The Different Types of Multiple Sclerosis

In some ways, each person with multiple sclerosis lives with a different illness. Although nerve damage is always involved, the pattern is unique for each individual with MS. Specific experiences with MS may vary widely, but doctors and researchers have identified several major types of MS. The categories are important because they help predict disease severity and response to treatment.

Myths and Facts About Multiple Sclerosis

If you're getting a lot of confusing advice about living with multiple sclerosis, you're not alone. Friends may be quick to offer suggestions, but sometimes they just repeat old myths. Getting the facts straight can help you lead a full life.

Primary Progressive Multiple Sclerosis

In primary progressive multiple sclerosis, symptoms continually worsen from the time of diagnosis. There are no well-defined attacks, and there is little or no recovery. Between 10% and 15% of people with MS have primary progressive MS.

Several aspects of primary progressive MS distinguish it from other types of MS:

• People with primary progressive MS are usually older at the time of diagnosis -- an average age of 40. 
• Roughly equal numbers of men and women develop primary progressive MS. In other types of MS, women outnumber men three to one. 
• Primary progressive MS usually leads to disability earlier than relapsing-remitting MS (see below). 

Perhaps the most upsetting difference in primary progressive MS is its poor response to treatment. So far, no treatments have been shown to help, although studies are ongoing.

Relapsing-Remitting Multiple Sclerosis

Most people with multiple sclerosis, around 90%, have the relapsing-remitting type. Most people with this type of MS first experience symptoms in their early 20s. After that, there are periodic attacks (relapses), followed by partial or complete recovery (remissions).

The pattern of nerves affected, severity of attacks, degree of recovery, and time between relapses all vary widely from person to person. Eventually, most people with relapsing-remitting MS will enter a secondary progressive phase of MS.

Secondary Progressive Multiple Sclerosis

After living with relapsing-remitting MS for many years, most people will develop secondary progressive MS. In this type of MS, symptoms begin a steady march, without relapses or remissions. (In this way, secondary progressive MS is like primary progressive MS.) The transition typically occurs between 10 and 20 years after the diagnosis of relapsing-remitting MS.

It's unclear why the disease makes the transformation from relapsing-remitting to secondary progressive MS. A few things are known about the process:

• The older a person is at original diagnosis, the shorter the time for the disease to become secondary progressive. 
• People with incomplete recovery from initial relapses generally convert to secondary progressive MS sooner than those who recover completely. 
• The process of ongoing nerve damage changes. After the transformation, there's less inflammation, and more slow degeneration of nerves.

Secondary progressive MS is challenging to treat -- and to live with. Treatments are moderately effective at best. Progression occurs at a different rate in each person and generally leads to some disability.

Progressive Relapsing Multiple Sclerosis

Progressive relapsing multiple sclerosis is the least common form of the disease. Relapses or attacks occur periodically. However, symptoms continue and are progressive between relapses.

Progressive relapsing MS is rare enough that little is known about it. Probably around 5% of people with multiple sclerosis have this form. Progressive relapsing MS seems similar to primary progressive MS in many ways.

Migraine Headache Pain

A condition I see all too often is the non-specific migraine headache pain. A suffering event with pain that is many cases is physically and emotionally debilitating.

A migraine is a headache with throbbing pain that is usually worse on one side of the head. The pain is often severe enough to hamper daily activities and may last from four hours to three days if untreated. More than one in 10 Americans, including one in 6 women, have migraines, but many have been told mistakenly that they have a sinus or tension headache. Foods, stress, and hormones can be migraine triggers.

The symptoms are a throbbing pain typically occurring on one side near the temples, forehead, and eyes. Migraines can make you very sensitive to light, sound, or mild exertion, such as climbing the stairs. Many people have nausea, vomiting, or vision problems. The pain can be disabling, forcing people to miss work or other activities. About 20% of people who suffer from migraines will have an aura about 20 minutes to an hour before the pain. They may see flashing lights, wavy lines, or dots, or they may have blurry vision or blind spots. These are called "classic migraines."

Warning signs of an impending migraine are that some people may have a change in mood before a migraine begins. They may become more excitable or irritable or depressed. Others may detect a sensation, such as a funny smell or taste. They may feel more fatigued, yawn frequently, or experience muscle tension. About 1 in 4 people experience this prodrome phase, which can occur as early as 24 hours before any head pain.

The exact cause of migraines is still not well understood, but the problem is considered to be neurological (related to the nervous system). It is believed that  brain chemicals, blood vessels, and nerves of the brain are involved. They may be set off by some specific cause, such as flickering lights. This could be a reflection from snow or water or from fluorescent bulbs or television or movie screens. Wearing polarizing sunglasses outside and using daylight spectrum fluorescent bulbs inside may help. Most non-specific headache pain I have found in my practice is digestive in origin.

The migraines may be triggered by emotional stress. While it's impossible to completely avoid stress, relaxation exercises can help you cope. Inhale and exhale slowly, letting the air fill you and then deflate like a balloon. Some people find that thinking of a peaceful scene or listening to favorite music can help. It's important for people prone to migraines to have a regular pattern of meals and sleep. Low blood sugar from skipping meals can trigger a migraine. Eating too much sugar also can cause a spike, then a "crash" in blood sugar. Drink water throughout the day to avoid dehydration and sleep at least six to eight hours a night.

For many women, migraines are tied to their menstrual cycle, occurring either a few days before or during their period, when estrogen levels drop. Some women may benefit from anti-inflammatory medication before their headaches begin, or hormonal birth control such as pills, patches, or rings. Others may have no benefit or worse migraines with hormonal birth control.

Migraine sufferers often report that certain foods trigger their headaches. Common culprits include MSG, red wine, cheese, chocolate, soy sauce, and processed meats. However, scientific studies haven't confirmed any particular food as a migraine trigger. Aged, fermented, and stored foods have higher levels of tyramine, a substance created from the breakdown of the amino acid tyrosine. Tyramine may cause blood vessels to constrict then expand, and it may be a trigger for some migraines. Some headache experts advise limiting fermented or aged foods, such as cheese, soy sauce, pickles, and pepperoni.

When combined with some pain medications, caffeine can help provide relief. Most migraine sufferers can drink a cup or two a day of coffee without any problems. However, too much caffeine can lead to headaches when the stimulant effect wears off.

Find out what triggers your migraines by keeping a headache diary. Each time you suffer from a migraine, make a note about the warning signs (the "prodrome"), triggers, and severity. If you can discover some of your personal triggers, you may be able to avoid future headaches.

Women are three times more likely to have migraines than men. If you have a close relative with migraines, you are much more likely to have migraines, too. Experts believe migraines may be related to mutations in genes that affect certain areas of the brain. Migraine is also more common among people who have epilepsy, depression, asthma, anxiety, stroke, and some other neurologic and hereditary disorders.

About 5% of the children with headache problems suffer from migraines. Both boys and girls can get migraines, but after puberty they are more common among girls. Children may have symptoms other than headache, including stomach pain (abdominal migraine) or forceful and frequent vomiting (cyclic vomiting). If young children become wobbly on their feet, pale, and fussy, or have involuntary eye movements or vomiting, they may have a form of migraine.

Calculating headache burden is important. Before you begin treatment, your doctor may want to assess your "headache burden" -- how much your life is affected by your migraines. A simple questionnaire asks how many times you have missed work, school, or family or leisure activities because of your migraines.

Treatment combinations of common pain relievers and anti-inflammatories may help: aspirin, naproxen sodium, ibuprofen, acetaminophen. Some have been formulated specifically to treat migraines. However, overuse may actually make headaches worse or may lead to ulcers or other gastrointestinal problems.

Because of possible serious drug interactions, including the over-the-counter meds, you should also include chiropractor to your list of doctors. Why? We work with the nervous system and hormonal systems of the body treating the cause of the problem, not the symptom. Make certain to talk to your doctor about alternatives and especially the side effects with medications, including nausea, dizziness, tingling, numbness, and chest pain.

Limit any use of medication. Overuse of medications can sometimes lead to chronic headaches. You shouldn't take prescribed medicines more than two times per week. You can get rid of the chronic headaches by tapering and discontinuing your medication – under a doctor's supervision. Pain medicines containing narcotics should be taken only when other medications fail to relieve pain because they can be habit-forming.

Any new headache that is unusually severe or lasts more than a couple of days should be examined by a doctor. It's also important to let your health care provider know if the pattern of your headaches change. If you have a headache accompanied by paralysis, confusion, fever, or stiff neck, seek emergency medical care.

From Acorn To Oak

Do you count material blessings and belongings in a big way? Little things count also, so try to never discredit  those small things - especially yourself because you might feel so minor in this great world of ours. Someone once said, "An oak tree is only a little nut that held its ground long enough to grow up." How true!

Have you ever stopped to ponder that everything, regardless of size, starts from a small beginning? The whale was once a little mammal in a great ocean, the giant Sequoia tree grew from a seed, almost as tiny as a mustard seed. The largest skyscrapers began with a single brick. Hoover Dam started with a bag of cement and a yard of sand. And so it goes....

Every giant enterprise or important invention started with a simple idea. Most found their beginnings in a home or even a garage setting. The iron teakettle singing on the stove produced the original idea for the steam engine. A spider web across the garden path may have suggested the suspension bridge. An apple falling from a tree gave Sir Isaac Newton the idea which is known today as "the law gravity". A bullet wound in the abdomen of a patient aided a doctor in studying principle of digestion.

All these were little things, yet what tremendous wonders they held in store when the right moment arrived for the world to see the light and find the way.

The revolution in the world of healing has been magnificent. More and more, instead of treating effects of pain and discomfort with drugs and surgery, we are recognizing in mass that healing is done by clearing the cause of most disease. And that is done effectively by opening the nerve channels, thus allowing nature's healing forces within the body to function normally.

The nervous system is the directing and controlling medium of the body. Through the nervous system sensation is flashed to the brain informing the Innate Mind of the needs of the body, or the dangers to it. These impressions are interpreted and responding impulses are flashed back over the nervous system to the glands, organs and muscles of the body awakening them to normal activity.

Little things like discomfort, sleepless nights or even an emotional day may be signs of something bigger. See your doctor and grow healthy and strong.

We only have this life once .... and never again.  Make it happen.

Wash Your Fruits And Vegetables

A frustrating part of our culture is thinking other people are completing simple tasks which should be our responsibility. We take much for granted in our quest for an easier life. Thus, many of us get sick and question why.

Fresh fruits and vegetables are a necessity of life. They provide nutritional benefits that keep us healthy and full of energy. However, all foods must be clean or they can cause stomach aches, diarrhea or worse. Fruits, along with potatoes, leafy greens, tomatoes and sprouts and other "fresh" produce are the most likely to trigger food-borne illness. They can harbor salmonella, norovirus, E. coli and other problems if produce is exposed to contaminated water or mishandled during processing or shipping. Presented in the well-displayed isle of your favorite grocery store does NOT mean the fruits and vegetables are clean. The "mist" is not a way to clean the produce, it just makes them look fresh and enticing. They also can pick up microorganisms in your kitchen if you don't store or cook them properly, or if they come in contact with raw meat or seafood.

These are prudent instructions for the safety of you and your family:

• Wash your hands for before and after handling any and all produce.
• Cut away discolored or soft spots and outside or wilted leaves. Always cook sprouts.
• Wash produce in running water - use no soaps or disinfectants. Be certain to dry to further remove contaminants.
• Scrub firm produce like melons, potatoes or cucumbers with a vegetable brush. Dry well.
• Cooking produce to 160 degrees, for even a few seconds, will kill parasites, viruses and most bacteria. 

Better to be safe ... than to be sorry!

Screening Athletes For Heart Defects

Almost weekly we read of another young athlete that suddenly collapses and in far too many cases dies of a "heart attack". The following are excerpts are from various articles including:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994446/

Example: "Shane del Rosario has died, nearly two weeks after suffering a heart attack, the UFC announced Monday. The 30-year-old Del Rosario, a professional MMA fighter since 2006. Official Statement: Shane Del Rosario had a catastrophic cardiovascular collapse at home on Tuesday morning. He was brought to the hospital in full cardiac arrest. Del Rosario’s management team released a statement saying doctors were looking at the potential that the fighter had a rare heart condition known as Long QT Syndrome that typically goes undetected until there’s a problem.

The goals of evaluating individuals for exercise and sports participation is crucial. The most important reason to screen for heart disease is to prevent sudden, unexpected death. Heart disease may also lead to sudden incapacity which may result in injuries, and pre-existing heart disease may be exacerbated by exercise. It has been estimated that there are 5 million active athletes at the high school, university, professional and master's levels in the United States.1 The sudden death rate among high school athletes is 1:100–200 000; among marathon runners 1:50 000; and among recreational joggers 1:15 000.2 Thus, athletic sudden cardiac death is a rare event.

“Sudden cardiac deaths in competitive athletes continue to be highly visible, compelling emotional events with significant liability concerns. These catastrophes are frequently subjected to intense public scrutiny largely because of their occurrence in young otherwise healthy-appearing individuals, including elite participants in collegiate and professional sports”

CAUSES OF SUDDEN DEATH IN ATHLETES
In athletes above the age of 35, especially men, the most common cause of sudden death is atherosclerotic coronary artery disease. In younger individuals atherosclerotic coronary artery disease is much less common and other diseases predominate. The most common cause of sudden death in young athletes is hypertrophic cardiomyopathy. The second most common is coronary artery anomalies, and the third is abnormal left ventricular hypertrophy.

RECOMMENDATIONS FOR SCREENING
Ideally screening should be done pre-participation by a physician trained in this activity, but other well-trained healthcare workers are acceptable as long as they do not have a conflict of interest. Screening should be done yearly just before training for the sports activity begins. The evaluation should include a history of symptoms suggestive of heart disease, a family history of premature death or specific cardiac diseases, and questions about substance abuse. The physical examination should include blood pressure, femoral pulses, auscultation of the heart in the standing position and inspection for Marfan syndrome features. There should be a low threshold for delaying clearance to play to evaluate further suspected cardiovascular disease.

I currently suggest and strongly recommend that each patient/athlete consult with a cardiologist regarding the above concerns. The heart matter can only be found with the special testing. One day all athletes will be required to comply with examinations including ECG, echocardiography and referral to a cardiologist.

Better to be healthy and safe ... than to ignore a hidden problem.

A Baby Whispers Her Thoughts

I found this "letter" buried deep in my files. With political views being cast both ways, I ask that an open mind read this from a different perspective. That being .... from the unborn child.

                                  *********************************************

   Oct. 5: Today my life began. My parents do not know it yet. I am as small as the pollen of a flower, but it is I already. I will be a girl. I will have blonde hair and blue eyes. Nearly everything is settled already, even that I shall love flowers.

Oct 19: I have grown a little, but I am still too small to do anything for myself. My mother does almost everything for me, though she still does not know that she is carrying me under her heart.
   But, is it true that I am not yet a real person? That only my mother exists? I am a real person, just as a small crumb of bread is still bread. My mother is, and I am.

Oct. 23: My mouth is beginning to open. Just think, in a year or so I’ll be laughing; later I’ll start to talk. My first word will be “Mama”.

Nov. 2: Today my heart began to beat. It will beat softly for the rest of my life. After many years it will tire and stop and I shall die.
   My arms and legs are taking shape, but I must wait a long time before these tiny legs will raise up to my mother’s arms; and before these tiny arms can conquer the earth and befriend people.

Nov. 12: Tiny fingers are forming. How small they are. One day I’ll stroke my mother’s hair with them.

Nov. 20: Only today the doctor told my mother that I am living here under her heart. How happy she must be. Are you happy, Mother?

Nov. 25: My mother and father are probably thinking about a name for me. They don’t know I’m a girl, so they are probably calling me “Andy”.  But I want to the called Shannen. I am growing so big.

Dec. 10: My hair is growing. It is as bright and shining as the sun. I wonder what kind of hair my mother has?

Dec. 13: I can almost see, though it is night around me. When mother brings me into the world, it will be full of sunshine and flowers.
   More than anything, I want to see my mother. How do you look, Mother?

Dec. 24: I wonder if Mother heard the delicate beat of my heart?
   Some children are born with sickly hearts, but mine is healthy. It beats so evenly ... tup-tup, tup-tup, you shall have a healthy little daughter, Mother.

Dec. 28: Today my mother killed me.

Belly Fat And Your Health

We are witnessing the ever threatening fear of ill health, especially osteoporosis, dementia, Alzheimer's disease, diabetes, colorectal cancer, metabolic syndrome, high blood pressure, and other health problems. This article is simple and direct enough to hopefully motivate some to consider immediate changes in their lifestyle. The alternative is serious health issues and all too often .... death.

Excess accumulation of belly fat is more dangerous than excess fat around your hips and thighs. Belly fat is associated with serious health problems, such as heart disease, stroke, and type 2 diabetes. Your genes can contribute to your being overweight and help determine where you carry this extra fat, but poor lifestyle choices are likely to worsen the issue.

Eating high-fat foods is not helpful, but excess calories of any kind can increase your waistline and contribute to belly fat. Still, there is no single cause of belly fat. Genetics, diet, age, and lifestyle can all play a role. Changing dietary habits can help you fight the battle of the bulge and fight belly fat: Read labels, reduce saturated fats, increase the amount of fruits and veggies you eat, and control and reduce your portions.

Excess calories -- whether from alcohol, sweetened beverages, or over-sized portions of food -- can increase belly fat. Our bodies need calories, yet gram for gram, alcohol has almost as many calories as fat.

Alcohol does seem to have a particular association with an increased waistline, though. In general, that’s because when you drink alcohol, your liver is too busy burning off alcohol to burn off fat, leaving you with a beer belly. Studies show that alcohol can cause you to feel hungry by affecting hormones that regulate a sense of satiety.

Researchers at Wake Forest University found that trans fats, which are created by partially hydrogenated oil, increase the amount of fat around the belly and redistribute fat tissue to the abdomen from other parts of the body. Trans fats may be found in such foods as margarine, pastries, cookies and crackers, and fried and convenience foods.

Green tea, in combination with exercise, could help you lose weight, according to the Journal of Nutrition. Researchers think substances in green tea known as catechins stimulate the body to burn calories and enhance loss of belly fat. Blueberries also show promise, albeit in rodents. In one study, rats bred to become obese were fed either a high-fat diet or a low-fat diet rich in blueberries. Rats fed a blueberry-rich diet had less abdominal fat.

Many fast food options are typically high-fat, calorie-dense foods that are eaten in large portions -- all of which contribute to over-consumption of calories, weight gain, and an increase in belly fat when eaten frequently. Many fast food restaurants don’t provide nutritional information, but studies have shown that when this is available, people tend to pick lower-calorie meals.

According to the American Heart Association, “soft drinks and other sugar-sweetened beverages are the No. 1 source of added sugars in the American diet.” Added sugars mean added calories – something you want to avoid to help with weight loss and cut down on belly fat. Yet, high-fructose corn syrup has gradually replaced refined sugar as the main sweetener in soft drinks and has been blamed as a potential contributor to the obesity epidemic.

Does switching to diet sodas help? Although some research has suggested that people who drink artificially sweetened sodas as part of a calorie-restricted diet do lose weight, other studies have suggested that diet soft drinks could even lead to weight gain. For now, there’s no conclusive evidence either way.

To trim your waistline, add whole grains to your diet. For example, choose brown or wild rice instead of white rice. Refined and other highly processed foods can contribute to weight gain and interfere with weight loss. A study in the American Journal of Clinical Nutrition showed that a calorie-controlled diet rich in whole grains can trim extra fat from the waistline of obese subjects.

Couscous, spaghetti, and corn flakes are made from refined grains (though whole grain options may be available). But popcorn is a whole grain food that can boost fiber. The best way to prepare popcorn is with an air-popper, which requires no oil for cooking. Read labels to see what oils have been added to microwave popcorn.

All else being equal, though, whole grains are better than refined grains because they tend to be high in fiber and take longer to digest. This satisfies your hunger better and helps lower blood glucose levels and reduce fat.

Overall, men tend to store fat in the abdominal area more than women do, thanks to sex hormone differences. Before age 40, women tend to store most of their fat in the hips, thighs, and buttocks. After 40, as estrogen levels drop, body fat is redistributed to the abdomen.

When you lose weight, you’re much more likely to lose it in your midsection. Losing weight on a well-balanced plan will melt body fat, including belly fat. The best way to decrease your waist size is through healthy eating and regular exercise.

Doing sit-ups, crunches, or other abdominal exercises will strengthen your core muscles and help you lose fat, but they don’t specifically work on belly fat. In other words, spot exercise won’t decrease belly fat. The only way to lose belly fat (or any kind of fat) is through dieting and exercise. Aerobic exercises, such as running, swimming, cycling, and tennis, are some of the best to help reduce body fat.

Belly fat appears to be especially bad for the heart. Studies have linked belly fat to heart failure, atherosclerosis, and other cardiovascular problems. It also has been associated with osteoporosis, dementia, Alzheimer's disease, diabetes, colorectal cancer, metabolic syndrome, high blood pressure, and other health problems.

Most scientific evidence suggests that a calorie-controlled diet rich in fruits, vegetables, whole grains, low-fat dairy, beans, nuts, seeds, lean meat, fish, eggs, and poultry is the foundation for a diet that provides all the nutrients you need while helping to whittle your waistline. Weight loss experts recommend combining this diet with 30 to 60 minutes of exercise most days of the week.

The above informational article is important .... read it more than once.