Tuesday, October 12, 2010

Managing Multiple Sclerosis

~Guest Post By Chay~

After a year and a half in the nursing program, things are looking up. We are learning a lot about diseases, nursing diagnosis and interventions. As we inch closer to the end of the school year, study materials are becoming increasingly complex and hospital duties are more challenging. The patient’s cases are more acute and severe as we near the end of our training. We are assigned two patients and as part of our training we independently study their illnesses and present our findings to our clinical instructor during post conference at the end of the day.

In one of my clinical assignments, I was presented with a 42-year-old female, admitted with complaints of weakness and spasm in the right leg, difficulties with balance, fatigue and malaise. She arrived in the hospital in a wheel chair. She was incontinent and reported last bowel movement was three days ago. She also reported tingling and numbness in her arms and legs. One month ago she had noticed overall body aching and a loss of vision in the left eye that has since improved. The patient described other symptoms of being severely depressed, anxious, anger at her circumstances, and frequent crying spells.

Tests performed in the hospital revealed abnormalities in spinal fluid and MRI brain scan which were consistent with the diagnosis of multiple sclerosis.

Multiple Sclerosis is an autoimmune disease that affects body’s central nervous system - the brain, optic nerves and spinal cord. Autoimmune disease is when our body attacks our own cells. In this case the white blood cells which are meant to fight infection or disease attacks the body’s own cells. The attack causes inflammation in the CNS which damage the myelin sheath and injure the nerves . With MS, visual loss, paresthesias, weakness, fatigue, pain are some of the symptoms. In the late stage of the disease, most patients progress to some permanent disability. MS is not contagious and does not shorten the life expectancy of patients diagnosed with the disease. MS treatment is focused on reducing the severity and delay of progression. MS effect is different with each individual. Some patients experience the symptoms in the beginning and remain symptom-free for a period of time. Some may experience steady progression of the disease.

Medications used to slow the progression of multiple sclerosis are taken on a long-term basis. Interferons (Avonex, Betaseron, or Rebif), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and natalizumab (Tysabri) are approved for treating MS. Methotrexate, azathioprine (Imuran), intravenous immunoglobulin (IVIg) and cyclophosphamide (Cytoxan) may also be used if the above drugs are not working well.

Steroids may be used to decrease the severity of attacks. Medicines to reduce muscle spasms such as Lioresal (Baclofen), tizanidine (Zanaflex), or a benzodiazepine. Cholinergic medications to reduce urinary problems. Antidepressants for mood or behavior symptoms. Amantadine for fatigue.

Physical therapy, speech therapy, occupational therapy, and support groups may also help MS patients. Assistive devices to ensure safety and ease in moving around the home are often needed, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars. A planned exercise program early in the course of the disorder can also help. It is suggested a healthy lifestyle, with good nutrition and enough rest and relaxation. Avoiding fatigue, stress, temperature extremes, and illness. While no diet can cure or prevent MS, but a balanced, low-fat, high fiber Ms Diet promotes healthy bowel function.
~by Chay~
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  1. Chay this is a wonderful article on a very debilitating disease. I think you will make a wonderful nurse.

  2. Thanks for this article. I am 50 and have been diagnosed with MS for just over two years, so I found it very interesting. You are very succinct and to the point and include lots of relevant facts. I'm sure you will make a great nurse and take great interest in your patients. I hope it all goes well. I enjoyed reading this.

  3. I think being nurse is like being a teacher, or a mother. You have to be incredibly patient

  4. great post thanks

  5. Thanks for good stuff