Saturday, May 5, 2018

Lesson Learned (Follow up to Scary Night)

It seems no matter how many articles I’ve read about MS, there’s always something new to learn. Several of you read my post about last week’s scary night, but I now have some not-quite-so-scary answers.

Even though I called my neurologist’s office the very next morning, my appointment was made for nearly a full week later. When I was discussing with my doctor what I had experienced, she stopped me and looked at me like I was crazy. “This was Thursday? Why didn’t you see someone immediately?” I had no idea that’s what I was supposed to do. There didn’t seem to be too much concern when I called and I really didn’t know what they could possibly do for me anyway. Besides, I was sure it was my MS and I was slowly improving again so I wasn’t too worried once my ability to move and speak returned. Apparently, this is unacceptable. Who knew?

Before I explain what actually happened, it’s important to know what a relapse officially is. I am in no way, shape, or form a doctor, but I'll give you my understanding of how things work. When you have a new or worsening symptom that lasts at least 24 hours that can’t be explained (like overheating or pushing yourself too hard) and is likely accompanied by new lesion formations, that’s a relapse. There is no one spot in the brain, spine, or anywhere else in the body that controls everything where a new lesion could form and take several functions out at once, so what I experienced was not an actual relapse as I originally thought. It was, however, what they call a pseudo relapse.

MS damages the myelin sheath of the nerves so they work about as well as this cord does
A pseudo relapse can be a good thing because it means MS is not progressing, but if the underlying cause is an infection (most likely if there are no large stressors at the time) it may trigger an actual relapse if left untreated. I was completely unaware there was such a thing & had no clue what that meant. My doctor explained that when you have an infection, your body is using a lot of energy to fight it off and that most people without MS may feel tired, but can still power through. When we have damaged pathways because of MS, our body uses extra energy in its attempt to push signals along these paths and sometimes it is forced to make the choice between continuing to use excess energy to force the signals or focus on healing the rest of the body. When it chooses the latter, you have a pseudo relapse.

Pseudo relapses are frequently more difficult to deal with than an actual relapse simply because you’re dealing with more symptoms at once. During a true relapse, you may have blurred vision, difficulty using your right arm, or slurred speech; basically you’re just dealing with one or two issues. During a pseudo relapse, any problems caused by your lesions in the past may hit all at once which was my case last week. It’s much more difficult to function and recover. When it hits, you are to immediately go to the neurologist, primary care physician, or ER to get a urinalysis & bloodwork to determine the type of infection and get it treated quickly to prevent further damage. Clearly, I didn’t do that.

The good news for me was that even though my doctor said 9 times out of 10 in women a pseudo relapse is caused by a urinary tract infection, it was not the cause of mine or I would’ve been in the hospital days ago since they don’t go away on their own. After some discussion, we decided mine was most likely triggered by a stomach bug. I had been over it for about a week by the time my pseudo relapse hit, but I had the infection for over a week before getting better. She said my body just needed to take a break to catch up from my trying to power through the illness. In her “I’m so disappointed in you” mom voice, my doctor scolded me for not taking time off work and resting enough during that week and a half. I had to promise that from now on, whenever I have a fever, vomiting, or diarrhea I will not wait it out with optimism that it will soon go away on its own. Instead, I will make an appointment with my primary care physician the first  day of symptoms and remain off work with lots of rest for the duration of whatever bug someone (usually my kids) decide to share with me. Ugh.

For now, I’m speaking normally and moving around much easier, albeit more slowly than I was a few weeks ago. I’ll make sure to always have hand sanitizer nearby and try to avoid getting sick as much as possible. I was overwhelmed by the number of people who read my post about last Thursday evening and appreciate all the private messages expressing concern and encouragement! You guys are amazing! I have a knack for annoying my doctors, family, and coworkers with my stubbornness, but I will do my best to behave (mostly) and rest a bit more when illness strikes to prevent this in the future.

Occasionally, I may need to retreat into my shell and take a nap


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