Multiple Sclerosis
Deborah DeCairos Grandmaitre, M.Ed., CCC
Canadian Certified Counsellor
Overview of Multiple Sclerosis
What is MS
MS is believed to be an autoimmune disease in which the immune system attacks and damages the myelin and possibly oligodendrocytes of the central nervous system (CNS). It is characterized by the following signs and symptoms: muscle weakness, paresthesia and other sensory changes, bowel and bladder dysfunction, diplopia, optic neuritis and other visual changes, tremors, changes in balance and coordination, spasticity, mood disorders, sexual dysfunction, cognitive changes, and fatigue. Fatigue is the most common complaint among MS patients.
MS is the most common neurological disease in young adults and is also one of the leading causes of disability in North America.
Epidemiological studies of MS have shown that geographic distribution, demographics, gender, age and migration to other countries may be associated with the development of the disease.
MS onset occurs between 20 and 40 years in most patients, with the mean age of onset being 29-33 (and slightly younger in females). MS onset is infrequent in the young and the elderly; only approximately 0.3% of patients are younger than 10 years at disease onset, and it is rare in those over 59.
The most frequently used diagnostic tests for MS are the lumbar puncture test, evoked potential tests and magnetic resonance imaging (MRI).
MS, the Family, and Wellness
A potentially disabling disease such as MS has a major effect on other family members, especially the spouse and children. Most people develop the disease when they are young, just as they are thinking about marriage or starting a family. The MS patient is not alone in his/her suffering as a result of his or her illness, and the difficulties experienced by the patient's partner and children can have a negative effect on their ability to offer the kind of support and encouragement that is required. MS can result in a profound sense of unfairness in a relationship, leaving other family members feeling angry and even cheated. Treatment plans can fail if other family members are not given the management tools to be active participants in assisting the MS patient, and hence feel that their own needs are not being acknowledged. Common areas of concern and distress include, but are not limited to: the impact of MS diagnosis on couples, divorce and abandonment, changes in family responsibilities, explaining MS to children, coping with emotional and behavioral changes, and family planning.
Healthcare today encompasses health and wellness promotion. Wellness is described as spanning six dimensions: occupational, social, spiritual, emotional, intellectual and physical. Wellness can be described by the following acronym:
- Weighing options
- Eating well
- Living life to the fullest
- Learning new skills
- Needing others
- Evaluating situations realistically
- Surviving stress
- Staying responsible
Good social support can have a positive impact on how patients and their families live with MS. Families can be their most important source of support. However, the patients must be realistic; families are complex and there is friction even in the best relationships.
Patients can improve their relationships and other sources of support by:
- Identifying who is in their network of support.
- Sharing themselves with others.
- Making it a goal to improve shaky relationships by spending more time with those people.
- Trying to develop their sense of humour.
- Dealing with hostility in key relationships such as those with members of the patient's immediate or extended family.
- Opening lines of communication.
Taken from: A Practical Guide for MS Nurses.
