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Sun City resident and MS Ambassador Sue Iwinski explains “MS is divided into two major classifications: relapsing-remitting and progressive.” Inside those two larger titles, the National Multiple Sclerosis Society informs says “people with MS can typically experience one of four disease courses, each of which might be mild, moderate, or severe.”
1. Relapsing-Remitting MS includes about 85 percent of patients initially diagnosed. According to the NMSS, “Attacks – which are called relapses, flare-ups, or exacerbations – are followed by partial or complete recovery periods [remissions], during which no disease progression occurs.”
Sun City resident Sharon Bocik, who was diagnosed at 30, was classified here.
“I was told that my case would be moderate [due to her later age of 47 at time of diagnosis]” resident Joanne Nitti said. “However, I didn’t know what my outcome would be.”
2. Primary-progressive MS is the course where 10 percent of diagnosed individuals show “slowly worsening neurologic function from the beginning – with no distinct relapses or remissions” according to the NMSS. However, occasional plateaus and temporary small improvements may happen and vary over a period of time.
3. Secondary-progressive MS occurs when many people develop a steady worsening of MS after the initial period of (1) above. This course can be punctuated by occasional flare-ups, plateaus or remissions. Sun City residents Carol Schaefer, diagnosed at 47, and Sue Iwinski, diagnosed at 30, are both now under this classification.
4. Progressive-relapsing MS happens when 5 percent of MS patients, at the disease’s onset, experience a steady worsening of the disease. Worsening functioning of the nervous system progresses with or without recovery from relapses.
According to the Mayo Clinic, those with a benign form of MS may experience stability without progressing to more serious forms of MS following the first attack.
Experiences with MS and manifestation of the disease varies from person to person. Even the diagnosing doctor may have difficulty in determining the patient’s course at its onset due to the disease’s mimicking of other nervous system problems.
Another issue occurs with diagnosis, according to Mayo Clinic, “because symptoms may come and go, sometimes disappearing for months.” PubMed Health explains “symptoms vary because – the location [the specific nerve’s myelin’s erosion site] and the severity of each attack can be different. Episodes can continue for days, weeks, or months and alternate with remissions.”
Iwinski said symptoms can be:
1. Lack of sensation
“I do have trouble with my hands … my fingers are numb,” Nitti said. “I can type fast, but I don’t know where my fingers are going. As soon as I feel my MS problems coming on [numbness and tingling from the chest down] I must rest.”
2. Lack of balance
3. Muscle weakness (causing difficulties in moving arms and legs) and cramping.
“I do jobs around the house and run errands, but I have to raise my feet and rest in between,” Nitti said.
4. Urinary weakness or retention.
Other symptoms may include vision problems, brain issues that can include balance and walking difficulties, tremors, as well as depression, and memory loss.
“I have blanks in my brain,” Nitti said.
Speech and chewing/swallowing issues may also occur. Chronic sleep difficulty and on-going fatigue (which occurs especially in late afternoon) are often nagging symptoms, among many more too numerous to mention here.
Next Edition: Part III: Taking charge of MS
