series of range-of-motion exercises uses the SAM format, which describes the correct body position for you and your attendant, if you need assistance, and details the proper motions for you to perform the exercises safely. Remember 1010-1. Hold for a slow 10 count, repeat 10 times, one session a day. A Your attendant's or care partner's action Place your palm down, with your thumb and fingers relaxed. Cup your hand in both hands, with attendant's right thumb and index finger...

June Halper Mscn Anp Faan

Some health issues affect all women and men, whether or not they have multiple sclerosis (MS), but are of particular concern when they may add to the symptoms or functional impairment brought about by a disabling condition. Therefore, health maintenance is extremely important in MS. Be aware that not all symptoms are related to MS. General healthcare should include regular general checkups by your primary care physician, with assessments appropriate for your age and current symptoms and...

Chemical Name Modafinil moedafinil

Description Modafinil is a wakefulness-pro-moting agent approved for the treatment of narcolepsy. While it does not cure narcolepsy, it helps people stay awake during the day. In 2000, the manufacturer, Cephalon, conducted a study of modafinil in people with MS to evaluate it as a potential treatment for MS-related fatigue. Seventy-two people with different forms of MS took two different doses of modafinil and inactive placebo over 9 weeks, and self-evaluated their fatigue levels using standard...

Chemical Name Gabapentin gabapentin

Description Gabapentin is an antiepileptic used to control some types of seizures in epilepsy. it is used in multiple sclerosis to control dysesthesias pain caused by MS lesions and the pain caused by spasticity. Gabapentin may be taken with or without food. You must wait 2 hours after taking an antacid to take gabapentin. If gabapentin is taken 3 times a day, do not allow more than 12 hours to elapse between any 2 doses. If you miss a dose of this medication, take it as soon as possible....

Chemical Name Interferon interfeeron beta1b

Brand Name Betaseron U.S. and Canada Generic Available No Description Betaseron is a medication manufactured by a biotechnological process from one of the naturally occurring interferons a type of protein . In a clinical trial of 372 ambulatory patients with relapsing-remitting MS, those taking the currently recommended dose of the medication experienced fewer exacerbations, a longer time between exacerbations, and exacerbations that were generally less severe than those of patients taking a...