What might be missing – Diagnosis
Once the pre-diagnosis period is over and a diagnosis is reached, the person with confirmed MS still remains a precious resource. Every person with MS could be an opportunity to further our knowledge and improve the way we diagnose and treat this disease.
The disease process has shown itself and is now unfolding. If the pre-diagnosis period has not been wasted, then in a more ideal world, the person with MS now has a list of the differential diagnoses that were examined, discarded, and why; together with copies of any related test results. They would have been offered support to boost their emotional resilience to a diagnostic outcome, and a thorough investigation made of their digestive health and other crucial body systems, as well as any other disease states, deficiencies, habits and so on that may have a negative impact on their neurological and musculoskeletal outcomes. They would have been offered individualised education on nutritional and biochemical support for exercise capacity, and offered a structured exercise program to maximise their fitness.
Not everyone would wish to involve themselves in these investigations or adopt these practices, but at least they can be offered.
If the pre-diagnostic period was very short, or these services were not offered previously, they could be offered now. In any case, they could be adjusted for the confirmed diagnosis and offered on a continuing basis. The information learned in these investigations can be used to optimise individual health outcomes, post-diagnosis.
Checking for co-morbidities should be ongoing, as certain authorities recommend checking for things like easily treatable causes of fatigue (like hypothyroidism) on a yearly basis. Other states of ill – health may develop with age, surgery or medications and the like, (B12 deficiency), or a change in other circumstances, such as MS disease progression or weight gain, in the case of sleep apnoea.
Nutritional support and exercise therapy should be ongoing too.
At the stage of confirmed diagnosis, it would be desirable if an enquiry into the possible causes of MS in the individual (genetic and environmental) could be conducted so as to further our knowledge into the prevention of this cruel disease.
As our understanding of the genetics behind this disease evolves, therapies may be developed. In some cases, genes that are involved in a particular illness have direct biochemical effects, which are easily supported and corrected. People with MS are often concerned about the risk to their descendants, and it is to be hoped that as our knowledge about the constellation of genes that have some input into MS evolves, that counselling can be offered to prospective parents.
Finally, a confirmed diagnosis will have further emotional repercussions, and perhaps a re-evaluation of lifestyle, not to mention needs for practical supports, a desire for effective treatment, and for coherent research efforts.
It matters how the news of a diagnosis is delivered, and whether there is coherent support for the multitude of issues the diagnosis will create, or whether the person is merely given the diagnosis and a choice of drugs to take.
It is to be hoped that all of the things listed above can be considered within the realm of treatment options. This is especially so when people are given a diagnosis of primary progressive MS or secondary progressive MS, because these are diagnoses where it is the received wisdom that there are no treatments available.
Treatment
Once the pre-diagnosis period is over and a diagnosis is reached, the person with confirmed MS still remains a precious resource. Every person with MS could be an opportunity to further our knowledge and improve the way we diagnose and treat this disease.
The disease process has shown itself and is now unfolding. If the pre-diagnosis period has not been wasted, then in a more ideal world, the person with MS now has a list of the differential diagnoses that were examined, discarded, and why; together with copies of any related test results. They would have been offered support to boost their emotional resilience to a diagnostic outcome, and a thorough investigation made of their digestive health and other crucial body systems, as well as any other disease states, deficiencies, habits and so on that may have a negative impact on their neurological and musculoskeletal outcomes. They would have been offered individualised education on nutritional and biochemical support for exercise capacity, and offered a structured exercise program to maximise their fitness.
Not everyone would wish to involve themselves in these investigations or adopt these practices, but at least they can be offered.
If the pre-diagnostic period was very short, or these services were not offered previously, they could be offered now. In any case, they could be adjusted for the confirmed diagnosis and offered on a continuing basis. The information learned in these investigations can be used to optimise individual health outcomes, post-diagnosis.
Checking for co-morbidities should be ongoing, as certain authorities recommend checking for things like easily treatable causes of fatigue (like hypothyroidism) on a yearly basis. Other states of ill – health may develop with age, surgery or medications and the like, (B12 deficiency), or a change in other circumstances, such as MS disease progression or weight gain, in the case of sleep apnoea.
Nutritional support and exercise therapy should be ongoing too.
At the stage of confirmed diagnosis, it would be desirable if an enquiry into the possible causes of MS in the individual (genetic and environmental) could be conducted so as to further our knowledge into the prevention of this cruel disease.
As our understanding of the genetics behind this disease evolves, therapies may be developed. In some cases, genes that are involved in a particular illness have direct biochemical effects, which are easily supported and corrected. People with MS are often concerned about the risk to their descendants, and it is to be hoped that as our knowledge about the constellation of genes that have some input into MS evolves, that counselling can be offered to prospective parents.
Finally, a confirmed diagnosis will have further emotional repercussions, and perhaps a re-evaluation of lifestyle, not to mention needs for practical supports, a desire for effective treatment, and for coherent research efforts.
It matters how the news of a diagnosis is delivered, and whether there is coherent support for the multitude of issues the diagnosis will create, or whether the person is merely given the diagnosis and a choice of drugs to take.
It is to be hoped that all of the things listed above can be considered within the realm of treatment options. This is especially so when people are given a diagnosis of primary progressive MS or secondary progressive MS, because these are diagnoses where it is the received wisdom that there are no treatments available.
Treatment