Table of Contents
Introduction xi
Chapter 1 MS: The Nuts and Bolts 1
What Is Multiple Sclerosis? 1
The Role of the Immune System 2
Understanding Plaques 3
The Role of the Blood-Brain Barrier 4
Suspected Causes of MS 6
New Treatments and Choices 10
Chapter 2 Signs and Symptoms 13
Disease Types in MS 13
The Symptoms of MS 15
Visual Disturbances 17
Sensory Symptoms 19
Motor Symptoms 19
Fatigue 21
Cognitive Symptoms 22
Bladder and Bowel Problems 22
Less Common Symptoms 23
Visible and Invisible MS 24
Chapter 3 The Diagnosis Process 26
Differential Diagnosis 26
Your Medical History 28
Neurological Exam 29
Imaging Techniques 30
Evoked Potentials 33
Lumbar Puncture 34
Diagnostic Criteria 35
The Importance of Early Diagnosis and Treatment 36
The Delayed Diagnosis: Now What? 37
Chapter 4 Dealing with a Diagnosis 40
Lighten the Load 40
The Grieving Process 41
Make a Plan 45
Address Your Fears 46
Defining a Positive Outlook 47
Reach Out for Support 48
Keeping Perspective 49
Chapter 5 Creating an MS Management Team 51
Finding the Right Doctor and Specialists 51
Your Doctor's Credentials 53
Routine Care with a Neurologist 55
The Team Approach 57
Coordinating Your Team 62
Comprehensive MS Treatment Centers 64
Establish a Relationship with Your Health Care Team 65
Chapter 6 The Treatment of MS 67
Early Treatment Makes a Difference 67
Starting a DMT Before a Definite Diagnosis 68
The Disease-Modifying Therapies 69
Injectable Immunomodulating Medications 71
Infusion Treatments 73
The Scoop on Tysabri 76
Managing Side Effects 78
Treatment Support 81
Recognizing Problems with DMTs 83
Paying for Treatment85
Chapter 7 The Relapse 89
What Is a Relapse? 89
Is This the Real Thing? 90
What Causes a Relapse? 92
How Long Does a Relapse Last? 93
Treatment for Relapses 93
The Relapse Plan 98
Remission 100
Chapter 8 Taking Charge 102
Understanding the Disease Course 102
Creating a Strategic Plan 105
Multidisciplinary Care 106
Tips for Daily Living 108
Resetting Your Pace 110
Coping Strategies 112
Planning Ahead 115
Chapter 9 Managing Symptoms 118
Fatigue 118
Spasticity 124
Ataxia and Tremor 125
Bladder Dysfunction 126
Bowel Problems 127
Visual Changes 128
Swallowing and Speech Dysfunction 130
Sexual Problems 133
Sensory Symptoms and Pain 136
A Word about Walking 139
Chapter 10 Cognitive Challenges and Mood Changes 142
Cognitive Changes 142
The Cognitive Evaluation 146
Treatment Options 147
Toolbox for Cognitive Challenges 148
Mood Swings and Emotional Challenges 150
Controlling Depression 151
Chapter 11 Complementary and Alternative Therapy 155
What Is CAM? 155
Types of CAM 156
Choosing Wisely 157
Understanding Studies 159
CAM Therapies for MS 160
The Spiritual Approach 167
Chapter 12 Stress and MS 168
The Science Behind Stress 168
The Symptoms of Stress 170
Identifying Your Stressors 171
Creating a Stress-Management Plan 175
Putting Your Plan to Use 178
Chapter 13 Practicing Wellness 180
Physical Wellness 180
Exercise 184
Just Do It 187
Emotional Well-Being 189
Living Well with MS 192
Barriers to Self Care 193
Chapter 14 Mind and Body 195
Mind-Body Connection 195
Spirituality 196
Mind-Body Techniques 199
Relaxation Techniques 200
Prayer 203
Cognitive Behavior Therapy (CBT) 204
Do Mind-Body Techniques Work? 204
Chapter 15 MS and Employment 206
To Tell or Not to Tell 206
Americans with Disabilities Act (ADA) 209
Choosing Assistive Technology for the Workplace 213
Leaving Your Job 215
Social Security Disability Insurance 216
Chapter 16 Family Life 220
Family Issues 220
Changing Roles 224
Parenting with MS 229
Family Trips 232
Chapter 17 MS and Real Life 235
Pregnancy: Your Questions and Concerns 235
MS and Relationships 239
Sharing Your Diagnosis 242
MS and the Holidays 243
Flu Shots and Other Vaccinations 245
Beat the Heat 247
Chapter 18 The Future with MS 251
Oral Therapies 251
Therapies for Progressive MS 253
The Future of Symptom Relief 254
Stem Cell Research 255
Blood Test to Diagnose MS 255
Statins and MS Research 255
Genetic Research 256
Remyelination 257
Cytokines 257
Participating in a Clinical Trial 257
Do Your Homework 263
Staying One Step Ahead 266
Chapter 19 Creating a Support Network 268
Reaching Out 268
Cultivating Your Support Network 270
Friends as Support 271
Family as Support 275
Support Groups 275
Internet Support 277
Chapter 20 Advanced MS and the Caregiver's Role 280
Treatment for Advanced MS 280
Tips on Managing Advanced MS 282
Options for Care 286
The Caregiver's Role 289
Tips for Caregivers 290
Appendix A Additional Resources 292
Appendix B Glossary 297
Index 303
