Thursday, June 20, 2013

Medication

A view of my medications as I was getting ready to fill my medicine holder. I think I missed a calling as a pharmacy technician.

Sleep

So today I managed to sleep to noon, AGAIN! It seems no matter how much sleep I get I never feel rested. I am so tired all the time. I suppose I am lucky as this is my worse symptom, but it is kicking my butt :(

Fatigue is one of the most common symptoms of MS, occurring in about 80% of people. Fatigue can significantly interfere with a person's ability to function at home and at work, and may be the most prominent symptom in a person who otherwise has minimal activity limitations. Fatigue is one of the primary causes of early departure from the workforce.

What Makes MS Fatigue Different?

Several different kinds of fatigue occur in MS. For example, people who have bladder dysfunction (producing night-time awakenings) or nocturnal muscle spasms, may be sleep deprived and suffer from fatigue as a result. People who are depressed may also suffer fatigue. And anyone who needs to expend considerable effort just to accomplish daily tasks (e.g., dressing, brushing teeth, bathing, preparing meals) may suffer from additional fatigue as a result.
In addition to these sources of fatigue, there is another kind of fatigue—referred to as lassitude—that is unique to people with MS. Researchers are beginning to outline the characteristics of this so-called "MS fatigue" that make it different from fatigue experienced by persons without MS.
  • Generally occurs on a daily basis
  • May occur early in the morning, even after a restful night’s sleep
  • Tends to worsen as the day progresses
  • Tends to be aggravated by heat and humidity
  • Comes on easily and suddenly
  • Is generally more severe than normal fatigue
  • Is more likely to interfere with daily responsibilities
MS-related fatigue does not appear to be directly correlated with either depression or the degree of physical impairment.

Cause of Fatigue in MS Remains Unknown

The cause of MS fatigue is currently unknown. Ongoing studies are seeking to find an objective test that can be used as a marker for fatigue and for precise ways to measure it. Some people with MS say that family members, friends, co-workers, or employers sometimes misinterpret their fatigue and think the person is depressed or just not trying hard enough.

Treatment Recommendations
for Managing Fatigue

Because fatigue can also be caused by treatable medical conditions such as depression, thyroid disease, or anemia, or may occur as a side effect of various medications or be the result of inactivity, persons with MS should consult a physician if fatigue becomes a problem. A comprehensive evaluation can help identify the factors contributing to fatigue and make it possible to develop an approach suited to the individual’s needs.
Options for dealing with fatigue include:
  • Occupational therapy to simplify tasks at work and home.
  • Physical therapy to learn energy-saving ways of walking (with or without assistive devices) and performing other daily tasks, and to develop a regular exercise program.
  • Sleep regulation, which might involve treating other MS symptoms that interfere with sleep (e.g., spasticity, urinary problems) and using sleep medications on a short-term basis.
  • Psychological interventions, such as stress management, relaxation training, membership in a support group, or psychotherapy.
  • Heat management—strategies to avoid overheating and to cool down.
  • Medications—amantadine hydrochloride (Symmetrel®) and modafinil (Provigil®) are the most commonly prescribed. While neither is approved specifically by the U.S Food and Drug Administration (FDA) for the treatment of MS-related fatigue, each has demonstrated some benefit in clinical trials. The most recent trial of modafinil, however, reported no difference between modafinil and placebo in relieving fatig

Wednesday, June 19, 2013

Optic Neuritis

Yes, I know I have not been posting. Sorry for that. Life has sorta just happened. Anyways. how is everyone? 

I am doing fine. Fuzzy hands and feet and painful eyeballs, but it could be so much worse. I was talking to someone about optic neuritis and it got me thinking, so here is some more information about it.

http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/symptoms/visualsymptoms/optic-neuritis/index.aspx

Optic Neuritis

Optic Neuritis is inflammation or demyelination of the optic nerve-- the nerve that transmits light and visual images from the retina to the brain. Because the nerve is located behind (“retro”) the globe of the eye, the condition is also known as retrobulbar neuritis.

It has been estimated that about 66% of people with MS will have at least one episode of optic neuritis. Frequently, it is the first symptom of MS.

Optic Neuritis Causes Acute Blurring or Loss of Vision, Usually in One Eye at a Time

Optic neuritis is generally experienced as an acute blurring, graying (change in color saturation), or loss of vision, most often in only one eye. It is rare that both eyes are affected at the same time. There may or may not be pain in the affected eye. The pain, when it occurs, can be of several types—dull and aching, pressure-like, or sharp and piercing. Loss of vision usually reaches its maximum extent within a few days, and generally improves within 4 to 12 weeks without treatment.

It is Possible to Have Optic Neuritis without Affecting Vision 

A person may have a subclinical episode of optic neuritis. That is, there may be inflammation and/or demyelination of the optic nerve that occurs without affecting visual function so that the person is not aware of any changes. In these subclinical cases, visual evoked potential (VEP) testing is still able to demonstrate evidence of lesions or damaged areas along the optic pathways. It is for this reason that VEPs are often used as part of the diagnostic workup; a positive finding can provide evidence of a second demyelinating event even in the absence of visual symptoms.

Not Everyone Who Experiences Optic Neuritis Develops MS

Not everyone who has an episode of optic neuritis goes on to develop MS. Long-term follow-up from the Optic Neuritis Treatment Trial, which involved 388 people with a single episode of optic neuritis, yielded the following:
  • The ten-year risk of developing clinically definite MS following a single episode of optic neuritis was 38% for the entire study group; the twelve-year risk was 40%. Most of those who developed MS did so within the first five years after the initial episode of optic neuritis.
  • The strongest predictor of MS in the study group was the presence of brain lesions on MRI at the time of the episode of optic neuritis. Within the study group, patients with at least one brain lesion on MRI at the time of the optic neuritis episode had a 56% risk of developing MS within 10 years, while those with no brain lesions had only a 22% risk of developing MS within 10 years.
While other disease processes can cause optic neuritis, MS is the most likely cause in a young, otherwise healthy individual.

Optic Neuritis is Often Treated with Corticosteroids

Studies have suggested that a short course of methylprednisolone administered intravenously, sometimes followed by a tapered course of oral steroids, may help reverse the inflammation and restore vision more quickly. However, if the symptoms of optic neuritis are mild and an MRI does not show any lesions, the doctor may decide to allow the disorder to resolve on its own. Intravenous steroids are used because people treated with oral steroids in the Optic Neuritis Treatment Trial appeared to have an increased risk of recurrence and did not do as well as those who received no treatment.

There is no definitive evidence that treatment with steroids produces a more complete recovery than that which would have happened without treatment.

Eyeglasses Don’t Help Vision Affected by Optic Neuritis

Because the visual changes that occur with optic neuritis are the result of inflammation or demyelination of the optic nerve rather than changes in the shape of the eye, prescription glasses cannot correct the problems.
 

 

Tuesday, March 5, 2013

MUST Ministries

Tomorrow is my first official day as a MUST Ministries volunteer. JoAnne and I have to be there at 9:00am. I am kinda nervous as I don't know what to expect...