A Journey Through Life with Multiple Sclerosis

The Diagnosis

Stairs become more difficult to climb. You think maybe you are just out of shape. Your legs feel heavy, like cement. You just want to close off the world and sleep. Numbness and tingling.. the feeling of a foot or other part of your body "falling asleep" followed by pins and needles to you is just something everyone has, don't they? Only it seems to be a daily occurance. Others assure you that they have that too! Only to affirm that  you are way to concerned about your health and must be a hypochondriac.

Suddenly others begin to notice things. Maybe they notice a limp and ask you if you hurt your leg. Maybe a tremor of the hands, or you seem to slip and fall a lot (of course blaming it on your shoes or the highly waxed floors).

You seem to burn yourself more often when cooking, drop things. You have become clumsy where once you were precise. Any or all of these things or other symptoms may occur.

Eventually you are so sure there is something wrong you start to ask questions and research.

You look up symptoms in medical books. Or you might have a doctor who is perceptive enough to see these changes in you and suspects you may have a problem after all. Either you ask to see a neurologist or your doctor will send you to one,  maybe after many negative CAT scans and blood tests.

Because something is now happening that the physician and/or others can also see. By this time you may have had MS for years, trying to cope. Trying to overcome the mental stigma you have been given by hearing so many times "there is nothing wrong with you".

Finally your doctor or the neurologist you are sent to decides to do an MRI. This is short for Magnetic Resonance Imaging. You are placed in a large tube head first. Magnets clang and move around, producing bounce-back images of your brain, layer by layer.

There is no pain to this test, but it can be frightening if you are afraid of enclosed spaces (though today there are "open air" MRI machines, where you are not enclosed like this).

A good neurologist who is familiar with multiple sclerosis can make a diagnosis based on three criteria:

• A Positive MRI (MRI shows "plaques" - areas of demyelination)
• A medical history that shows the trend of unexplained illnesses, heat sensitivity and/or other symptoms and periods of illness followed by remission.
• An abnormal neurological exam. Hyperactive reflexes, other abnormal findings during a complete neurological exam can help point the way to the correct diagnosis.

There are other tests your neurologist may want to run if he is still unsure of the diagnosis. These include a spinal tap, evoked potentials (machines are used to check for abnormal eye movements and for the reaction of nerve fibers to stimulation).

If I had a dollar for every doctor, who having seen the MRI told the patient "either you have MS or a brain tumor" I would be rich. Why physicians so often say these words is beyond my understanding. It would be much kinder to tell the patient they may have found the cause of their problems but are not sure yet. I speak with many a panicked individual prior to their diagnosis who are so afraid of a brain tumor that they rush to make out wills and live in a state of anxious dread while the physician makes a follow-up appointment or test for a couple of weeks down the road.

Finally, after years of hearing "it's all in your head" you are told "you have multiple sclerosis". Those who are lucky enough to be diagnosed sooner due to an astute opthalmologist during a bout of optic neuritis or due to waking up with one side numb or paralyzed are spared those years of uncertainty. In the first case you are almost relieved that what you have has a name, in the second you are shocked and afraid.