";s:4:"text";s:29387:"Asking for help can be one of the hardest things to do but the chances are that your family and friends really want to help and perhaps just aren't sure what they should offer to do - so talk to them! Steroids can help speed up your recovery from a relapse, but they don't prevent further relapses or stop MS getting worse over time. 2015 Sep 5;386(9997):974-81. doi: 10.1016/S0140-6736(15)61137-0. Soon after diagnosis, your MS nurse should explain what to do if you think you're having a relapse. Here are some of the questions the MS nurse may ask: It'll be easier to answer these questions if you have been keeping track of your symptoms and any drugs you are taking. If you are struggling more than usual it may be possible to arrange some social services support, just to help in the short-term. It is possible to experience a sudden worsening of symptoms that does not meet this time frame. When this protective layer is So all along they knew that l had MS - and were giving me extra care - l did go privately for a MRI/LP as there was no nhs facilities that had a MRI scanner then - well not in this area. Your MS nurse will also want to know if there's anything happening that could be making your symptoms worse such as any signs of a possible infection - this will often include having a test for a urinary tract infection (UTI). Also referred to as exacerbations, attacks, bouts, or flares, MS relapses are caused by inflammation in the central nervous system, which further damages the protective coating that insulates nerves, known as the myelin sheath. During a relapse, symptoms get worse. How long does it take for an MS drug to be fully effective? You might also have concerns about what the future holds for you or be concerned about the impact that MS will have on your relationships or your work. Relapses occur with relapsing-remitting and sometimes secondary-progressive forms of MS. Relapses do not occur with primary-progressive MS, although patients may experience day-to-day fluctuations in how they feel. stock up on everyday essentials such as longlife milk, food with long use-by dates, a selection of easy meals in the freezer, toilet rolls etc. symptoms must occur at least 30 days from the start of the last relapse MS symptoms should have been stable for about one month before symptoms become worse or new symptoms appear. Effect of vitamin D supplements on MS activity. Damage caused by MS builds up over time, so the sooner you begin treatment, the less damage will have built up before treatment starts to take effect. Introducing our new Advanced MS Champion for Cumbria, Introducing our new Advanced MS Champion for Swansea, Lara’s story: “You can emerge in a new way”, Laura's story: my Covid-19 vaccine experience, Living with primary progressive MS: Yvonne's story, MS Trust funded nurses in Lanarkshire have improved support and care for people with MS, NICE recruiting people living with MS and health professionals to update the MS Clinical Guideline, NICE rejects Sativex in draft guidance on cannabis-based medicinal products, New guidelines for pregnancy in multiple sclerosis, Ocrevus (ocrelizumab) for primary progressive MS – NICE confirms approval in final guidance, Ocrevus approved for primary progressive MS in Scotland, Ofatumumab (Kesimpta) approved for relapsing MS in England and Wales, Ofatumumab (Kesimpta) gets UK licence for relapsing remitting MS, Ozanimod (Zeposia) approved for relapsing remitting MS in Scotland, Ozanimod (Zeposia) for relapsing remitting multiple sclerosis rejected by NICE, Ozanimod (Zeposia) recommended for European licence, Plegridy approved for relapsing remitting MS in England, Preliminary research on Covid-19 in people with MS in Italy offers some reassurance, Providing the best service we can for people affected by MS, Remembering my sister with a 50-day cycle ride, Remyelination research: what it means for people with MS, Researchers develop mRNA vaccine to treat MS-like condition in mice, Sativex cost-effective in final NICE guideline on cannabis-based medicines. If you are unwell, for example if you have a cold, a bladder infection or a stomach bug, you may find that your MS symptoms get worse. Whatever symptoms you experience, they're likely to get gradually worse over a few days, or perhaps longer, and then level off. build up a support network - you can let people know that from time to time, you may need help during a relapse. Your healthcare professional should check that nothing else could be causing these symptoms, such as an infection, and confirm your diagnosis with a health professional with expertise in MS. An MS flare can go on for a long time and although the steroids won't stop any progression, they can help to stop the attack, or at least slow it down. have you been ill lately or had any symptoms of infection, for example unexplained shivering? However, this is not always the case and around half of all relapses may leave some lingering problems, however slight. Coming out of lockdown - slowly. This can lead to a variety of symptoms, depending on the part of the brain or spinal cord that is affected. Methylprednisolone is the steroid most often used to treat MS relapses. Can I reduce my risk of having a relapse? MS sometimes goes undiagnosed during this time there is a lot about the fact that it means that allow for easier if you have multiple sclerosis It would be families of pronounced the cause one of the scans. Relapse clinic: Thursday morning (twice a month) Clinic for monitoring of second line therapies: Thursday afternoon. Guidance for young people with MS, Call for national neurology plan following largest ever survey of people with neurological conditions, Challenged myself to walk 150 miles throughout May, Coffee Break: Five minutes with MS specialist nurse Michelle Meehan. There are steps you can take to manage them and plan for them, to minimise the effect MS has on your life as far as possible. Once you've cooled down, you should find the symptoms settle down again. You should be deciding together with your specialist what your treatment plan is. Covid-19 vaccine and MS: Your questions answered, Covid-19 vaccines and people with MS: side effects and the second dose, Covid-19 vaccines: what they mean for people with MS, David's Diary - An afternoon volunteering with Cards for Good Causes, Disappointing topline results from high dose biotin study, EMA warns that Gilenya must not be taken during pregnancy, End of life planning: starting difficult conversations, European drug regulator recommends restricted use of Lemtrada, Fampyra approved for use on the NHS in Scotland, Fampyra approved for use on the NHS in Wales, Five top tips for improving your lung health, Focus on: using orthoses to improve walking difficulties, Gabapentin and pregabalin - new rules for prescriptions, Good news! This slows or blocks the transmission of signals to and from the brain and spinal cord. And l was in hospital for 2weeks. Different centres have different approaches to reporting and managing relapses. Relapses may be unpredictable, but you can make sure you're better prepared for one. If you have secondary progressive or primary progressive MS, you may also experience relapses, but much less frequently. An infection can cause a temporary flare-up of symptoms (sometimes called a pseudo-relapse) but more serious infections can also trigger a genuine relapse. One important step could be to take a disease modifying therapy (DMT). For patients who are considered as having suspected MS relapse: Where they have progressive spinal cord syndrome or rapidly progressive visual loss – discuss these patients with neurology for admission to hospital or send the patient to A+E. The relapse could last days or it could last weeks :/ Steroids can help to shorten the time but they can come with some bad side effects. If you're going to an area where a serious infectious disease is prevalent, it's generally far better to have a vaccination than to risk serious illness, which could have far worse consequences. Relapses can come out of the blue, and make life with MS unpredictable. During pregnancy, women are less likely to have a relapse, although the risk of relapse increases in the six months after the birth. have the symptoms stopped you doing anything that you can normally manage, such as preparing meals, driving, getting up and down stairs, working etc? If you are thinking of supporting the MS Trust in these difficult times, we would encourage you to do it! Relapses can be a sign that your MS is becoming more active so it's important to report each one, even if you don't think you need medical treatment. when did your symptoms start to change and what has been the pattern of this change? Multiple Sclerosis Society. Around 85% of people with multiple sclerosis are diagnosed with RRMS. MS Specialist Nurse Miranda Olding from the Beds and Northants MS Therapy Centre answers your questions about relapses in MS. For many people with MS, relapses are a big part of their condition. “The MS Trust is delighted that ofatumumab, the first self-administered B-cell therapy for people with relapsing forms of MS with active disease, has been granted both MHRA and EMA licence. Poor diet. You know yourself best, so listen to your body. At their worst, acute relapses may need hospital treatment, but many relapses are managed at home, with the support of the GP, MS specialist nurse, and other care professionals. Steroids speed up recovery from a relapse by reducing inflammation and ideally should be started as soon as possible after your relapse has been confirmed. The booklet has another half-dozen chapters that include a list of questions to ask your neurologist about relapses, some handy, fill-in-the-blank forms for contact information and the drugs that you use, what to tell your doctor when you call, details of various treatment options, and some really useful ideas about planning, at home and at work, for a possible relapse. Symptoms which come and go can sometimes be considered a relapse – they don’t always have to be continuous. In critical flare-ups, it takes a lot more than just managing your vocabulary. You might find you're not able to do all the household tasks that you'd normally undertake. The MS Society defines a relapse as any new or worsening symptom that lasts for more than 24 hours, happens more than 30 days after a previous attack, and that occurs in the absence of another cause such as stress, infection, or an elevation in body temperature. But there is one thing we know that can reduce the number of relapses people get: treatment with a disease modifying therapy (DMT). NICE approves Ocrevus (ocrelizumab) for primary progressive multiple sclerosis, Heath Technology Wales guidance for AHSCT. If required, your MS nurse may arrange a follow-up appointment, which might be either face-to-face or over the phone. Learning a second language improves brain structures in MS, MS research update - Exercise early in the course of MS and FES effects on bladder symptoms - 31 July 2018, MS research update - The right word won't come to me... A study looking at slowed word retrieval in MS - 21 October 2013, MS research update – Abdominal massage for constipation – 4 December 2018, MS research update – Cell therapy targeting Epstein-Barr virus tested in progressive MS – 20 December 2018, MS research update – Could cocoa help MS fatigue? Steroids (also known as corticosteroids) may be used to treat a relapse in MS. Methylprednisolone is the recommended steroid.. Steroids can help the symptoms of your relapse improve more quickly. One day you could be going about life as normal and the next your life as you knew it is over, confined to the past forever, never to be reclaimed. Please see the MS relapse pathway (can be accessed via the blue button on the left) for more detail. You may find it difficult to tell if you're having a relapse or not, particularly if you've only been diagnosed recently. This can stops you exploring everything that could be causing a new symptom. Messages are able to pass along the affected nerves more easily and symptoms gradually improve. Consider asking for some help from family and friends while you're recovering – perhaps help with the shopping, washing up or collecting children from school could make all the difference. Sometimes the symptoms of a relapse go away completely but, in other cases, they may not fully disappear. During some relapses, you may have more obvious problems with thinking. Continence clinic: Specialist MS Clinics outside the Queen Elizabeth Hospital. A healthy diet, as well as regular exercise, can go a long way to helping you avoid a flare … Some women find their MS symptoms worsen around the time of their period, so your MS nurse may ask about your menstrual cycle. The symptoms of a relapse will generally improve on their own. These thinking problems are fairly common during a relapse but should become less of an issue as you recover. How do families affected by MS manage health information? What should I do if I think I'm having a relapse? While they usually lessen the severity and duration of a relapse, they do not appear to affect the long-term progression of the disease. It's likely that you will feel unwell and more tired than usual while you're recovering from your relapse. If you are having a relapse, it’s best to seek medical attention quickly. These are known as silent lesions, or a subclinical relapse, and can only be seen using MRI scans. Temperature Highly active disease: Patients with an unchanged or increased relapse rate or ongoing severe relapses compared with the previous year despite treatment with beta interferon. Stress can make any symptoms harder to live with and there is some evidence to suggest that stress could trigger relapses, so try to identify the things that make you stressed and find ways to manage this. Some MS teams have relapse clinics that you can attend at fairly short notice. Remyelination – what progress has been made? There’s no proven link between vaccinations (eg. Your MS nurse should also make a record of your relapse and pass this on to your neurologist, so that your MS team has a full record of your relapses and symptoms. One of the most common triggers for sudden symptoms is overheating; or, … Most people find that relapses happen with little or no warning, though sometimes people can tell when a relapse is "coming on". For example, some people experience a shock-like sensation when they bend their neck. Registered charity nos 1139257 / SC041990. If you've had to stop working for a period of time, it's a good idea to stay in regular contact with your manager or supervisor rather than just sending in the required paperwork. which part of your body is affected, for example if you have numbness, where is this? What does the future look like for community MS support? If they interfere with your ability to do important tasks, an occupational therapist or neuropsychologist can work with you to develop strategies to help you manage. Testing iStep-MS, a new programme to encourage physical activity, Tysabri risk of PML with extended interval dosing. Should I be wearing a face covering during the COVID-19 outbreak? This will typically take place about two months after the start of your relapse and is an opportunity for your MS nurse to check how you are and for you to discuss other treatment options if things are still difficult. A relapse should be diagnosed if the person develops new symptoms or their existing symptoms get worse and last for more than 24 hours in the absence of infection or any other cause after a stable period of at least 1 month. If you need additional support, talk to your MS nurse. They can happen spontaneously, without any obvious cause. Clinic review: Friday morning. Many people with MS feel they can identify things that trigger a relapse for them. In order to be considered a true MS relapse, symptoms must last longer than 24 hours. Any MS symptom can be associated with a relapse but the most common ones include issues with fatigue, dizziness, balance and coordination, eyesight, bladder, weakness in a leg or arm, areas of numbness, pins and needles or pain, memory and concentration, and mobility. Unfortunately, what appears to affect one person doesn’t always apply to someone else, and research has not yet found what triggers a relapse. A UK study in 2012 found that on average, people with relapsing remitting MS have around one relapse every two years. It should be noted that inflammation doesn't always result in a relapse. 1 Cochrane Database of Systematic Reviews 2012;(3):CD006921. To reduce the risk of permanent damage to your body, you should be offered a DMT as soon as possible after a diagnosis of relapsing MS. DMTs work better the sooner you start them but taking one later can still have benefits. Your symptoms should be assessed and you should be offered treatment for the relapse as early as possible, and within 14 days of your symptoms starting. Relapses could also have an impact on people close to you. Our understanding of how MS attacks the body is changing. You'll find all sorts of tips and tricks to help with cognitive symptoms on the MS Trust website Staying Smart. If you need a rest then do your best to take one. Some people find that being too cold makes their symptoms flare up. Because a relapse is often stressful, many people can feel distracted and a bit overwhelmed and may have problems thinking through complex tasks. Am I normal? When you're planning your return to work, it may be helpful to request a phased return, slowly building up the number of hours/days that you work over a period of time. During a relapse, patients will have a temporary worsening or recurrence of existing symptoms and/or the appearance of new symptoms. Disease modifying therapies (DMTs) are used to treat types of MS where you get relapses. MS relapses can be devastating, life-altering events which, depending on severity, can result in a sudden and rapid increase in disability. You may find that when you get hot, for example if you're in a hot, stuffy room or have been exercising hard, your MS symptoms get worse. Making Sense of MS: Gail Clayton, Lead MS Clinical Nurse Specialist, and Neil Robertson, Professor of neurology, explains what a multiple sclerosis relapse is? Call our free enquiry service Mon - Fri: 9am - 5pm, Spirella Building, Bridge Road, Letchworth Garden City, Hertfordshire, SG6 4ET, Registered as a limited company in England and Wales 4247766. Comorbidities such as diabetes or mental health conditions require monitoring. Continuing to support health professionals as far as we can, Coronavirus COVID-19 and multiple sclerosis - update 13 March. 0800 032 38 39 There are treatments and ways of managing symptoms which can help manage many different MS symptoms. These symptoms will usually settle down. Some MS nurses will discuss your concerns by phone or email, others may book an appointment to see you. But it can't predict exactly how MS will affect you. She will talk to your dr and call you back!!! Oral versus intravenous high-dose methylprednisolone for treatment of relapses in patients with multiple sclerosis (COPOUSEP): a randomised, controlled, double-blind, non-inferiority trial Lancet . If you're not sure whether you are having a relapse, you could wait a day or two to see if your symptoms improve before contacting a health professional. 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