Thirty-three-year-old, Traci McKeeman remembers the day her symptoms of multiple sclerosis (MS) began… she did not know at the time, but her journey with this life-long disease was about to begin.
“I was in college and I remember driving and getting pain in my left eye every time I looked in my rearview mirror,” says Traci. “I was concerned so I contacted a local eye doctor and made an appointment.”
By the time Traci saw the doctor, she noticed a change in her vision and was concerned she was losing her eyesight.
“When the doctor examined me he said my eyesight was fine, but that I needed to see a neurologist because there was swelling in my brain that was affecting my optic nerves.”
Traci ended up having an MRI that night and proceeded to undergo numerous tests to determine the cause of these problems. She soon found out that she had MS, an autoimmune disease of the central nervous system, which affects thousands of Americans each year.
“When I was first diagnosed with MS it was a little overwhelming because there is so much uncertainty associated with the disease,” explains Traci. “I started to read as much as I could to answer the millions of questions going through my head.”
In autoimmune diseases like MS, the body’s immune system becomes confused. Instead of attacking foreign invaders, like bacteria or viruses, the immune system attacks its own central nervous system. Specifically it attacks the nerve coating called myelin, which normally enhances the conduction speed of nerve impulses. In MS, this attack causes an inflammatory reaction that may involve the nerves within the brain, optic nerves and/or spinal cord.
This reaction occurs most often in an intermittent fashion and involves multiple sites. When the reaction subsides, there is usually a scar (called sclerosis) that develops and slows the nerve signal. These scars, which affect various areas of the nervous system, determine the symptoms of MS. Because the nervous system has so many functions, MS can cause many different types of symptoms.
“Traci is not alone in her sense of uncertainty,” says Bridget A. Bagert, MD, neurologist in the MS Clinic at Newton-Wellesley Hospital. “Many patients experience similar feelings when first diagnosed, and have many questions about what the future holds. The good news is over the past 13 years there has been a revolution in the care of MS patients.”
Since 1993, five medications have been FDA approved for MS. These medications may significantly modify the disease course by reducing the rate of MS relapses.
“Even though the sense of uncertainty among newly diagnosed patients is real, physicians can now offer patients genuine hope in the form of new therapies,” says Marybeth Toran, MD, also a neurologist in the MS Clinic. “Medications are important in the care of MS patients, but equally important is promoting a healthy lifestyle by addressing emotional health, sleep issues and implementing behavioral therapies and non-traditional medicine when indicated.”
Though MS is an unpredictable disease affecting each patient in different ways, some common symptoms include:
- Sensory loss, irritating sensations or electrical sensations.
- Vision loss or double vision.
- Slurred speech or swallowing disorders.
- Muscle weakness, spasticity or clumsiness.
- Fatigue or dizziness.
- Bladder dysfunction.
- Decreased attention, concentration or short-term memory.
Since Traci’s diagnosis, she has found it most difficult to deal with the fatigue.
“I’ve noticed that the fatigue, which is common for people with MS, is the biggest hurdle for me,” adds Traci. “By the end of the day I’m exhausted. I also cope with tingling and numbness, migraines and eye pain.”
To help Traci cope with her symptoms, she has used the resources at Newton-Wellesley to find the best treatments as well as get the support she needs. Because MS has various manifestations that require different types of medical expertise, the MS Clinic brings together a team of medical professionals, including neurologists, a nurse practitioner and certified nurse. Many other specialty services are utilized including physical and occupational therapy, speech-language pathology, nutrition, urology and ophthalmology.
“Within a single visit, our patients typically see between two and four MS Clinic staff members,” says Michelle Freshman. “The team also dedicates time at the end of the Clinic to discuss patient issues together, benefiting from the input of multiple perspectives. After each visit, we send a letter to the patient and his or her primary doctor with our collective findings and recommendations. This approach has proven satisfying to our patients. We have many loyal followers and a steady stream of new referrals.”
The medical professionals at the MS Clinic have extensive experience with this disease and can help patients and their families manage both the acute and long-term effects of MS.
“When it was time to start a treatment program, I sat down with Dr. Toran to discuss my options,” explains Traci. “I then met with Michelle who helped me start my treatment. She continued to keep in close contact with me to make sure I wasn’t having problems managing the side effects.”
This collaborative approach at the MS Clinic requires that medical professionals work together to design the best plan of care for each patient and helps assure that the team is working with the same information and diminishing the possibility of miscommunication or mixed messages.
“Experts from different backgrounds work together in a dedicated fashion to offer the highest level of care to patients,” says Dr. Bagert.
“The advantage of this collaborative approach is highly tailored, individualized, comprehensive care. The multidisciplinary model saves time and minimizes travel burdens for patients because they can meet with physicians, nurses and therapists all in the same visit.”
The staff at the Clinic have helped Traci transition into the treatment of her disease. “Not only have the staff been there to offer medical guidance, they are also concerned about my day-to-day life and how the disease is affecting me,” says Traci. “They continue to ask about my support system and my exercise routine, which reassures me that they are genuinely concerned for their patients and are helping them attain the best quality of life possible.”
While the cause of MS has not been determined, some researchers believe that a virus may initiate the confusion of the immune system. Other environmental factors also appear to be important. Although no clear hereditary link has been identified, there is a slightly increased risk of developing MS for individuals with a family history of the disease. Researchers continue to search vigorously for the cause because they still do not know conclusively what triggers this abnormal reaction in the immune system.
“There is currently a tremendous amount of research being conducted in the field of MS,” adds Dr. Bagert. “Several different and important areas of MS are being actively investigated including genetics, environmental factors, molecular mechanisms and most importantly, novel therapies. It is an exciting time to be an MS physician for, as we continue to gain a greater understanding of this disease, we are increasingly able to offer effective treatments to our patients.”
MS affects each diagnosed individual in different ways. For the majority, the disease is bothersome, but they are able to go about many, if not all, of their usual activities for years. It is uncommon for the disease to limit longevity. For others, however, MS can produce serious disability. Though this disease brings so much uncertainty, Traci has coped by keeping a positive outlook and continuing to participate in everyday activities.
Appreciating the Little Things
“I find that I appreciate the little things in life more,” says Traci. “I try to have a good time no matter what I do and not focus on the future problems that are inevitable, which some people with this disease do. My hope is that treatment options for MS will keep advancing and obviously, there will one day be a cure.”
Because Newton-Wellesley Hospital is a member of the Partners HealthCare System, the staff of the MS Clinic can coordinate care for patients at other Partners-affiliated hospitals and enroll patients in studies or programs being conducted at these hospitals.